Intro to Physical Exam

Question 1

Universal Precautions

Answer 1

Handwashing, nail care, ppe, gloves

Question 2

Traditions in medicine

Answer 2

Exam the pt from the right side, use bare hands to examine

Question 3

IPPA

Answer 3

Inspection, palpation, percussion, auscultation

Question 4

Tangential Lighting is good for?

Answer 4

See veins and arteries in the neck

Question 5

Inspection

Answer 5

Observation through sight and smell

Question 6

Things to look for during inspection

Answer 6

symmetry, contour, shape, size, color, moisture, dryness, intact, movement, gait, abnormal statements, chest movement

Question 7

Palpation

Answer 7

Using touch to exam patient

Question 8

Palmar surface (palpation)

Answer 8

Good for movement, textures, and fine details (sensitive part of hand)

Question 9

Ulnar surface (palpation)

Answer 9

Good for distinguishing vibrations

clinical note: good for finding heart valve problems, vocal frematis

Question 10

Dorsal surface (palpation)

Answer 10

Good for distinguishing temperature (because there is less subcu tissue on this part of hand)

Question 11

Light Palpation

Answer 11

One-handed, circular (up to 1cm)

Question 12

Deep Palpation

Answer 12

2-handed (up to 4cm)

Question 13

Percussion

Answer 13

Striking one object against another to produce vibration and sound

Question 14

Plexor

Answer 14

Hammer (tip of long finger)

Question 15

Pleximeter

Answer 15

Nail (what hammer strikes) DIP of long finger

Question 16

Density and tone (percussion)

Answer 16

Denser = quieter Less Dense=Louder

i.e muscle vs lung

Question 17

5 main percussion sounds

Answer 17

1. Dullness - soft to moderate, thud
2. Resonance- Loud, hollow
3. Tympany-Loudest, drum like
4. Flatness-quietest (muscle) not used often in clinic
5. Hyperresonance-Very loud, boomlike

Question 18

Dullness

Answer 18

Thud, solid organs (liver)

Question 19

Resonance

Answer 19

Hollow, healthy lung tissue

Question 20

Tympany

Answer 20

Drum like, Gastric bubble, abdomen

Question 21

Flatness

Answer 21

Very dull, muscle

Question 22

Hyperresonance

Answer 22

Boom like, asthma or diseases where there is excessive air

Question 23

Purpose of blunt percussion (direct percussion)

Answer 23

To elicit pain (recreate what patient is telling you) Done over kidneys to identify stone or infection

Question 24

Auscultation

Answer 24

Listening for sounds (usually with a stethoscope)

Question 25

Sounds heard with bell of stethoscope

Answer 25

Low pitch

Question 26

Sounds heard with diaphragm of stethoscope

Answer 26

High pitch

Question 27

Light pressure with stethoscope hears

Answer 27

Low pitch

Question 28

Firm pressure with stethoscope hears

Answer 28

High pitch

Question 29

At what frequency is a bruit heard best at?

Answer 29

Low pitch