Physical Exam Flashcards
order of exam
- hands
- vitals
- HEENT
- Pulm
- Cardia, axillary, lymph nodes
- GI
- Neuro/MSK
- MSE
- Gait
- spine
- Labs (chem-7, CBC)
vitals
BP HR RR Temp O2 Sat
HEENT
head eyes mouth, throat Ears, eyes, nose sinuses, lymph, thyroid, CN
head
examine head, skin (normocephalic, atraumatic)
eyes
snellen chart (CN II) visual fields EOM (CN III, IV, VI) sclera, fundi light, accommodation reaction (CN II, III)
mouth/throat
oral cavity (int/ext) (CN IX, X) stick out tongue (CN XII)
eyes, ears, nose
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
sinuses, lymph thyroid, CN
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)
pulm
inspect back (scars, skin lesions) chest symmetry percuss back (percuss diaphragm on inhalation/exhal) pulm auscultation (fremitus, egophany if indicated)
cardiac, axillary lymph nodes
cardiac auscultation (asses w/ pules) carotid pulses (auscultate for bruits if necessary) asses JVP (30 degress) PMI (edema) axillary lymph nodes
GI
- inspect abdomen (scaphoid/protuberant/distended, hernias, scars, masses, asymetry, pulsations)
- Bowel Sounds (Ao, renal bruits)
- Percuss (hepato/spleno megaly)
- Palpate (light then deep, 4 quads)
- Liver edge on expiration?
- Inguinal lymph nodes, femoral pulses
- upright
7. CVA tendernes
Neuro/MSK
- hands (clubbing, cyanosis, nails)
- Median/ulnar/radial
- muscle bulk, tone
- Active ROM (Passive if indicated)
- strength of muscle groups
- sensation (light touch, pain/temp, vibration, proprioception)
- coordination (finger-nose, heel shin, rapid finger tap)
- reflexes (bi, tri, brachiorad, knee, ank, babinski)
- pedal pulse
- feet: edema, toe webspaces, ulcers
MSE
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
gait, spine
normal? (if indicated: tandem, heel-toe)
romberg
pronator drift
spine alignment (scoliosis, kyphosis)