Physical Examination

1. Physical Examination

2. Objectives After this lesson, students should be able to: • Explain the importance of physical examinations. • Describe the characteristics of a healthy animal. • Monitor vital signs and explain why they might vary. • Explain the concept of a “regional approach” to animal health.

3. Family Friends Pets We Want All Our Loved Ones To Be Healthy

4. The Purpose of a Physical Exam • Enables assessment of the overall health and condition of the animal • Allows detection of minor abnormalities before they become serious problems. • Helps determine the extent of an injury or illness. • Opportunity to educate clients

5. Performing a Physical Exam • Taking an animal’s signalment & history is the first step in any physical exam. • This is the first interaction with a client, listen carefully. • Signalment includes the animal’s species, breed, sex, & age. • History is information about environment, diet, reproductive history, medical history, vaccination status, & current medications. • Finally, record the chief complaint if applicable.

6. Initial Observations • Observe the animal both from a distance and up close before handling. • General appearance • Body condition • Behavior • Conformation and gait • Neurological deficits • Vision deficits

7. Characteristics of a Healthy Animal • Clear bright eyes • pink mucous membranes • An appearance of contentment • An alert and interested attitude • A sleek, shiny coat with pliable hair • Good appetite • Feces & urine are normal in appearance & easily passed. • Temperature, pulse, & respiration are in the normal range.

8. Say “Hello”! • Socialize yourself with the animal before the examination begins • Saves time and decreases stress for you and the animal • Promotes the safety of everyone in the room

9. Vital Signs • Before beginning the actual physical exam an animal’s weight, temperature, heart rate, and respiration rate are taken. • These base-line measurements indicate how an animal is functioning at the time of the exam and may be a first indication that something is wrong.

10. Temperature • The result of the balance between basal metabolism and muscular heat & heat lost. • Taken rectally with a thermometer. • Varies due to illness, physical activity, stage of pregnancy, time of day, &/or environmental surroundings.

11. Average Temperature of Different Species

12. Pulse • The rhythmic, periodic thrust felt over an artery in time with the heartbeat. • Evaluate rate, strength, and quality • Palpate (touch with fingers) at the lower jaw in horses & cattle, the femoral artery in dogs & cats • Varies due to illness, age, size, sex, breed, exercise, atmospheric conditions, time of day, eating, &/or excitement

13. Average Pulse of Different Species

14. Respiration • The acts of taking in oxygen, using it in the body tissues, and giving off carbon dioxide. • Evaluated visually or by auscultation with a stethoscope • Count inspirations OR expirations • Assess rate, depth, character, rhythm, and sound • Variations due to illness or body size, age, exercise, excitement, environmental temperature, atmospheric conditions, pregnancy, & fullness of the digestive tract.

15. Average Respiration Rates of Different Species

16. Capillary Refill Time/Mucous Membrane Color • Provides indication of blood flow • Press on the gums; they will "blanch" white and become pink again when pressure is released. • Normal: < 2 seconds

17. Hydration Test • Tests skin elasticity • Grasp the loose skin over the dog's shoulders, lift it up as far as it will stretch, and then release. • The skin should snap back into place immediately

18. Body Condition Score • Evaluates an animal as to the amount of body reserves, particularly fat and muscle, an animal possesses. • Visually examine and (or) palpate certain areas of the animal’s body • Range of body condition scores: • Beef cattle, horses, dogs, & cats – 1 to 9 • Dairy cattle, sheep, swine, dogs & cats – 1 to 5 • (the lower the number, the thinner the animal)

19. BCS 3 BCS 1 BCS 5 BCS 7 BCS 9

20. The Regional (Systems) Approach • Examine the animal from head to tail • Be consistent – always use the same order of examination so as not to forget a component of the exam • Example approach: • Head and Neck • Trunk and Limbs • Thorax • Abdomen • External Genitalia

21. Head and Neck • Oral Cavity • Eyes - opthalmoscope • Nose • Ears - otoscope • Lymph nodes • Salivary glands • Trachea

22. Trunk and Limbs • Limb and joint • Feet, nails, and hooves • Assess limbs in weight bearing & non-weight bearing positions • Muscle mass and tone • Skin and hair coat • Pelvic region • Vertebral column • Peripheral lymph nodes

23. Thorax • Palpate for symmetry, conformation, masses, etc… • Cardiac Auscultation – stethoscope • Rate and rhythm • Multiple locations on both sides of the chest • Respiratory Auscultation – stethoscope • Rate, depth/effort, character

24. Abdomen • Auscultate for intestinal motility • Palpate organs: stomach, spleen, small intestine, kidneys, urinary bladder, prostate, uterus, colon

25. External Genitalia • Verify sex and reproductive status • Inspect perianal area • Palpate anal sacs in dogs • Males: • Inspect prepuce and penis • Inspect both testicles if intact • Females: • Palpate and visually assess mammary glands • Inspect vulva

26. Physical Exam Findings • Upon completion of the physical exam the Dr. is able to address chief complaints or abnormal findings. • This may lead to diagnostic tests • Urine, blood, or fecal samples • Imaging: CT, X-ray, or ultrasound

27. Summary • A physical exam is an important component of a healthy animal. • What are the main sections of a physical exam? • Questions or comments?

28. References • http://www.ruralareavet.org/PDF/Physical_Examination.pdf • http://www.vetmed.wsu.edu/resources/restraint/index.aspx#Physical%20Examination • http://www.iowabeefcenter.org/Beef%20Cattle%20Handbook/Vital_Signs.pdf • http://pubs.ext.vt.edu/400/400-795/400-795.html • http://www.extension.purdue.edu/extmedia/AS/AS-550-W.pdf