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Physical Exam Maneuvers SPA 1

IMPORTANT EVALUATOR NOTES:

Students are expected to perform all PE maneuvers listed on this form .
Credit for each PE maneuver should only be given if it was performed correctly.
Students can perform these PE maneuvers in any order, unless otherwise noted for a particular maneuver.
Students should not be penalized for performing maneuvers not listed on this list.
Preparation/Prior to Patient Exam

Done

Not
done

Incorrectly
done

Not
done

Washes hands

Vital Signs
(NOTE: vital signs are given to students on patients chart; only BP needs to be repeated)
Checks patients blood pressure

HEENT
Inspects conjunctiva of each eye
Inspects oral cavity (w/light source)
Inspects auditory canals and tympanic membranes, bilaterally (w/otoscope)
Inspects nasal cavities, bilaterally (w/otoscope)
Palpates the frontal and maxillary sinuses, bilaterall y

Neck
Palpates lymph nodes in the occipital, posterior chain, anterior chain, pre- and post-auricular, submandibular,
submental, and supraclavicular areas, bilaterally
Palpates thyroid
Chest/Lungs
Adjusts patients gown and drape appropriately, respecting patients modesty
Anterior chest wall
Auscultates lungs
Lateral chest wall
(must listen on skinno credit if done
over clothes)
Posterior chest wall
Palpates infraclavicular lymph nodes, bilaterally
Palpates axillary lymph nodes, bilaterally
Cardiovascular
Adjusts patients gown and drape appropriately, respecting patients modesty
Measures jugular venous pressure (patient at 30-45 degrees)
Auscultates carotid pulse bilaterally (with bell of stethoscope)
Palpates carotid pulse bilaterally (only one side at a time)
Auscultates heart valves,
Aortic area
using bell and diaphragm
Pulmonic area
modes of stethoscope
Tricuspid area
(patient supine; must listen on skin
Mitral (apical) area
no credit if done over clothes)
Palpates point of maximum impulse
Radial pulse
Palpates pulse strength
Dorsalis pedis and posterior tibial pulses (bilaterally)
Inspects for lower extremity edema
Abdomen
Adjusts patients gown and drape appropriately, respecting patients modesty; warms hands
Auscultates for bowel sounds (must be done before palpation or percussion, and must listen on skin)
Inspects abdomen for scars, asymmetry, masses, protuberances, general contour
Palpates superficially, then deeply: RUQ, RLQ, epigastrum, LUQ, LLQ, suprapubic area
Percusses liver, measures span
Palpates liver edge
Palpates spleen
Palpates abdominal aorta

Correctly
done

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Musculoskeletal (screening exam)

Visual inspection
& ROM

Visual inspection

Strength testing

Neck flexion, extension, right and left rotation, lateral flexion

Finger flexion & extension
Wrist flexion & extension
Elbow flexion & extension
Shoulder flexion, internal and external rotation
Hip flexion, extension, internal & external rotation
Knee flexion, extension
Ankle dorsiflexion and plantar flexion
Lumbar flexion, extension, lateral flexion
Inspect dorsal and palmar surfaces of hands
Inspect foot, toes, & plantar surfaces of feet
Interosseous muscles
Grip
Wrist flexors and extensors
Biceps
Triceps
Deltoids
Hip flexors, adductors, and abductors
Knee flexors and extensors
Foot dorsiflexion, plantar flexion, inversion, and eversion

Neuro
Orientation to person, place, time, and situation
Name objects
Language
Repetition: no ifs, ands, or buts
Memory (remember 3 objects, 5-10 minutes apart)
Attention (one of the following or similar task: serial 7s, spell world backwards, or months of year backwards)
Visual fields
Visual acuity
CN II
Pupillary response to light (direct and consensual)
Fundoscopic exam
CN III, IV, VI Extraocular movements
Raise eyebrows
CN III
Facial sensation (3 divisions, bilaterally)
Cranial Nerves
CN V
Mastication muscles (jaw opening, teeth clenching)
Facial expression (smile/puff out cheeks/close eyes tightly)
CN VII
Hearing (gross assessment onlyRinne/Weber not required)
CN XIII
Palatal elevation (ahhhh)
CN IX, X
Shoulder shrug; sternocleidomastoid
CN XI
Tongue movement
CN XII
Coordination (one of the following: rapid alternating movements, finger-to-nose, or heel-to-shin)
Upper extremity reflexes: biceps, brachioradialis, triceps
Lower extremity reflexes: patellar, achilles
Reflexes
Babinski reflex
Light touch*
Sensation
Pin prick*
(*brief assessment
Temperature*
of face, upper and
Vibration (assess at least one joint in each foot)
lower extremities)
Proprioception (finger or toe, up vs. down)
Routine gait
Toe and heel gaits
Gait and station
Tandem gait
Rhomberg