Icm: Physical Exam

Front 1

components of pulse to feel for (3)

Back 1

frequency
waveform
intensity

Front 2

you should take pulse for ___ seconds unless ___ in which case do it for ___

Back 2

15
it's fast, slow or irregular
60

Front 3

assymmetric pulse can be caused by

Back 3

aortic dissection
coarctation of aorta before left subclavian

Front 4

if radial pulse is present, it means

Back 4

systolic BP > 100

Front 5

bottom of sphygmo cuff should be ___ above antecubital fold

Back 5

2 cm

Front 6

___ causes difference in BP between arms and legs

Back 6

coarctation of aorta

Front 7

reasons you can't hear a pulse when measuring BP (2)

Back 7

1. patient is in shock
2. you suck: you are off of the brachial artery

Front 8

auscultatory gap is

Back 8

when korotkoff sounds disappear after initially being heard

Front 9

reasons why you might hear korotkoff sounds all the way down

Back 9

1. aortic insufficiency (diastolic BP near 0)
2. you suck: there is pressure being applied by stethescope

Front 10

pulsus alternans is ___. it is due to ___.

Back 10

fluctuation in systolic BP
HF

Front 11

pulsus paradoxus is ___

Back 11

difference of more than 10 mm Hg between expiratory and inspiratory systolic BP

Front 12

causes for pulsus paradoxus (4)

Back 12

tamponade
pneumothorax
occlusion of IVC by diaphragm
severe obstructive respiratory disease

Front 13

causes for orthostatic hypotension (3)

Back 13

ANS disorders
hypovolemia
antihypertensive drugs

Front 14

one cause for ANS disorders is ___

Back 14

DM

Front 15

BP checks for orthostatic hypotension

Back 15

1. lying down
2. 30 s after standing up
3. 2 min after standing up
4. 5 min after standing up
5. walk around for a few min, then check again

Front 16

factors to check in respiration count (7)

Back 16

frequency
depth
use of accessory muscles, if present
asymmetry of thoracic expansion, if present
inspiration/expiration ratio
paradoxical respiration
cheyne-stokes respiration

Front 17

use of accessory muscles in breathing reflects

Back 17

respiratory distress

Front 18

causes of asymmetrical thoracic expansion (4)

Back 18

pain (pleuritis, e.g.)
altered thoracic structure
asymmetrical impairment of respiratory muscles
collapsed lung

Front 19

items to check in skin exam (6)

Back 19

color
hemorrhages
rash
texture
temperature
turgor

Front 20

hemorrhages that may be present (4)

Back 20

purpura
petechiae
echymoses
hematomas

Front 21

turgor check

Back 21

pinch some skin and release. see how long it takes to resume original state

Front 22

decreased skin tugor is commom in ___

Back 22

elderly

Front 23

excess or diminished hair can reflect ___ issues

Back 23

hormonal

Front 24

2 important nail findings

Back 24

splinter hemorrhages
clubbing

Front 25

splinter hemorrhages occur in ___
clubbing occurs in ___

Back 25

IE
lung diseases

Front 26

in nose exam, check for ___ (3). ask patient to ___. then tap ___ (3)

Back 26

inflammation
deformations
secretions
inhale through one nostril at a time
frontal sinus
ethmoidal sinus
maxillary sinus

Front 27

mouth exam includes ___ (2)

Back 27

mouth
pharynx

Front 28

parts of mouth to check (6)

Back 28

lips
gingiva
teeth
palate
buccal mucosa
sublingual region

Front 29

___ can be seen in sublingual region

Back 29

central cyanosis

Front 30

in the pharyngeal exam, ask the patient to say ___. when he says this, do ___. this checks ___.

Back 30

aah
touch soft palate
glossopharyngeal (CN IX)
recurrent laryngeal (CN X)

Front 31

eye exam includes (3)

Back 31

inspection
palpation
lid lag test

Front 32

inspection part of eye exam should be done in ___. ___ is pulled down with ___, and patient is asked to ___.

Back 32

natural light
lower lid
right thumb
look up

Front 33

in palpation part of eye exam, patient is asked ___ (2). then ___

Back 33

close eyes
look down
poke eyeball

Front 34

thyroid exam includes (2)

Back 34

inspection
palpation

Front 35

inspection part of thyroid exam

Back 35

watch patient swallow
observe neck

Front 36

palpate thyroid in 2 conditions

Back 36

at rest
during deglutition

Front 37

trachea exam

Back 37

use 2 fingers to locate trachea in suprasternal notch
note if deviation is present

Front 38

causes of tracheal deviation (4)

Back 38

pneumothorax
tumor
pleural fluid
collapse of lung

Front 39

item 12: thorax inspection includes (2)

Back 39

observation at rest
expansion during deep respiration

Front 40

causes for bilateral reduced expansion

Back 40

obstructive lung disease (emphysema)
restrictive lung disease (fibrosis)