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whisper pectoriloquy - ANSWER -1, 2, 3, 1, 2, 3; Whispered voice
will be heard
faintly or indistinctly if at all; Clearer louder sounds =
underlying consolidation
anterior thorax - ANSWER -Lie supine and breath normally -
Observe condition of skin and inspect chest for deformities,
asymmetry and respiratory movement Palpate chest for
lesions, abnormalities, tenderness; Assess chest expansion
anterior assessment of chest expansion - ANSWER -place
thumbs along each
costal margin with hands along lateral rib cage - deep breath;
Observe how far
thumbs diverge and feel for extent and symmetry
of movement
tactile fremitus of anterior chest - ANSWER -sing ball or ulfar
surface of the hand ; decreased or absent over precordium;
Percuss anterior chest and lateral chest - heart produces area
of dullness from 3rd to 5th interspaces left to the
,sternum; Left lung lateral to the area of dullness ; Percuss in
progressive steps
downward in right midclavicular line; Identify upper board
of liver dullness
auscultation of the anterior thorax - ANSWER -Breath with
mouth open;
Compare symmetric area of lungs; Listen to breath sounds
Louder in upper anterior lung fields; Bronchovesicular breath
sounds can be heard over large airways, esp to the right
Stridor - ANSWER -loud, continuous, high pitched crowing
sound that is caused by upper airway obstruction. Most serious
of adventitious sounds and requires immediate attention;
audible without stethoscope
musculoskeletal system - ANSWER -Involves evaluating for
issues of the bones, joints, skeletal muscles, ligaments and
tendons, and cartilage examination should be systematic;
inspection, palpation of bony structures and related joint and
soft tissue structures, assessment of range of motion, and
special maneuvers to test specific movements
tips for assessing pain - ANSWER -Always ask patient to point
to it; Clarify when the it started, the mechanism of injury or how
the it began ; Detail related to trauma, exercise, movement;
Identify key features - localized/diffuse, acute or chronic,
inflammatory/noninflammatory
,during musculoskeletal exam - ANSWER -Assess surrounding
tissues; Test ROM; Perform maneuvers to demonstrate
limitations; Note swelling, redness, tenderness or warmth;
Look for join symmetry, alignment, bony deformities, swelling
Temporomandibular joint (TMJ) - ANSWER -Arises from
articulation between mandible and skull; Fibrocartilaginous
disc cushions the action of the condyle of the mandible against
the synovial membrane of the articulating surfaces of the
temporal bone
Assess TMJ - ANSWER -Place tips of fingers in front of the
tragus of each ear - ask the patient to open and close their
mouth. Fingers should fall into the joint spaces as the mouth
opens; Check for smooth ROM; Note tenderness, swelling,
crepitus; Palpate muscles of mastication
muscles of mastication - ANSWER -temporal, pterygoid muscle,
massetters
protrusion and retraction - ANSWER -jutting mandible forward
and side to side
motion
(laterally)
bone structures of the shoulders - ANSWER -Humerus, scapula,
clavicle
, joint structures of the shoulders - ANSWER -
sternoclavicular joint,
glenohumeral joint and
acromioclavicular joint
muscle groups of the shoulders - ANSWER -
scapulohumeral group,
Axioscapular group,
Axiohumeral group
scapulohumeral group - ANSWER -SITS muscles,
rotator cuff
Supraspinatus, infraspinatus,
subscapularis, teres
Axioscapular group - ANSWER -trapezius , levator
scapulae, rhomboids,
serratus
anterior
Axiohumeral group - ANSWER -Latissimus dorsi, pectoralis
minor, pectoralis
major
Examination of the shoulders - ANSWER -Inspect should and
girdle anterior and Inspect scapulae muscles posteriorly; Note
any swelling, deformity, fine tremors of muscles, atrophy;
Palpate for tenderness at the sternoclavicular joint; Trace
clavicle laterally with fingers