REVIEW FOR CUMULATIVE EXAM AND FOR HESI – 304 –

REVIEW FOR CUMULATIVE EXAM AND FOR HESI – 304 – The list below should help you frame your studying. It is not considered exhaustive, just a helpful guide. The written physical exam was an excellent review of the complete assessment. Vital signs – there are always questions on HESI about when to take a rectal vs axillary – and how to do so. Pulse pressure, pulse deficit, how to size a BP cuff, what the BP numbers mean, apical pulse. BMI – normal, abnormal. Study your fundamentals textbook Skin – common lesions and configurations, primary and secondary ABCDE analysis of a mole Colors – erythema, ecchymosis, jaundice, pallor Common diagnoses – herpes, chickenpox, carcinoma, eczema, psoriasis Fingernails – clubbing, pitting, capillary refill, spoon nails Head and Neck – normo, macro and microcephaly Thyroid palpation – normal results – the isthmus is always palpable Lymph nodes Carotid, JVD, sternomastoid and trapezius Hypo and hyperthyroid Eyes – PEERLA – know accomodation, normal pupils, sluggish and dilated pupils Sclera and conjunctivia- normal and abnormal color EOM – vision testing – Snellen – Nystagmus, strabismus, ptosis, ectropion, estotropia Ears – Weber and Rinne tests – Romberg, external exam – anatomy of ear TM examination Nose, mouth – turbinates, polyps Tonsils – graded Salivary glands Respiratory – inspection – AP:T diameter, barrel chest, pectis excavatum Tactile fremitus – normal and abnormal – you did not know this for the write-up Percussion – normal and abnormal – and possible diagnosis Auscultation – what should you hear? Adventitious sounds – egophony, bronchophony Common diagnoses – pneumonia, asthma, pulmonary edema, atelectasis, pneumothorax Cardiovascular – apical pulse – location and normals Heaves, thrills Location of valve sounds – meaning of S1 and S2 – location, anatomy of these sounds Murmurs, S3, S4 - physiologic explanation Pulses – location on body – grading 0-+4 Venous insufficiency – symptoms Arterial insufficiency – symptoms Varicosities, edema, tests of perfusion Neuro – Reflexes – location, grading Spinothalamic and Corticospinal tests – sensation, motor Cerebellar tests –and what the results mean Cranial nerves by number only– tests, normal, abnormal Common diagnosis – CVA, Parkinson, Bell’s palsy Abdomen – auscultation – normal and abnormal bowel sounds Percussion Palpation – normal and abnormal Signs of peritonitis, appendicitis, cholecystis, internal hemorrhage Breast – tail of Spence, 4 quadrants Normal anatomy – areola, nipple, lobes, lobules Symptoms of abnormal mass, rash, cancer Musculoskeletal – joint and muscle testing – graded 0-5/5 Common diagnoses – carpal tunnel, osteoarthritis, rheumatoid arthritis, gout, scoliosis Female – normal anatomy – uterus, adnexa, Skene, Bartholin, introitus, hymen, clitoris, labia, vagina Exam of internal and external genitals – PAP, speculum, bimanual Common diagnoses – STI, candida, bacterial vaginosis, cancer Pregnancy – common findings Male – normal anatomy – scrotum, testes, penis, glans, foreskin, epididymis, vas deferens, prostate, bladder, seminal vesicles, urethra, corpus Examination – assessment external – digital rectal Common diagnoses – BPH, prostatitis, torsion, cryptorchidism, phimosis, STI Anal – anatomy Common diagnosis – abscess, hemorrhoid, prolapse, rectal bleeding Stool colors and reason – bright red blood, melana, pasty-grey/white, steatorrhea Urinary – anatomy Examination – bladder palpation, CVA tenderness Common diagnosis – UTI, calculi, pyelonephritis, bladder cancer, Incontinence – types and causes Remember to look at the age differences for each system – infant, adolescent, pregnant female, aging adult