Polyclinic. A physical examination, medical examination, or clinical examination

1.

Independent work
Theme:
Polyclinic
Prepared by: Tuleubekov Magzhan
Group: 103 B
Faculty: General medicine
Checked by: Kosbatyrova Nauat
Almaty 2012

2. A physical examination, medical examination, or clinical examination is the process by which a doctor 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 experie

A physical examination, medical
examination, or clinical
examination is the process by
which a doctor 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.

3.

A physical examination may be provided under health insurance cover, required of new
insurance customers, or stipulated as a condition of employment. In the United States,
physicals are also marketed to patients as a one-stop health review, avoiding the
inconvenience of attending multiple appointments with different healthcare providers

4.

Comprehensive physical exams of this type are also known as executive
physicals, and typically include laboratory tests, chest x-rays, pulmonary function
testing, audiograms, full body CAT scanning, EKGs, heart stress tests, vascular
age tests, urinalysis, and mammograms or prostate exams depending on gender.
The executive physical format was developed from the 1970s by the Mayo Clinic
and is now offered by other health providers, including Johns Hopkins
University, EliteHealth and Mount Sinai in New York City.

5.

• While elective physical exams have become more elaborate, in routine use
physical exams have become less complete. This has led to editorials in
medical journals about the importance of an adequate physical
examination. In addition to the possibility of identifying signs of illness, it
has been described as a ritual that plays a significant role in the doctorpatient relationship. Physicians at Stanford University medical school have
introduced a set of 25 key physical examination skills that were felt to be
useful.

6.

• Although providers 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 or
specific tests when a particular
disease is suspected.

7.

• With the clues obtained during the history
and physical examination the healthcare
provider can now formulate a differential
diagnosis, a list of potential causes of the
symptoms. Specific diagnostic tests
generally confirm the cause, or shed light
on other, previously overlooked, causes.

8.

While the format of examination as
listed below is largely as taught and
expected of 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.

9.

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.

10.

The physician begins the examination by
asking about the patient's symptoms. The
patient may be asked to describe the
symptoms and how long he or she has
been experiencing them. If the patient is
in pain, information is collected about the
location, type, and duration of the pain.
Other symptoms that may be present but
may not have been noticed by the patient
must be explored.