Final: methods and order of examinations Flashcards
Skin examination
- Inspection: intactness, color
- Palpation: pain, intactness, turgor, pull out hair/feathers, greasiness, thickness, elasticity,
- Smelling: greasy = bad smell
- Additional: Skin scraping, otoscopic, cytology, biopsy, blood and special; immunology and histopath.
- Order: hair and coat, skin, ext. ear canal, planum nasale and foot pads, cutaneus appendages (nails, claws, hoofs, horns), perianal and circumanal glands, paraproctal glands
Hair examination
- Density -> alopecia/hypo-/hypertrichosis/prim/sec hair loss
- Colour -> hormonal/alopecia arrabiata
- Gloss
- Closure
- Occurance of loose hairs -> pullatability
- Stiffness
- Localization of abnormalities
- Ext. parasites
- Accessory: foot pads, nasal plane, cutaneus appendages, perianal and circumanal glands
- External ear: otoscopy, lab exam. (microscopy, microbiology)
Exam. of epidermis, color, smell, temp.
- Epidermis: intactness, hyperkeratosis (esp. nasal plane and foot pads)
- Color: albinism, loss of pigmentation, haemorrhages
- Smell: sex pheromones, apocrine/sebaceous glands, NH4 (uraemia), acetone (DM), greasy hair
- Temp: depends on density of hair and thickness of skin, not even (rectal temp!)
Thickness, elasticity, greasiness, sensitivity and humidity of skin
- Thickness: dogs: 0.5-5mm, cats: 0.4-2mm
- Elasticity: turgor (dehydration), collagen and elastic fibers, older
- Greasiness: palpate+smell, sebaceous glands (incr: seborrhea oleous, decr.: s. sicca)
- Sensitivity: pruritus, hyperaesthesia, hypoaesthesia
- Humidity: sweat glands (apocrine/eccrine), sudation, hydrosis, hyperhydrosis
Primary skin lesions
(Many-Poor Poets Pee Near-tunnel, While Violent-bullying Crybabies Puke) -Macules, Patches -Papules -Plaques -Nodules, Tubers -Wheals -Vesicles, bullae -Cysts -Pustules (+Angiodema, Tumor, Abscess)
Primary or secondary skin lesions
(Apes steal cute cats, for chilling, and picking)
- Alopecia
- Scars
- Crusts
- Comedo
- Follicular casts
- Abnormal pigmentation
Secondary skin lesions
(Exotic catwoman, eloped unemotionally, since freaky, lovers charmed naughtily)
- Epidermal collarettes
- Excoriations
- Ulcers
- Scars, fissures
- Lichenifications
- Callus
- Necrosis
Swelling of the skin
- Oedema: fluid under skin - inflammation/stagnation/hydraemica
- Emphysema: gas under skin (subcut.) - lung condition
- Haematoma: blood under skin (subdermal) - often trauma
- Tumor: localization, number, size, temp, pain, consistency, percussion, content
Lymph nodes
- Methods: inspection, palpation
- Additional methods: FNA, biopsy, excision, extirpation, x-ray, US, CT, sounding
- Location, number, size, shape, consistency, structure, pain, movability, surface, skin above (temp, elasticity, intactness), symmetry
- Carnivores: mandibular, subscapular, popliteal (only enlarged: retropharyngeal, parotid, axillary, supf. inguinal, mesenteric)
Mucous membranes
- Oral, nasal, conjunctiva, anal, genital
- Colour, moisture, vessel, CRT, surface
- Methods: inspection, palpation, (smelling)
- Additional methods: endoscopy, US, x-ray, contrast x-ray, discharge: quantity, quality, microbiological
- Discharge: uni-/bilateral, how much, color, consistency, smell
- Abnormal:
1. Colour: pale=anaemic, yellow=icterus (lemon=haemolytic, orange=non-haemolytic), red=hyperaemic (cherry-red=CO-toxicosis, dirty-red: endotoxaemia), chocolate-brown: methHg., grey/purple/blue (cyanotic/hypoxia: full bloodvessels, livid: empty blood vessel)
2. Moisture: dry/sticky: dehydration, excess: discharge
3. Blood vessels: haemorrhages, petechia, suffusions
3. Surface: lesions (erosions, ulcers, nodules, masses), smoothness: swellings=inflammation
Nose and the paranasal sinuses. Nasal discharge, breath, respiratory sounds around the nostrils.
- Methods: inspection, palpation, percussion, smelling, auscultation
- Additional methods: discharge: lab-tests, biopsy, endoscopy, diagn. punction, x-ray, rhinotomy, CT, MRI
- Exam: shape/form, stridor, expired air, discharge, nasal plane, nostrils+mm, palate+nasopharynx, paranasal+frontal sinuses
- Resp.sounds:
- Stridor: nasal=sniffing, laryngeal=snoring, pharyngeal=sawing, collapsed trachea=expir. tooting/honking, paralysed larynx=insp. stridor, narrowed airways=mixed
- Sneezing: dogs+horses=usually normal, cats=rhinotracheitis, rabbits=rhinitis
- Snoring
- Reversed sneezing
- Singultation (hiccups)
- Purring (cats), panting (dogs)
- Pain sound: growling, howling, shrieking,
- Alterated voice (rabies) / voiceless
Coughing, cough induction
- Exam:
- Origin: spontaenous/stimulated
- Frequency
- Strength
- Tone
- Occuranse: morning/night etc.
