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 form Examples 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 for basic guidelines in DHO textbook