-
The Medical Clinics of North America May 2018The physical examination in the outpatient setting is a valuable tool. Even in settings where there is lack of evidence, such as the annual physical examination of an... (Review)
Review
The physical examination in the outpatient setting is a valuable tool. Even in settings where there is lack of evidence, such as the annual physical examination of an asymptomatic adult, the physical examination is beneficial for the physician-patient relationship. When a patient has specific symptoms, the physical examination-in addition to a thorough history-can help narrow down, or in many cases establish, a diagnosis. In a time where imaging and laboratory tests are easily available, but are expensive and can be invasive, a skilled physical examination remains an important component of patient evaluation.
Topics: Ambulatory Care; Diagnosis, Differential; Humans; Physical Examination
PubMed: 29650068
DOI: 10.1016/j.mcna.2017.12.008 -
JAMA Cardiology Apr 2018Inspection, palpation, percussion, and auscultation have been the 4 pillars of clinical bedside medicine. Although these basic methods of physical examination have...
Inspection, palpation, percussion, and auscultation have been the 4 pillars of clinical bedside medicine. Although these basic methods of physical examination have served us well, traditional bedside examination, for a number of reasons including diminishing interest and expertise, performs well less than what is required of a modern diagnostic strategy. Improving the performance of physical examination is vital given that it is crucial to guide diagnostic possibilities and further testing. Current efforts at improving physical examination skills during medical training have not been very successful, and incorporating appropriate technology at the bedside might improve its performance. Selective use of bedside ultrasound (or insonation) can be one such strategy that could be incorporated as the fifth component of the physical examination. Seeing pathology through imaging might improve interest in physical examination among trainees, and permit appropriate downstream testing and possibly superior decision making. Current ultrasound technology makes this feasible, and further miniaturization of ultrasound devices and reduced cost will allow for routine use at the bedside. It is time to have a wider debate and a possible consensus about updates required to enhance current paradigms of physical examination.
Topics: Auscultation; Humans; Palpation; Percussion; Physical Examination; Physician-Patient Relations; Point-of-Care Testing; Ultrasonography
PubMed: 29490335
DOI: 10.1001/jamacardio.2018.0001 -
The Medical Clinics of North America May 2018This article focuses exclusively on physical examination (PE) in the context of clinical medicine, that is, the interaction between a health care provider and patient.... (Review)
Review
This article focuses exclusively on physical examination (PE) in the context of clinical medicine, that is, the interaction between a health care provider and patient. In essence, there is not only benefit (value) to PE but also that it will last (endure) for some time. Both "enduring" and "value" are explored in more depth with respect to the future integration of PE into the clinical assessment of a patient and how its value extends well beyond current diagnostic/cost-based metrics.
Topics: Clinical Competence; Humans; Patient Satisfaction; Physical Examination; Physician-Patient Relations; Risk Assessment
PubMed: 29650063
DOI: 10.1016/j.mcna.2017.12.003 -
Journal of Graduate Medical Education Aug 2019
Topics: Female; Humans; Internship and Residency; Male; Physical Examination; Students, Medical
PubMed: 31440347
DOI: 10.4300/JGME-D-18-01063.1 -
Emergency Medicine Clinics of North... Nov 2021The physical examination of the patient is the cornerstone of the practice of medicine, and the skills to complete a thorough abdominal examination are critical in the... (Review)
Review
The physical examination of the patient is the cornerstone of the practice of medicine, and the skills to complete a thorough abdominal examination are critical in the care of patients. When performed correctly, the abdominal examination can be revealing when it comes to the overall health of the patient as well as acute pathology. The examination of the abdomen has the potential to minimize further testing or radiation and serves as a key diagnostic tool. In this article, we will discuss each portion of the abdominal examination in detail as well as pathologic findings, abdomen-specific signs, special patient populations, and clinical pearls.
