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Techniques of physical assessment:
Aspects of inspection include:
- look for size, shape, color, symmetry, position, and abnormality.
- check for symmetry
- Validate findings with patient
Aspects of palpation:
- start with light - move to deep
- use differing parts of the hand to detect different characteristics.
What can percussion help you to determine?
size and density of structures
During auscultation what portion of the stethoscope would you use for low sounds?
Bell for low
murmurs or carotid artery
What is a bruit?
pronounced "brew-ee' - abnormal sound made by blood flowing through a narrowed artery
General survey entails:
assessment of: appearance, vial signs, height & weight
- personal care
- breathe smell
Skin assessment entails what techniques?
inspection & palpation
What details are included in a skin assessment?
Color: pigmentation and color
- Turgor / hydration
bluing of the skin, may indicate low oxygenation
Yellowing of the skin or sclera, may indicate poor kidney function
Redness, may indicate circulation changes.
Can be seen in the scrum, heels, hips
What does ABCD stand for when using in skin assessment?
- Border irregularity
Where and how would you assess for edema?
ankles, instep, calf
palpate to determine mobility, consistency, and tenderness.
Turgor refers to:
elasticity of the skin.
edema or dehydration may affect turgor
Hearing is associated with which cranial nerve?
- vestibulocochlear nerve -
- inner ear to the brain - balance
Hearing acuity can be tested by what 3 methods?
What is ototoxicity?
injury to the auditory nerve due to antibiotic use
What should a healthy tympanic membrane look like?
pearly gray / cone of light
Describe a normal bronchovesicular sound:
blowing, medium in pitch, medium intensity, inspiratory is equal to expiratory
Where is best to hear bronchovesicular sounds?
anterior over bronchioles, lateral to the sternum at intercostal spaces 1 and 2
posterior between scapulae
What side of the stethoscope would you use to listen to a child?
Normal Vesicular sounds can be described as :
soft, breezy, and low pitched.
Inspiration lasts 3 X longer than expiration
Rails or crackles can indicate what in the lungs?
random, sudden re-inflation of aveoli - fluid
may be cleared with coughing
Rhonchi may indicate what in the lungs?
Fluid, mucus in the larger airways
Wheeze heard in the lungs may indicate what?
narrowed airways due to inflammation
Where would you assess PMI?
Point of Maximal Impulse
intercostal space 5 - medial to the midclavicular line
Closing of the bicuspid or mitral valve is called what?
At what location would you hear the closure of the tricuspid valve?
- Apex - this would be S1 or "lub"
- 5th intercostal space
When the aortic and pulmonic valves close, what do you hear?
"dub" or S2
What heart sound can you hear at the Left ICS 2 ?