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S1 - DETAILED ANSWER-normal, closure of AV, Start of systole, loudest at Apex, contraction of
ventricles
S2 - DETAILED ANSWER -normal, closure of semilunar, end of systole, loudest at base, filling of
ventricles
,S3 - DETAILED ANSWER-third heart sound (normal in pregnant young adults, and children), gallop
S4 - DETAILED ANSWER-extra heart sound, end of diastole, indicative of disease-AFIB
Order of Assessment - DETAILED ANSWER-Inspection, Palpation, Percussion and Auscultation. EXCEPT
with abdomen
Comprehensive Health History - DETAILED ANSWER-chief complaint, reason for visit, ROS, past medical
and surgical history, social history and family history
Pediatric Body measurements - DETAILED ANSWER-length, height, weight, head circumference fro
birth to 36 months
Normal/Hypertension cut off - DETAILED ANSWER-<130 normal 140+ hypertension
Fontanel Closure - DETAILED ANSWER-posterior 1-2 months, anterior 9mo-2years
otoscope - DETAILED ANSWER-adult-up and back, peds- down and back, using largest speculum that
will fit comforably
tympanic membrane - DETAILED ANSWER-Cone of light R-5 l-7
EOM testing - DETAILED ANSWER-CN III, IV, VI
AP diameter of chest - DETAILED ANSWER-1:2 (AP less than transverse)
barrel chest - DETAILED ANSWER-COPD
, Flat or Dull percussion - DETAILED ANSWER-effusion or pneumonia
normal resonant percussion - DETAILED ANSWER-healthy lung
Hyperressonance (percussion) - DETAILED ANSWER-trapped air
crackles/rales - DETAILED ANSWER-high pitched, discontinuous
Wheezes - DETAILED ANSWER-high-pitched whistling or squeaking sounds during inspiration or
expiration
Rhonchi - DETAILED ANSWER-snoring, rumbling sounds heard upon auscultation of the chest during
respiration-low pitched
tactile fremitus - DETAILED ANSWER-• INCREASED FREMITUS
- Means there is liquid or solid inside the lungs (consolidation such as with pneumonia) -
Remember Liquid or solid transmits vibrations better than air
• DECREASED FREMITUS
Means air trapping such as with emphysema or bronchial obstruction.
Bronchophony - DETAILED ANSWER-the spoken voice sound heard through the stethoscope, which
sounds soft, muffled, and indistinct over normal lung tissue, clearer over disease
Egophony - DETAILED ANSWER-abnormal change in tone of voice that is heard when auscultating the
lungs EE-->AA
UE Arteries - DETAILED ANSWER-radial-thumb side, ulnar pinky side