Volume 2 Chapter 2A

• Inspection
• Palpation
• Percussion
• Auscultation

The process of informed observation

Using your sense of touch to assess for injuries or abnormalities

The production of sound waves by striking one object against another

• Tympany-Drumlike, Stomach
• Hyperresonance- Booming, Hyperinflated lung
• Resonance- Hollow, Normal lung
• Dull- Thud, Solid organs
• Flat- Extremely dull, Muscle or atelectasis

Listening with a stethoscope for sounds produced by the body

• Stethoscope- used to auscultate
• Sphygmomanometer- blood pressure cuff
• Opthalmoscope- used to see into the eye
• Otoscope- used to see into the ear and nose
• Scale- weight
• Tongue blades
• Penlight
• Visual acuity chart/card
• Reflex hammer
• Thermometer

Pressure gauge on BP cuff. Used to measure pressure in mmHg

• Appearance
• Vital signs
• Additional assessments
• -PulseOx
• -Capnography
• -Cardiac monitoring
• -Blood glucose

• Level of conciousness
• Signs of distress
• Apparent state of health
• Vital statistics- height, weight
• Sexual development
• Skin color and obvious lesions
• Posture, gait and motor
• Dress, grooming, hygiene
• Odors
• Facial expressions

• Pulse
• Respiration
• Blood pressure
• Body temp

Number of pulses in one minute

Pattern and equality of intervals between beats

Strength, which can be weak, thready, strong or bounding

Below 60 bpm

Higher than 100 bpm

• Pulse: 60-100
• Respirations: 12-20
• Systolic BP: Men: 100-135 Women: 90-135
• Body Temp: 98.6

Exchange of oxygen and carbon dioxide in the lungs and at the cellular level

Number of breaths in one minute

Rapid breathing

Slow breathing

How hard the patient works to breath

Depth and pattern of breathing

• Eupnea- normal rate and pattern
• Tachypnea- fast breathing
• Bradypnea- slow breathing
• Apnea- no breathing
• Hyperpnea- deep breaths
• Cheyne-stokes- Gradual increases and decreases in respirations with periods of apnea
• Biot's- Rapid, deep gasps with short pauses between sets
• Kussmaul's- Tachypnea and hyperpnea
• Apneustic- Prolonged inspiratory phase with shortened expiratory phase

Amounth of air one breath moves in and out of lungs

Force of blood against artery walls as the heart contracts and relaxes

Force of blood against arteries when ventricles contract

Force of blood on the arteries when ventricles relax

Sounds of blood hitting arterial walls

Passage of blood through an organ or tissue

Difference between systolic and diastolic BPs

BP higher than normal

BP lower than normal

Increase in body's core temperature

Decrease in body's core temperature

Noninvasive device that measures the oxygen saturation of blood

Real-time measurement of exhaled carbon dioxide concentrations

A device used in capnography to measure exhaled carbon dioxide concentrations

Machine that displays and records electrical activity of the heart

Tool used to measure blood glucose

• Skin
• Hair, eyes, ears, nose, mouth
• Neck
• Chest and lungs
• Abdomen
• Extremities
• Posterior body
• Peripheral vascular
• Neurologic

• Color
• Moisture
• Temperature
• Texture
• Mobility and turgor
• Lesions

Normal tension in the skin

Any disruption in normal tissue

• Purpura- reddish purple blotches larger than 0.5 cm
• Petechiae- reddish purple spots less than 0.5 cm
• Ecchymoses- reddish purple blotch varying in size
• Spider Angioma- reddish legs radiate from red spot
• Venous Star- bluish legs radiate from blue center
• Capillary Hemangioma- Irregular red spots

• Macule- flat spot. color varies, white, brown, red, purple. less than 1 cm
• Patch- irregular flat macule. greater than 1 cm
• Papule- elevated firm spot. color varies. less than 1 cm
• Plaque- superficial papule. more than 1 cm. rough texture
• Wheal- pink irregular spot varying in shape and size
• Nodule- elevated firm spot. 1-2 cm
• Tumor- elevated solid. more than 2 cm. same color as skin
• Vesicle- elevated area less than 1 cm. contains serous fluid
• Bulla- vesicle with diameter more than 1 cm.
• Pustule- elevated area less than 1 cm. contains purulent fluid
• Cyst- elevated palpable area containing liquid or viscous matter
• Telangiectasia- red, threadlike line

• Fissure- linear red crack ranging into dermis
• Erosion- depression in epidermis caused by tissue loss
• Ulcer- red or purple depression ranging into dermis caused by tissue loss
• Scar- fibrous. variable depth. color ranges from white to red
• Keloid- elevated scar, irregular in shape. larger than original wound
• Excoriation- linear. may be hollow or crusted. caused by loss of epidermis
• Scale- elevated area of excess exfoliation. varies in thickness, shape and dryness. white, silver or tan
• Crust- reddish, brown, black, tan or yellowish dried blood, serum or pus
• Lichenification- thickening and hardening of epidermis with lines
• Atrophy- skin surface thins and markings disappear

• Clubbing- angle between proximal nail and plate is increased. indicates chronic hypoxia
• Paronychia- folds appear red or swollen. people who get their hands wet frequently
• Onycholysis- nail bed seperates from nail plate. many causes including hyperthyroidism
• Terry's Nails- mostly white nail with a and of reddish brown at the distal tip. liver cirrhosis, CHF, diabetes
• White Spots- trauma to the nails
• Transverse White Lines- may appear after severe illness. parallel to the finger
• Psoriasis- small pits in the nails
• Beau's lines- transverse depressions in the nail. associated with severe illness.

SCALP

• Skin
• Connective tissue
• Aponeurosis
• Loose tissue
• Periosteum

Joint where the mandible connects to the skull

• Dry, cracked- dehydration, wind damage
• Swlling/edema- infection, allergic reaction, burns
• Lesions, infection, irritation, skin cancer
• Pallor- anemia, shock
• Cyanosis- respiratory or cardiac insufficiency

• Spinal cord
• Carotid arteries
• Jugular veins
• Larynx/trachea
• Esophagus

light, crackling, popping, nonmusical sounds heard usually during inspiration. associated with fluid

Continuous, high pitched musical sounds. Asthma, bronchospasm, small foreign bodies in the lower airway

Continuous sounds heard with a lower pitch and snoring quality. Secretions in larger airways. Bronchitis, penumonia. Usually in early exhalation but also sometimes in inhalation

Predominatly inspiratory wheeze/high pitched squeal. Laryngeal obstruction

Squeaking or grating sound

Abnormal clarity of patient's transmitted voice sounds while auscultating the chest. Can happen with fluid in the lungs.

Abnormal clarity of patient's transmitted whispers while auscultating

Abnormal change in patient's tone while auscultating