THE PHYSICAL EXAM: TERMS AND FINDINGS Flashcards
drowsy or sleepy disposition
somnolent
physically wasting or extremely thin
cachectic/emaciated
large body mass index (BMI)
morbidly obese
well-appearing patient in minimal distress (often used to describe well-appearing pediatric patients)
non-toxic appearing
normal appearance and size of the head
normocephalic
no signs of trauma present
atraumatic
bluish discoloration of the skin sue to a lack of oxygen
cyanosis
an unhealthy paleness of the skin
pallor
superficial reddening of the skin
erythema
yellowing of the skin due to abnormal bilirubin build-up
jaundice
superficial wound to the top most layer of the skin
abrasion
a region of skin in which blood capillaries are ruptured (aka bruise)
contusion
an area of ruptured blood vessels similar to a contusion (aka bruise)
ecchymosis
a cut in the skin
laceration
a small hole in the skin
puncture
round, localized area of edema on the skin
wheal
(a reaction) rash or hives (irregular, blanch raised areas with redness)
wheal-and-flare
hives or wheals which are either redder or paler than the surrounding area and are often accompanied by itching
urticaria
rash or hives (flat red area covered with small confluent bumps)
maculopapular
small collection of pus under the skin
pustules
fluid-filled blisters
bullae
a small round flat dark-red spot caused by bleeding into the skin or beneath the mucus membrane
petechiae
purple spots or blotches (don’t turn white when pressed)
purpura
a hardened area of normally soft tissue
induration
movable and compressible
fluctuance
a benign tumor consisting of blood vessels
hemangioma
the transparent coat of the eyeball that covers the iris and pupil; lets light into the eye
cornea
the dense fibrous opaque outer coat enclosing the eyeball (except the part covered by the cornea)
sclera
white area of the eyes
conjunctiva
yellowing of sclera due to bilirubin build-up (often seen with jaundice)
icterus
bright red patches in conjunctiva of eyes due to ruptured blood vessels
subconjunctival hemorrhage
appropriate function of the extraocular muscles, tested with “follow my finger
Extraocular Movements Intact (EOMI)
Normal evaluation of the size, shape of the pupils, and their reactivity to light
PERRL (pupils equal, round, and reactive to light)
swelling of the optic disk due to an increase in intracranial pressure
papilledema
non-swollen optic nerve on exam of fundus (back of the eye) with an opthalmoscope
Fundi Sharp
acuteness/sharpness of vision as measured by the eye chart
visual acuity
flipping of the eyelid for exam underneath the eyelid
eyelid eversion
eyelid membrane is clear
normal palpebral conjunctiva
bulging of eyes out of socket
exophthalmos
involuntary rapid eye movements (often reported as horizontal, vertical, or rotary)
nystagmus
redness of the outer ear canal
erythema of the external canal
excessive earwax
cerumen impaction
eardrum
tympanic membrane (TM)
red color of the tympanic membrane
erythematous TM
protruding/outward curvature of the tympanic membrane
bulging TM
inward curve of the tympanic membrane
retracted TM
cone of light does not reflect on the tympanic membrane
poor light reflect
provider cannot see landmarks behind tympanic membrane
unable to visualize landmarks
blood on the tympanic membrane
hemotympanum
tenderness over mastoid bones (located posterior to ear)
mastoid tenderness
clear nasal drainage
clear rhinorrhea
displacement of the nasal septum
septal deviation
bruising or bleeding in the nasal septum
septal hematoma
dry mouth
dry mucous membranes
cut on the tongue
tongue laceration
no cuts/chipped teeth/etc.
no signs of oral trauma
cavity
dental caries
bad teeth
poor dentition
infection of the gums (gingiva)
pericoronitis
enlargement of the parotid gland (salivary glands that sit in front of the ears)
parotid mass
inability to open mouth normally due to spasm of the jaw muscles
trismus
normal jaw alignment
normal jaw approximation
misalignment of the teeth when mouth is closed
malocclusion
no deviation of the uvula to one side or another
uvula midline
redness of the throat
pharyngeal erythema
pus seen on the posterior throat
pharyngeal exudate
deep abscess adjacent to infected tonsils (collection of pus/swelling which is usually only visible if drained)
peritonsilar abscess
abnormal flow of blood through the carotid artery
carotid bruit
swelling of the jugular vein (usually seen in heart failure patients)
jugular vein distension (JVD)
pain along cervical spine
cervical vertebral tenderness
no misalignment of the vertebral bodies (spinous processes) as the spine is palpated
no step-offs or crepitus
swollen lymph nodes under jaw and along anterior neck area
anterior cervical lymphadenopathy
no deviation of trachea from its usual location
trachea midline
patient has neck stiffness, photophobia, and headache which may suggest meningitis
meningismus
neck stiffness with neck movement
nuchal rigidity
gas or air present under the subcutaneous skin
subcutaneous emphysema
crackling/popping sensation that a provider feels under the skin due to air being present in the skin tissue
crepitus (or crepitance)
slow heart rate (less than 60 beats per minute)
bradycardia
fast heart rate (greater than 100 beats per minute)
tachycardia
an abnormal sound heard when listening to the heart
murmur
heart murmur heard during systole (active pumping)
systolic murmur
heart murmur heard during diastole (active filling or resting)
diastolic murmur
faint-sounding heart beat
distant heart sounds
coarse sounds produced when the heart “rubs” on inflamed pericardium (heart tissue) during contractions
