Physical Exam Paper

PHYSICAL EXAMINATION: Vital Signs. TEMPERATURE: 101.0, Blood Pressure- 127/179, Heart Rate-129, Respirations- 185, Weight-215. Situations 96% on room air. Pain Scale- 8/10. HEENT-Normal cephalic, atrumatic pupils equally round and reactive to light. Extra ocular motions intact. ORAL: Shows oral pharynx clear but slightly dry mucosal membranes. TMS: Clear. NECK: Supple, No thrangegally or JVD. No cervical, subclavicular, axilarry or lingual lymphinalpathy.

In general he is a not acutely ill appearing male. His neck veins were elevated to the angle of the jaw. He had no thyromegaly or lymphadenopathy. His lungs were clear to auscultation. His heart was regular rate and rhythm with an S3 and an S4. His PMI was laterally displaced by 1 cm. His abdomen was (full), slightly distended and had a positive fluid wave. He had no pitting edema in the abdominal exterior wall. His rectal exam was heme-negative. His extremities showed 4+ pitting edema up to his knees and in his feet

An evaluation of Mrs Smith circulation was the next step carried out by the nurse, as in the breathing assessment Mrs Smith pallor was noted as being flushed and the patient appeared confused this could be associated with poor cardiac output. The nurse recorded the patient’s blood pressure using a dinamap it was measured at 88/50, it was then rechecked manually to ensure accuracy. The pulse was checked manually for rate and rhythm it was recorded as 98 beats per minute. Capillary refill was checked, was found to be normal.

4. What should you keep in mind, regarding this patient’s age, when assessing her neck veins?

No bruits. Trachea Midline ROM Full ROM Thyroid gland non-palpable, non-tender. Chest and Lungs: Posterior and Lateral Thoracic cage configuration • Skin characteristics

Cardiovascular Assessment: No visible pulsations, no heaves or lifts. Apical pulse present in the fifth intercostal space at the left midclavicular line. Auscultation of apical rate 62 beats per minute, normal rhythm regular S1 - S2 heart sounds present. Pulsations present when supine and disappear at a 45 degree angle position. Extremities are brown color without redness, cyanosis, lesions or varicosities bilaterally. Temperature warm bilaterally, Allen test was negative. Homan’s sign negative. Carotids: +2 and present bilaterally. Right Radial +2, left radial +1 , Right Brachial: +2

The patient has been diagnosed with atrial defibrillation and congestive heart failure. There is no visible jugular vein distention or pulsations on either side of the neck. The patient was not comfortable with removing her sweater, therefore, pulsations, lifts, or heaves were not seen if present. Palpated and auscultated the carotid arteries for vascular sounds, no bruits heard. Heart sounds were auscultated with the bell and diaphragm of the stethoscope. S1 82/min, even and regular. S2 85/min, even and regular. S3 82/min, even and regular. S4 83/even and regular. No murmurs were heard. The apical pulse rate was 92 bmp, regular and was accessed with patient in sitting position and between the 4th and 5th intercostal space. Patient stated

I feel no thyroid tissue, there is no JVD. I hear no carotids. She does not mention dental issues today although two months ago this dental technician had told me of plans to have a crown placed. Lung fields are clear. There is mild dorsal kyphosis. Heart rhythm is regular. An S4 is not heard. No ectopy is noted. There are good radial pulses, dorsalis pedis and posterior tibials are palpated but may be slightly diminished. Postphlebitic changes of skin discolorations and a few small scratches are noted. There are numerous varicose veins. She is conversational, although there is some delusional thought it is not as intense as it had been at one

In this paper physical therapy will be discussed through the authors of, Efficacy of a Physical Therapy Program in Patients with Parkinson’s Disease, Quadriceps Strength and the Time Course of Functional Recovery After Total Knee Arthroplasty, The Effect of Low-intensity Pulsed Ultrasound Therapy on Time to Fracture Healing, Amphetamine Paired With Physical Therapy Accelerates Motor Recovery After Stroke, and Physical Therapy Treatment Effectiveness for Osteoarthritis of the Knee. The authors and doctors that came up with these clinical studies help show that physical therapy is an effective way to help patients recovery from injury. Each section discusses how this is true. Physical therapy benefits professional athletes, the average person,

In this case study, the main focus of our interest is to evaluate the non traditional incentive system. But before going into the detail of Non-traditional incentive system, let us summarize the case study first.

On examination, Mrs. K. is pale and clammy sitting upright in a chair. She has bibasilar crackles to her scapulae, and her heart rhythm is irregularly irregular. She has pitting edema bilaterally to her thighs, jugular venous pulsation to the earlobe, and bilateral infiltrates. An ECG shows a left ventricular ejection fraction of 78% with

A physical therapist is health care profession who help patients with potential physical and mobility limitations. They help them regain their health well-being through therapy that involves mechanical force and movements as portrayed in the interview. An advantage of performing this interview was that from it I learn a lot about the physical therapy profession.

Kussmaul’s sign can be observed due to increased venous pressure. Heart sounds are usually normal, however a third heart sound referred to as S3 may be heard due to rapid ventricular filling. Regurgitation murmurs may also be heard. EKG abnormalities vary depending on the progression of the disease, but are abnormal in more than 90% of cases (Reardon 2017). Abnormalities include a low voltage QRS most often due to an infiltrative disease, atrial arrhythmias and abnormal ST-T waves. Chest radiography shows a normal cardiac profile with cardiomegaly and bi-atrial enlargement. Pleural effusions may be present as

Physical Therapy is a medical specialty that restores the functions of the human body in such a way that the patient’s quality of life and health perception reaches its greatest exponent. Physical Therapy promotes the mobility of the human body through physical intervention ensuring the patient’s adequate healthiness. Physical Therapy is a science that helps healing, recovering and adapting patients with physical dysfunctions.

A: Janie is a 60 year old Female with PMH of A-Fib, COPD, Hypothyroidism, HTN, Lung Cancer and recently diagnosed Pulmonary Embolism. Janie presents to ER for evaluation on SOB, cough with greenish sputum, sore thoart, hoarseness and generalized weakness. Janie lives at home with her husband, use to smoke ½ pack per week, but quit many years ago, denies alcohol or drugs. Family history is non-contributory. Allergies: NKDA. Differential diagnosis includes worsening Lung Ca, PE, COPD and CHF. Janie uses home O2 at 4 L/NC. V/S: T=98.7, HR=89, R=16, B/P=132/56, O2 sats=100% on 4L/NC, Pain=6/10. Labs: WBC=7.6, H&H=8.5/27, Na=141, Troponin=0.08/0.06, BNP=495, INR=4.2, UA=3+ protein, 1+ blood and 6-10 RBC. CXR: Impression:1). COPD with nonspecific coarsening of the basilar interstitium. 2). Mild cardiomegaly with borderline cardiac compensation. 3). Right