Physical Exam Flashcards

1
Q

What is the most important diagnostic tool?

A

Physical exam

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2
Q

General approach

A

Systematic/repeatable

  • nose to tail (or opposite)
  • approach patient and system from macro to micro
  • eyes/hands first, then instruments
  • perform complete exam, then focus on problems
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3
Q

Body

A
  • attitude
  • body condition
  • gait
  • smell/odor
  • haircoat
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4
Q

Head

A

Check for muscle symmetry

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5
Q

Eyes

A
  • symmetry/position
  • 3rd eyelid
  • discharge
  • blepharospasm
  • full blink
  • cornea, lens, pupil size
  • PLR
  • fundic exam
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6
Q

Ears

A
  • position
  • odor
  • moisture
  • characterize debris
  • vertical canal
  • horizontal canal
  • tympanic membrane
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7
Q

Nose

A
  • symmetry
  • airflow
  • nare size
  • characterize discharge
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8
Q

When using a stethoscope, you are collecting _______

A

Heart rate

  • check pulse with your fingers
  • may not be the same number
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9
Q

Dog dental formula

A
I = 3/3
C = 1/1
PM = 4/4
M = 2/3
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10
Q

Cat dental formula

A
I = 3/3
C = 1/1
PM = 3/2
M = 1/1
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11
Q

Teeth

A
  • MM/CRT
  • gingiva
  • halitosis
  • masses
  • fistulas
  • cleft palate
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12
Q

Neck

A
  • mandibular/prescapular LN
  • mandibular salivary gland
  • thyroid slip/enlargement
  • tracheal palpation
  • neck range of motion
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13
Q

Thorax

A
  • chest excursions

- axillary lymph nodes

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14
Q

Respiratory auscultation

A
  • resting dog rate: 10-30 breaths/min
  • resting cat rate: 20-40 breaths/min
  • listen to all fields for crackles, wheezes ,referred, dull/absence
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15
Q

Cardiac auscultation

A
  • resting dog rate: 60-160 beats/min
  • resting cat rate: 120-220 beats/min
  • left/right, parasternal in cats
  • base and apex
  • murmur, arrhythmia, gallop
  • palpate pulse for quality and synchrony
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16
Q

Maximal point of intensity

A
  • pulmonic: 3rd intercostal space (left)
  • aortic: 4th intercostal space (left)
  • mitral: 5th intercostal space (left)
  • tricuspid: 4th intercostal space (right)
17
Q

Murmur grades

A

1: skilled listener, quiet room
2: quiet focal, takes effort to hear
3: moderate intensity, heard in more than 1 location
4: loud, heard over cardiac silhouette w/ no palpable thrill
5: loud, w/ palpable thrill
6: very loud w/ thrill and audible with stethoscope off chest

18
Q

Abdomen

A
  • tucked, lordosis/kyphosis, pot-bellied
  • skin
  • masses
  • abdominal effusion
  • back pain –> thoracolumbar or lumbosacral
19
Q

Abdominal palpation

A
  • mammary glands
  • liver margins/spleen
  • intestinal loops
  • kidneys –> can feel both in cats
  • urinary bladder
  • inguinal LN
  • foreign body/masses
20
Q

Inguinal region

A
  • prepuce
  • penis
  • scrotum/testicles
  • vulva
21
Q

Extremities

A
  • range of motion
  • bony proliferation/masses
  • crepitus of joints
  • joint effusion
  • pain
  • look between toes/pads
  • popliteal LN
22
Q

Tail and perianal region

A
  • tailhead for ectoparasites
  • tail –> pain, limber, ROM, carriage
  • anus –> temp, anal tone, parasites, irritation, diarrhea
  • hernias
  • anal glad abscess/saculitis
  • fecal staining
  • urine staining
23
Q

Rectum

A
  • anal glands: express, mass, pain
  • prostate: size, symmetry, pain
  • urethra: size, stones, pain
  • pelvis: symmetry, fractures, pain
  • sacrum: symmetry, back pain
24
Q

Other exam types

A
  • orthopedic
  • neurologic
  • ocular
  • oral
  • reproductive
25
Q

Documentation is important for _______

A
  • observing trends

- remembering things

26
Q

What are 4 strategies for diagnostic problem-solving?

A
  • hypothesis testing (problem based)
  • pattern recognition (categorization)
  • specific instances
  • general prototypes
27
Q

For an expert, choice of strategy is influenced by _________

A

Perceived difficulty of the case and knowledge base

28
Q

More errors occur when _______

A

Simple strategies are employed due to cognitive limitations and biases

29
Q

Problem-based approach

A
  • master problem list
  • differential list
  • diagnosis