Examinations Flashcards

Question

Abdominal examination - process

Answer 1

1. Introduction 2. General inspection [Abdominal distention, pain, jaundice, ] 3. Hands and arms [Dupytrens contracture, palmar erythema, finger clubbing, leuchonychia, koilonychia, purpura, radial pulse, fistulae, injection marks] 4. Face and neck [Xanthelasma, jaundice, pallor, ulcers, pigmentation, telangiectasia, stomatitis, glossitis, poor dentition, gingivitis, candidiasis, tonsillar infections, odours, JVP] 5. Chest inspection [Spider naevi, gunaecomastia, loss of axillary hair] 6. Abdominal inspection [Movement, distension, scars, hernias, dilated veins, scratch marks, pulsations, striae, grey turner's sign, Cullen's sign] 7. Abdominal palpation [Superficial, deep, hepatomegaly, splenomegaly, ballot the kidneys, aorta, murphy's sign] 8. Abdominal percussion [Liver, spleen, bladder, flanks] 9. Abdominal auscultation [Renal bruits, bowel sounds, aorta bruits] 10. Renal tenderness 11. Lymphadenopathy 12. Ankle oedema 13. Conclusion and summary

Answer 2

Introduction General inspection [Bell's palsy, herpes zoster virus, position of head, glasses, hearing aid] Cranial nerve I [Olfactory] = Have you noticed a change in sense of smell or taste recently? ``` Cranial nerve II [Optic] = Inspect eyes closely = Double vision? = Difficulty walking down the stairs when walking? = Visual acuity (snellen chart) = Visual field (occlude one eye and chest quadrants] = Fundoscopy = Light reflexes (direct and consensual) = Accommodation reflex =Eye movements ``` Cranial nerve II [Occulomotor] = Light reflexes = Accommodation reflex = Eye movements Cranial nerve IV [Trochlear] = Eye movements Cranial nerve V [Trigeminal] = Cutaneous facial sensation (neuropin and light touch) = Temporalis and masseter wasting and power = Protraction = Side-side movement = Open jaw against resistance = Jaw jerk Cranial nerve VI [Abducens] = Eye movements ``` Cranial nerve VII [Facial] = Inspect for mouth dropping, nasolabial fold = Muscle power = Corneal reflex (CN V and VII) = Change in taste ``` ``` Cranial nerve VIII [Vestibulocochlear] = Hearing aid? = Inspect ears = Auroscopy = Whisper test = Weber and Rinne's test = Vertigo? ``` ``` Cranial nerve IX [Glossopharyngeal] and X [Vagus] = Inspect palate pharynx = Observe uvula = Observe speaking and coughing = Gag reflex ``` Cranial nerve XI [Accessory nerve] = Sternocleidomastroid - head movement against resistance = Trapezius - shrugs shoulder ``` Cranial nerve XII [Hypoglossal] = Inspect tongue = Movement of tongue = Power of tongue = Tongue twister ``` Conclusion

Answer 3

1. Introduction 2. General inspection [Breathlessness, Catheters, IV fluids, drains, vomit/sputum bowels] 3. Inspect Hands [Capillary refill time, skin turgor, temperature, pulse, blood pressure, collapsing pulse] 3. Inspect face [Sunken eyes, dry mouth, JVP, carotid pulse] 4. Inspect and palpate chest [Skin turgor, capillary refill time, apex beat] 5. Auscultate chest [Heart sounds, lung bases] 6. Inspect abdomen [Ascites] 7. Inspect legs [Peripheral oedema] 8. Conclusion

Answer 4

1. Introduction 2. General inspection 3. Cervical lymphadenopathy 4. Axillary lymphadenopathy 5. Inguinal lymphadenopathy 6. Palpate and Percuss liver 7. Palpate and percuss spleen 8. Conclusion

Answer 5

1. Introduction 2. General inspection - surroundings (drains, drugs, drips, drinks) - patient - shoes - swelling - bones/joints 3. Palpation - temperature - capillary refill - pulses - monofilament - vibration

Answer 6

``` Site = Gaiter region Depth = Superficial Edges = Sloping Base = Granulating Colour = Pink Pain = Moderate Other = varicosities, venous eczema, haemosiderin deposits, lipodermatosclerosis ```

Answer 7

