OSCE 1 - OE and Instruments lab

Question 1

1. Name/describe the 6 positions for a physical examination

Answer 1

• Sitting and standing
  b. Supine- the patient’s back is down
  c. Prone- the patient’s belly is down
  d. Left lateral recumbent- the patient’s LEFT side is down
  e. Right lateral recumbent- the patient’s RIGHT side is down

Question 2

Name/ the 4 techniques of examination

Answer 2

Inspection
Auscultation
Percussion
Palpitation

Question 3

INSPECTION

Answer 3

Assess appearance of age, posture, mobility, asymmetry, color changes

Question 4

AUSCULTATION:

Answer 4

performed with the stethoscope

i. Listen to lung, heart, GI, vascular sounds

Question 5

PERCUSSION:

Answer 5

performed with your hands

i. Flatten fingers over thorax/abdomen
ii. Strike the distal knuckle with 3rd finger to elicit sound
iii. Note the sound difference when percussing over a hollow organ vs bone
iv. Dull sounding- fluid, Flat sounding- solid, Tympanic sounding- air

Question 6

PALPITATION:

Answer 6

performed with your hands

i. Superficial and deep palpitation

Question 7

Opthalmoscope use -

Answer 7

Use to examine the fundus/retina/posterior chamber as well as the pupillary
reflex (direct and consensual) and red reflex, which is the normal reflection off
the retina

Question 8

SNELLEN EYE CHART:

Answer 8

Assess visual acuity (20/20 is normal, 20/40 vision means that the test subject
sees at 20 feet what normal person sees at 40 feet)
ii. Held at ~14 inches from eyes
iii. Be sure to test both eyes open, then covering one eye at a time

Question 9

OTOSCOPE

Answer 9

Understand and be able to use as part of the ear and oropharyngeal
examination. Identify the components of the tympanic membrane. Perform an
oropharyngeal exam.
i. Gently grasp auricle. Pull up, out and back
ii. Insert approx. ¼ to ½ length of speculum
iii. Identify canal and tympanic membrane
iv. Remove speculum
v. Use tongue depressor for oropharyngeal exam. Ask the patient to say “AHH” to
raise the soft palate. Identify structures of the oral cavity

Question 10

TUNING FORK: Understand the multiple uses

Answer 10

. Air conduction- lasts longer, hold fork at external auditory meatus
ii. Bone conduction- less than air conduction, hold handle at occipital condyle
behind ear
iii. Vibratory sense- place handle on patella (knee cap) and compare left and right
for duration.

Question 11

REFLEX HAMMER use

Answer 11

elicit DTRs:
patellar
achilles
bicep (hammer strikes thumb)
tricep (hammer strikes ligament)
brachioradialis (hammer strikes ligament)

Question 12

stethoscope, identify parts

Answer 12

Diaphragm- larger circle, for higher frequency sounds such as breath sounds and
heart sounds
ii. Bell- smaller circle, for lower frequency sounds such as bruits

Question 13

LOOD PRESSURE CUFF/SPHYGMOMANOMETER:

Answer 13

Listen for the 1st Korotkoff sound (systolic number) and the last Korotkoff sound
(diastolic number) [NO SOUND, artery open]
ix. Deflate cuff

Question 14

Understand and describe use of Universal Precautions

Answer 14

Protect the patient and provider from spread of infectious disease

b. Gloves used in presence of blood or bodily fluids
c. Hand washing before and after wearing gloves