Physical Examination Health Article

Diagnosis/Preparation

The individual being examined should be comfortable and treated with respect throughout the examination. As the examination continues, examiners should explain what they are doing and share any relevant findings. Using language appropriate to the person being examined improves the effectiveness of communications and ultimately fosters better relations between examiners and examinees.

Before visiting a health care professional, individuals should write down important facts and dates about their own medical history, as well as those of family members. There should be a complete listing of all medications and their dosages. This list should include over-the-counter preparations, vitamins, and herbal supplements. Some people bring their bottles of medications with them. Any questions or concerns about medications should be written down.

Before the physical examination begins, the bladder should be emptied. A urine specimen is usually collected in a small container at this time. The urine is tested for the presence of glucose (sugar), protein, and blood cells. For some blood tests, individuals may be told ahead of time not to eat or drink for 12 hours prior to the test.

Individuals being examined usually remove all clothing and put on a loose-fitting hospital gown. An additional sheet is provided to keep persons covered and comfortable during the examination.

Aftercare

Once a physical examination has been completed, the person being examined and the examiner should review what laboratory tests have been ordered, why they have been selected, and how and with whom the results will be shared. A health professional should discuss any recommendations for treatment and follow-up visits. Special instructions should be put in writing. This is also an opportunity for persons to ask any remaining questions about their own health concerns.

Risks

There are virtually no risks associated with a physical examination. Complications with the process of a physical examination are unusual. Occasionally, a useful piece of information or data may be overlooked. More commonly, results of associated laboratory tests compel physicians to recheck an individual or reexamine portions of the body already reviewed. In a sense, complications may arise from the findings of a physical examination. These usually trigger further investigations or initiate treatment. They are really more beneficial than negative, as they often begin a process of treatment and recovery.

Normal results

Normal results of a physical examination correspond to the healthy appearance and normal functioning of the body. For example, appropriate reflexes will be present, no suspicious lumps or lesions will be found, and vital signs will be normal.

Abnormal results of a physical examination include any findings that indicate the presence of a disorder, disease, or underlying condition. For example, the presence of lumps or lesions, fever, muscle weakness or lack of tone, poor reflex response, heart arrhythmia, or swelling of lymph nodes will indicate possible health problems.

BOOKS

Bickley, L. S., P. G. Szilagyi, and J. G. Stackhouse. Bates' Guide to Physical Examination & History Taking, 8th edition. Philadelphia: Lippincott Williams & Wilkins, 2002.

Chan, P. D., and P. J. Winkle. History and Physical Examination in Medicine, 10th edition. New York: Current Clinical Strategies, 2002.

Seidel, Henry M. Mosby's Physical Examination Handbook, 4th edition. St. Louis, MO: Mosby-Year Book, 2003.

Swartz, Mark A., and William Schmitt. Textbook of Physical Diagnosis: History and Examination, 4th edition. Philadelphia: Saunders, 2001.

PERIODICALS

Ahmed, A. M. "Deficiencies of Physical Examination Among Medical Students." Saudi Medical Journal, 24, no.1 (2003): 108–111.

ORGANIZATIONS

American Academy of Family Physicians. 11400 Tomahawk Creek Parkway, Leawood, KS 66211-2672. (913) 906-6000. E-mail: <fp@aafp.org>. <http://www.aafp.org>.

American Academy of Pediatrics. 141 Northwest Point Boulevard, Elk Grove Village, IL 60007-1098. (847) 434-4000; Fax: (847) 434-8000. E-mail: <kidsdoc@aap.org>. <http://www.aap.org/default.htm>.

American College of Physicians. 190 N Independence Mall West, Philadelphia, PA 19106-1572. (800) 523-1546, x2600, or (215) 351-2600. <http://www.acponline.org>.

American Medical Association. 515 N. State Street, Chicago, IL 60610. (312) 464-5000. <http://www.ama-assn.org>.

OTHER

Karolinska Institute. [cited March 1, 2003]. <http://isp.his.ki.se/text/physical.htm>.

Loyola University Chicago Stritch School of Medicine. [cited March 1, 2003]. <http://www.meddean.luc.edu/lumen/MedEd/MEDICINE/PULMONAR/PD/Pdmenu.htm>.

National Library of Medicine. [cited March 1, 2003]. <http://www.nlm.nih.gov/medlineplus/ency/article/002274.htm>.

Review of Systems School of Medical Transcription. [cited March 1, 2003]. <http://www.mtmonthly.com/studentcorner/cpe.htm>.

L. Fleming Fallon, Jr. MD, DrPH

WHO PERFORMS THE PROCEDURE AND WHERE IS IT PERFORMED?

A physical examination is best performed by a trained physician. Other health care professionals such as physician assistants and nurse practitioners have similar but limited training. Examinations are usually performed in professional medical offices or hospitals. Occasionally, they may be performed in private homes or in the field.

QUESTIONS TO ASK THE DOCTOR

• What are my results, both normal and abnormal?
• What has changed since the last physical examination?
• What do you recommend as a result of the findings of this physical examination?
• When do you want to repeat the physical examination?