Final Head to Toe Exam Flashcards
Before the exam
Assemble equipment
Wash hands
Introduce self
Comfort/privacy
Explain exam
Vitals/Measurement
State height and weight
State vital signs (BP, T, HR, RR, O2)
General survey
State health, stature, weight, posture, and hygiene
Affect, speech, state of awareness, behavior, facial expression, and mannerisms
Cranial Nerves
1 Olfactory: smell test
2 Optic: Snellen
3 Oculomotor: blink and move eyes
4 Trochlear: Move eyes
5 Trigeminal: Sensation in face/cheeks
6 Abducens: move eyes
7 Facial: facial expression and taste
8 Vestibularcochlear: hearing and balance
9 Glossopharyngeal: say ah
10: Vagus: Say ah
11 Accessory: Shoulder shrug
12 Hypoglossal: tongue movement
Integumentary
Describe the presence or absence of lesions
Describe:
Macule/Patch
Papule/Nodule
Vesicle/Bulla
Pustule/Abscess
Describe hair texture/distribution
Inspect nails (feet and hands)- cap refill, color, clubbing test
Head and Face
Inspect and palpate the head, hair, scalp, face
Eyes
Inspect eyes
Verbalize: corneal reflex ( CN 5/7)
Fundoscopic exam- optic disc, macula, retinal vessels
Cover/Uncover test
Red Reflex
Corneal Light Reflex
Ears
Inspect and palpate ears
Assess hearing by rubbing fingers
Weber/Rinne test
Otoscopic exam: report on canals, tympanic membrane, cone of light
Dix-Hallpike Maneuver
Nose/Sinuses
Inspect and palpate nose
Interior nose exam
Patency by covering one nostril at a time
Palpate/Percuss sinuses
Transilluminate sinuses
Oropharynx
Inspect lips, buccal mucosa, gums, teeth, palates, tongue, grade tonsils, floor of mouth, and uvula.
Neck
Inspect, palpate, and verbalize lymph nodes: preauricular, post auricular, occipital, tonsillar, submandibular, submental, supraclavicular, lateral neck deep/posterior and superficial/anterior, and infraclavicular.
JVD and carotid pulse, auscultate with bell
inspect/palpate tracheal position
Palpate thyroid gland from behind
MSK upper extremities
Inspect and palpate arms and hands
Palpate radial pulses and compare and grade
Back
Inspect and palpate back
Palpate spinous processes for tenderness
Percuss for CVA
Back Lungs
Inspect respiratory effort
Palpate for lumps or tenderness
Palpate for tactile fremitus 8 places both hands and explain use
palpate thoracic expansion and explain use
Percuss lung fields 8 places and explain use
Percuss diaphragmatic excursion
Auscultate breath sounds 8 positions
Explain bronchophony, egophony, and whispered pectoriloquy
Chest lungs
Inspect respiratory effort and skin, AP:TD ratio
Palpate for lumps or tenderness
Tactile fremitus 4 areas
Percuss lung fields 4 areas
auscultate 4 areas
Heart
Verbalize inspect precordium for pulsation and heaves
Auscultate heart sounds
Aortic 2 ICS RSB
Pulmonic 2 ICS LSB
Erb’s 3 ICS LSB
Tricuspid 4 ICS LSB
Mitral 5 ICS LMCL
Listen with diaphragm and bell
Abdomen
Inspect contour, symmetry, skin, and aortic pulsation
Auscultate:
4 quadrants for bowl sounds
renal ateries above BB on sides
illiac arteries below BB on sides
aorta LCM off midline
Percuss 4 quadrants, multiple in each quadrant
Light and deep palpation in 4 quadrants
Palpate liver and spleen
palpate inguinal nodes
Verbalize why use special abdominal tests (appendicitis or peritoneal irritation)
Perform Psoas test
Perform Murphy’s point for gallbladder
Verbalize assessment of femoral pulse in newborns for coarctation of the aorta
MSK Lower extremities
Inspect symmetry, skin, hair distribution
Grade dorsalis pedis pulse and grade
Assess ROM in hips, knee, ankle
Assess ROM in back: flex, extend, rotate, lateral bend
Describe varus/valgus deformities
Scoliosis test
Verbalize Barlow and Ortolani rationale
Neuro
Cerebellar: Finger to nose, heel to shin, hand flipping
DTR: biceps and patellar
Gait: walk, heel-to-toe, heel and toe walking
Romberg: hands in front
Shallow knee bend
