Scribe: Physical Exam

Arthralgia

literally means joint pain

Atelectasis

the collapse or closure of alveoli resulting in reduced or absent gas exchange. It may affect part or all of one lung.

Cachexia/cachectic

emaciated

Hematochezia

the passage of fresh blood through the anus, usually in or with stools

Venous stasis

a condition of slow blood flow in the veins, usually of the legs

Afebrile

Without fever

Anisocoria

Unequal pupil sizes

Conjunctiva

Thin transparent membrane covering the lining of eyelids and whites of the eyes

Conjunctival Pallor

a sign of anaemia, pale conjunctivae

Conjunctiva

Thin transparent membrane covering the lining of eyelids and whites of the eyes

Cornea

Transparent coat of the eyeball that covers the iris and pupil

Funduscopic

inside of the eye; seen with the ophthalmoscope

Lacrimation

Production of tears

Malocclusion

a misalignment of teeth or incorrect relation between the teeth of the two dental arches.

Rhinorrhea

a condition where the nasal cavity is filled with a significant amount of mucous fluid.

Cerumen

Earwax

Dentition

The condition of the teeth

Brudzinski's sign

sign of meningitis

Carotid bruit

noise from carotid artery narrowing heard with stetoscope

Kernig's sign

sign of meningitis

Lymphadenopathy

enlarged lymph nodes

Meningismus

stiff neck and can be a sign of meningitis

Thyromegaly

enlarged thyroid

Hemoptysis

the expectoration (coughing up) of blood or of blood-stained sputum

CVAT

costovertebral angle tenderness; tenderness posteriorly at the lower rib margins

Vertebral point tenderness

tenderness directly over the spine

Guarding

involuntary tightening of stomach muscles when palpated due to irritation of the lining of the abdominal cavity

Hematemesis

vomiting of blood

Hepatomegaly

enlarged liver

Mass

any firm abnormality seen or palpated on physical exam

Prominent abdominal aortic pulsation

possible abdominal aortic aneurysm

Pulsatile mass

possible abdominal aortic aneurysm

Rebound

pain when releasing hand from abdominal palpation or from other movements

Splenomegaly

enlarged spleen

Costovertebral Angle

Location of the back overlying the kidneys

Cellulitis

infection of the skin characterized by erythema, warmth and tenderness

Cyanosis

blue skin due to lack of oxygen

Dehiscence

a surgical complication in which a wound breaks open along surgical suture

Diaphoresis

sweating

Ecchymosis

bruising

erythema

warmth and redness of the skin

Eschars

a slough or piece of dead tissue that is cast off from the surface of the skin, particularly after a burn injury

Icteric

jaundice, a yellowish pigmentation of the skin

Induration

Hardening of an area of the body as a reaction to inflammation, hyperemia, or neoplastic infiltration.

Jaundice

yellow discoloration of skin

Keloid

Scar formation consisting of dense tissue

Pallor

paleness

Induration

Hardening of an area of the body as a reaction to inflammation, hyperemia, or neoplastic infiltration.

JVD

jugular vein distention

Murmur

abnormal heart sound rated on a 1 - 6 scale, 6 being the loudest

Extrasystoles

extra beats of the heart

Gallop

extra heart sound often heard in CHF patients

Tachycardia

fast heart rate

Irregularly irregular rhythm

no consistent pattern to heart rhythm, usually implying atrial fibrillation

Carotid bruit

noise from carotid artery narrowing

PMI displaced laterally

sign of enlarged heart

Bradycardia

slow heart rate

Friction rub

abnormal heart or lung sound

Thrill

palpable vibratory sensation over a vessel in which a loud bruit is audible

Accessory muscle use

struggling for breath using muscles in the neck

Dullness on percussion

sign of fluid or solid mass under area being percussed

Prolonged expirations

indicates airway narrowing on expiration, common in asthma patients

Rales

clicking, rattling, or crackling noises hear in the lungs on inhalation, indicating fluid in the alveoli (sign of pneumonia or heart failure)

Retractions

sucking in between ribs or sternum during inspiration; usually seen in children

Rhonchi

a coarse sound in the lungs that indicates the presence of thick fluid

Splinting

not moving due to painful breathing

Stridor

high-pitched sound heard on inspiration that is indicative of airway obstruction

Wheezing

high-pitched whistling sound of air moving through narrowed airways

ROM

Range Of Motion

Clubbing

swelling and softening of the nailbed indicating a chronic lung problem

Lymphangitis

infection traveling up the lymphatic system

Pedal edema

water retention in the foot/ankle area

Axilla

Underarm

Crepitus/crepitance

Crackling or grating sound, usually at joint articulations

Ataxia/ataxic

a neurological sign consisting of lack of voluntary coordination of muscle movements, as in walking

pronator drift

test of upper motor neuron disease. The patient is asked to hold both arms fully extended at shoulder level in front of him, with the palms upwards, and hold the position. If they are unable to maintain the position the result is positive.

Romberg's sign

falling to one side while standing with eyes closed

Hemiparesis

weakness on one half of body

Hemiplegia

paralysis on one half of body

Ambulatory

Able to walk

Bimanual Exam

Pelvic examination using the digits

Cervical

Pertaining to the cervix of the uterus

Cervical motion tenderness

Finding on bimanual examination of the uterus

Fundus

The large, upper end of the uterus

Labia majora/minora

Skin surrounding the opening of the vagina

Os (cervical)

Orifice of the cervix

Speculum Exam

Pelvic examination using a speculum

Urethra

External opening to the urinary tract

Uterus

Female womb

Vault

Inside of the vagina

Vulva

Female genitalia

Circumcised

Foreskin of penis removed

Urethra

External opening to the urinary tract