PE Notes for Veterinary Tech Exam

WHAT IS A PHYSICAL EXAM?

• Diagnostic test

• Serves as the basis for subsequent assessment and intervention

• An inaccurate PE can be worse than no exam at all

WHY DO TECHS NEED TO DO THIS TEST?

• Normal versus abnormal

• Aids in efficiency of the DVM (doctor of veterinary medicine)

HOW DO TECHS PERFORM A PE?

• Always work in a systematic fashion and do not stray from your system

• Developing a system equals accuracy and efficiency

PE HANDOUT

• YOU ARE GOING TO PERFORM A PE ON TRACEY TODAY!

• DON\'T TOUCH ME

SIGNALMENT

• NAME

• AGE

• BREED

• GENDER

PRIMARY VITALS (1°)

• TEMPERATURE

• PULSE AND HEART RATE

• TPR (Temperature, Pulse, Respiration)

• RESPIRATION

• WEIGHT

TEMPERATURE

• RECTAL THERMOMETER

• AURICULAR THERMOMETER

• unit: $^{\circ}\mathrm{F}$

TEMPERATURE NORMAL RANGES

• CANINE: $100-102.2^{\circ}\mathrm{F}$

• FELINE: $100-102.2^{\circ}\mathrm{F}$

• ELEVATED TEMPERATURE CAN INDICATE ANXIETY, EXCITEMENT, INFECTION OR INFLAMMATION

PULSE

• PALPATE FEMORAL ARTERY

• LOCATE AT PROXIMAL MEDIAL GROIN

• COUNT NUMBER OF PULSES OVER 15 SECONDS

• MULTIPLY THAT AMOUNT BY 4

• TOTAL = $\text{BPM}$ (beats per minute)

• IF YOU CANNOT FEEL A PULSE, PLEASE LET SOMEONE KNOW

• OBESITY MAKES PALPATING A PULSE MORE DIFFICULT

PULSE PRACTICE

HEART RATE

• FEEL THE HEART BEATING OR LISTEN WITH STETHOSCOPE

• LEFT SIDE WHERE ELBOW INTERSECTS WITH CHEST OR STERNAL CHEST WITH BARREL SHAPED ANIMALS

• COUNT NUMBER OF BEATS OVER 15 SECONDS

• MULTIPLY THAT AMOUNT BY 4

• TOTAL = $\text{BPM}$

HEART RATE PRACTICE

• https://YOUTU.BE/GJPTWHZEF8 (reference)

PULSE AND HEART RATE NORMAL RANGES

• CANINE: $60-160\ \text{BPM}$

• HIGHER RATES FOR PUPPIES AND SMALLER BREEDS

• FELINE: $140-220\ \text{BPM}$

• HIGHER RATES FOR KITTENS

PULSE AND HEART RATE RELATIONSHIPS

• SHOULD CORRESPOND

• Tachycardia

• Bradycardia

• Pulse deficit

HEART RHYTHM

• SHOULD SOUND LIKE “LUP-DUP” = 1 BEAT

• REGULAR = NORMAL RHYTHM

• IRREGULAR = ARRHYTHMIA

• IDENTIFY TYPE (e.g., SINUS ARRHYTHMIA)

• SINUS ARRHYTHMIA IS NON-PATHOGENIC IN DOGS

• RATE INCREASES WHEN PET INHALES AND DECREASES WHEN EXHALES

• Auscultation Assistant: https://www.med.ucla.edu/wilkes/Physiology.htm

HEART SOUNDS & MURMURS

• MURMURS: SOFTENING OF THE EDGES OF THE NORMAL CRISP HEART SOUND

• CAUSED BY ABNORMAL BLOOD FLOW THROUGH THE HEART

• GENERALLY HEAR A WHOOSH OR A SWISH SOUND

• BRING TO THE VET\'S ATTENTION

• THEY WILL GRADE THE MURMUR

RESPIRATION

• OBSERVE RISE AND FALL OF THE CHEST, OR FEEL, OR LISTEN WITH THE STETHOSCOPE

• TRY TACTICS TO STOP THEM FROM PANTING

• COUNT NUMBER OF BREATHS OVER 15 SECONDS

• MULTIPLY THAT AMOUNT BY 4

• TOTAL = $\text{RPM}$

RESPIRATION NORMAL RANGE

• CANINE: $16-32\ \text{RPM}$

• FELINE: $20-42\ \text{RPM}$

• IS THAT NORMAL?

