detailed_physical_exam medic12

Card Set Information

Author:
thom.mccusker@gmail.com
ID:
96885
Filename:
detailed_physical_exam medic12
Updated:
2011-08-14 13:26:53
Tags:
detailed physical exam medic12
Folders:

Description:
detailed_physical_exam medic12
Show Answers:

Home > Flashcards > Print Preview

The flashcards below were created by user thom.mccusker@gmail.com on FreezingBlue Flashcards. What would you like to do?


  1. DCAP-BTLS
    • 1. derformity
    • 2. contusions
    • 3. abrasions
    • 4. punctures/penetrating injuries
    • 5. bruising/burns
    • 6. tenderness
    • 7. lacerations
    • 8. swelling
  2. Examination Techniques
    • 1. inspection
    • 2. auscultation
    • 3. palpation
    • 4. percussion
  3. Areas of Exam
    • 1. head
    • 2. eyes
    • 3. ears
    • 4. nose & sinus
    • 5. mouth & pharynx
    • 6. face
    • 7. jaw
    • 8. neck
    • 9. chest
    • 10. abdomen
    • 11. pelvis
    • 12. genitalia
    • 13. annus & rectum
    • 14. peripheral
    • 15. posterior
    • 16. neurologic
  4. Head
    • I) inspect
    • 1. symmetry
    • 2. obvious deformities
    • 3. obvious bleeding
    • 4. bruises
    • 5. lice, parasites
    • II) palpate
    • 1. DCAP-BTLS (specifically for)
    • a. deformities
    • b. areas of unusual warmth
    • c. point tenderness
    • 2. step offs
    • 3. crepitus, loose fragments
  5. Eyes
    • I) inspect
    • 1. symmetry in size, shape, contour
    • 2. sclera & conjuctive for discoloration, swelling & exudates
    • 3. orbits for periorbital ecchymosis "raccoon eyes"
    • 4. test cranial nerves II, III, IV & VI - optic, oculomotor, trochlear & abducens
    • a. pupils for equality, reactivity (CN2)
    • b. test for conjugate movement & extra ocular movement
    • c. test for accommodation
    • d. test for ability to follow your finger in an H pattern
    • e. test for peripheral vision & visual acuity (CN3, 4, 6)
  6. Ears
    • I) inspect
    • 1. deformities, lumps, lesions, erythema
    • 2. drainage [a)blood b)csf c)mucus d)pus]
    • 3. visualize they tympanic membrane w/ otoscope
    • 4. visualize behind ear for discoloration suggestive of battlesigns
    • 5. test CN VIII (vestibulocochlear nerve)
    • a. hearing acuity, orientation & balance
    • II) palpate
    • 1. tragus & mastoid process for tenderness
  7. Nose & Sinus
    • I) inspect
    • 1. symmetry (deviation shape/color)
    • 2. flaring of nostrils
    • 3. blood or other drainage
    • 4. nasal mucosa for evidence of drainage (note color, quantity, consistency)
    • 5. II) palpate
    • 1. integrity
    • 2. nasal obstruction
    • 3. frontal & maxillary sinuses for swelling & tenderness
    • 4. ability to smell CN I (olfactory)
  8. Mouth & Pharynx
    • I) inspect
    • 1. condition/color of lips for pallor or circumoral cyanosis
    • 2. oral musosa for color, turgor, lesions, nodules, fissures
    • 3. buccal mucosa
    • 4. tongue for malignancies & discoloration - especially sides & bottom
    • 5. test CN IX & X (glossopharyngeal, vagus)
    • a. ability to extend tongue & move side to side
    • 6. test CN XII (hypoglossal)
    • a. verbalize "aaaah" w/ tongue blade in center of tongue
    • 7. note fluids or odors coming from mouth
  9. Face
    • I) inspect
    • 1. symmetry
    • 2. test CN VII (facial)
    • a. ability to use facial muscles equally & bilaterally (have pt smile, wrinkle forehead, clench eyes tightly)
    • b. mastoid process for discoloration (battle signs)
    • II) palpate
    • 1. integrity/stability of bones
  10. Jaw
    • I) inspect
    • 1. symmetry, discoloration, bruising, swelling, deformity
    • II) palpate
    • 1. point tenderness
    • 2. test CN V (trigeminal)
    • a. corneal reflex, ability to clench
    • 3. TMJ for equal movement w/ presure
    • 4. evaluate tempormandicular joint for tenderness, swelling & range of motion
  11. Neck
    • I) inspect
    • 1. symmetry, discoloration, bruising, swelling, deformity
    • 2. visible lymph nodes, surgical scars, masses
    • 3. evaluate JVD at 45 degree angle
    • 4. trachea deviation
    • II) auscultate
    • 1. carodid arteries for bruits
    • III) Palpate
    • 1. back of neck
    • a. point tenderness
    • b. crepitus
    • c. step offs
    • 2. lymph nodes for swelling
