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What are the landmarks for cardiac auscultation?
- Apical
- Pulmonic
- Erb's point
- Tricuspid
- Mitral
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The PMI is best found where?
Mitral
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What does pallor look like in a brown-skinned person?
In a black-skinned person?
- Yellowish-brown
- Ashen gray
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Thorax and lungs includes the examination of:
Includes:
Posterior, lateral, and anterior thorax
inspection, palpation, percussion and auscultation.
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Abnormal findings of the neck include:
- - asymmetry of neck muscles
- - decreased ROM
- - enlarged or tender lymph nodes
- - enlarged thyroid
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Abn findings of Mouth and Throat:
- - gingivitis - ulcer
- - dryness - white patches
- - edema - lesions
- - tenderness - parotitis
- - ulcer - bldg ulcers
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Posterior Thorax Landmarks:
Inspect posterior thorax for:
- -spine
- - right scapula line
- - left scapula line
- - shape
- - symmetry
- - spinal alignment
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Anterior Thorax landmarks:
- - midsternal line
- - right midclavicular line
- - left midclavicular line
- - right anterior axillary line
- - left anterior axillary line
- - apex
- - base
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What do you palpate during palpation of anterior thorax?
- - tactile fremitus "ninety-nine"
- (start at scapula, down lung fields, about 5x)
- lumps and tenderness
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Normal breath sounds include:
- - vesicular
- - bronchovesicular
- - bronchial sounds
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What do vesicular breath sounds sound like?
Where are they best heard?
- - soft
- - breezy
- - low-pitched
Over lungs periphery
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What do bronchiovesicular breath sounds sound like?
Where are they best heard?
- - blowing sounds
- - medium-pitched
- - medium intensity
Best heard posteriorly, between scapulae and anteriorly over bronchioles lateral to sternum at 1st and 2nd intercostal spaces.
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What do bronchial breath sounds sound like?
Where are they best heard?
- - loud
- - high-pitched
- - hollow
Best heard over trachea.
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Abnormal findings of the skin include:
- diaphoresis
- pallor, cyanosis
- severely dry/parched mucuous membranes
- tenting
- jaundice
- lesions
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What is subjective data?
Things the pt tells you that you cannot observe (i.e. pain, headache)
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What is OBJECTIVE data?
Things that you can observe (viatal signs, edema)
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Abnormal findings in the nails
- soft and brittle
- inflammation
- pale/cyanotic nail beds
- spoon-shaped nails
- clubbed nails
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Head & Neck exam includes:
- head
- eyes
- ears
- nose/sinuses
- mouth/throat
- neck
-
What do you examine on the head?
- size
- facial bones
- symmetry
- postion/control
- shape
- TMJ
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What is examined in the eyes?
- testing visual acuity
- extraocular movements
- external and internal eye structures
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Testing visual acuity involves:
- distance and near vision
- extraocular movements
- accomodation
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What do you inspect in the EYES?
- postion/alignment
- eyebrows/eyelids
- lacrimal apparatus
- conjuctivae and sclera
- pupils
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PERLLA means what?
Pupils are EQUAL, ROUND REACTIVE TO LIGHT and ACCOMODATION
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Abnormal findings in the eye:
- Redness indicates infection or allergies
- Pale conjectiva-anemia
- Bright red blood in localized area (indicates subconjuctival hemorrhage)
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Examination of the ears includes:
- Inspection of auricles, tragus and lobule
- Palpate auricles for texture, tenderness or skin lesions
- Insepct opening of ear canal for discharge/occlusion
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Voice test includes:
- Stand 1-2 ft from pt
- Have pt occlude ear on opposite side and whisper in unoccluded ear
- Move 6 ft away and speak in normal voice tones
- Repeat on opposite side
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Neck lymph nodes include:
- Preauricular
- Occiputal
- Postauricular
- Anterior cervical
- Posterior cervical
- Supraclavicular
- Superficial cervical
- Tonsillar
- Submandibular
- Submental
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Formula for converting C to F:
C=F-32 /1.8
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Formula for converting F to C
F=(1.8)C +32
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