History Taking & Physical Examination

Question 1

How many minutes can you perform a thorough history and physical exam?

Answer 1

10-15 minutes

Question 2

YES or NO
prefer to take the history prior to the examination

Answer 2

YES

Question 3

Avoid leading questions (example: “You haven’t observed any change in appetite, have you?”

Question 4

age, sex, breed

Answer 4

Signalment

Question 5

Signalment

Answer 5

age, sex, breed

Question 6

Usually want to address this with owner early so they are aware that you know the reason for the visit.

Answer 6

Chief complain

Question 7

Body system review

Answer 7

Integument
Eyes and ears
Musculoskeletal
Cardiovascular
Respiratory
GI
Urogenital
Nervous

Question 8

“any history of skin problems; i.e., fleas, allergies, hair loss …?”

Body system to be review

Answer 8

Integument

Question 9

“any previous infections, hearing difficulties, sore eyes, head shaking…?”

Body system to be review

Answer 9

Eyes and ears

Question 10

“any problems walking or climbing stairs?…”

Body system to be review

Answer 10

Musculoskeletal

Question 11

“any coughing or weakness with exercise…?”

Body system to be review

Answer 11

Cardiovascular

Question 12

“ever see runny eyes, runny nose, cough, sneeze…?”

Body system to be review

Answer 12

Respiratory

Question 13

“how’s his/her appetite; any vomiting/diarrhea; foul breath…?”

Body system to be review

Answer 13

GI

Question 14

“is he/she neutered/spayed; any discharges; how is his/her H20 intake -increased/decreased; how is his/her urination - same as always; intact female?…”

Body system to be review

Answer 14

Urogenital

Question 15

“any history of seizures; tremors; weakness; collapse?…”

Body system to be review

Answer 15

Nervous

Question 16

Physical Examination Tools

Answer 16

Stethoscope
otoscope
ophthalmoscope
penlight
pleximeter
hemostat
glove

Question 17

Inspection from a distance:

Answer 17

Observe gait as animal enters room
Demeanor: shy, assertive, etc.
Mental status
Conformation and symmetry
Nutritional status
Neurological deficits
Visual deficits present Head tilt
Weakness

Question 18

Close inspection

Answer 18

Socialize first
Proceed slowly, using least restraint necessary

Question 19

uremic smells

Answer 19

NH3

Question 20

sweet smells

Answer 20

acetone

Question 21

-Use application of light finger pressure to the body surface to determine consistency of parts underneath. Trace structures, don’t grab them.

Answer 21

Abdominal Palpation

Question 22

Techniques for Abdominal Palpation of Cats and smaller dogs

Answer 22

one hand

Question 23

Techniques for Abdominal Palpation of Larger dogs

Answer 23

both hands

Question 24

Organs that are not palpable

Answer 24

liver, stomach, right kidney

Question 25

This organ may be palpable.

Answer 25

Left kidney

Question 26

Ability to palpate this organ is dependent upon degree of distension

Answer 26

bladder

Question 27

Primarily used for evaluation of the cardiovascular and respiratory systems. Can also be used in gastro-intestinal system.

Answer 27

Auscultation

Question 28

Bell for ______ sounds-heart

Answer 28

low-pitched

Question 29

Diaphragm for _______ sounds-airways

Answer 29

high-pitched

Question 30

blowing, like air through straw. Created by air moving through larger airways (sinuses, larynx, trachea, major bronchi)

Answer 30

Bronchial (tubular)

Question 31

Respiratory organs w/ loudest sound when auscult

Answer 31

larynx and trachea

Question 32

Thought to originate in part from separation and distention of alveoli by in-rushing air. Increased vesicular sounds occur with intensified respirations (physiologic), increased respiratory excursions (e.g., from fever), emphysema (are harsh), developing bronchitis.

Answer 32

Vesicular sounds

Question 33

__________ sounds secondary to decreased expansion of a lung, pleuritis, consolidation, neoplasia, pneumothorax

Answer 33

Decreased sounds

Question 34

Abnormal sounds

Answer 34

adventitial sounds

Question 35

Abnormal sounds = adventitial sounds

Answer 35

Rales Moist Dry

Question 36

most prominent on inspiration but can be heard in both phases. Produced by exudate within air passages. May vary in intensity, temporarily relieved by coughing.

Answer 36

Rales

Question 37

fluid of low viscosity. Can be coarse, medium or fine

Answer 37

Moist

Question 38

vibration of sticky, tenacious mucus within large bronchi; in chronic respiratory conditions. May be hissing, squeaking or whistling

Answer 38

Dry

Question 39

between parietal and visceral pleura.

Answer 39

Pleural friction rubs

Question 40

Develop following chronic pleuritis when pleura is thick and dry. Not altered by coughing and best heard at periphery of lung fields.

Answer 40

Pleural friction rubs

Question 41

Detect presence of murmurs, other abnormal heart sounds, arrhythmias

Answer 41

Cardiac auscultation

Question 42

AV valve closure - louder, longer, lower pitched- "lub"

Answer 42

1st heart sound

Question 43

semilunar valve closure - softer, shorter - "dub"

Answer 43

2nd heart sound

Question 44

Interval between 1st and 2nd and shorter

Answer 44

(systole)

Question 45

1st heart sound

Answer 45

AV valve closure "lub"

Question 46

2nd heart sound

Answer 46

semilunar valve closure "dub"

Question 47

Interval between 1st and 2nd

Answer 47

systole

Question 48

Interval between 2nd and 1st

Answer 48

diastole

Question 49

point of maximal intensity (PMI) of valves should ausculted on __________. Auscult thoracic inlet.

Answer 49

left (pulmonic, aortic, LAV) and right (RAV)

Question 50

Characterize as to location, intensity, systole/diastole. Use bell and diaphragm as murmurs will differ in pitch.

Answer 50

Murmurs

Question 51

for low-pitched sounds-heart

Answer 51

Bell

Question 52

for high-pitched sounds-airways

Answer 52

Diaphragm

Question 53

Associated with hydrothorax, pneumonia, masses, hernia, effusions, cardiac paresis, obesity.

Answer 53

Muffled heart sounds

Question 54

Interval between 2nd and 1st sound

Answer 54

(diastole)

Question 55

Interval between 2nd and 1st sound

Answer 55

(diastole)