Preliminary General Exam
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Outline the Preliminary General Examination of the Patient (general headings):
- 1. Owner's Complaint, History and Anamnesis
- 2. Signalment - Description of Animal
- 3. Clinical Examination of the Patient
13 steps that are part of the Clinical Exam of the patient:
- 1. Condition
- 2. Demeanor
- 3. External Body Surfaces
- 4. Mucus membranes
- 5. Pulse
- 6. Respiration
- 7. Temperature
- 8. Feces
- 9. Urine
- 10. Examine head (eyes, oral cavity, pharynx, ears and nose)
- 11. Papillary light reflex & consensual light reflex
- 12. Auscultate the heart and lungs
- 13. Palpate the superficial lymph nodes
What constitutes the past and present (immediate) history?
Past History: past illnesses, vaccination record or previous surgeries like neuters, ORE,· tonsillectomy, etc.
Immediate History: questioning the owner about the duration of illness, symptoms observed and the animal's appetite, etc.
Two things you shouldn't do when obtaining a patients history:
- 1. Don't ask questions that only require a yes, or no answer, as this will make the history incomplete, or misleading.
- 2. Don't ask leading questions of the owner.
Why do we need a good description of the animal?
Legal evidence requiring the animal is likely to be required.
List 9 Signalments that should be documented on a patient's records:
- 1. Breed
- 2. Age
- 3. Sex
- 4. Color
- 5. Marking
- 6. Brand
- 7. Name and Number
- 8. Tattoo Marks
- 9. Permanent Blemishes or Defects
Define the General Demeanor and Condition of a patient:
General Demeanor: Basically used to identify the animal simply as looking healthy, or looking sick.
Condition: We are looking for all parts of the skeleton being covered with flesh giving the body a well rounded appearance. Look at hips and ribs for determining the condition.
Differentiate between a Healthy Animal and Sick Animal:
Healthy Animal: Lies quietly, eats normally and remains within the her.
Sick Animal: Shows various abnormalities of posture and behavior such as allowing the head, or ears to drop, etc.
Characteristics of a Poor Condition:
- - See the ribs
- - Rough; dry hair coat
- - Alopecia
- - Loss of skin elasticity
- - Broken coccygeal vertebrae
- - Phalanges missing; eye missing
Factors Associated with Poor Condition:
- - Nutrition
- - Poor living conditions
- - Illness
- - Trauma
Differentiate between Good Health and Bad Health when Examining External Surfaces of the Body:
Good Health: Smooth, glossy, pliable, and elastic skin.
Bad Health: Dry, scruffy, loss of elasticity and animals is to be "Hidebound."
______ and _______ has to be the two most common complaints small animal owners talk about when discussing the Integumentary System.
In determining the characteristics of deeper, underlying body structures, describe the structures as either:
- a) Doughy
- b) Firm
- c) Hard
- d) Fluctuant
- e) Emphysema
From a regional "hands on approach" one should evaluate the following 6 areas:
- a) Ears
- b) Eyes
- c) Nose
- d) Lymph Nodes (palpate)
- e) Vulva
- f) Penis
When examining the visible mucus membranes, what do the following colors mean:
- a) Pink - reflect the character of the circulating blood. A decrease in pink color indicates a decrease in RBC's and indicates anemia.
- b) Blue - the membranes are said to be cyanotic. This indicates a lack of oxygen in the blood.
- c) White - decrease in RBCs - possible anemia.
- d) Yellow - southern part of the United State means blood parasites and possible hepatitis. In the north, it means primarily hepatitis as blood parasites are infrequently noted in practice.
A decrease in pink color of the mucous membranes indicates a decrease in ____ and is indicative of _______.
- - RBCs; anemia
- - Ancylostoma, anemia, shock, large vessels that have been severed
When speaking of mucous membranes what are they talking about?
Visible mucus membranes around the eyelids, the mouth (lips and cheeks), opening to the penis and vulva-vagina
List 4 common causes of blue colored mucous membranes:
- - Heart failure (CHF)
- - Pneumonia
- - Disease of the lungs
- - Nitrate poisoning
What are some other 3 causes of Yellow colored mucous membranes?
- - Autoimmune Hemolytic Anemia (AIHA)
- - Hepatic syndrome
- - Blockage of the bile ducts
What 4 things would you look for when inspecting the lips as part of the oral cavity exam?
- - Inflammation ("lip fold pyoderma")
- - Tumors
- - Papillomas
- - "Hair-Lip"
Where to take the dogs pulse?
What 7 things can make the heart rate go up or down/alter the heart beat?
- 1. Exercise
- 2. Excitement
- 3. Weather
- 4. Fever
- 5. Pain
- 6. Inflammation
- 7. Local Heart Disease
What is the normal pulse rate of the:
Sheep and Goat:
- Dog: 60-120 bpm
- Cat: 110-130 bpm
- Sheep and Goat: 70-80 bpm
- Cattle: 40-80 bpm
- Horse: 28-40 bpm
- Swine: 60-80 bpm
- Poultry: 200-400 bpm
What animals have slower pulse rates?
