VERIFIED SOLUTIONS 2023 APRIL SPRING/A+ GRADE
Order of Assessment - ANSWER: Inspection, Palpation, Percussion and Auscultation.
EXCEPT with abdomen
Comprehensive Health History - ANSWER: chief complaint, reason for visit, ROS, past
medical and surgical history, social history and family history
Pediatric Body measurements - ANSWER: length, height, weight, head circumference
fro birth to 36 months
Normal/Hypertension cut off - ANSWER: <130 normal 140+ hypertension
Fontanel Closure - ANSWER: posterior 1-2 months, anterior 9mo-2years
otoscope - ANSWER: adult-up and back, peds- down and back, using largest
speculum that will fit comforably
tympanic membrane - ANSWER: Cone of light R-5 l-7
EOM testing - ANSWER: CN III, IV, VI
AP diameter of chest - ANSWER: 1:2 (AP less than transverse)
barrel chest - ANSWER: COPD
Flat or Dull percussion - ANSWER: effusion or pneumonia
normal resonant percussion - ANSWER: healthy lung
Hyperressonance (percussion) - ANSWER: trapped air
crackles/rales - ANSWER: high pitched, discontinuous
Wheezes - ANSWER: high-pitched whistling or squeaking sounds during inspiration or
expiration
Rhonchi - ANSWER: snoring, rumbling sounds heard upon auscultation of the chest
during respiration-low pitched
tactile fremitus - 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 - ANSWER: the spoken voice sound heard through the stethoscope,
which sounds soft, muffled, and indistinct over normal lung tissue, clearer over
disease
Egophony - ANSWER: abnormal change in tone of voice that is heard when
auscultating the lungs EE-->AA
UE Arteries - ANSWER: radial-thumb side, ulnar pinky side
Pulse grading - ANSWER: 0 absent
1+ weak
2+ normal
3+ increased
4+ bounding
palpate bilaterally
PMI - ANSWER: point of maximal impulse mid-clavicular and 5th ICS
S1 - ANSWER: normal, closure of AV, Start of systole, loudest at Apex, contraction of
ventricles
S2 - ANSWER: normal, closure of semilunar, end of systole, loudest at base, filling of
ventricles
S3 - ANSWER: third heart sound (normal in pregnant young adults, and children),
gallop
S4 - ANSWER: extra heart sound, end of diastole, indicative of disease-AFIB
murmur grading scale - ANSWER: I-Barely Audible
II-Quiet, Clearly Audible
III-moderately Loud
IV-loud, thrill
V-Very loud, can palpate thrill
VI-Very loud, thrill palpable and visible
clubbing - ANSWER: bulbous enlargement of distal phalanges of fingers and toes that
occurs with chronic cyanotic heart and lung conditions
edema scale - ANSWER: 1+ = disappears rapidly. 2+ = last 10-15 seconds. 3+ = lasts
more than one minute. 4+ = lasts 2-5 minutes. These are signs used in what scale?
normal/abnormal findings spleen - ANSWER: normal=tympanic, dullness could be
enlargement not normally felt on exam