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Physical Exams. Types, techniques, equipment, and positions Medical and Nursing Services Part 1 Berryhill & cashion , Fall 2016-2017. Types of Physical exams. types of physical exams. 3 major kinds of examinations are: EENT GYN General, or complete, physical.
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Physical Exams Types, techniques, equipment, and positions Medical and Nursing Services Part 1 Berryhill & cashion, Fall 2016-2017
types of physical exams 3 major kinds of examinations are: • EENT • GYN • General, or complete, physical
Main types of physical exams • EENT: Eye, ear, nose & throat exam • GYN (gynecological): exam of female reproductive organs=vagina, cervix, uterus, ovaries, & breasts. A Pap (Papanicolaou) test is usually done to detect cancer of the cervix or reproductive organs
Main types of physical exams • General, or complete, physical: all areas of the body are examined; blood, urine, radiographs, & electrocardiogram may be done. An EENT and/or GYN exam may be done during this exam.
physical exams techniques 4 main techniques used during exams: • Observation • Palpation • Percussion • Auscultation
physical exams techniques • Observation: inspection Physician looks at the pt to observe things Example: skin color, rash, swelling, deformities, etc.
physical exams techniques • Palpation: feeling Physician uses their hands to feel various parts of the body. They are feeling for enlargement, anything out of place, or painful areas https://www.youtube.com/watch?v=aSPqXd9PILo (2:15)
physical exams techniques • Percussion: tapping Physician taps & listens for sounds. They place fingers of one hand on a part of the body, then use the fingers of the other hand to tap the body part. The sound emitted tells them the size, density, & position of underlying organs https://www.youtube.com/watch?v=P4Ryk5IKf_4 (1:10)
physical exams techniques • Auscultation: listening Physician uses a stethoscope to listen to sounds coming from within the body. Can listen to heart, lungs, and intestines
Physical Exam Equipment Some of the instruments and equipment used for different exams can include: • Cervical spatula (Ayer blade) • Laryngeal mirror • Ophthalmoscope • Otoscope • Percussion (reflex hammer) • Sigmoidoscope • Speculum • Sphygmomanometer • Stethoscope • Tongue blade/depressor • Tuning fork
Physical Exam Equipment Cervical spatula (Ayer blade): wooden or plastic blade used to scrape cells from the cervix usually done as part of a Pap smear to check for cancer.
Physical Exam Equipment Laryngeal mirror: instrument with a mirror at one end to examine the larynx
Physical Exam Equipment Ophthalmoscope: lighted instrument used to examine the eyes
Physical Exam Equipment Otoscope: lighted instrument used to examine the ears
Physical Exam Equipment Percussion (reflex) hammer: used to test tendon reflexes
Physical Exam Equipment Sigmoidoscope: lighted instrument used to examine the sigmoid colon
Physical Exam Equipment Speculum: instrument used to examine internal canals of the body (nasal speculum, vaginal speculum, rectal speculum)
Physical Exam Equipment Sphygmomanometer: instrument used to measure BP
Physical Exam Equipment Stethoscope: instrument used for listening to internal body sounds
Physical Exam Equipment Tongue blade/depressor: wood or plastic stick used to depress (hold down) the tongue so the throat can be examined
Physical Exam Equipment Tuning fork: instrument with two prongs used to test hearing acuity
Physical exam Positions Supine: used for examination of the anterior side • Pt lies flat on back with legs slightly apart
Physical exam Positions Prone: used for examination of the back or spine • Pt lies on abd & turns head to either side
Physical exam Positions Lateral: used for simple rectal & sigmoidoscopic exams, enemas, rectal temps • Pt lies on left side
Physical exam Positions Fowler’s positions: used to facilitate breathing, relieve distress, encourage drainage, & examine the head, neck, & chest • Low Fowler’s: HOB elevated to 25 degrees • Semi-Fowler’s: HOB elevated to 45 degrees • High Fowler’s: HOB elevate to 90 degrees
Physical exam Positions Low Fowler’s
Physical exam Positions Semi-Fowler’s
Physical exam Positions High Fowler’s
Physical exam Positions Lithotomy: used for vaginal exams, Pap tests, urinary catherizations, cystoscopic exams, & surgery of the pelvic area • Pt lies supine with knees separated & flexed & feet in stirrups
Physical exam Positions Trendelenburg: used to increase circulation of blood to the head and brain, during shock, or for surgery on pelvic organs • Pt lies supine with the bed elevated at the feet (head is lower than the feet)