- - Larger animals & older animals have a slower pulse rate than then smaller ones.
- - Males have a slower pulse rate than Females.
________ is the art of listening with the stethoscope to sounds produced by the function of various body organs
Guidelines for Good Auscultation:
- a) Performed in a quiet room.
- b) Performed with the bell portion of the stethoscope for the low-pitch sound and the diaphragm for high pitch sound.
- c) Performed with ear pieces directed anteriorly to align with the ear canal.
What are 2 general categories and causes of abnormal lung sounds?
- 1. Crackles (rales): compare to the crackling sound of cellophane. Due to fluid accumulation in the alveoli.
- 2. Wheezes (rhonchi): due to airway obstruction.
______________ is a fluctuation in the heart rate concurrent with respiration, and increasing heart rate is seen with respiration.
What are the 2 phases of respiration?
- - Inspiration: breathing in; rising of chest wall.
- - Expiration: breathing out; chest returns to normal resting position.
How do you count respiration?
Observe the rise and fall of the chest cavity. Each cycle represents one respiratory movement.
List the Respiration Rates:
Sheep and Goat:
- Dog: 10-30 rpm
- Cat: 20-30 rpm
- Cattle: 10-30 rpm
- Horse: 8-15 rpm
- Swine: 8-16 rpm
- Sheep and Goat: 10-20 rpm
- Chicken: 15-30 rpm
Differentiate a Productive and Non-Productive Cough:
Productive Cough - secretions, fluid, and mucous may be expelled from the airway.
Non-productive Cough - dry, hacking coughing with no material coming out with the cough.
What is Kennel Cough?
- - AKA Canine Infectious Tracheobronchitis.
- - Is an upper respiratory infection affecting dogs.
- - Parainfluenza virus (CpiV-2), Canine Adenovirus II, Bordatella bronchiseptica, and Canine Corona Virus.
What is the 1st noticeable sign of infection?
Where to obtain the temperature in birds?
Under the wing
Where to obtain the temperature in domestic animals?
List the normal temperatures for the following:
- Dog: 100 – 102° F
- Cat: 100-102° F
- Sheep: 102-104° F
- Goat: 101-104° F
- Cattle: 100-102° F
- Horse: 99-101° F
- Swine: 100-104° F
List 5 ways normal body temperature may be altered:
- - Exercise
- - Season
- - Pregnancy
- - Transportation
- - Excitement
List 2 Reasons Feces may Change Color, or Consistency:
- 1. Diet: cattle- green grass makes feces forever green and soft. Animals on a diet of hay and concentrates make the feces harder and darker brown.
- 2. Drugs: Phenothiazine (cattle de-wormer) occasionally leads to a reddish coloration in feces and in urine.
List 2 causes of Blood in the Feces:
- 1. Blood mixes with the feces from the upper part of the digestive tract is usually dark and tarry, i.e. hookworms
- 2. Blood from the lower part of the, digestive tract is bright redstained i.e. whipworms or colitis
If the urine is darker, the causes could be i.e.
- Red - Phenothiazine
- Blue - Methylene Blue
- Purple - Diathiazanine Iodide (Dizan)
List the term associated with Urination: Excessive Drinking -
Excessive Urination -
Small Amounts Frequently -
Difficult Urination -
Straining During Urination
- - Polydipsia
- - Polyuria
- - Pollakiuria
- - Dysuria
- - Stranguria
The Reproductive System and the Urinary System make up the _________ System.
_______: pupil constriction is normal.
_______: dilation of the pupil in the presence of light is abnormal.
_______: pupil constriction in the eye with light stimulus will result in pupil constriction in eye with no light stimulus.
- - Miosis
- - Mydriasis
- - Consensual Reflex
Identify the 4 valves and where to place the stethoscope:
- 1. Pulmonary Valve: Left side at intercostals space 3
- 2. Aortic Valve: Left side at intercostals space 4
- 3. Mitral Valve: Left side at intercostals space 5
- 4. Tricuspid Valve: Right side at intercostals space 5
Enlarged lymph nodes may be an indication of what 3 conditions/diseases?
- - The presence of a local or system infection
- - Allergy
- - Neoplastic disease (cancer)
List 4 common lymph nodes:
- 1. Mandibular
- 2. Axillary
- 3. Inguinal
- 4. Popliteal
3 common Venipuncture Sites -
- Feline: 1. External jugular
- 2. Cephalic
- 3. Femoral
- Canine: 1. External jugular
- 2. Cephalic
- 3. Lateral saphenous
List the 4 lobes of the lung:
- - apical
- - cardiac
- - diaphragmatic
- - intermediate
Lymph nodes are also known as:
Coughing at night is suggestive of ________.
Odor in the urine is indication of ______.
Wheezing, or Steror (snoring) is indication of what?
Airway may be obstructed.
Cardiovascular function can be evaluated by what?
- - Mucous membranes
- - Capillary Refill Time (CRT)
List 4 problems that might occur in the ear:
- - Otitis
- - Earwax with mites
- - Yeast infection
- - Grass awns
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