Physical examination is the process of evaluating objective anatomic findings...(More)

Physical examination is the process of evaluating objective anatomic findings through the use of observation, palpation, percussion, and auscultation. The information obtained must be thoughtfully integrated with the patient's history and pathophysiology. Moreover, it is a unique situation in which both patient and physician understand that the interaction is intended to be diagnostic and therapeutic. The physical examination, thoughtfully performed, should yield 20% of the data necessary for patient diagnosis and management. recommendations can be made when reporting and interpreting physical findings. 1. Emphasis should be placed on dichotomous variables (i.e., presence or absence of râles) rather than on graded variables (i.e., intensity of breath sounds). 2. Some physical signs (i.e., clubbing of the fingers) represent a continuum from obviously normal to obviously abnormal. Emphasis should be placed on those findings which represent the extremes rather than the "borderline" cases. 3. Recognition of those physical findings which have a high degree of interobserver variability is important. Good examples of this include detection of moderate or small amounts of ascitic fluid and detection of diaphragmatic movement by percussion. These findings should be deemphasized in favor of those with better reproducibility. 4. It is beneficial to use the body's "symmetry" to advantage. Differences auscultated in breath sounds between similar area of the right and left lung are far more clinically important than an overall decrease in breath sounds. If these points are kept in mind, the physical exam will fill its proper role in the care of the patient. That is as an adjunct to a thorough history and as a way for the physician to interact physically with the patient.(Less)