MA Test 2 Flashcards
Purpose of a Physical Exam
- to examine healthy patient
- to confirm overall health status and provide baseline values
- to diagnose a medical problem
Role of MA in Physical Exam (5)
- makes sure all materials are available.
- all lighted equipment checked in advance
- stock all supplies like drapes and gowns
- help pt into exam positions and drape as needed
- give pre-op and post-op instructions.
Penlight (PE equipment)
lighted instrument used to examine the pupil
Opthalmoscope (PE Equipment)
lighted instrument used to examine entire eye
Otoscope
lighted instrument used to examine the ear
audiometer
used to test hearing
Diagnosis definition
the process of determining which disease/condition explains a patient’s Signs and symptoms
clinical diagnosis vs differential diagnosis
clinical: based on S&S and lab findings
differential: rules out S&S of similar diseased to determine actual disease
prognosis definition
the forecast of a probable cause of a disorder
Describe sitting position and what can be examined?
pt. sits at edge of table without back support
- can examine head, back, chest, and arms
Describe standing position, uses, and what can be examined?
pt standing with upper body resting on exam table
- used for injections and examining rectal and back ares.
Describe supine position and what can be examined.
pt. is laying flat on back
- can examine head, neck, chest, abdomen, and arms
Describe dorsal recumbent and what can be examined?
pt is laying flat on his back, knees bent, and feet flat on table.
- can examine head, neck, chest, cervix, and genital area
What exam position is the alternative to lithotomy for the elderly?
dorsal recumbent
Describe lithotomy and what can be examined.
pt. laying on back, knees bent, and feet in stirrups
- used for exam of female genitals
- used to exam perineal area
Describe Trendelenburg and it’s use.
Pt. supine with head lower than feet
used to treat hypotension
Which exam position is used if patient experiences hypotension?
Trendelenburg
Describe Reverse Trendelenburg and its use.
pt. supine with legs lower than head
used to treat hypertension.
Which exam position is used if patient experiences hypertension?
Reverse Trendelenburg
Describe prone position and what can be examined.
pt. lying on table facedown head turned to the side
- can examine back, head, neck, and legs
Describes Fowler’s position and it’s use.
pt. sitting at a 90 degree angle
used for SOB
Describe Semi-Fowler’s position and it’s use.
pt. sitting at a 45 degree angle
used for SOB
Describe Sim’s position and it’s uses (3)
pt. laying on left side with right leg slightly bent
used for enemas, rectal temperatures, and suppositories
Describe Knee-Chest position and what is examined.
pt. facedown resting on forearms, weight on knees and chest, hips are at a 90 degree angle and thighs are separated.
- used to examine perineal area for proctologic procedures
Describe Proctologic (Jack-Knife) position
pt. facedown, ben t at the hips at a 90 degree angle. middle of table is bent and both sides are positioned downward.
What are the 6 exam methods?
- inspection
- palpation
- Auscultation
- Mensuration
- Manipulation
- Percussion.
Describe Inspection exam method
visual exam of patient’s body
Describe palpation exam method
MD assesses temperature, shape, and presence
Describe Auscultation exam method
process of listening to body sounds with a stethoscope
Describe Mensuration exam method (AKA___)
measuring body parts(height, weight, and head/chest circumference)
AKA anthropometric
Describe Manipulation exam method.
systematic movement of patient’s body parts using force
checking ROM
Describe percussion exam method.
involves striking of the body.
What is the most common visual screening test?
Snellen Test
What does the Snellen test assess and diagnose
Assesses far vision
diagnoses nearsightedness.
Describe how to perform Snellen Test.
stand 20 ft away from sign.
stand straight with hands to the side, no squinting or leaning
begin with the 3rd line.
Read with both eyes, then right eye, then left eye.
What does a bigger bottom number for Snellen Test indicate
more blurry vision.
What age is visual screening done after?
only done after 3 yo.
Big E chart is used on?
pediatric and non-English speaking pts.
Kindergarten Test is used on?
young pts who don’t recognize letters
What does the Jaeger Test assess and diagnose
assesses near vision
diagnoses farsightedness
Describe how to perform Jaeger Test
hold chart 14-16 inches away from eyes
keep both eyes open when reading
record the smallest line read without erro
Define Presbyopia
visual condition related to aging
Define myopia (otherwise known as)
distant objects appear blurred
nearsightedness
Define hyperopia (otherwise known as)
closes objects appear blurred
farsightedness
What does the Ishihara Test determine?
color blindness
What is color blindness?
when your eyes don’t recognize certain colors.
Daltonism
can’t distinguish b/w red and green
Achromatic Vision
total color blindness
Deuteranopia
can’t tell difference between bluish greens and neutral shaded
Color-vision acuity
inability to receive colors of the spectrum
Protanopia
partial color blindness, difficulty received red, yellow, and green
Tritanopia
can’t distinguish blue
What does mensuration mean?
to measure
Height and weight are conducted laying down on pediatric patients until what age?
until 36 months.
