Course 4: Physical Exam Flashcards
Benign Exam: Constitutional
Well developed, well nourished. No acute distress.
Benign Exam: Eyes
PERRL, EOMI
Benign Exam: ENT
Moist mucous membranes.
Benign Exam: Neck
Supple, no lymphadenopathy.
Benign Exam: Cardiovascular
Regular rate and rhythm. No murmurs, rubs, or gallops. Distal pulses intact.
Benign Exam: Respiratory
No respiratory distress. Clear to auscultation bilaterally. No wheezes, rales, or rhonchi.
Benign Exam: Abdominal
Soft. Non-tender. No guarding, rebound, or rigidity.
Benign Exam: Extremities
No edema. Full ROM.
Benign Exam: Skin
Warm, dry.
Benign Exam: Neurological
Alert and oriented. Normal speech.
Benign Exam: Psychiatric
Normal affect.
If the physician examines the throat, they are looking for… (2)
pharyngeal erythema or exudates
If the physician examines the inner-ear, they are looking for… (2)
TM erythema or bulging
If the physician auscultates the abdomen, they are looking for…
hyperactive/hypoactive bowel sounds
If the physician touches the wrist, they are looking for…
radial pulses
If the physician squeezes the calf muscles, they are looking for…
calf tenderness
If the physician pounds on the back, they are looking for… (2)
CVA tenderness
General/Const. Normal Findings: (3)
NAD
Well developed, well nourished
Alert
Mild/Mod/Severe Distress
Cachectic/Emaciated/Malnourished
Somnolent (drowsy, respond to name), Obtunded (out of it, respond to pain), Unresponsive (neither)
Head Normal Findings:
Atraumatic/Normocephalic (3)
Any signs of trauma
Sinus tenderness
Angioedema (swelling)
Eyes Normal Findings: Pupils are Equal, Round, Reactive to Light (PERRL) Extra Ocular Movements Intact (EOMI) Sclera are anicteric (white) Normal conjunctiva
Anisocoria (unequal pupils)
EOM entrapment
Scleral icterus (yellow)
Pale conjunctiva (anemia) or conjunctival infection
Ears Normal Findings: Normal TM (4)
TM erythema
TM bulging
TM dullness
TM obscured by cerumen (earwax)
Nose Normal Findings: Normal nares (4)
epistaxis
rhinorrhea
septal hematoma (raised area)
boggy turbinates (swollen inner nose)
Mouth /Throat Normal Findings:
Moist mucous membranes
Oropharynx (back of throat) normal (7)
Dry mucous membranes (DMM) Dental caries edentulous (missing teeth) pharyngeal erythema tonsillar exudate (plaque on tonsil) tonsillar hypertrophy (swollen) peritonsillar abscess (PTA) (pus pocket)
Neck/Cervical Spine Normal Findings:
Supple (5)
JVD
Carotid bruit
Cervical lymphadenopathy (swollen lymph nodes)
Vertebral point (midline) v paraspinal tenderness
thyromegaly (thyroid enlargement)
Cardiovascular Normal Findings:
Regular rate and rhythm. Heart sounds normal. (6)
Tachycardia/Bradycardia Irregularly irregular rhythm murmur pleural rub gallop extrasystole (extra beat)
Perfusion Normal Findings:
Pulses are equal and symmetric. Capillary refill less than 2 seconds.
