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Physical Assessment > Physical Assessment Exam 1 > Flashcards

Physical Assessment Exam 1 Flashcards

1
Q

During history taking, what key aspects should the therapist find out?

A

Primary complaint, past medical history, family history, review of systems

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2
Q

What questions should you ask the patient to find out the primary complaint during history taking

A

“Why are you here today?”

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3
Q

During history taking, what are some key factors that we should know about regarding family history

A

history of hypertension, coronary artery disease, cancer, heart problems

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4
Q

What useful tool can be used to obtain the review of systems information during history taking

A

screening forms

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5
Q

In regards to the review of systems, what should you look for when it comes to the skin?

A

Rashes, sores, lumps

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6
Q

In regards to the review of systems, what should you look for when it comes to the HEENT system

A

HA, vision, hearing, nasal, horseness, sore throat

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7
Q

In regards to the review of systems, what should you look for when it comes to the neck

A

lumps, pain, and stiffness

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8
Q

In regards to the review of systems, what should you look for when it comes to the breasts

A

Lumps, discharge, self-exam

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9
Q

In regards to the review of systems, what should you look for when it comes to the respiratory system

A

cough and wheeze

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10
Q

In regards to the review of systems, what should you look for when it comes to the cardiovascular system

A

chest pain, discomfort, orthopnea

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11
Q

In regards to the review of systems, what should you look for when it comes to the GI system

A

heartburn, change in bowel habits, stool color changes

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12
Q

In regards to the review of systems, what should you look for when it comes to the peripheral vascular system

A

skin color, changes, swelling, and sensation

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13
Q

In regards to the review of systems, what should you look for when it comes to the genitals

A

Males: pain, sores, masses
Females: menstrual changes, sores, lumps, masses

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14
Q

In regards to the review of systems, what should you look for when it comes to the urinary system

A

polyuria, dysuria, incontinence

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15
Q

In regards to the review of systems, what should you look for when it comes to psychiatric issues

A

mood changes, irritability, and depression

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16
Q

In regards to the review of systems, what should you look for when it comes to the neurologic system

A

memory, dizziness, speech

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17
Q

In regards to the review of systems, what should you look for when it comes to the hematologic system

A

bruising, bleeding

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18
Q

In regards to the review of systems, what should you look for when it comes to the endocrine system

A

heat/cold intolerance, excessive thirst, polyuria

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19
Q

what are the two different types scope of assessment

A

comprehensive vs focused

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20
Q

How would someone describe comprehensive scope of assessment

A

“head to toe” like a sports physical

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21
Q

which type of scope of practice develops proficiency in physical assessment skills

A

Comprehensive

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22
Q

Is a comprehensive scope of practice typically done in a PT setting?

A

no

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23
Q

How would someone describe focused scope of assessment

A

more specific problem oriented that should become part of the PT doctoring profession

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24
Q

Which type of scope of assessment would be found in the example, “so, you are having difficulty getting a full breath of air, let me listen and see if I can pick up something

A

focused

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25
Q

What is the definition of physical assessment

A

the use of psychomotor skills in the examination of a patient

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26
Q

Physical assessment requires the appropriate application of what four things

A

inspection, palpation, auscultation, and percussion

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27
Q

What is the purpose of physical assessment

A

to identify and address signs, symptoms, and other information which lead to appropriate intervention and referral

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28
Q

Feelings of insecurity for the novice practitioner are ________

A

normal

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29
Q

Patients often feel ___ about physical examination

A

anxious

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30
Q

As a PT, we should ____ showing alarm with your findings

A

avoid

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31
Q

What are things to consider in regards to proper environment and equipment

A

lighting, room temp, examination table height, equipment is available and functional

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32
Q

What are things to consider in order to make the patient more comfortable

A

proper draping, describe your plans before starting, be sensitive to the patients feelings

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33
Q

What order should the exam sequence occur in?

A

from head to toe and avoid unnecessary changes in patient position

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34
Q

which cardinal technique involves close observation of patient’s appearance, behavior, movements, expression, mood, skin conditions, gait, etc

A

inspection

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35
Q

Which of the cardinal techniques involve tactile pressure from your hand and fingers to the patient’s skin to assess elevation, depression, warm, tenderness, masses, crepitus, etc

A

palpation

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36
Q

Which of the cardinal techniques uses the striking or plexor finger to deliver a rapid tap or blow against the pleximeter finger laid against the surface of the chest or abdomen to assess resonance or dullness from the underlying structures

A

Percussion

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37
Q

Which of the cardinal techniques uses the stethoscope to detect heart, lung, bowel, and arterial sounds

A

auscultation

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38
Q

During the health history interview, we want to have a conversation with purpose. What three things will make a conversation purposeful

