SA triage, physical exam and patient management

Flashcards based on information extracted from: 

Humm K. (2022) 'Introduction to Small Animal Physical Exam, Triage and Major Body System Assessment' [Lecture], Principles of Science: Principles of Clinical Practice.

  • Created by: ZoeCouch
  • Created on: 04-10-22 13:36
What 3 things should you do immediately upon meeting client?
Introduce yourself
Greet animal
Get name and gender correct
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Describe tailored approach to physical examination
e.g. for Yearly vaccination, spay check, weight loss.
Head to tail is best.
2 of 69
pros and Cons of using system approach
Lots of moving around
Useful in emergency presentation when need to identify system in failure quickly.
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Step 1 of physical exam
patient observation (distance- look at eyes, ears, gait and mentation)
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Describe physical signs of tetanus
Locked Jaw
Eyes may point in opposite directions
Limbs may be extended/ rigid
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describe breathing of dog with pneumothorax
High resp rate
Shallow, fast breathing
May be crackling on auscultation
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Step 2 of physical examination
Patient palpation/ touch
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What 5 things to look for in palpation?
patient response
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Step 3 of Physical Exam
Patient demeanour (BAR/ QAR/ Obtunded/ Stuporous/ Comatose/ Aggressive)
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What scoring systems are included within patient observation?
Body Condition Scoring (1-9 or 1-5 scale)
Muscle Condition Scoring (1-3 scale)
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How would you examine eyes?
Push upper eyelid to bring 3rd eyelid down
Check MM
Excessive blinking?
Pain - Blepharospasm, Enophthalmos, Lacrimation and Photophobia indicate pain.
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What would you check for in ears?
Crust/ Flaking
Excess wax build-up
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What would you check when examining mucous membranes?
Capillary refill time
Hydration (dry/tacky = dehydrated)
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What is normal capillary refill time (CRT)?
1-2 seconds (NOT less than 2)
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What does the colour of the mucous membrane tell you?
pale - hypoperfusion, poor blood supply, possible anemia
yellow - icterus/ jaundice
dark red- hyperaemia, sepsis, shock
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How could you assess hydration of small animal?
Eye position (sunken if dehydrated)
Skin turgor (skin tents if high turgor)
Tackiness of mucous membranes
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Why might it be difficult to evaluate tackiness of mucous membranes?
If there is excessive salivating
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Why might older animals appear more dehydrated?
They have increased fat which increases skin turgor leading to increased skin tenting.
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Is it easier to palpate salivary or lymphatic nodes?
Lymph: you can palpate some nodes, and get your fingers around them e.g. prescapular. However, most are still difficult to palpate. If obvious, then pathology likely.
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What shape are the prescapular lymph nodes?
bi-lobed (peanut shape)
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Heart in the dog is located in which intercostal space?
3rd - 5th
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What approach should you use to auscultate lung field?
noughts and crosses: compare sides and compare dorsal sounds to ventral.
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Is the lung field quieter dorsally or ventrally?
Quieter dorsally.
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Which species is it unusual to hear lung sounds in?
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Describe approach to abdominal palpation in dog.
Start slow
Cranial to caudal movement
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What may you feel in cranial abdominal palpation of dog?
Sometimes feel caudal border of liver (not always obvious)
Can occasionally palpate spleen, stomach and kidneys if pathology.
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What may you palpate mid-abdomen on a dog?
Intestinal loops (in slimmer animals)
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What may you feel in caudal abdominal palpation of a dog?
28 of 69
Which artery is more difficult to feel in cats? Femoral or metatarsal?
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When is it appropriate to perform rectal exam?
If expecting issue or pathology
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What can you palpate on rectal exam?
Uterus (if enlarged)
Urethra (if blocked)
Sublumbar lymph nodes
Anal sacs
Foreign Material
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What may you assess in Orthopaedic exam?
Joints (pain, swelling, heat, ROM, crepitus)
Bones (pain, swelling, instability)
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What may you assess in Neurologic exam?
Cranial Nerve Assessment
Spinal Reflexes
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What may you look for in dermatologic exam?
Hair loss, pruritis, flaking
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Difference in mentation of cats vs dogs in clinic?
Cats generally quieter
