Resp/ Cardio/ GI

Question 1

resp: 10 steps of respiratory examination

Answer 1

1. introduction
2. end of bed assessment
3. hands
4. pulse and resp rate
5. face check
6. anterior: inspection, palpation, auscultation
7. neck check
8. posterior: inspection, palpation, auscultation
9. legs
10. closure

Question 2

resp: components of end of bed assessment

Answer 2

is the patient well enough for exam?
SOB, able to converse, obvious pain?
oxygen, inhalters, IV cannulation?

Question 3

resp: what to check in the hands

Answer 3

warmth of hands
peripheral cyanosis, tar staining, finger clubbing?
koilonychia, thin skin, bruising?
raise hands: CO2 retention flapping tremor?

Question 4

resp: what to check in the face

Answer 4

eyes for conjunctival pallor, anemia
inside mouth for central cyanosis
pursed lip breathing?

Question 5

resp: components of inspection

Answer 5

distress, SOB, converse, muscle use?
resp rate
shape & symmetry
movement during inspiration & expiration
scars: anterior, posterior, lateral, axillae

Question 6

resp: components of palpation

Answer 6

feel trachea for aviation
chest expansion w/ hands portion symmetrically: anterior and posterior

Question 7

resp: components of percussion

Answer 7

apices, move inferiorly, compare sides
anterior, posterior, lateral
notes: dullness, hyper-resonance?
cardio or hepatic dullness?

Question 8

resp: components of auscultation

Answer 8

apices, move inferiorly, compare sides
anterior, posterior, lateral
full inspiration-expiration cycle at each level
note: air entry, breath sounds, character, added sounds?

Question 9

resp: what to check for the neck

Answer 9

examine nodes
JVP (measure vertical height from sternal angle to internal mutual vein pulsation)

Question 10

lymph node regions to check during neck examination

Answer 10

submittal submandibular, anterior triangle, posterior triangle, pre-auricular, post-auricular, occipital, supraclavicular

Question 11

resp: what to look for in the legs

Answer 11

both legs: pitting oedema, rash, signs of DVT

Question 12

resp: what are some additional tests

Answer 12

vocal resonance
tactile vocal remits

Question 13

cardio: 12 steps of cardiovascular examination

Answer 13

1. introduction
2. end of bed assessment
3. hands
4. pulse and resp rate
5. blood pressure
6. face
7. JVP
8. inspection
9. palpation
10. auscultation
11. legs
12. closure