Podcast
Questions and Answers
During a general physical examination, which side of the patient is generally preferred for the examiner to stand?
During a general physical examination, which side of the patient is generally preferred for the examiner to stand?
- Left hand side.
- Right hand side. (correct)
- The side opposite to the patient's dominant hand.
- Any side, as long as it's convenient.
Before initiating a physical examination, what should a healthcare provider ensure?
Before initiating a physical examination, what should a healthcare provider ensure?
- That a detailed medical history has already been taken.
- That the patient has an empty bladder.
- Introduction, gaining permission, ensuring privacy, preparation and relevant equipment. (correct)
- That the room is fully lit.
Why is it important to wash your hands before a physical examination?
Why is it important to wash your hands before a physical examination?
- To prevent the spread of infections. (correct)
- To prepare for the use of gloves.
- To maintain personal hygiene.
- To ensure the patient feels respected.
Which of the following is the correct sequence of steps for hand washing?
Which of the following is the correct sequence of steps for hand washing?
Which of the following is typically assessed during the 'general appearance' component of a physical examination?
Which of the following is typically assessed during the 'general appearance' component of a physical examination?
What is the primary purpose of conducting a general examination?
What is the primary purpose of conducting a general examination?
A patient presenting with a 'moon face' appearance should prompt suspicion for which condition?
A patient presenting with a 'moon face' appearance should prompt suspicion for which condition?
What does 'toxic appearance' generally indicate during a patient assessment?
What does 'toxic appearance' generally indicate during a patient assessment?
The AVPU scale is used to quickly assess what aspect of a patient's condition?
The AVPU scale is used to quickly assess what aspect of a patient's condition?
According to the Glasgow Coma Scale (GCS), what is the range of scores indicating 'moderate brain injury'?
According to the Glasgow Coma Scale (GCS), what is the range of scores indicating 'moderate brain injury'?
In the context of general examination, what does 'built' refer to?
In the context of general examination, what does 'built' refer to?
What is the correct way to measure height for a general examination?
What is the correct way to measure height for a general examination?
What does a 'span' measurement indicate in a general examination?
What does a 'span' measurement indicate in a general examination?
How is Body Mass Index (BMI) calculated?
How is Body Mass Index (BMI) calculated?
According to BMI classifications, what range indicates that someone is 'overweight'?
According to BMI classifications, what range indicates that someone is 'overweight'?
What does the measurement of 'skin fold thickness' primarily indicate?
What does the measurement of 'skin fold thickness' primarily indicate?
What is the typical tool used to measure skin fold thickness?
What is the typical tool used to measure skin fold thickness?
In anthropometric measurements, what does mid-arm circumference (MAC) primarily indicate?
In anthropometric measurements, what does mid-arm circumference (MAC) primarily indicate?
What type of tape should be used to measure mid-upper arm circumference?
What type of tape should be used to measure mid-upper arm circumference?
Why is waist circumference measured during a physical examination?
Why is waist circumference measured during a physical examination?
What waist circumference measurement in men is considered suggestive of elevated health risk?
What waist circumference measurement in men is considered suggestive of elevated health risk?
What does the presence of 'sulphur granules & angular stomatitis' primarily indicate?
What does the presence of 'sulphur granules & angular stomatitis' primarily indicate?
What vitamin deficiency is associated with bleeding gums and delayed wound healing?
What vitamin deficiency is associated with bleeding gums and delayed wound healing?
A patient reports that they experience shortness of breath when lying down, which is relieved by sitting upright. What is this condition called?
A patient reports that they experience shortness of breath when lying down, which is relieved by sitting upright. What is this condition called?
What is the term used to describe dyspnea in the upright position that is relieved by lying down?
What is the term used to describe dyspnea in the upright position that is relieved by lying down?
What is a key characteristic of a patient exhibiting 'professorial attitude'?
What is a key characteristic of a patient exhibiting 'professorial attitude'?
What does 'prayer's position' typically indicate in a patient?
What does 'prayer's position' typically indicate in a patient?
What does AVPU stand for in patient assessment?
What does AVPU stand for in patient assessment?
During a general exam, a patient is determined to have a BMI of 31. According to this information, how would this patient be classified?
During a general exam, a patient is determined to have a BMI of 31. According to this information, how would this patient be classified?
A patient experiencing flushing in the face due to an infection would be classified as having what type of appearance?
A patient experiencing flushing in the face due to an infection would be classified as having what type of appearance?
Which of the following would a GCS score of 14 indicate?
Which of the following would a GCS score of 14 indicate?
Which of the following is NOT a site used for determining the skin fold thickness?
Which of the following is NOT a site used for determining the skin fold thickness?
If a patient measures in with 80 cm circumference around the waist, how should this be interpreted?
If a patient measures in with 80 cm circumference around the waist, how should this be interpreted?
A butterfly are rash could indicate a deficiency in what vitamin?
A butterfly are rash could indicate a deficiency in what vitamin?
What does it mean if a tricep skinfold is measured to be less than 5mm?
What does it mean if a tricep skinfold is measured to be less than 5mm?
A patient is noted to have wasting in the face muscles and fats. Which term best describes this condition?
A patient is noted to have wasting in the face muscles and fats. Which term best describes this condition?
What does it mean for a patient to be in the "squatting position?"
What does it mean for a patient to be in the "squatting position?"
Flashcards
General Physical Examination
General Physical Examination
A systematic assessment of a patient's body to detect signs of disease.
Proper Positioning
Proper Positioning
Stand on the patient's right-hand side to perform the examination.
Preparing the Patient
Preparing the Patient
Introduce yourself, shake hands, ensure necessary equipment is available, provide privacy, and obtain patient's permission.
