In medicine, the physical examination or clinical examination is the process by which the physician investigates the body of a patient for signs of disease. It generally follows the taking of the medical history — an account of the symptoms as experienced by the patient. Together with the medical history, the physical examination aids in determining the correct diagnosis and devising the treatment plan. This data then becomes part of the medical record. Medicine is the branch of health science and the sector of public life concerned with maintaining or restoring human health through the study, diagnosis and treatment of disease and injury. ... Physician examining a child A physician is a person who practices medicine. ... A patient is any person who receives medical attention, care, or treatment [1]. A patient is often ill or injured and is being treated by, or in need of treatment by, a physician or other medical professional. ... In medicine, a sign is a feature of disease as detected by the doctor. ... A disease is an abnormal condition of the body or mind that causes discomfort, dysfunction, or distress to the person afflicted or those in contact with the person. ... The medical history of a patient (sometimes called anamnesis [1][2] ) is information gained by a physician by asking specific questions, either of the patient or of other people who know the person and can give suitable information (in this case, it is sometimes called heteroanamnesis). ... The term symptom (from the Greek syn = con/plus and pipto = fall, together meaning co-exist) has two similar meanings in the context of physical and mental health: Strictly, a symptom is a sensation or change in health function experienced by a patient. ... Diagnosis (from the Greek words dia = by and gnosis = knowledge) is the process of identifying a disease by its signs, symptoms and results of various diagnostic procedures. ... Look up Therapy in Wiktionary, the free dictionary Therapy (in Greek: θεραπεία) or treatment is the attempted remediation of a health problem, usually following a diagnosis. ... A medical record folder being pulled from the records A medical record, health record, or medical chart is a systematic documentation of a patients medical history and care [1][2]. The term Medical record is used both for the physical folder for each individual patient and for the body...

Although doctors have varying approaches as to the sequence of body parts, a systematic examination generally starts at the head and finishes at the extremities. After the main organ systems have been investigated by inspection, palpation, percussion and auscultation, specific tests may follow (such as a neurological investigation, orthopedic examination) or specific tests when a particular disease is suspected (e.g. eliciting Trousseau's sign in hypocalcemia). For other uses of the word head, see head (disambiguation). ... Extremities is a play by William Mastrosimone that was first performed on Broadway in 1982. ... Inspection (Latin word Inspectio or the act of beholding) 1. ... Palpation is a method of examination in which the examiner feels the size or shape or firmness or location of something (of body parts when the examiner is a health professional). ... Percussion is a method used by a doctor to find out about the changes in the thorax or abdomen. ... Auscultation is the technical term for listening to the internal sounds of the body, usually using a stethoscope. ... Neurology is a branch of medicine dealing with disorders of the nervous system. ... Orthopedic surgery or orthopedics (BE: orthopaedics) is the branch of surgery concerned with acute, chronic, traumatic and recurrent injuries and other disorders of the locomotor system, its musclular and bone parts. ... Trousseau sign is the name of two distinct phenomena observed in clinical medicine. ... In medicine, hypocalcaemia is the presence of less than a total calcium of 2. ...

With the clues obtained during the history and physical examination the doctor can now formulate a differential diagnosis, a list of potential causes of the symptoms. Specific diagnostic tests (or occasionally empirical therapy) generally confirm the cause, or shed light on other, previously overlooked, causes. In medicine, differential diagnosis (sometimes abbreviated DDx or ΔΔ) is the systematic method physicians use to identify the disease causing a patients symptoms. ...

Whilst the format of examination as listed below is largely as taught and expected of medical students, a specialist will focus on their particular field and the nature of the problem described by the patient. Hence a cardiologist will not in routine practice undertake neurological parts of the examination other than noting that the patient is able to use all four limbs on entering the consultation room and during the consultation become aware of their hearing, eyesight and speech. Likewise an Orthopaedic surgeon will examine the affected joint, but may only briefly check the heart sounds and chest to ensure that there is not likely to be any contraindication to surgery raised by the anaesthetist.

A complete physical examination includes evaluation of general patient appearance and specific organ systems. It is recorded in the medical record in a standard layout which facilitates others later reading the notes. In practice the Vital signs of Temperature examination, Pulse and Blood pressure are usually measured first. A medical record folder being pulled from the records A medical record, health record, or medical chart is a systematic documentation of a patients medical history and care [1][2]. The term Medical record is used both for the physical folder for each individual patient and for the body... Link title:This article is about the medicinal use. ... Taking a patients temperature is an initial part of a full clinical examination. ... In medicine, a persons pulse is the throbbing of their arteries as an effect of the heart beat. ... Blood pressure is the pressure exerted by the blood on the walls of the blood vessels. ...

