ED4: Physical Exam

How is right and left determined?

Its the right and left for the patients perspective

What is normal Bp?

120/80

what is it called for BP being to high and low?

hypertensive and hypotensive

what is normal pulse rate?

60-100bpm

what is it called for pulse rate being to high and low?

bradycardic and tachycardic

what is the normal respiratory rate?

12-18

what is it called for respiratory rate to be to high and low?

bradypneic and tachypneic

what is the normal temperature?

98.6

What is it called for temperature to be to high and low

hypothermia and fever (100.4 F)

What is the normal oxygen saturation?

over 96%

what is it called for oxygen saturation to be too low?

hypoxic (below 92)

Constitutional abnormalities

mild/moderate/severe distress dut to pain or respiratory difficulty

cachet/emaciated/malnourished

somnolent, obtunded, unresponsive

Eye Abnormalities

fixed and dilated(stroke, tumor or brain injury, congenital)

EOM entrapment

Nystagmus(inner ear problem, alcohol or drug use, or abnormal brain conditions)

Scleral icterus(liver failure)

pale conjunctiva(anemia)

conjunctival injection(conjunctivitis)

discharge or crusting(infection)

Ear abnormalities

TM erthyma, TM effusion, TM bulging, TM dullness (otitis media)

TM obscured by cerumen( cannot see TM because earwax)

Nose abnormalities

clear or yellow discharge

boggy turbinates/ swelling of nasal mucosa(rhinitis)

site of bleeding identified(epistaxis)

Throat and Mouth abnormalities

dry mucuos membrane(dehydration)

pharyngeal erythema(pharyngitis)

exudates(pharyngitis, tonsillitis)

tonsillar hypertrophy(tonsillitis)

tonsillar aysymmetry(peritonsillar abcess)

uvular shift(peritonsillar abscess)

edentulous(no teeth)

dental caries(cavities)

gum tenderness or edema(infection)

Neck abnormalities

limited range of motion

nuchal rigidity, meningisums

vertebral point(fracture) v paraspinl tenderness(muscle strain)

anterior and/or posterior cervical lymphadenopathy(infection)

jugular vein detention(JVD)(heart failure)

carotid bruit(carotid artery stenosis)

Cardiovascular abnormalities

tachycardia

bradycardia

irregulatory irregular rhythm(atrial fibrillation)

murmurs

rubs(pericarditis)

gallops(ventricular failure or hypertrophy)

extrasystoles

Pulse abnormalities

0 = absent pulse

1 = barely palpable

3= full

4= bounding/aneurysmal

delayed capillary refill(decreased blood flow or dehydration)

Respiratory abnormalities

mild/moderate/severe respiratory distress

tachypnea

accessory muscle use

pursed lip breathing(emphysema)

diminished breath sounds

wheezes(asthma or COPD)

rales(crackles)(CHF)

rhonchi(pneumonia)

Gastrointestinal abnormalities

rigidity

mild/moderate/severe tenderness

guarding, rebound, rigidity(peritoneal signs)

positive Murphy's sign(cholecystitis)

positive McBurney's point(appendicitis)

absent/hypoactive/hyperactive bowel sound

hepatomegaly

splenomegaly

Musculoskeletal abnormalities

paraspinal tenderness(muscle injury)

vertebral point tenderness(spinal injury)

costovertebral angle tenderness(kidney stone, pyelonephritis)

bony tenderness(fracture)

soft tissue tenderness(contusion, strain)

calf tenderness(DVT)

edema(trace 4+, CHF)

limited range of motion secondary to pain

pulse/sensory/motor deficits

tendon laxity

skin abnormalities

cool to touch

hot to touch(febrile or infection)

diaphoretic

jaundice(liver failure)

cyanotic(hypoxic- blue)

pallor(anemia)

urticaria/wheals/maculopapular rash (hives)

petechiae

induration(cellulitus)

fluctuance(abscess)

purulent drainage(abscess)

neurological abnormalities

somnolent(drowsy)

confused

responsive to voice

reposnive to painful stimuli

unresponsive to voice and pain

disoriented

aphasia(expressive or receptive)

dysarthria

Nuerological- Strength Sensation, Reflexes abnormalities

2/5-0/5

hypesthesia(decreased sensation)

0,1,3,4 on reflexes scale

nuerological- cerebellar abnormalities

ataxia(uncoordinated)

antalgic(walking to avoid pain)

nystagmus

dysmetria

positive Romberg