Physical Exam

Question 1

Benign Exam - Constitutional

Answer 1

Well developed, well nourished.
No acute distress.
Alert

Question 2

Benign Exam - Eyes

Answer 2

PERRL
EOMI (touch)
Sclera are anicteric (normal)
Normal conjuctiva

Question 3

Benign Exam - Mouth

Answer 3

Moist mucous membranes

Oropharynx (OP) normal

Question 4

Benign Exam - Neck

Answer 4

Supple, No lymphadenopathy (touch)

Question 5

Benign Exam - Cardiovascular

Answer 5

Well perfused. Regular rate and rhythm (touch),
No murmurs, rubs, or gallops (touch).
Distal pulses intact (touch).

Question 6

Benign Exam - Respiratory

Answer 6

No respiratory distress.
Clear to ausultation bilaterally (CTAB) (touch).
No wheezes, rales, or rhonchi (touch).

Question 7

Benign Exam -Abdominal

Answer 7

Non-distended. Soft (touch).
Non-tender (touch).
No guarding, rebound, or rigidity (touch).

Question 8

Benign Exam - Extremities

Answer 8

No edema, Full ROM (touch)

Question 9

Benign Exam - Skin

Answer 9

Dry, no rashes. Warm (touch)

Question 10

Benign Exam - Neurological (Non-Focal Neuro Exam)

Answer 10

Alert and oriented (A&Ox4) }
Normal speech. }-Non-Focal Neuro Exam
Motor Strength 5/5 and Symmetric
Deep Tendon Reflex (DTR) 2+

Question 11

Benign Exam - Psychiatric

Answer 11

Normal affect.

Question 12

Abnormal Exam - Constitutional

Answer 12

Mild/moderate/severe distress
Cachectic/emaciated/malnourished
Somnolent, obtunded, unresponsive

Question 13

Benign Exam - Head

Answer 13

Atraumatic/normocephalic (AT/NC)

Question 14

Abnormal Exam - Head

Answer 14

Any signs of trauma
Sinus tenderness
Angioedema (facial swelling)

Question 15

Abnormal Exam - Eyes

Answer 15

Anisocoria (unequal pupils)
EOM entrapment (mvmt stopped)
Sclera icterus
Pale conjunctiva or conjunctival injection

Question 16

Abnormal Exam - Detailed Eye and Instruments

Answer 16

Retinal detachment - Ophthalmoscope
Papilledema
Hyphema
Coneal Abrasion or Ulcerations - Wood’s Lamp or Fluorescein uptake

Question 17

Benign Exam - Detailed Eye

Answer 17

Clear anterior chamber
Sharp disk margins
Normal cornea

Question 18

Abnormal Exam - Ears

Answer 18

TM erythema
TM bulging
TM dullness (infected)
TM obscured by cerumen (earwax)

Question 19

Benign Exam - Ears

Answer 19

TMs Normal

Question 20

Abnormal Exam - Nose

Answer 20

Epistaxis
Rhinorrhea
Septal hematoma
Boggy turbinates
Nasal deformity

Question 21

Benign Exam - Nose

Answer 21

Normal Nares. (naris - singular)

Question 22

Abnormal Exam - Mouth

Answer 22

Dry Muccous Membranes (DMM)
Dental Caries
Edentulous (no teeth)
Pharyngeal Erythema
Tonsilar Exudate
Tonsillar Hypertrophy
Peritonsillar Abscess (PTA)

Question 23

Abnormal Exam - Neck and C-Spine

Answer 23

JVD
Carotid bruit
Cervical lymphadenopathy
Vertebral Point vs. Paraspinal Tenderness
Thyromegaly
Nucal Rigidity, meningismus, limited ROM

Question 24

Abnormal Exam - Cardiovascular

Answer 24

Tachycardia/Bradycardia
Irregular Irregular Rhythm
Murmur
Extrasystoles
Pleural Rub
Gallop

Question 25

Abnormal Exam - Perfusion

Answer 25

Delayed capillary refill | 0=absent,1+=Barely palpable,2+=Easily palpable,3+=Full,4+=Bounding/aneurysmal

Question 26

Abnormal Exam - Pulmonary

Answer 26

``` Mild/Moderate/Severe Respiratory Distress Tachypnea Accessory muscle use Diminished breath sounds Wheezes (inspiratory/expiratory) Rales (crackles) Rhonchi ```

Question 27

Abnormal Exam - Abdominal

Answer 27

Mild/mod/severe Tenderness to Palpation (TTP) Voluntary Guarding } Rebound Tenderness }- Peritoneal Signs Rigidity (involuntary guarding) }

Question 28

Abnormal Exam - Abdominal Detailed

Answer 28

Absent/Hypoactive/Hyperactive Bowel Sounds Organomegaly (Hepato or spleno) Distended Murphy's Sign McBurney's point tenderness } Psoa's sign, Obturators, Rovsing's}-Appendicitis Signs

Question 29

Abnormal Exam - Rectal

Answer 29

Heme Positive (Guaiac positive) Abnormal stool color: Black/Melanoic, red, yellow, white, bright red Hemorrhoids (internal, external, thrombosed) Rectal prolapse Decreased rectal tone (spinal chord injury)

Question 30

Abnormal Exam - Female Genital

Answer 30

Sores, Lesions, Rashes Cervical motion tenderness (CMT), uterine tenderness, adenexal tenderness (ovaries Cervical Os is open, blood in vaginal vault, malodorous/thick white discharge

Question 31

Abnormal Exam - Male Genital

Answer 31