at risk for rupture
Pulmonary Normal Findings:
No resp distress. Clear to auscultation bilaterally. (7)
Mild/Mod/Severe Distress Tachypnea Accessory muscle use Diminished breath sounds Wheezes Rales Rhonchi
Abdominal Normal Findings:
Soft and non-tender. (4)
mild/mod/severe tenderness to palpitation (TTP)
voluntary guarding
rebound tenderness (feel pain when let go of area)
rigidity (involuntary guarding)
Detailed Abd Normal Findings:
Normal bowel sounds. No organomegaly. No mass. (6)
absent/hypoactive/hyperactive bowel sounds organomegaly distended murphy's sign mcburney's point tenderness psoa's sign, obturators, rovsing's
Rectal Normal Findings:
normal rectal tone. heme neg. (5)
heme pos. abnormal stool color hemorrhoids rectal prolapse decreased rectal tone
Female Genital Normal Findings: Normal external genitalia Normal bimanual exam (3) Normal speculum exam Cervical os is closed No blood or discharge
sores, lesions, rashes cervical motion tenderness (CMT) uterine tenderness adnexal tenderness (ovaries) cervical os open blood in vaginal vault malodorous/thick white discharge
Male Genital Normal Findings:
circumcised/uncircumcised
testicular tenderness testicular edema epididymal tenderness testicular mass urethral discharge inguinal hernia indwelling catheter
Musc./Extremities Normal Findings: non-tender (3) full ROM distal CSMT intact (2) no edema no calf tenderness
bony tenderness (fracture) soft tissue tenderness (contusion) calf tenderness (DVT) decreased ROM pulse/sensory/motor deficits tendon laxity pitting pedal edema palpable cords/homan's sign
Musc. /Back Normal Findings:
non-tender thoracic and lumbar spine
CVA tenderness
paraspinal tenderness
vertebral point tenderness
midline deformities/step offs
Skin Normal Findings: Warm (2) dry normal color (3) no rashes (2)
cool to touch hot to touch diaphoretic jaundice (yellow) cyanotic (blue) pallor urticaria (hives) petechiae/ purpura
Skin Infection Normal Findings:
no erythema, warmth or drainage (6)
erythema increased warmth induration (firmness) fluctuance purulent drainage lymphangitis (spreading infection)
Skin Trauma Normal Findings:
atraumatic, intact
ecchymosis contusion (bruise w swelling) abrasion laceration skin tear avulsion (flap of skin)
Neuro Normal Findings: alert oriented x4 normal speech (2) non-focal neuro exam
somnolent disoriented to (x4) aphasia dysarthria (slurred speech) any abnormal findings
Neuro LOC Normal Findings:
A&O x4
Somnolent
obtunded
unresponsive
Neuro Motor and Sensation
motor strength 5/5 and symmetric (2)
sensation intact (2)
extremity weakness
pronator drift
hypoesthesia (dec sensation)
numbness (absent sensation)
Neuro Reflexes Normal Findings:
2+ deep tendon reflexes
Babinksi downgoing toes
upgoing toes
Pediatric Normal PE: General
non-toxic, alert, interactive, playful, smiling, crying with tears on exam, quickly consolable
Pediatric Normal PE: Head
flat fontanel (
Pediatric Normal PE: Eyes
PERRL. No scleral icterus.
Pediatric Normal PE: Ears
Nml TMs
Pediatric Normal PE: Throat
Moist mucous membranes
Pediatric Normal PE: Neck
Supple. No meningismus
Pediatric Normal PE: Cardiac
Regular rate and rhythm
Pediatric Normal PE: Respiratory
No distress. Clear and equal
Pediatric Normal PE: Abdominal
Soft, no crying or grimacing with palpation
Pediatric Normal PE: Genital
Nml external, testicles descended
Pediatric Normal PE: Extremities
FROM
Pediatric Normal PE: Skin
Warm, dry, no rash
Pediatric Normal PE: Neuro
Alert. Appropriate for age. Moves all 4 extremities (MAE x4)
Pediatric Abnormal PE: General
lethargic, inconsolable, febrile
Pediatric Abnormal PE: Head
Sunken fontanel, bulging fontanel
Pediatric Abnormal PE: Eyes
scleral icterus
Pediatric Abnormal PE: Ears
TM erythema, bulging
Pediatric Abnormal PE: Throat
pharyngeal erythema
Pediatric Abnormal PE: Neck
lymphadenopathy
Pediatric Abnormal PE: Cardiac
Murmur, tachycardia
Pediatric Abnormal PE: Respiratory
Wheezes, stridor, retractions, nasal flaring
Pediatric Abnormal PE: Abdominal
Crying with abd pain
Pediatric Abnormal PE: Genital
erythema
Pediatric Abnormal PE: Extremities
Ecchymoses in various stages of healing
Pediatric Abnormal PE: Skin
rash (diaper rash, eczema)
Pediatric Abnormal PE: Neuro
post-ictal, somnolent
Neuro Cranial Nerves Normal Findings: visual field intact PERRL EOMI tongue midline normal gag reflex facial symmetry facial sensation intact normal shoulder shrug
visual field loss unequal pupils EOM palsy, rightward/leftward gaze tongue deviation decreased gag reflex facial droop, ptosis hypoesthesia, numbness unequal shoulder shrug
Neuro Cerebellar Exam Normal Findings: Normal gait no nystagmus normal finger to nose normal heel to shin negative Bromberg's normal RAM (rapid alt movements ) no tremor
ataxia (off balance), antalgic (painful walking)
nystagmus (shaking eyes)
dysmetria
positive romberg (stand with feet together)
dysdiadochokinesia
tremor
