Final Practicum Flashcards
General Survey
Introduction, wash hands, explain visit, acknowledge VS and visual acuity.
Pt appropriately exposed
Psych
A and O to person, place, time, and event
Hygiene and affect appear appropriate
Derm
Inspect: lesions, nevi, color
Palpate: verbalize turgor, temp, moisture
Hair: verbalize color, distribution, quantity
Nails: Pigmentation, clubbing, ridging, peeling, nail angle
Head
Inspect: head, scalp, facies
Palpate: for areas of tenderness or masses
Eyes: Inspect
Inspect: eyebrows and lids. conjunctiva and sclera for injection drainage or jaundice. Lacrimal apparatus for signs of redness or blockage. PERRLA + accom + converg. Corneal light reflection. EOMs. Visual fields by confrontation
Eyes: palpate
Palpate: lacrimal glands and ducts for tenderness, inflammation
Orbits with eyes closed
Fundoscopy
Evaluate anterior chamber for white cells, blood. Identify red reflex and optic disc.
Optic disc for sharpness, color, size.
Retinal vessels for AV nicking, copper wiring,
Locate fovea centralis
Comment on papilledema, hemorrhages, exudates
Ears
Hearing acuity - finger rub. Verbalize webber/rinne
Inspect auricle, canal, mastoid, lesions, masses
Otoscopy for canal, TM - note landmarks
Palpate auricle and tragus for pain
Nose/Sinuses
Inspect - external nose size, shape, color, deformity, patency. Internal mucous membrane, septum, turbinates, discharge
Palpate frontal/maxillary sinuses for tenderness
Mouth/Throat
Inspect: lips, tongue, palate, mucosa, tonsils for: symmetry, edema, color, lesions.
Teeth for caries, loose/missing teeth, bite occlusion
Palpate: verbalize lips, tongue, gingiva, and base of mouth for tenderness/masses
Neck
Inspect: swelling, deformity, tracheal deviation
Inquire: neck pain or tenderness
Palpate: pain or tenderness, trachea midline, thyroid
Lymph nodes
Inspect: swelling, deformity
Palpate: for masses/tenderness: pre/post auricular, occipital, subtonsilar, submandibular, submental, ant/post chain, supra/infra clavicular
Verbalize axillary, epitrochlear, femoral, and popliteal
Pulmonary
Inspect: respirations, use of accessory muscles, shape of chest, AP diameter, audible wheezing/stridor
BONUS: surgical scars, physical characteristics, PMI
Palpate: AP/lat compression, equal expansion
Percussion: all fields ant/post
Auscultate: w/ diaphragm all fields for R/R/W/C
Cardio
Inspect: do with pulm inspection
Palpate: verbalize heaves/lifts/thrills and PMI
Auscultate: Name and listen A/P1/P2/T/M for murmurs. Carotids with bell for bruits. Verbalize LLD and supine
Pulses: Brachial, radial, femoral, popliteal, DP, PT. CAP REFILL
ABD
Inspect: shape, symmetry, scars, color, contour
Auscultate: all quadrants for BS. Listen for bruits at abd aorta, renal, iliac, and femoral arteries.
Palpate: w/ flexed knees, light/deep in all quadrants. Palpate liver, spleen, kidneys. CVA tenderness
Percuss: all quadrants for masses. Liver/spleen for size. Nl is 6-12cm