Physical Exams

Question 0

What are some things that can be found using an external PE?

Answer 0

1. General: No acute distress, well developed & well nourished.
2. Eyes: PERRL
3. ENT: moist mucosa
4. Neck: supple
5. Respiratory: no respiratory distress
6. Skin: warm and dry
7. Neuro: alert and oriented
8. Psych: normal affect

Question 1

What are the 11 body systems reviewed in a PE?

Answer 1

1. General/constitutional
2. Eyes
3. ENT
4. Neck
5. Cardiovascular
6. Respiratory
7. Abdominal
8. Extremities
9. Skin
10. Neurological
11. Psychiatric

Question 2

What are normal cardiac findings in a PE?

Answer 2

RRR, no murmurs, rubs, or gallops. Distal pulses intact.

Question 3

What are normal findings when auscultating the lungs?

Answer 3

Clear to auscultation bilaterally, no wheezes, rales, or ronchi.

Question 4

What are normal findings when palpating the abdomen?

Answer 4

Soft, non tender. Non distended. No guardig, rebound, or rigidity.

Question 5

What are normal findings when examining the legs?

Answer 5

No edema, distal pulses intact.

Question 6

What is a physician looking for when he…examines the throat?

Answer 6

Pharyngeal erythema or exudates

Question 7

What is a physician looking for when he…examines the inner ear?

Answer 7

TM erythema or bulging

Question 8

What is a physician looking for when he…auscultates the abdomen?

Answer 8

Hyper/hypo active bowel sounds

Question 9

What is a physician looking for when he…touches the wrists?

Answer 9

Radial pulses

Question 10

What is a physician looking for when he…squeezes the calves?

Answer 10

Calf tenderness

Question 11

What is a physician looking for when he…pounds on the back?

Answer 11

CVA tenderness

Question 12

In a general/constitutional exam, what is the opposite/abnormal finding of NAD?

Answer 12

Mild/moderate/severe distress (due to pain)

Question 13

In a general/constitutional exam, what is the opposite/abnormal finding of well developed and well nourished?

Answer 13

Cachetic/emaciated/malnourished

Question 14

In a general/constitutional exam, what is the opposite/abnormal finding of alert?

Answer 14

Somnolent, obtunded (blocked airway and unresponsive), unresponsive

Question 15

In a PE of the head, what is the abnormal finding of AT/NC?

Answer 15

Any signs of trauma, sinus tenderness, angioedema

Question 16

In a PE of the eyes, what is the abnormal finding of PERRL?

Answer 16

Anisocoria (unequal pupils)

Question 17

In a PE of the eyes, what is the abnormal finding of EOMI?

Answer 17

EOM entrapment

Question 18

In a PE of the eyes, what is the abnormal finding of sclera are anicteric?

Answer 18

Scleral icterus (yellow eyes)

Question 19

In a PE of the eyes, what is the abnormal finding of normal conjunctiva?

Answer 19

Pale conjunctiva, conjunctival infection (red and blood shot)

Question 20

In a PE of the eyes, what is the abnormal finding of clear anterior chamber?

Answer 20

Hyphema (blood in anterior chamber of eye)

Question 21

In a PE of the eyes, what is the abnormal finding of sharp disc margins?

Answer 21

Papilledema (optic disc swelling)

Question 22

In a PE of the eyes, what is the abnormal finding of normal cornea?

Answer 22

Corneal abrasion/ulcerations, fluorescein uptake, or foreign body

Question 23

What instrument is used in a fundoscopic internal eye exam?

Answer 23

Opthalmascope

Question 24

What instrument is used in a PE of the external eye?

Answer 24

Woods lamp or fluorescein

Question 25

What instrument is used in a PE of the ears?

Answer 25

Otoscope

Question 26

In a PE of the ears, What is the abnormal finding of a normal TM?

Answer 26

TM erythema, TM bulging, TM dullness, TM obscured by cerumen (ear wax)

Question 27

In a PE of the nose, what is the abnormal finding of normal nares (nostrils)

Answer 27

Epistaxes, rhinorrhea, boggy turbinates (swollen inner nose), septal hematoma

Question 28

In a PE of the mouth/throat, what is the abnormal finding of moist mucous membranes?