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Difference in cat vs dog mucous membranes?
Cats generally paler and harder to assess
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What gland may you feel in cat that you won't in dog?
Thyroid: only if enlarged.
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How to palpate thyroid gland in cats?
Pinch thumb and fingers around larynx and move towards thoracic inlet
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What auscultation is important in cats?
Parasternal (better to hear heart)
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Difference in approach to abdominal palpation in cat vs dog?
Use one handed ventral approach in cats
May only feel bladder/ kidney in cats.
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What is triaging?
determine urgency of problem
prioritise depending on severity of injuries
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What are the ABCs?
42 of 69
Once ABCs confirmed, what is next step?
Capsule history
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If ABCs not confirmed, what is next step?
CPR immediately
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Examples of things to include in capsule history?
Primary/Chief complaint
Duration of issue
Water intake
Activity level
Vax status
Current meds (prescribed and owner administered)
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What is next step after capsule history taken?
Major Body Systems Assessment
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What are 3 Major Body Systems?
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What would you assess to evaluate cardiovascular system?
Mucous Membranes
Heart Rate
Cardiac auscultation
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Normal ranges of Heart Rate in dogs and cats in clinic?
Dogs: 80-120bpm
cats: 160-200bpm
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Heart rate varies with?
breed, size and excitement/stress.
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Which sites would you take pulse?
Femoral artery
Metatarsal artery (medial aspect below hock)
Less likely to use metatarsal as is disappears with poor circulation.
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Describe cardiovascular physical exam signs of mild hypovolaemic shock
HR 130-150
MM N(pinker)
CRT <1s
Pulse amp. increased
Pulse dur. Mild decrease
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Describe cardiovascular physical exam signs of moderate hypovolaemic shock
HR 150-170
MM pale pink
pulse amp. Mod decrease
pulse dur. mod decrease
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Describe cardiovascular physical exam signs of severe hypovolaemic shock
HR 170-220
MM White
CRT >2.5s
Pulse amp. Sev decrease
Pulse dur. sev decrease
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Describe normal respiratory exam?
Resp rate: 12-28 bpm
Little chest movement
Chest and abdomen movement are in sync
Little audible noise (breed dependent)
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step one of respiratory exam?
Observe: respiratory pattern and degree of effort
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Step 2 of respiratory exam?
Listen without stethoscope.
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Step 3 of resp. exam?
Listen with stethoscope to localise abnormal sounds.
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postural signs of respiratory distress?
extended neck
abducted elbows
open-mouth breathing
anxious facial expression
increased abdominal movement
paradoxical abdominal movement
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Sign of respiratory distress that isn't audible or postural?
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Signs of Upper airway respiratory disease?
Increased Inspiratory Effort
Loud referred airway noise on ausculatation
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Signs of lower airway respiratory disease?
Increased Expiratory effort
Wheezes on auscultation
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Signs of pulmonary respiratory disease (in alveoli)?
Some increased inspiratory effort
mixed respiratory patterns
Harsh sounds/ crackles on auscultation
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Signs of Pleural Space respiratory disease?
Shallow breathing
Dull/distant lung/ heart sounds on auscultation.
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Different Classifications of mentation?
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What iatrogenic action may change mentation from normal?
Medication/ drugs
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How does sodium affect mentation?
Rapid changes of sodium in blood leads to rapid changes of Na+ in brain:
eyes unfocused
eyelids opening/ closing abnormally
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How may you assess gait?
Paresis vs Plegia
Which limbs involved
Is abnormality lateralised?
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Major Body System Assessment overlaps?
Lungs only: resp rate, resp effort
Lungs/ Heart: Thoracic auscultation, mucous membranes.
Heart only: Pulses, CRT, HR, cardiac auscultation
Heart/ Brain: Mentation status
Brain only: Gait
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Other cards in this set

Card 2


Describe tailored approach to physical examination


e.g. for Yearly vaccination, spay check, weight loss.
Head to tail is best.

Card 3


pros and Cons of using system approach


Preview of the front of card 3

Card 4


Step 1 of physical exam


Preview of the front of card 4

Card 5


Describe physical signs of tetanus


Preview of the front of card 5
View more cards


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