Physical Exam and General Survey

Inspection

Close observation of details of the patient such as appearance behavior movement and lesions

Palpation

Tactile pressure using palmar fingers to feel contours warmth tenderness organs and pulses

Percussion

Tapping one finger against another on the body surface to assess solid versus air filled structures

Auscultation

Listening with a stethoscope to evaluate sounds of heart lungs bowels and blood vessels

Fowler's position

Position where patient is seated on exam table with head of bed elevated at approximately forty five degrees

Trendelenburg position

Position where patient lies supine with foot of bed elevated above head

Auscultatory gap

Silent interval that may present between systolic and diastolic pressure readings

White coat hypertension

Elevated in office blood pressure in a patient with normal out of office readings

Masked hypertension

Normal in office blood pressure readings with elevated out of office readings

Orthostatic hypotension

Systolic blood pressure drop of twenty or diastolic drop of ten when moving to standing position

Tachycardia

Heart rate greater than one hundred beats per minute

Bradycardia

Heart rate less than sixty beats per minute

Bisferiens pulse

Increased arterial pulse with a double systolic peak

Pulsus alternans

Pulse with regular rhythm but alternating strong and weak beats

Bigeminal pulse

Normal pulse beat alternating with a premature contraction

Pulsus paradoxus

Abnormally large drop in pulse amplitude and systolic blood pressure during inspiration

Bradypnea

Abnormally slow respiratory rate less than twelve breaths per minute

Tachypnea

Rapid shallow breathing with rate greater than twenty breaths per minute

Hyperpnea

Rapid deep breathing pattern

Ataxic breathing

Irregular unpredictable breathing pattern with random clusters of breaths and periods of apnea

Obstructive breathing

Breathing pattern characterized by prolonged expiration due to narrowed airways

Cheyne Stokes breathing

Cyclic hyperventilation alternating with periods of apnea

Kussmaul breathing

Rapid deep labored breathing pattern associated with metabolic acidosis

Pyrexia

Fever characterized by elevated body temperature above one hundred point four degrees Fahrenheit

Hyperpyrexia

Extremely high fever above one hundred six degrees Fahrenheit

Hypothermia

Abnormally low body temperature below ninety five degrees Fahrenheit

Nociceptive pain

Pain linked to tissue damage with intact sensory nervous system usually described as dull achy or throbbing

Neuropathic pain

Pain linked to damage or disease of the somatosensory system usually described as burning or electric shock like