Physical Examination Flashcards
A complete health assessment generally conducted from head to toe.
PHYSICAL EXAMINATION
PHYSICAL EXAMINATION presents __________ through the usage of appropriate equipment where the source of data is still the patient
Objective Data
● Performed in organized manner
● Those that can alter sounds should be performed last
BASIC TECHNIQUES
Must be done in a sequential manner in all parts of the body except the abdomen
PPA / IPalPerA
BASIC TECHNIQUES
1. __________
2. __________
3. __________
4. __________
(1) Inspection
(2) Palpation
(3) Percussion
(4) Auscultation
Techniques used for the abdomen specifically
IAPerPal
IAPerPal
1. __________
2. __________
3. __________
4. __________
(1) Inspection
(2) Auscultation
(3) Percussion
(4) Palpation
For evaluating the skin, head, and neck; eyes, ears, nose, mouth, and throat; back; posterior thorax and lungs; anterior thorax and lungs; breast; axillae; heart; peripheral vasculature; musculoskeletal; neurological.
Sitting Position
For evaluating the head, neck, chest, breasts, axillae, abdomen, heart, lungs and all extremities.
Supine Position / Horizontal Recumbent
For evaluating the head, neck, chest, axillae, lungs, heart, extremities, breasts and peripheral pulses; female genitalia.
Dorsal Recumbent Position
For rectal and vaginal area assessment
Sim’s Position
For assessment of posture, balance and gait; and male genitalia
Standing Position
For hip, joint and back assessment
Prone Position
For examining rectum and prostate
Knee-Chest Position
For examining female genitalia, reproductive tracts, and the rectum
★ Common position when giving birth
Lithotomy Position
For evaluating the skin, head and neck; eyes, ears, nose, mouth and throat; thorax and lungs; heart and peripheral vascular; musculoskeletal; neurological.
★ Patient is sat up in a 60-90 degree position; Legs may be bent or straight.
★ Suggested for feeding and feeding tube insertion, for taking upright X-rays at the bedside, and for dependent draining following abdominal or pulmonary surgery.
High Fowler’s Position
For evaluating the skin, head and neck; eyes, ears, nose, mouth and throat; thorax and lungs; heart and peripheral vascular; musculoskeletal; neurological.
★ Head and torso are elevated at 30-45 degrees.
★ Utilized on patients who require a certain level of elevation for comfort, to aid in digestion or
drainage, or both.
Semi-Fowler’s Position
For evaluating skin, thorax and lungs
Side Lying Position / Lateral
● The skill of observing the patient in a deliberate systematic manner.
● Begins the moment the nurse meets the patient and continues until the end of the patient-nurse interaction.
- INSPECTION
o Survey of the patient’s appearance and a comparison of the right and left sides of the patient’s body.
o Inspects for colors, size, shape, contour, symmetry, movement, or drainage.
- INSPECTION
● The act of touching a patient in a therapeutic manner to elicit specific information
● Assess patient through the sense of touch
● There are three types: direct or immediate, indirect, and blunt.
- PALPATION
- Superficial, delicate, and gentle palpation with 1 cm depth
- Reveal information on skin texture and moisture; overt, large, or superficial masses; fluid, muscle guarding and superficial tenderness; for pulses and temperature
Light
- Depress the skin surface 1 to 2 cm and use a circular motion to feel for easily palpable organs and masses.
Moderate
- Depress the skin surface 1 to 2 cm and use a circular motion to feel for easily palpable organs and masses.
Moderate
- Most often used for abdominal, male, and female reproductive assessments
- Use with great caution
- Variations in the technique include single-handed and bimanual palpation.
Deep
A type of deep palpation where the use of two hands placing one on each side of the body part is being palpated
Bimanual
The vibratory tremors felt through the chest; can be vocal, when the patient speaks, or tussive, during coughing.
Fremitus
● Technique of striking one object against another to cause vibrations that produce sound.
● These sounds or vibrations enable the examiner to assess underlying structures
PERCUSSION
● How to perform percussion:
- The Stationary Hand / (1) __________
- The Striking Hand / (2) __________
(1) Pleximeter
(2) Plexor
Tapping the body with the fingertips of the dominant hand
Direct or Immediate
- Most commonly used
- Requires the use of plexor and pleximeter
Indirect
- Place the palm of nondominant hand flat against the surface and strike it with the closed fist of the dominant hand
Blunt
CHARACTERISTICS OF SOUNDS:
• (1) __________: Softness or loudness
• (2) __________: Number of vibrations per second
• (3) __________: Length of time
• (4) __________: Recognizable overtones
(1) Intensity of amplitude
(2) Pitch or frequency
(3) Duration
(4) Quality
- Loud, high-pitched, drum-like tone
- Sound of stomach
Tympany
- Loud, low-pitched, hollow tone
- Sound of normal lung
Resonance
- Abnormally loud, low tone of longer duration than resonance
- Detection of Emphysema (lung disease; damage to alveoli)
Hyperresonance
- High-pitched tone, soft and short
Dullness
- High-pitched tone, very soft and shorter than dullness
Flatness
● Skill of listening to sounds produced by the body.
● Requires a quiet environment for many sounds are extremely soft
AUSCULTATION
TYPES OF AUSCULTATION:
1. __________
2. __________
(1) Direct or Immediate
(2) Indirect or Mediate
