CM Intro to Adult Physical Exam Flashcards
Why should you avoid interpreting physical exam findings to a patient?
We can’t distinguish “normal” from “abnormal” yet.
Repeatedly saying “that’s normal” throughout an exam puts you in an awkward bind when you run into something not normal, and can worry the patient
Which side should you exam the patient from?
The patient’s right side.
Should visitors be in the room during a physical exam?
No, ask them to step out.
Should the patient move during an exam?
Avoid unnecessary changes in a patient’s position, but feel free to ask them to move to an optimal position and to arrange the room to facilitate the exam.
When should you exam on skin?
Always.
Which draping approach should be used with female patients?
“Top down, bottom up” as required.
What are the 4 basic physical exam techniques?
Inspection, Palpation, Percussion, Auscultation
What are universal precautions?
CDC guidelines to prevent healthcare worker exposure to bloodborne pathogens such as HIV.
Inspection
Close observation of the patient’s appearance, behavior, and movement such as facial expression, mood, body habitus, skin conditions such as petechiae or ecchymoses, eye movements, pharyngeal color, symmetry of thorax, height of jugular venous pulsations, abdominal contour, lower extremity edema, and gait.
Palpation
Tactile pressure from the palmar fingers or fingerpads to assess areas of skin elevation, depression, warmth, or tenderness, lymph nodes, pulses, contours and sizes of organs and masses, and crepitus in the joints.
Percussion
Use of the striking or plexor finger, usually the third, to deliver a rapid tap or blow against the distal pleximeter finger, usually the distal third finger of the left hand laid against the surface of the chest or abdomen, to evoke a sound wave such as resonance or dullness from the underlying tissue or organs.
Auscultation
Use of the diaphragm and bell of the stethoscope to detect the characteristics of heart, lung, and bowel sounds, including location, timing, duration, pitch, and intensity.
Should the physical exam be systematic?
Yes, follow a consistent pattern to avoid wasting mental energy but remember to actively elicit signs of illness, or you could miss something important.
What should you do if you see something abnormal on a physical exam?
Stop and repeat the maneuver until you clearly define the exam finding.
What is a screening maneuver?
A physical exam technique in the “head-to-toe” exam that is used in a comprehensive exam, such as admission to IM in a hospital.
