1. What are the four main components of a comprehensive physical examination? Explain the purpose and

procedure of each component.

- The four main components are: health history, inspection, palpation, and auscultation. Health history is

the collection of subjective data from the patient, such as their medical history, family history,

medications, allergies, and chief complaint. Inspection is the visual examination of the patient's body, such

as their skin, hair, nails, eyes, ears, nose, mouth, neck, chest, abdomen, extremities, and genitals.

Palpation is the use of touch to assess the patient's skin temperature, texture, moisture, turgor, lesions,

masses, tenderness, and organ size and location. Auscultation is the use of a stethoscope to listen to the

patient's heart, lungs, and bowel sounds.

2. What are some common abnormal findings in the head and neck examination? How would you

document and report them?

- Some common abnormal findings are: enlarged or tender lymph nodes, thyroid nodules or goiter, carotid

bruits or thrills, jugular venous distension or pressure, cranial nerve deficits, facial asymmetry or drooping,

scalp lesions or lumps, ear discharge or pain, hearing loss or tinnitus, nasal obstruction or discharge, sinus

tenderness or inflammation, oral lesions or ulcers, dental caries or abscesses, tongue deviation or tremor,

pharyngeal erythema or exudate, tonsillar enlargement or inflammation. To document and report them,

you should use clear and concise language that describes the location, size, shape, color, consistency,

mobility, tenderness, and any associated symptoms of the abnormal finding. You should also compare the

findings with the normal side or baseline and indicate the severity or grade of the abnormality.

3. How do you perform a cardiac examination? What are some normal and abnormal heart sounds that

you may hear?

- To perform a cardiac examination, you should first inspect the patient's chest for any visible pulsations or

heaves. Then you should palpate the patient's chest for any thrills or lifts. Next you should locate and

palpate the apical impulse or point of maximal impulse (PMI) at the fifth intercostal space in the

midclavicular line. Finally you should auscultate the patient's heart at four main areas: aortic area (second

intercostal space at the right sternal border), pulmonic area (second intercostal space at the left sternal

border), tricuspid area (fourth intercostal space at the left lower sternal border), and mitral area (fifth

intercostal space at the midclavicular line). You should listen for the normal heart sounds S1 and S2 and

identify their timing and intensity. You should also listen for any abnormal heart sounds such as S3 (a low-

pitched sound heard after S2 in early diastole), S4 (a low-pitched sound heard before S1 in late diastole),

murmurs (prolonged sounds caused by turbulent blood flow through valves or vessels), clicks (high-pitched

sounds caused by valve prolapse), rubs (grating sounds caused by pericardial inflammation), or gallops (a

rhythm with three or four sounds).

4. How do you assess a patient’s respiratory system? What are some normal and abnormal breath sounds

that you may hear?