HA handout 3 Physical assessment

Question 1

Before performing any procedure:
General Guidelines:

Answer 1

◈ Wash your hands
◈ Greet the patient
◈ Introduce yourself
◈ Explain the procedure

Question 2

Techniques in Physical assessment

Answer 2

Inspection
Auscultation
Percussion
Palpation

Question 3

◈ using vision, smell and hearing to assess normal conditions
◈ assess for color, size, location, movement, texture, symmetry, odors, and sounds as you assess each body system

Answer 3

1) INSPECTION

Question 4

Use good lighting preferably _____________ flourescent lights can alter the true color of the skin. Dim light can overlooked abnormalities

Answer 4

sunlight

Question 5

● involves listening for various lung, heart, and bowel sounds with a stethoscope
● The sounds detected using auscultation are classified according to the intensity (loud or soft), pitch (high or low), duration (length), and quality (musical, crackling, raspy) of the sound.

Answer 5

2) AUSCULTATION

Question 6

◈ involves tapping your fingers or hands quickly and sharply against parts of the patient’s body to help locate organ borders
◈ identify organ shape and position, determine if an organ is solid or filled with fluid or gas

Answer 6

PERCUSSION

Question 7

Functions of Percussion

Answer 7

◈ Eliciting pain
Determining location, size, and shape
Determining density:
Detecting abnormal masses

Question 8

Types of Percussion

Answer 8

1) DIRECT PERCUSSION
2) INDIRECT PERCUSSION
3) BLUNT PERCUSSION

Question 9

Percussion helps to detect inflamed underlying structures. If an inflamed area is percussed, the client’s physical response may indicate or the client will report that the area feels tender, sore, or painful.

Answer 9

Eliciting pain

Question 10

Percussion note changes between borders of an organ and its neighboring organ can elicit information about location, size, and shape.

Answer 10

Determining location, size, and shape

Question 11

Percussion helps to determine whether an underlying structure is filled with air or fluid or is a solid structure.

Answer 11

Determining density

Question 12

Percussion can detect superficial abnormal structures or masses. Percussion vibrations

Answer 12

Detecting abnormal masses

Question 13

• -this technique reveals tenderness
• using one or two fingers, tap directly on the body part
• ask the patient to tell you which areas are painful, an watch his face for signs of discomfort

Answer 13

DIRECT PERCUSSION

Question 14

• elicits sounds that gives clues to the make-up of the underlying tissue
• press the distal part of the middle finger of your non-dominant hand firmly on the body part
• keep the rest of your hands off the body surface
• flex the wrist of your nondominant hand
• using the middle finger of your dominant hand, tap quickly and directly over the point where your other middle finger touches the patient’s skin
• listen to the sounds produced

Answer 14

INDIRECT PERCUSSION

Question 15

• used to detect tenderness over organs (e.g., kidneys) by placing one hand flat on the body surface and using the fist of the other hand to strike the back of the hand flat on the body surface

Answer 15

BLUNT PERCUSSION

Question 16

◈ requires to touch the patient with different parts of your hands, using varying degrees of pressure
◈ because hands are tools, keep your fingernails short and hands warm
◈ wear gloves when palpating mucous membranes or areas in contact with body fluids
◈ palpate tender areas last

Answer 16

4) PALPATION

Question 17

Parts of the hand use in palpation
fine discriminations: pulses, texture, size, consistency, shape crepitus

Answer 17

fingerpads

Question 18

hand parts used in palpation
vibrations, thrills, fremitus

Answer 18

ulnar or palmar surface

Question 19

parts of the hand used in palpation
temperature

Answer 19

dorsal surface (back)

Question 20

Types of Palpation

Answer 20

LIGHT PALPATION
MODERATE PALPATION
DEEP PALPATION
BIMANUAL PALPATION

Question 21

• To perform light palpation, place your dominant hand lightly on the surface of the structure. There should be very little or no depression (less than 1 cm).
• Feel the surface structure using a circular motion.
• Use this technique to feel for pulses, tenderness, surface skin texture, temperature, and moisture

Answer 21

LIGHT PALPATION

Question 22

◈ Depress the skin surface 1 to 2 cm (0.5 to 0.75 inch) with your dominant hand, and use a circular motion to feel for easily palpable body organs and masses.
◈ Note the size, consistency, and mobility of structures you palpate.

Answer 22

MODERATE PALPATION

Question 23

◈ Place your dominant hand on the skin surface and your nondominant hand on top of your dominant hand to apply pressure (Fig. 3-2.
◈ This should result in a surface depression between 2.5 and 5 cm (1 and 2 inches).
◈ This allows you to feel very deep organs or structures that are covered by thick muscle.

Answer 23

DEEP PALPATION

Question 24

• Use two hands, placing one on each side of the body part (e.g., uterus, breasts, spleen) being palpated (Fig. 3-3).
• Use one hand to apply pressure and the other hand to feel the structure.
• Note the size, shape, consistency, and mobility of the structures you palpate.

Answer 24

BIMANUAL PALPATION

Question 25

infant 0-6
6-12 months heart rate

Answer 25

100-160

Question 26

infant 0-6 and 6-12
respiration

Answer 26

30-60
24-30