Mastery demo thorax

Name _______________________

Mastery Demonstration: Thorax

The student is expected to gather the necessary equipment and perform the exam without relying on other resources (including people, textbooks, notes or this form).

IMPLEMENTATION	YES	NO	COMMENTS
Posterior Chest
Inspection
1. Skin: color, texture, hair distribution, lesions, masses, scars	___	___
2. Thoracic shape, symmetry	___	___
3. Spine: range of motion, back & waist	___	___
4. Scoliosis	___	___
5. Muscle tone and rigor	___	___
6. Respirations: depth, effort, excursion, pattern	___	___
Palpation
7. Respiratory excursion, tenderness	___	___
8. Tactile fremitus	___
9. Subscapular & axillary lymph nodes	___	___
Percussion
10. Diaphragmatic excursion	___	___
11. Blunt CVA	___	___
Auscultation
12. Breath sounds: location & ratio of inspiration to expiration of bronchial, bronchovesicular & vesicular	___	___
13. Vocal fremitus: egophony, whispered pectoriloquy	___	___
Anterior Chest
Inspection
14. Skin: color, texture, hair distribution, lesions, masses, scars	___	___
15. Anterior-posterior diameter	___	___
16. Thoracic shape and symmetry	___	___
17. Respirations: rate, depth, effort, excursion, symmetry, pattern	___	___
18. Heart PMI, heaves, thrusts	___	___
Palpation
19. Tactile fremitus	___	___
20. Skin: tenderness, texture, turgor	___	___
Lymph nodes:
21. Supraclavicular	___	___
22. Infraclavicular	___	___
23. Central axillary	___	___
24. Lateral axillary	___	___
25. Pectoral	___	___
26. Heart: PMI, thrusts, heaves, thrills	___	___
27. Measures PMI from sternal border	___	___
28. Percussion: anterior chest	___	___

Auscultation
29. Vocal fremitus: egophony	___	___
30. Whispered pectoriloquy	___	___
31. Breath sounds: ratio & location of bronchial, bronchovesicular & vesicular	___	___
Heart sounds:
32. Sitting & leaning forward (aortic & pulmonic)	___	___
33. Supine: Aortic	___	___
34. Pulmonic	___	___
35. Erb's point	___	___
36. Tricuspid	___	___
37. Mitral	___	___
38. Left lateral: assess for S₃ and S₄	___	___
39. Use bell & diaphragm appropriately	___	___
40. Assess for splits, murmurs, where S₁ & S₂loudest	___	___
41. Apical pulse	___	___
Teaches Breast Self-examination
42. 3 positions
43. Inspection: Size, shape, dimpling, lesions, scars
44. Nipple: size, shape, color, number, placement, discharge, symmetry
45. Areola: color, location
46. Palpation: Breast/nipple: lumps, masses, discharge, temperature, turgor
47. Uses lotion
48. Positioning: arm over head, pillow beneath shoulder
Rationale Questions:
49. Asks client questions appropriate to the body system being assessed	___	___

Time allowed: 30 minutes

90% (49) = 45

Pass		Not Yet
Signature _____________________
Date _____________________