Generalities Conventional teaching has long recognized the abdomen as “the grave of the internist,” since in contrast to the chest, this cavity has been quite unyielding to physical exam. Although maneuvers devised by generations of physicians to unlock the secrets…
Generalities Lung auscultation has long suffered from a complex and onomatopoeic terminology that goes back to the original stethoscope and its inventor. Recent application of computer technology has rekindled this art by facilitating acoustic analysis. Still, its major difficulty lies…
Generalities Chest inspection, palpation, and percussion are the foundations of physical exam. Percussion is 15 years older than the United States, the brainchild of an Austrian innkeeper’s son who figured out that patients’ chests could behave like barrels of wine.…
Generalities Cardiovascular examination is centered around five main components – all essential for making a diagnosis. In this section we shall discuss inspection , palpation , and percussion . Next we shall address auscultation, first with heart sounds and extra…
Generalities The clinical breast examination (CBE) as screening tool for breast cancer is a controversial, changing field; it has mostly been studied in conjunction with screening mammography. (1) Inspection 1. Which areas should be examined? Breast tissue is contained in…
Generalities The thyroid may not be the most important organ in a busy general practice, but in physical diagnosis it is second only to the heart in number of examination errors and lack of physician’s confidence. This is unfortunate, as…
A Neck Features and Swellings (1) Generalities The neck is an important crossroad of anatomic structures and organ systems, the most important of which is the thyroid (discussed in Chapter 8 ). 1. What neck features should be identified during…
A The Nose (1) Generalities If you can excuse the pun, it is wise to be nosy about the nose. In fact, examination of this important facial appendix may reveal unsuspected abnormalities that lead to a diagnosis of either systemic…
Generalities The ear is an important site for physical examination; abnormalities may reflect either local or systemic disease. It also is an important sensory organ, whose function can be assessed (albeit in a rudimentary manner) with basic bedside tools. 1.…
Generalities The eye is often bypassed or cursorily examined. Yet from measurement of visual acuity to funduscopy, all components of the exam can unlock important secrets, not only of the eye but also of the body. Some findings are so…