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For some people, having an annual physical examination is a source of reassurance that they're as healthy as they feel. Others see it as an alarm system, to catch health problems before they become serious. The value of the routine annual exam has been debated recently, but it remains a cherished tradition among many doctors and patients. What can you expect from your annual physical exam? Annual Physical Exam: The Basics The physical exam is an essential part of any doctor's visit. Surprisingly, though, there are no absolutes in a routine physical. A good doctor may be thorough or brief, according to your individual circumstances, any new medical concerns you may have, and his or her personal style. A good doctor will spend time listening to your concerns and providing counseling for your particular needs. Most people have experienced many aspects of the annual exam: History. This is your chance to mention any complaints or concerns about your health. Your doctor will also likely quiz you about important behaviors, like smoking, excessive alcohol use, sexual health, diet, and exercise, The doctor will also check on your vaccination status and update your personal and family medical history. Vital Signs. These are some vital signs checked by your doctor: Blood pressure: less than 120 over 80 is a normal blood pressure. Doctors define high blood pressure (hypertension) as 140 over 90 or higher. Heart rate: Values between 60 and 100 are considered normal. Many healthy people have heart rates slower than 60, however. Respiration rate: Around 16 is normal. Breathing more than 20 times per minute can suggest heart or lung problems. Temperature: 98.6 degrees Fahrenheit is the average, but healthy people can have resting temperatures slightly higher or lower. What is your height? What is your weight? What is the color of your skin? What is the color of your hair? General Appearance. Your doctor gathers a large amount of information about you and your health just by watching and talking to you. How is your memory and mental quickness? Does your skin appear healthy? Can you easily stand and walk? Heart Exam. Listening to your heart with a stethoscope, a doctor might detect an irregular heartbeat, a heart murmur, or other clues to heart disease. Lung Exam. Using a stethoscope, a doctor listens for crackles, wheezes, or decreased breath sounds. These and other sounds are clues to the presence of heart or lung disease. Head and Neck Exam. Opening up and saying "ah" shows off your throat and tonsils. The quality of your teeth and gums also provides information about your overall health. Ears, nose, sinuses, eyes, lymph nodes, thyroid, and carotid arteries may also be examined. Abdominal Exam. Your doctor can use a range of examination techniques including tapping your abdomen to detect liver size and presence of abdominal fluid, listening for bowel sounds with a stethoscope, and palpating for tenderness. Neurological Exam. Nerves, muscle strength, reflexes, balance, and mental state may be assessed. Dermatological Exam. Skin and nail findings could indicate a dermatological problem or disease somewhere else in the body. Extremities Exam. Your doctor will look for physical and sensory changes. Pulses can be checked in your arms and legs. Examining joints can assess for abnormalities. Male Physical Exam An annual physical exam for men might also include: Testicular exam: A doctor can check each testicle for lumps, tenderness, or changes in size. Most men with testicular cancer notice a growth before seeing a doctor. Hernia exam: The famous "turn your head and cough" checks for a weakness in the abdominal wall between the intestines and scrotum. Penis exam: A doctor might notice evidence of sexually transmitted infections such as warts or ulcers on the penis. Prostate exam: Inserting a finger in the rectum lets a doctor feel the prostate for its size and any suspicious areas. Female Physical Exam A woman's annual exam might include: Breast exam. Feeling for abnormal lumps may detect breast cancer or benign breast conditions. The doctor will also check the lymph nodes in the underarm area and look for visual abnormalities of the breasts. Pelvic exam: The pelvic exam allows examination of the vulva, vagina, and cervix. Routine checks for sexually transmitted infections are often done. A Pap test can screen for cervical cancer. Laboratory Tests There are no standard laboratory tests during an annual physical. However, some doctors will order certain tests routinely: Complete blood count Chemistry panel Urinalysis (UA) Unless symptoms already suggest a problem, however, these tests are unlikely to provide useful information. A lipid panel (cholesterol test) is recommended every five years. Abnormal cholesterol levels increase the risk for heart attacks and strokes. Physicals Should Emphasize Prevention The annual physical exam is a great opportunity to refocus your attention on prevention and screening: At age 50, it's time to begin regular screening for colorectal cancer. People with immediate family members with colorectal cancer may need to be screened before age 50. For some women, age 40 marks the time to begin annual mammogram screening for breast cancer. Talk to your doctor about possible benefits and risks to starting mammography before 50 years of age. Everyone should have their cholesterol (lipids) checked every five years after age 20, according to the American Heart Association. Healthy behaviors work far better than medicine at preventing illness, and don't require a prescription: Do 30 minutes of brisk walking or other exercise, most days of the week. Your risk for cardiovascular disease, diabetes, and cancer will fall dramatically. Eat a mostly plant-based diet, low in animal fats. Above all, don't smoke. |
