Physical Assessment Final Exam
Inspection technique (3):
FIRST technique with general survey
General survey:
Observing mobility / gait, physical
... [Show More] appearance, general wellness/health, mood & behavior (facial expressions, interactions), mental status (observing patient’s body language and response when asking questions)
Do it the SAME WAY every time → less likely to forget something
Do not rush it, especially with anxious patients
Make sure the patient is comfortable
Temperature in the room is suitable for the patient
Make sure that you have everything that you need → so that the patient has confidence in you
Know normal vs abnormal when surveying appearance & symmetry
Compare ANYTHING that has a pair
Eyes- level, equal, is there eyelid drooping?
Smile- is there a droop?
Always compare the two sides to ensure that there is no abnormality between the two sides
Listen for natural sounds
Abnormal sounds: wheezing, labored breathing, crepitus during ROM
Detect abnormal odors:
CDIFF, alcohol on a patient, acetone / sugary breath
Try not to assume anything ! → use critical thinking!
Ex: someone with low blood sugar or issues with hypoxia can appear intoxicated
Know your normal values:
Blood pressure, HR, RR, O2 sats, temperature
For each age levels
Infants: must faster RR than elderly
Percussion technique (3)
Types:
Direct percussion- tapping body with fingertips of dominant hand
For a small infant → direct percussion on the chest
Adult → on the sinuses on the face
Blunt percussion- place palm of nondominant hand flat against the surface and strike it with closed-fist dominant hand
Used to assess the kidneys → assessing for pain / tenderness (UTI)
Indirect percussion- most commonly used
Plexor = hammer or tapping finger
Pleximeter = device or surface that accepts the tap
Sounds:
Intensity of amplitude: softness or loudness
Pitch or frequency: high or low (vibrations per second)
Duration: length of time
Quality: recognizable overtones or drumlike sounds
Tympany- sound heard over stomach or intestines
Loud, high-pitched, drum-like tone
Resonance- normal sound heard over lungs
Loud, low-pitched, hollow tone
Hyperresonance- air trapped in lungs
Abnormally loud, low tone of longer duration than resonance
COPD, trauma or lung collapse
Dullness- over solid body organs (liver)
High-pitched tone, soft and short
Flatness- over solid tissue, muscle, or bone
High-pitched tone, very soft & shorter than dullness
Ex: ribs [Show Less]