PEs Flashcards
(20 cards)
Cardio PE
Offer list:
1) vitals
2) palpate remaining peripheral pulses
3) hepatomegaly
4) urine dipstick
5) fundoscopy
Commonly forgotten steps
- radio-radial delay
- collapsing pulse
- offer to examine for radio-femoral delay
Respi PE
Offer list
- examine the cervical lymph nodes
- vitals
- review patient’s sputum mug
- peak flow measurement
Commonly forgotten steps
- asterixis
- palpate for position of trachea
Abdo PE
Offer list
- vitals
- cervical lymph nodes
- urinalysis
- DRE
- external genitalia
- hernial orifices
Commonly forgotten steps
- examine for parotidomegaly
- examine chest wall for gynaecomastia, spider naevi (more than 5 is abnormal) and loss of axillary hair
- ausculate abdomen
Cranial Nerves PE
Offer list
1) examine the rest of the neurological system
2) assess the 1st CN (sense of smell)
3) test corneal reflex
4) test for jaw jerk
5) fundoscopy
UL PE
Offer list:
- offer to examine the rest of the neurological system
Commonly forgotten step:
- pronator drift
- test for proprioception
LL PE
Offer list:
- offer to examine the rest of the neurological system
Commonly forgotten step:
- test for proprioception
- examine patient’s gait (normal + tandem)
- perform romberg’s test
Arterial PE
Offer list:
1) full neurological examination of the lower limbs
2) examine the rest of the arterial system - palpate for carotid, brachial and radial pulse, palpate abdomen for AAA
3) auscultate for renal bruit, femoral bruit, carotid bruit, + do cardial auscultation
4) suggest using a doppler to check for pulses and ankle brachial index
Commonly forgotten steps:
- inspect for pallor, duskiness, mottling, fixed staining, gangrene, open wounds, ulcers, ascending cellulitis, atrophic skin and nail changes, evidence of diabetic dermopathy, previous scars and amputations
- feel for temperature
- look for capillary refill time
Venous PE
Offer list
1) perform a full arterial examination to assess for concomitant arterial disease
2) examine the abdomen for any abdominal masses that may impair lower limb venous return
Commonly forgotten steps
- inspect for skin changes (venous eczema), pedal edema, telangectasia, spider veins, varicosities. lipodermatosclerosis, atrophe blanche, ulcers, evidence of thrombophlebitis, and scars over the limb and groin that may suggest previous intervention
- feel for temperature of legs and any edema
- feel for PT pulse and DP pulse
- examine for capillary refill time
Hernia PE
Offer list:
1) Respiratory, abdominal and per rectal examination to look for underlying cause
Commonly forgotten steps
- examine the scrotum
- auscultate hernia for bowel sounds
Rheum Hand PE
Offer list:
1) neurovascular examination of the upper limbs
2) examination of the shoulders and the joints of the lower limbs
Commonly forgotten steps:
- feel for temperature over the wrists
- palpate the elbow joints for tenderness/ synovitis
- tinel’s test for median nerve only
Breast PE
Offer list:
1) cervical lymph nodes
2) percuss spine for bony tenderness
3) palpate abdomen for hepatomegaly
4) auscultate and percuss the chest for pleural effusion
Commonly forgotten steps:
- palpation of the axillary tail
Thyroid PE
Offer list: NIL
Commonly forgotten steps
- palpate radial pulse to check for tachycardia + atrial fibrillation
- examine for collapsing pulse
- biceps tendon reflex
- test for power at the shoulders
Cervical Spine PE
Offer list:
1) Lhermitte’s (myelopathy) & Spurling’s (radiculopathy)
2) Check lumbar spine to look for any tandem stenosis
3) Test for function (button clothes & writing)
4) Do a DRE
Commonly forgotten steps:
- tandem gait
- hoffman’s
- grip & release
- finger escape
- radial pulse
Shoulder PE
Offer list
1) Offer to examine the cervical spine and the elbow
Commonly forgotten steps
- Biceps tendonitis tests - Speed’s & Yergason’s test
- Anterior apprehension test
Elbow PE
Offer list
1) Examine the hands and the shoulder
Commonly forgotten steps
- Test for power of flexion, extension, pronation and supination
- Hook test to check for distal biceps tendon rupture
Ortho Hands PE
Offer list: NIL
Commonly forgotten steps
- Ask for numbness & test for sensation
- Prayer sign & Reverse prayer sign to test for wrist ROM
- Inspection of elbow joints for gouty tophi
- Finkelstein’s for DeQuervain’s
- Test for hand function using red bottle cap
Lumbar Spine PE
Offer list
1) Check cervical spine to see if there’s any tandem stenosis
2) Do a DRE
Commonly forgotten steps
- Straight leg raise test
- Painful straight leg raise test steps (bragard’s sign, bowstring test)
- FABER test on both sides
- Check for dorsalis pedis pulse
Hip PE
Offer list
1) Offer to examine the lumbar spine
Commonly forgotten steps
- Get the patient to lie down and then measure for any limb length deformities
- Galeazzi test
- Bryant’s triangle
Knee PE
Offer list
1) Offer to do a full examination of the hips
Commonly forgotten steps
- Do a fluid bulge test
- Do the cross fluctuance test
- Do a quick hip screen (FABER & FADIR test)
Foot & Ankle PE
Offer list
1) Offer to take a full history from the patient
Commonly forgotten steps
- Palpate the feet to look for any tenderness
- Silverskold test
