Exam 3 - advanced health assessment
Abdomen
Deep palpation
peculiar - ANS-- Physiologic - pregnant uterus
- Inflammatory - diverticulitis
- Vascular - stomach aortic aneurysm
- Neoplastic - colon cancer
- Obstructive - distended bladder or dilated loop of bowel
Abdomen
Deep palpation
everyday - ANS-- to perceive abdominal loads
-area
-length
-shape
-consistency
-tenderness
-pulsations
-mobility with breathing
Abdomen
Inspection
ordinary - ANS-- Cushings syndrome: red purple striae
- Hepatic cirrhosis: dilated veins
- inferior vena cava obstruction: dilated veins
- intraperitoneal hemorrhage: ecchymosis stomach wall
- intestinal obstruction: increased peristaltic waves
- aortic aneurysm: increased pulsation
Abdomen
Inspection
ordinary - ANS-- scar, vintage silver striae/stretch marks
- small veins
- symmetric contour
- persitalsis can be visible in very thin human beings
- pulsation of aorta is often visible within the epigastrium
Abdomen
light palpation
peculiar - ANS-- Peritoneal inflammation
- involuntary rigidity = muscular spasm, commonly persists in spite of palpating
Abdomen
mild palpation
, everyday - ANS--gentle palpation to perceive:
- stomach tenderness
- muscular resistance
- superficial organs and hundreds
Abdomen
percussion
ordinary - ANS-- intestinal obstruction: tympany at some point of
- ascites: dullness in both flanks
Dull regions can indicate a
- pregnant uterus
- ovarian tumor
- distended bladder
- huge liver or spleen
Abdomen
percussion
ordinary - ANS-- proper facet - typically dullness of the liver
- left aspect - tympany (air) gastric air bubble and splenic flexure of the colon
Abdominal bruit - ANS-- * suggest vascular occlusive disorder
- * pay attention to epigastrium, RUQ, LUQ
- Bruit with each systolic and diastolic strongly indicates renal artery stenosis (20% of healthful
humans have this)
Anterior drawer check - ANS-- check ligamentous balance of the anterior cruciate ligament -
ACL
- affected person lays supine with knee flexed, examiner pulls lower leg forward
- sit on affected person foot to stabilize and pull
Aortic place - ANS-- second intercostal area on the higher right sternal border
Aortic stenosis - ANS-- a medium pitched harsh systolic murmur
- high-quality heard on the right higher border of the sternum
Babinski Test - ANS-- plantar reflex
- stroke plantar surface of foot
- nice test is dorsiflexion of the huge toe and fanning of the opposite ft
- can be everyday in some toddlers till age 2 years
Brudzinski Test - ANS-- sign of meningeal infection
- patient lays supine, carry patients head up ( flex neck ) and hip and knees will mechanically
flex = high quality test
Carpal tunnel syndrome - ANS-- repetitive movement with wrists flexed (e.G. Keyboard use or
mail sorting) being pregnant, rheumatoid arthritis, diabetes or hypothyroid
- nice thumb abduction take a look at (have patient raise thumb against resistance)
- diagrams that confirm sensory symptoms within the hand
- and decreased sensation inside the median nerve distribution
- all of those double the probability
Cauda equina syndrome - ANS-- low returned ache
Abdomen
Deep palpation
peculiar - ANS-- Physiologic - pregnant uterus
- Inflammatory - diverticulitis
- Vascular - stomach aortic aneurysm
- Neoplastic - colon cancer
- Obstructive - distended bladder or dilated loop of bowel
Abdomen
Deep palpation
everyday - ANS-- to perceive abdominal loads
-area
-length
-shape
-consistency
-tenderness
-pulsations
-mobility with breathing
Abdomen
Inspection
ordinary - ANS-- Cushings syndrome: red purple striae
- Hepatic cirrhosis: dilated veins
- inferior vena cava obstruction: dilated veins
- intraperitoneal hemorrhage: ecchymosis stomach wall
- intestinal obstruction: increased peristaltic waves
- aortic aneurysm: increased pulsation
Abdomen
Inspection
ordinary - ANS-- scar, vintage silver striae/stretch marks
- small veins
- symmetric contour
- persitalsis can be visible in very thin human beings
- pulsation of aorta is often visible within the epigastrium
Abdomen
light palpation
peculiar - ANS-- Peritoneal inflammation
- involuntary rigidity = muscular spasm, commonly persists in spite of palpating
Abdomen
mild palpation
, everyday - ANS--gentle palpation to perceive:
- stomach tenderness
- muscular resistance
- superficial organs and hundreds
Abdomen
percussion
ordinary - ANS-- intestinal obstruction: tympany at some point of
- ascites: dullness in both flanks
Dull regions can indicate a
- pregnant uterus
- ovarian tumor
- distended bladder
- huge liver or spleen
Abdomen
percussion
ordinary - ANS-- proper facet - typically dullness of the liver
- left aspect - tympany (air) gastric air bubble and splenic flexure of the colon
Abdominal bruit - ANS-- * suggest vascular occlusive disorder
- * pay attention to epigastrium, RUQ, LUQ
- Bruit with each systolic and diastolic strongly indicates renal artery stenosis (20% of healthful
humans have this)
Anterior drawer check - ANS-- check ligamentous balance of the anterior cruciate ligament -
ACL
- affected person lays supine with knee flexed, examiner pulls lower leg forward
- sit on affected person foot to stabilize and pull
Aortic place - ANS-- second intercostal area on the higher right sternal border
Aortic stenosis - ANS-- a medium pitched harsh systolic murmur
- high-quality heard on the right higher border of the sternum
Babinski Test - ANS-- plantar reflex
- stroke plantar surface of foot
- nice test is dorsiflexion of the huge toe and fanning of the opposite ft
- can be everyday in some toddlers till age 2 years
Brudzinski Test - ANS-- sign of meningeal infection
- patient lays supine, carry patients head up ( flex neck ) and hip and knees will mechanically
flex = high quality test
Carpal tunnel syndrome - ANS-- repetitive movement with wrists flexed (e.G. Keyboard use or
mail sorting) being pregnant, rheumatoid arthritis, diabetes or hypothyroid
- nice thumb abduction take a look at (have patient raise thumb against resistance)
- diagrams that confirm sensory symptoms within the hand
- and decreased sensation inside the median nerve distribution
- all of those double the probability
Cauda equina syndrome - ANS-- low returned ache
