STUVIA 2024/2025
Physical Diagnosis Exam 1 - Spring 2024
-<20 y/o or >50 y/o
-hx of cancer
-unexplained weight loss, fever, declined health
-pain lasting over 1 mo & not responding to tx
-pain at night or present at rest
-hx of IVDU, addiction, immunosuppression
-active infx/HIV
-long term steroids
-saddle anesthesia, bladder/bowel incont.
-neuro sx or progressive neuro deficit - ✔✔what are the red flags for low back from underlying
systemic disease?
-a localized, steady, more severe pain of the parietal peritoneum (e.g. peritonitis)
-aggravated by movement like coughing - ✔✔what are the characteristic of parietal pain?
-abdominal tenderness that is more severe than visceral pain
-muscular rigidity
-involuntary guarding
%
-rebound tenderness
-percussion tenderness
-positive cough test - ✔✔signs of peritonitis
-abduct & adduct
-internal & external rot.
-scapula rotation can pull shoulder posteriorly - ✔✔movements of the shoulder
-ALWAYS BEFORE PALPATION & PERCUSSION
-place diaphragm gently on abdomen for a max of 5 minutes
-listen in all 4 quadrants - ✔✔how do we auscultate the abdomen?
-amount & distribution of gas
-determining if masses are solid or fluid
-measuring the liver & spleen - ✔✔what does percussion assess?
-anterior aspect of the wrist under carpal ligament
-median nerve - ✔✔where is the carpal tunnel located? what nerve is associated with it?
-anterior surface of scapula
stuvia
, STUVIA 2024/2025
-lesser tubercle of humerus - ✔✔subscapularis attachments
-anterior talofibular ligament
-calcaneofibular ligament
-posterior talofibular ligament - ✔✔major ligaments on lateral side of ankle
-articular capsule & cartilage
-synovial membrane & fluid
-intraarticular ligaments
-juxtaarticular bone - ✔✔list the components in the articular structure
-articular/extraarticular
-acute/chronic
-inflam/non-inflam
-monoarticular/polyarticular - ✔✔what are the 4 key features that characterize a patient's joint
problem?
-cervical vertebrae
-vertebral artery - ✔✔which type of vertebrae have the transverse foramen? what passes thru it?
%
-colicky, cramping pain that radiates to the flank/groin
-constantly moving to find comfortable position - ✔✔what is renal stone pain like?
-condylar synovial joint
-fossa & articular tubercle of the TEMPORAL BONE & condyle of the MANDIBLE - ✔✔what type of
joint is the TMJ? what bones form it?
-constriction & relaxation of the intestine
-abnormal - indicates blockage - ✔✔what is peristalsis & is it normal on abd exam?
-distal radius
-distal ulna
-8 carpal bones - trapezium, trapezoid, capitate, hamate, pisiform, triquetrum, lunate, scaphoid -
✔✔bones of the wrist
-eating issues (appetite change, food intolerance)
-UGI issues (N/V, dysphagia - solids or liquids, heartburn, belching)
-LGI issues (bowel habit changes, hematochezia, melena, hemorrhoids, constipation, diarrhea, gas)
-pain
-jaundice - ✔✔list some ROS questions for GI issues
stuvia
, STUVIA 2024/2025
-extensor pollicis brevis & longus
-scaphoid - ✔✔which tendons make up the anatomical snuffbox? what bone lies beneath?
-external pterygoids open the jaw
-masseter, temporalis, internal pterygoid close the jaw - ✔✔what muscles are part of the TMJ?
-foods like alcohol, caffeine, chocolate, citrus, onions, peppermint
-positions like bending over, lying down, exercising, lifting - ✔✔what triggers heartburn?
-general appearance of pt (comfortable, lethargic, etc)
-skin (scars, veins, lesions, etc)
-umbilicus (contour, location, etc)
-contour of abdomen (flat, rounded, protuberant, scaphoid)
-symmetry
-bulging of flanks/local bulges
-masses or enlarged organs
-peristalsis
-pulsations - ✔✔what are you looking for on inspection of the abdomen?
%
-genitourinary
-cardiac
-psych - ✔✔what are some other body systems that can present as GI complaints?
-joint symmetry
-deformities/malalign.
-skin changes, nodules, atrophy
-inflam. signs - ✔✔what should you be assessing on inspection for the MSK exam?
-less than 3 BM per week at least 25% of the time, more defecations with straining or sensation of
incompletion, lumpy or hard stool, manual facilitation
-sx present for at least 3 months with onset at least 6 mo before - ✔✔constipation
-light = tenderness, muscular resistance, superficial masses
-deep = liver edge, kidneys, abd masses, rebound tenderness - ✔✔why do we perform both light &
deep palpation on the abdomen?
