General Survey & Introduction
What is the first thing a student should do to ensure patient safety and comfort during the exam?
Perform hand hygiene and ensure patient privacy.
Which cranial nerve is responsible for visual acuity and pupillary reflex?
Cranial Nerve II (Optic).
Which heart sound is louder at the base of the heart?
S2
What quadrant should auscultation begin in during the abdominal exam?
Right lower quadrant (RLQ)
What does the examiner assess when inspecting the spine?
Posture, alignment of shoulders and hips, and curvature.
Name three elements of the general appearance the examiner should comment on during inspection.
Posture, grooming, and eye contact
How is the corneal reflex test performed?
By gently touching the cornea with a wisp of cotton and observing for a blink.
Name the five auscultatory areas of the heart.
Aortic, pulmonic, Erb's point, tricuspid, and mitral.
What does tympany heard during percussion of the abdomen indicate?
Presence of air in the intestines or stomach.
What is the normal range of motion for shoulder abduction?
180°
When inspecting a patient’s behavior, what does ‘affect’ refer to?
he patient’s emotional state as observed by the examiner.
What does the six cardinal fields of gaze test evaluate?
Extraocular muscle function controlled by CN III, IV, and VI
What should the examiner assess when auscultating for bruits in the carotid arteries?
Presence or absence of turbulent blood flow.
When percussing the liver, what anatomical landmarks are used to determine the upper and lower borders?
Upper border: intercostal spaces along the right midclavicular line. Lower border: below the umbilicus in the right midclavicular line.
What is the anatomical location of the 'snuffbox,' and why is it significant?
The area over the scaphoid bone in the wrist; tenderness may indicate a scaphoid fracture.
Name two motor activities (normal or abnormal movements) the examiner could observe during the general inspection?
Normokinetic, bradykinetic, or hyperkinetic movements
What is the significance of nystagmus observed during the six cardinal fields of gaze?
It could indicate a neurological disorder such as vestibular dysfunction or multiple sclerosis.
What is the proper technique for auscultating the posterior lung fields?
Systematically progress side to side, from apex to base, while including the lateral fields.
What is the significance of detecting a venous hum during abdominal auscultation?
It may indicate increased collateral circulation, such as in portal hypertension.
During the Romberg test, what does significant swaying or falling suggest?
A possible deficit in proprioception or vestibular function.
During the general inspection, a patient appears unkempt, with poor hygiene, flat affect, and minimal eye contact. What conditions might these observations suggest, and what additional questions would you ask?
These observations may suggest a mental health issue such as: depression, schizophrenia, or dementia. Or could indicate an SDOH issue. Additional questions include inquiring about mood, daily hygiene habits, living situation, and any recent life stressors.
A patient presents with difficulty chewing and reports decreased sensation in parts of their face. Which cranial nerve is likely affected, what specific tests would you perform, and what findings would confirm your suspicion?
You auscultate a harsh systolic murmur at the 2nd intercostal space, right sternal border. What is the likely diagnosis, what additional maneuvers would you perform to confirm, and what findings would you expect?
A patient presents with severe right lower quadrant pain and guarding. Describe the specific tests you would perform to confirm appendicitis, and the expected findings for a positive result.
Name the 5 exams to test for balance and gait
• Pronator Drift: instructs patient to stand with arms extended, palms up (assess for 20 seconds)
• Natural Gait: instructs patient to walk across room
• Tandem Walking: instructs patient to walk heel-to-toe
• Toes & Heels: instructs patient to walk across room on toes & back on heels