Care During Chemotherapy and Beyond
The Physical Examination and Health Assessment
Many people who visit the doctor or healthcare provider's office wonder: "What are
What are they looking for?" During a physical examination, there are many things
that your healthcare provider may be looking for as they are gathering cues and
clues, during the short time you are in the office. Some of the clues are based
on the spoken information that you provide, or they may be based on physical examination
During a health assessment, diagnosing an illness, disorder or a condition is like
a puzzle. Diagnosis often includes laboratory studies, radiology studies to look
at certain organs, and the physical exam itself. This process is called data
collection. Before modern technology, it was important for healthcare providers
to perfect their physical examination techniques, because x-ray machines, scanners,
and echocardiograms were non-existent.
In a physical examination, there are many things that your healthcare provider can
find out by using their hands to feel (palpate), stethoscope and ears to listen,
and eyes to see. Findings that are present on the physical exam may by themselves
diagnose, or be helpful to diagnose, many diseases. The components of a physical
Your examiner will look at, or "inspect" specific areas of your body for normal
color, shape and consistency. Certain findings on "inspection" may alert your healthcare
provider to focus other parts of the physical exam on certain areas of your body.
For example, your legs may be swollen. Your healthcare provider will then pay special
attention to the common things that cause leg swelling, such as extra fluid caused
by your heart, and use this information to help them make a diagnosis. Common
areas that are inspected may include:
- Your skin - to look for bruising, cuts, moles or lumps
- Your face and eyes
- to see if they are even and "normal"
- Your neck veins - to see if these are
bulging, distended (swollen)
- Your chest and abdomen (stomach area)- to see if
there are any masses, or bulges
- Your legs - to see if there are any swelling
Your muscles- to check for good muscle tone
- Your elbows and joints - check for
swelling and inflammation, if any deformities are present
This is when the examiner uses their hands to feel for abnormalities during a health
assessment. Things that are commonly palpated during an exam include your lymph
nodes, chest wall (to see if your heart is beating harder than normal), and your
abdomen. He or she will use palpation to see if there are any masses or lumps,
anywhere in your body.
This is when the examiner uses their hands to "tap" on an area of your body. The
"tapping" produces different sounds. Depending on the kind of sounds that are produced
over your abdomen, on your back or chest wall, your healthcare provider may determine
anything from fluid in your lungs, or a mass in your stomach. This will provide
further clues to a possible diagnosis.
This is an important physical examination technique used by your healthcare provider,
where he or she will listen to your heart, lungs, neck or abdomen, to identify if
any problems are present. Auscultation is often performed by using a stethoscope.
The stethoscope will amplify sounds heard in the area that is being listened to.
If there is an abnormal finding on your examination, further testing may be suggested.
- The neck: When your doctor or healthcare provider is listening to your neck, they
are often listening for a "swishing" sound in your arteries. This may suggest that
there is a narrowing of the arteries, which would increase the sound of blood flow.
- The Heart: Normally, your heart produces a "lub-dub" sound, when the heart valves
are opening and closing during the flow of blood. Your healthcare provider will
listen to see if your heart is beating regularly, or if there are any murmurs (extra
sounds with every heart beat). Heart murmurs may be "innocent", meaning they are
normal, and non-life threatening, or they may signify a problem may be present.
To diagnose this, your healthcare provider may listen with their stethoscope to
many areas around the heart, instead of just one area, and suggest further testing,
- The Lungs: Your doctor or healthcare provider may listen to your lungs with their
stethoscope, anywhere on your back (posterior), or on the front of your chest wall
(anterior). He or she may be able to tell if air is moving to the bottom of your
lungs, by listening to the airflow in and out of your lungs with each breath. These
are called normal lung sounds. If there is a blockage, constriction or narrowing
of your lung tubes, or fluid in your lungs, this can be heard by the examiner.
- The Abdomen: The abdomen will be examined using a stethoscope, to listen for any
"swishing" sounds of blood through the arteries near your stomach (such as the aorta),
or abnormal bowel sounds.
- Other locations: Auscultation may be used anywhere your healthcare provider wants
The Neurologic Examination:
- During a physical examination by the health care professional, a neurologic examination
may be performed. This can be very brief or more detailed depending on concerns
and findings. In general the physical examination is divided into 4
parts; cranial nerve assessment, motor function assessment, sensory function assessment,
and assessment of reflexes.
- Cranial nerve assessment: There are 12 cranial nerves
and these arise from the brain. Each nerve has its own function and the assessment
of the nerves is done by evaluating each function. For example, testing the
gag reflex with the tongue depressor is testing the 9th and 10th cranial nerves.
- Motor function assessment is checking a person's gait, muscle strength and coordination.
The test where a person is asked to touch their nose then the finger of the examiner,
with eyes open then with eyes closed is an example of how coordination may be evaluated.
Sensory function assessment is checking sensations such as pain, temperature, position
sense, crude and fine touch along certain pathways. A test that may used to
evaluate this is asking the person to close their eyes and then using a wisp of
cotton, ask the person if they can feel the cotton brushed on the skin.
a physical examination, testing reflexes helps to assess the status of the central
nervous system, this indicates whether the pathway from the spinal cord to the area
stimulated and back is intact. The briskness of response is evaluated.
Note: We strongly encourage you to talk with your health care professional
about your specific medical condition and treatments. The information contained
in this website is meant to be helpful and educational, but is not a substitute
for medical advice.
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