Physical Assessment - Exam I

Front 1

phyiscal exam of lesions

Back 1

- color/texture
- shape/configuration
- size
- number
- location/distribution
- exudates - fluid or drainage? color? odor? etc

Front 2

waist-to-hip ratio

Back 2

waist circumference / hip circumference

**waist circumference greater than 35(women) and 40(men) increases risk for cardiovascular and obesity-related disease and mortality

Front 3

upper body obesity

Back 3

1.0 or greater in men
0.8 or greater in women

*waist-to-hip ratio

Front 4

present illness history

PQRSTU

Back 4

P - provocative/palliative - what brings it on?
Q - quality/quantity - how look, feel, sound
R - region/radiation - where?
S - severity - how bad? (scale 1-10)
T - timing - onset/frequency/duration
U - understand patients perception

Front 5

hypodermis

Back 5

AKA subcutaneous layer

- majority adipose tissue
- generates heat
- provide insulation

Front 6

nevi

Back 6

mole

Front 7

macule

Back 7

flat area
- solely color change
- less than 1 cm

Front 8

papule

Back 8

raised area
- superficial thickening
- less than 1 cm

Front 9

Mongolian spot

Back 9

dark blue pigmentation usually on buttocks of infants

common in Asian, Hispanic, and African Americans

Front 10

petechiae

Back 10

very tiny, flat spots usually secondary to hemorrhage

Front 11

lanugo

Back 11

fine, downy hair on entire bodies of infants

Front 12

skin turgor

Back 12

ability for skin to return to place promptly

used when determining dehydration

Front 13

cherry angioma

Back 13

slightly raised bright red dot usually on trunk on persons greater than 30 years old

Front 14

malignant melanoma

Back 14

most lethal form of skin cancer

usually change in existing nevi

Front 15

alopecia

Back 15

partial or total hair loss

Front 16

erythema

Back 16

redness

Front 17

ecchymosis

Back 17

bruises, bruising

Front 18

circumscribed

Back 18

bordered (when referring to a lesion)

Front 19

linea nigra

Back 19

dark or black line that appears over abdomen of pregnant women

Front 20

pallor

Back 20

in light skinned persons - generalized pale white

in dark or brown skinned persons - dull, yellow-brown or dull, ashen gray

*check areas w/less pigmentation (conjunctiva, mucous membranes)

Front 21

cyanosis

Back 21

in light skinned persons - dusky blue

in dark or brown skinned persons - dark but dull, lifeless

**check conjunctiva, oral mucosa, nail beds

Front 22

jaundice

Back 22

in light skinned persons - yellow in sclera, hard palate, mucous membranes, then over skin

in dark or brown skinned persons - check sclera near limbus (best noted in junction of hard or soft palate and also palms)

Front 23

erythema

Back 23

in light skinned persons - red, bright pink

in dark or brown skinned persons - purplish tinge, but difficult to see

**palpate for increased warmth w/inflammation, taut skin, and hardening of deep tissue

Front 24

primary lesion

Back 24

inital manifestation on intact skin

usually macule, papule

Front 25

secondary lesion

Back 25

trauma or change in a primary lesion

Front 26

annular

Back 26

circular

begins in center and spreads to peripheral

Front 27

discrete

Back 27

distinct, individual lesions that remain separate

Front 28

grouped

Back 28

clusters of lesions

Front 29

target

Back 29

iris
- resembles iris of eye
- concentric rings of color in lesion

Front 30

linear

Back 30

scratch, streak, line or stripe

Front 31

polycyclic

Back 31

annular lesions grow together

Front 32

zosteriform

Back 32

linear arrangement along a nerve route

Front 33

Conversion from
Fahrenheit
to
Celcius

Back 33

Celcius = 5/9 (F - 32)

Front 34

Conversion from
Celcius
to
Fahrenheit

Back 34

Fahrenheit = (9/5 x C) + 32

Front 35

BMI

Back 35

Body Mass Index

= weight (in kg) / height (in meters)2

= weight (in lbs) / height (in inches)2 x 703

Front 36

ambi-

Back 36

around

Front 37

ampho-

Back 37

both

Front 38

ana-

Back 38

up, back, again, excessive

Front 39

ap-
apo-

Back 39

from, separation

Front 40

bis-

Back 40

two

Front 41

cata-

Back 41

down, under, lower, against

Front 42

dia-

Back 42

between, through, apart, across, completely

Front 43

dys-

Back 43

difficult, abnormal

Front 44

histo-

Back 44

tissue

Front 45

ABCDE in self-exam

Back 45

Danger signs - changes in:

A - asymmetry - equal
B - border - irregular
C - color variation
D - diameter - greater than 6 mm (larger than pencil eraser)
E - elevation/enlargement

Front 46

confluent

Back 46

lesions run together

Front 47

gyrate

Back 47

twisted, coiled spiral, snakelike

Front 48

CRAFFT

Back 48

Adolescent to identify alcohol/drug abuse
C - car w/someone on alcohol/drugs
R - need to relax
A - while you are alone
F - forget while on alcohol/drug
F - family or friend want to cut down
T - trouble while taking alcohol/drug

Front 49

em-
en-

Back 49

in

Front 50

endo-

Back 50

within

Front 51

epi-

Back 51

upon, on

Front 52

de-

Back 52

away from

Front 53

dis-

Back 53

from

Front 54

e-
ex-
exo-

Back 54

out, away from

Front 55

amphi-

Back 55

about
on both sides
both

Front 56

ec-

Back 56

out from

Front 57

ecto-

Back 57

on outer side
situated on

Front 58

General Survey

Back 58

Obsevation
1. stated vs. apparent age
2. personal hygiene
3. posture
4. body or breath odors
5. skin color
6. speech
7. mobility
8. mood

