Physical Exam Flashcards

1
Q

order of exam

A
  1. hands
  2. vitals
  3. HEENT
  4. Pulm
  5. Cardia, axillary, lymph nodes
  6. GI
  7. Neuro/MSK
  8. MSE
  9. Gait
  10. spine
  11. Labs (chem-7, CBC)
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2
Q

vitals

A
BP
HR
RR
Temp
O2 Sat
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3
Q

HEENT

A
head
eyes
mouth, throat
Ears, eyes, nose
sinuses, lymph, thyroid, CN
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4
Q

head

A

examine head, skin (normocephalic, atraumatic)

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5
Q

eyes

A
snellen chart (CN II)
visual fields
EOM (CN III, IV, VI)
sclera, fundi
light, accommodation reaction (CN II, III)
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6
Q

mouth/throat

A
oral cavity (int/ext) (CN IX, X)
stick out tongue (CN XII)
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7
Q

eyes, ears, nose

A
opthalmoscopy
nasal examination (int/ext)
otoscopy (external inspection, w/ear pull and tragus compression)
ear finger rub test (CN VIII)
if indicated, Weber's midline? Rinne R/L
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8
Q

sinuses, lymph thyroid, CN

A

facial sensation (pain/temp, light touch) (CN V)
temporalis, masseter clench (CN V3)
facial grimaces (CNVII)
neck turn, shoulder shrug against resistance (CN XI)
palpate sinuses
lymph nodes
thyroid exam (transition to back)

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9
Q

pulm

A
inspect back (scars, skin lesions)
chest symmetry
percuss back (percuss diaphragm on inhalation/exhal)
pulm auscultation (fremitus, egophany if indicated)
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10
Q

cardiac, axillary lymph nodes

A
cardiac auscultation (asses w/ pules)
carotid pulses (auscultate for bruits if necessary)
asses JVP (30 degress)
PMI
(edema)
axillary lymph nodes
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11
Q

GI

A
  1. inspect abdomen (scaphoid/protuberant/distended, hernias, scars, masses, asymetry, pulsations)
  2. Bowel Sounds (Ao, renal bruits)
  3. Percuss (hepato/spleno megaly)
  4. Palpate (light then deep, 4 quads)
  5. Liver edge on expiration?
  6. Inguinal lymph nodes, femoral pulses
  • upright
    7. CVA tendernes
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12
Q

Neuro/MSK

A
  1. hands (clubbing, cyanosis, nails)
  2. Median/ulnar/radial
  3. muscle bulk, tone
  4. Active ROM (Passive if indicated)
  5. strength of muscle groups
  6. sensation (light touch, pain/temp, vibration, proprioception)
  7. coordination (finger-nose, heel shin, rapid finger tap)
  8. reflexes (bi, tri, brachiorad, knee, ank, babinski)
  9. pedal pulse
  10. feet: edema, toe webspaces, ulcers
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13
Q

MSE

A

consciousness
orientation x3
attention: WORLD

language (rate, volume, prosody)
memory (ocean, red, honesty)
spatial LvR

calculations (3 qtrs, nickel, dime=90 cents)
affect/mood
thought content: suicidal/homicidal

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14
Q

gait, spine

A

normal? (if indicated: tandem, heel-toe)
romberg
pronator drift

spine alignment (scoliosis, kyphosis)

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