A
  1. Establish a trusting relationship
  2. Gather information
  3. Offer information
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39
Q

During the health history interview, we want to effectively relate with the patient. What two things can we do to make this possible

A

convey respect and promote trust

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40
Q

During the health history interview, we want to formulate a ______ or series of _____ and test them with more detailed questions

A

hypothesis, hypotheses

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41
Q

During the approach to the interview, what should we consider in regards to establishing the agenda

A

start with open ended questions like why are you here today or how can I help you

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42
Q

During the approach to interview, what should we do in regards to self reflection

A

clarify how our own expectations affect what we hear and how we react, be as unbiased as possible

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43
Q

During the approach to the interview, what should we consider in regards to reviewing medical records

A

age, gender, insurance, meds, intake sheet, pain diagram

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44
Q

During the approach to the interview, what should we consider in regards to behavior and appearance

A

PT’s send messages through words, attention, voice tone, body language. do not underestimate the affect of hygiene and attire

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45
Q

During the approach to the interview, what should we consider in regards to the proper environment

A

lighting, temp, necessary equipment, proper draping

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46
Q

During the approach to the interview, what should we consider in regards to note taking

A

Maintain good eye contact especially when the patient is talking about sensitive/disturbing material

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47
Q

During the approach to the interview, what should we consider when greeting the patient and establishing rapport

A

Have a proper introduction and a proper title. Be attuned to patient comfort, and always maintain confidentiality if others are present

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48
Q

During the approach to the interview, what should we consider in regards to inviting the patients story

A

do not interrupt, use phrases to show engagement, use positive body language like nodding

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49
Q

During the approach to the interview, what should we consider in regards to clarifying the patients story

A

repeat back to the patient what you believe the patient has told you

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50
Q

How should you adapt to the silent patient

A

understand the patient be be collecting thoughts, they may be depressed or overwhelmed

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51
Q

How should you adapt to the confusing patient

A

a somatization disorder may be in play and they will have bizarre descriptions may seems peculiar or be psychotic

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52
Q

How should you adapt to the patient with altered capactity

A

understand they may have dementia

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53
Q

How should you adapt to the talkative patient

A

allow a few minutes of rambling but you need to courteously interrupt

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54
Q

How should you adapt to the crying patient

A

pause, be empathetic, offer tissue, be affirmative

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55
Q

How should you adapt to the angry/disruptive patient

A

accept angry feelings and/or alert security staff maintain non-threatening posture

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56
Q

How should you adapt to the language barrier between you and the patient

A

find an interpreter

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57
Q

How should you adapt to the patient with low literacy

A

be aware and ask how comfortable they are filling out a form

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58
Q

How should you adapt to a patient with impaired hearing

A

know how much loss is there and make appropriate accommodations like ASL or speak up

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59
Q

How should you adapt to a patient with impaired vision

A

Know how much loss is there and make accommodations like orienting patient to surroundings or adjust lighting

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60
Q

How should you adapt to a patient with personal problems

A

be a good listener, do not be judgmental and avoid advice outside of your practice act

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61
Q

Fever, chills, and night sweats are ______ symptoms

A

concerning

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62
Q

What term can be defined as having a high body temperature that could indicate infection

A

fever

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63
Q

What term can be defined as having recurrent shaking and suggests extreme swings in temperature

A

chills

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64
Q

What term can be defined as having hormonal changes, menopause, fever, cancer, and hyperhydrosis

A

night sweats

65
Q

Is weight change a concerning symptom

A

yes

66
Q

What does a rapid change of weight change usually indicate

A

a loss or gain of fluids

67
Q

What does a gradual change of weight change usually indicate

A

an increase or decrease of body fat due to a high or low caloric intake

68
Q

Gradual changes can be _____ edema due to heart failure, liver disease, venous stasis, or medications

A

systemic

69
Q

True or False:

Pain is not a concerning symptom

A

false, it is concerning

70
Q

What is the most common presenting symptom

A

pain

71
Q

Healthy weight is defined as BMI between ____ and ____

A

18.5 and 24.9

72
Q

What is the BMI range to be considered overweight

A

between 25 and 29.9

73
Q

what is the BMI range to be considered obese

A

between 30 and 39.9

74
Q

What is the BMI range to be considered extremely obese

A

40 or more

75
Q

Overweight and obesity increases risk for heart disease, _____, type 2 diabetes, stroke, arthritis, ____ _____, and increased risk of death

A

cancer, sleep apnea

76
Q

Is obesity increasing or decreasing worldwide

A

increasing

77
Q

True or False:

Most obese adults have not been told by their health care provider that they are overweight and need to lose weight

