Course 4: Physical Exam Flashcards
1
Q
Benign physical exam: constitutional
A
Well developed, well nourished. No acute distress.
2
Q
Benign physical exam: Eyes
A
PERRL, EOMI
3
Q
Benign physical exam: ENT
A
Moist mucous membranes
4
Q
Benign physical exam: Neck
A
Supple. No lymphadenopathy
5
Q
Benign physical exam: cardiovascular
A
Well perfused. Regular rate and rhythm. No murmurs, rubs, or gallops. Distal pulses intact.
6
Q
Benign physical exam: respiratory
A
No respiratory distress. Clear to auscultation bilaterally. No wheezes, rales, or rhonchi.
7
Q
Benign physical exam: abdominal
A
Non-distended. Soft. Non-tender. No guarding, rebound, or rigidity.
8
Q
Benign physical exam: extremities
A
No edema, full ROM
9
Q
Benign physical exam: skin
A
Dry, no rashes. Warm
10
Q
Benign physical exam: neurological
A
Alert and oriented. Normal speech
11
Q
Benign physical exam: psychiatric
A
Normal affect
12
Q
Physical exam-Basic
A
- Looking at the pt
- Auscultating the heart
- Auscultating the lungs
- Palpating the abdomen
- Examining the legs
13
Q
Exam findings: external inspection
A
- No acute distress
- Well developed
- Well nourished
- PERRL
- Moist mucosa
- Supple neck
- No respiratory distress
- Skin is warm and dry
- Alert and oriented.
- Normal affect
14
Q
Exam findings: auscultating the heart
A
- Regular rate and rhythm.
2. No murmurs, rubs or gallops.
15
Q
Exam findings: auscultating the lungs
A
- Clear to auscultation bilaterally
2. No wheezes, rales, or rhonchi
16
Q
Exam findings: palpating the abd
A
- Soft
- Non-tender.
- Non-distended.
- No guarding, rebound, or rigidity
17
Q
Exam findings: examining the legs
A
- No edema
2. Distal pulses intact
18
Q
Exam findings: examines throat
A
Pharyngeal erythema or exudate
19
Q
Exam findings: examines the inner-ear
A
TM erythema or bulging
20
Q
Exam findings: auscultates the abd
A
Hyperactive/hypoactive bowel sounds
21
Q
Exam findings: touches the wrists
A
Radial pulses
22
Q
Exam findings: squeezes the calf muscles
A
Calf tenderness
23
Q
Exam findings: “pounds” on the back
A
CVA tenderness
24
Q
Anatomical Position
A
Standing erect, facing directly forward, feet pointed forward and slightly apart, and arms hanging down at the sides with palms facing forward.
25
Normal: NAD
Abnormal: Mild/moderate/severe distress (due to pain)
26
Normal: Well developed, well nourished
Abnormal: cachectic/emaciated/malnourished
27
Normal: alert
Abnormal: somnolent, obtunded, unresponsive
28
AT/NC
Atraumatic/Normcephalic
29
Normal: AT/NC
Abnormal: any signs of trauma, sinus tenderness, angioedema
30
Normal: PERRL
Abnormal: anisocoria (unequal pupils)
31
EOMI
Extra Ocular Movements Intact
32
Normal: EOMI
Abnormal: EOM entrapment
33
Normal: Sclera are anicteric
Abnormal: Scleral icterus
34
Normal: Normal conjunctiva
Abnormal: Pale conjunctiva, conjunctival injection
35
Clear anterior chamber Sharp disc margins
1. Retinal detachment
2. Papilledema
3. Hyphema
36
Normal: Cornea
Abnormal:
1. Corneal abrasion or ulcerations
2. Fluorescein uptake
37
Normal: TM's
Abnormal:
1. TM erythema
2. TM bulging
3. TM dullness
4. TM obscured by cerumen (earwax)
38
Normal: Nares (nostrils, singular: naris)
Abnormal:
1. Epistaxis
2. Rhinorrhea
3. Septal hematoma
4. Boggy turbinates (swollen inner nose)
5. Nasal deformity
39
Normal: Moist Mucous Membranes Oropharynx (OP)
Abnormal:
1. Dry Mucous Membranes
2. Dental Caries
3. Edentulous
4. Pharyngeal Erythema
5. Tonsillar Hypertrophy
6. Peritonsillar Abscess
40
DMM
Dry Mucous Membranes
41
PTA
Peritonsillar Abscess
42
Normal neck: supple
Abnormal:
1. JVD
2. Carotid bruit
3. Cervical lymphadenopathy (swollen lymph nodes)
4. Vertebral Point (midline) vs. paraspinal tenderness
5. Thyromegaly
43
Normal heart: regular rate and rhythm. Heart sounds normall
Abnormal:
1. Tachycardia/ bradycardia
2. Irregularly irregular rhythm
3. Murmur
4. Extrasystoles (extra beats)
5. Pleural rub
6. Gallop
44
Normal heart: regular rate
Abnormal:
| tachycardic, bradycardic
45
Normal heart: regular rhythm
Abnormal:
| irregularly irregular
46
