COMPLETE SOLUTION GUIDE FOR THE FINALS NEW
SOLUTION 2021-2022
Order of Assessment - CORRECT ANSWER Inspection, Palpation, Percussion and
Auscultation. EXCEPT with abdomen
Comprehensive Health History - CORRECT ANSWER chief complaint, reason for visit, ROS,
past medical and surgical history, social history and family history
Pediatric Body measurements - CORRECT ANSWER length, height, weight, head
circumference fro birth to 36 months
Normal/Hypertension cut off - CORRECT ANSWER <130 normal 140+ hypertension
Fontanel Closure - CORRECT ANSWER posterior 1-2 months, anterior 9mo-2years
otoscope - CORRECT ANSWER adult-up and back, peds- down and back, using largest
speculum that will fit comforably
tympanic membrane - CORRECT ANSWER Cone of light R-5 l-7
EOM testing - CORRECT ANSWER CN III, IV, VI
AP diameter of chest - CORRECT ANSWER 1:2 (AP less than transverse)
barrel chest - CORRECT ANSWER COPD
Flat or Dull percussion - CORRECT ANSWER effusion or pneumonia
normal resonant percussion - CORRECT ANSWER healthy lung
,Hyperressonance (percussion) - CORRECT ANSWER trapped air
crackles/rales - CORRECT ANSWER high pitched, discontinuous
Wheezes - CORRECT ANSWER high-pitched whistling or squeaking sounds during inspiration
or expiration
Rhonchi - CORRECT ANSWER snoring, rumbling sounds heard upon auscultation of the chest
during respiration-low pitched
tactile fremitus - CORRECT 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 - CORRECT ANSWER the spoken voice sound heard through the stethoscope,
which sounds soft, muffled, and indistinct over normal lung tissue, clearer over disease
Egophony - CORRECT ANSWER abnormal change in tone of voice that is heard when
auscultating the lungs EE-->AA
UE Arteries - CORRECT ANSWER radial-thumb side, ulnar pinky side
Pulse grading - CORRECT ANSWER 0 absent
1+ weak
2+ normal
3+ increased
4+ bounding
palpate bilaterally
, PMI - CORRECT ANSWER point of maximal impulse mid-clavicular and 5th ICS
S1 - CORRECT ANSWER normal, closure of AV, Start of systole, loudest at Apex, contraction
of ventricles
S2 - CORRECT ANSWER normal, closure of semilunar, end of systole, loudest at base, filling
of ventricles
S3 - CORRECT ANSWER third heart sound (normal in pregnant young adults, and children),
gallop
S4 - CORRECT ANSWER extra heart sound, end of diastole, indicative of disease-AFIB
murmur grading scale - CORRECT 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 - CORRECT ANSWER bulbous enlargement of distal phalanges of fingers and toes
that occurs with chronic cyanotic heart and lung conditions
edema scale - CORRECT 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 - CORRECT ANSWER normal=tympanic, dullness could be
enlargement not normally felt on exam
Blumberg Sign: Rebound Test - CORRECT ANSWER peritoneal inflammation, hurts more when
release from palpation