``` Testicular tenderness, edema, mass Epidiymal tenderness Urethral discharge Inguinal hernia Indwelling catheter ```

Question 32

Abnormal Exam - Musculoskeletal/extremities

Answer 32

Bony tenderness (fractures),Soft tissue tenderness (contusion), calf tenderness (DVT) Decreased ROM secondary to pain Pulse/sensory/motor deficits/tendon laxity Pitting pedal edema (trace to 4+) Palpable cords/homan's sign (DVT)

Question 33

Abnormal Exam - Musculoskeletal/back

Answer 33

``` CVA Tenderness Paraspinal Tenderness (muscle pain) Vertebral Point Tenderness (spinal cord injury) Midline deformities/step-offs ```

Question 34

Abnormal Exam - Integumentary

Answer 34

Cool/hot to touch Diaphoretic Jaundice, cyanotic, pallor Urticaria, petechiae/purpura

Question 35

Abnormal Exam - Skin Infection

Answer 35

Erythema, increased warmth (calor), induration (cellulitis), fluctuance (abscess), purulent drainage (pus-like), lymphangitis (spreading infection)

Question 36

Abnormal Exam - Skin Trauma

Answer 36

Ecchymosis, contusion, abrasion, laceration, skin tear, avulsion

Question 37

Abnormal Exam - Neurological

Answer 37

Somnolent Disoriented to person,place,time,situation Aphasia (expressive/receptive), dysarthria (slurring)

Question 38

Abnormal Neurological Level of Consciousness

Answer 38

Somnolent, obtunded, responsive to voice, responsive to painful stimuli, unresponsive, does not follow commands

Question 39

Abnormal Neurological Motor and Sensation

Answer 39

Extremity weakness: 0=flacid/limp,1=slight contraction, no mvmt,2=unable to overcome gravity,3=unable to overcome resistance,4=very mildly weak Pronator drift Hypoesthesia (decreased sensation) Numbness (absent sensation)

Question 40

Abnormal Neurological Reflexes

Answer 40

Deep tendon reflexes (DTRs) 0=absent,1+=hypoactive,2+=normal,3+=increased,4+=unsustained clonus Babinski: Upgoing toes (normal=downgoing toes)

Question 41

Abnormal Neurological Cranial Nerve Exam

Answer 41

``` Visual field loss Unequal pupils (anisocoria) EOM palsy, Rightward/leftward gaze Tongue deviation Decreased gag reflex Facial droop, ptosis Hyposthesia, numbness Unequal shoulder shrug ```

Question 42

Abnormal Neurological Cerebellar Exam "Coordination"

Answer 42

``` Ataxia (unsteady), antalgic Nystagmus (eyes vibrating) Dysmetria (finger-to-nose, heel-to-shin) Positive Romberg (stand w/ eyes closed) Dysdiadochokinesia (rapid alternating movements) Tremor ```

Question 43

Abnormal Exam - Psychiatric

Answer 43

Flat/odd affect, tearful, anxious, depressed, hypomanic, poor eye contact Suicidal/homicidal, hallucinations, flight of ideas, paranoid Denies illness/Sx, non-compliant with treatment Tangential speech, pressured speech

Question 44

Abnormal Exam - Trauma Head,eyes,ears,nose,oropharynx,neck, respiratory,abd,rectal,musculoskeletal,back,skin,neurological

Answer 44

Battle's sign, racoon eyes, periorbital ecchymosis Unequal pupils, subconjuctival hemorrhage, hyphema Hemotympanum Nasal bone deformity, epistasis, septal hematoma Malocclusion, dental injury Vertebral point tenderness, deformities, step-offs Absent breath sounds, splinting, crepitus Tenderness, distended, ecchymoses Rectal laxity Pelvis unstable, bony tenderness, deformity Vertebral point tenderness, deformities, step-offs Ecchymosis, laceration, abrasion,skin tear, avulsion Glasgow Coma Scale

Question 45

Code Exam | General, head, eyes, oropharynx, cardiovascular, respiratory, abd, musculoskeletal, skin, neurological

Answer 45

``` Unresponsive Normocephalic, Atraumatic Fixed and Dilated Airway patent, ETT in place Absent heart sounds, no palpable pulses No spontaneous respirations, equal with controlled ventilation Distended No deformities Pallor,cyanotic,mottled Unresponsive ```

Question 46

Abnormal Pediatric Exam

Answer 46

Lethargic (only if Dr. states) Sunken fontanel, bulging fontanel (normal=flat) Wheezes, stridor, retractions, nasal flaring Crying with normal abd palpation