Module 3 Flashcards
Use of Eyes and Nose
Continuous throughout the physical examination
inspection
uses of fingers and hands
palpation
types of palpation
Light: about 1 cm depth
Deep: about 4 cm depth
The ulnar surfaces of hands and fingers
ball of the hand
metacarpo-phalangeal joints
vibration (palpation)
Dorsal surface of hands
temperature (palpation)
(Indirect)
Fingers and Fist
Used to determine percussion notes
mediate
direct
Fingers and Fist
Used to determine tenderness (flank, sinus)
immediate
Loudest, Drum-like
Gastric bubble
tympany
Boom-like
Emphysematous lungs
hyperresonance
Hollow
Normal lung tissue
resonance
Thud-like
Organs
dull
Quietest, Very dull
Muscles, bones
flat
Use Stethoscope and Ears
Auscultation
lying with the face up
supine
lies on their back with their knees bent up in an outward position while their feet are planted flat on the ground
Dorsal recumbent
examinations involving the pelvis and lower abdomen, as well as a common position for childbirth
Lithotomy
Best for assessing the entire perianal area if patient is in the bed
lateral sims
lies flat with the chest down and back up
prone
Concave cap: Transmits low-pitched sounds best
“Bellow”
Light pressure
bell of stethoscope
Flat: Transmits high-pitched sounds best
Firm pressure
diaphragm of stethoscope
Snellen chart
E chart or Picture chart
far vision (tested at 20)
Rosenbaum chart
near vision (tested at 14)
four parts of the general assessment
General Inspection
Mental Status Assessment
Nutritional Assessment
Vital Signs
what does general inspection begin with
observation
what are the main parts of general inspection
Apparent state of health
Outstanding characteristics
Speech patterns
what do outstanding characteristics include
apparent age, sex, race
facial expressions
hygiene
inability to express self through speech, writing, and/or loss of verbal comprehension
aphasia
difficult or defective speech due to impairment of tongue or other muscles or to a loss of motor power
Anarthria/dysarthria
difficulty or inability to produce sounds from the larynx
Aphonia/dysphonia
what speech patterns should be checked for
pace, clarity, tone, strength
what are the broad genres of mental health assessment
General appearance is part of this Level of consciousness Cognitive functioning Thought content Emotional status
what is tested during cognitive functioning
memory: immediate, recent, remote
what to ask for immediate memory
Recall information 3-5 minutes after given
Give a list of 3 things for them to remember
what to ask for recent memory
Several minutes to several hours ago
What they had for breakfast
what to ask for remote memory
Several days to several years ago
History
what is asked on the MMSE
orientation, registration, attention/calculation, recall and language
what is asked during orientation
What is the (year)(season)(date) (day)(month)?
Where are we (state)(county)(town) (hospital/clinic)(floor)
what is asked during registration
Name 3 objects and ask person to repeat them (repeat until can name all 3)
what is asked during attention
Serial 7s (stop after 5 answers)
what is asked during recall
Ask for the 3 objects repeated above
what is asked during language
Name a pencil and watch
Repeat the following: “No ifs, ands, or buts” [
Follow a 3-stage command.
“Take a paper in your right hand, fold it in half, and place it on the floor”
Read and obey the following: “CLOSE YOUR EYES”
Write a sentence
Copy a design: Draw 2 intersecting pentagons.
when are MMSE scores abnormal
below 22
measurement of man
Anthropometric
what are the Anthropometric Measurements
height, weight, ideal body weight,
what is the % desirable weight formula
Current weight/DBW x 100
BMI formula
(Weight in pounds x 703)/ height in inches2
what is an underweight BMI
<18.5
what is a normal BMI
18.5-24.9
what is an overweight BMI
25-29.9
