PHYSICAL EXAM

Question 1

What woul you look for in the physical exam of Head and Neck?

Answer 1

palpation of facial bones, scalp

Question 2

What woul you look for in the physical exam of Chest

Answer 2

inspect for midline trachea and flail segment: ≥2 rib fractures in ≥2 places; if present look for associated
hemothorax, pneumothorax, and contusions
• auscultate lung fields
• palpate for subcutaneous emphysema

Question 3

Abdomen

Answer 3

assess for peritonitis, abdominal distention, and evidence of intra-abdominal bleeding
• DRE for GI bleed, high riding prostate, and anal tone

Question 4

Musculoskeletal

Answer 4

examine all extremities for swelling, deformity, contusions, tenderness, ROM
• check for pulses (using Doppler probe) and sensation in all injured limbs
• log roll and palpate thoracic and lumbar spines
• palpate iliac crests and pubic symphysis and assess pelvic stability (lateral, AP, vertical)

Question 5

Neurological

Answer 5

• GCS
• full cranial nerve exam
• rate and rhythm of breathing
• assess spinal cord integrity

Question 6

alterations of rate and rhythm of breathing are signs of

Answer 6

structural or metabolic abnormalities with

progressive deterioration in breathing indicating a failing CNS

Question 7

Neurological in conscious and unconscious patient

Answer 7

• conscious patient: assess distal sensation and motor function
• unconscious patient: response to painful or noxious stimulus applied to extremities

Question 8

What does the INITIAL IMAGING include? (mention the 3 kinds of studies that are done)

Answer 8

-non-contrast CT head/face/C-spine (rule out fractures and bleeds)
• chest x-ray
• FAST (see Figure 2) or CT abdomen/pelvis (if stable)
• pelvis x-ray

Question 9

the 7 Signs of Increased ICP

Answer 9

• Deteriorating LOC (hallmark)
• Deteriorating respiratory pattern
• Cushing reflex (high BP, low heart rate,
irregular respirations)
• Lateralizing CNS signs (e.g. cranial nerve
palsies, hemiparesis)
• Seizures
• Papilledema (occurs late)
• N/V and headache