VITUITY SCRIBE - THE PHYSICAL EXAM
QUESTIONS AND ANSWERS
Costovertebral angle tenderness (CVAT) - Answer-Angle in back where kidneys are
(HCP taps); left, right and bilateral - if pain then possible kidney pathology
Paraspinal muscle tenderness - Answer-Tenderness in muscles adjacent to spine
Midline tenderness - Answer-Tenderness directly over spine
No step-offs - Answer-No misalignment of thoracic/lumbar spinar
Straight leg raise - Answer-If pain, indicative of a herniated disk
Saddle anesthesia - Answer-Loss of sensation around buttocks area
Abdominal distension - Answer-Bloating
Gravid - Answer-Pregnant
Ascites - Answer-Accumulation of fluid in the peritoneal cavity
Tympanitic - Answer-Sound generated by examiner tapping his/her finger in contact
with the belly distended due to extra gas/air in the large or small bowel
Organomegaly - Answer-Enlarged organ
Hepatomegaly - Answer-Enlarged liver
Splenomegaly - Answer-Enlarged spleen
Murphy's Sign - Answer-Pain in right upper quadrant (RUQ) that may indicated
gallbladder infection
Rovsing's Sign - Answer-Palpation of the left lower quadrant (LLQ) causes right lower
quadrant pain that may indicate appendicitis
Psoas Sign - Answer-Pain produced with bending of the patient's knees to chest that
may indicate appendicitis
Heel Tap Test - Answer-Tap the heel to see if it causes pain, also done by having the
patient jump up to see if pain is felt in the abdomen - may indicate appendicitis
, McBurney's Point Tenderness - Answer-Tenderness to palpation in the mid-point of the
right lower quadrant (RLQ) which can indicate appendicitis
Umbilical hernia - Answer-Outward protrusion of intra-abdominal tissue and/or bowel
through the belly button
Grey Turner's Sign - Answer-Bruising in flank area (lower back area)
Cullen's Sign - Answer-Bruising in skin around the umbilicus
Inguinal hernia - Answer-Protrusion in the groin
Cremasteric Reflex - Answer-Upward pull of testicles and scrotum due to touch
Paraphymosis - Answer-Inability to pull back the foreskin over the glans penis to its
normal position
Guiac (Hemoccult) positive/negative - Answer-Blood present/absent in stool
Rectal tone - Answer-Tone of rectal muscles during digital exam
Melena - Answer-Black, tarry like stoke containing blood
Cervical motion tenderness (CVT) - Answer-Pain with movement of cervix
Adnexal tenderness - Answer-Tenderness in location of the ovaries and fallopian tubes
Os open/closed - Answer-Cervical os (opening to cervix) is open/closed
Vaginal vault - Answer-Vaginal canal
POC - Answer-Product of conception (fetus, placenta, etc.)
Clubbing - Answer-Deformity of finger/fingernail due to chronic cyanosis
Snuff box tenderness - Answer-Pain in certain area of the wrist indicating a possible
scaphoid bone fracture
Median/Ulnar/Radial Sensory function - Answer-All these nerves run in the forearm -
tested in the hand exam
Purpura - Answer-Purple spots or blotches (don't turn white when pressed)
Induration - Answer-A hardened area of normally soft tissue
Fluctuance - Answer-Movable and compressible
QUESTIONS AND ANSWERS
Costovertebral angle tenderness (CVAT) - Answer-Angle in back where kidneys are
(HCP taps); left, right and bilateral - if pain then possible kidney pathology
Paraspinal muscle tenderness - Answer-Tenderness in muscles adjacent to spine
Midline tenderness - Answer-Tenderness directly over spine
No step-offs - Answer-No misalignment of thoracic/lumbar spinar
Straight leg raise - Answer-If pain, indicative of a herniated disk
Saddle anesthesia - Answer-Loss of sensation around buttocks area
Abdominal distension - Answer-Bloating
Gravid - Answer-Pregnant
Ascites - Answer-Accumulation of fluid in the peritoneal cavity
Tympanitic - Answer-Sound generated by examiner tapping his/her finger in contact
with the belly distended due to extra gas/air in the large or small bowel
Organomegaly - Answer-Enlarged organ
Hepatomegaly - Answer-Enlarged liver
Splenomegaly - Answer-Enlarged spleen
Murphy's Sign - Answer-Pain in right upper quadrant (RUQ) that may indicated
gallbladder infection
Rovsing's Sign - Answer-Palpation of the left lower quadrant (LLQ) causes right lower
quadrant pain that may indicate appendicitis
Psoas Sign - Answer-Pain produced with bending of the patient's knees to chest that
may indicate appendicitis
Heel Tap Test - Answer-Tap the heel to see if it causes pain, also done by having the
patient jump up to see if pain is felt in the abdomen - may indicate appendicitis
, McBurney's Point Tenderness - Answer-Tenderness to palpation in the mid-point of the
right lower quadrant (RLQ) which can indicate appendicitis
Umbilical hernia - Answer-Outward protrusion of intra-abdominal tissue and/or bowel
through the belly button
Grey Turner's Sign - Answer-Bruising in flank area (lower back area)
Cullen's Sign - Answer-Bruising in skin around the umbilicus
Inguinal hernia - Answer-Protrusion in the groin
Cremasteric Reflex - Answer-Upward pull of testicles and scrotum due to touch
Paraphymosis - Answer-Inability to pull back the foreskin over the glans penis to its
normal position
Guiac (Hemoccult) positive/negative - Answer-Blood present/absent in stool
Rectal tone - Answer-Tone of rectal muscles during digital exam
Melena - Answer-Black, tarry like stoke containing blood
Cervical motion tenderness (CVT) - Answer-Pain with movement of cervix
Adnexal tenderness - Answer-Tenderness in location of the ovaries and fallopian tubes
Os open/closed - Answer-Cervical os (opening to cervix) is open/closed
Vaginal vault - Answer-Vaginal canal
POC - Answer-Product of conception (fetus, placenta, etc.)
Clubbing - Answer-Deformity of finger/fingernail due to chronic cyanosis
Snuff box tenderness - Answer-Pain in certain area of the wrist indicating a possible
scaphoid bone fracture
Median/Ulnar/Radial Sensory function - Answer-All these nerves run in the forearm -
tested in the hand exam
Purpura - Answer-Purple spots or blotches (don't turn white when pressed)
Induration - Answer-A hardened area of normally soft tissue
Fluctuance - Answer-Movable and compressible
