Primary Physical Examinaton CMA
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Auscultation | show 🗑
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Bruit | show 🗑
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show | Abnormal enlargement of the distal phalanges (fingers/toes) associated with cyanotic heart disease or advanced chronic pulmonary disease
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show | A procedure in which a fiberoptic scope is used to examine the large intestine
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show | A graphic record of electrical conduction through the heart
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show | The pathologic accumulation of air in the alveoli, which results in alveolar destruction and overall oxygen deprivation: In the lungs, the bronchioles becomes plugged with mucus and lose elasticity
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show | The manner or style of walking
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Hematopoiesis | show 🗑
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Intercellular | show 🗑
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show | A term referring to the area within the cell membrane
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show | Movement or exercising of a body part by means of an externally applied force
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Mastication | show 🗑
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show | An abnormal sound heard during auscultation of the heart that may or may not have a pathologic origin; it is associated with valve disease or a congenital heart defect
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show | Small lumps, or lesions, or swellings that are felt when the skin is palpitated
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show | The use of touch during physical examination to assess the size, consistency, and location of certain body parts
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show | The rhythmic contraction of involuntary muscles lining the gastrointestinal tract
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Sclera | show 🗑
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Transillumination | show 🗑
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Trauma | show 🗑
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Vasoconstriction | show 🗑
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show | The study of how the body is shaped and structured
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show | Study of body functions
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Cells | show 🗑
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Tissues | show 🗑
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show | makes up the skin, glands, and linings of body parts and organs
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Squamous | show 🗑
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Cuboidal | show 🗑
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Columnar | show 🗑
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Transitional | show 🗑
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show | support and binds other body tissues. Types include: collagen, bone, cartilage, adipose, ligaments, tendons, blood, and lymph.
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show | produces movement
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show | surrounds the cell and creates an outer covering
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show | includes the cytoplasm that contains living material to carry out function
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show | contains the genetic code of the cell that determines the cells function
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show | (striated, voluntary) attached to bones, produces voluntary body movements when contracted
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show | (striated, involuntary) forms the heart muscle wall
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show | (nonstriated, involuntary) lines the walls of blood vessels and hollow organs. Causes peristalsis and vasoconstriction.
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show | conducts nerve impulses between the periphery and central nervous system
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show | composed of two or more types of tissue bound together to form a more complex structure for a common purpose or function
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show | composed of several organs and their associated structures
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show | arteries, arterioles, veins, venules, white blood cells, red blood cells, platelets, plasma
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Blood Functions | show 🗑
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show | heart, valves, arteries, arterioles, veins, venules
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Cardiovascular Functions | show 🗑
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Endocrine Cells, Organs, and Structures | show 🗑
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Endocrine Functions | show 🗑
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show | skin, subcutaneous tissue, sweat/sebaceous glands, hair, nails, sense receptors
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Integumentary Functions | show 🗑
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show | mouth, tongue, teeth, pharynx, esophagus, stomach, small intestine, large intestine, liver, gall bladder, pancreas, appendix
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show | mastication, swallowing, digestion, absorption of nutrients, excretion of waste materials
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show | lymph, lymph vessels, lymph nodes, thymus, tonsils, spleen, lymphocytes, antibodies
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show | maintains fluid balance; protects internal environment; defends against foreign cells/disease; provides immunity to some diseases
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show | bones, joints, muscles, tendons, ligaments, cartilage
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Musculoskeletal Functions | show 🗑
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show | brain, spinal cord, neurons, neuroglial cells, peripheral nerves, autonomic nerves
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show | controls body structures to maintain homeostasis; higher-order thinking and reflex centers that control autonomic processes; carries sensory stimulus to the brain and motor impulse to the periphery
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show | Female: estrogen/ progesterone, ovum, ovaries, fallopian tubes, uterus, vagina, vulva, mammary glands
Male: testosterone, sperm, epididymis, vas deferens, prostate gland, testes, scrotum, penis, urethra
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Reproductive Functions | show 🗑
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Respiratory Cells, Organ, and Structures | show 🗑
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show | responsible for inhalation of oxygen/ exhalation of carbon dioxide externally and exchange of oxygen/carbon dioxide internally at the cellular level; acid-base regulation
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show | eyes, ears, taste buds, olfactory receptors, sensory receptors
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show | helps sense changes in the external/internal environments through vision, hearing, balance, taste, smell
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show | nephron unit, bilateral kidneys, ureters, urinary bladder, urethra
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Urinary Functions | show 🗑
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Primary Care Physician (PCP) | show 🗑
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Physical Examination | show 🗑
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show | make sure patient feels comfortable. verify insurance information and necessary medical information (current medications, allergies, etc.)
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show | the exam room should be checked periodically to ensure it is fully stocked and equipment is functioning. MA must be aware of how to operate all equipment beforehand. exp. dates must be checked. private, well lit, comfy temp. clean & disinfected
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show | medical record complete. consent forms signed. introduce yourself. use pt preferred name. respect. watch nonverbal cues. verify insurance accuracy. obtain specimens. take vitals. investigate. help prepare. questions. positions. privacy. document. assist.
