PE General Survey, Mental Status, Skin, Hands and Nails Flashcards
how many parts are there in the physcial exam
19
what are the first 5 parts of the physical exam
1) introduction
2) general survey
3) mental status
4) measurements
5) Skin
what are part 6-10 of the physical exam
6) hands and nails
7) head
8) neck
9) eyes
10) nose
what are the parts 11-15 of the physical exam
11) mouth and throat
12) ears
13) axillary and epitrochlear nodes
14) chest
15) cardiovascular
what are parts 16-19 of the physical exam
16) peripheral vision
17) abdomen
18) muscloskeletal
19) neurological
how should the introduction phase play out
introduce yourself, your role, and ask permission to perform the physical exam
wash your hands
what 12 items to note during the general survey
- body habits
- nutritional state
- sexual development
- presenting appearance
- hygiene
- stated vs apparent age
- demeanor
- facial affect
- posture
- gait
- level of consciousness
- apparent pain or distress
what are 12 notable qualities to identify in the mental status exam
- speech,
- language
- mood
- thought content
- perceptions
- insight
- judgement
- orientation
- attention
- memory
- information
- vocabulary
what measurements are taken during the physical exam
- height/weight/BMI
- Pulse
- respiration
- blood pressure
what is a special procedure that might be included in the measurement area and when might it be used
orthostatic hypotension (tilt test)
when the patient is in a state of extracellular fluid depletion from dehydration or hemorrhage
when checking pulse during the physical exam, what two factors should be noted
rate: fast or slow
rhythm: regular or iregular
when checking respiration during the physical exam, what four factors should be noted
- rate
- rhythm
- depth
- effort of breathing
how should the pulse be measured in the physical exam
at the carotid or radial pulse, count for 30 seconds x 2
how long should respirations be counted during the physical exam
30 seconds
how should the patient be positioned when taking blood pressure
seated upright with the legs uncrossed, right arm then left arm
explain the skin portion of the physical examination
- patient can be sitting or standing
- make sure there is adequate light
- disrobe each area to inspect and palpate
what is an important consideration during the skin exam
modesty
what are 7 signs to look for during the skin exam
- color
- temperature
- texture
- turgor
- mobility
- moisture
- rashes/lesions
turgor
elasticity of the skin
body habitus
overall impression of physique
what are 5 signs to look for during the hands and nails examination
- cyanosis
- clubbing
- nail deformities
- tremors
- erythema or pallor in palmar creases
what are 5 areas to inspect while examining the skull
- skull
- scalp
- hair
- face, nose, mouth
- TMJ
when inspecting the skull during the head examination, what two signs should be looked for
- general size
- contour
when inspecting the scalp during the head examination, what three signs should be looked for
- scaliness
- nevi
- lesions
when inspecting the hari during the head examination, what four signs should be looked for
- quantity
- distribution
- pattern of loss
- dandruff
when inspecting the face/nose/mouth during the head examination, what seven signs should be looked for
- symmetry
- contours
- involuntary movements
- edema
- lesions
- masses
- expression
when inspecting the TMJ during the head examination, what sign should be looked for
redness or swelling
what special sign can be identified during the head examination
pathognomic facies
pathognomic facies
specific facial characteristics indicative of certain diseases
what two areas should be palpated during the head exam
- hair and scalp
- TMJ
when palpating the hair during the head examination, what six signs should be looked for
- hair texture
- quantity and quality
- deformities
- tenderness
- lesions
- scaliness
when palpating the TMJ during the head examination, what two signs should be looked for
- pain
- creptius
describe the process of palpating the TMJ during the head exam
visualize and palpate the TMJ in motion during opening/closing, protrusion/retrusion, lateral movement
