Physical Examination Skills Complete PE Grader Checklist

Student_____________________________________
Reviewer____________________________________

Note: all tests marked (((

weighted heavily

))) are

General and Vital Signs:

Introduce self as PA student
Established reason for visit
(((Sanitized hands before exam)))
Measure vital signs
BP
Pulse
RR
Appearance and Orientation:
General
appearance/development/age/etc
Assess orientation of patient to person,
place, time, and situation
Integument:
Inspection & palpation of hair/scalp
Inspection & palpation of skin for:
texture, hair
distribution, edema, color, rash,
turgor, gross temperature
Inspection & palpation of nails with
capillary
refill
Head & Face:
Inspection & palpation of head & face
Palpation of sinuses
Palpation of salivary glands
Palpation, ROM of TMJ
Assess tone of Masseter & Temporalis(CN
V
Facial symmetry & movements (CN VII)
(wrinkling forehead, smiling, showing
teeth, puffing out cheeks, pursing lips
and blowing, shutting eyes tightly)
Light touch Face (CN V 3 branches)
Pain Sensation Face (CN V 3 branches)
Auscultation of temporal arteries w/ bell
Palpation of temporal arteries

Eyes:
Inspect & palpate extraocular structures
Inspect conjunctivae, sclerae, irides,
pupils,
corneas
Snellen Visual Acuity Testing (CN II)
Visual Fields Testing (CN II)
EOMs and lid movements (CN III, IV, VI,
VII)
Convergence/accommodation (CN III)
Corneal light reflex (Hirschberg test)
Cover/uncover test
Direct/Consensual light reflex (CN III)
Palpate orbs for extraocular pressure
(((Ophthalmoscopic exam with bracing)))
Ears:
Inspection & palpation of external
structures
Hearing Whisper or finger rub (CN VIII)
Weber (CN VIII)
Rinne (CN VIII)
(((Inspection of auditory canal/TM/middle
ear with
Bracing)))
Mobility of TM
Nose:
Inspection & palpation of nose
Nasal patency
bilaterally
Inspection of internal nares
Olfaction (CN I)
(Lips, Mouth and) Throat:
Inspection lips,oral structures,oropharynx
Inspection of tongue
Palpation of oral structures
(((HYGIENE/STANDARD PRECAUTIONS)))
Tongue protrusion Up and Down (CN XII)
Tongue Strength and Lateral Motion (CN
XII)
Gag reflex, phonation & swallow (CN IX,
X)

Physical Examination Skills Complete PE Grader Checklist

Student_____________________________________
Reviewer____________________________________

Neck:
Auscultation carotid artery w/ bell
((( Palpates carotid arteries)))
Inspection & palpation of trachea for
position
Inspection and palpation of thyroid.
Palpation of lymph nodes:
Occipital
Preauricular
Postauricular
Submental
Submandibular
Anterior cervical
Posterior cervical
Supraclavicular
Cspine:
Inspect lateral and posterior(symmetry,
alignment, curvature)
Palpate spinous processes, name C7,
paraspinous muscles
Flexion
Strength
Extension
Strength
R bending
Strength
L bending
Strength
R rotation
Strength
L rotation
Strength
Test Shoulder Shrug against resistance
Pulmonary:
Inspection & palpation of thorax
Palpation for thoracic expansion
Palpation for tactile fremitus
Percussion of chest for resonance
Auscultation of lung fields
Auscultation for bronchophony
Auscultation for whispered pectoriloquy
Auscultation for egophony
Cardiovascular:
Pt sitting:
Inspection of precordium
Palpation of precordium

Palpation of apical impulse

Auscultation of heart:
Must name each area
at least one time while
auscultating.
Diaphragm Bell
Aortic
Pulmonic
2nd Pulmonic
Tricuspid
Mitral
Pt supine:
Auscultation of heart:
Diaphragm Bell
Aortic
Pulmonic
2nd Pulmonic
Tricuspid
Mitral
Auscultation of mitral area with pt in left
lateral recumbent position
Pulses:
Each pair done simultaneously, popliteal
usually needs to be done one at a time
however.
Radial
Popliteal (only if unable to palpate
distal
pulse )
Dorsalis pedis
Posterior tibialis
Abdomen:
Inspection of abdomen
(((Auscultation before palpation)))
Auscultation of abdomen for bowel
sounds
Auscultation for abdominal bruits: Use
bell.
Aortic
R renal
L
renal

Physical Examination Skills Complete PE Grader Checklist

Student_____________________________________
Reviewer____________________________________