RESPIRATION PRACTICE

• Tachypnea

• Bradypnea

• Eupnea

• Dyspnea

• MIMMIM

WEIGHT

• USE A SCALE TO OBTAIN AN ACCURATE WEIGHT

• RECORD USING THE UNIT OF MEASUREMENT USED (POUNDS, KILOGRAMS, ETC)

1° VITALS

• ALL PRIMARY VITALS (EXCEPT WEIGHT) CAN BE ELEVATED WHEN THE PATIENT IS EXCITED OR ANXIOUS

SECONDARY VITALS (2°)

• MUCUS MEMBRANE (MM)

• CAPILLARY REFILL TIME (CRT)

• SKIN TENT

MUCUS MEMBRANES (MM)

• MM ON GUMS, VULVA, PREPUCE, etc.

• DOCUMENT MM COLOR: PINK (NORMAL), CYANOTIC (BLUE), INJECTED (BRIGHT RED), MUDDY (DARK RED), PALE (PALE PINK/WHITE)

• OBSERVE MM MOISTNESS: MOIST, TUCKY (TACKY)

MM NORMAL RANGE

• CANINE: PINK

• FELINE: PINK TO LIGHT PINK

CAPILLARY REFILL TIME (CRT)

• PRESS ON ANY NON-PIGMENTED MM

• OBSERVE HOW LONG FOR COLOR TO RETURN

CRT NORMAL RANGE

• CANINE: $1-2\ \text{s}$

• FELINE: $1-2\ \text{s}$

• $<2\ \text{s}$ IS NOT ACCEPTABLE

SKIN TENT / SKIN TURGOR

• LIFT SKIN FOLD; TIME FOR IT TO RETURN TO NORMAL

• COMMON AREA: SCRUFF; IF ABNORMAL, ASSESS MID BACK

ST (SKIN TENT) NORMAL RANGE

• CANINE: IMMEDIATE

• FELINE: IMMEDIATE

• IS THAT NORMAL?

SYSTEMS REVIEW

• a.

• d

• b. -

• SYSTEMS REVIEW

• e.

• L

• k.

ALWAYS REMEMBER!

• BE DESCRIPTIVE USING MEDICAL AND PROFESSIONAL TERMS OR ABBREVIATIONS

• QUANTIFY WHEN POSSIBLE (SMALL, MODERATE, LARGE AMOUNT)

GENERAL CONDITION

• GROSS ABNORMALITIES

• ATTITUDE: FRIENDLY, AGGRESSIVE, SUBMISSIVE, FEARFUL, ETC

• BAR, QAR, LETHARGIC, DEPRESSED

• BODY CONDITION (BCS)

BODY CONDITION SCORE (BCS)

• Ribs prominent and easily felt with no fat cover.

• Bones are raised with minimal tissue between skin and bone.

• Body Condition Score 1: VERY THIN

• Ribs visible and easily felt: 2 UNDERWEIGHT

• 3 IDEAL WEIGHT: Ribs difficult to see or feel; slight sagging abdominal fat pad

• 4 OVERWEIGHT: Ribs not visible and difficult to feel; prominent sagging abdominal fat pad

• 5 OBESE

• Example notes on cat weight status (from slides):

  • Your cat is UNDERWEIGHT. Please check with your vet to see if there is anything to be concerned about.

  • Your cat is IDEAL WEIGHT. Congratulations!

  • Your cat is OVERWEIGHT and is at a higher risk of developing a weight-related health condition. Please consult your vet or vet nurse for further advice.

INTEGUMENT

• INTEGUMENT = SKIN AND COAT TEXTURE

• DRY, OILY, SHINY

• DANDER, ALOPECIA, ERYTHEMA

• STAINING, SCALES, CRUST

• FLEA DIRT, ECTOPARASITES

• LESIONS

EYES

• WORK EXTERNAL TO INTERNAL

• EYELID ABNORMALITIES: CHERRY EYE, ENTROPION, ECTROPION

• CONJUNCTIVA (LINING OF EYELIDS)

