The Physical Examination
In addition to exploring the patient's clinical history, the physician will carry out a physical examination to further narrow the list of possible conditions. The patient's temperature, blood pressure, and rate of respiration will be measured. He or she will be weighed and his or her height measured. The physician will use an otoscope to examine the eardrums and to look into the throat for signs of inflammation, infection, or other abnormal conditions.
The heart and lungs can be examined superficially using a stethoscope. Abnormalities in the heartbeat or in the functioning of the heart valves can be heard in this way, and the presence of water or other fluid in the lungs can be heard as noises called rales. The physician also can study the sounds made by the intestines by listening to them through the stethoscope.
Using his fingers, a technique called palpation, the physician probes the abdomen for signs of pain or an abnormal lump or growth. He also feels the neck, the axillary area (armpit) and other locales to locate any enlarged lymph nodes, a sign of an infection. Such probing also may bring to light the presence of a tender area previously unknown to the patient.
If the patient is complaining of an injury, the physician can carefully palpate around the injury to determine its size. He can bend an leg or arm to assess the integrity of the joint. Using other maneuvers, he can determine whether a ligament has been torn and if it may need surgical correction.
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