Hand Washing
Hand Washing
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Components of General Exam
Components of General Exam
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Appearance of Patient
Appearance of Patient
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Toxic Appearance
Toxic Appearance
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Emaciated Appearance
Emaciated Appearance
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Ape-like Appearance
Ape-like Appearance
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Moon Face
Moon Face
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Consciousness Assessment
Consciousness Assessment
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AVPU Scale
AVPU Scale
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Glasgow Coma Scale (GCS)
Glasgow Coma Scale (GCS)
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Built
Built
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Height
Height
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SPAN
SPAN
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Nutrition
Nutrition
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BMI
BMI
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Skin fold thickness
Skin fold thickness
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Mid arm circumference
Mid arm circumference
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Waist circumference
Waist circumference
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Vitamin Deficiency Signs
Vitamin Deficiency Signs
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Orthopnea
Orthopnea
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Platypnea
Platypnea
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Professorial attitude
Professorial attitude
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PRAYER 'S POSITION
PRAYER 'S POSITION
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Study Notes
- Physical exams assess the body for signs of disease
- Approaching from the patient's right-hand side is a rule
Preparing for Physical Examination
- First, introduce yourself
- Shake hands
- Ensure the relevant equipment is gathered
- Take permission
- Respect patient privacy
Thorough Hand Washing
- Wash palms and fingers
- Wash the backs of hands
- Wash fingers and knuckles
- Clean thumbs
- Wash finger tips
- Wash wrists
General Examination Consists of:
- Assessing the patient's appearance
- Evaluating corporation
- Checking the level of consciousness
- Assessing build and nutrition
- Checking for decubitus
- Evaluating gait and posture
- Measuring vital signs
- Checking complexion
- Head and neck examination
- Upper and lower limb examination
- Assessing the skin
- Examination of Lymph nodes
- Checking other systems
Assessing a Patient's Appearance
- Normal appearance is the baseline
- Toxic appearance presents a flushed face caused by a vasodilation effect from an infection
- Emaciated appearance shows a wasting of face muscles and fat, as seen in LCF
- "Ape like" appearance presents in acromegaly cases (large jaw, tongue, nose and ears)
- Moon face appearance presents in Cushing's syndrome
Assessing Consciousness
- Rapid initial assessment of consciousness uses:
- AVPU Scale
- Glasgow Coma Scale (GCS)
AVPU Scale For Rapid Consciousness Assessment
- Much simpler scale used for rapid assessment
- Often used in monitoring by non-specialist nurses
- Each letter represents:
- A = Alert
- V = Responds to Voice
- P = Responds to Pain
- U = Unresponsive
GCS (Glasgow Coma Scale)
- Provides an objective score of consciousness
- The total score ranges from 3 to 15
Glasgow Coma Scale Points
- Eye opening response:
- Spontaneous opening: 4 points
- Opens to verbal command, speech, or shout: 3 points
- Opens to pain (not applied to face): 2 points
- No eye opening: 1 point
- Verbal response:
- Oriented: 5 points
- Confused conversation, but able to answer questions: 4 points
- Inappropriate responses, words discernible: 3 points
- Incomprehensible sounds or speech: 2 points
- No verbal response: 1 point
- Motor Response:
- Obeys commands for movement: 6 points
- Purposeful movement to painful stimulus: 5 points
- Withdraws from pain: 4 points
- Abnormal (spastic) flexion, decorticate posture: 3 points
- Extensor (rigid) response, decerebrate posture: 2 points
- No motor response: 1 point
- Total score based on severity of brain injury:
- Minor: 13-15 points
- Moderate: 9-12 points
- Severe: 3-8 points
Built
- Refers to the measure of overall body size, including stature and body mass
Key Body Measurements
- Height is measured from head to heel
- Span is measured between the distal phalanges of middle fingers from out stretched arms
Nutrition Clinical Assessment
- Involves BMI, fat levels, protein levels, and vitamin levels.
- BMI, SFT, MAC, and signs of vitamin deficiencies are useful assessment tools.
BMI
- BMI = weight in kg / height in m^2
- Example: Gina is 1.6 meters tall and weighs 70 kg:
- BMI = 70 / (1.6 x 1.6) = 27.34
BMI Ranges
- Underweight: Less than 18.5
- Normal: 18.5-24.9
- Overweight: 25-29.9
- Obese: 30-39.9
- Morbidly obese: Greater than 40
Anthropometric measurement
- Involves skin fold thickness as an indicator of fat
- Mid-arm circumference indicates muscle mass, normal circumference about 25cm normally
- Includes patient's waist circumference
Skin Fold Thickness
- Skin fold thickness shows body fat
- Measureable at several sites
Recommended Sites
- Triceps
- Subscapular
Mid-Arm Circumference Measurement
- Measures the sum of the muscle and subcutaneous fat in the upper arm.
- The tools you need:
- Use a non-stretchable insertion tape
- Tapes generally graduated in millimeters
Waist Circumference Measurement
- Is correlated with visceral fat
- Included as a clinical risk factor
- Waist circumferences greater than 102 cm (40 in) in men
- Waist circumferences greater than 88 cm (35 in) in women, it is suggestive of elevated risk.
Signs of Vitamin Deficiency
- Nutritional edema from hypoalbuminemia
- Anemia from iron or vitamin B12 deficiency
- Peripheral neuropathy caused by vitamin B complex deficiency
- Sulpher granules and angular stomatitis linked to vitamin B2 "riboflavin" deficiency
- Brown desquamated rash in butterfly area of the face & neck lace area and dementia and diarrhea, related to vitamin B3 "niacin" deficiency(Pellagra)
- Bleeding gum and delayed wound healing can be result of vitamin C deficiency "Scurvy"
Physical Positions
- Orthopnea means dyspnea on laying down which is relieved by sitting upright
- Platypnea means dyspnea on upright position which is relieved by lying down
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