Intro to Physical Exam/Instruments

Question 1

Before you walk in the room…

Answer 1

Sanitize your hands

Question 2

Universal Precautions

Answer 2

-set by CDC to protect patients and providers from infectious disease

Question 3

Standard Precautions for all patient care

Answer 3

1. Perform Hand Hygiene
2. Use personal protective equipment (PPE) if possible exposure to infectious
   material
3. Follow respiratory hygiene/cough etiquette principles
4. Ensure appropriate patient placement/isolation
5. Properly handle, clean, and disinfect patient care equipment and instruments
6. Follow safe injection practices – Face shield for LPs.
7. Proper handling of needles and sharps

Question 4

Hand Hygiene

Answer 4

-wash hands for at least 20 seconds (ABCs)

Question 5

Patient terms for Inspection, Auscultation, Palpation, Olfaction, and Percussion

Answer 5

• Inspection (Look)
• Auscultation (Listen)
• Palpation (Touch)
• Olfaction (Smell)
• Percussion – Tap over an area to differentiate air,
fluid, or solid underneath the surface of the area examined.

Question 6

General Survey

Answer 6

*Apparent State of Health
– General judgement Level of Consciousness
– Awake, alert, and responsive to you.
*Level of Consciousness
– Awake, alert, and responsive to you.
*Signs of Distress
– Cardiac or Respiratory Distress
– Pain
– Anxiety or Depression
Etc.

Question 7

Supine

Answer 7

lie on your back

Question 8

Prone

Answer 8

lie on your stomach

Question 9

Lateral Recumbent

Answer 9

lie on your side

Question 10

Ophthalmoscope

Answer 10

To visualize inner aspect of eye— retina, vascular supply, optic nerve, etc.

Question 11

Otoscope

Answer 11

To visualize the inner ear

Question 12

Tuning Fork

Answer 12

1. Hearing Evaluation
   a. Air conduction
   • Lasts longer than bone conduction
   • Hold fork in front of external
   auditory meatus
   b. Bone conduction
   • Hold handle on boney area behind ear
2. Vibratory Sense
   •Place handle on patella
   •Compare left and right for duration

Question 13

Reflex

Answer 13

Reflex is an involuntary response.

Question 14

Reflex Tendon

Answer 14

Elicits a reflex

Question 15

Upper Extremity Deep Tendon Response

Answer 15

• Biceps (hammer strikes your thumb)
• Triceps (hammer strikes ligament)
• Brachioradialis (hammer strikes ligament

Question 16

Lower Extremity Deep Tendon Response

Answer 16

• Patellar Reflex

* Achilles Reflex

Question 17

Stethescope

Answer 17

• Bell for low pitched sounds (bruits)

* Diaphragm for high pitched sounds (breath sounds and heart tones)

Question 18

Sphygmomanometers

Answer 18

• There are three types of sphygmomanometers used to measure blood pressure: mercury, aneroid, and digital.

Question 19

Vial Signs

Answer 19

• Blood Pressure
• Pulse
• Respiratory Rate
• Temperature
• Pain (sometimes considered the 5th vital sign)

Question 20

Blood Pressure Measurement

Answer 20

• Cuff selection
• Palpate brachial artery and appropriate cuff placement -Arm supported at heart level
• Pump up to 180
• Repeat BP measurement with auscultation
• Verbalize results.

Question 21

How BP works

Answer 21

• Air in the bladder compresses the artery stopping blood flow
• As the cuff deflates, circulation starts moving through the artery – turbulent flow which is audible.
• First sound is systolic BP
• Diastolic BP is when the sound stops

Question 22

Ausculatory Gap

Answer 22

• Period of diminished or absent Korotkoff sounds during the manual measurement of blood pressure.
• The improper interpretation leads to blood pressure monitoring errors

Question 23

Pulse Locations

Answer 23

• Radial artery (MC)
• Dorsalis pedis artery
• Carotid artery
• Brachial artery
• Abdominal aorta
• Femoral artery
• Popliteal artery

Question 24

Normal Temperature

Answer 24

97.8-99 degree F

Question 25

Temperature can be measured…

Answer 25

orally, rectally, axillary, ear, and skin

Question 26

Osteopathic Structural Exam

Answer 26

TART