Practical exam 1: GU, ABG, ACLS Flashcards
When to wear gloves for clinical breast exam?
Only if weeping/excoriated lesions
Need a chaperone for clinical breast exam?
Yes
What to verbalize for PT position for inspection part of clinical breast exam?
Seated, disrobed at waist
What to assess for in inspection of clinical breast exam? (Hint: 4)
- Skin changes
- Size/symmetry
- Countour
- Nipple characteristics (inverted or not)
4 PT maneuvers in inspection of clinical breast exam?
- Arms at side
- Arms overhead
- Hands pressed at hips
- Lean forward
PT position for palpation of clinical breast exam?
Supine, one arm above head, shoulder raised with towel, undrape one breast
Pattern and fingers for palpation of clinical breast exam?
Vertical stripe patters with 2, 3, and 4 fingers
How to palpate in clinical breast exam?
Small concentric circles
What to palpate in clinical breast exam?
Entire breast including periphery, tail of spence (armpit area), and axilla
Which 3 lymphnodes to palpate for malignancy in clinical breast exam?
- Supraclavicular
- Infraclavicular
- Axillary regions
What to verbalize for findings consistent with malignancy in clinical breast exam? (Hint: 5)
- Hard
- irregular shape
- dimpling of overlying skin
- nipple retraction
- non-tender mass
Need gloves and chaperone for male GU exam?
Yes
Position for inguinal hernia in male GU exam?
Standing
Where to place index finger for inguinal hernia?
Near inferior scrotal sack. Move digit up near inguinal canal following spermatic cord up to inguinal ligament. Feel for external ring.
What to tell mannequin/patient while checking for bulges in inguinal hernia?
Grunt/cough and valsalva
If external ring is large enough what to do in male GU exam?
Palpate near ext ring with valsalva for bulges
Position for assessing femoral hernia?
Standing
Where to place fingers in femoral hernia assessment?
Anterior thigh/femoral canal region
How to assess for femoral hernia?
Tell PT to valsalva (grunt/cough). Assess for pulse, bulging, tenderness, swelling.
3 indications for Arterial Blood Gas?
- General diagnostic, therapeutic purposes
- Exacerbation of COPD and asthma
- After hyperventilation/CPR
4 CIs for Arterial Blood Gas?
- Aterial pulse not palpable
- Negative result of Allen’s Test
- Superficial landmarks not visible
- Presence of arterial dz
How to do Allen’s Test prior to Arterial Blood Gas?
Make fist, occlude radial and arteries at wrist with thumbs, open hand.
What to verbalize for normal Allen’s Test?
“Normal ulnar artery if the hand flushes red in 3-5 seconds after taking pressure off ulnar artery.”
What to verbalize for abnormal Allen’s Test?
Flushing delayed or part of hand pale then do not perform radial puncture.
Position for penis and scrotum exam?
Standing or supine
How to inspect base and prepuce of penis?
Base for excoriation or inflammation
Prepuce=ask PT to retract and look for smegma. Check glans penis for ulcers, scars, nodules, and inflammation.
How to inspect scrotum?
Lift to view posterior surface. Check for scrotal contous, swelling, lumps, and veins.
How to palpate scrotum?
Palpate each testis and epididymis for size, shape, consistency, tenderness, nodule, and swelling (hydrocele)
4 things to transilluminate scrotum for?
- Inguinal hernia
- Varicocele
- Testicular tumor
- Hematoma
How to assess cremasteric reflex
Stroke medial thigh briskly inferiorally downwarn fashion with reflex hammer. Testis on that side move upward. DOES NOT HAPPEN WITH TORSION!
