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  #1  
Old 07-12-2013
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Clock To Save Time - Advice Needed!

Hi all
anyone who has done cs
how many areas of the abdomen
should u palpate? 4 quadrants
or the 9 areas?
Also, how many areas should
you percuss and auscultate in
the lung exam? And can u do it
posteriorly only or both anteriorly
and posteriorly?
thanks alot.
Bates physical examination shows
this for lung exam:
Anteriorly tactile fremitus
in 3 areas, percussion in 6 areas
and auscultation in 6 areas
whereas from the back:
tactile fremitus in 4 areas
and percussion and auscultation
in 7 areas.
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  #2  
Old 07-12-2013
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how many areas of the abdomen
should u palpate? 4 quadrants
or the 9 areas?


4 areas to palpate (RUQ, LUQ, RLQ and LLQ), 4 areas to auscultate (2 renals and 2 iliacs) for bruits and Bowel sounds..

Also, how many areas should
you percuss and auscultate in
the lung exam? And can u do it
posteriorly only or both anteriorly
and posteriorly?


Auscultate/percuss minimum 4, but to get full credit auscultate/percuss 6, 4 in the back and 2 in the front (there's a little tip also, don't forget to ask the sp to Breath In and BREATH OUT, people forget to ask to breath out, just say: "Breath IN, breath out, IN, OUT), after you do this 4 times on the back of the patient, ask if he is ok, otherwise, he might pass out from Hyperventilation and you'll miss an easy case!! Also, always compare left and right, otherwise the sp might take some points off of you..
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Old 07-12-2013
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Remember that the new CS format wants you to be focused and complete, so it's often not necessary to do a Pulmonary exam in a MSK or Neuro case, instead perform a full msk or full neuro instead and don't waste time in things or maneuvers that are not going to be graded. Conversely, if it's a HEENT case, do a full Pulmonary and full HEENT, if it's a CV case, perform full CV and full Chest examination and maybe abdominal to assess ascites and Hepatojugular reflux..
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Old 07-12-2013
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The book Kaplan Complex Cases for CS have an initial chapter that gives you all of those hints. This is a very good book that complements First Aid very well!!
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Old 07-12-2013
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Thanks for replying very useful!
Would u be downgraded if u did
lung exam posteriorly only?
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Old 07-12-2013
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Quote:
Originally Posted by add1 View Post
Thanks for replying very useful!
Would u be downgraded if u did
lung exam posteriorly only?
I was doing only posterior, but when I did the simulated exam at ximedus the guys there told me that I needed to perform anterior chest also in order to get full credit. I don't know how much you'd be downgraded in the real deal, but other courses like C3 and Kaplan also recommend 6, so I considered 6 as my minimum! C'mon my friend, in less than 15 seconds you can do 2 more!
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Old 07-12-2013
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Quote:
Originally Posted by cearamor View Post
I was doing only posterior, but when I did the simulated exam at ximedus the guys there told me that I needed to perform anterior chest also in order to get full credit. I don't know how much you'd be downgraded in the real deal, but other courses like C3 and Kaplan also recommend 6, so I considered 6 as my minimum! C'mon my friend, in less than 15 seconds you can do 2 more!
Don't hurry doing the auscultation though, be sure to actually stay at each spot and listen to the full inspiration and expiration!!
That probably takes longer than 15 seconds in total, but you won't get credit if you don't even listen to the breath sounds.
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