Front 59

supine

Back 59

on back, flat

AKA dorsal recumbant

Front 60

Sims

Back 60

on side but more toward prone with upper leg bent

Front 61

prone

Back 61

on front, flat

Front 62

lithotomy

Back 62

pelvic exam position

Front 63

bell

Back 63

part on stethoscope

- light touch
- low pitched sounds **BP is low pitch
- good/used for murmurs

Front 64

diaphragm

Back 64

part on stethoscope

- firm touch
- high pitched sounds
- good/used for breath, normal heart, and bowel sounds

Front 65

tympany

Back 65

percussion tone

loudest
over abdomen (drumlike)

Front 66

hyperresonance

Back 66

percussion tone

over unhealthy lung tissue (resembles hollow air)
- w/ephysema or young children

Front 67

resonance

Back 67

percussion tone

over healthy lung tissue

Front 68

dull

Back 68

percussion tone

over organ

Front 69

flat

Back 69

percussion tone

quietest
over bone

Front 70

percussion

Back 70

process of body tapping

- checks size, position, consistency, and presence of fluid
- Direct - on body
- Indirect - hand and a 'barrier'

Front 71

palpation

Back 71

process of touching

- uses touch
- Ulnar surface - vibration
- Dorsal surface - temperature

- Light - depress 1/2" (palmar surface)
- Deep - depress 1-2" (one or two hands)

Front 72

inspection

Back 72

process of observation

- uses vision and smell
- adequate lighting
- attention to detail

Front 73

ausculation

Back 73

process of active listening to body sounds
- Direct
- Indirect

Front 74

respiration

Back 74

inhale/exhale = 1 respiration

technique = regular - 30 sec x 2
irregular - full 60 sec

Front 75

blood pressure

Back 75

force of blood against artery walls
- relationship between CO and peripheral resistance

technique = upper arm w/anaeroid cuff and stethoscope
- Systolic - max pressure - 1st 2 beats
- Diastolic - resting pressure - silence starts

Front 76

pulse

Back 76

technique = index and middle finger - minimum of 30 sec

assess for force (amplitude)
+4 bounding
+3 full
+2 normal
+1 weak
0 absent

Front 77

Korotkoff sounds

Back 77

sounds heard in BP checking

I - V
I - systolic
V - diastolic

Front 78

Auscultatory Gap

Back 78

Korotkoff sounds are heard, disappear, and reappear 10-15 mmHg lower

- problem/common in elderly
- decreased elasticity

Front 79

Principles of Exam

Back 79

1. warm, comfortable environment
2. privacy
3. equipment accessible/available
4. sequence - less intrusive to more intrusive

Front 80

CAGE

Back 80

Alcohol Abuse

C - concerned about yours or others drinking? felt the need to cut down?
A - annoyed by criticism
G - guilty about your drinking or something said or did while drinking?
E - need for eye-opener

Front 81

TACE

Back 81

supplement to CAGE

T - how many does it take?
A - annoyed by criticism
C - felt you should cut down
E - eye-opener first thing in morning

Front 82

a-
an-

Back 82

without, not

Front 83

ab-

Back 83

away from

Front 84

ad-

Back 84

to, toward

Front 85

adeno-

Back 85

gland

Front 86

aero-

Back 86

air

Front 87

angio-

Back 87

vessel

Front 88

ante-

Back 88

before, forward

Front 89

anti-

Back 89

against, counteracting

Front 90

arterio-

Back 90

artery

Front 91

arthro

Back 91

joint

Front 92

bi-

Back 92

double

Front 93

bili-

Back 93

bile

Front 94

bio-

Back 94

life

Front 95

branchio-

Back 95

arm

Front 96

brady-

Back 96

slow

Front 97

broncho-

Back 97

bronchus

Front 98

cardio-

Back 98

heart

Front 99

cerebro-

Back 99

cerebrum

Front 100

cervico-

Back 100

neck

Front 101

chole-

Back 101

gall, bile

Front 102

cholecysto-

Back 102

gall bladder

Front 103

chondro-

Back 103

cartilage

Front 104

circum-

Back 104

around

Front 105

com-
con-

Back 105

with, together

Front 106

contra-

Back 106

opposite, against

Front 107

costo-

Back 107

ribs

Front 108

cranio-

Back 108

head

Front 109

cyto-

Back 109

cell

Front 110

cysto-

Back 110

bladder

Front 111

demi-

Back 111

half

Front 112

derm-
derma-

Back 112

skin

Front 113

dorso-

Back 113

back

Front 114

electro-

Back 114

related to electricity

Front 115

encephal-

Back 115

brain

Front 116

equi-

Back 116

equal

Front 117

eryth-

Back 117

red

Front 118

extra-

Back 118

in addition to
outside of

Front 119

ferro -

Back 119

iron

Front 120

fibro-

Back 120

fiber

Front 121

fore-

Back 121

in front of
before

Front 122

gastro-

Back 122

stomach

Front 123

glosso-

Back 123

tongue

Front 124

glyco-

Back 124

sugar

Front 125

hemi-

Back 125

half

Front 126

hemo-
hema-

Back 126

blood

Front 127

hepa-
hepato-

Back 127

liver

Front 128

homo-

Back 128

same

Front 129

hydro-

Back 129

water

Front 130

hyper-

Back 130

high
excessive

Front 131

hypo-

Back 131

low
decreased

Front 132

hyster-
hystero-

Back 132

uterus

Front 133

ano-

Back 133

anus

Front 134

cepha-
cephalo-

Back 134

head

Front 135

co-

Back 135

together

Front 136

entero-

Back 136

intestines

Front 137

dermis

Back 137

middle layer of skin

- vascular
- primarily connective tissue

Front 138

epidermis

Back 138

outermost layer of skin

- avascular
- flattened, keratinized cells