Course 4: Physical Exam Flashcards
What are the 8 systems covered in a PE?
- Eyes: PERRL= Pupils are equal round and responsive to light
- ENT: Moist mucosa membranes
- Neck: Supple, No Lymphadenopathy (no swollen lymph nodes
- Cardiovascular: Regular rate & rhythm and heart sounds normal. Well perfused (Blood is flowing appropriately)
- Respiratory: No issues breathing, CTAB (clear to auscultation bilaterally)
- Extremities: No edema
- Skin: Dry, no rash
- Gastrointestinal: non-distended (not enlarged, normal size)
Define perfusion
flow of blood through the body’s blood vessels. (Pulse)
What is the normal GCS for people?
a Nml GCS adds up to 15
If there is unilateral edema what might be the DDx?
DVT
If there is bilateral edema what might be the DDx?
CHF
Define anicteric
normal sclera
Define icteric
yellowing of the eye
Define CVA tenderness in a PE
Costovertebral Angle
Why would a physician conduct a CVA tenderness PE?
To check the Flank area of the body where the kidneys are located. The Physician might suspect the Pt. to have a kidney stone or pyelo
What is a normal general/constitutional PE?
- No Acute Distress (NAD)
- Well nourished, Well developed
- Alert
What is an abnormal General/Constitutional PE?
•Mild/moderate/severe distress (due to pain)
•Emaciated/Malnourished/Cachetic
•Unresponsive: no rxn to a stimulus
—Somnolent: drowsy, sleepy and postictal (confused, drowsy nausea, non with sz)
–Obtunded: slowed respond to the environment
———-Both obtunded and somnolent Pt. will give some response to stimuli
What is the normal PE of the Head?
-Atraumatic and Normocephalic (AT/NC)
What is the abnormal PE of the head?
Any signs of trauma, Sinus tenderness (Sinusitis)
Angioedema (Allegric reaction)
What is the normal PE of the Eyes?
PERRL: Pupils Equal, Round, Reactive to light
EOMI: Extraocular movement intact
Sclerae Anicteric
Normal conjunctiva (mucous membrane that lines the eye)
What is the abnormal PE of the eyes?
Anisocoria (Unequal pupils) EOM entrapment Scleral icterus (liver failure) Pale conjunctiva Conjunctival injection (redness)
Define Anisocoria
Unequal pupil
What does EOM entrapment mean?
The Extraocular movement is not intact
What does scleral icterus indicates?
liver failure
What is conjunctiva injection?
Redness of the conjunctiva
What tool is used for an internal PE of the eye?
Ophthalmoscope
What tool is used for an external PE of the eye?
Wood’s lamp or fluorescein uptake
Which would be used to look at a corneal abrasion Wood’s lamp or fluorescein uptake?
Fluorescein uptake
Define papilledema
optic nerve at the back of the eye becomes swollen.
Defien hyphema
collection of blood in the eye caused by trauma
What are abnormal finding for a PE of the ear?
Bulging of the Tympanic Membrane Erythema of the TM Dullness of the TM TM effusion TM obscured by Cerumen
Define cerumen
earwax
List some abnormal PE of the nose
All are caused by trauma
- Epistaxia
- Rhinorrhea
- septal hematoma
- Boggy Turbinates
- Nasal deformatity
What is septal hematoma
Infection of the septum
Define boggy turbinates
swollen inner nose
What is the normal PE of the mouth and throat ?
Moist mucous membrane
What is the medical terminology for mouth and throat region?
oropharynx (o. ro. phar. ynx)
What is the abnormal PE of the mouth and throat ?
- Dry mucous membrane
- Dental caries (decay)
- Edentulous (toothless)
- Pharyngeal edema
- Tonsillar asymmetry and uvular shift (symptoms of peri-tonsillar abscess)
- Tonsillar exudate (fluid)
- Tonsillar hypertrophy (enlargement)
A dry mucous membrane is a sign of what?
Dehydration
What are symptoms of peritonsillar abscess?
Tonsillar asymmetry and uvular shift
What is a normal PE of the neck and cervical spine?
Supple
What is a abnormal PE of the neck and cervical spine?
- Thyromegaly
- jugular venous distention (JVD)
- Carotid bruit
- Cervical Lymphadenopathy (swollen lymph nodes)
- Vertebral Point (Midline) vs. Paraspinal Tenderness
- Nuchal Rigidity, Meningismus, Limited ROM
Define enlarged thyroid
Thyromegaly
What is Carotid Bruit?
Auscultate the neck and hear a whoosh sound. This is caused by plac build up
Define Cervical Lymphadenopathy
Swollen Lymph nodes
Which spinal tenderness would physicians be more concerned about Vertebral Point (Midline) or Paraspinal Tenderness?
They would be most concerned about Vertebral point (midline spinal) tenderness because it could be a spinal fracture possible
while Paraspinal tenderness would indicate muscle sprain possibly
What are the normal PE for cardiovascular contradictions?
- Regular Rate
- Regular rhythm
- Heart sounds normal
What are the abnormal PE for cardiovascular contradictions?
Tachycardic/Bradycardic (rate)
Irregularly irregular (rhythm)
Heart sounds: Murmurs, rubs, gallops, extrasystoles (hearts hiccups)
List the type of pulse that is found in a Perfusion PE.
Radial Pulse (forearm) Carotid pulse (neck) Femoral pulse (hip) Dorsails Pedis (DP) pulse (above the foot) Posterior Tibial (PT) pulse (ankle)
what is the medical term for rhythm?
Cadence
What are the normal PE for perfusion ?
Pulses equal and symmetric, Capillary refill less than 2 seconds
What is the normal value of a pulse?
2+ = easily palpable (normal)
What are the normal PE for pulmonary?
No respiratory distress
CTAB (Clear to auscultation Bilaterally
What does CTAB stand for?
Clear to auscultation Bilaterally
What are the abnormal PE for pulmonary?
-Mild/moderate/severe respiratory distress
- Tachypnea
-Accessory muscle use
-diminished breath sounds
-wheezes
Rales (crackles)
-Rhonchi
What are indications of respiratory distress?
- Mild/moderate/severe respiratory distress
- Tachypnea
- Accessory muscle use
What are indications of unclear to auscultation bilaterally?
diminished breath sounds
-wheezes
Rales (crackles)
-Rhonchi
