Assisting with Physical Examinations

• Methods and equipment vary from MD to MD• 3 major kinds of examinations– EENT– GYN– General/complete physical

4 main techniques used• 1. Observation- MD looks at pt- observes

skin color, rash, growths, swelling, scars, deformities, body movements, hair/nail conditions, general appearance

• 2. Palpation- MD uses hands and fingers to feel various parts of body to determine whether part of the body is enlarges, hard, out of place, or painful to the touch

• 3. Percussion- MD taps and listens for sounds coming from various organs; MD places one or several fingers of one hand on body part, then uses fingers of other hand to tap the body part> sounds allow MD to determine size, density, and position of organs

• 4. Auscultation- MD listens with stethoscope

Examples of equipment/instruments used for Examinations

• Cervical spatula (Ayer blade)- wooden or plastic blade used to scrape cells from cervix ; usually part of a pap (Papanicolaou) kit; pap test is to check for cervical cancer

• Laryngeal mirror- instrument with a mirror at one end; used to examine the larynx

• Ophthalmoscope- lighted instrument to examine eyes

• Otoscope- lighted instrument to examine ears• Percussion (reflex) hammer- used to test tendon

reflexes• Sigmoidoscope- lighted instrument used to

examine the sigmoid colon• Speculum- used to examine internal canals of the

body> Ex. Nasal, vaginal, rectal

• Sphygmomanometer- used to measure BP• Stethoscope- used for auscultation• Tongue blade/depressor- wood or plastic stick

used to depress the tongue so throat can be examined

• Tuning fork- instrument with two prongs that is used to test hearing acuity

Preparing the pt for exam

• Explain procedure> alleviate fears• Usually needs to remove all or at least some

articles of clothing an put on gown• Have pt void> If urine specimen is

needed/ordered> collect at this time• Position and drape pt according to exam being

performed

Frequent test done prior to exam

• Ht and Wt• VS (TPR and BP)• Vision screening• Audiometric screening• Blood tests• Electrocardiogram

• **Practice standard precautions**

Info on Lab requisition formExamples• Date• Time• Pt’s name• Pt’s address• Pt’s ID number• Doctor’s name• Type of specimen• Test ordered• Date of LMP

•Read pages 741-747 for basic guidelines in DHO textbook