Health Assessment and Promotion Assessment Techniques General survey  and measurement Test and Flashcards

Physical examination

use of technical skills through senses to obtain data sight-smell-touch-hearing

Inspection

Close, scruitny of the indivdual as a whole and then each body system. It requires good lighting, adequate exposure, use of instruments and checking the symmetry of the body.

Palpation

applie a sense of touch to assess texture, temperature, moisture, organ location and size, swelling, vibration, pulsation, crepiation, rigidity, spasticity, presence of lumps or masses, and prescense of tenderness and pain. Start light and proceed to deep.

Palpation techniques

fingertips, fingers, and thumb, dorsa of hands and fingers, and base of fingers or ulnar surface of hand

Fingertips

best for fine tactile discrimination of skin texture, swelling, pulsation, determining presence of lumps

Fingers and thumbs

detection of position, shape, and consistency of an organ or mass

Dorsa of hands and fingers

best for determining temperature because skin here is thinner than on palms

Base of fingers or ulnar surface of hand

best for vibrations

Percussion

tapping a person's skin with short, sharp storkes to assess underlying structures Uses: mapping location and size of organs, signaling density, detecting superficial abnormal mass, eliciting pain if underly structure is inflame, eliciting deep tendon reflex using tool

sationary hand

pleximeter-middle finger hyperextension place distal joint and tip firmly against the person's skin only distal joint of hand should touch skin

striking hand

plexor-striking finger middle finger of dominant hand hold forearm to skin surface making muscles steady but not rigid flex finger so tip makes contact

Resonance

clear, hollow sound over normal lung tissue

hyperresonant

booming sound that is normal over a child's lung. In an adult it could mean the lung is hyperinflated such as in emphysema

tympany

musical and drum like sound over air-filled viscus (stomach, intestine)

Dull

muffled thud over dense organ such as liver or spleen

Flat

a dead stop of sound when no air is present over muscle, bone, or tumor

Auscultation

Listening to the sounds produced by the body stethescope blocks out extraneous sounds. Eliminate extra noise. Keep environment warm. Don't listen over body hairs, don't listen through gown or clothing.

Stethescope

Tool used to auscultate the body. Contains a diaphragm end and a bell end that hear different pitches.

Diaphragm

Flat edge of a stethoscope that good for hearing high pitched sounds. It needs to be pressed firmly. Mainly used to hear the lung heart, and bowel sounds

Bell

Deep, hollow cuplike shape. Used to hear low-pithced sounds. Press lightly. Used to hear extra heart sounds, murmurs and bruits.

The Exam

Room needs to be quiet warm private and comfortable Introduce self and addres patient remove distractions natural light or two sources use standard precautions

Clinical setting

Consider patient's emotional state beging with nonthreatening actions establish your own way of examining examine in a way that doesn't require patient to move around a lot teach patient

General Survey

Study of the whole person. Covers general health state and physical characteristic while giving an overall impression of the person.

Physical Apperance

age, sex, level of consciousness, skin color, facial features, overall apperance

Body structure

stature, nutrition, symmetry, posture, position

Gait

normally base is as wide as shoulder width

Foot placement

accurate walk, smooth, even, and well balanced, associated movments, such as symmetric arm swing, are present

Range of motion

full mobility of each joint with smooth deliberate, accurate, and coordinated movement

Behavior

facial expression, mood and affect, speech, dress, personal hygiene

Weights

use a standarized balance remove shoes and record in kilograms

Height

use wall mounted device align extended headpice with top of the head. Make sure person is shoeless looking straigh, and feet and shoulders on a hard surface

BMI

body mass index is a marker of optimal weight for height and an indicator of obesity or protein calorie malnutrition

Waist circumference

Body fat distribution is an indicator of health risk. If there is excess abdominal fat there is a risk of disease. Measure the circumference in inches at smallest circumference below rib cage and above iliac crest. Measure hips in inches at largest circumference of the buttocks

Waist to hip ratio

waist circumference/hip circumference

Developmental competence infants

interpret based on age and developmental ability behavior and parental bonding measurement- weight and length physical growth based on CDC growth charts head and chest circumference

Aging adults

normal consequence of aging changes posture and gait. Measure weight and height

Hypopituitary dwarfism

Deficiency in growth hormone in childhood results in retardation of growth below the 3rd percentile, delayed puberty, hypothyroidism, and adrenal insufficiency. The 9-year-old girl at left appears much younger than her chronologic age, with infantile facial features and chubbiness. The age-matched girl at right shows increased height, more mature facial features, and loss of infantile fat

achondroplasia dwarfism

A genetic disorder in converting cartilage to bone results in normal trunk size, short arms and legs, and short stature. It is characterized by a relatively large head with frontal bossing; midface hypoplasia (small); and often thoracic kyphosis, prominent lumbar lordosis, and abdominal protrusion. The mean adult height in men is about 131.5 cm (4 ft 4 in) and in women about 125 cm (4 ft 1 in).

gigantism

Excessive secretion of growth hormone by the anterior pituitary results in overgrowth of the entire body. When this occurs during childhood before closure of bone epiphyses, it causes increased height (here 2.09 m, or 6 ft 9 in), as well as increased weight and delayed sexual development.

Anorexia nervosa

This inherited connective tissue disorder is characterized by tall, thin stature (≥95th percentile), arachnodactyly (long, thin fingers), hyperextensible joints, arm span greater than height, pubis-to-sole measurement exceeding crown-to-pubis measurement, sternal deformity (note pectus excavatum), high-arched narrow palate, narrow face, and pes planus (flat feet). Early morbidity and mortality occur as a result of cardiovascular complications such as mitral regurgitation and aortic dissection.

Endogenous obesity—Cushing’s syndrome

This inherited connective tissue disorder is characterized by tall, thin stature (≥95th percentile), arachnodactyly (long, thin fingers), hyperextensible joints, arm span greater than height, pubis-to-sole measurement exceeding crown-to-pubis measurement, sternal deformity (note pectus excavatum), high-arched narrow palate, narrow face, and pes planus (flat feet). Early morbidity and mortality occur as a result of cardiovascular complications such as mitral regurgitation and aortic dissection.

Marfan syndrome

This inherited connective tissue disorder is characterized by tall, thin stature (≥95th percentile), arachnodactyly (long, thin fingers), hyperextensible joints, arm span greater than height, pubis-to-sole measurement exceeding crown-to-pubis measurement, sternal deformity (note pectus excavatum), high-arched narrow palate, narrow face, and pes planus (flat feet). Early morbidity and mortality occur as a result of cardiovascular complications such as mitral regurgitation and aortic dissection.

acromelagy

Excessive secretion of growth hormone in adulthood after normal completion of body growth causes overgrowth of bone in face, head, hands, and feet but no change in height. Internal organs also enlarge (e.g., cardiomegaly), and metabolic disorders (e.g., diabetes mellitus) may be present.

Flashcards: Health Assessment and Promotion Assessment Techniques General survey and measurement

Flashcards: Health Assessment and Promotion Assessment Techniques General survey  and measurement