How often are height and weight conducted for pediatric patients?
at every office visit.
Describe how to obtain head circumference
- where to place measuring tape
place measuring tape above the eyebrow
Describe how to obtain chest circumference
- where to place measuring tape
place measuring tape above the nipples
What is height and weight used to determine?
BMI
Febrile definition
a sign of?
with fever, sign of inflammation
pyrexia
with fever
Afebrile
without fever
Continuous fever definition
fever remains above the baseline
Intermittent fever definition
fever fluctuates but remains above the baseline
hyperpyrexia
an exceptionally high fever
Most accurate method to obtain temperature?
rectally
Least accurate method to obtain temperature?
axillary
Temperature values for oral method
98.6 F/37 C
Temperature values for Axillary Method
97.6 F
36.5 C
Temperature values for Rectal Method
98.6-100.6 F
37 - 48 C
Temperature values for Slight Temperature
99.6-101 F
37.5 - 38.3 C
Temperature values for Moderate Temperature
101- 102 F
38.3 - 38.8 C
Temperature values for Severer Temperature
102 - 104 F
38.8 - 40 C
Temperature values for Dangerous Temperature
104 - 105 F
40- 40.5 C
Temperature values for Fatal Temperature
Greater than 106 F
Greater than 41.1 C
Respiration =
total inspiration + expirationn
Apnea definition
absence of breathing
Average respiration for adults (ages 15+)
16-20
Average respirations for newborns
30-80
Average respirations for early childhood
20-40
Average respirations for late childhood
16-26
Bradpnea
respirations less than 12
Tachypnea
respirations greater than 20
When does Cheyne stokes normally occur and what is it?
- occurs with acute brain, heart, or lung damage.
slow and shallow breathing that increases in depth frequency followed by shallow breaths then apnea for 10-12 second.s
Blood pressure definition
amount of force exerted on the walls of the artery
Normal Blood pressure.
120/80
Orthostatic ypotension
when there is a drop of 20 mm/hg or more after going from sitting to standing
How many times is the BP taken to test for orthostatic hypotension
3 times.
What are the positions orthostatic hypotension is obtained in (in order)
- lying down
- sitting up.
- standing.
What do you allow patient to do before obtaining orthostatic hypotension
sit for 10 minutes.
Prehypertension values
Systolic: 120-139
Diastolic: 80-89
Stage 1 Hypertension values
Systolic: 140-159
diastolic: 90-99
Stage 2 hypertension values
Systolic: above 160
Diastolic: above 100
Hypotension values
Below 90/60
What does pulse oximetry measure and how does it measure it?
measures the amount of oxygen in the blood
- uses infrared signals to read the amount of oxygen in the blood.
Where can pulse oximetry machine be attached to?
ear lobe or finger
What can pulse oximetry reading be affected by? (3)
nail polish, artificial nails, and poor circulation.
If pulse oximetry reading is below ___, you should ask patient to do what during reading.
if below 92%, ask patient to take deep breath during reading.
Hypoxia is defined by
pulse oximetry below 94%.
What does Pulmonary Function Test measure
how well the lung takes in and releases air.
What should the patient not do prior to PFT
taking bronchodilators.
How to obtain PFT.
- how many breaths should patient take
pt. should sit straight and breath through a mouthpiece.
pt. should take 10 deep breaths in and out.
When is PFT always done and when is it sometimes done?
Always done after surgery
sometimes done before surgery
How often should Breast Self Exam (BSE) be performed?
monthly
When is the best time to perform BSE?
7-10 days after menstrual cycle
What should pt observe for during BSE?
discharge, puckering, dimpling, and scaling of the skin
When does testicular self examination begin?
at the age of 15
Where is Testicular Exam best done (2)
in shower or standing inn front of mirrror.
What should patient look for during testicular exam and how should they examine testicles?
look for swelling of the skin of the scrotum
- roll testicles between the thumb and the 2nd and 3rd digit.
What temperature should ear irrigation solution be at?
warm between 99-100 F
What should you do first before ear irrigation?
view ear with otoscope
Which direction is solution directed in ear?
upward and to one side to avoid the eardrum.
Describe the process for ear irrigation?
- place ear drops first to soften wax.
- drape shoulder and place basin under the ear
- chart amt of solutionn used.
What temperature should eye irrigation solution be at?
room temperature.
Describe the process for eye irrigation/ direction?
what should be charted?
irrigation is done from the inner canthus to the outer canthus.
- chart the name and amount of solution that was placed in the eys.
Lavage definition
was out an area of the body.
Gt/Gtt
drop/drops
Absorption definition
drug goes into the bloodstream
Distribution definition.
drug is distributed throughout the body
Metabolism definition
chemical conversion of drugs
Excretion definition
- what is it done by?
permanent removal of drugs
done by the liver.
osteomalacia definition
cracks in the bone
what is the name of the pregnancy hormone?