- Duration
- Secretion content: wet/med. wet/dry
- Pain
- Deepness: supf/deep
- Location of origin: larynx (periodical, heavy, gagging, vomit), trachea: tracheitis (load, explosive, barking)/collapse (expir., goose honking), bronchi: acute(like tracheitis)/chronic (mucous, pus, wet, rough), emphysema (short, weak, dry), pneumonia (soft), cardiac disease (wet, hacking)
- Quality of sputum
- Induction: pressing tracheal rings/tracha rapidly during expir.
- Medium held, unsnapping, med. intensive, med. deep, dry, sharp, painless, not reoccuring
Larynx and trachea
LARYNX:
-External:
1.Inspection: skin, symmetry, swellings, deformities
2.Palpation: form, outline, muscles, surface, abnormal masses, temp, pain, compression/press sensitivity of arytentoids, fremitus
3.Auscultation: norm. weak stridor during exp./insp.
-Internal: inspection: epiglottis, nasopharynx, movements of arytenoids, rima glottidis, muc.mem., tonsillaes
-Further methods: x-ray, endoscopy/laryngoscopy
TRACHEA:
-External:
1.Inspection
2.Palpation
3.Auscultation
-Further methods: x-ray, endoscopy/tracheoscopy, tracheal fluid sample (endoscopy, transtracheal aspiration), +analysis: quality, cytology, bact., viro., muco., parasit.
Ear
- Position of head and external ears
- Shape
- Skin on ear pinna and external ear canal
- Otoscopy: look inside, wax, drum - tympanic membrane intactness
- Lab. exam: microscopy, microbiology
Thorax
- Inspection: skin, size, shape, bilat. symmetry, local deformities
- Palpation: temp., fremitus, painfullness, deformities
- Auscultation
- Percussion
- Additional: X-ray, US, CT, MRI, scintigraphy, bronchial fluid sample+analysis, thoracocentesis, biopsy, thoracotomy, lung function test, blood count, acid-base analysis
Respiration
- (Fordi rike typer dealer)
1. Frequency- Incr.: polypnea/tachypnea
- Decr.: oligopnea/bradypnea
2. Rhytm: periodi rhytmical insp+exp. - Abnorm.: held insp., held exp., shorter insp/exp., asymmetrical, intermittent
3. Type: costoabdominal in dogs+cats - Abnormal: costal/abdominal
4. Depth: med. deep - Abnormal: shallow/deep
Male genital tract
-Scrotum: skin, surface, temp., pain, content (hernia)
-Testis: location, size, shape, surface, structure, symmetry, consistency, pain, movability
-Perineum: inspection+palpation
-Penis+prepuce:
1. Inspection:
-Penis: shape, size, mucosa, pain, consistency
-Prepruce: size of orifice, discharge, mucosa, skin
2.Palpation: draw prepuce back to examine MM and urethral opening
3.Cathetherisation
-Prostate gland: palpation: abdominal and rectal
size, shape, surface, symmetry, consistency, structure, pain, movability
-Additional: US, X-ray, urinalysis, prostatic fluid, semen, cytology, biopsy
Female genital tract
- Vulva/perivulvar area: skin, size, shape, discharge, vulvar opening, mucosa
- Vagina/vestibulum: mucosa, surface, consistency, pain, deformities, presence of foetus/neoplasm
- Abdomen/uterus+ovaries: only palp. when enlarged
- Mammary glands: location, size, shape, skin, temp., pain, structure, deformities, milk
- Additional: Blood; CBC+biochem, vagina smear-cytology, discharge/milk-microbiology, hormones; oestrogen+progesterone, US; ovaries+uterus, radiography, vaginoscopy
Bones
- Inspection: size, shape
- Palpation: firmness, shape, surface, skin above (intactness, temp), pain, abnormal movements, symmetry
- Additional: radiography, CT, lab. (metabolic, osteolysis, inflam. markers, sepsis), histopath., microbio., rectal palp. (pelvis)
Joints
- Inspection: shape, size, skin, symmetry, axis (varus/valgus),
- Palpation: consistency, temp., pain,
- Range of motion
- Additional: radiography, CT/MRI, lab. (inflam. markers, sepsis, serology), arthroscentesis, arthroscopy, joint fluid analysis
Muscles
- Inspection: shape, volume, symmetry, fibrillar contractions/tics/clonus
- Palpation: consistency, pain, temp., lumps/masses, tone
- Additional: US, MRI, lab. (metabolic-Ca/Mg, inflam. markers), biopsy, serology, functional test-electromyography
Neurological
- History
- General impression
- Physical exam:
1. Inspection: standing/moving
2. Palpation: postural reactions, reflexes, sensitivity of skin+MM
3. Pain perception: manipulation, percussion - Additional: X-ray, EEG, CT, MRI, lab. (CSF, CBC/biochem., pathogens),
Skull and vertebral column
- Inspection:
- Head position: lateral turn, head tilt, opisthotonus
- Body position: abnormally curved; kyphosis, lordosis, scoliosis - Palpation:
- Head: shape, symmetry, movability, pain, ears
- Vertebra: abnormal form/position, sensitivity - Additional: x-ray, EEG, CT, MRI, lab. (CSF, CBC/biochem., pathogens)
