PHYSICAL EXAMINATION

PHYSICAL EXAMINATION

Conducted from head to toes (cephalo-caudal technique).

INSPECTION

PALPATION

PERCUSSION

AUSCULTATION

Modes of Examination (sequence)

Inspection

assessing the patient using the sense of sight

Palpation

Examining the body using the sense of touch by using the fat pads of the fingers.

Percussion

Tapping the body parts to produce sound

Auscultation

Listening to the body sounds with the use of a stethoscope

light and deep palpation

Two types of Palpation

Flatness, Soft, Extremely dull

Muscle and bone

Liver and Heart

Dullness, Medium, Thud-like

Normal lung

Resonance, Loud, Hollow

Emphysematous Lung (pneumothorax)

Hyper resonance, Very loud, Booming

Stomach filled with gas (air)

Tympany, Loud, Musical

INSPECTION

AUSCULTATION

PERCUSSION

PALPATION

Sequence for examination of the abdomen

flex the knees

During abdominal examination, it is important to ____ to relax the abdominal muscles

1. Right lower quadrant

2. Right upper quadrant

3. Left upper quadrant

4. Left lower quadrant

The sequence of examining the abdomen quadrant

Tracheal

Bronchial

Bronchovesticular

Vesticular

BREATH SOUNDS:

Tracheal

Very loud, high-pitched, equal inspiratory and expiratory, over the trachea.

Bronchial

Loud, high-pitched, inspiratory sound shorter than expiratory, over the manubrium.

Bronchovesticular

Medium in loudness and intermediate pitch, inspiratory and expiratory sounds equal, first and second intercostal spaces next to the sternum and between scapula.

Vesticular

Soft, relatively low pitch, inspiratory longer than expiratory, most of the lung field.

WHEEZE

CRACKLES

RHONCHI

STRIDOR

FRICTION RUB

Abnormal breathing sounds

Crackles

short, popping discontinuous sounds

(Fine) Crackles

sounds of wood burning in a fireplace

(Coarse) Crackles

Low pitched and longer

Stridor

a harsh, vibratory sound that occurs due to the narrowing of the upper airway,

Wheezes

high-pitched or musical sound through both inspiration/expiration.

Rhonchi

lower-pitched that wheezes, snoring quality, loudest during expiration.

Ex: Bronchitis & Pneumonia

Friction Rub

deep, harsh, grating sounds, primarily in inspiration.

Ex: Pleuritis or pneumonia

Parietal pleura

Visceral pleura

The two layers that rub against each other in pleural friction are:

Visceral pleura

the inner layer covering the lungs.

Parietal pleura

the outer layer lining the chest wall.