Vital Signs

Temperature

Temperature recording gives an indication of core body temperature which is normally tightly controlled (thermoregulation) as it affects the rate of chemical reactions. Taking a patients temperature is an initial part of a full clinical examination. ... Core temperature is the operating temperature of an organism, specifically in deep structures of the body such as the liver, in comparison to temperatures of peripheral tissues. ... Thermoregulation is the ability of an organism to keep its body temperature within certain boundaries, even when temperature surrounding is very different. ...

The main reason for checking body temperature is to solicit any signs of systemic infection or inflammation in the presence of a fever (temp > 101.4 F or sustained temp > 100.4 F). Other causes of elevated temperature include (hyperthermia. Temperature depression (hypothermia) also needs to be evaluated. It is also noteworthy to review the trend of the patient's temperature. A patient with a fever of 101 F does not necessary indicate an ominous sign if his previous temperature has been higher. See Fever for the Kylie Minogue album; Fever is also a song by Otis Blackwell. ... Hyperthermia, also known as heat stroke or sunstroke, is an acute condition which occurs when the body produces or absorbs more heat than it can dissipate. ... Hypothermia is a medical condition in which the victims core body temperature has dropped to significantly below normal and normal metabolism begins to be impaired. ...

Blood pressure

The blood pressure is recorded as two readings, a high systolic pressure which is the maximal contraction of the heart and the lower diastolic or resting pressure. Usually the blood pressure is taken in the right arm unless there is some damage to the arm. The difference between the systolic and diastolic pressure is called the pulse pressure. The measurement of these pressures is now usually done with an aneroid or electronic sphygmomanometer. The classic measurement device is a mercury sphygmomanometer, using a column of mercury measured off in millimeters. In the United States and UK, the common form is millimeters of mercury, whilst elsewhere SI units of pressure are used. There is no natural 'normal' value for blood pressure, but rather a range of values that on increasing are associated with increased risks. The guideline acceptable reading also takes into account other co-factors for disease. Elevated blood pressure hypertension therefore is variously defined when the systolic number is persistently over 140-160 mmHg. Low blood pressure is hypotension. Blood pressures are also taken at other portions of the extremities. These pressures are called segmental blood pressures and are used to evaluate blockage or arterial occlusion in a limb (see Ankle brachial pressure index). Systolic is the adjective form of systole, typically referring to the contraction activity of the heart. ... Diastolic is the adjective form of diastole referring to relaxation of the heart, between muscle contractions. ... Pulse pressure is the change in blood pressure seen during a contraction of the heart. ... Bourdon Tube Type Indicator Side Mechanical Side Mechanical Details A pressure or vacuum gauge usually consists of a closed coiled tube (called a Bourdon tube) connected to the chamber or pipe in which pressure is to be sensed. ... Mechanical sphygmomanometer with aneroid manometer and stethoscope Digital sphygmomanometer A sphygmomanometer or blood pressure meter is an inflatable cuff used to measure blood pressure. ... General Name, Symbol, Number mercury, Hg, 80 Chemical series transition metals Group, Period, Block 12, 6, d Appearance silvery white Atomic mass 200. ... A millimetre (American spelling: millimeter), symbol mm is an SI unit of length that is equal to one thousandth of a metre. ... Cover of brochure The International System of Units. ... For other forms of hypertension see hypertension (disambiguation). ... In physiology and medicine, hypotension refers to an abnormally low blood pressure. ... Segmental blood pressure is used to measure actual limb pressures. ... A limb (from the Old English lim) is a jointed appendage of the human or animal body; a large or main branch of a tree; a representative, branch or member of a group or organization. ... The Ankle Brachial Pressure Index (ABPI) is a measure of the fall in blood pressure in the arteries supplying the legs and as such is used to detect evidence of blockages (peripheral vascular disease). ...

Pulse

The pulse is the physical expansion of the artery. Its rate is usually measured either at the wrist or the ankle and is recorded as beats per minute. The pulse commonly is taken is the radial artery at the wrist. Sometimes the pulse cannot be taken at the wrist and is taken at the elbow (brachial artery), at the neck against the carotid artery (carotid pulse), behind the knee (popliteal artery), or in the foot dorsalis pedis or posterior tibial arteries. The pulse rate can also be measured by listening directly to the heart beat using a stethescope. Arteries of the right forearm - anterior view. ... The brachial artery is a blood vessel of the upper arm. ... In human anatomy, the carotid artery is a major artery of the head and neck. ... Arteries of the lower limb - posterior view. ... In anatomy, the dorsalis pedis artery of the lower limb carries blood to the dorsal surface of the foot, from the anterior tibial artery. ... Arteries of the lower limb - posterior view. ... Heart rate is a term used to describe the frequency of the cardiac cycle. ... Stethoscope The stethoscope (Greek στηθοσκόπιο, of στήθος, stéthos - chest and σκοπή, skopé - examination) is an acoustic medical device for auscultation, i. ...