A

true

78
Q

What are three ways to promote weight loss

A
  1. set realistic goals
  2. Exercise
  3. Encourage behavioral habits
79
Q

Promoting weight loss involves setting realistic goals. What are two ways to set realistic goals

A
  1. Reduce calories 500 to 1000 per day

2. Weight loss of 0.5 to 2 pounds per week

80
Q

Promoting weight loss involves exercising, how much should a person exercise a day

A

walk 30 to 60 minutes per day for 5 days a week

81
Q

Promoting weight loss involves encouraging behavioral habits. What are three habits someone can practiced

A
  1. portion controlled meals
  2. meal planning
  3. food diaries
82
Q

When observing general appearance and apparent state of health, what should you look for

A

ill and frail vs fit a robust

83
Q

When observing general appearance and level of consciousness, what should you look for

A

awake and alert vs slow to respond

84
Q

When observing general appearance and signs of distress, what should you look for

A

labored breathing, grimacing, guarding/favoring

85
Q

When observing general appearance and skin color and obvious lesions, what should you look for

A

pallor, cyanosis, jaundice

86
Q

When observing general appearance and dress, grooming, and personal hygiene, what should you look for

A

excess clothing, dirty, unkept/bedraggled

87
Q

When observing general appearance and facial expression what should you look for

A

immobile facies, flat expression, sad affect

88
Q

When observing general appearance and odors of body and breath, what should you look for

A

alcohol, acetone (fruity or nail polish like)

89
Q

When observing general appearance and posture, gait, and motor activity, what should you look for

A

everything PT’s do

90
Q

Vital signs are used to get a quick assessment essential body functions, what are the vital signs

A

blood pressure, heart rate, respiratory rate, temperature

91
Q

What is a normal range of blood pressure systolic and diastolic

A

less than 120 and less than 80

92
Q

What is an elevated range of blood pressure systolic and diastolic

A

120-129 and less than 80

93
Q

What is a high blood pressure - Hypertension stage 1 - range of blood pressure systolic and diastolic

A

130-139 or 80-89

94
Q

What is a high blood pressure - hypertension stage 2 - range of blood pressure systolic and diastolic

A

140 or higher or 90 or higher

95
Q

What is a hypertensive crisis range of blood pressure systolic and diastolic

A

higher than 180 and higher than 120

96
Q

What is the etiology of hypertension

A

we don’t know but we tend to use the risk factors to explain.

97
Q

Etiology of hypertension can be caused by an increased sympathetic nervous system activity which causes what two things

A

an increase of cardiac output and an increase of arterial pressure

98
Q

What are the age risk factors for hypertension

A

men = 45 or older

female 55 or older

99
Q

What are major risk factors for hypertension

A

age, family history, cigarette smoking, physical inactivity, dyslipidemia, and diabetes

100
Q

What is palpated to asses heart rate, rhythm and amplitude

A

an artery

101
Q

What is normal heart rate for an adult

A

60-100 beats per minute

102
Q

what is the range to have bradycardia

A

less than 60 beats per minutes

103
Q

what is the range to have tachycardia

A

greater than 100 beats per minute

104
Q

When we palpate for heart rate, what are we actually feeling?

A

The frequency of the pulsation felt by your fingers follows an even tempo with equal intervals between pulsations which is called normal sinus rhythm

105
Q

In regards to the respiratory rate and rhythm, what do we observe

A

the rate, rhythm, depth, and effort of breathing

106
Q

How do we count the number of respirations per minute

A

by inspecting the best or shoulder movements of breathing and/or by listening to the tracheal with stetchoscope

107
Q

What is a normal breathing rate for an adult

A

14-20

108
Q

What is the range of breathing to be considered bradypnea

A

less than 14

109
Q

What is the range of breathing to be considered tachypnea

A

greater than 20

110
Q

what is considered to be a normal rhythm of breathing

A

equal tempo of inspiration and expiration, an occasional delay or sigh is normal

111
Q

What is normal effort in regards to breathing rate

A

effortless with no noticeable use of accessory muscles

112
Q

What does an elevated temperature usually indicate

A

an infection

113
Q

How is temperature usually assessed

A

an electric thermometer or infrared thermometer

114
Q

What is normal oral temperature?

A

98.6 F or 37 C

115
Q

What are the 6 functions of the skin

A

Boundary of fluids, sensations, protection, body temp control, eliminate waste, synthesis of vitamin D

116
Q

The skin has a protective function. What are three things the skin protects against?

