NR509 Advanced Physical Assessment
Practice
Abdomen 21:26 - ANS-Inspect for contours and symmetry
-abdomen flat and symmetrical
Auscultate bowl sounds x4 quadrants
-present, normoactive bowl sounds all four quadrants
Auscultate for bruits with bell of stethoscope (aorta, renal arteries, iliac arteries)
-no bruits
Percuss all 4 quadrants
-RUQ stupid as anticipated
- Tymphany as anticipated all other quads
Palpate mild then deep all four quads
-no hundreds or tenderness
Blumberg's Test
-bad. No rebound tenderness.
Palpate liver and spleen
-unable to palpate liver or spleen, as anticipated.
Chest - ANS-Inspect for deformities & symmetry
-none mentioned
Auscultate anterior lungs x6 times starting at intercostal spaces
Auscultate posterior lungs x8 instances starting above scapulars and consist of proper center
lobe
-lungs clear throughout anteriorly and posteriorly
Ears - ANS-Inspect outer ear
- no nodules, lesions cited. Symmetrical.
Palpate pinna and tragus
-no nodules or tenderness bilaterally
Inspect auditory canal and tympanic membrane
, -auditory canal clear of cerumen, no redness, drainage, or swelling mentioned
-pearly grey tympanic membrane w/o effusion
CN8 acoustic... Whisper take a look at
-listening to intact bilaterally
Eyes - ANS-Inspect sclera and conjunctiva
-sclera whit and clean
-conjunctiva crimson and moist. No drainage or lesions.
CN2 Optic
-snellen chart... 20/20 left eye, right eye, and each eyes
-peripheral vision... Peripheral vision intact
-pupillary response... 2mm equal, round, reactive to mild bilaterally
CN3,4,&6 Occulomotor, Trochlear, and Abducens (H)
-all extraocular eye movements intact bilaterally
Head & Face - ANS-Inspect pores and skin
-no lesions or discolorations cited
Inspect head
-normocephalic, symmetrical, and midline
Palpate lymph nodes (preauricular, submit auricular, occipital, tonsillar, submandibular,
submental, anterior cervical, posterior cervical, supraclavicular)
-identical bilaterally, nontender, no longer enlarged
CN5 Trigeminal
-Motor (clench jaw): suitable energy and no distortion
-Sensory (touch): intact
CN7 Facial (smile, frown, improve eybrows, puff cheeks, pucker lips)
-intact, symmetrical, bilaterally
Heart - ANS-Auscultate w/ diaphragm and bell
-Aortic (proper sternal border second intercostal space)
-Pulmonic (left sternal border second intercostal space)
-Erb's ( left sternal border 3rd intercostal space)
-Tricuspid (left sternal border 4th intercostal area)
-Mitral (midline fifth intercostal space)
No adventitious heart sounds mentioned.
Practice
Abdomen 21:26 - ANS-Inspect for contours and symmetry
-abdomen flat and symmetrical
Auscultate bowl sounds x4 quadrants
-present, normoactive bowl sounds all four quadrants
Auscultate for bruits with bell of stethoscope (aorta, renal arteries, iliac arteries)
-no bruits
Percuss all 4 quadrants
-RUQ stupid as anticipated
- Tymphany as anticipated all other quads
Palpate mild then deep all four quads
-no hundreds or tenderness
Blumberg's Test
-bad. No rebound tenderness.
Palpate liver and spleen
-unable to palpate liver or spleen, as anticipated.
Chest - ANS-Inspect for deformities & symmetry
-none mentioned
Auscultate anterior lungs x6 times starting at intercostal spaces
Auscultate posterior lungs x8 instances starting above scapulars and consist of proper center
lobe
-lungs clear throughout anteriorly and posteriorly
Ears - ANS-Inspect outer ear
- no nodules, lesions cited. Symmetrical.
Palpate pinna and tragus
-no nodules or tenderness bilaterally
Inspect auditory canal and tympanic membrane
, -auditory canal clear of cerumen, no redness, drainage, or swelling mentioned
-pearly grey tympanic membrane w/o effusion
CN8 acoustic... Whisper take a look at
-listening to intact bilaterally
Eyes - ANS-Inspect sclera and conjunctiva
-sclera whit and clean
-conjunctiva crimson and moist. No drainage or lesions.
CN2 Optic
-snellen chart... 20/20 left eye, right eye, and each eyes
-peripheral vision... Peripheral vision intact
-pupillary response... 2mm equal, round, reactive to mild bilaterally
CN3,4,&6 Occulomotor, Trochlear, and Abducens (H)
-all extraocular eye movements intact bilaterally
Head & Face - ANS-Inspect pores and skin
-no lesions or discolorations cited
Inspect head
-normocephalic, symmetrical, and midline
Palpate lymph nodes (preauricular, submit auricular, occipital, tonsillar, submandibular,
submental, anterior cervical, posterior cervical, supraclavicular)
-identical bilaterally, nontender, no longer enlarged
CN5 Trigeminal
-Motor (clench jaw): suitable energy and no distortion
-Sensory (touch): intact
CN7 Facial (smile, frown, improve eybrows, puff cheeks, pucker lips)
-intact, symmetrical, bilaterally
Heart - ANS-Auscultate w/ diaphragm and bell
-Aortic (proper sternal border second intercostal space)
-Pulmonic (left sternal border second intercostal space)
-Erb's ( left sternal border 3rd intercostal space)
-Tricuspid (left sternal border 4th intercostal area)
-Mitral (midline fifth intercostal space)
No adventitious heart sounds mentioned.
