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Examination methods Flashcards

1
Q

Diagnosis making process

A

History, physical exam and additional techniques are all processed to eventually come to a diagnosis, then we can determine prognosis and treatment

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2
Q

Purpose of clinical exam

A

To detect the clinically significant abnormalities of function and determine the body system involved

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3
Q

Purposes of a diagnosis

A

Recommend specific treatment
Accurate prognosis
Recommendations of cost effective control
Prevention of new cases when groups of animals are at risk

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4
Q

Methods of exam

A

Physical
Additional
Clinical lab

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5
Q

Physical exam

A 
Inspection
Palpation
Auscultation
Percussion
Olfaction
Measuring
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6
Q

Additional exams can be …

A

Instrumental or non-instrumental

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7
Q

Non-instrumental additional exams

A 
Aspiration
Biopsy
Centesis
Excision
Extirpation
Tubing 
Catheter
Laparotomy
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8
Q

Instrumental additional exams

A 
X-ray
ECG
US
Endoscopy 
CT
MRI
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9
Q

Clinical lab exams

A 
Urine 
Blood
Faeces
Rumen content 
Liquor 
Milk
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10
Q

What is a symptom?

A

Changes which are observed by the owner

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11
Q

What is a sign?

A

Abnormal findings of the vet during the physical exam
Can be:
Specific= pathognomic
Permanent
Main=chief
Non-specific/ temporary e.g anorexia, lethargy, vomitting
Accessory (so not the chief?)

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12
Q

What is a syndrome?

A

Special group of symptoms that are characteristic/ highly specific for a disease

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13
Q

Diagnosis

A

The name of the disease

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14
Q

Inspection, 2 areas

A

General and by body regions

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15
Q

Inspection: general

A 
Skin
Posture
Behaviour 
Gait
Condition
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16
Q

Inspection: body regions

A

With the unaided eye
With aid of instruments e.g opthalmascope, otoscope, vaginoscope, penlight, radiography, US, endoscope
Give enough time and attention
Good lighting

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17
Q

Palpation

A

Direct vs indirect
Outside vs inside
Superficial vs deep

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18
Q

What are you looking for alterations in when you palpate?

A 
Location
Shape
Size
Consistency
Structure
Painfulness
Movability
Surroundings
Symmetry
Surrounding skin: integrity, temp, lifting up to a skinfold
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19
Q

Palpation: ballotation

A

Ballotation and auscultaion

“Floating” organs, push sharply with a finger and detect it by the returning impact

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20
Q

Undulation

A

Tactile percussion
Detects fluid, like a ballon filled with water
Pneumoundulation can be seen with fat

21
Q

Terms of consistency

A 
Doughy
Soft,Hard Rubber, Firm
Hard 
Fluctuating 
Emphysematous
22
Q

Doughy

A

Pressure causes pitting which can last for variable periods of time
Often seem in edema

23
Q

Soft-hard, rubber, firm

A

Resistance to pressure is similar to that of a normal liver

24
Q

Hard

A

Bone like consistency

25
Fluctuating
Indicates fluids? | Wave-like movement produced by the structure by the alternating application of pressure
26
Emphysematous
Indicates air or gas in the tissue Structure is enlarged or puffy Yields on pressure Crepitating or crackling sound
27
Auscultation
Use a stethoscope Want to detect spontaneous or artificially induced sounds Indirect- mediate Direct- immediate
28
General rules of auscultation
Animal is standing still Follow a certain exam order Silence *Lift left leg Move 5-6 ICS 1 or 2 full inspiration and expiration cycles
29
Auscultation: sound
Combination of vibrations with different frequencies
30
Auscultation: noise
No special underlying relation among frequencies | No periodic character
31
Acoustic percussion
``` Conducted to obtain info about the surrounding tissues It creates sound waves/ resonance Lung border estimation Tissue depth estimation up to 7cm Lesions at least 5cm in diameter ```
32
Acoustic percussion: areas
Thorax Paranasal sinuses Abd cavity Subcut emphysema
33
Pain percussion
Percussion blow, first do it weak and superficial- to define the borderline, then do it stronger and deeper To localize pain
34
Methods of percussion
Direct: finger on finger Indirect: plessimeter and percussion hammer
35
Components of percussion sound
Crackling sound of hammer and plessimeter Sound of thoracic wall or wall of any organ Resonant sound of gas/fluid filled organ
36
The main percussion sounds
Sonorous/resonant: air containing organ e.g lung Damped/dull: not containing gas! e.g muscle Tympanic: higher in pitch due to large amount of air in the organ e.g in gastric volvulus
37
The normal percussion sound of small animals
Volume: Sharp Pitch/frequency: high or low Tone: sonorous/ resonant Duration: long
38
Special sounds heard during percussion
Metallic/ steel-like Cracked Hollow/drum like
39
Metallic/ steel like abnormal percussion sound
High pitch Sharp Musical Often heard with abomasal displacement
40
Cracked abnormal percussion sound
Rasping, whizzing sound with additional noises
41
Hollow/ drum like abnormal percussion sound
Strong, high, long | Can be tympanic or non-tympanic
42
Smelling
Expired air Oral cavity Skin Excreta e.g urine and faeces * EPI faeces contain undigested fat, smells like melted butter Gastroenteritic- smells putrid
43
Measuring
Thermometer Measuring tape Vernier caliper- thickness of skin String of calibrated ovoids
44
Deductive diagnosis
Based on pathognomic symptoms e.g tetanus
45
Excluding diagnosis
I.e Differential diagnosis
46
Diagnosis ex juvantibus
From obtaining the therapeutic results | E.g babesiosis
47
Types of diagnosis
Casual, aetiological e.g parvoenteritis Topographical- concerning an organ e.g hepatitis Symptomatic e.g jaundice, fever Functional e.g lameness of the urinary bladder Tentative- suspect before the final diagnosis e.g scabies Main and additional e.g enteritis and flea allergy
48
Diagnosis: comparing with reality
``` Exact Objective Presumptive Undetermined False ```
49
Possible causes of a false diagnosis
``` Diagnosing without examination Exam is not accurate enough Misunderstanding symptoms Prestige-based diagnosis Not doing repeat exams Insufficient diagnostic equipment Incorrect interpretation of lab data ```

SAM (16 decks)

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