Physical Exam Abbreviations Flashcards

Abbreviations in Physical Exams and Progress Notes

• GEN: Refers to the general condition of the patient.
• NAD: Indicates the patient is in no acute distress, which suggests stability.
• AAOx3: Signifies the patient is awake, alert, and oriented to person, place, and time, indicating cognitive functionality.
• WDWN: Describes a patient who is well-developed and well-nourished, reflecting overall health status.
• HEENT: An acronym for head, ears, eyes, nose, and throat, often assessed in examinations.
• NCAT: Means normocephalic and atraumatic, indicating a normal-shaped head without trauma.
• MMM: Stands for moist mucous membranes, which are assessed for hydration status.
• EOMI: Refers to extraocular muscles intact, confirming full eye movement.
• PERRLA: Indicates pupils are equally round and reactive to light and accommodation, a crucial neurological assessment.
• b/l: Abbreviation for bilaterally, referring to findings on both sides of the body.
• NECK: Discussion of the neck region during examination, which may include vital signs or structural evaluations.
• JVD: Stands for jugular venous distention, which can indicate fluid overload or heart problems.
• LAD: Refers to lymphadenopathy, which is the enlargement of lymph nodes and may suggest infection or malignancy.
• CV: Denotes cardiovascular system, essential in assessing heart health.
• RRR: Indicates a regular rate and rhythm of the heart, signifying normal cardiovascular function.
• m/r/g: Abbreviation for murmurs/rubs/gallops, significant sounds assessed during cardiac exams.
• PMI: Refers to point of maximal intensity, often related to cardiac apex beat findings.
• HJR: Stands for hepatojugular reflux, a test for congestive heart failure.
• CR: Indicates capillary refill less than two seconds, which is a method of assessing peripheral circulation.