physical exam

Question 1

cardio ROS

Answer 1

chest pain, irregular heartbeat, palpitations, leg swelling

Question 2

derm ROS

Answer 2

rashes, skin changes

Question 3

gastro-urinary ROS

Answer 3

blood in urine, pain urinating, incontinence

Question 4

general ROS

Answer 4

changes in weight, fatigue, fever/chills

Question 5

GI ROS

Answer 5

abdominal pain, constipation, diarrhea, nausea/vomiting, difficulty swallowing

Question 6

gyn ROS

Answer 6

change in periods, vaginal discharge, breast pain/discharge

Question 7

HEENT ROS

Answer 7

vision changes, hearing changes, ear pain, sore throat, nasal discharge, ear discharge

Question 8

how is BMI calculated

Answer 8

weight in kg / height in m^2

Question 9

muscular ROS

Answer 9

joint pain or swelling, muscle aches

Question 10

neuro ROS

Answer 10

headache, dizziness, fainting, weakness

Question 11

normal BP

Answer 11

90-120 / 60-80

Question 12

normal HR

Answer 12

60-100bpm

Question 13

normal pulse Ox range

Answer 13

96-100%

Question 14

normal respiratory rate

Answer 14

12-20bpm

Question 15

psych ROS

Answer 15

sad, depressed, anxious, trouble with memory

Question 16

respiratory ROS

Answer 16

SOB (lying down or active), wheezing, coughing

Question 17

what BMI range is overweight, obese, and morbidly obese?

Answer 17

overweight: 25-29.9
obese: >30
morbidly obese: >35

Question 18

what BMI range is underweight

Answer 18

<18.5

Question 19

what is considered a fever?

Answer 19

normal temp is 97-99F

fever is anything over 100.4F

Question 20

what is considered hypoxemia?

Answer 20

<88% O2 sat

Question 21

what is normal range of BMI

Answer 21

18.5 - 24.9

Question 22

what range of BP is considered hypotensive?

Answer 22

<90/60

Question 23

what questions to ask regarding pain?

Answer 23

OPQRSTU:
onset
precipitating/palliating/place
quality (how to describe pain)
radiation
severity
temporal
understanding (what do you think might have caused it?)

Question 24

cephalad in embryology anatomical terms is equivalent to what in adults?

Answer 24

superior, towards the head

Question 25

caudal in embryology is equivalent to what anatomical term in adults?

Answer 25

inferior, towards the feet

Question 26

place in correct flow from proximal to distal arm: | ulnar artery, brachial artery, axillary artery, radial artery

Answer 26

axillary artery —> brachial artery —> ulnar and radial arteries

Question 27

match: radial and ulnar arteries medial and lateral

Answer 27

radial artery is lateral (thumb) | ulnar artery is medial

Question 28

where can the brachial artery be palpated?

Answer 28

midarm - medial side between biceps and triceps anterior to elbow - cubital fossa (medial to biceps tendon - where stethoscope is placed for BP reading)

Question 29

where can the radial artery be palpated?

Answer 29

distal forearm - lateral to anterior forearm tendons (most common pulse reading site)

Question 30

which ribs are “floating”?

Answer 30

rib 1-10 attach to costal cartilage | ribs 11, 12 are “floating” - not attached to cartilage

Question 31

the diaphragm ascends on inspiration or expiration?

Answer 31

diaphragm ascends/relaxes on expiration (decreases thoracic volume) diaphragm contracts/descends on inspiration (increases thoracic volume)

Question 32

ventricles of heart are relaxed as they fill with blood during ____ ventricles of heart contract as blood is pumped during _____

Answer 32

diastole: passive filling systole: ventricle contraction

Question 33

what are Korotkoff sounds

Answer 33

“heart beat” sound heard between systolic and diastolic pressure (sounds heard through stethoscope)

Question 34

pulse oximetry could be inaccurate in patients with: (looking for 4 answers)

Answer 34

abnormal hemoglobin structure abnormal hemoglobin levels hemoglobin abnormally bound to other molecules (ex- carbon monoxide, CO) abnormal peripheral blood flow *note: pulse ox works because oxyhemoglobin absorbs light differently than deoxyhemoglobin, so result is based on how much light is absorbed

Question 35

intercostal spaces (ICS) are numbered by rib [inferior/superior] to the space?

Answer 35

SUPERIOR

Question 36

at which rib does the inferior border of the lung lie posteriorly?

Answer 36

10th rib

Question 37

at what vertebral level are the kidneys found? are they even?

Answer 37

T12-L3 | right kidney is usually a little inferior to the left

Question 38

which lung has 3 lobes

Answer 38

right

Question 39

the pleural cavity extends about ___ rib spaces inferior to the lung

Answer 39

2 rib spaces

Question 40

what is the base and apex of the heart, respectively?

Answer 40

base: LA (left atrium) - found on back side of heart | apex (bottom tip): LV (left ventricle) - at 5th ICS

Question 41

you place your stethoscope at the left 5th ICS in the mid clavicular line. What are you hearing?

Answer 41

location is LV (apex of heart), you are hearing mitral valve

Question 42

what do the first and second heart sounds signify, respectively

Answer 42

first heart sound: diastole (closing of tricuspid and mitral valves) second heart sound: systole (closing of aortic and pulmonic valves)

Question 43

where is the point of maximal impact (PMI) when auscultating the heart?

Answer 43

left ventricle (apex) - the “motor” of the heart

Question 44

what does the femoral artery become as it travels distally to the foot?

Answer 44

femoral artery —> popliteal artery —> posterior tibial artery —> dorsalis pedis artery

Question 45

where can the femoral pulse be palpated?

Answer 45

femoral triangle - inferior to inguinal ligament, halfway between ASIS (anterior superior iliac spine) and pubic tubercle

Question 46

where can posterior tibial artery be palpated?

Answer 46

between medial malleolus of ankle and calcaneous of heel

Question 47

where can dorsalis pedis artery be palpated?

Answer 47

between extensor tendons of great toe and 2nd digit (top of foot near big toe)