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Ch. 22
physical examination
| Question | Answer |
|---|---|
| what is auscultation | method of listening to body sounds with a stethoscope |
| what is the dorsal recumbent position | position in which the patient is lying flat with the knees bent and feet on the examination table |
| what is fowler position | position in which the patient sits with his head as close to 90 degrees as possible and his legs resting outstretched on the exam table |
| define inspection | process of gathering information about the patient through observation |
| what is the jack-knife position | position in which the patient sits on a special table in a semi-sitting position with the thighs flexed to 90 degrees |
| what is the knee-chest position | position in which the patient sits on her knees with her chest and face and arms resting forward and her buttocks in the air |
| lithotomy position | position in which the patient reclines face up with legs apart and feet in stirrups |
| manipulation | application of touch to assess joint symmetry and passive range of motion or the therapeutic application of force to increase mobility and realign dislocated joints |
| mensuration | measurements of body parts including height length and circumference |
| palpation | examination of the patients body by touching it with the hands and pads of the fingers |
| percussion | tapping on the body surface with the fingers or a small hammer and noting the sound elicited to determine the position size or density of underlying structures |
| semi-fowler position | position in which the patient reclines at 45 degrees with legs outstretched |
| sims position | position in which the patient lies on his left side with his upper arm forward on the table, lower leg flexed slightly and upper leg flexed sharply |
| skin turgor | resistance of the skin to deformation when grasped between the fingers that is used to assess hydration |
| supine position | position in which the patient is lying flat face up toward the ceiling |
| trendelenburg position | position in which the patient lies with her head approximately 30 degrees lower than her outstretched legs and feet |
| what are the three parts of the exam | history taking, physical examination, diagnostic testing |
| components of the physical exam | general appearance, skin, arms and hands, head and neck, eyes, ears, nose, mouth and pharynx, chest and lungs, cardiovascular function, breasts, abdomen, genitalia and rectum, legs and feet, mental status. |
| normal findings for general appearance | healthy and well nourished, well groomed, upright posture and a steady gait |
| normal findings for skin | warm, dry, intact, supple, appropriate color for ethnicity, free from lesions, normal turgor |
| normal findings for arms and hands | smooth and supple skin with appropriate color for ethnicity, absence of rashes or lesions, present of strong regular pulses, full active rom with symmetricalandoptimalstrengthand coordinationsmoothclearnailswithconvexcurveand normalangleofnailbedtotheskin |
| normal findings for head and neck | symmetrical head shape, lustrous hair that is even distributed with a clean scalp that is free of scales or lesions, supple neck that is free of lumps or tenderness and a non palpable thyroid |
| normal findings for eyes | accurate visual acuity and color vision, intact visual field and extraocular movements, pupils that are equal round and reactive to light and accommodation, white clear sclera that is free of drainage |
| normal findings for ears | intact hearing, ears that are symmetrical and normally placed, pink patent ear canal with minimal cerumen, pink to pearly grey tympanic membrane that is semitransparent and intact |
| normal findings for nose | straight nose with a midline septum, patent nares, pink moist mucosa, absent or scant clear drainage, intact odor identifaction |
| normal findings for mouth and pharynx | structures and membranes that are pink, moist, smooth, and free of lesions, teeth present with good dental hygiene, pink firm gums, intact gag reflex, pink tossils with out swelling or exudate |
| normal findings of the chest and lungs | symmetrical chest shape with normal anterior- posterior dimension, clear lungs, regular unlabored respirations |
| normal findings for cardiovascular | regular heart rhythm, S^1 and S^2 heart sounds present, palpable regular peripheral pulses, capillary refill, blood pressure within normal range, normal sinus rhythm on ECG |
| normal findings for breast | soft with irregular feel and deep tissue, symmetrical size and shape, and color of breasts and nipples, free of lumps, lesions, dimpling, or nipple dranage, nonpalpable axillary lymph nodes |
| normal findings for genitalia and rectum | absence of rashes or lesions, no purulent drainage, smooth skin, pink, moist smooth mucous membranes, good pelvic floor muscle tone, smooth firm movable testicles, intact anal sphincter tone, absence of hemorrhoids or anal fissures, no blood in stool |
| normal findings for legs and feet | smooth supple skin w/ appropriate color for ethnicity, absence of rashes, lesions, ulcerations, or edema, capillary refill < 3 sec., full active rom w/ symmetrical and optimal strength and coordination, smooth clear nails, intact pulse. |
| normal findings for mental status | alert and oriented to person, place, and time; appropriate identification of sensory data; intact reflexes |
| glass slides | holding specimens that are viewed under a microscope |
| laryngeal and pharyngeal mirrors | examining the pharynx and larynx |
| nasal speculum | examining the nose and nasal mucous membranes |
| otoscope | examining the ear |
| ophthalmoscope | examining eyes |
| penlight | examining the pupils and providing additional light for examination, of the throat, or other body parts |
