General Skills

Question 1

What are the subjects for the general survey

Answer 1

Alertness
Age
Distress
Body habitus (type/BMI)
Movement (posture/gait/strength/tremors/tics/etc.)
Appearance/hygiene
Behavior

Question 2

Normal HR

Answer 2

60-100 bpm

Question 3

Normal RR

Answer 3

12-20/min

Question 4

Normal temperature (C)

Answer 4

35.8 - 37.3

Question 5

Normal temperature (F)

Answer 5

96.4 - 99.1

Question 6

Fever temperature

Answer 6

38 C or 100.3 F

Question 7

Hypothermia temperature

Answer 7

<35 C or <95 F

Question 8

Normal BP

Answer 8

<120/80

Question 9

Elevated BP

Answer 9

> 120/80

Question 10

Hypertensive BP

Answer 10

<130/>80

Question 11

Hypotensive BP

Answer 11

<90/60

Question 12

What do we look at on the head exam

Answer 12

Hair
Scalp
Skull
Face
Skin

Question 13

What tests are run on the eye exam

Answer 13

Visual acuity
Visual fields
Inspection
Pupillary reaction
Extraocular muscles
Ophthalmoscope

Question 14

Normal optic disc features

Answer 14

Blurring on nasal side
Yellow-creamy pink
Cup is half the size of the disc
Symmetrical

Question 15

What does a papilledema indicate

Answer 15

Meningitis
Subarachnoid hemorrhage
Trauma
Lesions

Question 16

What is the diopter setting for anterior structures and why

Answer 16

+10 or +12
For opacities in vitreous humor or lens

Question 17

When assessing tenderness on the external ear, what are we looking for

Answer 17

Pain with otitis externa (auricle and tragus)
Pain with mastoiditis (mastoid process)

Question 18

Most common CN II tests

Answer 18

Visual fields
Pupillary light reflex

Question 19

Test for CN III, IV, and VI

Answer 19

“H” Test

Question 20

Most common CN V test

Answer 20

Facial sensation
Corneal reflex

Question 21

Most common CN VII test

Answer 21

Smile
Raise eyebrows
Clench eyes

Question 22

Most common CN VIII test

Answer 22

Finger rub

Question 23

Most common CN IX, X test

Answer 23

“AH” while observing soft palate

Question 24

Most common CN XI test

Answer 24

Shoulder shrug
Turn head

Question 25

Most common CN XII test

Answer 25

Stick out tongue

Question 26

Scale of muscle strength

Answer 26

0-5 0 - no contraction 1 - barely detectable 2 - activation w/ gravity eliminated 3 - active movement against gravity 4 - active movement against gravity and resistance 5 - active movement against full resistance (normal)

Question 27

What muscle and spinal level is tested with motor strength for abduction at shoulder

Answer 27

Deltoid C5 - C6

Question 28

What muscle and spinal level is tested with motor strength for elbow flexion

Answer 28

Biceps C5 - C6

Question 29

What muscle and spinal level is tested with motor strength for elbow extension

Answer 29

Triceps C6 - C8

Question 30

What spinal level is tested with motor strength for hand grip

Answer 30

C7 - T1 (includes C8)

Question 31

What muscle and spinal level is tested with motor strength for hip flexion

Answer 31

Iliopsoas L2 - L4

Question 32

What muscles and spinal levels are tested with motor strength for knee flexion

Answer 32

Hamstrings L4 - S2

Question 33

What muscle and spinal level is tested with motor strength for knee extension

Answer 33

Quadriceps L2 - L4

Question 34

What spinal level is tested with motor strength for foot dorsiflexion

Answer 34

L4 - L5

Question 35

What spinal level is tested with motor strength for foot plantar flexion

Answer 35

S1

Question 36

Scale for reflex grading

Answer 36

0 - 4 0+ - absent 1+ - diminished 2+ - average 3+ - brisk but not pathologic 4+ - very brisk/hyperactive

