Block 1 - Physical Exam Techniques

Question 1

Describe function and purpose of the otoscope

Answer 1

Instrument used to examine the ear, both the external auditory canal and the tympanic membrane. May be used to inspect for infection or trauma, cerumen impaction, and foreign objects.

Question 2

Describe function and purpose of the ophthalmoscope

Answer 2

An instrument used to view the eye, particularly the back of the eye. Used to visualize the retina, examine blood vessels and view the optic disc.

Question 3

Describe function and purpose of the sphygmomanometer

Answer 3

An inflatable cuff device used to manually obtain blood pressure. Vital to the diagnosis of hypertension and used daily in clinical practice.

Question 4

Describe function and purpose of thermometers

Answer 4

Device used to assess body temperature. An elevated temperature (> ~99.5 degrees F) may indicate a disease process and need for treatment.

Question 5

Describe function and purpose of the stethoscope

Answer 5

Instrument used for auscultation primarily of heart, lung, and abdominal sounds. The diaphragm piece best transmits high-pitched sounds (such as the second heart sound). The bell end piece transmits low-pitched sounds.

Question 6

Describe the function and purpose of Snellen visual acuity

Answer 6

Used for screening examination of far vision. Visual acuity is recorded as a fraction with a numerator of 20 (the distance of feet between the patient and the chart) and the denominator as the distance from which a person with normal vision could read the lettering.

Question 7

Describe the function and purpose of Rosenbaum visual acuity

Answer 7

Used for screening of near vision. Visual acuity is recorded as a fraction with a numerator of 20 (the distance of feet between the patient and the chart) and the denominator as the distance from which a person with normal vision could read the lettering.

Question 8

Describe the function and purpose of tuning forks

Answer 8

512 Hz - auditory evaluation via estimating hearing loss in the range of normal speech.
128 Hz - Vibratory sensation applied to bony prominence - pt should feel vibration/tingling

Question 9

Describe the function and purpose of the percussion hammer

Answer 9

Used to test deep tendon reflexes.

Question 10

Describe the function and purpose of the tape measure

Answer 10

Used to determine circumference, length, diameter.

Question 11

Describe the function and purpose of the transilluminator

Answer 11

Strong light source with narrow beam directed into body cavity to differentiate between various media present in that cavity (air, fluid, tissue).

Question 12

Describe and discuss inspection

Answer 12

Using eyes and nose to gather data continuously throughout exam. Should be adequate exposure and lighting for assessment. Offers clinically useful info regarding: color, texture, odor, demeanor, gait (musculoskeletal), handshake and eyes (neuro). Tangental lighting for contour.

Question 13

Describe and discuss palpation

Answer 13

Using hands and fingers to gather info and offer therapeutic touch. Palmar surface: postition, texture, size, consistency, fluid, mass, structure. Ulnar surface: vibration. Dorsal surface: temperature. Turgor/tenting. Varying pressure for deeper structures.

Question 14

Describe and discuss percussion

Answer 14

Using tip of middle finger of dom hand to strike MCP joint of non-dom hand against pt’s skin producing resonance. Offers info regarding: denisty of tissue - fluid or air, tone - quiter for denser tissue.

Question 15

Describe and discuss auscultation

Answer 15

Listening assisted by stethoscope and not. Identify: intensity, pitch, duration, quality.

Question 16

Describe intensity, pitch, duration, quality, and an example of tympanic percussion

Answer 16

Intensity: Loud
Pitch: High
Duration: Moderate
Quality: Drumlike
Example where heard: Gastric bubble

Question 17

Describe intensity, pitch, duration, quality, and an example of hyperresonant percussion

Answer 17

Intensity: Very loud
Pitch: Low
Duration: Long
Quality: Boomlike
Example of where heard: Emphysematous lungs

Question 18

Describe intensity, pitch, duration, quality, and an example of resonant percussion

Answer 18

Intensity: Loud
Pitch: Low
Duration: Long
Quality: Hollow
Example of where heard: Healthy lung tissue

Question 19

Describe intensity, pitch, duration, quality, and an example of dull percussion

Answer 19

Intensity: Soft to moderate
Pitch: Moderate to high
Duration: Moderate
Quality: Thud-like
Example of where heard: Over liver

Question 20

Describe intensity, pitch, duration, quality, and an example of flat percussion

Answer 20

Intensity: Soft
Pitch: High
Duration: Short
Quality: Very dull
Example of where heard: Over muscle

Question 21

Best surface of hand for palpation of temperature, vibration, and fine detail

Answer 21

Temperature: dorsal
Vibration: oral
Fine detail: palmar

Question 22

Sound best heard with diaphragm of stethoscope

Answer 22

High-pitched sound (eg heart sounds and bowel sounds)

Question 23

Sound best heard with bell of stethoscope

Answer 23

Low-pitched sound (eg bruits and heart murmurs)