Respiratory rate

Varies with age, but normal adults usually have 12-20 breaths per minute.

Basic biometrics

Height

Height is the anthropometric longitudinal growth of an individual. A statiometer is the device used to measure height although often a height stick is more frequently used for vertical measurement of adults or children older than 2. The patient is asked to stand barefoot. Height declines during the day because of compression of the intervertebral discs. Children under age 2 are measured lying horizontally. It has been suggested that Bertillion Record be merged into this article or section. ... The term, longitudinal means front-to-back or top-to-bottom as opposed to transverse which means side-to-side. In automotive engineering, the term, longitudinal refers to an engine in which the crankshaft is oriented along the long axis of the vehicle, front to back. ... An object is in a vertical position when it is aligned in an up-down direction, perpendicular to the horizon. ... This photo shows a very 12-year-old girl walking barefoot and leaving footprints on the floor. ... Intervertebral discs lie in between adjacent vertebrae in the spine. ... Horizontal is an orientation relating to, or in parallel with the horizon, and thus perpendicular to the vertical. ...

Weight

Weight is the anthropometric mass of an individual. A scale is used to measure weight. // Technical usage in physical sciences Established official technical definition : In the physical sciences, the weight of an object has a particular technical meaning. ... Mass is a property of a physical object that quantifies the amount of matter and energy it contains. ... A doctors scale A weighing scale (usually just scale in common usage) is a device for measuring the weight of an object. ...

Body mass index or BMI is used to calculate the relationship between healthy height and weight and obesity or being overweight or underweight. The body mass index (BMI) or Quetelet Index is a measure of the weight of a person scaled according to height. ...

Medical professionals generally prefer to use the SI unit of kilograms, and many medical facilities have ready-reckoner conversion charts available for professionals to use when patients describe their weight in non-SI units. (In the US, pounds and ounces are common, while in the UK stones and pounds are frequently used; in most other countries the metric system predominates.) The international prototype, made of platinum-iridium, which is kept at the BIPM under conditions specified by the 1st CGPM in 1889. ... The pound is the name of a number of units of mass, all in the range of 300 to 600 grams. ... The ounce is the name for a number of different units of mass (oz), and also of two units of fluid volume (fl oz) and of one unit of force, the ounce-force (ozf). ... The stone is a unit of mass in the Imperial system of weights and measures used in the United Kingdom, Ireland, and most Commonwealth countries. ... The pound is the name of a number of units of mass, all in the range of 300 to 600 grams. ... The International System of Units (symbol: SI) (for the French phrase Syst me International dUnit s) is the most widely used system of units. ...

Pain

Because of the importance of pain to the overall wellness of the patient, subjective measurement is considered to be a vital sign. Clinically pain is measured using a FACES scale which is a series of faces from '0' (no pain at all showing a normal happy face) to '5' (the worst pain ever experienced by the patient). There is also an analog scale from '0' to maximum '10'. It is important to allow patients to make their own choices on a pain scale. Physicians and health care workers frequently understate patient pain. Look up Pain in Wiktionary, the free dictionary. ... This is a disambiguation page — a navigational aid which lists other pages that might otherwise share the same title. ... Faces is also a part of the name of: The Faces Faces (movie) This is a disambiguation page — a navigational aid which lists other pages that might otherwise share the same title. ...

Structure of the written examination record

General appearance

• Obvious apparent features as the patient enters the consulting room and in the course of taking the history (e.g. mobility problem or deafness)
• JACCOL, a mnemonic for Jaundice, suggestion of Anaemia (pale colour of skin or conjunctiva), Cyanosis (blue coloration of lips or extremities), Clubbing of fingernails, Oedema of ankles, Lymph nodes of neck, armpits, groins.

A mnemonic (pronounced in American English, in British English) is a memory aid. ... Jaundice, also known as icterus (attributive adjective: icteric), is a yellowing of the skin, sclera (the white of the eyes) and mucous membranes caused by increased levels of bilirubin in the human body (or the body of another red blooded animal). ... This article discusses the medical condition. ... The conjunctiva is a membrane that covers the sclera (white part of the eye) and lines the inside of the eyelids. ... Cyanosis refers to the bluish coloration of the skin due to the presence of deoxygenated hemoglobin in blood vessels near the skin surface. ... In medicine, clubbing (or digital clubbing) is a deformity of the fingers and fingernails that is associated with a number of diseases, mostly of the heart and lungs. ... Edema (BE: oedema, formerly known as dropsy) is swelling of any organ or tissue due to accumulation of excess fluid. ... Lymph nodes are components of the lymphatic system. ...

