Term
| What are some of the challenges with obtaining a thorough history? |
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Definition
Some owners are difficult to get info from, may not be owner or may not know the answers, some probs or dz states requires specifically tailored ?s.
Tailoring ?s to their level of understanding, asking ?s in an effective manner |
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Term
| List the 4 parts of the “Signalment” |
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Definition
Age
Breed (or dominant breed, if mixed)
Sex
Reproductive status |
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Term
| What is included in the background information of the patient? |
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Definition
General management - how long owned, where and when obtained, any previous med probs, recent travel, where and how kept, diet hx (type of food, amt, frequency, any recent changes, fed anything unusual or got into anything just before onset of illness)
Preventative medicine – if pet is not a previous pt, note vx hx (what vx given, when, and when they expire. Heartworm, flea/tick, consistency (yr-round or only warm months?), whether o has seen fleas/ticks on pt)
Behavioral information – day to day behavior and and if any changes
Household info – health status of other pets, if exposed to outside pets/animals, if any humans in the family are ill (esp important in some cases of infectious dermatologic dz or info regarding pt’s exposure to toxins, such as human meds
Allergy hx – any known allergies or adverse rxns to meds/food, even if not confirmed to be related. Prior blood products and transfusions
Reproductive hx – current repro status was noted in signalment but important to ask re prior repro hx, if s/n, what age, whether had 1st heat first. If not spayed, ask if bred, timing of most recent heat cycle |
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Term
| For returning patients or once you have obtained the background information, what information would you obtain? |
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Definition
| Past pertinent medical hx, Presenting complaint, last normal, progression, systems review, medications |
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Term
| Before you begin the hands-on part of the PE, always observe the patient from a distance and assess the animal’s: |
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Definition
o Mentation - Bright, alert, responsive / quiet, alert, responsive / depressed, nervous, unresponsive
o Movement – Lame, ataxic, running into objects, hunched up
o Body Language – Nervous, protective, fearful
o Body Condition Score |
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Term
| Two things that may be helpful in temporarily halting the purring during ascultation |
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Definition
o Gently place your finger over the nares of the cat for a few seconds
o If there is a sink in the exam room, turn on the water and move the cat near the sink.
(you must have the stethoscope in place and will probably be able to auscult the chest for just a few seconds) |
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Term
| 5 important points for a PE |
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Definition
-Before hands-on, always observe pt from a distance and assess mentation, movement, body language, BCS
- Develop a routine
-every animal has a "temperature"
-throughly document PE findings in medical record
-if use acronyms/shorthand, make sure well-known in clinic (and others) what they mean |
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Term
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Definition
| The mental activity or acuity of a pt |
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Term
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Definition
| As detected by simultaneous cardiac auscultation and pulse palpation, a condition where each audible heartbeat is not accompanied by a palpable pulse wave |
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Term
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Definition
| Elevation of body temp caused by a temporary increase in the body’s thermoregulatory set-point, usually caused by infection, inflammation, or neoplasia |
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Term
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Definition
| Elevation of body temp caused by inadequate heat-dissipating mechanisms to overcome excessive ambient heat, w/o a change in the body’s thermoregulatory set-point |
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Term
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Definition
| Abnormally low body temp. the measured body temp must be compared with what is normal for the age group because neonates have lower body temps than adults |
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Term
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Definition
| A foul odor to the breath |
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Term
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Definition
| Yellow discoloration of the skin and mm resulting from accumulation of excess bilirubin (as seen in certain liver dzs) or excessive breakdown of RBCs (as seen after internal hemorrhage or various hemolytic states) |
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Term
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Definition
| The partial or complete absence of hair from areas of the body where it normally grows; baldness |
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Term
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Definition
| The sense of touch used to assess what structures lay beneath the skin and presence of potential injury to those structures |
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Term
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Definition
| Listening with a stethoscope (usually to heart and lung sounds) |
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Term
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Definition
| The enveloping membrane of the body, including the dermis, epidermis, hair, nails, and sebaceous, sweat, and mammary glands |
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Term
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Definition
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Term
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Definition
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Term
| the normal Temperature / Pulse / Respiratory rates of adult dogs |
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Definition
T 100 – 102.2
HR 60 – 160/min (very large, small, young may be higher/lower, pups up to 200)
RR 16 - 32/min |
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Term
| normal Temperature / Pulse / Respiratory rates of adult cats |
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Definition
T 100 – 102.2
HR 140 – 220/min
RR 20 – 42/min |
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Term
| What are 2 terms for an elevated body temperature? |
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Definition
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Term
| What does an elevated body temp indicate? |
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Definition
