MT Training > Terminology > Physical Examination

PHYSICAL EXAMINATION TERMS/PHRASES (SECTION WISE):

GENERAL / GENERAL APPEARANCE:

A&O x3

agitated

ambulatory

Apgar score 

blank, staring, expressionless face

cachectic

Cheyne-Stokes breathing

chronological age (younger/older than chronological age)

comatose

conscious

cushingoid

depleted nutritionally

diaphoretic

disheveled

elderly, frail

engages with the examiner without difficulty

engaging appropriately

insight to current problem

language disturbance

intubated and sedated

lucid and follows commands

lying in semi-Fowler position

malaise

mask facies

no acute distress

obtunded

orthostatic changes

postanesthesia drowsiness

slurred speech

The patient appears fatigued.

The patient has slurred speech and abruptness of speech.

The patient is a cachectic male/female.

The patient is a pleasant, cooperative, overweight male/female.

The patient is a well-built elderly/young/middle-aged male/female.

The patient is a well-developed, well-nourished male/female.

The patient is alert, awake, and oriented.

The patient is ill appearing.

The patient is in no acute distress, resting comfortably in bed.

The patient is intubated.

The patient is lethargic, confused.

The patient is malnourished.

The patient is moaning and groaning.

The patient is nontoxic, calm, conversant

The patient is responsive to commands.  He is following commands verbally.

The patient is lying on a gurney in the emergency room

undue distress

vocabulary

WDWN (well-developed, well-nourished)

wearing glasses

well hydrated

VITAL SIGNS: 

blood pressure

BMI (body mass index).

height

O2 saturation

pulse/heart rate

respirations or respiratory rate

T-max

weight

 HEENT:  HEAD, EYES, EARS, NOSE, THROAT

agnathia

 allergic salute

 alopecia

 allergic shiners

 alopecia noted

 anicteric sclerae

 anisocoria

 anterior tonsillar pillars are red

 aphthae

 aphthous ulcers

 arcus senilis

 AV nicking

 Battle's sign

 best-corrected visual acuity

 bifid

 bifid uvula

 bifocals (wears bifocals)

 boggy turbinates

 buccal mucosa

 bulbar conjunctivae

 cataracts

 cleft palate

 cobblestoning

 conjunctivae pink

 conjunctivitis

 cornea clear/cloudy

 corneal reflex intact

 Cowden disease

 crowded oropharynx

 Dennie-Morgan lines /Dennie-Morgan fold

 dental caries

 dental hygiene

 dentition

 dentures

 deviation of mouth

 disk margins well-delineated

 disks sharp

 dysconjugate gaze

 ears have mild cerumen or no cerumen

 edentulous

 effusion

 elongation of soft palate

 endotracheal tube

 enucleated

 EOMI

 EOMS full.  (EOMS can mean either extraocular movements or extraocular muscles)

 ET (endotracheal) tube in place

 external auditory canal

 extraocular movements intact

 extraocular muscles intact

 facial droop

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