Normal heart: heart sounds normal
Abnormal:
| murmurs, rubs, gallops, extra systoles
47
Delayed capillary refill: 0
Absent
48
Delayed capillary refill: 1+
Barely palpable
49
Delayed capillary refill: 2+
Easily palpable (normal)
50
Delayed capillary refill: 3+
Full
51
Delayed capillary refill: 4+
Bounding/aneurysmal
52
Normal finding:
| No respiratory distress
Contradictory finding:
1. mild/moderate/severe respiratory distress
2. tachypnea
3. accessory muscle use
53
Normal finding:
| Clear to auscultation bilaterally
Contradictory finding:
1. diminished breath sounds
2. wheezes
3. Rales
4. Rhonchi
54
CTAB
Clear to Auscultation Bilaterally
55
TTP
Tenderness to Palpation
56
Abdominal normal finding: soft and non-tender
Abnormal finding:
1. mild/moderate/severe TTP
2. Voluntary guarding
3. Rebound tenderness
4. Rigidity
5. Murphy's sign
57
Normal rectum: normal rectal tone, heme negative
Abnormal findings:
1. Heme positive (Guaiac positive)
2. Abnormal stool color
3. Hemorrhoids
4. Rectal Prolapse
5. Decreased rectal tone
58
CMT
Cervical motion tenderness
59
Normal female: normal external genitalia
Abnormal:
| Sores, lesions, rashes
60
Normal female: normal bimanual exam
Abnormal:
CTM
Uterine tenderness
Adnexal tenderness (ovaries)
61
Normal female: normal speculum exam cervical Os is closed no blood or discharge
Abnormal:
Cervical Os is open Blood in the vaginal vault
Malodorous/thick white discharge
62
Normal male: normal genital exam circumcised/uncircumcised
Abnormal:
1. Testicular tenderness
2. Epididymal tenderness
3. Testicular edema
4. Testicular mass
5. Urethral discharge
6. Inguinal hernia
7. Indwelling catheter
63
normal muskuloskeletal extremities: non-tender
Abnormal:
Bone tenderness
soft tissue tenderness
calf tenderness
64
normal musculoskeletal extremities: full ROM
Abnormal:
| Decreased ROM 2nd degree pain
65
normal musculoskeletal extremities: Distal CSMT intact
Abnormal:
pulse/sensory/motor deficits
Tendon Laxity
66
CSMT
Circulation, Sensory, Motor, Tendon
67
A&Ox4
```
Alert and oriented to:
person
time
place
situation
```
68
normal neurological finding: normal speech
Abnormal:
| aphasia, dysarthria
69
normal neurological finding: alert, Ox4
Abnormal:
| obtunded
70
Strength: Normal strength 5/5
```
Abnormal:
4/5 very mildly weak
3/5 unable to overcome resistance
2/5 unable to overcome gravity
1/5 slight contraction, no movement
0/5 flaccid, limp
```
71
Motor normal finding:
| sensation intact
Abnormal:
| Hypoesthesia (decreased sensation)
72
Motor Strengths
1. Pronator Drift
2. Upper Extremity Strength "Grip strengths"
3. Lower extremity strengths
73
Deep tendon reflexes
```
0 Absent
1+ Hypoactive
2+ Normal
3+ Increased
4+ Unsustained clonus
```
74
Babinski: normal
Downgoing toes
75
Babinski: abnormal
Upgoing toes
76
Neurological normal findings:
1. Visual field intact
2. PERRL
3. EOMI
4. Tongue midline
5. Normal gag reflex
6. Facial symmetry
7. Facial sensation intact
8. Normal shoulder shrug
77
Neurological abnormal findings:
1. Visual field loss
2. Unequal pupils (anisocoria)
3. EOM palsy, rightward/leftward gaze
4. Tongue deviation
5. Decreased gag reflex
6. Facial droop, ptosis
7. Hypoesthesia, numbness
8. Unequal shoulder shrug
78
Normal cerebral exam: normal gait
Abnormal finding:
| ataxia, antalgic
79
Normal cerebral exam: no nystagmus
Abnormal finding:
| nystagmus
80
Normal cerebral exam: normal finger-to-nose normal heel-to-shin
Abnormal finding:
| dysmetria
81
Normal cerebral exam: negative Romberg's
Abnormal:
| Positive Romberg
82
Normal cerebral exam: normal RAM
Abnormal:
| dysdiadochokinesia
83
Normal cerebral exam: no tremor
Abnormal:
| tremor
84
RAM
Rapid Alternating Movements
85
Normal (psychiatric): normal affect
Abnormal
- Flat affect
- Odd affect
- Tearful
- Anxious
- Depressed
- Hypomanic
- Poor eye contact
86
Normal (psychiatric): normal judgment
Abnormal:
- Suicidal/Homicidal
- Hallucinations
- Flight of ideas
- Paranoid
87
Normal (psychiatric): normal insight
Abnormal:
- Denies illness/ symptoms
- Non-compliant with treatment