Answer 28

Dry mucous membranes (DMM)

Question 29

In a PE of the mouth/throat, what is the abnormal finding of oropharynx (OP) normal?

Answer 29

Pharyngeal erythema, tonsillar exudate, tonsillar hypertrophy, peritonsillar abscess (PTA)

Question 30

In a PE of the mouth/throat, what is the abnormal finding of normal dentition?

Answer 30

Edentulous (missing teeth), dental caries (cavities)

Question 31

In a PE of the neck, what is the abnormal finding of supple?

Answer 31

Nuchal rigidity, meningismus, limited ROM, JVD, carotid bruit, cervical lymphadenopathy (swollen lymph), thyromegaly, vertebral point vs para spinal tenderness

Question 32

In a PE of the cardiovascular, what is the abnormal finding of a regular rate?

Answer 32

Tachycardia (>100 bpm) or bradycardia (<60 bpm)

Question 33

In a PE of the cardiovascular, what is the abnormal finding of a regular rhythm?

Answer 33

Irregular irregular rhythm

Question 34

In a PE of the cardiovascular, what is the abnormal finding of heart sounds normal?

Answer 34

Murmurs, rubs, or gallops, or extrasystoles (extra beats)

Question 35

In a PE of the perfusion rates, what is the abnormal finding of pulses equal and symmetric?

Answer 35

Unequal pulses

Question 36

In a PE of the perfusion rates, what is the abnormal finding of capillary refill <2 sec?

Answer 36

Delayed capillary refill

Question 37

What is the pulse grading scale?