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Assisting The Physician | show 🗑
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show | used to inspect the inner structures of the eye
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Tongue Depressor | show 🗑
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Otoscope | show 🗑
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Nasal Speculum | show 🗑
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show | used to check the patients auditory acuity and to test bone vibration
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show | measuring device, typically used to assess length/head circumference of infants or wound size
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Stethoscope | show 🗑
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show | used to strike the tendons of the knee and elbow to test nuerologic reflexes
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show | used whenever the potential exists for contact with body fluid or contaminated items exist
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show | gauze, cotton balls, cotton tipped applicators, specimen containers, hemocult packets, pap smear supplies, lubricating jelly, and laboratory request forms must be readily accessible during the examination
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show | ranges from focusing on patients general appearance (posture, mannerisms, grooming), to more detailed observations such as body contour, gait, symmetry, visible injuries, deformities, tremors, rashes, and color changes
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show | uses sense of touch. perceptions include: temperature, vibration, consistency, form, elasticity, moisture, texture, position, and contour. performed with one hand, both hands (bimanual), one finger (digital) fingertips, or the palmar aspect of the hand
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Percussion | show 🗑
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show | the physician uses a stethoscope to listen to sounds that originate within the body. mostly used for sounds originating in the lungs, heart, and abdomen
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Mensuration | show 🗑
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Manipulation | show 🗑
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show | the medical assistant is responsible for instructing and assisting the patient into various positions for the exam. do not place the patient in an uncomfortable position or a privacy compromising position. dont leave if patient is in a dangerous position
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show | the patient sits on the exam table with the head of the table elevated to 90 degrees, or he/she sits on the edge. this position is useful for exams of the head, neck, and chest as well as for patients with orthopnea. drape placement varies
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show | head of table is positioned at a 45 degree angle. useful for postoperative exams, patients with breathing disorders, patients with elevated temperature, those suffering from head trauma. the drape should cover the entire patient from the nipple line down
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Direct Percussion | show 🗑
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Indirect Percussion | show 🗑
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show | lying horizontally with the face and torso facing up
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show | individual (usually a patient) lies on their back with their knees bent up in an outward position while their feet are planted flat on the ground, a bed, table or resting platform allowing the pelvic area to be easily examined and observed.
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show | a supine position of the body with the legs separated, flexed, and supported in raised stirrups, originally used for lithotomy and later also for childbirth.
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Sims Position | show 🗑
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Prone Position | show 🗑
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show | individual rests on the knees and upper part of the chest, assumed for gynecologic or rectal examination.
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Tredelenburgs Position | show 🗑
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Principles of Body Mechanics | show 🗑
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show | body mechanics. wheelchair pt, chair close to table, wheels locked, foot rests lifted. support pt strong side. stepstool. pt close to your side. bend at knees. signal and lift. help step up with strong leg. shoulder or waist never neck.
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show | get help if heavy. maintain alignment. do not reach. bend at knees. keep weight close to body. keep back straight. slide, roll, push heavy item if possible
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show | if pt is female and physician is male, female ma must be present. keep convo to minimum. exam begins at fowlers position
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Presenting Appearance (General Appearance) | show 🗑
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Nutrition and Stature | show 🗑
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Speech | show 🗑
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show | often associated with poor oral hygiene/dental care. a musty odor is associated with liver disease. an ammonia smell may be caused by uremia. acidosis/smell of acetone may be the result of diabetes mellitus, starvation, or renal disease
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Skin | show 🗑
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Head | show 🗑
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show | pupils checked for light reaction. sclera checked for color. inflammation apparent in sclera. yellow sclera indicate liver disease. movement tested. diabetes damage blood vessels of eye. ophthalmoscope used to examine eye
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Ears | show 🗑
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show | mucosa examined for color/texture. can not see sinuses, frontal/maxillary examined by palpitation and transillumination. if in need of specialist, pt referred to ophthalmologist or otorhinolaryngologist.
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show | oral hygiene and dental care. includes condition of teeth, how pt cares for teeth/gums, whether upper/lower jaws meet ok for chewing. healthy=pale pink, glossy, smooth, do not bleed with pressure. palatine tonsils visible. cheeks checked for marks/color
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show | ROM. thyroid gland for symmetry, size, texture. check thyroid through palpitation and swallowing. carotid artery palpitated. lymph nodes palpitated. lymphadenopathy=infection in face, head, neck.
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Reflexes | show 🗑
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show | sitting. exam for symmetric expansion. emphysema cause barrel shaped chest. percussion used to determine density of lung . stethoscope to auscultate lung sounds. abnormalities cause for further tests.
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show | arms may be at side, across chest, or under head. relaxation necessary. dorsal recumbent position. auscultates abdomen in all quadrants to hear bowel sounds. palpates for abnormalities. percussion used for density, position, and size of organs.
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show | breasts are examined symptomatic or not. examined visually and palpated in supine and high fowler. breast cancer most common in women. males at 15 will receive testicular exam.
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Rectum | show 🗑
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Legal and Ethical Issues | show 🗑
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show | conversations can be overheard. guard confidentiality by ensuring privacy glass is closed, turn away from waiting room while on phone. physician schedule faced away from pt areas. medical records face door of exam room. EMR use, close files, lock computer
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show | inability to speak due to loss of the voice (commonly seen with overuse or laryngitis)
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Aphasia | show 🗑
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Dysphasia | show 🗑
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show | the patients knows what he/she wants to say but cannot use muscles properly to speak
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Sensory Aphasia | show 🗑
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show | pupils are equal, round, respond to light, adjust/focus on objects
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