| usually signifies the presence of infxn, inflammation, or neoplasia. Mild elevations may be noted secondary to stress or anxiety associated with the hosp. |
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Term
| What can severe temp elevations lead to? |
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Definition
| Temps >107 F can lead to organ dysfunction and warrant initiation of gradual cooling mechanisms |
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Term
| decreased body temp (hypothermia)results from? |
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Definition
| usually results from impaired thermoregulation in any sick animal, esp cats. more common in young, old, thin. Te,ps <90 F can be life-threatening. |
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Term
| What conditions commonly result in impaired thermoregulation and thus hypothermia? |
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Definition
| CRF, hypothyroidism, and CNS dz. |
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Term
| 4. Why should “peripheral arterial pulses” be palpated, which artery is most commonly evaluated, where is this artery located? |
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Definition
| To determine pulse rate and quality. Pulses generally palpated by way of the femoral artery, which is located high on the medial thigh of the animal |
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Term
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Definition
| The absence of a palpable pulse (or significant change in pulse quality) |
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Term
| What do pulse deficits generally indicate? |
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Definition
| Usually indicate an abnormal heart rhythm and warrant further evaluation, like electrocardiography |
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Term
| What does a weak peripheral pulse indicate? |
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Definition
| Poor perfusion and may be caused by decreased cardiac output (as in CHF or hypovolemia) or increased peripheral resistance (as in shock). Abnormal pulse quality warrants eval of BP |
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Term
| What is a slow to rise pulse? |
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Definition
| A pulse is slow to rise if the peak of intensity comes late in the pulse wave. Can be seen with obstruction to cardiac output, such as with aortic stenosis. |
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Term
| What about a pulse that is stronger than normal? |
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Definition
| Pulses described as bounding, tall, or hyperkinetic may indicate a problem. Bounding pulses may be palpated in hyperdynamic states (early septic shock, anemia) or when there is a rapid drop-off in diastolic pressure (patent ductus arteriosus). |
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Term
| Why should you note the respiratory rate and heart rate prior to performing the in-depth PE? |
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Definition
| Stress will commonly cause an increase in RR/HR |
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Term
| 7. When obtaining the heart rate and respiratory rate, is it necessary to count for an entire minute? How would you obtain the rate? |
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Definition
| Count breaths/beats for 15 seconds then multiply by 4 |
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Term
| Know the 3 sets of lymph nodes that you should be able to palpate in normal animals |
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Definition
Mandibular - located on either side of the neck just caudal-dorsal to the ramus of the mandible and cranial-ventral to the mandibular salivary glands. Can be differentiated from the salivary gland because more movable, sl firmer and smaller (in normal pt)
prescapular - located in the SQ tissue just medial to the scapular-humeral joint on either side of the pt. often encased in fat and may feel sl softer than other lymph nodes
popliteal lymph nodes - located on the caudal aspect of each hind limb at the level of the stifle joint |
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Term
| what lymph nodes are only palpable upon enlargement? |
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Definition
Axillary – located in the SQ space on the lateral aspect of the ventral thorax under the arm.
inguinal – located in the most caudal part of the ventral abdomen, just medial to the thighs, on either side of the midline |
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Term
| What 2 things can cause dry, tacky mucous membranes? |
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Definition
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Term
| Capillary Refill Time (CRT) |
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Definition
| Less than 2 seconds. >2 seconds are indicative of poor perfusion, as seen with hypotensive states. Very rapid refill (< 1 second) may be seen in stressed pts or hyperdynamic states, such as the early phase of septic shock. |
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Term
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Definition
| usually indicate anemia or poor perfusion |
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Term
| A complete cardiac exam includes |
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Definition
| assessment of perfusion status, heart rate, heart rhythm, and heart sounds |
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Term
| In dogs, where should the heart be ascultated? |
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Definition
| On each side of the chest around the level of the costochondral junction (just behind the elbow when the pt is standing). By moving the chest piece slightly, one can ascultate in the vicinity of each heart valve. |
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Term
| in dogs, Which valves are ascultated best on the left side? |
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Definition
| Pulmonic, aortic, and mitral valves |
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Term
| In dogs, Which valves are ascultated best on the right side? |
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Definition
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Term
| Respiratory sinus arrhythmia |
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Definition
| a slight variation of the heart rhythm in dogs, where the heart rate increases sl during inspiration and decreases sl during expiration. A sign of normal cardiac fxn. |
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Term
| In cats, where should the heart be ascultated? |
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Definition
| Best to auscultate directly over sternum initially and move the chest piece gradually up to the left side and back over to the right side. Valve positions similar to dog, but in cats abnormal heart sounds are more commonly ascultated in the sternal area |
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Term
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Definition
| An abnormal sound caused by turbulent blood flow which typically sounds like a “swishing” noise. Can indicate cardiac dz, can also occur with noncardiac dz, such as anemia, or can be normal in some young animals. |
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