What is done in a physical exam?

A physical exam is a comprehensive assessment of a patient's physical health through a series of observations, maneuvers, and tests performed by a healthcare provider. It plays a crucial role in diagnosing medical conditions, monitoring health status, and evaluating treatment effectiveness. Here are the key components of a physical exam:

1. Inspection:

The healthcare provider visually examines the patient for any abnormalities in appearance, skin color, posture, gait, body proportions, and any visible signs of distress or discomfort.

2. Palpation:

The healthcare provider uses their hands to feel the patient's body for temperature changes, texture variations, tenderness, swelling, enlarged organs, and any palpable masses or abnormalities.

3. Percussion:

Percussion involves tapping specific areas of the body with the fingers to assess underlying structures. The sound, pitch, and vibrations produced can provide information about the organs, air pockets, and fluid levels within the body.

4. Auscultation:

The healthcare provider listens to sounds produced by different organs and body parts using a stethoscope. This includes heart sounds, lung sounds, bowel sounds, and any abnormal bruits or murmurs.

5. Neurological Assessment:

The healthcare provider checks the patient's mental status, level of consciousness, orientation, memory, reflexes, sensation, coordination, and balance. This helps assess the function and integrity of the nervous system.

6. Cardiovascular Examination:

The provider evaluates the patient's pulse, blood pressure, and heart rate. Auscultation of the heart is performed to identify any murmurs, gallops, or arrhythmias.

7. Respiratory Examination:

The healthcare provider assesses the patient's breathing patterns, respiratory rate, and any signs of respiratory distress. Auscultation of the lungs is done to listen for abnormal breath sounds, wheezes, rales, or decreased air entry.

8. Gastrointestinal Examination:

The abdomen is examined for any distension, tenderness, masses, or unusual sounds. The healthcare provider may perform gentle palpation and percussion of the abdomen to assess the underlying organs.

9. Musculoskeletal Examination:

The provider evaluates the range of motion, strength, and any tenderness or deformities in the patient's joints, muscles, and bones.

10. Integumentary Examination:

The healthcare provider examines the skin for any lesions, rashes, changes in texture, color, moisture, or temperature. The hair, nails, and mucous membranes are also assessed.

11. Genitourinary Examination:

In males, the exam may involve checking the external genitalia, testes, and prostate gland (usually performed during a separate digital rectal exam). In females, it may include a visual inspection of the external genitalia and a pelvic exam (performed by a healthcare provider trained in gynecological exams).

Overall, a physical exam provides valuable information about a patient's health and helps the healthcare provider make informed decisions regarding diagnosis, treatment, and further investigations.