Chapter 11: Physical Exam Techniques

Although assessment of a medical patient formally starts w/the history, the physical examination actually begins when you first set eyes on your patient. Examination Techniques Inspection Palpation Percussion Auscultation Vital Signs Pulse Bradycardia- 60bpm> Normal- 60-100bpm Tachycardia- 100bpm< Respiration o Adult 12-20 o Child 20-40 o Infant 40< Blood Pressure Hypertension 140/90 Hypotension 90/60 Normal 90-140/90-60 Body Temperature 98.6F Additional Assessment Techniques Pulse Oximetry- 95%> Respiratory distress EKG Blood Glucometer- Norm 60-120 Breath Sounds Crackles (Rahles) Wheezes Rhonchi Stridor Pleural Rubs Cullens sign- discoloration around the umbilicus, suggesting intra-abdominal Hemorrhage. Grey-Turners sign- discoloration over the flanks, suggesting intra-abdominal bleeding.

Crainial Nerves I- Olfactory Nerves: smell II- Optic Nerves: Vision III- Oculomotor Nerves: eye movement, pupil contraction IV- Trochlear Nerve: eye movement V- Trigeminal Nerve: facial sensory & motor function VI- Abducens Nerve: eye movement VII- Facial Nerve: taste & facial expression VIII- Acoustic Nerve: hearing IX- Glossopharyngeal Nerve: taste & swallowing X- Vagus Nerve: Parasympathetic nervous system XI- Spinal Accessory Nerve: movement of head and shoulders, swallowing XII- Hypoglossal Nerve- movement of the tongue