Medical Consultation Process: Chest Examination Landmarks

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Questions and Answers

What is the recommended patient position for a cardiorespiratory examination?

  • Prone position
  • Flat on the back
  • 45 degrees upright (correct)
  • Standing position

In chest examination, what is assessed by observing the patient's level of comfort?

  • Blood pressure
  • Muscle strength
  • Heart rate
  • Breathing pattern (correct)

How is body built defined in a clinical examination?

  • Height to span relationship (correct)
  • Body mass index (BMI)
  • Weight to height ratio
  • Muscle mass to fat ratio

What is the Glasgow Coma Scale used to assess in patients?

<p>Consciousness level (C)</p> Signup and view all the answers

What is one of the signs of vitamin deficiency that can be observed during a chest examination?

<p>Central cyanosis (B)</p> Signup and view all the answers

How is nutrition clinically assessed using anthropometric measurements?

<p>Recording height and weight measurements (A)</p> Signup and view all the answers

What is the normal ratio of the anteroposterior diameter to the transverse diameter of the chest?

<p>$\frac{5}{7}$ (C)</p> Signup and view all the answers

Which of the following is NOT a characteristic of a normal chest shape?

<p>Bulging during inspiration (A)</p> Signup and view all the answers

Which of the following chest abnormalities is characterized by a depression in the sternum?

<p>Pectus excavatum (D)</p> Signup and view all the answers

What is the normal range for the subcostal angle in a healthy individual?

<p>90° ± 20° (B)</p> Signup and view all the answers

Which of the following techniques is used to assess the respiratory rate while avoiding voluntary changes by the patient?

<p>Counting chest movements while distracting the patient (B)</p> Signup and view all the answers

Which of the following chest abnormalities is characterized by a protrusion of the sternum?

<p>Pectus carinatum (B)</p> Signup and view all the answers

Which of the following observations is NOT a normal finding during examination of the jugular venous pulse (JVP)?

<p>The JVP being visible above the clavicles on both sides (B)</p> Signup and view all the answers

Which of the following findings during lower limb examination is suggestive of peripheral arterial disease?

<p>Absent peripheral pulsations and cool extremities (C)</p> Signup and view all the answers

Which of the following conditions is NOT a common cause of non-pitting edema?

<p>Hypoalbuminemia (C)</p> Signup and view all the answers

Which of the following findings during lower limb examination is suggestive of deep vein thrombosis (DVT)?

<p>Tender calf muscle with redness and warmth (C)</p> Signup and view all the answers

Which of the following statements regarding personal history taking is INCORRECT?

<p>The patient's name should be recorded as their first name only (C)</p> Signup and view all the answers

Which of the following statements regarding examination of the thyroid gland is correct?

<p>Thyroid examination is performed after examining the jugular venous pulse (B)</p> Signup and view all the answers

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Study Notes

General Examination

  • Introduce yourself, explain the purpose, obtain consent, wash hands, and position yourself and the patient
  • Ensure adequate exposure while maintaining patient privacy
  • Observe the patient's general appearance, including:
    • Level of consciousness (Glasgow Coma Scale: 3-15)
    • Level of comfort (pain, sweating, breathlessness, use of accessory muscles)
    • Body build (relationship between height and span according to age, sex, and race)
    • Any medical equipment nearby (oxygen cylinders, nebulizers, sputum pots, medicines, intercostal tube)

Nutrition and Anthropometric Measurements

  • Measure Body Mass Index (BMI)
  • Look for signs of vitamin deficiency
  • Evaluate attitude and decubitus (position of the patient in bed)

Chest Examination

  • Inspect the chest for:
    • Shape (elliptical, symmetrical, AP diameter = 5/7 transverse diameter)
    • Respiratory movement (rate, rhythm, depth, type of breathing)
    • Pulsation, dilated veins, pigmentation, sinuses, fistula, scars, skin rashes
    • Subcostal angle (90 ±20)
  • Palpate, percuss, and auscultate the chest

Thyroid Examination

  • Examine the thyroid gland for goiter

Lower Limb Examination

  • Inspect the nails for clubbing, color, splinter hemorrhage, pitting, etc.
  • Examine the skin for rashes, pigmentations, scars
  • Check for edema (type, unilateral or bilateral, level, and test for sacral edema in bedridden patients)
  • Evaluate peripheral pulsations, tender calves, and diabetic foot

Patient History Taking

  • Take a thorough personal history, including:
    • Name and surname
    • Sex
    • Age and occupation
    • Marital status
    • Residence
    • Special habits

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