Instruments

Question 1

Prone

Answer 1

Patient’s belly is down

Question 2

Left lateral recumbent

Answer 2

Patient’s LEFT side is down

Question 3

Right lateral recumbent

Answer 3

Patient’s RIGHT side is down

Question 4

General Examination Order

Answer 4

Inspection
Auscultation
Percussion
Palpation

Question 5

Osteopathic Structural Exam (OSE)

Answer 5

Integrates information about the musculoskeletal system even when dealing with non-musculoskeletal complaints

Question 6

Ophthalmoscope

Answer 6

Examine fundus/retina/posterior chamber & pupillary reflex
Patient looks over examiner’s shoulder
Hand and patient’s head
RIGHT hand examine RIGHT EYE
LEFT hand examine LEFT EYE
Lateral to medical under over iris, move toward patient
Direct and consensual pupillary light reflex
Red reflex
Bilaterally

Question 7

Direct pupillary light reflex

Answer 7

When light shined in eye that pupil constricts

Question 8

Consensual pupillary light reflex

Answer 8

When light shined in eye, pupil of other eye also constricts

Question 9

Snellen Eye Chart

Answer 9

20/20 = normal
20/40 = person sees at 20 ft what normal people see at 40 ft
Held 14 inches from eyes
Read at least two lines of letters in order of decreasing size
Test both eyes open then cover one eye at a time

Question 10

Otoscope

Answer 10

Pull up, out, and back
Insert about 1/4 - 1/2 length of speculum
Use depressor for oropharyngeal exam
Say “ahh” to raise soft palate

Question 11

Stethoscope

Answer 11

Diaphragm - higher frequency sounds
Bell - lower frequency sounds

Ear pieces face forward in the external auditory meatus

Question 12

Tuning fork

Answer 12

Air conduction - last longer, hold fork at external auditory meatus
Bone conduction - less than air conduction, hold handle at occipital condyle behind ear
Vibratory sense - place hand on patella and compare left and right for duration

Question 13

Reflex hammer

Answer 13

Strike bilaterally and compare
Patient relaxed, examiner quickly strikes tendon
Note speed and intensity

Question 14

Sphygmomanometer

Answer 14

Choose a cuff where the width of the bladder is 40% of upper arm circumference, length 80%
Patient’s arm between you and the patient
Arrow aligned with brachial artery
Hold arm at level of their heart
Ask patient to relax
Place diaphragm of stethoscope just below cuff over brachial artery
Listen for 1st Korotkoff sound (systolic number) and later Korotkoff sound (diastolic number)

Question 15

Universal Precautions

Answer 15

Protect patient and provider from spread of infectious disease
Gloves used in presence of blood or bodily fluids
Hand washing before and after wearing gloves

Question 16

Proper glove use

Answer 16

Wash and dry hands
Remove glove and hold it at open end
Pull cuff over hand
Dispose in proper container

Question 17

Inspection

Answer 17

Begins when you walk into the room
Age, self-care, posture
Mobility
Asymmetry
Color changes
EVENTUAL GOAL: "SICK" OR "NOT SICK"

Question 18

Auscultation

Answer 18

Identify sounds of various body structures

• air moving in lungs
• heart tones, valves opening and closing
• vascular flow in large arteries
• gastric contents moving through intestines

Question 19

Percussion

Answer 19

Tap with 3rd finger over last joint while pads of finger are in contact with surface
Differentiate between fluid, air, or solid below the surface based on sound
* dull, flat, tympanic

Question 20

Osteopathic Tenets

Answer 20

The body is a unit
The body possesses self-regulatory mechanisms
Structure and function are reciprocally interrelated
Rational therapy is based upon an understanding of body unity, self-regulatory mechanisms, and interrelationship of structure and function

Question 21

Applying and Removing Gloves

Answer 21

Wash hands
Apply gloves
Remove one glove and hold onto it
Pull the cuff over the hand and encase the gloves
Dispose in proper container - Red Bags are for supplies contaminated with body fluid or potentially infectious debris

Question 22

Supine

Answer 22

Patient’s back is down