General Inspection and Integument

Question 1

General Apparent State of Health Appearance

Answer 1

frail, fit, obese, healthy, chacectic, etc

Question 2

Level of consciousness

Answer 2

awake, alert, responsive, unconscious, unresponsive, etc.

Question 3

Signs of distress

Answer 3

wincing, grimacing, respiratory distress, anxious, depressed, etc.

Question 4

Skin color

Answer 4

pallor (white), cyanosis (blue), jaundice (yellow), erythmatous (redness)

Question 5

Obvious lesions

Answer 5

ecchymosis, bruising, nevi, mottling, seborrheic keratosis, actinic keratosis, lacerations, scars

Question 6

Dress, grooming, personal hygiene

Answer 6

clean, weather suitable, general appearance, including hair, nails, makeup or attire

Question 7

Facial expression

Answer 7

eye contact, flat face/affect, etc.

Question 8

Odor

Answer 8

sweet/fruity (acetone) - diabetes
sweet/musty - Fetor Hepaticus (breath of the dead)
fishy, urine odor (ammonia) - uremic fetor

Question 9

Posture/gait/motor activity

Answer 9

Leaning forward (CHF sign)
Hemiparesis (stroke)
shuffling feet (Parkinson)
Antalgic Gait (pain in LE with compensation)
Agitation, tremors, tics

Question 10

Height, weight, waist circumference

Answer 10

Short/loss of height (congenital/acquired)
long limbs
weight loss (malignancy, diuretic, laxative abuse)
weight gain (Cushing syndrome, CHF)

Question 11

BMI

Answer 11

To calculate: weight (lbs) *700/ height (in)
weight (kg)/height (m^2)

Underweight <18.5
Normal 18.5-24.9
Overweight 25.0-29.9
Obese (I) 30.0-34.9
Obese (II) 35.0-39.9
Morbidly Obese >/= 40

Question 12

Gait Steps

Answer 12

Normal is smooth, continuous, and rhythmic

1. Initial contact
2. Load response
3. Heel off
4. Opposite initial contact
5. Toe off
6. Feet adjacent
7. Tibia Vertical
8. Next initial contact

Question 13

Body Planes

Answer 13

Sagittal/Anterior-Posterior
Coronal/Frontal
Transverse/Horizontal

Question 14

Gravitational Line

Answer 14

External Auditory canal
Lateral head of humerus
third lumbar vertebrae
anterior third of sacrum
greater trochanter of femur
lateral condyle of knee
lateral malleolus

Question 15

Postural Compensation

Answer 15

Motion in all three planes occur to keep the body balanced and the eyes level.

Vision, proprioception from tendons and muscles, as well as vestibular inputs contribute to keeping eyes level.

Question 16

Inspection of integument

Answer 16

Look for color, uniformity, thickness, symmetry, hygiene, lesions, odors

Question 17

Inspection of hair

Answer 17

Look for color, distribution, density, texture, fragility

Question 18

Inspection of nails

Answer 18

Look for pigmentation of nail plates and nail beds, length, symmetry, surface changes, clubbing

Question 19

Internal/Deep

Answer 19

Away from surface of body

Question 20

External/Superficial

Answer 20

Toward surface of body

Question 21

Proximal

Answer 21

Towards the trunk of the body, to the point of origin.

Question 22

Distal

Answer 22

Away from trunk of the body, from point of origin

Question 23

Ipsilateral

Answer 23

Same side

Question 24

Contralateral

Answer 24

Opposite side

Question 25

Anterior/Ventral

Answer 25

Front surface of body

Question 26

Posterior/Dorsal

Answer 26

Back surface of body

Question 27

Superior/Cephalad

Answer 27

Situated above, directed upward, toward the head

Question 28

Inferior/Caudad

Answer 28

Situated below, directed downward, toward tail

Question 29

Medial

Answer 29

Toward midline

Question 30

Lateral

Answer 30

Away from midline

Question 31

Prone

Answer 31

Lying face down

Question 32

Supine

Answer 32

Lying face up