PROCEDURE OF THE MEDICAL EXAMINATION: THE PHYSICAL EXAMINATION
March 11th, 2009 | Posted by admin | Category: General healthNo Comments
There are four parts to a general medical examination: (1) inspection, (2) palpation, (3) percussion, and (4) auscultation.
This is the way in which these procedures would be applied to the examination, for example, of your heart: The doctor first inspects the chest over the heart, looking for the heave and beat of the heart, which provides a guide to its size and the way it is working. Then, by palpation—putting his fingers and hands over the heart—he feels the way the heart beats. The normal heart feels one way, the diseased heart feels another way. Percussion means striking the body with the fingers to bring out resonant sounds. Because the heart is not resonant and the adjacent lungs are, sound waves will change in pitch as soon as the doctor’s fingers strike the chest over the heart. His experienced ears detect the change, and thus he has a guide to the precise location of the heart and its size. Auscultation means listening with a stethoscope. The normal heart sounds a certain way; if heart trouble is present, the stethoscope picks up characteristic sounds that help in the diagnosis.
The doctor uses the same methods for examination of the lungs. In examinations of some other parts of the body, he may find that only inspection and palpation are useful.
The doctor adapts the medical examination to the situation. In elderly people, he will search most carefully for cancer, high blood pressure, and heart trouble; with children the doctor will be concerned with the milestones of normal physical and mental development as well as evidence of any disease.
No check-up, particularly of middle aged or elderly people, is complete without an examination of the rectum and the genital organs. These areas of the body are frequently the sites of cancers that can be terribly serious if not detected in the early, curable stage. Other diseases occur in these organs, too. The rectum and the female genital organs must be examined internally, requiring the insertion of the physician’s gloved fingers. In examining women, he will also use a speculum, a cylindrical instrument that distends the vagina, enabling him to see the cervix, or tip of the womb. It is at this time that the cervical smear is taken, as a simple check for the early development of cancer of the uterus.
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