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5 VISCERAL DIAGNOSIS > VERBALS > Flashcards

Flashcards in VERBALS Deck (36):
1

Listen at S1 and Palpate the Carotid Pulse

Assessing for:  

Pairing;  What location is S1?

- Mitral Area

2

Palpate the Epigastric Pulsations

Verbals:  Pulsations coming from superior to inferior may indicate right ventricular hypertrophy; pulsations coming from inferior to superior may indicate abdominal aortic aneurysm

3

Perform Vocal Resonance

  • Broncophany:
    • Normal:  Muffled Voice
    • Abnormal:  Loud, clear, crisp voice
  • Whispered Pectoriloquy:
    • Normal:  Muffled Voice
    • Abnormal:  Loud, Clear, Crisp voice
  • Egophony:
    • Normal:  Muffled voice
    • Abnormal:  Vocalization changes to "A" sound

4

Percussion of the Posterior or Anterior Thorax

  • Normal sound:  Resonance
  • Abnormal:  
    • Dull:  Lung Mass or Pneumonea 
    • Hyper Resonant:  Air/Emphysema

5

6

Palpate the 5 cardiac regions for pulsations

State locations:  Aortic, Pulmonic, Erbs, Tricuspid, Mitral

7

Tactile Fremitus

  • Normal:  Bilateral Symmetrical Vibration
  • Abnormal:
    • Increased:  Indicate:  Lung Consolidation/Mass/Pneumonia
    • Decreased:  Indicate:  Air in lung/Emphsema

8

Palpate for the arterial pulses of the Neck and Upper Extremity

  • Carotid, Subclavian, Brachial, Radial, Ulnar
  • Rate, Rhythm, amplitude, and contour

9

Why do we percuss the right sternal border?

Assessing for right ventricular hypertrophy

10

Listen/Assess the S1 heart sounds

Listening at the Apex of the heart during Systole for S1.  I am listening for accentuated, diminished or splitting of S1, other abnormal heart sounds, or mitral murmurs

11

Palpate the arterial pulses of lower extremity

  • Rate, Rhythym, Amplitude, and Contour
  • Femoral, Popliteal, Posterior Tibial, Dorsal Pedis

12

Palpate the arterial pulses of the upper extremity:

  • Rate, Rythym, Amplitude, and contour
  • Subclavian, Brachial, Radial, Ulnar

13

Percuss for the location and size of the heart

State areas for male and female percussion

  • Males:  Percuss along 3rd, 4th, 5th intercostal space
  • Females:  Percuss along 3 & 5th intercostal space

14

Palpation of the posterior or anterior thorax

Pain, Tenderness, Masses, Sensations, and Further assess any abnormalities

15

Auscultate the 5 major arteries of the body

  • Locations are:  Temporal, Carotid, Subclavian, Abdominal Aorta, Femoral (WITH BELL**)
  • Define Bruit:  "Turbulent blood flow"

16

Evaluate the skin temperature on the extremities

  • Cool/cold skin = decreased blood flow to an area
  • Warmth = increased blood flow/pooling

17

Palpate for Cardiac Thrills:

Define Thrill:  "Palpable Vibration through the chest wall"

18

Auscultate for Venous Hum:

  • State Locations:  Epigastric and Base of the Neck (bilateral) (with the bell)
  • "When present, it is a low pitched continous sound that is louder during diastole"

19

Vascular Exam Inspection:

  • Assess for Pitting Edema:
    • Seen in Cardiac, Liver, or Kidney Disease
  • Inspect for Greater Saphenous Vein:
    • Looking for Tortuosity and Dilation
  • Inspect for Lesser Saphenous Vein:
    • Looking for Tortuosity and Dilation

20

Infected lymph nodes:

Enlarged, soft, mobile, tender

21

Palpate Arterial Pulses of the abdomen and lower extremity

  • Abdominal Aorta, femoral, popliteal, dorsal pedis, posterior tibial
  • Rate, rhythm, amplitude and contour

22

Assess Tracheal Position:

Normal:  For the Trachea to be in the midline

23

Assess for Aortic Murmurs

State you'll be using the Diaphragm

24

Diaphragmatic Excursion:

  • Normal:  3-5 cm bilaterally
  • Abnormal:  Unequal Measurments indicating lesions in pulmonary, abdominal areas, or acute trauma

25

Listen at S2

Listening at the base of the heart during Diastole for S2.  I am listening for accentuated, diminished, or splitting of S2, other abnormal heart sounds or pulmonic murmurs

26

Assess or palpate for pitting edema

Conditions seen:  Cardiac, Liver, or Kidney Disorders

27

Listen for high pitched cardiac sounds:

State you would use the Diaphragm at Aortic, Pulmonic, Erbs, Tricuspid, and Mitral

28

Listen for rate and rhythm:

Verbals:  Identifying systole and diastole with rates less than 100 beats per minute, systole the time between S1 and S2, is shorter than Diastole

29

Assess for Mitral Murmurs

State you'll be using the bell

30

Cancerous Lymph Nodes

Enlarged, hard, immobile, non-tender

31

Normal lymph nodes

Nonpalpable

32

Auscultate the posterior or anterior Thorax

  • Normal sound throughout the lung fields:  Vesicular
  • Normal sound over the trachea:  Bronchial
  • Normal Sound over the right intrascapular or manubrium:  Broncho Vesicular

33

Listen for Low pitched Cardiac sounds

State you would use the bell at Aortic, Pulmonic, Erbs, Tricuspid, and Mitral

34

Palpate for Apical Impulse

Assessing for:  Location at the 5th intercostal and Amplitude (height of the pulse)

35

Palpate Lymph Nodes

  • Thorax Lymph Nodes:
    • State:  Checking for size, consistency, mobility, and condition
    • Supraclavicular, Infraclavicular, Epitrochlear, lateral, Medial, Anterior, Posterior
  • Axillary Lymph Nodes
    • State:  Checking for Size, Consistency, Mobility, and Condition
    • Lateral, Medial, Anterior, Posterior Lymph Nodes ONLY (In the axillary - not around it)

36

Respiratory Excursion

  • Normal:  Bilateral Symmetrical Motion
  • Abnormal:  Lung lag unilaterally indicate phrenic nerve paralysis, pneumonia, tumor, etc.