Examination Techniques and Equipment

Question 1

What contains transmissable infections agents?

Answer 1

Blood
Body fluids
Secretions
Excretions (except sweat)
NONintact skin 
Mucus membranes

Question 2

What procedures require masks to prevent the spreading of transmissable infectious agents

Answer 2

insertion of catheters or injection of material into spinal or epidural spaces via lumbar puncture

Question 3

Transmission-based precautions

Answer 3

Applies to pathogens spread by 
Air 
Droplet
Dry Skin
Contaminated Surfaces

Question 4

Latex Allergy

Answer 4

Occurs from direct or mucus membrane contact

Healthcare and pts with multiple surgeries or procedures are at risk

Question 5

Four examination techniquest

Answer 5

Inspection
Palpation
Percussion
Auscultation

Question 6

Guidelines for Inspection

Answer 6

Adequate lighting
Unhurried and careful inspection
Expose what you want to inspect
Validation of findings with patient

Question 7

Palpation guidelines

Answer 7

Keep fingernails short
Have warm hands 
Be gentle in approach 
Use correct palpation depth 
Use appropriate hand surface

Question 8

Palmar surface of the fingers and finger pads allow for?

Answer 8

Position, texture, size,consistency, fluid, creptitus (joint popping) form of a mass or structure

Question 9

Ulnar surface of the han

Answer 9

Side of little finger allows for inspection of vibration

Question 10

Dorsal surface of the hand

Answer 10

Checks temperature

Question 11

Percussion guidelines

Answer 11

One object striking against another produces vibrations and sound waves
Tapping fingers produces vibrations on underlying tissues
Sound waves from vibrations produce percussion tones (resonance)
Tone is related to density of underlying tissues

Question 12

Tympany

Answer 12

loud, high, drumlike 
gastric bubble (stomach)

Question 13

Hyperresonance

Answer 13

very loud, low, booming

normal lungs in children, emphysematous lungs in adults

Question 14

Resonance

Answer 14

loud, low, hollow

healthy lung tissues

Question 15

Dullness

Answer 15

soft, moderate, thudlike

Over liver

Question 16

Flatness

Answer 16

soft, high, dull

Over muscle

Question 17

Immediate (direct) percussion

Answer 17

finger strikes directly against body (reflexes)

Question 18

Mediate (indirect)

Answer 18

Middle finger of dominant hand is hammer, middle finger finger of nondominant hand is placed on body and struck

Question 19

Fist percussion

Answer 19

Nondominant hand is placed on body and struck with fist of dominant hand (CVA tenderness)

Question 20

Auscultation guidelines

Answer 20

Sounds produced by body
Performed last in examination (2nd in abdominal)
Stethoscope placed on naked skin
Listen for sound, and one sound at a time
Take time to identify
Do not anticipate next sound

Question 21

What are the 6 vital signs?

Answer 21

Pulse, respirations, BP, temp, pain, and O2

Question 22

Normal arterial O2

Answer 22

97-99

Question 23

Pediatric VS

Answer 23

high HR, higher temp

Question 24

Geriatric VS

Answer 24

low HR, lower temp

Question 25

Measurement of height and weight

Answer 25

Adult - Standing platform scale with height attachment
Infant - Weight on platform scale lying or sitting
Child (when able to stand) - stadiometer
infants and children up to 2-3 y/o need their head circumference taken

Question 26

Special Concerns for Patients with Disabilities

Answer 26

Bowel and bladder concerns
Autonomic hyperreflexia (overreaction to external or bodily stimuli)
Hypersensitivity
Spasticity

Question 27

Stethoscope

Answer 27

Amplifies auscultations
Bell - low pitched sounds
Diaphragm - high pitched sounds

Question 28

Pulse Oximeter

Answer 28

Measures percentage of hemoglobin saturated with oxygen
Measures how much oxygen the blood is carrying as a percentage of the maximum it could carry
Taken via the finger, toe or pinna of the ear

Question 29

Snellen Alphabet (visual acuity chart)

Answer 29

Smallest complete line patient can see is recorded
Recorded as a fraction (20/20)
Larger denominator = poorer vision
20/40 a normal person can see at 20 is what a poorer person sees at 40

Question 30

Rosenbaum and Jaeger charts (Near Vision)

Answer 30

Series of numbers, E, X and O in graduated sizes

Acuity recorded at distance (20/20) or Jaeger equivalents (J-2)

Question 31

Otoscope

Answer 31

Contains illumination piece for external auditory canal and tympanic membrane
Speculum directs beam of light down ear canal
Pneumatic attachment evaluates fluctuating capacity of tympanic membrane
Hold otoscope like a pencil and use other hand to hold pt head

Question 32

Nasal Speculum

Answer 32

Used with penlight to see lower and middle turbinates of nose (ridges)
Open blade by squeezing handles of instrument
Stabilize speculum with index finger to avoid contact of blades to nasal septum
Tilt pts head

Question 33

Tuning Fork

Answer 33

Cranial nerve eight
test auditory fxn and vibratory sensation
measures in cycles per second or Hz
Auditory used to estimate hearing loss by noting which vibrating tuning forks can be hears (500-1000Hz)
Vibratory sense is measured by holding vibrating fork against bony prominence (100-400Hz)

Question 34

Percussion Hammer

Answer 34

Tests deep tendon reflexes (DTRs)
Hammer held loosely between thumb and index finger and a tendon is tapped to elicit reaction
Finger may also be used as percussion hammer in peds

Question 35

Neurologic Hammer

Answer 35

Variant of percussion hammer (can test DTRs)
Base of handle unscrews, revealing soft brush
Knob on head unscrews, revealing sharp needle (no longer used due to cross contamination)

Question 36

Monofilament

Answer 36

Test sensation on plantar surface of foot
Bends at 10g of linear pressure-patient has lost sensation if not felt when bent (used in diabetics)
Guidelines include:
Test various foot points while patients eyes are closed
Press and bend filament
Have patient indicate if filament if felt