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Claudication - ✔✔a condition in which cramping pain in the leg is induced by exercise,
typically caused by obstruction of the arteries. May be characterized as a dull ache with
accompanying muscle fatigue and cramps. Usually appears with sustained exercise. Site
of pain is distant to narrowing.
How do you test EOM? - ✔✔Eye movement is controlled by 6 extraocular muscles and
3 cranial nerves, III, IV, and VI. To evaluate eye movement, use 4 techniques.
● First have the patient watch your finger move through the 6 cardinal fields of gaze.
Jerking or sustained nystagmus is abnormal. A few beats of horizontal nystagmus may
occur.
● Second have the patient follow your finger vertically from the ceiling to the floor.The
globes and the upper eyelids should move smoothly without eyelid lag or exposure of
the sclera.
● Third, test extraocular muscle balance using the corneal light reflex. WIth the patient
looking at a nearby object, shine a light on the nasal bridge. The eyes should converge
and reflect the light symmetrically.
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,● Fourth, if the corneal light reflex is imbalanced, perform the cover-uncover test. As
the patient stares at a fixed point nearby, cover one eye and observe the uncovered eye.
Then remove the cover and observe that eye as it focuses on the object. Note any eye
movement.
Your patient should be able to follow your finger with full, smooth extraocular
movements and without nystagmus, or "shaky" eye motion. Normal extraocular
movements indicate intact cranial nerves III, IV, and VI.
*******What is the difference between objective and subjective data? What components
of the health history are objective and subjective? *********** - ✔✔Seidel pg 618:
objective: "direct observation, what you see, hear, and touch". This includes vital signs
and actual assessment. Subjective: "information patients offer about their condition or
feelings." This includes chief complaint, past medical history, history or present illness,
family history, and review of symptoms.
Erb's point - ✔✔Erb's point is the auscultation location for heart sounds and heart
murmurs located at the third intercostal space and the left lower sternal border. Erb's
point, found two interspaces below the pulmonic area, does not reflect sound from one
particular heart valve, but is a common listening post, lying halfway between the base
and the apex of the heart.
Tonsil assessment - ✔✔• Enlargement; Acute infection, 2+, 3+, or 4+
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,o 1+ - visible
o 2+ halfway between tonsillar pillars
o 3+ touching uvula
o 4+ touching each other
Order physical assessment is done - ✔✔Inspection, Palpation, Percussion, Auscultation
Proper use of Otoscope on adult or child - ✔✔Adult- straighten the external auditory
canal by pulling auricle up and back
Child- face child sideways with one arm around parents waist. Pull auricle either
downward and back or upward and back to gain best view of tympanic membrane.
How do you assess for sensoineural hearing loss - ✔✔air conduction heard longer than
bone conduction with Rinne Test; lateralization to unaffected ear; loss of high-frequency
sounds
How do you assess for conductive hearing loss - ✔✔bone conduction heard longer than
air conduction with Rinne Test; lateralization to affected ear with Weber Test; loss of
low frequency sounds; loss of 11-30 decibels on audiometry with cerumen impaction.
Rinne Test***** - ✔✔helps distinguish whether patient hears better by air or bone
conduction. Place the tuning fork at base of vibrating tuning fork against the patient's
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, mastoid bone and ask patient to tell you when the sound is no longer heard. Time this
interval of bone conduction noting number of seconds. Continue timing the interval of
sound due to by air conduction heard by the patient. Compare # of seconds air vs. bone.
Air conducted should be heard twice as long as bone conducted sounds. (If bone
conducted heard for 15 seconds, air conducted should be heard for additional 15
seconds).
Weber Test - ✔✔helps assess unilateral hearing loss. Place base of fork on mid-line of
patient's head. Ask patient if sound heard equally in both ears or in one ear
(lateralization of sound). Should hear sound equally.
Presbyopia - ✔✔Progressive weakening of accommodation (focusing power). The major
physiologic change that occurs after the age of 45 years; the lens becomes more rigid,
and the ciliary muscle becomes weaker.
Strabismus - ✔✔a condition in which both eyes do not focus on the object
simultaneously, although either eye can focus independently; may be paralytic or non-
paralytic.
Photopsia - ✔✔presence of perceived flashes of light. (Most commonly associated with
posterior vitreous detachment, migraine with aura, retinal break, or detachment).
Amblyopia - ✔✔also called lazy eye; is disorder of sight d/t eye and brain not working
well together. Results in decreased vision in an eye that otherwise typically appears
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