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Anatomy and Radiology - Test 1 > Introduction to Physical Exam > Flashcards

Introduction to Physical Exam Flashcards

1
Q

Two tiers of investigation

A

Screening for new patients

Extended or problem based

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2
Q

Examination Techniques

A

Inspection (observation)
Percussion
Palpation
Auscultation

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3
Q

Observation

A

Least mechanical part of physical exam

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4
Q

More diagnoses made during which part of physical exam?

A

Inspection

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5
Q

Observation includes

A

What you see, hear, olfactory diagnosis, emotions, dress and hygeine

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6
Q

Inspection general appearance

A 
State of consciousness
Signs of distress
Apparent state of health 
Skin
Dress and grooming
Facial expression 
Gai and posture 
Motor activity
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7
Q

Olfactory diagnosis can help with

A

Certain diseases
Ingestion of toxins
Certain infections

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8
Q

Percussion

A

Method of physical examination in which the surface of the body is struck to emit sounds that vary in quality according to the density of the underlying tissues

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9
Q

Density and tone relationship

A

More dense, quieter tone

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10
Q

Sound waves arise from how deep in body tissue?

A

4 to 6 cm

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11
Q

Sonorous percussion

A

Determines density

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12
Q

Definitive percussion

A

Maps extent of border of an area

Easier to move from resonance to dullness

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13
Q

Uses of percussion

A

Sonorous
Definitive
ID area of tenderness

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14
Q

Direct

A

Strinking finger, hand, or lunar aspect of fist against body

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15
Q

Indirect

A

Dominant middle finger used as a hammer to strike the distal joint of non-dom middle finger

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16
Q

Tympany

A

Gastric Air bubble

Similar to sound against side of mouth

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17
Q

Hyperressonance

A

Emphysemic lung

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18
Q

Resonance

A

Healthy lung

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19
Q

Dullness

A

Liver

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20
Q

Flatness

A

Muscle, thigh

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21
Q

Tractile sense

A

Finger pads more sensitive than finger tips

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22
Q

Vibratory sense

A

Ulnar aspect of hands, palmer metacarpaphalngeal joints

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23
Q

Position and consistency

A

grasping fingers

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24
Q

Temperature

A

Dorsum of hand

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25
Q

Qualities elicited by palpatation

A 
Texture 
Moisture
Temperature
Masses 
Precordial Cardiac thrust 
Crepitus (crunch of knee)
Tenderness
Vocal fremitus
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26
Q

Stethoscope mechanism

A

Conveys vibrating column of air from body wall to ears and does not amplify
Excludes outside noise

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27
Q

heart and lung sound frequency

A

60-3000

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28
Q

Hearing range

A

30-20000

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29
Q

Components of stethoscope

A

Chest piece
Rubber tubing
Angled biaurals
Ear pieces

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30
Q

Bell piece

A

Transmits all sounds
Good for low pitches
Lightly touch test
Rubber edge

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31
Q

Diaphragm

A

Filters out low
Better for high pitch
Press firmly

32
Q

Where to hold stethoscope

A

Between second and third fingers

33
Q

Point ear pieces toward…..

34
Q

Ophthalomoscope

A

Lenses and mirrors with a light source and various apertures

35
Q

Opthalomoscope apertures

A

Small - small pupils
Red free filter - green beam
Slit - elevation of lesions
Grid - size of lesions

36
Q

Otoscope

A

Speculum narrows and directs beam of light into ears

Can be used for nasal exam too

37
Q

Auditory tuning fork

A

500-1000 HZ

38
Q

Vibratory tuning fork

39
Q

3 types of reflex hammers

A

Tomahawk
Babinski
Neurologic

40
Q

Sphygomanometer size

A

Width - 40% arm cicumference

Length - 80% arm circumference

41
Q

Normal oral temp

42
Q

Normal axillary temp

43
Q

Normal rectal temp

44
Q

Normal aural temp

45
Q

Which temp is least and most accurate

A

Least - Axillary

Most - Rectal

46
Q

Pyrexia

47
Q

Hyperpyrexia

A

Greater than 106

48
Q

Hypothermia

A

Less than 95

49
Q

Flase temp measurements

A

Smoking or drinking hot/cold liquid
Rapid resp rate
Failure to use thermometer correctly

50
Q

How to record temp

A

Temp, location, (type of thermometer)

51
Q

Which artery to compress for pulse?

52
Q

Regular pulse

A

Evenly spaced beats

53
Q

Regularly irregular

A

Regular pattern with skipped beats

54
Q

Irregularly irregular

A

Chaotic with no real pattern

55
Q

Tachycardia

A

Pulse greater than 100 BPM

56
Q

bradycardia

A

Pulse less than 60 BPM

57
Q

Normal HR

A

50-100 BPM

58
Q

How to do respiration

A

Don’t tell patient and just observe breathing…normal or labored?

59
Q

Normal respiratory rate

A

14-20 breaths per minute

60
Q

Tachypnea

A

Rapid respiration

61
Q

Diastole

A

Blood flows into ventricles

62
Q

Systole

A

Blood flows out of ventricles

63
Q

Systolic BP

A

Pressure generated by LV during systole when LV ejects blood into aorta

64
Q

Diastolic BP

A

Pressure generated by blood remaining in arterial tree during diastole

65
Q

Pulse pressure

A

Systolic-diastolic

66
Q

Why is BP not 0?

A

When ventricle shuts, there is elasticity of aorta that causes recoil

67
Q

Which part of stehoscope for BP

68
Q

BP technique

A 
no caffeine, tobacco, vigorous activity for 30 min
Sit for 5-10 min 
Back supported, feet flat on ground, 
room quiet and warm, 
arm rested and free of clothing, 
Arm at level of heart
Arm supported
69
Q

Which artery for BP?

A

Brachial artery

70
Q

Bottom of cuff should be how far above crease of cubital fossa?

71
Q

Arrow points toward

A

brachial artery

72
Q

How to estimate systolic BP

A

Palpate radial artery and pump cuff til you cannot feel

73
Q

Where to start BP cuff pressure

A

30 + estimated systolic

74
Q

Auscultatory gap

A

Causes underestimation of BP by going silent before diastolic pressure present

75
Q

Causes of increased BP

A 
Loose or too small of cuff 
Bladder ballooning outsdie cuff
Smoking 
Caffeine
Being cold 
Athersclerosis 
White coat
Circadian variations
Physcial activity
Artery below heart
76
Q

Falsely decrease BP

A

Brachail artery too high
Too large of cuff
Circadian

Anatomy and Radiology - Test 1 (21 decks)

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