Physical Examination

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Physical examination
Definition
A physical examination is the evaluation of a body to determine its state of health. The techniques of inspection include palpation (feeling with the hands and/or fingers), percussion (tapping with the fingers), auscultation (listening), and smell. A complete health assessment also includes gathering information about a person's medical history and lifestyle, conducting laboratory tests, and screening for disease. These elements constitute the data on which a diagnosis is made and a plan of treatment is developed. Purpose

The term annual physical examination has been replaced in most health care circles by periodic health examination. The frequency with which it is conducted depends on factors such as the age, gender, and the presence of risk factors for disease in the person being examined. Health-care professionals often use guidelines that have been developed by organizations such as the United States Preventative Services Task Force. Organizations such as the American Cancer Society or American Heart Association, which promote detection and prevention of specific diseases, generally recommend more intensive or frequent examinations, or suggest that examinations be focused on particular organ systems of the body. Comprehensive physical examinations provide opportunities for health care professionals to obtain baseline information about individuals that may be useful in the future. They also allow health care providers to establish relationships before problems occur. Physical examinations are appropriate times to answer questions and teach good health practices. Detecting and addressing problems in their early stages can have beneficial long-term results. Every person should have periodic physical examinations. These occur frequently (monthly at first) in infants and gradually reach a frequency of once per year for adolescents and adults. Description

A complete physical examination usually starts at the head and proceeds all the way to the toes. However, the exact procedure will vary according to the needs of the person being examined and the preferences of the examiner. An average examination takes about 30 minutes. The cost of an examination will depend on the charge for professional time and any tests that are included. Most health plans cover routine physical examinations, including some tests. The examination

Before examiners question the patient, they will observe a person's overall appearance, general health, and behavior. Measurements of height and weight are made. Vital signs such as pulse, breathing rate, body temperature, and blood pressure are recorded. With the person being examined in a sitting position, the following systems are reviewed: •Skin. The exposed areas of the skin are observed; the size and shape of any lesions are noted. •Head. The hair, scalp, skull, and face are examined.

Eyes. The external structures are observed. The internal structures can be observed using an ophthalmoscope (a lighted instrument) in a darkened room. •Ears. The external structures are inspected. A lighted instrument called an otoscope may be used to inspect internal structures. •Nose and sinuses. The external nose is examined. The nasal mucosa and internal structures can be observed with the use of a penlight and a nasal speculum. •Mouth and pharynx. The lips, gums, teeth, roof of the mouth, tongue, and pharynx are inspected. •Neck. The lymph nodes on both sides of the neck and the thyroid gland are palpated. •Back. The spine and muscles of the back are palpated and checked for tenderness. The upper back, where the lungs are located, is palpated on the right and left sides and a stethoscope is used to listen for breath sounds. •Breasts and armpits. A woman's breasts are inspected with the arms relaxed and then raised. In both men and women, the lymph nodes in the armpits are felt with the examiner's hands. While the person is still sitting, movement of the...
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