General Medicine Lecture 1 Small Animal Physical Exam

Front 1

What are the 11 elements of a routine exam on a small animal?

Back 1

1) Temperature, pulse
2) Respiration
-pulse character, respiratory noise, capillary refill time
3) Body weight
-Body condition score
4) External appearance
5) Oral exam
6) Palpable lymph nodes
7) Abdominal palpation
8) Otic exam
9) Ocular exam
10) External genitalia
11) Rectal exams
-Most adult male dogs

Front 2

What are 6 non-routine exams performed on small animals?

Back 2

1) Full neurological exam
2) Orthopedic exam
3) Vaginal exam on all species
-often have to sedate
4) Rectal exam on cats
5) Detailed ocular exam
6) Thorough dermatologic exam

Front 3

A veterinarian should always live and die by _______.

Back 3

Documentation
-as you go along or at least ASAP

Front 4

How should you correct a mistake in your medical records?

Back 4

With a single line and initial the changes

Front 5

When does the physical exam begin?

Back 5

As soon as you see the animal
-first initial impression can be very important
-introduce yourself and see how animal responds

Front 6

Why is it so important to obtain an accurate body weight?

Back 6

Most drugs are dosed in mg/kg
-should record weight in both pounds and kilograms

Front 7

What should be included in patient history?

Back 7

Why are they here?
Chronology, chronicity, progression
-other health issues
-What is animal doing while you take the history

Front 8

What are the 5 ways to classify the mental state of the animal?

Back 8

1) Bright, alert, responsive (BAR)
2) Quiet, alert, responsive (QAR)
3) Dull, depressed, obtunded
4) Non-responsive, comatose
5) Altered mentation, dysphoric

Front 9

What is meant by altered mentation?

Back 9

Animal may look alert but not truly there

Front 10

What is meant by an animal is dysphoric?

Back 10

Animal that's post seizure is often dysphoric: moving, vocalizing but if say their name or snap fingers don't react to you as would be appropriate

Front 11

What are 8 things should you examine on the head of a small animal?

Back 11

1) Facial symmetry
2) Muscles of mastication
3) Submandibular lymph nodes
4) Salivary glands
5) Capillary refill time
6) MM color
7) Teeth condition
8) Gingiva

Front 12

What is the normal capillary refill time of a small animal?

Back 12

< or equal to 1.5 s

Front 13

What 3 things can cause a prolonged capillary refill time?

Back 13

Poor peripheral circulation
Shock
Hypovolemia

Front 14

What 2 breeds have a different normal color to their mucous membranes?

Back 14

1) chow chows
2) Dark-haired breeds

Front 15

What are 5 possible appearances to the mucous membranes?

Back 15

1) Normal is pink to red
2) Icterus
3) Cyanosis
4) Pale
5) Muddy

Front 16

What should you be looking for during an oral exam?

Back 16

-Masses
-string under tongue
-inflammatory lesions
-gingival hyperplasia, epulis
-missing teeth?

Front 17

What 3 structures should you look AT during an oral exam of a small animal?

Back 17

1) Tonsils
2) Glossopalatine arches
3) Base of tongue

Front 18

What 4 things should you examine in the neck during a small animal physical exam?

Back 18

1) Prescapular lymph nodes
2) Thyroid
3) Larynx and trachea
4) Cough on palpation

Front 19

What 2 things should you listen for on thoracic auscultation?

Back 19

1) Cardiac sounds
2) respiratory sounds
-increase? decrease?

Front 20

Once you detect a murmur in a small animal, what are the 4 things you need to determine about the murmur?

Back 20

1) Systolic, diastolic, continuous
2) Point of maximal intensity
-heart base, apex, sternal
3) Palpate pulse while listening
-pulse deficit?
4) Are sounds increased? Muffled?

Front 21

Should you be able to hear a cat breathe?

Back 21

No, cats normally have quiet respiratory sounds

Front 22

What are the 2 types of sounds that can be heard on respiratory auscultation? Where does each sound come from?

Back 22

Crackles (alveolar)
Wheezes (bronchial)
-musical

Front 23

What are the 2 things you should define upon thoracic auscultation?

Back 23

1) Define time in respiratory cycle
-Inspiratory vs expiratory
2) Define point of peak intensity
-larynx? trachea? Referred?

Front 24

What should you note when a thoracic auscultation is muffled?

Back 24

Dorsal or ventral

Front 25

What do you feel on abdominal palpation of a dog from cranial to caudal? (6)

Back 25

1) Caudal border of liver
2) Stomach (maybe)
3) spleen
4) Caudal pole of left kidney (maybe)
5) Large and small intestinal loops
6) bladder

Front 26

What do you feel on abdominal palpation of a cat from cranial to caudal? (6)

Back 26

1) Caudal border of liver
2) Stomach (maybe)
3) Spleen (maybe)
4) Both kidneys- right cranial to left, mobile
5) Large and small intestinal loops
6) bladder

Front 27

What 4 things are you feeling for upon abdominal palpation?

Back 27

1) Masses?
2) Distention?
3) Fluid?
4) Painful?
-where?

Front 28

Where are the anal glands located?

Back 28

In the perineum- 4 & 8 o'clock

Front 29

What 4 things should you examine in the perineum of small animals?

Back 29

1) anal glands
2) Anal tone
3) Circumanal lesions?
-hepatoid adenoma
-Anal furunculosis
4) Rectal exam

Front 30

What are the 3 things you are checking on a rectal exam of a male dog?

Back 30

Anal tone
Prostate symmetry
Sublumbar lymph nodes

Front 31

The popliteal lymph nodes are normally located deep in the ______ muscle.

Back 31

Gracillis

Front 32

Digital thermometers take anywhere from 15 s to > 1 minute to equilibrate, so what can you do while taking the temperature?

Back 32

Convenient time to feel peripheral pulse quality

Front 33

What are 4 ways to categorize peripheral pulse quality?

Back 33

1) Normal
2) Weak (hypovolemia)
3) "thready" (hypovolemia)
-can't feel much pressure change occurring
4) Bounding
-Pulse pressure difference is high

Front 34

What can cause a bounding pulse?

Back 34

PDA or peripheral vasodilation from shock because diastolic pressure can drop (not systolic increasing)

Front 35

How direction is the ear canal?

Back 35

Canal goes craniomedial then medial

Front 36

What should you look for during an otic exam?

Back 36

Look for excess cerumen, purulent exudate, foreign bodies, masses, inflammatory polyps
-attempt to visualize tympanum

Front 37

At what point during a physical exam should you perform the ocular exam?

Back 37

At end of exam so animal trusts you

Front 38

What should you do for a full ocular exam?

Back 38

Dilate pupils
Direct VS indirect
Opthalmoscope

Front 39

How can purring affect the physical exam of a cat?

Back 39

Can block auscultation of heart and lungs

Front 40

How can you stop a cat from purring?

Back 40

Running water, strong scent, tap nose, finger over nostrils
-sometimes nothing works

Front 41

What kidneys are palpable in cats?

Back 41

Both kidneys

Front 42

Where are heart murmurs best heard in cats?

Back 42

Over the sternum
-heart murmus are often dynamic

Front 43

What are the 4 essential differences b/w a physical exam on cats and dogs?

Back 43

1) Cats can purr
2) Can usually palpate both kidneys
3) Heart murmurs in cats are usually heard best over sternum
4) Heart murmurs are often dynamic in cats