    • 3. thyroid gland for swelling/tenderness
    • 4. carodid arteries for equility (gently & separately)
    • 5. test CN XI (spinal accessory)
    • a. have pt shrug shoulders then turn head side to side
    • 6. subcutaneous emphysema
  12. Chest
    • I) inspect
    • 1. note respiratory rate & breathing patterns
    • 2. symmetrical or asymmetrical movements
    • 3. structural symmetry
    • 4. use of sternocleidomastoidal, suprasternal, supraclavicular & intercostal muscle use (accessory muscles)
    • 5. bruising, contusions, discolorations, lacerations, punctures
    • 6. skin pallor & other signs of decreased perfusion
    • 7. count respiration rate & note breathing pattern
    • II) auscultate
    • 1. quality at 6 points of evaluation (side to side, anterior & posterior)
    • 2. heart sounds (murmurs, valve noise or hyper resonance)
    • a. S1 (apex of heart)
    • b. S2 (base of heart)
    • c. S3 (apex w/ PT on their L side)
    • d. S4 (at the width (???) w/ PT on their L side)
    • III) palpate
    • 1. bilateral expansion
    • 2. mechanical integrity (covering entire rib cage)
    • 3. loose segments
    • 4. crepitus
    • 5. tenderness/deformity
    • 6. evaluate for excursion (anterior/posterior)
    • 7. evaluate for tactile fremetis
    • 8. apical impulse - PMI
    • IV percuss (anterior/posterior 6 points or more for resonance)
  13. Abdomen
    • I) inspect
    • 1. distension, rigidity, symmetry
    • 2. guarding
    • 3. discoloration, bruising, scars, stretch marks
    • 4. rashes, lesions
    • 5. Cullen's sign / Grey Turner's sign
    • 6. ascites or other masses
    • II) palpate
    • 1. point tenderness all 4 quadrants & epigastric - examining area of complaint LAST
    • a. using fingertips gently 1st - then deeper for rebound
    • 2. regidity
    • 3. superficial organs
    • III) percuss (for resonance)
  14. Pelvis
    • I) inspect
    • 1. symmetry, bruising, deformities
    • II) palpate (compress gently)
    • 1. stability, point tenderness, crepitus
    • 2. range of motion
    • 3. equality of femoral pulses
  15. Genitalia
    • I) inspect (ONLY if indicated by complaint or index of suspicion)
    • 1. priapism, hemorrhage or penetrating injury
    • 2. inflamation, swelling, lessions
  16. Anus & Rectum
    • I) inspect (only if indicated by complaint or index of suspicion)
    • 1. anus for hemorrhoids, lacerations
    • 2. perineum for wounds, tears, punctures
    • 3. hemocult if indicated
  17. Peripheral (all four extremities)
    • I) inspect
    • 1. size & symmetry
    • 2. deformaties, bruising, discolorations, hemorrhage
    • 3. puncture, lacerations, burns, swelling, lesions, tenderness
    • 4. color of skin
    • 5. nail beds & fingertips
    • 2. test for range of motion passively & actively
    • 3. evaluate for swelling
    • II) palpate
    • 1. skin temperature, moisture, turgor, edema
    • 2. regidity
    • 3. crepitus
    • 4. capillary refill, sensory & motor sensation distally
    • 5. joints
    • 6. locate & compare peripheral pulses for rate & quality
  18. Posterior
    • I) inspect (head to tow "every inch")
    • 1. DCAP-DTLS
    • II) palpate (head to tow "every inch")
    • 1. DCAP-BTLS
  19. Neurologic
    • I) ascertain for signs of hypoperfusion
    • II) focused history for neurologic
    • 1. reassess mental status
    • 2. access perceptual process for coherence, hallucination, delusion or phobias
    • 3. access mood & effect for depression, elation, anxiety & agitation
    • 4. access intelligence for speech, level of covabulary & ability to formulate an idea (note speech patterns & use language)
    • 5. access judgement for recognition of problems, denial & blame of others
    • 6. access psychomotor for unusual posture or movements
    • 7. assess motor tone/strength. check for pronator drift sideways or upwards.
    • 8. assess cerebellum for coordination w/ rapid alternating movements & point to point testing.
    • 9. test all cranial nerves
    • 10. test deep tendon reflexes
    • a. bicep, triceps, brahcioradialis, quadriceps, achilles, superficial abdominal & plantar
    • 11. assess ability to differentiate between sharp & dull sensation scatter stimuli

What would you like to do?

Home > Flashcards > Print Preview