Question 37

What does a hyperactive reflex indicate

Answer 37

Upper motor neuron lesion

Question 38

What does an absent reflex indicate

Answer 38

Lower motor neuron lesion

Question 39

Upper extremity reflexes are tested where and for what spinal levels

Answer 39

Biceps (C5-C6) Brachioradialis (C6) Triceps (C7)

Question 40

Lower extremity reflexes are tested where and for what spinal levels

Answer 40

Patellar (L4) Achilles (S1) Plantar response

Question 41

What is the Romberg test

Answer 41

Stand with feet together, arms crossed or at side. Eyes open and eyes closed to look for swaying/imbalance

Question 42

Which of the following is the most accurate measure of core body temperature

Answer 42

Rectal

Question 43

What is not part of the general survey

Answer 43

Temperature

Question 44

What is most closely associated with the sounds of turbulent blood flow

Answer 44

Korotkoff

Question 45

What respiratory rate is consistent with bradypnea

Answer 45

Less than 10/min

Question 46

What BMI is consistent with ectomorph

Answer 46

<18.5

Question 47

What BMI is consistent with mesomorph

Answer 47

18.6 - 24.9

Question 48

What BMI is consistent with endomorph

Answer 48

>25

Question 49

If the initial BP reading is too high, what is the next alternative

Answer 49

Change arms

Question 50

What is the top number on the vision test

Answer 50

Standard 20 foot vision

Question 51

What is the bottom number on the vision test

Answer 51

Where a standard person would be able to see what the patient sees at 20 feet

Question 52

What is the best lighting during a fundoscopic exam

Answer 52

Dim

Question 53

Where are the hands placed while palpating the thyroid

Answer 53

Below cricoid cartilage

Question 54

What is the S1 heart sound

Answer 54

Tricuspid and mitral valve closure

Question 55

What is the S2 heart sound

Answer 55

Aortic and pulmonic valve closure

Question 56

Where is the aortic valve auscultated

Answer 56

Right second intercostal space at right sternal border

Question 57

Where is the pulmonic valve auscultated

Answer 57

Left second intercostal space at left sternal border

Question 58

Where is the tricuspid valve auscultated

Answer 58

Left fourth intercostal space at left sternal border

Question 59

Where is the mitral valve auscultated

Answer 59

Left fifth intercostal space at midclavicular line

Question 60

How many grades are there for murmurs

Answer 60

1 - 6

Question 61

What is a grade 1 murmur

Answer 61

Very faint, must "tune in", may not be heard in all positions

Question 62

What is a grade 2 murmur

Answer 62

Quiet but heard immediately

Question 63

What is a grade 3 murmur

Answer 63

Moderately loud

Question 64

What is a grade 4 murmur

Answer 64

Loud with palpable thrill

Question 65

What is a grade 5 murmur

Answer 65

Very loud, with thrill, may be heard with stethoscope barely on chest

Question 66

What is a grade 6 murmur

Answer 66

Very loud, with thrill, may be heard with stethoscope entirely off chest

Question 67

Shapes of murmurs

Answer 67

Crescendo Crescendo-decrescendo Decrescendo Plateau

Question 68

Sequence of thorax examination

Answer 68

Inspection Palpation Percussion Auscultation

Question 69

What is indicative by hyperresonance when percussing thorax

Answer 69

Pathological - COPD/emphysema Pneumothorax

Question 70

What is indicative by dullness when percussing thorax

Answer 70

Over heart, liver, below diaphragm Also heard with effusion or consolidation

Question 71

What is indicative by typmany when percussing thorax

Answer 71

Gastric bubble

Question 72

Types of breath sounds

Answer 72

Vesicular (lateral, distal lung) Bronchovesicular (bronchial tree) Bronchial (trachea, primary bronchials)

Question 73

Adventitial lung sounds

Answer 73

Crackles (course and fine) Wheezes Rhonchi