A
  1. Against disease
  2. Against physical trauma
  3. Against electromagnetic energy
117
Q

What is the rule to use when screening for cancer

A

The ABCDE rule

118
Q

In the ABCDE rule to screen for cancer, what does the A stand for

A

asymmetry from one side of the mole to the other

119
Q

In the ABCDE rule to screen for cancer, what does the B stand for

A

Border irregularity like ragged, notched, or blurred

120
Q

In the ABCDE rule to screen for cancer, what does the C stand for

A

Color, look for variation and more than 2 colors

121
Q

In the ABCDE rule to screen for cancer, what does the D stand for

A

Diameter, greater than 6mm (pencil eraser)

122
Q

In the ABCDE rule to screen for cancer, what does the E stand for

A

evolving, does is change rapidly in size, symptoms or morphology

123
Q

What are risk factors regarding skin cancer

A

family history, more than 50 common moles, light hair, eyes, or skin pigmentation, severe blistering sunburn in childhood, UV exposure from heavy sun/tanning.

124
Q

How to prevent skin cancer

A

avoid excessive sun exposure and tanning booths. Use sun screen

125
Q

What is the rule for self examination of skin cancer

A

ABCD rule

126
Q

What are the types of flat skin lesions

A

Macule and patched

127
Q

What are the size parameters for the flat skin lesions

A 
macule = less than 1 cm
patch = greater than 1 cm
128
Q

What are the types of raised skin lesions

A

papule, nodule, plaque, vesicle, bulla, pustule, cyst

129
Q

What type of raised skin lesion is less than 1cm and not fluid filled

A

papule

130
Q

What type of raised skin lesion is deeper than a papule

A

nodule

131
Q

What type of raised skin lesion is rough and flat, greater than 1cm and not fluid filled

A

plaque

132
Q

What type of raised skin lesion is less than 1 cm with serous fluid

A

vesicle

133
Q

What type of raised skin lesion is greater than 1cm with serous fluid

A

bulla

134
Q

What type of raised skin lesion is filled with puss

A

pustule

135
Q

What type of raised skin lesion is filled with fluid to semi-solid stuff

A

cyst

136
Q

What type of lesion has a linear crack in the skin

A

fissures

137
Q

What type of lesion has a deep loss of tissue

A

ulcers

138
Q

What are two skin color changes to be looking for

A

cyanosis and jaundice

139
Q

What is cyanosis and what is it caused by

A

It is a bluish tinge of the skin due to deoxygenated blood

140
Q

What is jaundice and what is it caused by

A

It is a yellowish tinge due to excess bilirubin that effects the liver, gallbladder, and metabolic problems

141
Q

What are common or concerning symptoms in regards to HEENT

A

HA, visual changes, hearing changes, vertigo, nose bleeds, sore throat, and swollen glands

142
Q

What is a very common symptom of the head

A

headaches

143
Q

What are the red flags when it comes to the head

A

Severe and sudden onset, associated with hypertension, or recent head trauma

144
Q

What are questions to ask a patient to make sure the head isn’t experiencing pathological signs

A
  1. Do they have aura
  2. Do they have any nausea or vomiting
  3. Do they have photophobia
  4. Are they experiencing coughing, change of head positioning caused increased pain
  5. Any new medication
  6. Family history
145
Q

What are visual symptoms to be looking for when it comes to pathology of the eyes

A

close and far vision, blurred vision, visual field loss, floaters and flashes, diplopia

146
Q

What are other symptoms to be looking for in regards to the eye besides visual changes

A

pain, redness, tearing, exudate

147
Q

What is involved during an exterior assessment of the eyes

A

Inspect sclera and conjunctiva, finger wiggles test for visual field defects, check for convergence, text extraocular movement, and check corneal reflecion

148
Q

What is involved during an interior assessment of the eyes

A

Ophthalmoscope for looking at the interior of eye ball

149
Q

How is the assessment of vision done

A

By testing near and far images

150
Q

What disease is tinnitus related to

A

Meniere’s disease

151
Q

Explain weber’s test for assessment of hearing

A

Bang the thing and set on top of the patients head and ask if they can hear anything

152
Q

Explain Rinne’s test for assessment of hearing

A

Bang the thing and set on the mastoid process. Once the patient can’t hear it, move the thing in front of their ear

153
Q

When does rhinorrhea occur

A

allergies and URI’s

154
Q

What is rhinorrhea

A

runny nose

155
Q

What is epistaxis

A

nose bleeds

156
Q

How can epistaxis occur?

A

Inflammation and drying of mucosa, foreign bodies, bleeding disorder, and nose picking

157
Q

If a sore throat is associated with fever and swollen lymph nodes, what should we expect

A

strept

158
Q

If a sore throat is not associated with fever and swollen lymph nodes, what is probably the cause of the sore throat

A

allergies or viral infection

159
Q

What are some things we should look for when we assess the mouth, throat, and neck

A

sore throat, inflamed pharynx, bleeding of gums (gingivitis), hoarseness, swollen lymph nodes or thyroid gland

Physical Assessment (8 decks)

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