1. The Physical Examination
Chapter 25
The Physical Examination

2. Methods of Examination
Observation or inspection
General health
Posture
Body movements
Skin

3. Methods of Examination
Observation or inspection
Mannerisms
Care in grooming
Body symmetry and contour
Skin rashes and color
Deformities

4. Methods of Examination
Palpation
Examination of body using touch
Abdominal masses
Skin texture, moisture, temperature
Use of fingertips, one or both hands, or palm of hand
[FIGURE 25-2]

5. Methods of Examination
Percussion
Eliciting sounds from body by tapping
Vibrations and sounds from underlying organs and cavities
Presence of air or solid material
Dull and hollow sounds
Direct and indirect methods

6. Methods of Examination
Auscultation
Listening directly to body sounds
Provider normally uses stethoscope
Lung, heart, abdomen, bowel sounds
Determines blood pressure reading
[FIGURE 25-4]

7. Methods of Examination
Mensuration
Measuring process
Height
Weight
Length of limb
Amount of flexion and extension
Chest and infant head circumference
Use of tape measure

8. Methods of Examination
Manipulation
Checks degree of flexion and extension of joints
Applying forceful passive movement on joint
Range of motion of joints

9. Positioning and Draping
Each position makes examination of area of body easier and more efficient
Always provide for patient safety
Proper draping
Protect modesty
Prevent embarrassment
Provide comfort from chills

10. Examination Positions
Supine (horizontal recumbent)
Dorsal recumbent
[FIGURE 25-6 and FIGURE 25-7]

11. Examination Positions
Lithotomy
Semi-Fowler’s (45-degree angle)
[FIGURE 25-8 and FIGURE 25-9]

12. Examination Positions
High-Fowler’s (90-degree angle)
Prone
[FIGURE and FIGURE 25-12]

13. Examination Positions
Knee-chest position
Rarely used
Used for proctologic examinations and sigmoidoscopy procedures
Proctologic table has made position unnecessary
Fenestrated drape covers patient from shoulders to knees
(See FIGURE 25-11)

14. Examination Positions
Sims’ (lateral) >>
Trendelenberg
Aid person who is in shock
Elevate and incline legs
[FIGURE 25-13]

15. Equipment and Supplies for the Physical Examination
[FIGURE 25-14]
(See Table 25-1: Some Common Instruments and Supplies Needed for a Physical Examination)

16. Equipment and Supplies for the Physical Examination
Equipment and supplies needed vary with provider and type of examination
Equipment in working order
Room properly stocked
MA responsible for patient preparation
(See FIGURE 25-11)

17. Basic Components of a Physical Examination
[FIGURE 25-16]

18. Basic Components of a Physical Examination
Patient appearance
Gait
Stature
Posture
Body movements
Speech
Breath odors
Nutrition
Skin and appendages

19. Physical Examination Sequence
Patient’s vital signs, height, weight, visual acuity, auditory ability
Laboratory procedures
Patient instructed about undressing
Gown and drape provided
MA remains in room when provider examining patient

20. Physical Examination Sequence
MA places instruments for examination on counter or Mayo stand
Starts at head and proceeds downward
Head
Eyes
Ears
Nose
Mouth and throat
(See Table 25-2: Components of the Physical Examination)

21. Physical Examination Sequence
Starts at head and proceeds downward
Neck
Chest
Breast
Abdomen
Genitals
Rectum
Reflexes
(See Procedure 25-1: Assisting with a Complete Physical Examination)

22. After the Examination Patient instructed to dress
Remain in room if patient requires assistance
Instructions regarding testing procedures and treatment plans given by provider
Once patient has left room, equipment and supplies sanitized, disinfected, sterilized