Topics: Abdomen; Auscultation; Digital Rectal Examination; Emergency Medicine; Genitalia; Humans; Palpation; Percussion; Physical Examination
PubMed: 34600631
DOI: 10.1016/j.emc.2021.07.004 -
Topics in Companion Animal Medicine Aug 2013This article reviews the approach to a patient with respiratory distress, with a focus on clues obtained from the physical examination. Respiratory distress is a common... (Review)
Review
This article reviews the approach to a patient with respiratory distress, with a focus on clues obtained from the physical examination. Respiratory distress is a common reason for presentation of a companion animal to a veterinarian on an emergency basis, and thus the clinician should have a comfort level with the approach to these patients. Our discussion includes a basic review of respiratory pathophysiology and the differential diagnoses for hypoxemia. In the majority of cases, physical examination should allow localization of the cause of the respiratory problem to the upper airways, lower airways, pleural space, or pulmonary parenchyma. Such localization, coupled with signalment and historical clues, guides additional diagnostics and therapeutics based on the most likely differential diagnoses. Although managing a patient with respiratory distress can be challenging, a systematic approach such as the one presented here should ensure appropriate intervention in a timely fashion and maximize the chance of a good outcome.
Topics: Animals; Cat Diseases; Cats; Diagnosis, Differential; Dog Diseases; Dogs; Pets; Physical Examination; Respiration Disorders
PubMed: 24182994
DOI: 10.1053/j.tcam.2013.06.005 -
The American Journal of Medicine Mar 2021
Topics: COVID-19; Echocardiography; Health Services Needs and Demand; Heart Auscultation; Humans; Infection Control; Patient Care Management; Physical Examination; Point-of-Care Testing; SARS-CoV-2
PubMed: 33220283
DOI: 10.1016/j.amjmed.2020.10.026 -
Clinical Anatomy (New York, N.Y.) Apr 2017Physical examination of the abdomen is an essential skill. Knowledge of its clinical anatomy and application is vital for making diagnoses. Misinterpretation of anatomy... (Review)
Review
Physical examination of the abdomen is an essential skill. Knowledge of its clinical anatomy and application is vital for making diagnoses. Misinterpretation of anatomy during examination can have serious consequences. This review addresses understanding of the anatomy, methodology, and complications of abdominal physical examination. It includes particular reference to modern technology and investigations. Physical examination is performed for diagnostic purposes. However, the art of physical examination is declining as more and more clinicians rely on newer technology. This can have regrettable consequences: negligence, waste of time and resources, and deterioration of clinical skills. With a sound knowledge of clinical anatomy, and realization of the importance of physical examination of the abdomen, clinician, and patients alike can benefit. Clin. Anat. 30:352-356, 2017. © 2017 Wiley Periodicals, Inc.
Topics: Abdomen; Attitude of Health Personnel; Auscultation; Clinical Competence; Humans; Palpation; Percussion; Physical Examination; Physician-Patient Relations; Time Factors
PubMed: 28165642
DOI: 10.1002/ca.22832 -
Lancet (London, England) Dec 2003
Topics: False Positive Reactions; Health Services Research; Humans; Physical Examination; Practice Guidelines as Topic; Predictive Value of Tests
PubMed: 14683669
DOI: 10.1016/S0140-6736(03)15031-3 -
The Physician and Sportsmedicine Feb 2012The elbow is a complex joint consisting of 3 separate but important articulations: the ulnohumeral, radiohumeral, and proximal radioulnar joints. The elbow assists in... (Review)
Review
The elbow is a complex joint consisting of 3 separate but important articulations: the ulnohumeral, radiohumeral, and proximal radioulnar joints. The elbow assists in positioning the hand in space through 2 important motions, flexion-extension and pronation-supination. Although the elbow is not a weightbearing joint, it is subjected to significant loads, especially in overhead and throwing athletes. An accurate knowledge of the anatomy and physiology of the elbow joint is critical for conducting a focused physical examination and arriving at an accurate diagnosis. The goal of this article is to review general and focused physical examination of the elbow in a systematic manner based on medial, lateral, anterior, and posterior aspects.
Topics: Biomechanical Phenomena; Elbow; Elbow Joint; Humans; Joint Diseases; Physical Examination; Range of Motion, Articular; Tennis Elbow
PubMed: 22508251
DOI: 10.3810/psm.2012.02.1951