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HIPPIRONEL---physical assessment
Physical assessment involves examining a patient's history, appearance, vital signs, range of motion, and systems through inspection, palpation, percussion, and auscultation. It includes assessing skin, joints, nerves, heart, lungs, abdomen, and neurological functions to evaluate symptoms, diagnose conditions, and monitor health. A thorough physical can provide essential information about a patient's overall health and identify areas requiring further testing.
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HIPPIRONEL---physical assessment
- 1. Physical assessment HIPPIRONEL canbe used to find most diagnosis. history--OPQRST inspection---scars, redness,symetry,gait palpation--nodule, pain, spasm percussion--heart/abdomen instrumentation--stethoscope,tuning fork range of motion---spine and extremities orthopedic test--many tests neurologic test---dermatomes, reflex,motor related test---xray, MRI,ect lab tests----CBC,ect
- 2. History--OPQRST • Onset--when? • Palliative--makesit better? • Provacative--irritates? • Quality--stab,burn,numb? • Radiation/Referral--shoot down arm/leg? • Severity---0-10 or mild/moderate/severe • Timing--after dinner, 2am?
- 3. History • Past history---happenedbefore? • Family history--stroke,MI, cancer • medications/vitamins • other clinics? • Medical history--surgeries • Social history---alcohol,drugs,STD • Occupational history--hard job,work comp
- 4. Vital signs • BP •pulse • resp • temp • height/weight • pain rating
- 5. ROM--range of motion •neck--flexion,extension, lateral flexion, rotation • lumbar--flexion,extension, lateral flexion, rotation • elbow--flexion,extension • forearm--supination,pronation • wrist--flexion, extension, radial deviation ulnar deviation • fingers--flexion, extension • shoulder--flexion,extension, abduction, adduction, internal rotation, external rotation, circumduction
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- 7. ROM--range of motion •knee--flexion, extension • hip-flexion,extension,int rotation, ext rotation, abduction, adduction • ankle--inversion,eversion, • plantar flexion,dorsiflexion • toes-flexion,extension
- 8. eye exam • http://www.youtube.com/watch?v= •ear exam • http://www.youtube.com/watc h?v=iIbaq15t1L0
- 9. Musculoskeletal • motor stength--0to 5 • 5--Full ROM with gravity & full resistance • 4--Full ROM with gravity & some resistance • 3--Full ROM with gravity & No resistance • 2-Full ROM with gravity eliminated • 1--slight contractility; no joint motion • 0--No evidence of contractility
- 10. Neurology • oriented?---time, place,name • cranial nerves--I to XII these can be seen on the bottom of brain • ‘On old Olympus towering top, a Fin and German viewed some hops’
- 11. Cranial nerves I Olfactory- olfaction (smell) s IIOptic - vision (Contain 38% of all the axons connecting to the brain.) s III Oculomotor - eyelid and eyeball muscles m IV Trochlear - eyeball muscles m V Trigeminal - facial and mouth sensation , chewing b VI Abducens - eyeball movement m VII Facial - taste, facial muscles and salivary glands b VIII Auditory - hearing and balance s IX Glossopharyngeal - taste, swallowing b X Vagus - long nerve goes to heart, GI, lungs b XI Accessory - moving head and shoulder m XII Hypoglossal - tongue muscles m Some cranial nerves give sensation, some give muscle control, some do both.
- 12. test your nerves IOlfactory - olfaction (smell) s IIOptic - vision (Contain 38% of all the axons connecting to the brain.) s III Oculomotor - eyelid and eyeball muscles m IV Trochlear - eyeball muscles m V Trigeminal - facial and mouth sensation , chewing b VI Abducens - eyeball movement m VII Facial - taste, facial muscles and salivary glands b VIII Auditory - hearing and balance s IX Glossopharyngeal - taste, swallowing b X Vagus - long nerve goes to heart, GI, lungs---gag b XI Accessory - moving head and shoulder m XII Hypoglossal - tongue muscles m
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- 16. Abdomen • RUQ LUQRLQ LLQ--any bruises, bulges, discoloration • sounds of borborygmus-normal 3-30? sound/minute • no sounds after 5 minutes----severe GI problem • McBurneys point---for appendix. between navel and ASIS • Murphy sign--------press under liver then release. severe pain=cholecystitis • murphys punch-----fist tap over kidneys
- 17. Orthopedic tests stressing abody part to determine cause of pain • neck • lumbar • elbow • knee • ankle • hip • shoulder
- 18. dermatome, motor, reflex •http://www.youtube.com/watch? v=esEWwFq940g
- 19. check your own borborygmus •normal, hyperactive, hypoactive
- 20. Cardiac • percussion tofind heart size • systole (S1 sound)--ventricles contract and aortic/pulmunary valves open.mitral/tricuspid close.= lub • diastole (S2 sound)--ventricles relax, mitral/tricuspid open to let in blood, aortic/pulmunary valves close.= dub
- 21. Cardiac • pulses--- • 0absent • 1 weak/thready • 2 palpable • 3 strong • 4 bounding
- 22. Pulses • radial • brachial •popliteal • dorsalis pedis • carotid • femoral • http://www.youtube.com/watch? v=74v4mEWhOao
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- 24. Lungs 14-20 bpm labored breathing? scalenemuscles used? finger,lips color, coughing, sputum chest shape--barrel, excavatus palpation--hands on back,symetric movement with breathing ‘99’ hand on back---fremitis vibration auscultation---crackles, rales, wheezes