physical exam midterm Flashcards
(33 cards)
ABCDE’s of Melanoma
A: asymmetrical - configuration B: borders - irregular, esp notching C: color - especially mixtures of black, blue & red D: diameter - >6mm E: elevation or evolution
refer to dermatologist or MD pathologist
xanthelasma
slightly, raised yellowish, well-circumscribed plaques that appear along the nasal portions of one or both eyelids. may accompany lipid disorder
weber’s test
- grasp tuning fork by handle and make it vibrate
- place stem toward back of patient’s head, equidistant from each ear
- sound should be transmitted equally to both ears, if not the one that can hear better has the blockage
signs of vitiligo
disease that causes loss of skin color in blotches
Percussion of Lungs
dull: medium intensity & pitch, thud like, solid areas (dyspnea)
resonant: long, loud, low pitched, hollow (normal)
hyper-resonant: very loud found over pneumothorax or stomach (acute asthma-wheezing)
tympanic: loud, very high pitched, drum like, found over air filled areas (emphysema)
Otitis Externa
Acute: canal is often swollen, narrowed, moist, pale & tender. -may be reddened
Chronic: skin of canal is often thickened, red & itchy
tug auricle & tragus to test for px
Otitis Media
- look for red bulging drum of acute purulent cases;
- amber drum of serous effusion
- press behind ear for px*
7 Attributes to a Condition
- Location-where & does it radiate
- Quality- what does it feel like
- Quantity/Severity- intensity scale
- Timing-when did it start, how long it lasts, how often it occurs
- Setting in which it occurs- activities, emotions, etc
- Remitting or Exacerbating Factors- anything make it better or worse
- Associated Manifestations- does anything accompany it?
Cancer Masses
can be painful or painless
Normal Temperature Readings
orally: 98.6 F rectal: 99.1-99.6 F
How to test for appendicitis
- McBurney’s Pt tenderness: 1/3 of distance from ASIS to umbilicus
- manual muscle test of psoas
- rebound test
pancreatitis symptoms
People may experience:
Pain: in the back or abdomen, can be dull or sudden in the abdomen, severe
Gastrointestinal: vomiting, bloating, indigestion, or fat in stool
Whole body: sweating, nausea, or loss of appetite
Also common: fast heart rate or weight loss
peptic ulcer
Pain: in the upper abdomen or chest, can occur at night, can be dull
Gastrointestinal: belching, bloating, indigestion, vomiting, or heartburn
Whole body: nausea or fatigue
Also common: abdominal discomfort
detect sinusitis
Palpation
All but the sphenoidal sinuses can be palpated for tenderness:
Frontal sinus - press upward beneath the medial side of the supraorbital ridge.
Maxillary sinus - press against the anterior wall, below the inferior orbital margin.
Ethmoidal sinus - press medially against the medial wall of the orbit
Order of Examination Abdominal/GI
- question
- Inspection
- auscultation
- palpation
- percussion
graves disease (hyperthyroidism)
Goiter (enlarged thyroid) Trouble sleeping Irritability or nervousness Heat sensitivity, increased sweating Hand tremors Rapid heartbeat Thinning of skin or fine, brittle hair Frequent bowel movements Weight loss without dieting Fatigue or muscle weakness bulging eyes thickening and reddening of skin, esp shins
cushings syndrome
People may experience:
Skin: stretch marks, thinning, darkening of the skin, or acne
Psychological: depression or anxiety
Muscular: muscle weakness or loss of muscle
Whole body: osteoporosis, excess sweating, excessive hunger, high blood pressure, flushing, excessive hairiness, or fatigue
Also common: irritability, swelling in extremities, insomnia, easy bruising, pot belly, weight gain, hair loss, headache, round face from gradual swelling, or infertility
clubbing of fingers
lung cancer or diseases, cirrhosis of liver, diabetes, celiac, infection of heart lining (endocarditis), grave’s disease, overactive thyroid, other types of cancer
common sources of chest pain
angina, myocardial infarction, dissecting aortic aneurysm, pulmonary embolism, esophageal spasm, anxiety, pericarditis, pneumothorax, peptic ulcer, cholecystits
vocal fremitus
the vibration of the chest wall as a person speaks or sings that allows the person’s voice to be heard by auscultation of the chest with a stethoscope.
egophony
is an increased resonance of voice sounds[1] heard when auscultating the lungs, often caused by lung consolidation and fibrosis.
grade heart murmurs
- very faint, only heard in ideal circumstances; no thrill
- loud enough to be generally heard; no thrill
- louder than 2; no thrill
- louder than 3; w/ thrill
- heard w/ stethoscope partially off chest; w/ thrill
- heard w/ stethoscope entirely off chest; w/ thrill
signs of acute pulmonary embolism
sudden stabbing px may be accompanied by cyanosis, dyspnea or cough
Symptoms of pulmonary embolism include difficulty breathing, chest pain on inspiration, and palpitations. Clinical signs include low blood oxygen saturation and cyanosis, rapid breathing, and a rapid heart rate
risks of breast cancer
BRCA1&2 gene, 2 or more first degree relative w/ breast cancer at early age, personal history, high breast tissue density, biopsy confirmed atypical hyperplasia, high dose radiation to chest, high bone density
