History, physical exam, restraint Flashcards
Signalment (7)
information collected at the start of/before the visit.
Name
Species
Breed
Age
Gender
Neutered/intact
Weight
BAR
QAR
BAR – bright, alert responsive
QAR – quiet, alert, responsive
hemi- & paraparesis
weakness or paralysis of one side of the body is a hemiparesis or hemiplegia;
weakness or paralysis of both legs is a paraparesis or paraplegia
kyphosis
hunched back
opposite to lordosis
BCS scale
Scale 1-5 or 1-9
Muscle condition score (MCS) - what do you palpate (4) and how do you rate (4).
Spine, scapulae, skull, wings of the ilia
Normal, mild loss, moderate loss, severe loss
Bilateral or unilateral loss in limbs
Counting Respiratory rate: how and norm. for dogs and cats.
Resting state; count during 10 or 15 seconds, multiply by 6 or 4.
Normal rate:
Dogs - 10-40/min (consider the size of the dog)
Cats - 20-40/min
Try and localize whether increased effort on inspiration or expiration.
Stridor indicates ?
rigid tissue vibrations (larynx, trachea)
Stertor indicates?
soft tissue vibrations (soft palate/upper airways)
Pathological Breathing patterns are often described as 1 of 3:
Obstructive
Restrictive
Asynchronous (paradoxical)
Obstructive breathing pattern =
Increased inspiratory effort (+/- respiratory noise) → upper airway disease.
Increased expiratory effort → lower airway disease.
Restrictive breathing pattern =
Mixed respiratory pattern in which you see both increased inspiratory and expiratory effort → primary lung disease (parenchymal disease).
Asynchronous (paradoxical) breathing pattern =
Abdomen moves inward during inspiration → pleural disease.
Dogs
Deciduous teeth
Deciduous teeth 2x (I3/3:C1/1:P3/3) = 28
Dogs
Permanent teeth
2 x (I3/3:C1/1:P4/4:M2/3) = 42
Cats
Deciduous teeth
2x (I3/3:C1/1:P3/2) = 26
Cats
Permanent teeth
2x (I3/3:C1/1:P3/2:M1/1) = 30
ptyalism
excessive salivation
A prolonged CRT indicates?
peripheral perfusion is Normal at 1-2 sec
Prolonged = dehydration, hypovolemia, shock
A decreased CRT can indicate?
Decreased – early shock, fever, hyperthermia
peripheral perfusion is Normal at 1-2 sec
pale white mucous membranes can indicate (3)
anemia
poor perfusion
vasoconstriction
possible causes of red mucous membranes (4)
sepsis
early shock
SIRS (Systemic inflammatory response syndrome)
fever
brownish mucous membranes can indicate?
not when its not pigment!
methemoglobulinemia/ intravascular hemolysis
enophtalmia
sunken eyes
skin turgor is normally reduced in what types of healthy patient? (2)
geriatric or underweight patients
and vice versa, overweight patients normally have increased turgor
estimate dehydration percentage when history of few episodes vomiting and/ diarrhea, clinical exam normal.
<5%
estimate dehydration percentage when history of episodes vomiting and/ diarrhea, clinical exam finds increased turgor, dry mm, enophtalmia.
6-8%
estimate dehydration percentage when history of excessive episodes vomiting and/ diarrhea, clinical exam finds marked degree turgor, dry mm, enophtalmia, slow CRT, rapid pulse.
9-11%
estimate dehydration percentage when hypovolemic shock.
12-15%
A Normal thyroid gland can’t be
palpated
An Overfilled, pulsating Jugular vein can indicate?
Right-sided heart failure
Palpable lymph nodes (5)
Submandibular lnn
Prescapular lnn
Axillary lnn
Inguinal lnn
Popliteal lnn
Normal rate heart rate
Dogs
Cats
Dogs - 60-140/min (consider the size)
Cats – 140 (180) -200/min
sinus arrhythmia
HR faster during inspiration and slower during expiration
is normal for dogs but not cats
what is a cardiac gallop?
Cardiac gallop is a mechanical hemodynamic event associated with a relatively rapid rate of ven- tricular filling and accompanied by a ventricular bulge and a low-frequency sound.
It includes three or four sounds, thus resembling the sounds of a gallop.
Gallop rhythms may be associated with the following: Ventricular overload.
grading heart murmurs
Auscultate all valve areas
Murmurs are graded I-VI
Sound caused by turbulent blood flow
Assess where the murmur is the loudest (PMI)
Systolic vs diastolic vs continuous
Feel the femoral pulse at the same time!
On the left side of the thorax you can auscultate which valves?
P - pulmonary valve, most cranial
A - aortic valve, most dorsal
M - mitral valve, towards apex most caudal
On the right side of the thorax you can auscultate which valves?
T - tricuspid valve
Thoracic auscultation for respiratory sounds.
Divide the thorax into 4 areas each side.
Pathological sounds:
- Increased lung sounds
- Wheezes
- Crackles
- Decreased lung sounds:
Dorsally → pneumothorax
Ventrally → pleural effusions
Assess whether sounds on inspiratory or expiratory phase.
Larynx - isolate upper airway sounds.
Abdominal palpation.
Use gentle but firm pressure, both hands, move dorsal to ventral and cranial to caudal.
Avoid the spine - back pain vs abdominal pain.
Pain/discomfort + localization.
Is the abdomen soft, firm/tense, hard.
Palpable abdominal organs vs. Non-palpable organs (when normal/healthy):
Palpable organs:
- Intestines with Fecal matter, foreign bodies, neoplasia.
- Bladder (if full)
- Kidneys (cats)
Non-palpable organs when normal:
Liver, pancreas, stomach, spleen, adrenal glands, uterus.
Normal temps in
Dogs
Cats
Dogs - 37,5 – 39,1℃
Cats - 37,8 – 39,1℃
Take into consideration fear, anxiety, stress.
And Hyperthermia vs pyrexia.
Rectal palpation for what types of patients? (3)
Older intact males,
males with urinary problems,
all patients with defecation problems.
A normal Prostate on palpation:
Normal - symmetrical, two lobes, nonpainful.
In Large dogs they may be non-palpable.