``` Site = Sole Depth = Deep Edges = Punched out Base = Sloughy and pale Colour = Pale Pain = Painful Other = Loss of pulses ```

Answer 8

``` Site = Sole Depth = Deep Edges = Punched out Base = Sloughy and bloody Colour = Red Pain = No pain Other = Neuro loss ```

Answer 9

1. Introduction 2. General inspection = Walking aids ``` 3. Inspection of the upper limbs = Muscle fasciculations = Posture, asymmetry = Size and shape of muscles = Scars or bruising ``` 4. Assess tone 5. Assess power = Shoulder abduction [Deltoid C5/6] = Elbow flexion [Biceps C5/6] = Elbow extension [Triceps C7/8] = Wrist extension [Radial and ulnar extensors C6/7/8] = Wrist flexion [Radial and ulnar flexors C6/7/8] = Finger flexion [Long and short finger flexors C8] = Finger abduction/adduction [Intrinsic muscles T1] = Thumb abduction [Abdctor pollicis brevis T1] 6. Assess reflexes = Biceps [C5] = Brachioradialis [C6] = Triceps [C7] ``` 7. Assess sensation = Light touch = Pinprick = Vibration = Proprioception ``` ``` 8. Assess co-ordination = Dysdiadochokinesia (flip hand around quickly) = Finger-to-nose test (tremor) = Finger-to-thumb test = Pronator drift = Cerebellar drift ``` 9. Conclusion

Answer 10

1. Introduction 2. General inspection = Walking aids ``` 3. Inspection of the lower limbs = Muscle fasciculations = Posture, asymmetry = Size and shape of muscles = Scars or bruising ``` 4. Assess tone 5. Assess power = Hip flexion [Iliopsoas L1/2] = Hip adduction [Adductors L2/3] = Knee extension [Quadriceps L3/4] = Ankle dorsiflexion [Tibialis anterior L4] = Ankle plantarflexion [Gastrocnemius S1/2] = Great toe dorsiflexion [Extensor hallucis longus L5] ``` 6. Assess reflexes = Knee jerk [L3/4] = Ankle jerk [S1] = Clonus = Plantar's response (Babinski's sign) ``` ``` 7. Assess sensation = Light touch = Pinprick = Vibration = Proprioception ``` ``` 8. Assess co-ordination = Heel-shin = Gait = Heel-to-toe = Romberg's test ``` 9. Conclusion

Answer 11

1. Introduction 2. General inspection 3. Inspect hands + measure pulse 4. Inspect face and eyes 5. Inspect neck 6. Palpate neck and thyroid 7. Cervical lymphadenopathy 8. Percuss sternum 9. Auscultate over thyroid gland 10. Inspect lower limbs - pre-tibial myxedema 11. Assess reflexes 12. Ask patient to stand from a chair without assistance 13. Conclusion

Answer 12

1. Introduction 2. General inspection HYPER = heat intolerance, sweating, agitation, tremor, weight loss, HYPO = cold intolerance, shivering, lethargy/drowsy, puffiness/general oedema, weight gain 3. Inspect hands + measure pulse HYPER = warm and sweaty hands, palmar erythema, thyroid acropachy (clubbing = GRAVES), tachycardia, irregular pulse i.e. AF HYPO = cold dry skin, bradycardia 4. Inspect face and eyes HYPER = hair loss, Exophthalmos, Lid lag, Lid retraction, opthalmoplegia HYPO = Puffiness, hair loss, loss of lateral eyebrows, dry skin 5. Inspect neck HYPER = goitre (GRAVES, MULTINODULAR) HYPO = goitre (HASHIMOTO'S) 6. Palpate neck and thyroid HYPER = goitre (GRAVES, MULTINODULAR) HYPO = goitre (HASHIMOTO'S) 7. Cervical lymphadenopathy 8. Percuss sternum HYPER = Retrosternal goitre 9. Auscultate over thyroid gland HYPER= thyroid bruits 10. Inspect lower limbs - pre-tibial myxedema HYPER = Pre-tibial myxedema 11. Assess reflexes HYPER = Brisk reflexes HYPO = Slow relaxing reflexes 12. Ask patient to stand from a chair without assistance HYPER = Proximal myopathy 13. Conclusion

Examinations Flashcards

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