Irene Gold Part 4: The Physical Exam (Purple Pages 1-5)
1. Palpate and 1. Temporal artery
name the 9 pe- 2. Facial artery
ripheral pulses in 3. Carotid artery
yourself or a part- 4. Brachial artery
ner: 5. radial artery
6. Femoral artery
7. Popliteal artery
8. Posterior tibial artery
9. Dorsal pedis artery
2. Test for verte- Dekleyn's: Patient supine with head extended off table. Dr instructs patient to
brobasilar artery hyperextend and rotate head. Hold for 15-45 seconds. Dr may provide minimal
insufficiency support. Repeat on opposite side.
Positive: dizziness, diplopia, dysarthria, dysphagia, drop attacks, nausea and vom-
iting, sensory changes, nystagmus
3. Evaluate the ear Weber: Place the 512hz tuning fork on vertex of patient's head. Ask if they can hear
for hearing loss the sound on both sides. If not, this is called lateralization. If they hear louder in
(2 orthopedic one ear this can mean either air conduction on louder side or nerve deficit on the
tests). other side.
Rinne: Used to determine air conduction or sensorineural problems. 1st test the
1/6
, Irene Gold Part 4: The Physical Exam (Purple Pages 1-5)
side that was louder to check for air conduction loss. Place tuning fork on mastoid
process and ask patient to verbalize when they can no longer hear it. After sound
stops, place in front of EAM. Normal is hearing near the EAM for 2X's as long as on
mastoid. If not 2X's as long, consider air conduction on that side. If normal (rinne
+) consider nerve on opposite side.
4. Where do we pal- Frontal is at medial aspect of the eyebrow. Maxillary is under the medial aspect of
pate the frontal zygomatic arches.
and maxillary si-
nuses? Indication: Tenderness which is possibly sinusitis
5. Inspect for Her- Elevated serous filled cavity that is 0.5cm in size which follow a thoracic dermatome
pes Zoster and is sensitive to clothing.
6. How to per- Place hands over posterior ribs and take tissue slack lateral-medial at T10. Have
form respirato- patient take 3 deep breaths. Should move laterally equally.
ry excursion/ex-
pansion test?
2/6
1. Palpate and 1. Temporal artery
name the 9 pe- 2. Facial artery
ripheral pulses in 3. Carotid artery
yourself or a part- 4. Brachial artery
ner: 5. radial artery
6. Femoral artery
7. Popliteal artery
8. Posterior tibial artery
9. Dorsal pedis artery
2. Test for verte- Dekleyn's: Patient supine with head extended off table. Dr instructs patient to
brobasilar artery hyperextend and rotate head. Hold for 15-45 seconds. Dr may provide minimal
insufficiency support. Repeat on opposite side.
Positive: dizziness, diplopia, dysarthria, dysphagia, drop attacks, nausea and vom-
iting, sensory changes, nystagmus
3. Evaluate the ear Weber: Place the 512hz tuning fork on vertex of patient's head. Ask if they can hear
for hearing loss the sound on both sides. If not, this is called lateralization. If they hear louder in
(2 orthopedic one ear this can mean either air conduction on louder side or nerve deficit on the
tests). other side.
Rinne: Used to determine air conduction or sensorineural problems. 1st test the
1/6
, Irene Gold Part 4: The Physical Exam (Purple Pages 1-5)
side that was louder to check for air conduction loss. Place tuning fork on mastoid
process and ask patient to verbalize when they can no longer hear it. After sound
stops, place in front of EAM. Normal is hearing near the EAM for 2X's as long as on
mastoid. If not 2X's as long, consider air conduction on that side. If normal (rinne
+) consider nerve on opposite side.
4. Where do we pal- Frontal is at medial aspect of the eyebrow. Maxillary is under the medial aspect of
pate the frontal zygomatic arches.
and maxillary si-
nuses? Indication: Tenderness which is possibly sinusitis
5. Inspect for Her- Elevated serous filled cavity that is 0.5cm in size which follow a thoracic dermatome
pes Zoster and is sensitive to clothing.
6. How to per- Place hands over posterior ribs and take tissue slack lateral-medial at T10. Have
form respirato- patient take 3 deep breaths. Should move laterally equally.
ry excursion/ex-
pansion test?
2/6
