week 4: physical examination

Question 1

auscultation can be ____ or ____

Answer 1

direct or indirect

Question 2

This is a ___, don’t forget it in your physical examination equiment

Answer 2

callipers

Question 3

for temperature you would use the ____ surface

Answer 3

dorsal

Question 4

the palma/ulnar surface is used for _____

Answer 4

vibrations

Question 5

____ percussion is the ____ of an ____ (finger) held against the body area to be examined.

Used over ____ or ____ to indicate the ____ of the underlying structures

____ finger of ____-____ hand is pressed ____ on the patients skin

The ____ ____ is ____ with the ____ finger of of the ____ hand.

Answer 5

indirect, stricking, object

chest, abdomin, density

middle, non-dominant, firmly

interphalangeal joint, struck, middle, dominant

Question 6

positioning the patient

This is _____ _____ _____.

Answer 6

knee to chest

Question 7

this is a ___ ___, don’t forget it in your physical examination equipment

POSTGRAD’S Never

Answer 7

nasal speculum

Question 8

intestine, gastric air bubble or puffed-out cheek would all produce ____ percussion sounds

Answer 8

tympany

Question 9

percussion sounds

____: ____ sound produced by dense tissue e.g., muscle or bone - no air present

____: ____ like/____ sound produced by dense tissie e.g., liver, spleen, heart

____: ____, ____ sound produced by air, e.g., normal lung tissue

____-____: ____ sound e.g., children’s lungs, lung affected by emphysema

____: ____ like sound produced from air filled stomach e.g., intestine, gastric air bubble or puffed-out cheek

Answer 9

flat, dull

dull, thud like/muffled

resonance, clear, hollow

hyper-resonance, booming

tympany, drum

Question 10

normal lung tissue would produce ____ percussion sounds

Answer 10

resonance

Question 11

auscultation requires a good ____ with ____ fitting ear pieces, ____ not longer than ____, ___ & ___, ___ ___ ___.

Answer 11

stethoscope, snug, tubing, 15 inches, bell & diaphragm, rubber tubing intact

Question 12

In a physical examination, the order is

___ > ___ > ___ > ___ > (circle)

Answer 12

look, listen, smell, feel

Question 13

percussion is the ____ of a portion of the body to elicit ____ or ____ that vary with the ____ of the underlying structures.

It assists in locating ____ ____, identifying ____ ____, ____ & ____.

It requires a ____ ____ & a ____ ____.

May be ____ or ____ depending on the reason why the assessment is being conducted.

Answer 13

tapping, tenderness, sounds, density

organ borders, organ shape, position, consistency

skilled touch, trained ear

direct or indirect

Question 14

auscultation involves ____ to ____ produced in the body such as ___, ___, ___ & ___ sounds.

Answer 14

breath, heart, blood, bowel

Question 15

palpation involves ____ & ____ body parts with the ____ to determine the following characteristics:

____, ____, ____, ____, ____, ____

‘TTMMCD’

Answer 15

texture, temperature, moisture, motion, consistency, distension

Question 16

with a diaphragm you press ____ ____ against the patient’s skin, it is used to detect ___-___ sounds

e.g., ____ & ____ sounds

Answer 16

reasonably firmly, high-pitched, beath & bowel

Question 17

____ palpation precedes ____ palpation.

____ areas are percussed/palpated ____.

technique should be ____ & ____.

Answer 17

light, deep

tender, last

slow, systematic

Question 18

deep palpation: skin is depress __ - __ cm with f__, deep p__

should only be used by a__ p__

used to feel i__ o__ & m__

Answer 18

2 - 4cm, firm, deep pressure

advanced practitioners

internal organs and masses

Question 19

deep palpation should only be used by ____ ____.

The skin is depressed ____ to ____ with ____, ____ pressure

____ hand may be used ___ ___ of the other to exert the required amount of ____.

used to feel ____ ___ and ____.

Answer 19

advanced practitioners

2 to 4cm firm, deep

one, on top, pressure

internal organs and masses

Question 20

muscle or bone with no air present is likely to produce ____ percussion sounds

Answer 20

flat

Question 21

this is a ___, don’t forget it in your physical examination equipment.

‘POSTGRAD’S’

Answer 21

specula

Question 22

This is a ___, don’t forget it in your physical examination equiment

Answer 22

percussion hammer

Question 23

preparing the patient you must ____ the ____ and ____ of the examination.

Make sure the patient is ____ & free from ____.

Sequence the exam in ____ ____ changes.

Monitor the patients ____ throughout the examination.

Pace the examination according to the patient’s ____.

Answer patient questions ____ & ____.

Answer 23

explain, purpose, procedures

comfortable, pain

minimise position

responses

tolerance

directly & honestly

Question 24

bimanual palpation should only be used by a__ p__

used to assess d__ a__ o__

upper hand applies p__ whilst lower one is used to detect d__ s__

Answer 24

advanced practitioners

deep abdominal organs

pressure, deep structures

Question 25

purpose of the physical examination 'The purpose is SET in stone' 1. s__ d__ obtained from p__ during the h__ h__ i__. 2. e__ o__ v__ of s__ d__ 3. together with the h__ h__ i__ it provides basis for c__ p__.

