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Intro to Physical Exam - 2016 > Lecture 5 - Putting It All Together > Flashcards

Lecture 5 - Putting It All Together Flashcards

1
Q

The ____________ is done in response to specific complaints:

A. Comprehensive screening examination
B. Regional examination
C. Extended examination

A

B

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2
Q

Which is true regarding extended examinations?

A. They are never part of a comprehensive examination.
B. They are never part of a regional examination.
C. They provide more detail in response to an abnormality noted on the screening physical exam.
D. They are done to purposely elicit a patient complaint.

A

C is true.

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3
Q

What are the 7 steps of prepping for physical examination?

A
  1. Reflect on approach
  2. Adjust the lighting/environment
  3. Determine SCOPE of exam
  4. Choose SEQUENCE of exam
  5. Observe the correct examining position, handedness
  6. Make PT. comfortable
  7. Make SELF comfortable
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4
Q

What should you tell the pt. in your introduction?

A
  1. Medical student
  2. Spending extra time
  3. Doing complete exam
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5
Q

Which is NOT a goal of the perfect exam?

A. Be thorough without wasting time
B. Be systematic without being rigid
C. Do not examine an area out of sequence when you forget it
D. Be gentle yet not afraid to cause discomfort if it is required
E. Examine each region thoroughly without forgetting about the whole patient

A

C is false - it is ok to return to a forgotten area out of sequence.

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6
Q

What are 4 key parts of adjusting the environment?

A
  1. Stand at right side of bed and clear misc. things
  2. Elevate bed (LOWER when finished!)
  3. Tie examining gown
  4. Move pt. to comfort position
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7
Q

During what two parts of the exam should the lights be off?

A
  1. Pupillary reflexes

2. Retinal exam

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8
Q

What type of patients does the comprehensive examination address?

A

New patients in the office or in the hospital

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9
Q

What type of patients does the focused examination address?

A

Established patients, especially during routine or urgent care visits

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10
Q

What are three examples of parts of the exam with usefulness as screening tools?

A
  1. Blood pressure
  2. Breast exam
  3. Cardiac examination for murmurs
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11
Q

Which is NOT one of the three general goals of the sequence of the exam?

A. Maximize patient comfort
B. Avoid unnecessary changes in position
C. Examine back, than front, of patient
D. Enhance clinical efficiency

A

C is false - you should start by examining front, then back, and move head-to-toe.

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12
Q

Do vital signs or the thyroid exam come first?

A

Vital signs. The thyroid exam is done from the back of the patient.

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13
Q

Do the extraocular movements and visual fields or the funduscopic exam come first? Why?

A

Extraocular movements - always move from “far away” to close in during the exam

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14
Q

What is the sequence of action at the posterior lung?

A. Palpate, percuss, auscultate
B. Percuss, palpate, auscultate
C. Auscultate, palpate, percuss

A

A

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15
Q

What should you look for when inspecting and percussing the spine?

A

CVA tenderness

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16
Q

Do you address the anterior or posterior lungs first?

A

Posterior - after neck/back exam.

THEN anterior lungs - palpate, percuss, ausculate.

17
Q

When is the axillary lymph node examination done?

A

After anterior lung and breast exam

18
Q

What is the sequence of action in the cardiac exam?

A. Palpate, percuss, auscultate
B. Percuss, palpate, auscultate
C. Auscultate, palpate, percuss
D. Inspect, palpate, ausculate
E. Inspect, ausculate, palpate
A

D

19
Q

The patient should be in the ____________ to better listen for extra heart sounds and mitral murmurs.

A

left lateral decubitus

20
Q

Before beginning the anterior lung exam, you should ask the patient to lie recumbent at _____ degrees.

A

30

21
Q

After the cardiac exam, adjust the drapes up from below so that the chest is covered but the abdomen is visualized from the ____________ to the ______.

A

inguinal region to lower thorax

22
Q

What is the sequence of action in the abdominal exam?

A. Palpate, percuss, auscultate
B. Percuss, palpate, auscultate
C. Inspect, ausculate, percuss
D. Inspect, palpate, ausculate
E. Inspect, ausculate, palpate
A

C

23
Q

What two pulses are found in the lower extremities?

A
  1. Dorsalis pedia

2. Posterior tibial

24
Q

What can you ask the patient to do that will help relax the abdominal musculature?

A

Flex legs

25
Q

Besides examining pulses in the lower extremities, you should check for __________ and inguinal lymph nodes.

A

Edema

26
Q

What two exams are often combined?

A

Neurologic and musculoskeletal

27
Q

What are the five parts of the neurologic/musculoskeletal exams?

A
  1. Mental status
  2. Cranial nerves
  3. Motor system
  4. Sensory Examination
  5. Reflexes
28
Q

Which is NOT part of the cerebellar exam?

A. Finger to nose
B. Rapid alternating movements
C. Heel to shin
D. Walk normally
E. Babinski reflex
F. Perform a tandem gait
A

E - this is part of the reflex exam (along with biceps, triceps, brachioradialis, patellar, and ankle)

29
Q

What 4 things should you do at the end of an exam?

A
  1. Acknowledge that exam is over
  2. Ask pt. if they have any questions; provide some type of reassurance
  3. Thank them for their time
  4. Remind them that you will tell everything to the physician and that you will be back!
30
Q

What are two parts of the motor system exam?

A
  1. Check strength against resistance (upper/lower extremities!)
  2. Check range of motion of joints

Intro to Physical Exam - 2016 (7 decks)

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