The Physical Exam Flashcards
Somnolent
Drowsy or sleepy disposition
Cachectic/Emaciated
Physically wasting (extremely thin)
Morbidly Obese
Large body mass index (BMI)
Nontoxic Appearing
Well-appearing patient in minimal distress
Often used to describe well-appearing pediatric patients
Normocephalic
Normal appearance and size of the head
Atraumatic (Head)
No signs of trauma present
**Cyanosis
Bluish discoloration of the skin due to a lack of oxygen
Pallor
An unhealthy paleness of the skin
Erythema
Superficial reddening of the skin
Jaundice
Yellowing of skin due to abnormal bilirubin build-up
Abrasion
Superficial wound to the top most layer of the skin
Contusion
A region of skin in which blood capillaries are ruptured; AKA bruise
Ecchymosis
An area of ruptured blood vessels similar to a contusion; AKA bruise
**Laceration
A cut in the the skin
Puncture
A small hole in the skin
Wheal
Round, localized area of edema on the skin
Wheal-and-Flare
(A reaction) rash or hives (irregular, blanch raised areas with redness)
Urticaria
Hives or wheals which are either redder or paler than the
surrounding area and are often accompanied by itching
Maculopapular
Rash or hives (flat red area covered with small confluent bumps)
Pustules
Small collection of pus under the skin
Bullae
Fluid-filled blisters
Petechiae
A small round flat dark-red spot caused by bleeding into the skin or beneath the mucus membrane
Purpura
Purple spots or blotches (don’t turn white when pressed)
Induration
A hardened area of normally soft tissue
Fluctuance
Movable and compressible
Hemangioma
A benign tumor consisting of blood vessels
Cornea
The transparent coat of the eyeball that covers the iris and pupil; lets light into the eye
Sclera
The dense fibrous opaque outer coat enclosing the eyeball - except the part covered by the cornea
Conjunctiva
White area of the eyes
Icterus
Yellowing of sclera due to bilirubin build-up (often seen with jaundice)
Subconjunctival Hemorrhage
Bright red patches in conjunctiva of eyes due to ruptured blood vessels
Extraocular Movements
Intact (EOMI)
Appropriate function of the extraocular muscles, tested with “follow my finger”
Pupils equal, round and reactive to light (PERRL)
Normal evaluation of the size, shape of the pupils and their reaction to light
Papilledema
Swelling of the optic disk due to an increase in intracranial pressure
Fundi Sharp
Non-swollen optic nerve on exam of fundus (back of eye) with ophthalmoscope
Visual Acuity
Acuteness / sharpness of vision as measured by the eye chart
Eyelid Eversion
Flipping the eyelid for exam underneath the eyelid
Normal Palpebral Conjunctiva
Eyelid membrane is clear
Exophthalmos
Bulging of eyes out of socket
Nystagmus
involuntary rapid eye movements – often reported as horizontal, vertical, or rotary
Erythema of the External Canal
Redness of outer ear canal
Cerumen Impaction
Excessive earwax
Tympanic Membrane (TM)
Eardrum
Erythematous TM
Red color of the TM
Bulging TM
Protruding / outward curvature of the TM
Retracted TM
Inward curve of the TM
Poor Light Reflect
Cone of light does not reflect on TM
Unable to Visualize Landmarks
Provider cannot see landmarks behind TM
Hemotympanum
Blood on the TM
Mastoid Tenderness
Tenderness over mastoid bone (located posterior to ear)
Clear Rhinorrhea
Clear nasal drainage
Septal Deviation
Displacement of nasal septum
Septal Hematoma
Bruising or bleeding in the nasal septum
Dry Mucous Membranes
Dry mouth
Tongue Laceration
Cut on the tongue
No Signs of Oral Trauma
No cuts/chipped teeth/etc
Dental Caries
Cavity
Poor Dentition
Bad teeth
Pericoronitis
Infection of the gums
Parotid Mass
Enlargement of the parotid gland
Trismus
Inability to open mouth normally due to spasm of the jaw muscles
Normal Jaw Approximation
Normal jaw alignment
Malocclusion
Misalignment of the teeth when mouth closed
Uvula Midline
No deviation of the uvula to one side or another
Pharyngeal Erythema
Redness of the throat
Pharyngeal Exudate
Pus seen on the posterior throat
Peritonsilar Abscess
Deep abscess adjacent to infected tonsils (collection of
pus/swelling which is usually only visible if drained)
Carotid Bruit
Abnormal flow of blood through the carotid artery
Jugular Vein Distension (JVD)
Swelling of the jugular vein (usually seen in heart failure
patients)
Cervical Vertebral Tenderness
Pain along cervical spine
No Step-offs or crepitus
No misalignment of the vertebral bodies (spinous processes) as the spine is palpated
Anterior Cervical Lymphadenopathy
Swollen lymph nodes under jaw and along anterior neck area
Trachea Midline
No deviation of trachea from its usual location
Meningismus
Patient has neck stiffness, photophobia, and headache which may suggest meningitis
Nuchal Rigidity
Neck stiffness with neck movement
**Bradycardia
Slow heart rate; less than 60 beats per minute
**Tachycardia
Fast heart rate; greater than 100 beats per minute
Murmur
An abnormal sound heard when listening to the heart
Systolic Murmur
Heart murmur heard during systole (active pumping)
Diastolic Murmur
Heart murmur heard during diastole (rest/active filling)
Distant Heart Sounds
Faint-sounding heart beat
Rubs
Coarse sounds produced when the heart “rubs” on inflamed pericardium (heart tissue) during contractions
Gallops
Extra/abnormal heart sounds (should only hear 2 distinct sounds, but you hear 3 or 4 sounds)
