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SWC Heep Lab MT
Survey of Western Clinical sciences, Heep, Lab midterm
| Question | Answer |
|---|---|
| How do you take Heart Rate: | Taken at radial or carotid arteries. Note rate (bpm, calculated from 15 seconds of palpation) and rhythm (regular, irregular) |
| How do you take Respiratory Rate: | Note rate, rhythm, depth, effort (use of accessory muscle). Count breaths for 30sec-1min |
| How do you take Temperature: | Avoid food or drink for 15 minutes before measuring oral temperature |
| Inspection of Hair? | Quality: Coarse and dry in Hypothyroidism Thin and fragile in anemia Quantity: thinning senile/hypothyroidism/ anemia Distribution: Alopecia |
| Inspection of Scalp: | texture, color |
| Inspection of Skull: | size, contour, lumps, tenderness |
| Inspection of Face: | Inspect for symmetry, edema, masses |
| Evaluate facial expression: Smile, raise eyebrows | (CN VII) |
| Palpate muscles of mastication: | (CN V) |
| Inspection of eyebrows: | Loss of lateral portion: Hypothyroidism Patchy loss: syphilis, alopecia |
| Inspection of CN VII: | facial expression, smile, raise eyebrows. |
| Inspection of CN V: | palpate muscles of mastication |
| Inspection of Eyes: | Position and alignment Eyelids Edema Lesions: stye, chalazion Eyelashes Palpate lacrimal gland and sac Inspect conjunctiva for pallor or redness Lower: pale in anemia, red in HTN |
| Inspect sclera: | clear, no jaundice, redness |
| Corneal reflection: | ensures both eyes are looking forward |
| Inspection of Pupils: | Pupillary reaction: direct and consensual (CN II & CN III) Accomodation |
| Inspection of CNII & CN III | Pupillary reaction direct and consensual accomodation. |
| Inspection of Extra-ocular muscles | (check CN III, CN IV, CN VI) Extra-ocular muscle movements “H” in space Lid lag Convergence |
| Inspection of CN III, CN IV, CN VI: | Extra-ocular muscle movements “H” in space Lid lag Convergence |
| Inspection of Otitis externa: | pull ear |
| Inspection of Otitis media: | press tragus |
| Inspection of Mastoiditis: | tap on mastoid |
| Inspection of Auditory acuity: | (CN VIII): using “watch test” ! |
| Inspection of CN VIII: | Auditory acuity using watch test |
| Inspection of nose: | Palpate: Frontal sinus: press on frontal part or press up from under bony orbit Maxillary sinus: press up from under cheek |
| Inspection of Lips: | color (cyanosis), lumps, lesions (cancer), cracking |
| Inspection of Buccal mucosa: | color (cyanosis), ulcer, white patches (leukoplakia, candida) |
| Inspection of Gums: | inflammation, swelling, bleeding |
| Inspection of Tongue: | lesions |
| Inspection of CN XII: | if affected, tongue will point to one side |
| Inspection of Pharynx: | Inspect tonsils: Patient say “ah”, press on tongue with tongue depressor – assess CN IX and X |
| Inspection of CN IX and X: | Patient say “ah”, press on tongue with tongue depressor |
| Inspection of TMJ: | Evaluate TMJ while opening and closing for alignment Palpate TMJ while opening and closing, feeling for crepitus, pain and tenderness |
| Inspection of Neck: | Inspection: Symmetry, masses, scars Palpation: lymph nodes Tender node = inflammation Hard and fixed node = malignancy |
| What are the lymph nodes? | pre-auricular; posterior auricular; occipital; tonsillar; submandibular; submental; Cervical: superficial cervical; posterior cervical and deep cervical Supraclavicular |
| What we use to measure BP? | Proper blood pressure cuff (Sphygmomanometer) Stethoscope |
| Where do we measure it? | Brachial artery and Popliteal artery |
| How do we measure it? | Listen to Korotkoff sounds (turbulent and laminar flow) Use the bell of your stethoscope |
| Describe Inspection of Posterior Chest: | AP/lateral diameter ratio – normal would be 1:2 – barrel chest in COPD (emphysema) Slope of ribs – flattening in COPD ICS retraction (sucking in of intercostals) – COPD or upper airway obstruction (indicated respiratory distress) |
| Describe Palpation of Posterior Chest: | Check for masses Assess respiratory expansion Hands on the sides, make fold in middle and ask patient take deep breath in. Unilateral decrease: lung fibrosis, pleural effusion, pneumonia |
| How do you check for fremitus on Posterior Chest? | Assess tactile fremitus (feel vibration) in 4 sites Decreased vibration with fluid in lung: pleural effusion, pneumothorax, emphysema, asthma and atelectasis Increased in consolidation in lungs like fibrosis or pneumonia |
| Describe Percussion on Posterior Chest: | Tap twice in each of the 7 areas Identify percussive notes: flat, dull, resonant, hyper-resonant |
| Describe Auscultation of Posterior Chest: | 7 areas – same as percussion Check for normal breath sounds: Tracheal, bronchial, broncho-vesicular, vesicular Check for abnormal sounds Crackles Wheezes Rhonchi |
| What do you check for in breathing patterns? | Check for respiratory rhythm, depth, |
| Describe Inspect neck: | Trachea in midline – no deviation Supra-clavicular retraction Contraction of SCM and scalenes Both indicate respiratory distress |
| Describe Inspect chest of Anterior Chest: | Shape Asymmetry Impairment of respiratory movement |
| Describe Palpation of Anterior Chest: | Tender areas Assess tactile fremitus in 3 areas |
| Describe Auscultation of Anterior Chest: | 6 areas Identify breath sounds |
Created by:
bastyr41
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