Answer 37

``` 0 absent 1+ barely palpable 2+ easily palpable 3+ full 4+ bounding/aneurysmal ```

Question 38

In a PE of the pulmonary, what is the abnormal finding of no respiratory distress?

Answer 38

Mild/moderate/severe respiratory distress

Question 39

In a PE of the pulmonary, what is the abnormal finding of normal respiratory rate?

Answer 39

Tachypnea

Question 40

In a PE of the pulmonary, what is the abnormal finding of normal effort?

Answer 40

Accessory muscle use

Question 41

In a PE of the pulmonary, what is the abnormal finding of breath sounds clear and equal?

Answer 41

Wheezes (inspiratory or expiratory) rales, ronchi

Question 42

In a PE of the abdomen, what is the abnormal finding of soft?

Answer 42

Rigid (involuntary guarding)

Question 43

In a PE of the abdomen, what is the abnormal finding of non tender?

Answer 43

Mild/mod/severe tenderness, voluntary guarding

Question 44

In a PE of the abdomen, what is the abnormal finding of no peritoneal signs?

Answer 44

Rebound tenderness, rigidity

Question 45

In a PE of the abdomen, what is the abnormal finding of normal bowel sounds ?

Answer 45

Absent/hypo/hyper active bowel sounds

Question 46

In a PE of the abdomen, what is the abnormal finding of non distended?

Answer 46

Distended

Question 47

What is Murphy's sign?

Answer 47

Palpating abd for gall bladder tenderness in RUQ

Question 48

What is positive mc burneys pt?

Answer 48

2/3 of way b/t superior iliac crest and epigastrium

Question 49

What is positive obturators sign?

Answer 49

Knee to chest

Question 50

What is positive rovsings sign?

Answer 50

Palpate LLQ that causes inc. pain in RLQ

Question 51

What are the 4 signs for appendicitis?

Answer 51

1. Mc burneys point 2. Positive psoas sign 3. Positive obturators sign 4. Positive rovsings sign

Question 52

A normal rectal exam is...

Answer 52

Heme negative (guaiac)

Question 53

What is a rectal prolapse?

Answer 53

Rectum protruding from anus

Question 54

What does it mean when something is thrombosed?

Answer 54

Actively bleeding

Question 55

What is. Decreased rectal tone indicative of?

Answer 55

Spinal cord injury

Question 56

What is important to document during a male or female genital exam?

Answer 56

Female/male chaperone present

Question 57

Adnexal tenderness or mass is an abnormal finding for what female genital exam?

Answer 57

Normal external genitalia?

Question 58

Cervical motion tenderness, uterine tenderness is an abnormal finding for what?

Answer 58

Normal bimanual exam

Question 59

Abnormal findings in a genital exam are?

Answer 59

1. Testicular tenderness 2. Epididymal tenderness 3. Testicular edema 4. Testicular mass 5. Urethral discharge 6. Inguinal hernia

Question 60

What is a normal MS finding?

Answer 60

FROM, non tender

Question 61

What does distal CSMT stand for?

Answer 61

Circulation, sensory, motor, tendon

Question 62

What is abnormal FROM?

Answer 62

Decreased ROM 2 degrees, pain

Question 63

What is pitting pedal Edema and how is it measured?

Answer 63

When palpating leaves a "pit" in the skin. Measured from trace to 4+

Question 64

What are palpable cords/homans sign indicative of?

Answer 64

DVT

Question 65

What is homans sign?

Answer 65

Pain in calves when pointing toes

Question 66

Para spinal tenderness is indicative of what?

Answer 66

Muscular injury

Question 67

Vertebral point tenderness is indicative of what?

Answer 67

Spinal injury

Question 68

CVA tenderness is indicative of what?

Answer 68

Pyelonephritis

Question 69

Midline deformities/ step offs are indicative of what?

Answer 69

Spinal Injury/trauma

Question 70

Cyanotic skin is

Answer 70

Blue (hypoxia)

Question 71

Urticaria are

Answer 71

Hives

Question 72

Petechiae/purpura is

Answer 72

A dangerous rash

Question 73

Calor

Answer 73

Increased warmth

Question 74

Induration is indicative of...

Answer 74

Cellulitis

Question 75

Fluctuance comes from

Answer 75

An abscess

Question 76

Lymphangitis

Answer 76

Streaking visible infection

Question 77

Avulsion

Answer 77

Similar to skin tear but no longer there (older PT)

Question 78

Normal neuro is

Answer 78

A&O x4 (person, place, time, event)

Question 79

What do you document when deep tendon reflexes are normal?

Answer 79

DTR 2+ and equal

Question 80

What do you document when all cranial nerves intact?

Answer 80

CN II-XII intact

Question 81

What do you document with normal walking?

Answer 81

Norm gait

Question 82

What do u document when motor strength is normal?

Answer 82

Motor strength 5/5 and symmetric

Question 83

Dysarthria

Answer 83

Difficulty speaking

Question 84

Hypoesthesia

Answer 84

Decreased sensation

Question 85

How do you measure Motor strength?

Answer 85

0/5-5/5 (flaccid to normal)

Question 86

What is a positive babinski?

Answer 86

Toes fan out and up (normal is fanning down)

Question 87

What is positive Romberg?

Answer 87

PT stands and closes eyes and sees if off balance

Question 88

Vertical nystagmus

Answer 88

Eyes shake

Question 89

What are 2 abnormal psych findings for normal speech?

Answer 89

Tangential and pressured speech

Question 90

Battles sign is indicative of what kind of trauma?

Answer 90

Bleeding behind ears...head trauma

Question 91

If the physician notes bruising across the abdomen after an MVA, what will he verbalize to you?

Answer 91

Positive seatbelt sign

Question 92

Why is it important to note "crying with tears" in a pediatric exam?

Answer 92

It indicates hydration

Question 93

MAE X4 means what in a pediatric exam?

Answer 93

Moves all 4 extremities

Question 94

What is the most important thing to know when examining an abnormal pediatric pt?

Answer 94

Never document an abnormal finding unless the physician tells you to do so.

Question 95

Why is it important to document no scleral icterus in an abdominal exam?

Answer 95

It rules out liver failure

Question 96

FNF

Answer 96

Normal finger-nose-finger