| reflex hammer | testing reflexes |
| specimen bottles | holding tissue specimens that will undergo laboratory analysis |
| sphygmonometer | measuring blood pressure |
| stethooscope | measuring blood pressure and auscultating heart, lungs, and bowl sounds |
| tape measure | measuring the length and circumference of various body parts |
| thermometer | measuring body temperature |
| vaginal speculum | assisting in opening a vagina more fully to facilitate examination |
| alcohol pads | cleaning the skin prior to an injection or cleaning some medical equipment |
| cotton balls | applying medication or stopping minor bleeding |
| cotton tipped applicator | applying medication or collecting a specimen |
| emesis basin | collecting vomitus or sputum from patient |
| gauze pads | dressing a wound, stopping bleeding, or applying medication |
| lubricant | reducing anticipated discomfort from speculum insertion or rectal or vaginal examinations or easing suppository insertion |
| tongue depressor | depressing the tongue for easier examination of the throat |
| what is the sitting position mainly used for | examination of the upper body, including the head, eyes, ears, nose, throat, neck, chest, lungs, arms and hands |
| when is the supine position used | when examining the breast, anterior chest, heart, abdomen, and lower extremities |
| when is the dorsal recumbent position used | it is sometimes used for rectal and vaginal exams as well as with patients with back or abdominal pain |
| when is the sims position used | rectal examinations and sometimes vaginal examinations |
| when is the lithotomy position used | it is primarily used for vaginal examinations |
| when is the semi Fowler position used | when examining the chest and heart or for patients who need to rest in a semi-reclining position for comfort reasons |
| when is the fowler position used | for patients who are feeling short of breath and same reasons as sitting position |
| when is the trendelenburg position used | if a patient is in shock or blood pressure is dangerously low and sometimes during abdominal surgery |
| when is knee - chest position used | rectal and sigmoid colon examination and rarely for vaginal examinations |
| when is the jack-knife position used | male urological examinations and proceedures |
| abnormal findings for the general apperance | malnourished, morbidly obese, poor posture or gate |
| abnormal findings for the skin | rashes, scales, or lesions; wounds, pale, erythematous, cyanotic, dusky, or jaundice; moist or diaphoretic; taut or edemous; scaly |
| abnormal findings for arms and hands | rashes or lesions; abnormal color; weak irregular or missing pulse; muscle weakness lack of coordination or decreased rom; absent brittle ridged cracked yellow thickened or cyanotic nails; clubbing |
| abnormal findings for the head and neck | asymmetrical or abnormally sized head; hair loss; lumps, scales, lesions, lice, or nits on scalp; lymphadenopathy in the neck; enlarged thyroid |
| abnormal findings for the eyes | poor visual acuity, blindness colorblindness decreased visual field, cloudy lens, or decreased eom; pupils that are dilated, constricted dull unequal or slow to react or nonreactive to light; blepharoptosis; sclera that is jaundiced, inflamed; discharge |
| abnormal findings for the ears | hearing loss or deafness; ears that are asymmetrical or low set; ear canal that is impacted with cerumen or inflamed; perforated blistered retracted or bulging tympanic membrane |
| abnormal findings for the nose | deviated septum; nonpatent nares; mucous membranes that are inflmed edematous, boggy, or dry; purulent drainage; anosmia; polyps |
| abnormal findings for the mouth and pharynx | inflammation, lesions, ulcerations, or dry mucous membranes; dental caries, loose or absent teeth, loose dentures, or poor oral hygiene; gingivitis; absent gag reflex; inflamed enlarged tonsils with exudate |
| abnormal findings for the chest and lungs | barrel shaped chest, decreased lung sounds, crackles, rhonchi , pericardial friction rub, pleural friction rub, wheezes, irregular or labored respirations |
| abnormal findings for the cardiovascular system | irregular rhythm, distant heart sounds, murmur, and S^1 and S^2 heart sounds, diminished or absent peripheral pulses, slow or absent capillary refill, hypertesnsion or hypo-tension, abnormal rhythm |
| abnormal findings for breasts | lumps, abnormal tenderness, nipple discharge, nipple inversion, retraction or dimpling, enlarged axillary lymph nodes |
| abnormal findings for genitalia and rectum | abnormal tenderness, rashes, lesions, vesicles, or ulcerations, purulent drainage, inflamed, edematous or dry mucous membranes, weak pelvic floor, asymmetrical or enlarged testicles, poor anal sphincter tone, hemorrhoids or fissures, blood in stool |
| abnormal findings for abdomen | firm, distended, tender abdomen, hypoactive, hyperactive, or absent bowel sounds, masses, lesions, or hernias, hepatomegly or splenomegaly |
| abnormal findings for legs and feet | abnormal color,rashes, lesions, edema, weak irregular or absent pulses, varicosities, slow capillary refill, muscle weakness, lack of coordination, decreased rom, nails that are absent brittle ridged cracked yellowed or thickened |
| abnormal findings for mental status | confusion or inappropriate verbal responses, lethargy or agitation, aphasia or dysphasia, short or long term memory loss, diminished or absent reflexes or sensations, poor coordination, complaints of vertigo |
| what positions do you use a diamond drape | lithotomy, knee-chest and sims |
| what is the formula to convert lbs to kg | lb/2.2=kg |
| what is the formula to convert kg to lbs | kgx2.2=lbs |
Created by:
rewebb
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