Physical Exam Flashcards
Greeting (4)
1) Wash Hands
2) Introduce Self & Explain Exam
3) Tell to sit on exam table without shirt
4) Offer Gown
Vital Signs (6)
1) Height
2) Weight
3) Pulse
- Bilateral symmetry (2+ -> 0)
- One side Rate & Rhythm
4) Blood Pressure
5) Respiratory Rate
6) Temperature
Head (5)
1) Skin: (general)
- Color, warmth, moisture
2) Verbalize looking at skin on body as well for:
- ABCD
- Abnormal Texture, Pigmentation, Turgor
3) Hair & Scalp:
Alopecia/ Hirsuitism
4) Funny Faces: Forehead Eyes - test resistance Big smile Puff out cheeks
5) Facial sensation - sharp & soft
Eyes (5)
1) Eye chart test (1 @ a time, 14” from eye)
2) Field of vision – peripherals/wiggle test
3) Pupils
- Light
- Movement (6 fields of vision and hold at far sides)
- Accomodation - PERRLA
4) Inspect eyes grossly - alignment, position, eyebrows, lids, conjunctivae
5) Funduscopic exam = Opthalmascope
Ears (3)
1) Whisper test
2) External Ear
- Inspect
Palpate – auricle/taragus/mastoid process looking for signs of tenderness/infection
3) Internal Ear (canal) - Otoscopic Exam
- Appearance of canals & drums
- Wax build up
- Cone of light/tympanic membrane
Nose (3)
1) Examine External Nose
2) Internal Nose
- Appearance of mucosa/mucosal membranes
- Septum, inferior & middle turbinates
3) Palpate Frontal & maxillary sinuses
Mouth & Pharynx (5)
1) Gross morphology
- Lips
- Teeth
- Gums
- Buccal Mucosa
- Parotid Gland
- Oral Vestibule (dip packing)
2) Posterior Pharynx
- Inspect
- Tongue Depressor - Say “AH” & soft palatte rise
- Gag Reflex
- Tonsils - present/not
3) Tongue & Subglossal area
- Inspect & look at salivary gland
4) Open Jaw - looking for jaw deviation
5) Palpate Masseter & temporalis muscles with clenched jaw
Neck (3)
1) Neck MSK
- Neck ROM
- Trapezius Strength = Shoulder Shrug
- SCM Strength
2) Lymph Nodes (9)
Occipital, posterior cervical, Postaurical, Preauricular, Tonsillar, Submandibular, Submental, Anterior Cervical, Supraclavicular
3) Thyroid
- Tracheal Deviaiton/JVD
- Palpate
- Have drink water
Lungs, Chest & Back (7)
Posterior:
1) Inspect Back
2) Percuss Lungs
3) Auscultate Lungs
4) Check CVAT
Anterior
5) Inspect Chest
6) Percuss Lungs
7) Auscultate Lungs
Cardiac (3)
1) Upright
- Auscultate Heart - 4 valves
2) 30 degrees
- JVD
- Auscultate carotid pulses
- Palpate carotid pulses
3) Supine
- Palpate apical impulse - ntoing size, location, force & duration
- Auscultate Heart - 4 valves
- Pt rolls onto L side - auscultate apex
Abdomen & Groin (5)
Abdomen - on Patient’s RIGHT side
1) Auscultate
- ABD sounds
- ABD Aorta
- Renal Arteries
2) Percuss ABD
- Liver
- Suprapublic area
3) Palpate
- Gently
- Deeply
- Liver
- Spleen
- Aorta
Groin
4) Femoral Pulses
5) Inguinal Lymph Nodes
Lower Body
1) Inguinal Lymph Nodes
2) ROM
- Hips
- Knees
- Ankles
3) Muscle Strength:
- Heel to shin test
- Hips - flexion, abduction, adduction, ext/int rotation
- Quads - Flexion
- Hamstrings - Extension
- Ankle - Dorsiflexion
- Ankle Plantar flexion
4) Feet
- Cap Refill
- Pedal Edema When at feet doing PMS
- Pulses - Popliteal, Dorsalis pedis, posterior tibial (medial)
5) Reflexes
- Patellar
- Achilles
- Babinski?
6) Sensation
- Pain
- Light touch
- Vibration
Upper Body (6)
1) Axillary Lymph Nodes
2) ROM
- Shoulders
- Elbows
- Wrists
3) Muscle Strength:
- Shoulder - Flexion, Extension, Abduction, Adduction
- Biceps - Flexion
- Triceps - Extension
- Wrist Flexion
- Wrist Extension
4) Hands
- Fingers/Hand grip strength
- Nails -clubbing - make diamond
- Cap Refill
5) Reflexes
- Biceps
- Brachioradialis
- Triceps
6) Sensation
- Pain
- Light touch
- Vibration
Neuro/Mental
1) Orientation - name, location, date
2) spell WORLD backwards
3) Memory (3 words) - cheese, dog, dance
4) “No ifs ands or buts”
5) “What is similar about an apple and an orange?”
6) “What would you do if you found an addressed, stamped envelop on the sidewalk?”
7) Draw a clock.
Standing/Mobile tests
1) Still Sitting
- Rapid alternating movements - hands on lap
- Finger to nose - full arm extension
2) Stand Up
- Stand - Romberg’s balance test
- Stand, Arms out/palms up & eyes closed
3) Spine
- Examine Spine Upright
- Palpate vertebral processes from cervical to sacral
- Examine Spine bent over - Scoliosis/Kiphosis/Lordosis
- Examine for pelvic tilt
4) Walking - 4 components
- Walk across room
- Walk heel to toe
- Walk on toes
- Walk on heels
