Competency List Flashcards
Skin
Inspection Buccal mucosa Conjunctiva Skin Nails Hair Palpation Scalp/hair Fingernails Toenails Skin
HEENT
General Inspection Otoscopic ear exam including external auditory canal and TM Gross hearing with finger rub Weber- midline? Rinne - AC>BC = normal or BC>AC then conductive Otoscopic nose exam Sinus palpation Oral exam with light Visual acuity handheld chart Pupil reflexes with light EOMI in H, convergence and accommodation Peripheral visual fields Fundoycopic exam - left left left and right right right Palpate lymph nodes Thyroid with swallow Trachea position and mobility
Pulmonary
Inspection
Palpation = excursion upper or lower, later and anterior or posterior
Tactile fremits with 99 and crossed arms
Percussion posterior diaphragm excursion ant 2, post 3 and laterally 2
Open mouth auscultation ant 2, lat 2 and post 3
Ego phony “eee”
bronchophony 99
whispered pectoriloquy
Cardiovascular
Inspection Measure JVP PMI palpation Ant wall for heaves or thrills Pulses - carotid, radial, dorsal pedis and tibialis posterior Auscultate carotids Auscultation bell and diaphragm aortic, pulmonic, tricuspid and mitral Lead forward with aortic Bear down
Abdomen
Inspect fully exposed Auscultate all 4 quadrants Aorta Renal arteries Percuss all 4 quadrants Liver span
Mental status
Short term memory - 4 things Appearance/behavior Affect/mood Language Perception/Insight - 2 birds 1 stone Executive function - count back by 7s
Cerebellar
Rapid alternating movements Finger to nose Heel to toe Heel heel toe toe Romberg/Pronator Drift Heel down the shin Toe proprioception Kernigs Brudzinski
CN
1- Verbalize about smells 4/6 - EOMI 5 - Sensory in 3 zones, move jaw back and forth 7 - smile big, raise eyebrows 8 - gross hearing rub 9/10 - ahh with gag 11-shrug shoulders, turn head against resistance 12 - tongue out and wiggle
PNS
Inspection
Palpation of involved area
Soft sensation = dermatomes, peripheral cutaneous with soft and hard, vibration, two point discrimination, toe proprioception, temperature
DTRs - Bicep, Tricep, Brachioradialis, Patella, Achilles
Babinski
Strength Testing
Bicep Tricep Forearm flexors/extensors Hip flexors - knee up Hip extensors - knee down Quads Dorsiflexors/Plantar flexors Special - Tinels, phalens, Roos, Adsons, Straight leg raise
Shoulder
Inspection Palpation Active flexion Active extension Active extension Active abduction Active adduction External rotation Internal rotation Supraspinatus Infraspinatus Subscapularis
Hand and Wrist
Inspection Palpation Active/Passive ROM Open/close fit Wrist flexion/extension Wrist adduction/abduction Thumb opposition Finklestin - skiers thumb Ulnar collateral lig test - thumb back Thumb grind test
Back
Inspection Palpation Flexion Extension Sidebending
Hips
Inspection Palpation Gait Flexion Int rot Ext rot Abduction Adduction Trendelenburg Thomas Figure 4
Knees
Inspection Palpation Flex/extend Ant/post drawer Lachmans - flex knee to 15 and ext rotate, move tib/femur opposite Varus/Valgus Knee bend/wiggle McMurray int/ext rotate and extend Apprehension Palpation for effusion
Lower leg
Homans DVT dorsiflex
Thompsons squeeze calf
Ankle
Inspection Palpation Dorsiflexion/Planta Inversion/Eversion Ant drawers Ext rotate medial collateral lig