A physical examination is a methodical process that checks a patient thoroughly and helps to detect any abnormalities in the body. It can lead to the most probable diagnosis of a disease. Laboratory tests that may be part of a physical examination also help to diagnose and manage a disorder. Physical examinations for both men and women should be done in a well lighted and quiet room with the patient sitting or lying comfortably on an examining table at an appropriate level. A gown and drape helps to provide privacy, notes The National Center for Biotechnology Information. Physical examination methods vary slight for male and female patients.
Vital Signs
A physical examination begins with observing the general appearance of the patient, including the skin color, body status, apparent age and sitting position. The vital signs, the rate and pattern of respiration and heart beat, the body temperature and the blood pressure are also checked. This gives information about the immediate stability and condition of his general health.
Head and Neck
While examining the head, the doctor first looks at the face for symmetry and inspects the nasolabial skin folds around the mouth, the color of the eyes, the pupillary light reaction and structures inside the eyes with an ophthalmoscope. He then examines the nose and nasal septum, palpates the facial sinuses, asks the patient to open his mouth and examines the lips, teeth, mucosal surface, tongue and other structures of the oral cavity. Next, the doctor examinines the ears by inspecting and palpating the pinna, looks within the ear canal with an otoscope and checks the patient's hearing. The important structures that should be examined in the neck are the salivary, thyroid and lymph glands, the carotid pulse and the jugular vein, as listed by the University of California, San Diego.
Chest
During inspection of the chest in a physical examination, the shape, movement while breathing, muscle or tissue size, hair distribution and any other specific structure is noted. While palpating the area, the doctor checks chest expansion, asks the patient if he feels chest pain in any area, detects the site of maximum intensity of heart beat and any other heart sound. He then listens to the breath and heart sounds with a stethoscope, according to the Merck Manual of Diagnosis and Therapy.
Abdomen and Genitals
During the physical examination, the abdomen is properly exposed and the doctor inspects if for shape, size, symmetry, scarring, pulsation or bulging. He listens to the bowel sounds with a stethoscope before palpating the area. Palpation of the abdominal area is important to feel the underlying structures, including the liver, spleen and kidneys. The genital examination is an important part of male physical exam, though it may be embarrassing for the patient. The doctor will explain the procedure and its importance and ask the patient to stand up. The pubic region, scrotum, and testicles are then evaluated through feeling the area. Next a hernia test in male patients involves inserting a finger into the inguinal canal at the sides of the genital area and asking the patient to turn his face and cough. Any bulging on either side of the inguinal canal during coughing may indicate a hernia.
