week 4: physical examination Flashcards
purpose of the physical examination
‘The purpose is SET in stone’
S___ ___ obtained from ___ during the ___ ___ ___.
E__ ___ ___ of ___ ___ reported from ___
T___ with the ___ ___ ___ it provides basis for ___ ___.
supplements data, patient, health history interview
enables objective validation, subjective data, patient
together, health history interview, care planning
preparing the environment for the physical examination remember:
‘pErforM thE pHysicAl after’
E__ ___ & ___ (___). ‘EsPeCially Temperature’
M__ ___ ___ & ___ ‘MINimisE’
E__ adaquate ___ & ___ to ___ ___ the ___
‘Ensure to ALwayS MAP the environment’
H__ ___/___ ___ at an appropriate ___ ___
‘Have BETs And Win Handsomly’
A__ upon a ___ for the assessment
‘Agree on TAking assessment’
ensure privacy & comfort (temperature)
minimise interruptions & external noise
ensure, lighting & space, move around, patient
have bed/examination table, working height
agree, time
when preparing the equipment remember
‘CHeck When Preparing & Gathering’
C\_\_ equipment is \_\_\_ \_\_\_ H\_\_ equipment in \_\_\_ & \_\_\_ in \_\_\_ of use W\_\_ equipment that will \_\_\_ the \_\_\_ \_\_\_. P\_\_ \_\_\_ \_\_\_ before \_\_\_ \_\_\_ G\_\_ the \_\_\_ & \_\_\_ needed
check, functioning properly
have, reach & arranged, order
warm, touch, patient skin
perform hand hygiene, preparing equipment
gather, supplies & instruments
physical examination equipment:
‘POSTGRAD’S areN’T ProblematiC, they ProMiSe the PoSSibiTy of mistake is 0, they’re CAreful’
P\_\_ \_\_\_ O\_\_ S\_\_ T\_\_ G\_\_ R\_\_ A\_\_ D\_\_ S\_\_
pulse oximeter ophthalmoscope stethoscope thermometer gloves ruler auriscope doppler sphygmomanometer
these are ___, don’t forget them in the physical examination equipment
POSTGRAD’s
gloves
this is a ____, don’t forget it in your physical examination equipment
POSTGRAD’s
thermometer
this is a ___, don’t forget it in your physical examination equiment
POSTGRAD’s
stethoscope
this is a ___, don’t forget it in your physical examination equiment
POSTGRAD’S
sphygmomanometer
this is a ___ ___, don’t forget it in your physical examination equipment
POSTGRAD’S
pulse oximeter
this is a ___, don’t forget it in you physical examination equipment
POSTGRAD’s
doppler
this is a ___ ___ ___, don’t forget it in your physical examination equiment
POSTGRAD’S Never forget theSe’
snellen vision chart
this is a ___, don’t forget it in your physical examination equipment
POSTGRAD’s
opthalmoscope
this is a ___, don’t forget it in your physical examination equipment.
POSTGRAD’s
auriscope
this is a ___, don’t forget it in your physical examination equipment.
‘POSTGRAD’S’
specula
this is a ___ ___, don’t forget it in your physical examination equipment
POSTGRAD’S Never
nasal speculum
physical examination equipment:
‘POSTGRAD’S areN’T ProblematiC, they ProMiSe the PoSSibiTy of mistake is 0, they’re CAreful’
POSTGRAD’S areN’T
N__ ___
T__ ___
nasal speculum
tuning fork
physical examination equipment:
‘POSTGRAD’S areN’T ProblematiC, they ProMiSe the PoSSibiTy of mistake is 0, they’re CAreful’
‘POSTGRAD’S areN’T ProblematiC’
P__ ___
C__
percussion hammer
callipers
physical examination equipment:
‘POSTGRAD’S areN’T ProblematiC, they ProMiSe the PoSSibiTy of mistake is 0, they’re CAreful’
‘they ProMiSe’
P__
M__ ___
S__
pentorch
marking pen
scales
physical examination equipment:
‘POSTGRAD’S areN’T ProblematiC, they ProMiSe the PoSSibiTy of mistake is 0, they’re CAreful’
‘the PoSSibiliTy of mistake is 0’
P__ ___
S__ ___ ___
S__
T__ ___
protective equipment
snellen vision chart
specular
tongue depressors
physical examination equipment:
‘POSTGRAD’S areN’T ProblematiC, they ProMiSe the PoSSibiTy of mistake is 0, they’re CAreful’
‘they’re CAreful’
C__ A__
cotton applicators
physical examination equipment:
‘POSTGRAD’S areN’T ProblematiC, they ProMiSe the PoSSibiTy of mistake is 0, they’re CAreful’
This is a ___, don’t forget it in your physical examination equiment
tuning fork
This is a ___, don’t forget it in your physical examination equiment
percussion hammer
This is a ___, don’t forget it in your physical examination equiment
tongue depressor
This is a ___, don’t forget it in your physical examination equiment
pentorch
This is a ___, don’t forget it in your physical examination equiment
ruler/tape measure
This is a ___, don’t forget it in your physical examination equiment
marking pen
This is a ___, don’t forget it in your physical examination equiment
callipers
This is a ___, don’t forget it in your physical examination equiment
PE
This is a ___, don’t forget it in your physical examination equiment
scales/measuring pole
This is a ___, don’t forget it in your physical examination equiment
cotton applicators/specimens
preparing the patient you must ____ the ____ and ____ of the examination.
Make sure the patient is ____ & free from ____.
Sequence the exam in ____ ____ changes.
Monitor the patients ____ throughout the examination.
Pace the examination according to the patient’s ____.