HCG
DNR stands for and what is needed?
do not resuscitate
a living will is needed
Korotkoff sounds
sounds heard when taking BP
Eschericia coli
bacteria found in the intestines and is considered gram-negative bacillus
What is the 5th vital sign?
pain
Type 1 Diabetes is insulin ___
insulin dependent
pancreas produces little to no insulin
Type 2 diabetes is insulin ____
insulin resistant
the body becomes resistant to insulin and sugar builds up in the blood
Symptoms of diabetes Mellitus (4)
- blurred vision
- frequent urination
- weight loss
- headaches.
Complications often caused by diabetes
retinopathy, amputation, and slow wound healing
What should you give to a patient in insulin shock (severe hypoglycemia)?
glucagon or hard candy
Scoliosis definition
abnormal S-shape curvature of the spine
Abrasion
a wound in which the outer skin is scraped off
Hypothyroidism is a deficiency in?
iodine
Empathy
understanding how a patient feels
Hypothalamus regulated and controls??
body temperature
Anthropometric
to measure body parts
HPI stands for?
history of present illnesses
Coronary Bypass Graft
treats coronary artery disease/plaque buildup
Nucleus
houses the DNA and copies genetic content.
What are the 4 types of wound drainage
- purulent
- sanguineous
- serosanguineous
- serous
Purulent discharge
- color
- sign of
yellow pus-like drainage
sign of infection
Sanguineous discharge
- color
- sign of
bright red bloody discharge
sign pt. is currently bleeding
Serosanguineous discharge
- color
- occurs when
plasma-tinged bloody discharged
takes place after bleeding stops
Serous drainage
- color
clear, watery discharge
What is the most common pulse site?
Radial
Pulse range: less than 1
100-170 BPM
Pulse range: 2-6 yo
90-115 BPM
Pulse range: 6-10 yo
80-110 BPM
Pulse range: 11-16 yo
70-95 BPM
Pulse range: Midlife
65-80 BPM
Pulse range: elderly
50-65 BPM
Tachycardia
pulse above 100 BPM
Bradycardia
Pulse below 60 BPM
Radial pulse site
wrist
Brachial pulse site
space in front of antecubital
Carotid pulse site.
found in neck
Femoral pulse site
midway in the groin
Popliteal pulse site
back of the knee.
Dorsal Pedis pulse site, starts ___ and goes to ___
starts at the instep of the foot and goes to the top of the foot.
What is the most common instrument used for taking temperature in a clinical setting?
electronic digital thermometer.
How to obtain oral temperature
make sure lips are tightly sealed and place under tongue.
When should you wait to obtain oral temperature and how long should you wait?
if pt, has ate, drank, or smoked, wait 15 minutes
Tympanic temperature
- method for adults
- method for chiuldren
- pull ear up for adults
- pull ear down for children
Rectal: temp difference from oral temperature.
1 degree higher than oral.
What position should pt. be in to obtain rectal temperature.
Sim’s position.
How far should rectal temperature be inserted for
- adults
- children.
and what should be done prior to insertion
lubricate first.
- Adults: insert 1 inch
- Children: innser 0.5 inch.
What position should patient be in for Axillary Temperature.
arm is down and crossed over the stomach.
How to obtain Temporal temperature
gently stroke across the forehead.
Describe the purpose of a matrix
used for setting appointments as well as blocking off specific time periods like holidays, meetings, or lunch breaks.
Name the different types of scheduling (4)
- Wave scheduling
- Modified Wave scheduling/
- Double booking
- Stream scheduling.
Describe wave scheduling.
- what is not needed for this type of scheduling?
4 pts can be scheduled at the same time and they are seen based upon order of arrival within 1 hour.
- no appointments involved
Describe modified wave scheduling
2 pts can be scheduled at the same time and they are seen based upon order of arrival within 1 hr.
Describe double booking
2 pts are scheduled at the same time to see the same provided.
Describe stream scheduling
steady flow of patients.
Describe Same-day appointments
require pt. is triaged based on importance of medical treatment.
Which form of medical records is sent to facilities outside of the Primary Care Office
EHR or EMR.
EHR; electronic health records.
What is the preferred method for tracking and documenting patient data?
EHR.
Which form of medical records only has PCP records?
EMR: electronic medical records.
used within facilities.
who can make legal decisions in the event a patient can’t?
power of attorney.
Name the four planes of the body
- median/sagittal plane
- parasagittal plane
- frontal/coronal plane
- transverse/axial plane.
AD
right ear
AU
both ears
AS
left ear
OD
right eye
OU
both eyes
OS
left eye
what can cause incorrect measurements when taking a tympanic temperature measurement?
ingesting hot/cold liquids or cerumen in the ear
Which fingers should be used to palpate the pulse?
the second and third finger
Which pulse site is most commonly used for adults?
radial pulse
Which pulse site is most commonly used for children?
brachial pulse
Which pulse site is most commonly used in emergency situations?
carotid pulse.
What three things is pulse evaluated on?
rate, rhythm, strength
