NR 509 / NR509 Advanced Physical Assessment
Final Exam Week 5 to 8 Review
ANSWERS ARE MARKED WITH A SPECIAL COLOUR FOR RECOGNITION: BLUE
Breast Exam
Answer
5-7 days after the first day of menstruation
-Inspect for symmetry, contours, and retractions
-Palpitation with patient supine with arm above head
-Palpate in ladder pattern, circular motion for each location
1. Lactation
Answer
,Physiological secretion with pregnancy, lactation, chest wall stimula- tion,
sleep and stress.
2. Montgomery glands:
Answer sebaceous glands that secrete a protective lipid substance during
lactation
3. Galactorrhea
: Answer a milky discharge from the nipple unrelated to normal breast
feeding
4. Mammary souffle:
Answer "puff of air" heard during pregnancy and lactation (venous hum)
5. Breast Cancer
Answer
, Redness
-Peau d'orange: thickening and prominent pores
-Flattening instead of normal convexity
-Asymmetry
-Change in nipple direction
-Paget disease: rash, scaling, ulceration of nipple and areola
6. Breast cancer risk factors
Answer
Increasing age
-First degree family member
-Genetic mutations (BRCA1 & BRCA2)
-Personal history of precancerous breast mass
-Denser breast (confirmed by a mammogram)
-High dose radiation exposure
-High levels estrogen hormones
, 7. Abdominal Exam
: Answer Inspection-contours
Auscultation-bowel sounds/bruits
Percussion-liver size, dullness or tympany in colon
Palpation-liver size, splenomegaly, masses in colon (fecal matter, cancer,
divertic- ulitis)
Special maneuvers- murphy (gallbladder), appendix tests
8. Abdominal Pain: Visceral:
Answer Hollow abdominal organs forcefully contract or dis- tention
-nonspecific, difficult to localize
-Gnawing, cramping, aching
-Sweating, pallor, nausea, vomiting, restlessness
9. Abdominal Pain: Somatic/parietal:
Answer Inflammation of the parietal peritoneum
Final Exam Week 5 to 8 Review
ANSWERS ARE MARKED WITH A SPECIAL COLOUR FOR RECOGNITION: BLUE
Breast Exam
Answer
5-7 days after the first day of menstruation
-Inspect for symmetry, contours, and retractions
-Palpitation with patient supine with arm above head
-Palpate in ladder pattern, circular motion for each location
1. Lactation
Answer
,Physiological secretion with pregnancy, lactation, chest wall stimula- tion,
sleep and stress.
2. Montgomery glands:
Answer sebaceous glands that secrete a protective lipid substance during
lactation
3. Galactorrhea
: Answer a milky discharge from the nipple unrelated to normal breast
feeding
4. Mammary souffle:
Answer "puff of air" heard during pregnancy and lactation (venous hum)
5. Breast Cancer
Answer
, Redness
-Peau d'orange: thickening and prominent pores
-Flattening instead of normal convexity
-Asymmetry
-Change in nipple direction
-Paget disease: rash, scaling, ulceration of nipple and areola
6. Breast cancer risk factors
Answer
Increasing age
-First degree family member
-Genetic mutations (BRCA1 & BRCA2)
-Personal history of precancerous breast mass
-Denser breast (confirmed by a mammogram)
-High dose radiation exposure
-High levels estrogen hormones
, 7. Abdominal Exam
: Answer Inspection-contours
Auscultation-bowel sounds/bruits
Percussion-liver size, dullness or tympany in colon
Palpation-liver size, splenomegaly, masses in colon (fecal matter, cancer,
divertic- ulitis)
Special maneuvers- murphy (gallbladder), appendix tests
8. Abdominal Pain: Visceral:
Answer Hollow abdominal organs forcefully contract or dis- tention
-nonspecific, difficult to localize
-Gnawing, cramping, aching
-Sweating, pallor, nausea, vomiting, restlessness
9. Abdominal Pain: Somatic/parietal:
Answer Inflammation of the parietal peritoneum
