Weeks 1 - 6 Flashcards
Type of question not to ask
“why” questions
Physical Exam Sequence (4)
1) Inspection
2) Palpation
3) Percussion
4) Auscultation
Components of General Survey (4)
1) Physical appearance
2) Body structure
3) Mobility
4) Behaviour
“peanut butter makes breakfast”
Normal Temperature Range - General Population
35.8 - 37.3
Normal Temperature Range - Older Adults
35.8 - 36.2
Normal Pulse Range
50 - 95 bpm
Characteristics of Pulse (4)
1) Rate
2) Rhythm
3) Force - grade (0 to 3)
4) Equality - symmetrical?
Normal Respiratory Range
10 - 20
Characteristics of Respiration (3)
1) Rate
2) Rhythm - regular or irregular
3) Depth - shallow or deep
Normal Oxygen Saturation
97 - 99
Normal Oxygen Saturation in COPD
88 - 92
Normal BP
120/80
What the bell of the stethoscope is used for?
low pitched sounds
e.g. heart murmur, turbulent blood flow
What the diaphragm of the stethoscope is used for?
high pitched sounds
e.g. breath sounds, heart sounds
Orthostatic (postural) hypotension
drop in SYSTOLIC mercury more than 20 mmHg between positions
Landmark for apex of heart
5th intercostal space
Landmark for base of heart
2nd intercostal space
Where is the S1 sound the loudest?
apex
Where is the S2 sound the loudest?
base
What happens in diastole?
ventricles relax and fill with blood
AV valves are open
high pressure in atria as blood pours into ventricles
atria contract, pushing last bit of blood into ventricles
What marks the start of systole?
AV valves shutting = S1
What marks the end of systole?
semilunar valves shutting = S2
abnormal heart sounds
S3 and S4
Orthopnea
SOB lying down
relieved by sitting up
Normal Cardio Changes With Aging (3)
1) mild increase in systolic BP
2) NO Change in diastolic BP and resting HR
3) decreased ability to compensate for exercise
Cardiovascular Exam Sequence
1) Inspection
2) Palpation
NO PERCUSSION
3) Auscultation
What is matched correctly?
a) artery, valve
b) vein, pump
c) artery, pump
c) artery, pump
(and vein, valve)
What is the best indicator of DVT?
a) Positive Homan’s sign
b) venous ultrasonography
b) venous ultrasonography
Homan’s sign is outdated
How breathing should be (4)
1) regular
2) relaxed
3) silent
4) automatic
AVPU Scale for LOC
A - alert?
V - voice - responding to voice?
P - pain - squeeze of traps
U - unresponsive
Reasons for decreased tactile fremitus
excess air
e.g. pneumothorax, emphysema
Reason for increased tactile fremitus
consolidation
e.g. exudate, blood, pneumonia
Cheyne-Stokes Respirations
wax and wane in a REGULAR pattern, increasing in rate and depth then decreasing with periods of apnea
severe heart failure
Which populations are Cheyne-Stoke respirations normal in? (2)
1) infants
2) older adults
Biot’s Respiration
irregular breathing pattern
e.g. head trauma
Crackles
brief, popping sounds
discontinuous
during inspiration
often at lung bases
e.g. pneumonia, heart failure
Wheezes
narrowed airways
continuous
during expiration
upper airways
e.g. asthma, COPD, bronchitis
Stridor
high-pitched, harsh sounds
inspiration
trachea
obstruction of narrowing upper airway
e.g. croup, upper airway obstruction
Good, palpable landmark on the abdomen
aorta
Order of GI assessment
1) Inspection
2) Auscultation
3) Percussion
4) Palpation
