Solid Organs - ANSWER-maintain their shape: liver, spleen, kidney, pancreas, ovaries
Hollow Organs - ANSWER-the shape depends on contents: stomach, gallbladder,
intestines, bladder, uterus
Neoplasm of esophagus/stomach odor - ANSWER-severe bad breath
Peptic ulcers odor - ANSWER-acid breath
Hepatic failure odor - ANSWER-sickly sweet odor
Esophageal diverticulum odor - ANSWER-odor of decay
Severe bowel obstruction odor - ANSWER-odor of feces
Cirrhosis with portal shunting odor - ANSWER-odor of rotten eggs and garlic
increased lunula size - ANSWER-indicates hyperthyroid, leprosy, and scleroderma
Normal bowel sounds for small intestine - ANSWER-high-pitched, gurgling
Normal bowel sounds for colon - ANSWER-low-pitched, rumbling
Liver percussion - ANSWER-begins at abdomen just below the umbilicus at the right
midclavicular line, percuss upward until dullness is heard
Spleen percussion - ANSWER-lie supine, breathe normally, percuss in the lowest
intercostal space in the left anterior axillary line, beginning at an area of lung resonance
may be heard from 6-10th ribs, normal percussion sounds can be either resonance or
tympanic
Bladder percussion - ANSWER-percussion of the suprapubic area can detect dullness,
400-600ml in bladder before dullness heard
Fluid Wave Test - ANSWER-with the patient's hand placed vertically in the middle of
abdomen, place your hands on each side of the patient's abdomen and tap one side
while palpating the other side
If ascites is present, the examiner will feel fluid shifting from side to side
Rebound tenderness - ANSWER-elicit by deeply palpating then suddenly releasing
pressure. If present in the RLQ (McBurney's point), suggests patient has appendicitis
, McBurney's sign - ANSWER-tenderness and rigidity from the umbilicus to the right
anterior superior iliac spine. Frequently seen with appendicitis
Inspiration arrest (Murphy's sign) - ANSWER-palpate below right costal margin. Ask
patient to take a deep breath. If patient stops breathing mid-inspiration due to pain, the
sign is positive
Obturator test - ANSWER-place patient in supine position with right leg flexed at hip and
knee. Place a hand just above knee with your other hand at the ankle. Rotate the
patient's leg internally and externally, positive in appendicitis
AAA palpation - ANSWER-place each hand on either side of aorta and estimate the
diameter of aorta, diameter of 3cm or greater is positive
Grey Turner's sign - ANSWER-an uncommon subcutaneous manifestation of intra-
abdominal hemorrhage that manifests as ecchymosis or discoloration of the flank
Cullen's sign - ANSWER-finding of bruising around umbilicus
Intussusception - ANSWER-telescoping of large intestine
coryza (rhinitis) - ANSWER-inflammation of the mucous membranes of the nose; a
common cold
bacterial - ANSWER-Yellow, green, rust, clear, or transparent sputum
viral - ANSWER-mucoid or viscid sputum
bloody sputum - ANSWER-Chronic infectious disease, pulmonary carcinoma, pulmonary
infarction, Tb, nosebleeds
Kussmaul breathing - ANSWER-gasping, labored breathing, also called air hunger
metabolic acidosis
pleurisy - ANSWER-an inflammation of the pleura that produces sharp chest pain with
each breath
Hyperpnea - ANSWER-breathing deeper and more rapid than normal. Seen in
neurological pathology
Cheyne-Stokes breathing - ANSWER-periods of deep breathing alternating with periods
of apnea
Biot breathing - ANSWER-repeated sequences of deep gasps and apnea
pectus carinatum - ANSWER-pigeon chest
pectus excavatum - ANSWER-sunken sternum and adjacent cartilages (funnel chest)
Thoracic Expansion - ANSWER-stand behind patient and place thumbs along spinal
processes at level of the tenth rib, with your palms lightly in contact with the
posterolateral surfaces. Watch your thumbs move during the patient's inspiration and
expiration
tactile fremitus - ANSWER-a tremulous vibration of the chest wall during speaking that is
palpable on physical examination
best felt posteriorly at the second or third intercostal space
Diaphragmatic Excursion - ANSWER-assesses degree and symmetry of diaphragm
movement; percuss from areas of resonance to dullness
bronchial breath sounds - ANSWER-heard over trachea; high in pitch and intensity;
abnormal if heard over the peripheral lung base
bronchovesicular breath sounds - ANSWER-heard over major bronchi; abnormal if heard