Answer 25

supplements data, patient, health history interview enables objective validation, subjective data, patient together, health history interview, care planning

Question 26

this is a ___, don't forget it in you physical examination equipment

Answer 26

doppler

Question 27

you ____ for auscultation & percussion techniques

Answer 27

listen

Question 28

positioning the patient This is _____.

Answer 28

dorsal recumbant

Question 29

positioning the patient This is _____.

Answer 29

lithotomy

Question 30

you ____ for palpation techniques

Answer 30

feel

Question 31

when preparing the equipment remember 'CHeck When Preparing & Gathering' ``` C__ equipment is ___ ___ H__ equipment in ___ & ___ in ___ of use W__ equipment that will ___ the ___ ___. P__ ___ ___ before ___ ___ G__ the ___ & ___ needed ```

Answer 31

check, functioning properly have, reach & arranged, order warm, touch, patient skin perform hand hygiene, preparing equipment gather, supplies & instruments

Question 32

a bell is used to detect ____-____ sounds e.g., ____ & ____ sounds, you press ____ over body part, ___ ___ enough to ____.

Answer 32

low-pitched, heart, vascular, lightly, just firmly, seal

Question 33

____ auscultation uses a ____ & ____

Answer 33

indirect, diaphragm & bell

Question 34

4 physical assessment techniques: Physical - PAtIent P__ P__ A__ I__

Answer 34

palpation, percussion, auscultaion, inspection

Question 35

the dorsal surface is used to detect _____

Answer 35

temperature

Question 36

for light palpation the skin is depressed ____ with ____ ____. Do not palpate ____ ____.

Answer 36

1cm, finger pads, pulsating masses

Question 37

for vibrations you would use the ____ or ____ surface

Answer 37

palmar/ulnar

Question 38

this is a ___, don't forget it in your physical examination equipment. POSTGRAD's

Answer 38

auriscope

Question 39

light palpation: skin is depressed __cm with finger pads determines s__ v__ do NOT palpate p__ m__

Answer 39

1cm surface variations pulsating masses

Question 40

preparing the environment for the physical examination remember: 'pErforM thE pHysicAl after' E__ ___ & ___ (___). 'EsPeCially Temperature' M__ ___ ___ & ___ 'MINimisE' E__ adaquate ___ & ___ to ___ ___ the ___ 'Ensure to ALwayS MAP the environment' H__ ___/___ ___ at an appropriate ___ ___ 'Have BETs And Win Handsomly' A__ upon a ___ for the assessment 'Agree on TAking assessment'

Answer 40

ensure privacy & comfort (temperature) minimise interruptions & external noise ensure, lighting & space, move around, patient have bed/examination table, working height agree, time

Question 41

this is a ___, don't forget it in your physical examination equipment POSTGRAD's

Answer 41

opthalmoscope

Question 42

____ auscultation could be ____ the sounds made by gas/fluid in the bowel

Answer 42

indirect, hearing

Question 43

liver, spleen and heart would all produce ____ percussion sounds

Answer 43

dull

Question 44

This is a ___, don't forget it in your physical examination equiment

Answer 44

tongue depressor

Question 45

____ auscultation could be ____ to an expiratory wheeze

Answer 45

direct, listening

Question 46

you ___ & ___ for inspection techniques

Answer 46

look & smell

Question 47

auscultation sounds: ____: ____ of vibrations ____: ____, described as ____ or ____ ____: ____ of ____ the sound ____ ____: ____ of sound e.g., ____, ____, ____

Answer 47

pitch, frequency intensity, amplitude, loud or soft duration, length, time, last quality: type, blowing, gurgling, wheezing

Question 48

fingertips are used for ____ ____ & ____

Answer 48

dine discrimination, pulsations

Question 49

for fine discrimination or pulsations you would use your _____

Answer 49

fingertips

Question 50

children's lungs or a lung affected by emphysema would produce ____-____ percussion sounds

Answer 50

hyper-resonance

Question 51

____ percussion involves ____ with ____ to ___ fingertips or ____ using the ____ ____ of a closed fist. The strike is ____ & the movement is from the ____ not the ____. Used to detect ____ through ____.

Answer 51

direct, tapping, 1 to 2, striking, ulnar surface rapid, wrist, arm tenderness, vibrations

Question 52

this is a ___ ___ ___, don't forget it in your physical examination equipment

Answer 52

snellen vision chart

Question 53

positioning the patient This is _____ _____.

Answer 53

sims position

Question 54

Bimanual palpation should only be used by ____ ____. It is used to ____ ____ ____ ____. ____ hands are used, one ___ ___ of the body part or ____ being felt ____ hand applies ____ whilst the ____ one is used to detect ____ ____.

Answer 54

advanced professionals assess deep abdominal organs 2, each side, organ upper, pressure, lower, deep structures