Introduction to Physical Exam and Instruments

Question 1

What are the 5 components of every physical exam?

Answer 1

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 2

When would you use a the small light vs. medium vs. the larger light on an opthalmoscope?

Answer 2

Use small light when the pupil is very constricted.

Use large light is you are using mydriatic eye drops to dilate the pupil.

Medium most commonly used

Question 3

When would you use the red free light on an opthalmoscope?

Answer 3

To visualize the vessels and hemorrhages in better detail by improving contrast

Question 4

When would you use the slit beam on an opthalmoscope?

Answer 4

To examine contour abnormalities of the cornea, lens, and retina.

Question 5

Should you pull the outer ear up and back or down and back when checking the ear of anyone > 12 months old?

How about a child < 12 months old?

Answer 5

Up and back

Down and back

Question 6

What are two tests that can be done with a tuning fork?

Answer 6

Hearing evaluation and vibratory senses

Question 7

During a hearing evaluation with a tuning fork, how do test for air conduction vs. bone conduction?

Answer 7

For air, hold tuning fork in front of external auditory meatus.

For bone, hold handle on boney area behind ear.

Question 8

Where should I place the tuning fork to check for vibratory senses?

Answer 8

Place the handle on the patella, and check bilaterally

Question 9

How does the bell and diaphragm of a stethoscope differ?

Answer 9

Bell is used for low pitched sounds

The diaphragm is used for high pitched sounds, like the heart tones and breath sounds.

Question 10

What are considered vital signs (5)?

Answer 10

BP
Pulse
Respiratory rate 
Temp
Pain (sometimes considered the 5th vital sign)

Question 11

What is the name of the first knocking sound heard when taking a blood pressure?

Answer 11

Korotkoff

Question 12

What could produce a falsely high BP?

Answer 12

If brachial artery is below the heart, cuff is too small, or cuff is too large on a large arm

Question 13

What could produce a falsely low BP?

Answer 13

Brachial artery above the heart, or cuff is too large on a small arm

Question 14

What is the auscultatory gap, and how could it produce errors in blood pressure readings?

Answer 14

It is a period of diminished or absent Korotkoff sounds during the manual measurement of BP.

This could lead to an underestimation of systolic, and/or overestimation of diastolic BP.