in peripheral lung; moderate in pitch and intensity
Hollow Organs - ANSWER-the shape depends on contents: stomach, gallbladder,
intestines, bladder, uterus
Neoplasm of esophagus/stomach odor - ANSWER-severe bad breath
Peptic ulcers odor - ANSWER-acid breath
Hepatic failure odor - ANSWER-sickly sweet odor
Esophageal diverticulum odor - ANSWER-odor of decay
Severe bowel obstruction odor - ANSWER-odor of feces
Cirrhosis with portal shunting odor - ANSWER-odor of rotten eggs and garlic
increased lunula size - ANSWER-indicates hyperthyroid, leprosy, and scleroderma
Normal bowel sounds for small intestine - ANSWER-high-pitched, gurgling
Normal bowel sounds for colon - ANSWER-low-pitched, rumbling
Liver percussion - ANSWER-begins at abdomen just below the umbilicus at the right
midclavicular line, percuss upward until dullness is heard
Spleen percussion - ANSWER-lie supine, breathe normally, percuss in the lowest
intercostal space in the left anterior axillary line, beginning at an area of lung resonance
may be heard from 6-10th ribs, normal percussion sounds can be either resonance or
tympanic
Bladder percussion - ANSWER-percussion of the suprapubic area can detect dullness,
400-600ml in bladder before dullness heard
Fluid Wave Test - ANSWER-with the patient's hand placed vertically in the middle of
abdomen, place your hands on each side of the patient's abdomen and tap one side
while palpating the other side
If ascites is present, the examiner will feel fluid shifting from side to side
Rebound tenderness - ANSWER-elicit by deeply palpating then suddenly releasing
pressure. If present in the RLQ (McBurney's point), suggests patient has appendicitis
, McBurney's sign - ANSWER-tenderness and rigidity from the umbilicus to the right
anterior superior iliac spine. Frequently seen with appendicitis
Inspiration arrest (Murphy's sign) - ANSWER-palpate below right costal margin. Ask
patient to take a deep breath. If patient stops breathing mid-inspiration due to pain, the
sign is positive
Obturator test - ANSWER-place patient in supine position with right leg flexed at hip and
knee. Place a hand just above knee with your other hand at the ankle. Rotate the
patient's leg internally and externally, positive in appendicitis
AAA palpation - ANSWER-place each hand on either side of aorta and estimate the
diameter of aorta, diameter of 3cm or greater is positive
Grey Turner's sign - ANSWER-an uncommon subcutaneous manifestation of intra-
abdominal hemorrhage that manifests as ecchymosis or discoloration of the flank
Cullen's sign - ANSWER-finding of bruising around umbilicus
Intussusception - ANSWER-telescoping of large intestine
coryza (rhinitis) - ANSWER-inflammation of the mucous membranes of the nose; a
common cold
bacterial - ANSWER-Yellow, green, rust, clear, or transparent sputum
viral - ANSWER-mucoid or viscid sputum
bloody sputum - ANSWER-Chronic infectious disease, pulmonary carcinoma, pulmonary
infarction, Tb, nosebleeds
Kussmaul breathing - ANSWER-gasping, labored breathing, also called air hunger
metabolic acidosis
pleurisy - ANSWER-an inflammation of the pleura that produces sharp chest pain with
each breath
Hyperpnea - ANSWER-breathing deeper and more rapid than normal. Seen in
neurological pathology
Cheyne-Stokes breathing - ANSWER-periods of deep breathing alternating with periods
of apnea
Biot breathing - ANSWER-repeated sequences of deep gasps and apnea
pectus carinatum - ANSWER-pigeon chest
pectus excavatum - ANSWER-sunken sternum and adjacent cartilages (funnel chest)
Thoracic Expansion - ANSWER-stand behind patient and place thumbs along spinal
processes at level of the tenth rib, with your palms lightly in contact with the
posterolateral surfaces. Watch your thumbs move during the patient's inspiration and
expiration
tactile fremitus - ANSWER-a tremulous vibration of the chest wall during speaking that is
palpable on physical examination
best felt posteriorly at the second or third intercostal space
Diaphragmatic Excursion - ANSWER-assesses degree and symmetry of diaphragm
movement; percuss from areas of resonance to dullness
bronchial breath sounds - ANSWER-heard over trachea; high in pitch and intensity;
abnormal if heard over the peripheral lung base
bronchovesicular breath sounds - ANSWER-heard over major bronchi; abnormal if heard
in peripheral lung; moderate in pitch and intensity
