Week 1

Inspection

used for the initial and focused assessment

Palpation

4 finger pads

* uses to elicit crepitus on a patient who sustained an injury

Auscultation

use of stethoscope

* used to listen to heart and lungs

Percussion

uses middle finger tips

* techniques used for diaphragmatic excursion

Direct percussion

used to assess sinuses for sinusitis and sinus headaches

Indirect percussion

used to assess lungs and distended bladder

blunt percussion

used assess for tenderness or hematoma in the CVA area

Goniometer

used to measure the degree of joint flexion and extension

doppler

used to assess non-palpable pulses

Woods lamp

used to assess for fungal infections of the skin

skin fold caliper

measures subcutaneous thickness

transilluminator

used to detect blood, fluid, or massess in the body cavity

diaphragm of stethoscope

used for high pitched sounds

ex. heart and lungs

Bell of stethoscope

used for low pitched sounds

ex. cardiac murmurs or bruits

0 pulse grading

no pulse

1+ pulse grading

weak and thready

2+ pulse grading

normal pulse

3+ pulse grading

brisk

4+ pulse grading

bounding

radial pulse

palpated on the wrist laterally next to the thumb

ulner

palpated on the wrist medially inline with the pinky

brachial

palpated medially in the antecubital

popliteal

palpated behind the knee medially

femoral

palpated in the inguinal area

dorsalis pedis

palpated on the top of the foot in line with the big toe

carotid

palpated laterally on the neck, under the jaw

dorsal part of the hand

is used to assess skin temperature

annular lesion

singular circle

ex. ringworm

target lesion

concentric circles with dot in the center

ex. erythema

discrete lesion

separate lesions

confluent lesions

lesions that run together

linear lesions

lesions that form a line

grouped lesions

clusters or groups of lesions

wheal lesions

reddened with irregular border

ex. insect bites or hives

lichenification

rough, thick, hardened patch of skin due to itching and scrubbing

vesicle

palpable fluid filled mass with translucent walls

round or oval

grading edema

0: no edema

1+: 2mm

2+: 4mm

3+: 6mm

4+: 8mm

pneumonic for cranial nerves

Oh (olfactory) **Some (sensory)**

Oh (optic) **Say (sensory)**

Oh (oculomotor) **Marry (motor)**

To (trochlear) **Money (motor)**

Touch (trigeminal) **But (both)**

And (abducens) **My (motor)**

Feel (facial) **Brother (both)**

Very (vestibulocochlear) **Says (sensory)**

Good (glossopharyngeal) **Big (both)**

Vegas (Vagus) **Business (both)**

A-H (Accessory) **Makes (motor)**- (hypoglossal) **Money (motor)**

angle of louis

2nd ics

venous lake

soft lesion on lips or neck that are elevated, dark blue and compressible

* common on elderly over 50
* due to over exposure to sunlight

Port wine stain

flat irregular shape that pale red to deep purple

* color deepens with extreme temp or emotions
* present at birth and typically does not fade

hemangioma

bright red raised lesion

* nonblanchable
* present at birth
* disappears around age 10

spider angioma

flat bright red dot with tiny radiating blood vessels

* ranges from pinpoint to 2cm
* blanches with pressure

light palpation

uses finger pads of one hand with depth 0.5-1cm

moderate palpation

uses finger pads of one hand with depth of 2-3 cm.

* used to determine depth, shape, and consistency of organs

deep palpation

used by physicians or NPs by manual of 4-5cm

* must be done with caution
* used to asses organs that are deep within the body
* ex. liver, spleen, kidneys

when client refuses

document what was done and what was refused

When suspecting Lyme disease ask

Have you been hiking or camping recently?

indication of an open sore on the head that has not healed for several months

skin malignancy/cancer