Bradypnea
Abnormally slow breathing
Tachypnea
Abnormally rapid breathing
**Apnea
Temporary absence or cessation of breathing
Prolonged Inspiratory Expiratory Phase
Increased time between inspiratory and expiratory phases
Rales
Wet, crackling sound with respirations (aka crackles)
Rhonchi
A whistling or snoring sound heard on auscultation of the chest when air channels are partially obstructed; plural of rhonchus
Wheezes
Difficult breathing with a whistling sound resulting from
narrowing of the lumen of the respiratory passageways
Stridor
Harsh or high-pitched respiratory sound, caused by an
obstruction of the air passages
Intercostal Retractions
Use of intercostal muscles with breathing (indicates severe respiratory distress/work of breathing) – sunken intercostal muscles (can see ribs)
Accessory Muscle Use
Using extra muscles to breath (you can usually see an emphasis on use of diaphragm and intercostal muscles)
Costovertebral Angle Tenderness (CVAT)
Angle in back where kidneys are (HCP taps); left, right and bilateral – if pain then possible kidney pathology
Paraspinal Muscle Tenderness
Tenderness in muscles adjacent to spine
Midline Tenderness
Tenderness directly over spine
No Step-offs
No misalignment of thoracic/lumbar spine
Straight Leg Raise
If pain, indicative of herniated disk
Saddle Anesthesia
Loss of sensation around buttocks area
Distension
Bloating
**Gravid
Pregnant
Ascites
Accumulation of fluid in the peritoneal cavity
Tympanitic
Sound generated by examiner tapping his/her finger in contact with the a belly distended due to extra gas/air in the large or small bowel
Organomegaly
Enlarged organ
Hepatomegaly
Enlarged liver
Splenomegaly
Enlarged spleen
Murphy’s Sign
Pain in right upper quadrant that may indicate gallbladder infection
Rovsing’s Sign
Palpation of the left lower quadrant causes right lower quadrant pain that may indicate appendicitis
Psoas Sign
Pain produced with bending of the patient’s knees to chest that may indicate appendicitis
Heel Tap Test
Tap the heal to see if it causes pain, also done by having the patient jump up to see if pain is felt in the abdomen – may indicate appendicitis
McBurney’s Point Tenderness
Tenderness to palpation in the mid-point of the right lower quadrant (RLQ) which can indicate appendicitis
Umbilical Hernia
Outward protrusion of intra-abdominal tissue and/or bowel through belly button
Grey Turner’s Sign
Bruising in flank area (lower back area)
Cullen’s Sign
Bruising in the skin around the umbilicus
Inguinal Hernia
Protrusion in the groin
Cremasteric Reflex
Upward pull of testicles and scrotum due to touch
Paraphymosis
Inability to pull back the foreskin back over the glans penis to its normal position
Guaiac (Hemoccult) positive/negative
Blood present/absent in stool
Rectal Tone
Tone of rectal muscles during digital exam
**Melena
Dark, tarry like stool containing blood
Cervical Motion Tenderness (CMT)
Pain with movement of cervix
Adnexal Tenderness
Tenderness in location of the ovaries and fallopian tubes
Os Open/Closed
Cervical os (opening to cervix) is open or closed
Vaginal Vault
Vaginal canal
POC
Product of conception (fetus, placenta, etc)
Clubbing
Deformity of finger/fingernail due to chronic cyanosis
Snuff Box Tenderness
Pain in certain area of the wrist indicating a possible scaphoid bone fracture
Median/Ulnar/Radial Sensory Function
All these nerves run in forearm…tested in the hand exam
Pain Out of Proportion
Excessive pain not matching the expected with pressure applied by the doctor
Valgus/Varus Stress Test
Evaluation for knee instability
Homan’s Sign
Pain in calf or popliteal region
Pitting Edema
Persistent indention of an area of skin when pressed on by the provider due to excess edema
AKA / BKA
Above / below knee amputation (Indicate R or L)
Ligamentous Laxity
Loose ligaments
McMurray’s Test
Rotation of knee causes pain
Lachman’s Test
Pivot shift test causes pain
Bursa
Small fluid filled sack surrounding a joint
Aphasia
Loss of ability to express or understand speech
Dysphasia
Having a difficult time finding what words to say
Dysarthria
Difficult time communicating or articulation (i.e. slurred speech)
Purposeful Movements
Patient moves upon painful stimulation
Glasgow Coma Scale (GCS)
A scoring system used to describe the level of consciousness in a person following a traumatic brain injury
Localizes to Pain
Withdraws extremity where painful stimulation is applied
Grip Strength
Tested usually by patient gripping HCP’s fingers (L+R+Bi)
Pronator Drift
Hold palms out upwards and look for movement of palms (rotation)
Dysmetria
Finger to nose exam
Dysdiadochokinesia
Inability to perform rapid alternating movements
Ataxic
Gait walking abnormally and/or unsteadily
Heel to Shin Test
Test for coordination
Romberg’s Test
Patient stands up with feet together and arms out to see if they can balance
Heel Toe Gait
Tests the stability of a patient’s gait
Babinski Sign
A reflex - swipe sole of foot to see if big toe flexes up
Reflexes
Involuntary/instantaneous movement
Affect
The observed emotional state of a person
Orientation
Orientation to person, place, time, and event (A/O x 4)
Hallucinations (auditory or visual)
An experience involving the apparent perception of something not present
Suicidal (SI) /Homicidal Ideation (HI)
Thoughts of suicide / thoughts of homicide