R iliac
L iliac
Percussion of abdomen
Percussion of liver for liver span
(Mark skin, Measure with ruler)
Evaluation for Splenomegaly
Light palpation of abdomen
Deep palpation of abdomen
(((Knees flexed for palpation)))
Palpation of the liver (deep inspiration)
Palpation of the spleen (deep inspiration)
Palpation of the kidneys (deep
inspiration)
Check for CVAT
Musculoskeletal:
Upper Extremities:
Inspection (soft tissues, joints,
musculature, symmetry, deformity)
Palpation (SC joint, clavicle, AC joint,
spine of scapula, supraspinatus,
infraspinatus, rhomboids, coracoid
process, greater tubercle of humerus,
deltoid, biceps to tendon, triceps,
olecranon process, medial and lateral
epicondyles, forearm muscles, carpals,
metacarpals, MCPs, phalanges, PIPs,
DIPs, thenar eminence, hypothenar
eminence, anatomical snuff box)
Palpate the axillary lymph nodes
Palpate the epitrochlear lymph nodes
Shoulders
Flexion
Strength
Extension
Strength
Abduction
Strength
Adduction
Strength
Int Rotation
Strength
Ext Rotation
Strength
Elbows
Flexion
Strength
Extension
Strength
Supination
Strength
Pronation
Strength
Wrists

Flexion
Extension
Radial Motion

Strength
Strength
Strength

Ulnar Motion
Strength
Hands/Fingers
Make Fist
Strength
Inspect cascade
Extension
Strength
Abduction
Strength
Adduction
Strength
Opposition
Strength
Tspine/Lspine:
Inspect lateral and posterior
Palpate spinous processes,
Paraspinous m
Percussion of spine
Flexion
Extension
R bending
L bending
R rotation
L rotation
Cerebellar Function/Balance
Observe normal gait
Walk on toes
Walk on heels
Fwd. Heel-to-toe walk (must touch)
Romberg (eyes closed 1 min.)
Watch palms for Pronator drift
Balance-check (nudges pt.)
Stand on each foot (bilat)
Lower Extremities:
Inspection-standing (ht of iliac crests, soft
tissues, joints, musculature of LE

Physical Examination Skills Complete PE Grader Checklist

Student_____________________________________
Reviewer____________________________________

proximal to knee for symmetry,

deformity)
Palpation-standing (ASIS, iliac crest,
greater trochanter of femur, sacroiliac
joint, anterior thigh, posterior thigh)
Trendelenburg Test
Inspection-sitting (soft tissues, joints,
musculature of LE from knee distally
including soles of feet for symmetry,
deformity)
Palpation-sitting (patella, medial and
lateral joint lines, medial/lateral tibial
condyles, medial/lateral epicondyles of
femurs, tibial tubercles, popliteal fossae,
gastrocnemius, medial/lateral malleoli,
tarsals, metatarsals, MTP, IPs of toes,
phalanges)
Palpation of Popliteal lymph nodes
Pelvis/hips (supine)
Flexion
Strength
Int Rotation
Strength
Ext Rotation
Strength
ABduction
Strength
ADduction
Strength
Pelvis/hips (prone)
Extension
Strength
Knees (prone)
Flexion
Strength
Knees (sitting)
Extension
Strength
Ankles (sitting)
Dorsiflex
Strength
Plantar flex
Strength
Inversion
Strength
Eversion
Strength
Rotation
Feet & Toes (sitting)
Curl Toes
Strength
Extend toes
Strength
Neurologic:
Reflexes (Bilateral with grading)
Abdominal
Biceps
Brachioradialis
Triceps

Patellar
Achilles
Plantar
Sensory (Routinely, with pts. eyes
closed)
UE (light touch neck, arms and hands)
LE (light touch - legs and feet)
Abdomen (light touch)
UE (pain neck, arms and hands)
LE (pain - legs and feet)
Abdomen (pain)
Vibratory (boney prominence thumb)
Vibratory (boney prominence great toe)
Proprioception Testing
Thumb or index finger (bilat)
Great Toe (bilat)
Stereognosis (both hands)
Graphesthesia
(both hands)
Point Localization (2 areas bilat)
Cerebellar Function/Balance
RRAM - UE (Thigh Pat or Opposition bilat)
UE Accuracy (Finger to finger, or to nose
bil)
LE Accuracy (Heel to shin bil)
(((Did not auscultate through clothing)))
(((Examined from patients right side
when appropriate)))
Appropriate closing remarks to patient
Sanitized hands after exam
Informed patient before performing tests
Instruct patient about proper positioning
throughout exam

Physical Examination Skills Complete PE Grader Checklist

Student_____________________________________
Reviewer____________________________________

Total Points Missed

_____
Comments:
Mentors Signature
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