Mastering Physical Assessment Skills: Identify Cardiac, Respiratory and Neurological Disorders – Diane S Wrigley

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• Strategies to detect and identify abnormal heart and lung sounds
• Case Studies and audio playback to enhance learning
• Crackles, wheezes, rubs, gallops, clicks and snaps
• Full discussion and how this leads to proper differential diagnoses
• Characteristics and causes of heart murmurs
• Complete 6-part neuro exam made simple – exam will be demonstrated
• Discussion and work-up for mental status changes

Attend this seminar and learn to identify the different variants in the cardiac, respiratory and neurological assessments. National speaker and expert, Diane Wrigley, BS, PA-C, has developed a CD that accurately plays both abnormal and normal heart and lung sounds. Diane will teach you the origin and significance of these sounds utilizing the auditory portion of the CD. Differential diagnoses are considered and a systematic six-part neurological assessment is reviewed and demonstrated for you.

Case studies will be presented for discussion to help reinforce the physical assessment skills and listening techniques. Diane will also illustrate the proper methods to document your assessments and findings. You will feel confident leaving this seminar with information you can utilize for your future patient assessments.

Past attendees applaud Diane Wrigley and this seminar:

“The incorporation of real-life heart and lung sounds make this presentation come alive.”

“I would love to attend another seminar by this presenter! I liked the clinical assessment situations and the step by step helpful hints provided!”

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OUTLINE

Respiratory Exam

Abnormal Lung Sounds

• • Pneumonia
  • Atelectasis
  • URI
  • Bronchial Breathing
  • Bronchophony
  • Egophony
  • Whispered Petroliloquy
  • Death Rattle
  • Absent Breath Sounds
  • Pneumothorax
  • Hemothorax
• Crackles
• Rhonchi
• Stridor
• Wheezes
  • Asthma
  • COPD
  • Emphysema
• Pleural Friction Rub

Strategies for Detection

• Chronic Bronchitis
• Pneumonia
• Emphysema
• Acute Asthma
• Croup

NEUROLOGICAL EXAM

Mental Status

• Mnemonic to Cover All Bases
  • Stroke
  • Overdose
  • Infection
  • Toxic states
  • Mental illness

Cranial Nerves

• Techniques to Cover I-XII Quickly and Completely
• Motor
• Evaluate Strength and Symmetry

Sensory

• Quick Field/Bedside Assessment

Coordination

• Simple Test to Assess

Reflexes

• Systematic Approach/Technique

Head Injury Evaluation

• Glasgow Coma Scale

Abnormalities of Consciousness

Clinical Clues

• Delirium
• Stupor
• Coma

Altered Mental Status

• Confusion Assessment Method (CAM)

CARDIAC EXAM

Auscultation Sites, Sequencing and Skills

• S2 split
• S3
• S4
• Gallop
• Opening Snap
  • Mitral and Tricuspid Valves
• Clicks
  • Mitral Valve Prolapse
• Systolic Ejection Sounds
  • Hyperdynamic State

Murmurs

• Intensity (Grade I – VI)
• Location
• Radiation
• Pitch
• Quality
• Timing
• Pattern or Configuration
• Functional vs. Pathologic Murmur

Strategies for Detection of Abnormal Cardiac Sounds

• Innocent Systolic Ejection Murmur
• Mitral Valve Prolapse
• Aortic Stenosis
• Systolic Regurgitation
• Mitral Regurgitation
• Tricuspid Regurgitation

Diastolic Murmurs

• Aortic Regurgitation
• Aortic Stenosis
• Mitral Stenosis
• Patient Ductus Arteriosis

Prosthetic Heart Sounds

• Pericardial Rubs
• Mediastinal Crunch

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OBJECTIVES

• Identify where and why vesicular, bronchovesicular and bronchial sounds can be normal or abnormal and the significance of the abnormalities.
• Interpret pathophysiology and differential diagnoses for crackles, wheezes, rhonchi and rubs.
• Discuss management of obstructive vs. restrictive lung disease.
• Explain and demonstrate a thorough 6-part neurological exam and document findings.
• List primary causes of mental status changes and identify which patients are at risk for delirium and how to respond.
• Distinguish whether abnormal S1 and S2 heart sounds are pathological or benign.
• Define whether systolic and diastolic murmurs are benign or indicate cardiac disease.

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