Order of Assessment ans: Inspection, Palpation, Percussion and Auscultation. EXCEPT with abdomen
Comprehensive Health History ans: chief complaint,
... [Show More] reason for visit, ROS, past medical and surgical history, social history and family history
Pediatric Body measurements ans: length, height, weight, head circumference fro birth to 36 months
Normal/Hypertension cut off ans: <130 normal 140+ hypertension
Fontanel Closure ans: posterior 1-2 months, anterior 9mo-2years
otoscope ans: adult-up and back, peds- down and back, using largest speculum that will fit comforably
tympanic membrane ans: Cone of light R-5 l-7
EOM testing ans: CN III, IV, VI
AP diameter of chest ans: 1:2 (AP less than transverse)
barrel chest ans: COPD
Flat or Dull percussion ans: effusion or pneumonia
normal resonant percussion ans: healthy lung
Hyperressonance (percussion) ans: trapped air
crackles/rales ans: high pitched, discontinuous
Wheezes ans: high-pitched whistling or squeaking sounds during inspiration or expiration
Rhonchi ans: snoring, rumbling sounds heard upon auscultation of the chest during respiration-low pitched
tactile fremitus ans: • INCREASED FREMITUS
- Means there is liquid or solid inside the lungs (consolidation such as with pneumonia)
- Remember Liquid or solid transmits vibrations better than air
• DECREASED FREMITUS
Means air trapping such as with emphysema or bronchial obstruction.
Bronchophony ans: the spoken voice sound heard through the stethoscope, which sounds soft, muffled, and indistinct over normal lung tissue, clearer over disease
Egophony ans: abnormal change in tone of voice that is heard when auscultating the lungs EE-->AA
UE Arteries ans: radial-thumb side, ulnar pinky side
Pulse grading ans: 0 absent
1+ weak
2+ normal
3+ increased
4+ bounding
palpate bilaterally
PMI ans: point of maximal impulse mid-clavicular and 5th ICS
S1 ans: normal, closure of AV, Start of systole, loudest at Apex, contraction of ventricles
S2 ans: normal, closure of semilunar, end of systole, loudest at base, filling of ventricles
S3 ans: third heart sound (normal in pregnant young adults, and children), gallop
S4 ans: extra heart sound, end of diastole, indicative of disease-AFIB
murmur grading scale ans: I-Barely Audible
II-Quiet, Clearly Audible
III-moderately Loud
IV-loud, thrill
V-Very loud, can palpate thrill
VI-Very loud, thrill palpable and visible
clubbing ans: bulbous enlargement of distal phalanges of fingers and toes that occurs with chronic cyanotic heart and lung conditions
edema scale ans: 1+ = disappears rapidly. 2+ = last 10-15 seconds. 3+ = lasts more than one minute. 4+ = lasts 2-5 minutes. These are signs used in what scale?
normal/abnormal findings spleen ans: normal=tympanic, dullness could be enlargement not normally felt on exam
Blumberg Sign: Rebound Test ans: peritoneal inflammation, hurts more when release from palpation
shifting dullness ans: a sign of free peritoneal fluid wherein the dullness of percussion shifts, generally from one side to the other, as the patient is turned from side to side. [Show Less]