上海交通大学：《诊断学》课程PPT教学课件（英语版）Chapter 26 Physical examination

Physical examination o It is the process of examining the patient's body to determine the presence or absence of physical problems o The goal of the physical examination is to obtain valid information concerning the health of the patient The examiner must be able to identify, analyze and synthesize the accumulated information into a comprehensive assessment

Physical examination ⚫ It is the process of examining the patient’s body to determine the presence or absence of physical problems ⚫ The goal of the physical examination is to obtain valid information concerning the health of the patient ⚫ The examiner must be able to identify, analyze, and synthesize the accumulated information into a comprehensive assessment

The four cardinal principles of physical examination Inspection ● Palpation ● Percussion Auscultation teach the eye to see, the finger to feel and the ear to hear” o What is the fifth? Smelling

The four cardinal principles of physical examination ⚫ Inspection ⚫ Palpation ⚫ Percussion ⚫ Auscultation “teach the eye to see, the finger to feel, and the ear to hear” ⚫ What is the fifth? Smelling

Equipment for physical examination Required Optional Stethoscope Gloves Tongue blades Gauze pads Penlight Lubricant gel Tape measure Nasal speculum Sphygmomanometer Turning fork: 128 Hz, 512HZ Reflex hammer Pocket visual acuity card Safety pins Oto-ophthalmoscope

Equipment for physical examination Required Optional Stethoscope Gloves Tongue blades Gauze pads Penlight Lubricant gel Tape measure Nasal speculum Sphygmomanometer Turning fork: 128 Hz,512Hz Reflex hammer Pocket visual acuity card Safety pins Oto-ophthalmoscope

Important aspects of physical examination----physIclan Elegant appearance Decent manner Kind attitude Highly responsibility Good medical morals

Important aspects of physical examination----physician ⚫ Elegant appearance ⚫ Decent manner ⚫ Kind attitude ⚫ Highly responsibility ⚫ Good medical morals

Important aspects of physical examination---pnysIClan Wash your hands, preferably while the patient is watching Washing with soap and water is an effective way to reduce the transmission of disease

Important aspects of physical examination---physician ⚫ Wash your hands, preferably while the patient is watching ⚫ Washing with soap and water is an effective way to reduce the transmission of disease

Important aspects of physical examination---patient The patient should be made as comfortable as possible during the examination The patient should be properly draped

Important aspects of physical examination---patient The patient should be made as comfortable as possible during the examination The patient should be properly draped

Important aspects of physical examination Where is the bed placed? When possible, the examining table/bed be situated so that the examiner has access to both sides of the patient An ideal arrangement is to have the table located in the center of the examining room

Important aspects of physical examination Where is the bed placed? ⚫ When possible, the examining table/bed be situated so that the examiner has access to both sides of the patient ⚫ An ideal arrangement is to have the table located in the center of the examining room

Important aspects of physical examination Where does the examiner stand? Stand right side of the bed Exam with one right hand

Important aspects of physical examination Where does the examiner stand? ⚫ Stand right side of the bed ⚫ Exam with one’ right hand

Important aspects of physical examination How to perform the physical examination? ● Sequential Proper expose

Important aspects of physical examination How to perform the physical examination? ⚫ Sequential ⚫ Proper expose

Sequential Conducted in head to toe order: head neck---chest---abdomen---spine extremities---anal---genital---nerve system Patients tire quickly when asked to " sit up lie down, turn on your left side, "sit up “ lie down"and so on

Sequential ⚫ Conducted in head to toe order: head --- neck---chest---abdomen---spine--- extremities---anal---genital---nerve system ⚫ Patients tire quickly when asked to “sit up”, “lie down”, “turn on your left side”, “sit up”, “lie down” and so on