The Physical Exam PDF: An Innovative Approach in the Age of Imaging
|Author||Raymond E. Phillips|
|File size||7.28 MB|
This book invites the clinician to take a fresh look at the “routine” physical examination. The approach taken here is intended for those who have already learned the fundamentals and are interested in adapting a more efficient approach to this time-honored discipline. While technological advances provide astonishing diagnostic information even in the most remote parts of the body, they have not diminished the value of a careful “hands-on” examination.
To modernize the physical examination, the clinician can adopt a systematic sequence and focus that may prove more productive than the methods taught in the pre-imaging era. At the same time, the regional approach developed here – rather than the serial (head-to-foot) approach – provides a keen opportunity to observe the astonishing interactions of anatomy and physiology. These interactions, furthermore, are sometimes the basis for symptoms that can be challenging diagnostically. For just such situations, an insightful physical examination can reveal relevant information that is beyond the scope of the digital image. Presented here is a step-by-step sequence of the physical examination, mindful of the balance between being comprehensive and rapid while at the same time stressing accuracy. This approach emphasizes the signs that reveal how well an organ system is functioning and helps to sort out interrelated problems. Abnormal findings are organized descriptively and presented in regions where they are most likely to appear. With continued applications of these guidelines, the clinician will gain further confidence in the direct assessment of a patient. These skills, applied efficiently, are considered a critical supplement to imaging, not as an obsolete procedure required for medical records. Indeed, the severity of an organ failure, its interrelationship with other organs, and the identification of coexisting problems are within the special realm of the physical examination.
It is hoped that this approach to the routine physical examination will help the clinician achieve this balance while, at the same time, adding to the satisfaction of practicing medicine. Here, I am honored to acknowledge those who have reviewed portions
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