rubs
extra/abnormal heart sounds (should only hear 2 distinct sounds, but you hear 3 or 4 sounds)
gallops
abnormally breathing slow
bradypnea
abnormally rapid breathing
tachypnea
temporary absence or cessation of breathing
apnea
increased time between inspiratory and expiratory phases
prolonged inspiratory/expiratory phases
wet, crackling sound with respirations (aka crackles)
rales
a whistling or snoring sound heard on auscultation of the chest when air channels are partially obstructed
rhonchi
difficult breathing with a whistling sound resulting from narrowing of the lumen of the respiratory passageways
wheezes
harsh or high-pitched respiratory sound, caused by an obstruction of the air passages
stridor
use of intercostal muscles with breathing (indicates severe respiratory distress/work of breathing); sunken intercostal muscles (can see ribs)
intercostal retractions
using extra muscles to breath (you can usually see an emphasis on use of diaphragm and intercostal muscles)
accessory muscle use
bloating
distension
pregnant
gravid
accumulation of fluid in the peritoneal cavity
ascites
sound generated by examiner tapping his/her finger in contact with the belly distended due to extra gas/air in the large or small bowel
tympanitic
enlarged organ
organomegaly
enlarged liver
hepatomegaly
enlarged spleen
splenomegaly
(a sign) pain in the right upper quadrant that may indicate gallbladder infection
Murphy’s sign
(a sign) palpation of the left lower quadrant causes right lower quadrant pain that may indicate appendicitis
Rovsing’s sign
(a sign) pain produced with bending of the patient’s knees to chest that may indicate appendicitis
Psoas sign
(a test) tap the heel 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 appenddicitis
Heel Tap test
tenderness to palpation in the mid-point of the right lower quadrant (RLQ) which can indicate appendicitis
McBurney’s Point Tenderness
outward protrusion of intra-abdominal tissue and/or bowl through belly button
umbilical hernia
(a sign) bruising in the flank area (lower back area)
Grey Turner’s sign
(a sign) bruising in the skin around the umbilicus
Cullen’s sign
angle on the back where kidneys are (healthcare provider taps); left, right, and bilateral; if there is pain then possible kidney pathology
Costovertebral Angle Tenderness (CVAT)
tenderness in muscles adjacent to spine
paraspinal muscle tenderness
tenderness directly over spine
midline tenderenss
no misalignment of thoracic/lumbar spine
no step-offs
if the patient performs this test and there’s pain, it is indicative of a herniated disk
straight leg raise
loss of sensation around buttocks area
saddle anesthesia
pain with the movement of the cervix
cervical motion tenderness (CMT)
tenderness in location of the ovaries and fallopian tubes
adnexal tenderness
cervical os (opening to cervix) is open or closed
Os open or closed
vaginal canal
vaginal vault
product of conception (fetus, placenta, etc.)
POC
protrusion in the groin
inguinal hernia
(a reflex) upward pull of testicles and scrotum due to touch
Cremasteric Reflex
inability to pull back foreskin back over glans penis to its normal position
paraphymosis
blood present/absent in stool
guaiac (hemoccult)
tone of rectal muscles during digital exam
positive/negative rectal tone
dark, tarry-like stool containing blood
melena
deformity of finger/fingernails due to chronic cyanosis
clubbing
pain in certain area of the wrist indicating possible scaphoid bone fracture
Snuff Box Tenderness
all these nerves run in the forearm (tested in the hand exam)
median, ulnar, and radial sensory function
excessive pain not matching the expected with pressure applied by the doctor
pain out of proportion
(a test) evaluation for knee instability
Valgus/Varus Stress Test
(a sign) pain in calf or popliteal region
Hoffman’s Sign
persistent indention of an area of skin when pressed on by the provider due to excess edema
pitting edema
above/below the knee amputation (indicate R or L)
AKA/BKA
loose ligaments
Ligamentous Laxity
(a test) rotation of the knee causes pain
McMurray’s Test
(a test) pivot shift test causes pain
Lachman’s Test
small fluid filled sack surrounding a joint
bursa
loss of ability to express or understand speech
aphasia
having a difficult time finding what words to say
dysphasia
difficult time communicating or articulation (i.e., slurred speech)
dysarthria
patient moves upon painful stimulation
purposeful movements
a scoring system used to describe the level of consciousness in a person following a traumatic brain injury
Glasgow Coma Scale (GCS)
withdraws extremity where painful stimulation is applied
localizes to pain
tested usually by patient gripping healthcare providers fingers (right, left, or bilateral)
grip strength
hold palms out upwards and look for movement of palms (rotation)
pronator drift
finger to nose exam
dysmetria
inability to perform rapid alternating movements
dysdiadochokinesia
walking abnormally and/or unsteadily
ataxic gait
test for coordination
Heel to Shin test
(a test) patient stands up with feet together and arms out to see if they can balance
Romberg’s Test
(a test) tests the stability of a patient’s gait
Heel Toe Gait
A reflex where the HCP swipes the sole of the foot to see if the big toe flexes up
Babinski Sign
involuntary/instantaneous movement
reflexes
the observed emotional state of a person
affect
orientation to person, place, time, and event (A/Ox4)
orientation
an experience involving the apparent perception of something not present
Hallucinations (auditory or visual)
thoughts of suicide or homicide
suicidal or homicidal ideation
