Physical Examination Flashcards
what is the first aspect of physical examination?
general inspection
what is general inspection?
look from a distance
what 8 things are you examining in a general inspection?
- general appearance
- body condition
- level of consciousness
- posture and gait
- hydration status
- eating
- defecation
- urination
describe how to generally inspect general appearance
look at the animal from a distance, observe movements and symmetry
how is body condition used in a general inspection?
use the standard for each species
list and describe the 5 levels of consciousness as observed in a general inspection
- BAR: bright, alert, responsive, normal behavior
- depressed: decreased response to stimuli
- uncontrolled hyperexcitability: often in seizures
- stupor/shock: limited response to stimuli
- coma: no response to stimuli, patient unconscious
what is paresis?
some movement, but lack of strength and decreased muscle tone
what is ataxia?
keep muscle tone, but lack of proprioception
when is ataxia often observed?
inner ear infections
what is paralysis?
complete lack of movement
what is one of the first signs of dehydration?
reduced skin elasticity
when dehydration is >5%, what will be observed in the patient by the owner?
a few episodes of vomiting and or diarrhea, but no physical abnormalities
when dehydration is between 6-8%, what will be observed in the patient?
moderate-mild degree of skin turgor or fry mucous membranes, sunken eyes, increased episodes of vomiting and diarrhea
when dehydration is between 9-11%, what is observed in the patient?
marked degree of skin turgor, dry mucous membranes, weak, rapid pulse, slow CRT, moderate-marked mentaldepression, excessive vomiting and diarrhea
when dehyrdation is 12-15%, what is observed in the patient?
hypovolemic shock, death
is weight the best comparison for body condition? why or why not?
not the best comparison point because breed variation
in the case of swine body condition, what is the main point of observation?
all in the booty
what does degree of lameness determine?
how fast you need to procede with treatment
give an example of degree of lameness determining speed of treatment
large animals put more weight on front legs, so treat front lameness more urgently
what do problems with prehension indicate?
mouth/teeth problems
when examining eating in general inspection, what 3 things are you looking for?
problems in
- prehension
- mastication
- swallowing
what special part of eating are you looking at in general examination of ruminants?
eructation
what 3 things are you looking at in general inspection of feces?
- consistency
- smell
- color
what happens with the act of defecation in constipation, rectal paralysis, or stenosis?
the act may become difficult and may be accompanied by straining or tenesmus
what is stenosis?
narrowing of the spaces within the spine
what is tenesmus
the feeling that you need to defecate even though your bowels are empty
what does normal horse feces look like?
individual golf balls, will squish
what does diarrhea indicate in a horse?
can be too much sand in gut, stress, diet change, parasites, or disease
what does constipated horse feces look like? what does it indicate?
small dry balls; indicates an impaction because gut has sent all excess moisture to impaction to try to clear
are worms common in adult horse feces? what can they determine?
not common; easy way to determine worm and wormer type though
what is polyuria?
increased amount of urine
what is oliguria or anuria?
decreased or lack of urination
what is pollakuria?
increase of urination bouts, dribbling
what is dysuria?
painful/difficult urination
what is stranguria?
slow and painful urination
if there was a hemorrhage in the abomasum, what will the feces look like? what is this called?
black and tarry, melena
what will the feces look like after a hemorrhage in the small intestine?
uniformly dark red
if there is a hemorrhage in the large intestines (cecum or colon) what will the feces look like? what is this disease called?
blood appears evenly distributed throughout the feces; dysentery
if there is a hemorrhage in the rectum, what will the feces look like? what is this condition called?
blood as streaks or chunks or frank (obvious) blood, unevenly distributed; hematochezia
describe the 5 scores of cattle manure
score 1: cream-soup consistency score 2: cake batter score 3: thick pancake batter score 4: peanut butter score 5: firm and stacks over 2 inches in height
what does a score 1 of cattle manure (cream soup) indicate
a sick animal or a highly digestible ration and low fiber
what does a score 2 of cattle manure (cake batter) indicate?
excess protein, carbohydrates, and low fiber
what does a score 3 of cattle manure (thick pancake batter) indicate?
ideal!
what does a score 4 of cattle manure (peanut butter) indicate?
lack of degradable rumen protein, excess low quality fiber
what does a score 5 of cattle manure (firm and stacking) indicate?
poor-quality forage diet
from what distance does a regional inspection occur?
a distance
what do you look for in a regional inspection?
visual changes or defects (mass, bleeding, injuries, swelling, lack or hair) in head, neck, thorax, abdomen, external genitalia, mammary glands, and limbs
what do you look for in a regional exam of the thorax?