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What does your doctor do in a physical examination? The Purpose of an Annual Physical Exam How to Prepare for a Physical Examination How a Physical Examination Is Performed Following Up After a Physical Examination physical Examination physical Examination What does your doctor do in a physical examination? A physical examination together with a medical history is used by your doctor to assist in the diagnosis process. Physical examinations are great for the fact that they can be interpreted immediately. Physical examinations are not only reserved for patients experiencing symptoms but is also recommended as a way of ensuring your general health is good – you won't always notice symptoms when something is wrong. For example, your blood pressure may be high but you may not be experiencing any obvious symptoms. There can be great variation in how detailed a physical examination depending on the patient's requirements. A physical examination may be brief but a complete physical examination involves evaluating everything from the patient's appearance to specific organ systems. All the information is recorded which then becomes your medical record. There are several techniques your doctor may use during a physical examination. A visual examination is used to visually assess parts of the body by looking for abnormal color, shape, size, texture etc. Palpation involves feeling the body using the hands in order to assess size, shape, location and level of pain etc. Percussion involves producing a sound by tapping or scraping a part of the body which can allow determination of parameters such as organ size and density. Finally, auscultation involves listening to sounds produced by organs such as the stomach, lungs, heart. Your doctor will utilize a variety of instruments during a physical examination such as a thermometer to measure your temperature; a blood pressure monitor to measure blood pressure; a stethoscope to listen to organs such as the abdomen, heart and lungs; an ophthalmoscope to examine the eyes; a speculum to allow examination of the cervix; and an otoscope to examine inside the mouth, ears or nose During a physical examination, the doctor will first record your medical history. He may make notes on your general appearance and then check your vital signs – temperature, pulse, blood pressure. He will then measure your height and weight. Any pain being experienced will also be noted (usually be the patient's perception of the pain on a scale of 1-10). The doctor will then proceed through a range of possible examinations on various parts of your body as detailed below. As mentioned earlier, each doctor will perform physical examination in different orders and in varying detail depending on the patient's requirements. The doctor can evaluate the abdominal area by examining the abdomen, liver, spleen, kidneys, costo-vertebral angle, anus and rectum by using a variety of techniques such as visual examination, percussion, palpation and auscultation. The doctor may also look for a linguinal hernia and take a stool sample. A skin examination will involve visually examining the skin's color, texture, turgor, moisture, pigmentation, lesions, hair distribution and warmth in order to assess general health and detect local and systemic disease. The skin on the legs may also be examined to detect arterial and venous insufficiency. The doctor may do an ear, nose and throat assessment by examining the external ear, internal ear and nose – an otoscope is used to examine the inside of the ear or nose. A basic hearing test may also be conducted. Heart functioning can be assessed by measuring the radial pulse, auscultation of the heart, palpation of the precardium, examination of the neck veins, suprasternal notch and precardium. The limbs may also be assessed for evidence of edema. The doctor evaluates the head and neck area by examining the head, scalp, mouth, salivary glands, thyroid gland and cervical nodes. During this examination organs such as the tonsils, tongue, gums, scalp, teeth and membranes can be assessed. Various assessment techniques may be performed on male and female sexual organs. The doctor may examine the vagina, cervix, breasts, axillary nodes, penis scrotum, inguinal nodes and may perform a pap smear, bimanual examination or a rectovaginal examination. The doctor will also examine and evaluate the spine, arm, leg and neck joints to assess such things as joint mobility and spine alignment. The lungs may be assessed by measuring the respiratory rate, examining the trachea position, chest expansion and percussion, voice transmission and listening to the lungs. An eye examination may involve a vision test, inspection of structures around and in the eye and assessment of the functioning of muscles and pupils of the eye. A patient's nervous system can be assessed by evaluating the mental status, cranial nerves, motor system, sensory system, reflexes, cerebellar function and gait. The cranial nerves can be evaluated by performing a variety of tests involving various sensory organs such as the eyes, mouth, skin and ears. The patient's mental status is usually assessed verbally. Evaluation of the motor system utilizes tests involving the arm and leg muscles and the cerebellar functioning can be tested by asking the patient to perform specific movements. Further tests will be ordered by the doctor if deemed necessary e.g. blood tests. The doctor may then offer you advice on how to prevent disease and maintain or improve your health. You may even receive written information about what screening or preventative services you should undertake. Obviously it is then up to you whether you follow up your doctor's advice on further tests, screenings, lifestyle changes etc. Listed are some of the more common assessments and measurements that may be performed during a physical examination. General appearance * e.g. mobility problems, deafness, jaundice, cyanosis, swelling of ankles etc Vital signs Temperature Blood pressure Pulse Other parameters Weight Height Pain - scale of 1-10 Abdominal area * Abdomen * Liver * Spleen * Kidneys * Costo-vertebral angle * inguinal hernia * anus * rectum * Stool sample Skin Ear, Nose, Throat * Ear – external and internal * Hearing * Nose Heart * Pulse * Neck veins * Precardium * Suprasternal notch * Heart auscultation * Edema Head and Neck * Head * Mouth * Salivary glands * Thyroid gland * Cervical nodes Sexual organs * cervix * Pap smear * Vagina * Bimanual examination * Rectovaginal examination * Breast * Axillary nodes * Penis * Scrotum * Inguinal nodes * Female genitalia Joints * neck * arms * leg * spine Lungs * Respiratory rate * Trachea position * Chest observation * Chest expansion * Voice transmission * Chest percussion * Lung auscultation Eyes * External examination * Conjunctivae * Visual acuity * Papillary reaction * Visual field * Eye muscles * Internal examination Nervous system * Mental status * Cranial nerves * Motor system * Sensory system * Reflexes * Cerebellar function * Gait |