Physical Exam

Question 1

General

Answer 1

introduce self to patient, wash hands, general assessment, note height, weight, temp, take pulse, resp rate, BP, inspect skin, palpate skin (turgor,texture,temp)

Question 2

Head

Answer 2

inspect facial features, inspect hair/scalp/skull, test facial muscle function (CNVII), test light touch on face (CNV, sensory), palpate facial bones and sinuses, palpate TMJ, ROM of TMJ, palpate masseter muscle (CNV, motor), palpate hair, scalp, skull

Question 3

Eyes

Answer 3

inspect external eyes, test visual acuity (CNII), assess depth of anterior chamber, check corneal light reflection, test direct pupillary light reflex, test consensual pupillary light reflex, test extraocular movements, test accomadation, do opthalmoscopic exam(red reflex/fundus)

Question 4

Ear

Answer 4

check hearing (CN VIII), inspect external ear, palpate external ear, otoscopic exam,

Question 5

Nose

Answer 5

inspect external nose, test nasal patency bilaterally, palpate external nose, nasal speculum exam,

Question 6

Mouth/Throat

Answer 6

inspect lips, gums, mucosa, teeth, tonsils, ask pt to say Ah (CN IX/X), test tongue protrusion/side to side, palpate oral cavity (gloved/bimanual)

Question 7

Neck

Answer 7

inspect (thyroid, trachea, JVD), ask pt to perform ROM, lateral neck rotation against resistance, shoulder shrug against resistance, palpate cervical lymph nodes, palpate carotids B/L, auscultate carotids B/L, palpate tracheal position (from front), palpate thyroid gland (from back)

Question 8

Upper Extremities

Answer 8

inspect UE, palpate shoulder, elbow, wrist, hand, and finger landmarks, check shoulder ROM, shoulder abduction and adduction against resistance, check elbow ROM, elbow flexion/extension against resistance, check wrist ROM, wrist flexion/extension against resistance, test grip strength, extend/spread fingers

Question 9

Pulmonary

Answer 9

body habitus/skin, note breathing pattern, chest symmetry, excursion/expansion, palpate posterior and lateral thorax, percuss posterior/lateral lung fields, fist percussion of spine and CVAs, auscultate posterior and lateral lungs, inspect/palpate/percuss/auscultate anterior chest

Question 10

Cardiac

Answer 10

Pt seated: inspect chest wall for PMI, auscultate heart with diaphragm then the bell
Pt supine: inspect chest wall for PMI, palpate precordium (PMI/lifts), auscultate with diaphragm/bell, palpate axillary lymph nodes

Question 11

Abdominal

Answer 11

inspect, auscultate four quadrants, auscultate aorta for bruits, percuss, percuss liver size in RUQ, palpate four quadrants lightly/then deeply, palpate liver in RUQ, palpate spleen in LUQ, palpate for kidneys, palpate abdominal aorta for size, palpate ingunail nodes, femoral pulses, and for femoral hernias, auscultate femoral arteries

Question 12

Lower extremities

Answer 12

Pt supine: inspect hips/legs, palpate popliteal fossa(pulse, aneurysm, and cyst), palpate calf and achilles tendon, palpate ankle/foot for edema, palpate posterior tibial pulse, palpate dorsalis pedis pulse, check hip ROM
Pt seated: hip flexion against resistance, knee flexion/extension against resistance, check ankle ROM, ankle dorsiflexion/plantarflexion against resistance, check toe flexion and extension

Question 13

Back

Answer 13

Pt standing: inspect spinal curvature, inspect spine ROM

Question 14

Neuro

Answer 14

Pt Standing: romberg test, pronator drift, observe pts gait, obesrve heel-to-toe walking
Pt seated: note behavior, orientation and level of consciousness, check recent memory (give 3 words to memorize), check remote memory (3 events), check calculations (serial 7’s), finger to nose B/L, heel to shin B/L, light touch and pain sensory testing, biceps/triceps/brachioradialis/knee/achilles DTRs, plantar reflex B/L (babinskis)