-liver edge @ right costal margin
-spleen tip may be felt below left costal margin, definitely if splenomegaly
-sigmoid colon esp if there's stool - ✔✔which organs are palpable?
stuvia
Physical Diagnosis Exam 1 - Spring 2024
-<20 y/o or >50 y/o
-hx of cancer
-unexplained weight loss, fever, declined health
-pain lasting over 1 mo & not responding to tx
-pain at night or present at rest
-hx of IVDU, addiction, immunosuppression
-active infx/HIV
-long term steroids
-saddle anesthesia, bladder/bowel incont.
-neuro sx or progressive neuro deficit - ✔✔what are the red flags for low back from underlying
systemic disease?
-a localized, steady, more severe pain of the parietal peritoneum (e.g. peritonitis)
-aggravated by movement like coughing - ✔✔what are the characteristic of parietal pain?
-abdominal tenderness that is more severe than visceral pain
-muscular rigidity
-involuntary guarding
%
-rebound tenderness
-percussion tenderness
-positive cough test - ✔✔signs of peritonitis
-abduct & adduct
-internal & external rot.
-scapula rotation can pull shoulder posteriorly - ✔✔movements of the shoulder
-ALWAYS BEFORE PALPATION & PERCUSSION
-place diaphragm gently on abdomen for a max of 5 minutes
-listen in all 4 quadrants - ✔✔how do we auscultate the abdomen?
-amount & distribution of gas
-determining if masses are solid or fluid
-measuring the liver & spleen - ✔✔what does percussion assess?
-anterior aspect of the wrist under carpal ligament
-median nerve - ✔✔where is the carpal tunnel located? what nerve is associated with it?
-anterior surface of scapula
stuvia
, STUVIA 2024/2025
-lesser tubercle of humerus - ✔✔subscapularis attachments
-anterior talofibular ligament
-calcaneofibular ligament
-posterior talofibular ligament - ✔✔major ligaments on lateral side of ankle
-articular capsule & cartilage
-synovial membrane & fluid
-intraarticular ligaments
-juxtaarticular bone - ✔✔list the components in the articular structure
-articular/extraarticular
-acute/chronic
-inflam/non-inflam
-monoarticular/polyarticular - ✔✔what are the 4 key features that characterize a patient's joint
problem?
-cervical vertebrae
-vertebral artery - ✔✔which type of vertebrae have the transverse foramen? what passes thru it?
%
-colicky, cramping pain that radiates to the flank/groin
-constantly moving to find comfortable position - ✔✔what is renal stone pain like?
-condylar synovial joint
-fossa & articular tubercle of the TEMPORAL BONE & condyle of the MANDIBLE - ✔✔what type of
joint is the TMJ? what bones form it?
-constriction & relaxation of the intestine
-abnormal - indicates blockage - ✔✔what is peristalsis & is it normal on abd exam?
-distal radius
-distal ulna
-8 carpal bones - trapezium, trapezoid, capitate, hamate, pisiform, triquetrum, lunate, scaphoid -
✔✔bones of the wrist
-eating issues (appetite change, food intolerance)
-UGI issues (N/V, dysphagia - solids or liquids, heartburn, belching)
-LGI issues (bowel habit changes, hematochezia, melena, hemorrhoids, constipation, diarrhea, gas)
-pain
-jaundice - ✔✔list some ROS questions for GI issues
stuvia
, STUVIA 2024/2025
-extensor pollicis brevis & longus
-scaphoid - ✔✔which tendons make up the anatomical snuffbox? what bone lies beneath?
-external pterygoids open the jaw
-masseter, temporalis, internal pterygoid close the jaw - ✔✔what muscles are part of the TMJ?
-foods like alcohol, caffeine, chocolate, citrus, onions, peppermint
-positions like bending over, lying down, exercising, lifting - ✔✔what triggers heartburn?
-general appearance of pt (comfortable, lethargic, etc)
-skin (scars, veins, lesions, etc)
-umbilicus (contour, location, etc)
-contour of abdomen (flat, rounded, protuberant, scaphoid)
-symmetry
-bulging of flanks/local bulges
-masses or enlarged organs
-peristalsis
-pulsations - ✔✔what are you looking for on inspection of the abdomen?
%
-genitourinary
-cardiac
-psych - ✔✔what are some other body systems that can present as GI complaints?
-joint symmetry
-deformities/malalign.
-skin changes, nodules, atrophy
-inflam. signs - ✔✔what should you be assessing on inspection for the MSK exam?
-less than 3 BM per week at least 25% of the time, more defecations with straining or sensation of
incompletion, lumpy or hard stool, manual facilitation
-sx present for at least 3 months with onset at least 6 mo before - ✔✔constipation
-light = tenderness, muscular resistance, superficial masses
-deep = liver edge, kidneys, abd masses, rebound tenderness - ✔✔why do we perform both light &
deep palpation on the abdomen?
-liver edge @ right costal margin
-spleen tip may be felt below left costal margin, definitely if splenomegaly
-sigmoid colon esp if there's stool - ✔✔which organs are palpable?
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