Organ systems

• Cardiovascular system
  • Blood pressure, pulse rate and rhythm.
  • Jugular venous pressure (JVP), peripheral oedema and evidence for pulmonary oedema.
  • Precordial exam (cardiac exam)
• Lungs
  • Respiratory rate, chest expansion, lung auscultation
• Breasts
• Abdomen
  • Abdominal examination notes in particular any tenderness, bloating, organ enlargement, or aortic aneurysm.
  • No abdominal examination is complete without a Rectal examination
• Genitalia
• Musculoskeletal system
• Nervous system, including mental status
• Head and neck (HEENT a mnemonic for head, eyes, ears, nose and throat.)
• Skin
  • Check of the hair to see if the hair growth is receding (baldness) or there is loss of hair ( alopecia).
  • Check of the skin will tell if there are marks such as hemangioma or strawberry marks or changes to the skin. Dark spots on the skin, nevi are also places where cancerous changes can appear because the face, head and neck are most usually sun exposed. Specific skin conditions (e.g. pyoderma gangrenosum, erythema nodosum, acanthosis nigricans) may be associated with specific diseases (ulcerative colitis, sarcoidosis and polycystic ovary syndrome, respectively).

Human circulatory system. ... The jugular venous pressure (JVP, sometimes referred to as jugular venous pulse) is the indirectly observed pressure over the venous system. ... In medicine, the precordial exam, also cardiac exam, is performed as part of a physical examination, or when a patient presents with chest pain suggestive of a cardiovascular pathology. ... The lungs flank the heart and great vessels in the chest cavity. ... okay that is all ... The abdomen is a part of the body. ... The abdominal exam, in medicine, is performed as part of a physical examination, or when a patient presents with abdominal pain or a history that suggests an abdominal pathology. ... An aortic aneurysm is a general term for any swelling (dilatation or aneurysm) of the aorta, usually representing an underlying weakness in the wall of the aorta at that location. ... A rectal examination or rectal exam is an internal examination of the rectum by a physician or other healthcare professional. ... A sex organ, or primary sexual characteristic, narrowly defined, is any of those parts of the body (which are not always bodily organs according to the strict definition) which are involved in sexual reproduction and constitute the reproductive system in an complex organism; namely: Male: penis (notably the glans penis... The human musculoskeletal system is the musculoskeletal system that gives us the ability to move. ... The neurological examination is the physical examination of the nervous system. ... Mental status examination, or MSE, is a medical process where a clinician working in the field of mental health (usually a social worker, psychiatrist, psychiatric nurse or psychologist) systematically examines a patients mind. ... A human head In anatomy, the head of an animal is the anterior part (from anatomical position) that usually comprises the brain, eyes, ears, nose, and mouth (all of which aid in various sensory functions, such as sight, hearing, smell, and taste). ... The neck is the part of the body on many limbed vertebrates that distinguishes the head from the torso or trunk. ... Categories: Medicine stubs | Ophthalmology | Medical tests ... A section of Human Skin In zootomy and dermatology, skin is an organ of the integumentary system made up of a layer of tissues that guard underlying muscles and organs. ... mr wise is a perfect example Actor Patrick Stewarts bald head is considered part of his distinctive attractiveness. ... Alopecia is a set of disorders ranging from male and female pattern alopecia (alopecia androgenetica), to alopecia areata, which involves the loss of some of the hair from the head, alopecia totalis, which involves the loss of all head hair, to the most extreme form, alopecia universalis, which involves the... Hemangioma is a benign tumor, usually in the shape of a ball, but sometimes a flatter mat, formed by a collection of excess blood vessels in an area. ... Nevus (or naevus) is a general term that refers to a number of different, usually benign, pigmented lesions of the skin. ... Erythema nodosum is a form of inflammation of the subcutaneous fatty tissue. ... Acanthosis nigricans is a brown to black, poorly defined, velvety hyperpigmentation of the skin, usually present in the posterior and lateral folds of the neck, the axilla, groin, umbilicus, and other areas. ... Polycystic Ovary by Sonography Polycystic ovary syndrome (PCOS, also known clinically as Stein-Leventhal syndrome), is an endocrine disorder that affects 5–10% of women. ...

See also

• UCSD school of medicine - guide to writing HPI and performing complete physical exam. Excellent for medical students

• Eye examination
• Heart sounds
• Human weight
• Medical record
• Medical test