Physical exam

Question 1

why must the brachial artery be at the level of the heart while taking BP?

Answer 1

If brachial artery is below heart, blood pressure appears to be falsely high.

Question 2

what does high blood pressure mean for your patient?

Answer 2

It can effect target organs - eyes, heart, brain, kidneys.
hypertensive retinopathy
left ventricular hypertrophy
neurologic deficits suggestion stroke
poor kidney function

Question 3

what does low blood pressure mean?

Answer 3

dizziness, lightheaded, weakness, fatigue

Question 4

what can cause a patient to hyperventilate?

Answer 4

exercise, anxiety, metabolic acidosis

Question 5

causes of fevers?

Answer 5

infection
trauma such as surgery or crush injuries
malignancy
blood disorders such as acute hemolytic anemia, drug reactions, immune disorders

Question 6

what can you learn about a patient by looking at their posture or gait?

Answer 6

kyphosis, scoliosis, pelvic tilts

Question 7

Limited ROM indicates?

Answer 7

stiffness from arthritis, pain from trauma, muscle spasm

Question 8

JVP - what does elevated JVP mean?

Answer 8

JVP reflects pressure in right atrium or central venous pressure.
Elevated JCP means hypervolemic in right atrium.
Right sided congestive heart failure
superior vena cava obstruction

Question 9

What does absent JVP indicate in living patient

Answer 9

Low right atrial pressure

Question 10

What does a bruit mean?

Answer 10

a mumur-like sound of vascular origin

due to an obstruction in the blood vessel

Question 11

What does location of PMI tell you?

Answer 11

High left diaphrgam
Cardiac enlargement in congestive heart failure, cardiomyopathy, ischemic heart disease
displacement in thorax, mediastinal shift

Question 12

what does amplitude and duration of PMI tell you?

Answer 12

Amplitude: hyperthryoidism, severe anemia, pressure overladed in left ventricle, volume overladed in left ventricle
Duration: can detect hypertrophy of left ventricle

Question 13

diminished pulse one side/weak or absent pulses

Answer 13

may indicate an atrial occulusion from atherosclerosis or embolism

Question 14

How do you rate edema?

Answer 14

a four point scale from slight to very marked (4)

Question 15

delayed cap refill

Answer 15

dehydrated

poor peripheral profusion

Question 16

What is a lift or heave?

Answer 16

forceful cardiac contractions that cause vigorous mvmt of sternum and ribs

Question 17

What is a thrill?

Answer 17

vibrations of cardiac murmurs.

Turbulent blood flow

Question 18

asymmetric or limited lung expasion?

Answer 18

chronic fibrosis of lung of pleura
pleura effusion
lobar pneumonia
unilateral bronchial obstruction

Question 19

Decreased tactile fremetis

Answer 19

transmission of vibrations from the larynx is impeded.
obstructed bronchus
COPD
separation of pleura surface by fluid (pleura effusion)
fibrosis (pleural thickening)
penumothroact
tumor

Question 20

Dullness in lung percussion indicates

Answer 20

fluid or soft tissue replaces air in lung or pleural sapce

lobal pneuomia, blood, pus, tumor, serous fluid

Question 21

what do normal breath sounds sound like?

Answer 21

vesicular (short of low pitched)
bronchovesicualr : equal in length
absence of adventitious sounds

Question 22

Egophany

Answer 22

lobar consolidation from pneomonia

Question 23

what does inspecting the abdomen tell you about a patients health

Answer 23

Dilated veins: hepatic cirrrhosis or IVC obstruction
hernias
asymmetry from an enlarged rogan or mass
Increased perstatlic waves from intestinal obstruction
increased pulsation of an aortic anuerysm

Question 24

what is decreased bowel sounds?

Answer 24

peritonitis

adynamic ileus

Question 25

what does increased bowel sounds indicate?

Answer 25

diarrhea

early intestinal obstruction

Question 26

High pitched abdominal bowel sounds?

Answer 26

intestinal fluid and air under tension in dilated bowel

Question 27

Abdominal bruit

Answer 27

could be a hepatic bruit - carcinoma of liver or alcoholic hepatitis
partial occlusion of aorta or large arteries

Question 28

what is normal liver span

Answer 28

6-12 cm

Question 29

what does rebound tenderness indicate?

Answer 29

peritoneal inflammation

Question 30

positive murphy’s sight

Answer 30

acute chyolcytsitis

Question 31

what does abnormal hair tell you about a pateint?

Answer 31

malnutrition

hypothyroidism: brittle hair

Question 32

What might tenderness of the face indicate?

Answer 32

sinusitis

TMJ arthritis

Question 33

What might an enlarged or asymmetric thyroid mean?

Answer 33

goiter - idoine deficiency
hypo or hyperthyroidiism
thyroditis

Question 34

Otitis media vs otitis external

Answer 34

media: infection of middle ear
externa: infection of external ear canal

Question 35

What can you learn about looking in someone’s mouth?

Answer 35

heart health, diabetes

Question 36

Where do oral cancers usually occur?

Answer 36

bottom/ side of tongue

Question 37

what is tenderness of snuff box indicative of?

Answer 37

scaphoid fractures

Question 38

what is hyperresonance in lung percusson indicative of?

Answer 38

COPD

penumothorax

Question 39

increased tactile fremetis

Answer 39

penmonia

Question 40

Fine hair vs course hair

Answer 40

fine: hyperthyroidism
course: hypothyroidism

Question 41

Scaliness of scalp

Answer 41

seborrheic dermatis, psoriasis, celiac

Question 42

female hair patterns

Answer 42

hirsutism

Question 43

Rinne’s test ration

Answer 43

Air conduction 2: Bone conduction 1

Question 44

what is the name for ear wax?

Answer 44

Cerumen

Question 45

cavities

Answer 45

caries

Question 46

white dots on tonsils

Answer 46

exudates

Question 47

how are tonsils measured?

Answer 47

1+ barely visible

4+ touching