Unit 1

Question 1

Murphy’s percussion

Answer 1

direct or indirect percussion over costovertebral angle–screen kidney

Question 2

Murphy’s sign

Answer 2

PT fingers around anterior lower right ribs; pt inspires–>exquisite tenderness
–>screen for cholecystitis

Question 3

McBurney’s point

Answer 3

Point halfway between right ASIS and umbilicus
Palpate in hooklying and hip extension
–>screen for apendicitis

Question 4

Blumberg’s sign

Answer 4

Rebound tenderness/pain should be experienced on side of inflammation

Question 5

Pinch-an-Inch test

Answer 5

Less provocative than rebound tenderness test
pain should be experienced on side of inflammation
if negative, check for rebound tenderness

Question 6

Psoas or obturator tests

Answer 6

Abscess may be present in mm from peritonitis

Test muscles, stretch muscles, see if abdominal pain is reproduced

Question 7

Patellar-pubic percussion test

Answer 7

place stethoscope on pubic symphysis. pt holds steth in place.
stabilize tibia to keep LE in neutral
percuss over patella
dull side=questionable femoral integrity

Question 8

Fulcrum test

Answer 8

pt in seated/supine
PT use forearm as fulcrum
dorsal pressure on distal femur
pain–>question femoral integrity/stress fx

Question 9

asterixis/liver flap

Answer 9

pt extend arm, spread fingers, ext wrist. PT overpressures then releases. “Flap” looks like clonus—>suspicious of liver disease, opioid overdose

Question 10

axial percussion (spine)

Answer 10

tap spinous process with reflex hammer if suspicious of stress fx in other part of vertebrae

Question 11

When should you screen upper GI system?

Answer 11

pain in epigastric, thoracic, or shoulder region
Fatigue/other problems in general health
history of GI problems
Meds impacting GI system (NSAIDs, corticosteroids, narcotics)

Question 12

When should you screen lower GI system

Answer 12

Pain in umbilical/hypogastric region, pelvic pain, lumbar pain
Fatigue/other problems in general health
history of GI problems
Meds impacting GI system (NSAIDs, corticosteroids, narcotics)

Question 13

When should you screen pulmonary system?

Answer 13

Pain in thorax/shoulder girdle
unresolved/atypical TOS, Hoerner's syndrome, history of cancer
Yes to fatigue, nausea, vomiting
vital sign abnormalities, esp RR
Hx of pulmonary disease
Meds impacting pulmonary system

Question 14

When should you screen the cardiovascular and peripheral vascular system?

Answer 14

Pain in chest, jaw, tooth, shoulder, neck
pain on exertion/claudication
Fatigue and nausea
Atypical vital signs
Hx of CVD/PVD
Meds that impact CVD/PVD

Question 15

When should you screen genitourinary system?

Answer 15

Pain in flank, thoracolumbar region, pelvic region, costovertebral angle
Hx of genitourinary disorders
Meds that impact genitourinary function

Question 16

If a patient has shoulder girdle/scapular/clavicular pain, what should you screen?

Answer 16

1) CV system; Pulmonary system

2) GI system

Question 17

If a patient has thoracic pain, what should you screen?

Answer 17

1) CV, Pulmonary, GI, and urogenital systems

Question 18

If a patient has lumbopelvic pain, what should you screen?

Answer 18

1) GI, urogenital, and peripheral vascular systems

Question 19

If a patient has knee pain, what should you screen?

Answer 19

1) Peripheral vascular system

Question 20

If a patient has symptoms that aren’t consistent with any of the major body systems, what should you consider?

Answer 20

Psychological, endocrine, neurological, and rheumatological conditions

Question 21

What structures are retroperitoneal?

Answer 21

Kidneys, adrenals, ureters, bladder
aorta, IVC
esophagus, rectum
pancreas
ascending, descending colon
part of duodenum

Question 22

Where do retroperitoneal structures typically refer?

Answer 22

Back

Question 23

where do non-retroperitoneal structures typically refer?

Answer 23

anteriorly