Physical exam Flashcards
(47 cards)
why must the brachial artery be at the level of the heart while taking BP?
If brachial artery is below heart, blood pressure appears to be falsely high.
what does high blood pressure mean for your patient?
It can effect target organs - eyes, heart, brain, kidneys. hypertensive retinopathy left ventricular hypertrophy neurologic deficits suggestion stroke poor kidney function
what does low blood pressure mean?
dizziness, lightheaded, weakness, fatigue
what can cause a patient to hyperventilate?
exercise, anxiety, metabolic acidosis
causes of fevers?
infection
trauma such as surgery or crush injuries
malignancy
blood disorders such as acute hemolytic anemia, drug reactions, immune disorders
what can you learn about a patient by looking at their posture or gait?
kyphosis, scoliosis, pelvic tilts
Limited ROM indicates?
stiffness from arthritis, pain from trauma, muscle spasm
JVP - what does elevated JVP mean?
JVP reflects pressure in right atrium or central venous pressure.
Elevated JCP means hypervolemic in right atrium.
Right sided congestive heart failure
superior vena cava obstruction
What does absent JVP indicate in living patient
Low right atrial pressure
What does a bruit mean?
a mumur-like sound of vascular origin
due to an obstruction in the blood vessel
What does location of PMI tell you?
High left diaphrgam
Cardiac enlargement in congestive heart failure, cardiomyopathy, ischemic heart disease
displacement in thorax, mediastinal shift
what does amplitude and duration of PMI tell you?
Amplitude: hyperthryoidism, severe anemia, pressure overladed in left ventricle, volume overladed in left ventricle
Duration: can detect hypertrophy of left ventricle
diminished pulse one side/weak or absent pulses
may indicate an atrial occulusion from atherosclerosis or embolism
How do you rate edema?
a four point scale from slight to very marked (4)
delayed cap refill
dehydrated
poor peripheral profusion
What is a lift or heave?
forceful cardiac contractions that cause vigorous mvmt of sternum and ribs
What is a thrill?
vibrations of cardiac murmurs.
Turbulent blood flow
asymmetric or limited lung expasion?
chronic fibrosis of lung of pleura
pleura effusion
lobar pneumonia
unilateral bronchial obstruction
Decreased tactile fremetis
transmission of vibrations from the larynx is impeded.
obstructed bronchus
COPD
separation of pleura surface by fluid (pleura effusion)
fibrosis (pleural thickening)
penumothroact
tumor
Dullness in lung percussion indicates
fluid or soft tissue replaces air in lung or pleural sapce
lobal pneuomia, blood, pus, tumor, serous fluid
what do normal breath sounds sound like?
vesicular (short of low pitched)
bronchovesicualr : equal in length
absence of adventitious sounds
Egophany
lobar consolidation from pneomonia
what does inspecting the abdomen tell you about a patients health
Dilated veins: hepatic cirrrhosis or IVC obstruction
hernias
asymmetry from an enlarged rogan or mass
Increased perstatlic waves from intestinal obstruction
increased pulsation of an aortic anuerysm
what is decreased bowel sounds?
peritonitis
adynamic ileus