Answer patient questions ____ & ____.
explain, purpose, procedures
comfortable, pain
minimise position
responses
tolerance
directly & honestly
positioning the patient
This is _____.
standing
positioning the patient
This is _____.
sitting
positioning the patient
This is _____.
supine
positioning the patient
This is _____ _____.
sims position
positioning the patient
This is _____.
lithotomy
positioning the patient
This is _____.
dorsal recumbant
positioning the patient
This is _____.
prone
positioning the patient
This is _____ _____ _____.
knee to chest
4 physical assessment techniques:
Physical - PAtIent
P__
P__
A__
I__
palpation, percussion, auscultaion, inspection
you ____ for auscultation & percussion techniques
listen
you ___ & ___ for inspection techniques
look & smell
you ____ for palpation techniques
feel
In a physical examination, the order is
___ > ___ > ___ > ___ > (circle)
look, listen, smell, feel
auscultation involves ____ to ____ produced in the body such as ___, ___, ___ & ___ sounds.
breath, heart, blood, bowel
auscultation can be ____ or ____
direct or indirect
____ auscultation could be ____ to an expiratory wheeze
direct, listening
____ auscultation could be ____ the sounds made by gas/fluid in the bowel
indirect, hearing
auscultation requires a good ____ with ____ fitting ear pieces, ____ not longer than ____, ___ & ___, ___ ___ ___.
stethoscope, snug, tubing, 15 inches, bell & diaphragm, rubber tubing intact
____ auscultation uses a ____ & ____
indirect, diaphragm & bell
with a diaphragm you press ____ ____ against the patient’s skin, it is used to detect ___-___ sounds
e.g., ____ & ____ sounds
reasonably firmly, high-pitched, beath & bowel
a bell is used to detect ____-____ sounds e.g., ____ & ____ sounds, you press ____ over body part, ___ ___ enough to ____.
low-pitched, heart, vascular, lightly, just firmly, seal
auscultation sounds:
____: ____ of vibrations
____: ____, described as ____ or ____
____: ____ of ____ the sound ____
____: ____ of sound e.g., ____, ____, ____
pitch, frequency
intensity, amplitude, loud or soft
duration, length, time, last
quality: type, blowing, gurgling, wheezing
____ palpation precedes ____ palpation.
____ areas are percussed/palpated ____.
technique should be ____ & ____.
light, deep
tender, last
slow, systematic
percussion is the ____ of a portion of the body to elicit ____ or ____ that vary with the ____ of the underlying structures.
It assists in locating ____ ____, identifying ____ ____, ____ & ____.
It requires a ____ ____ & a ____ ____.
May be ____ or ____ depending on the reason why the assessment is being conducted.
tapping, tenderness, sounds, density
organ borders, organ shape, position, consistency
skilled touch, trained ear
direct or indirect
____ percussion involves ____ with ____ to ___ fingertips or ____ using the ____ ____ of a closed fist.
The strike is ____ & the movement is from the ____ not the ____.
Used to detect ____ through ____.
direct, tapping, 1 to 2, striking, ulnar surface
rapid, wrist, arm
tenderness, vibrations
____ percussion is the ____ of an ____ (finger) held against the body area to be examined.
Used over ____ or ____ to indicate the ____ of the underlying structures
____ finger of ____-____ hand is pressed ____ on the patients skin
The ____ ____ is ____ with the ____ finger of of the ____ hand.
indirect, stricking, object
chest, abdomin, density
middle, non-dominant, firmly
interphalangeal joint, struck, middle, dominant
percussion sounds
____: ____ sound produced by dense tissue e.g., muscle or bone - no air present
____: ____ like/____ sound produced by dense tissie e.g., liver, spleen, heart
____: ____, ____ sound produced by air, e.g., normal lung tissue
____-____: ____ sound e.g., children’s lungs, lung affected by emphysema
____: ____ like sound produced from air filled stomach e.g., intestine, gastric air bubble or puffed-out cheek
flat, dull
dull, thud like/muffled
resonance, clear, hollow
hyper-resonance, booming
tympany, drum
muscle or bone with no air present is likely to produce ____ percussion sounds
flat
liver, spleen and heart would all produce ____ percussion sounds
dull
normal lung tissue would produce ____ percussion sounds
resonance
children’s lungs or a lung affected by emphysema would produce ____-____ percussion sounds
hyper-resonance
intestine, gastric air bubble or puffed-out cheek would all produce ____ percussion sounds
tympany
palpation involves ____ & ____ body parts with the ____ to determine the following characteristics:
____, ____, ____, ____, ____, ____
‘TTMMCD’
texture, temperature, moisture, motion, consistency, distension
for fine discrimination or pulsations you would use your _____
fingertips
for vibrations you would use the ____ or ____ surface
palmar/ulnar
for temperature you would use the ____ surface
dorsal
for light palpation the skin is depressed ____ with ____ ____.
Do not palpate ____ ____.
1cm, finger pads,
pulsating masses
deep palpation should only be used by ____ ____.
The skin is depressed ____ to ____ with ____, ____ pressure
____ hand may be used ___ ___ of the other to exert the required amount of ____.
used to feel ____ ___ and ____.
advanced practitioners
2 to 4cm firm, deep
one, on top, pressure
internal organs and masses
Bimanual palpation should only be used by ____ ____.
It is used to ____ ____ ____ ____.
____ hands are used, one ___ ___ of the body part or ____ being felt
____ hand applies ____ whilst the ____ one is used to detect ____ ____.
advanced professionals
assess deep abdominal organs
2, each side, organ
upper, pressure, lower, deep structures
fingertips are used for ____ ____ & ____
dine discrimination, pulsations
the palma/ulnar surface is used for _____
vibrations
the dorsal surface is used to detect _____
temperature