- respiratory rate: breaths/min
- respiratory rhythm
- respiratory depth
- type of respiration
- respiratory noises and stridors
what is an increased respiratory rate called?
polypnea
what is a decreased respiratory rate called?
oligopnea
what is complete cessation of respiration called?
apnea
what 3 things are looked for in respiratory rhythm?
- inspiration
- expiration
- pause
what are you looking at when observing respiratory depth in a regional exam?
amplitude or depth of respiratory movements
what are the types of respiration?
thoracic or abdominal
list 6 types of respiratory noises and stridors
- coughing
- sneezing
- wheezing
- snoring
- roaring
- grunting
when is respiratory rhythm very important to track?
in stupor
what is palpation?
use of fingers to describe size, consistency, temperature, and sensitivity of a lesion or organ
describe doughy palpation
when the structure pits on pressure, as in edema
describe firm palpation
when the structure has the consistency of a normal liver
what should all compact organs feel like on palpation?
firm
describe hard palpation
when the consistency is bonelike
describe fluctuating palpation
soft, elastic, and undulates on pressure but does not retain the imprint of the fingers
describe tense palpation
when the structure feels viscus and distended with gas or fluid under some considerable pressure
describe emphysematous palpation
swollen structure that crackles under pressure because of the presence of gas in the tissue
what is percussion?
when the body surface is struck to set deep parts in vibration and cause them to emit audible sounds
describe the three noises commonly heard on percussion
- resonant: the sound emitted by organs containing air (like a normal lung)
- tympanic: a drum-like note emitted by an organ containing gas under pressure such as a tympanitic rumen or cecum
- dull: the sound emitted by solid irgans such as heart and liver
what is auscultation?
direct listening to the sounds produced by organ movement performed by placing the ear or stethoscope on the body surface over the organ
what is succession?
strike area under examination multiple times
what is ballottement?
strike area under examination with fist once
what are the three vital signs inspected in a regional inspection?
- temperature
- pulse
- hydration
list 4 variances of temperature?
- hyperthermia
- hypothermia
- fever
- pyrexia
what is hyperthermia?
high body temperature after work
what is fever?
high body temperature caused by disease
what are the 2 aspects of pulse? and the variances?
rate: bradycardia, tachycardia
rhythm: regular or irregular
what examination technique is mainly used when examining the heart in a regional exam?
auscultation
what heart rhythm/sounds are we hoping to hear?
LUBB-DUPP-pause
what is LUBB?
the first heart sound, systolic, caused by tricuspid and mitral valve closure
what is DUPP?
the second heart sound, diastolic, caused by aortic and pulmonary valve closure
when examining the lungs in a regional exam, what 3 methods are used?
auscultation, percussion, palpation
what are 3 abnormal lung sounds?
- crackles
- wheezes
- pleuritic friction rubs
after mild exercise, you hear increased lung sounds and observe closing of the nostrils. does this concern you?
no this is normal
what 2 exam methods help determine lung density?
auscultation combined with palpation
what should a normal lung sound/feel like?
resonant
what will an edematous or consolidated lung sound like?
dull
what 6 things does clinical examination of the abdomen include?
- visual inspection of abdominal contour for evidence of distension or gauntness
- auscultation of gastrointestinal sounds
- palpation and percussion through the abdominal wall
- rectal palpation
- passage of the nasogastric tube
- paracentesis of the abdomen
what is paracentesis?
suction/sample collection
what organs are located on the left sideof the cow?
rumen
where is the cow abomasum?
right side
where are cow intestines?
left side??
what does bloat in a cow mean?
gas is trapped
what does ascites/intestinal obstruction in a cow mean?
big guts
what does hydrops/severe ascites in a cow mean?
big ole calf
what does cecovolvulus/abomasal volvulus in a cow mean?
swollen cecum
what does OTF/abomasal impaction in a cow mean?
huge rumen
what 5 things are inspected in physical examination of head and neck?
- eyes
- nostrils
- mouth
- submaxillary regions
- neck
list the 5 other body regions/organ systems that are inspected in a physical examination
- urinary system
- reproductive system
- musculoskeletal system and feet
- nervous system
- skin (including ears, horns, hooves, feathers
