Introduction

Question 1

Purpose of a physical exam

Answer 1

• objective assessment of health
• guides your evaluation of the patients symptoms
• confirms or refutes suspected diagnoses
• allows measurement of progress

Question 2

four components of a physical exam

Answer 2

1. inspection
2. percussion
3. palpation
4. auscultation

Question 3

inspection

Answer 3

• always comes first
• avoid “tunnel vision”
• cultural bias and sensitivity
• document using standard medical terminology

Question 4

percussion

Answer 4

• a technique of tapping one finger sharply against another to produce resonance
• pitch of this changes with density of underlying structures
• used to determine size of solid organs or identify abnormal findings (masses, consolidation, etc.)

Question 5

Tricks to good percussion

Answer 5

• make firm contact against patient’s skin
• keep tapping finger stiffly bent
• whip tapping wrist like a hammer
• don’t hit yourself with fingernail

Question 6

palpation

Answer 6

• assess for tenderness
• assess for involuntary guarding/rigidity
• feel edges of solid structures
• feel consistency of structures
• feel temperature, texture, and turgor of skin
• generally comes last
• slow circular gestures

Question 7

Stethoscope

Answer 7

• born out of victorian modesty

- isolates and amplifies sounds

Question 8

diaphragm of stethoscope

Answer 8

side of the instrument used for high-pitched sounds

Question 9

bell

Answer 9

side of instrument used for low-pitched sounds

Question 10

Documentation of findings

Answer 10

• OBJECTIVE descriptions
• NEVER “normal” or “good”
• use medical terminology, not patients words
• use consistent head-to-toe order for consistency and standard charting