88
Normal (psychiatric): normal speech
Abnormal:
- Tangential speech
- Pressured speech
89
Trauma exam: head
Abnormal findings:
- Battle's sign
- Raccoon eyes
- Periorbital ecchymosis
90
Trauma exam: eyes
Abnormal findings:
- unequal pupils
- subconjunctival hemorrhage
- hyphema
91
Trauma exam: ears
Abnormal findings:
| hemotympanum
92
Trauma exam: nose
Abnormal findings:
- nasal bone deformity
- epistaxis
- septal hematoma
93
Trauma exam: oropharynx
Abnormal findings:
- malocclusion
- dental injury
94
Trauma exam: neck
Abnormal findings:
- vertebral point tenderness
- deformities
- step-offs
95
Trauma exam: respiratory
Abnormal findings:
- absent breath sounds
- splinting
- crepitus
96
Trauma exam: abd
Abnormal findings:
- tenderness
- distended
- ecchymoses
97
Trauma exam: rectal
Abnormal findings:
| -rectal laxity (decreased rectal tone)
98
Trauma exam: musculoskeletal
Abnormal findings:
- pelvis unstable
- bony tenderness
- deformity
99
Trauma exam: back
Abnormal findings:
- vertebral point tenderness
- deformities
- step-offs
100
Trauma exam: skin
Abnormal findings:
- ecchymosis
- laceration
- abrasion
- skin tear
- avulsion
101
Trauma exam: neurological
Abnormal findings:
| -Glasgow Coma Scale (GCS
102
GCS
Glasgow Coma Scale. Used to assess level of consciousness in trauma pts
103
Code exam: general
Common finding:
| unresponsive
104
Code exam: head
Common finding:
- normcephalic
- atraumatic
105
Code exam: eyes
Common finding:
| -fixed and dilated
106
Code exam: oropharynx
Common finding:
- airway patent
- ETT in place
107
Code exam: cardiovascular
Common finding:
- absent heart sounds
- no palpable pulses
108
Code exam: respiratory
Common finding:
- no spontaneous respirations
- equal with controlled ventilation
109
Code exam: abd
Common finding:
| -distended
110
Code exam: musculoskeletal
Common finding:
| -no deformities
111
Code exam: skin
Common finding:
- pallor
- cyanotic
- mottled
112
Code exam: neurological
Common finding:
- unresponsive
- neurological exam limited due to clinical condition
113
Pediatric physical exam: general
Normal:
- non-toxic
- alert
- interactive
- playful
- smiling
- crying with tears on exam
- quickly consolable
114
Pediatric physical exam: head
Normal:
| -flat fontanel (if less than 8 months old)
115
Pediatric physical exam: eyes
Normal:
- PERRL
- no scleral icterus
116
Pediatric physical exam: ears
Normal:
| Nml TMs
117
Pediatric physical exam: throat
Normal:
| Moist mucous membranes
118
Pediatric physical exam: neck
Normal:
- supple
- no meningitis
119
Pediatric physical exam: cardiac
Normal:
| -regular rate and rhythm
120
Pediatric physical exam: respiratory
Normal:
- no distress
- clear and equal
121
Pediatric physical exam: abd
Normal:
- soft
- no crying or grimacing with palpation
122
Pediatric physical exam: genital
Normal:
- Nml external
- testicles descended
123
Pediatric physical exam: extremities
Normal:
| -FROM
124
Pediatric physical exam: skin
Normal:
- warm
- dry
- no rash
125
Pediatric physical exam: neurological
Normal:
- alert
- appropriate for age
- moves all 4 extremities
126
MAEx4
Moves All 4 Extremities
127
Pediatric abnormal: general
- lethargic
- inconsolable
- febrile
128
Pediatric abnormal: head
- sunken fontanel
| - bulging fontanel
129
Pediatric abnormal: eyes
-scleral icterus
130
Pediatric abnormal: ears
- TM erythema
| - bulging
131
Pediatric abnormal: throat
-pharyngeal erythema
132
Pediatric abnormal: neck
-lymphadenopathy
133
Pediatric abnormal: cardiac
- murmur
| - tachycardia
134
Pediatric abnormal: respiratory
- wheezes
- stridor
- retractions
- nasal flaring
135
Pediatric abnormal: abd
-crying with abd palpation
136
Pediatric abnormal: genital
-erythema
137
Pediatric abnormal: extremities
-ecchymoses in various stages of hearing
138
Pediatric abnormal: skin
-rash
139
Pediatric abnormal: neurological
- post-ictal
| - somnolent
140
Tenderness
Pain felt on the release of pressure
141
Icterus
Yellowing, also known as jaundice
142
Perfusion
The flow of blood through the body's blood vessels
