Physical Assessment: Checking for Fluid Wave

This test is done to determine ascites or an excess of fluid in the peritoneal cavity, the cavity that encloses most of the abdominal organs. It is performed by having the patient push their hands down on the midline of the abdomen. The examiner then taps one flank, while feeling on the other flank for the tap. Fluid allows the tap to be felt on the other side.

Physical Assessment: Checking for Rovsing's Sign

A Rovsing's sign is elicited by palpation on the abdomen far from the appendix in the left lower quadrant (LLQ) as in most people the appendix is in the right lower quadrant. While this maneuver stretches the entire peritoneal lining, it only causes pain in any location where the peritoneum is irritating the muscle. In the case of appendicitis, the pain is felt in the right lower quadrant despite pressure being placed elsewhere. If left lower quadrant pressure by the examiner leads only to left-sided pain or pain on both the left and right sides, then there may be some other pathologic etiology. This may include causes relating to the bladder, uterus, descending (left) colon, fallopian tubes, ovaries, or other structures. The maneuver is said to named after a Danish surgeon, Niel Thorkild Rovsing Kimpel.

Physical Assessment: Obturator Lift

Another assessment of acute appendicitis.

Physical Assessment: Checking for Rebound Tenderness

Rebound tenderness indicates peritoneal irritation. It refers to pain upon removal of pressure rather than application of pressure to the abdomen. (The latter is referred to simply as abdominal tenderness.) It is a classical sign of peritonitis. Additional tests should be done before coming up with a specific diagnosis.

Physical Assessment: Checking for Psoas Sign

It is an indicator of irritation to the ilio-psoas group of hip flexors in the abdomen. An inflamed appendix lies on the psoas muscle and the patient will lie with the right hip flexed for pain relief. A number of clinical and laboratory based scoring systems have been devised to assist diagnosis of appendicitis. The most widely used is the Alvarado Score.

Physical Assessment: Checking for Murphy's Sign

It is useful in determining cholecystitis but will elicit a negative result in ascending cholangitis and choledocholithiasis. Ultrasound imaging will help in the diagnosis. The most common reason for a Murphy's sign is an inflamed gallbladder, usually due to a stone blocking the duct leading out of the gallbladder. Patients often complain of right-sided abdominal pain and may have vomiting and fever.

Physical Assessment: Weber's Test

A test that detects unilateral (one-sided) conductive and sensorineural hearing loss. A tuning fork (either 256 or 512 Hz) is struck and the stem of the tuning fork is placed at the vertex of the client's head making sure not to touch the tines. The placement should have an equal distance between the fork and the ears. The test does not measure normal hearing since it is not directed to sound sensitivity in a quantitative manner. An affected ear will hear the loudest sound compared to the other. Additional test should be done before confirming a defect.

Physical Assessment: Rinné Test

Rinné Test is a hearing test that evaluates the client's capacity to hear through air conduction and bone conduction by placing a vibrating tuning fork (512 or 256 Hz) initially on the mastoid process until sound is no longer heard, the fork is then immediately placed just outside the ear. The client should be able to hear in both tuning fork positions. In a normal ear, air conduction is better than bone conduction. Conductive hearing loss, bone conduction is greater than air conduction while sensorineural hearing loss both air and bone conduction are depreciated.

Physical Assessment: Tinel's Test

In relation to carpal tunnel syndrome earlier in my posting, Tinel's is performed by lightly tapping (percussing for those who don't know what "tapping" means) the area over the nerve to elicit a sensation of tingling or "pins and needles" in the nerve distribution.If the patient experienced these symptoms, he/she has elicited a positive (+) Tinel's Sign.

Physical Assessment: Phalen's Test

Phalen's Test* is a diagnostic test for carpal tunnel syndrome. The patient is asked to hold their wrist in complete and forced flexion (pushing the dorsal surface against the other) for 30 seconds. With the moderate pressure from it, it pinches the median nerve within the carpal tunnel. A positive Phalen's Test is characterized with symptoms of burning, tingling or numb sensation over the thumb, index, middle and ring fingers. Diagnostic accuracy will range from 51%-91%.

*American orthopedist George S. Phalen discovered carpal tunnel syndrome

Physical Assessment: Allen's Test

Allen's Test is to check for the patency of the radial and ulnar artery. The hand is normally supplied by blood from the ulnar and radial arteries. The arteries undergo anastomosis in the hand. Thus, if the blood supply from one of the arteries is cut off, the other artery can supply adequate blood to the hand. A minority of people lack this dual blood supply. The significance of the test is questioned by medical scientist and recommends a modification of the test since fluorescein dye injections or photoplethysmography are a much reliable test. This test is an preoperative assessment of hand circulation and a routine to test for systemic sclerosis and severe Raynaud's Phenomenon.

Physical Assessment: Visual Fields

I got this clipping from one of my clinical instructors back in college. I just don't have the idea who made this video. So if you think there were rights violated with this posting please leave a message in the message box or post a comment so I can delete it from my blog. I hope this will help a lot. :D