• EPIPHORA / KERATOCONJUNCTIVITIS SICCA

• DISCHARGE

• SCLERA

• CORNEA

• LENS: CATARACT

EARS

• WORK EXTERNAL TO INTERNAL

• PINNA

• EXTERNAL EAR CANAL

• DISCHARGE

• SWELLING

• REDNESS

• HAIR IN CANAL

• ODOR

• MUST LOOK WITH AN OTOSCOPE TO VISUALIZE THE HORIZONTAL CANAL AND TYMPANUM

NOSE

• WORK EXTERNAL TO INTERNAL

• DISCHARGE

• DRYNESS/CRUST

• LESIONS

MOUTH / THROAT

• WORK EXTERNAL TO INTERNAL

• DENTAL FORMULA

• TEETH: MISSING, BROKEN, RETAINED, SUPERNUMERARY

• JAW ALIGNMENT: SCISSOR, LEVEL, BRACHYGNATHIC, PROGNATHIC

• GINGIVA

• LESIONS

DENTAL FORMULA

• CANINE: $2\ I\ 3,\ C\ 1,\ P\ 4,\ M\ 2$

• 3 1 4 3

• FELINE: $2\ I\ 3,\ C\ 1,\ P\ 3,\ M\ 1$

• 3 1 2 1

ABDOMEN

• PLACE ONE HAND ON EACH SIDE OF ABDOMEN, FINGERS POINTING UPWARD, PRESS FINGERTIPS TOWARD THE OTHER HAND

• PALPATE IN QUADRANTS

• NOTE ANY PAIN, DISTENTION

• NOTE ANY FIRM MASSES OR ABNORMALITIES

• RECORD LOCATION, ESTIMATED SIZE, SHAPE

GENITALS

• FEMALE: VULVA, SPAY INCISION?

• MALE: TESTICLES, CRYPTORCHID (MONORCHID, BILATERAL)

• PREPUCE, PENIS, NIPPLES / MAMMARY GLANDS

RECTUM – PERIANAL

• GROSS EXAM: SWELLING, MATS, SORES, PARASITES, MAGGOTS

• ANAL GLAND ASSESSMENT

• RECTAL: NOT ROUTINELY PERFORMED UNLESS INDICATED

• ASSESS PROSTATE IN MALES

• RECTAL WALL

EXTREMITIES

• PALPATE BONES, MUSCLES, JOINTS

• RANGE OF MOTION (ROM)

• NOTE ANY SWELLING, HEAT, MASSES, CREPITUS

• ASSESS SYMMETRY LEFT VERSUS RIGHT

NECK / BACK

• GROSS DEFORMITIES

• STIFFNESS, LORDOSIS, KYPHOSIS, KINKED TAIL, ETC

• PALPATE SOFT TISSUES: SALIVARY GLANDS, TRACHEA, THYROID, MUSCLES ALONG VERTEBRAE

• ASSESS MOBILITY

• PALPATE SPINE

• ASSESS LIMITATIONS, DISCOMFORT

• DO NOT PERFORM IF DISPLAYING OBVIOUS DISCOMFORT

NEUROLOGIC

• SENSORY

• HEARING

• CLAP

• SIGHT

• THROW A COTTON BALL, PLR (PLR = PUPILLARY LIGHT REFLEX)

• COORDINATION

• RIGHTING REFLEX

• CONSCIOUS PROPRIOCEPTION (CP)

LUNG SOUNDS

• QUIET LOCATION

• AUSCULT IN 9 QUADRANTS

• AUSCULT ALONG TRACHEA

• NORMAL = CLEAR

• RALES = ABNORMAL LUNG SOUNDS: CRACKLING, WHEEZING, CLICKING, BUBBLING, RATTling

• COUGH: PRODUCTIVE VS NON-PRODUCTIVE

LYMPH NODES

• BILATERALLY PAIRED

• MEASURED 2-DIMENSIONALLY IN MILLIMETERS (MM)

• E.G. 4 MM X 10 MM

LYMPH NODES (Locations)

• MANDIBULAR

• POPLITEAL

• PRESCAPULAR

• INGUINAL

• AXILLARY

COMMENTS

• NOTE AND ADDITIONAL COMMENTS IN THE COMMENTS SECTION (IF COMMENTS ANY)

VETERINARY TECHNICIAN PRACTICE MODEL

• PURPOSE: PROVIDE A STRUCTURED, CYCLICAL FRAMEWORK FOR CRVT TO DELIVER COMPREHENSIVE PATIENT CARE BY OUTLINING A SYSTEMATIC APPROACH TO ASSESSMENT, PLANNING, INTERVENTION, AND EVALUATION

• THIS MODEL ENSURES CONSISTENT AND QUALITY PATIENT OUTCOMES BY STANDARDIZING CARE AND EMPOWERING TECHNICIANS TO UTILIZE THEIR SKILLS EFFECTIVELY

• IT ALSO SERVES TO OPTIMIZE THE UTILIZATION OF TECHNICIANS WITHIN A PRACTICE BY DEFINING THEIR ROLES AND RESPONSIBILITIES, LEADING TO IMPROVED PATIENT CARE AND A MORE EFFICIENT HEALTHCARE TEAM

DEVELOP YOUR SYSTEM AND KNOW YOUR NORMALS

• IMPORTANT NOTE: freepik attribution lines appear here