Week 10: Assisting with General Physical Examination

Sign

objective information detected by the physician

Symptom

subjective information supplied by the patient

Laboratory or other diagnostic tests

• ordered to confirm a diagnosis or to rule out other possible disorders

• to help the physician formulate a treatment plan or appropriate drug therapy

Differential diagnosis

determining the correct diagnosis when two or more are possible

Prognosis

probable course and outcome of the disorder and the possibility of recovery

Role of MA in assisting licensed practitioner and patient:

• interview - chief complaint (subjective)

• obtain histories - subjective

• determine vital signs - objective

• measure weight and height - objective

• ensuring instruments and supplies are available

• helping into position, ensuring patient comfort

• observing for signs of distress or need for assistance

• educating patients on self-examinations

• performing injections, EKG, phlebotomy

Aseptic hand washing (when)

• before and after each patient contact

• before and after each procedure

Wear gloves if there may be contact with:

• blood

• non intact skin

• body fluids

• when handling specimens

Respiratory hygiene/cough etiquette

wear a mask to prevent exposure by airborne droplets

sitting position best for:

• knee reflexes

• listening to the lungs

• apical pulse

supine position best for:

• EKG

• abdominal exam

• exams involving the front of the body

• administration of CPR

prone position best for:

• back procedures

• exams involving the back of the body

• examining the bottoms of feet

• contraindicated in late-term pregnancy

fowlers position best for:

exams of the eyes, ears, nose, throat, and chest

semi-fowler’s position best for:

EKG, chest exams, patients experiencing SOB (COPD, CHF), ear lavage

dorsal recumbent position best for:

Can be an accommodation for low back pain

• EKG

• abdominal exam

• catheterizations

• genital exam of younger children

knee-chest position best for:

• gynecological and rectal exams

• treatments of spinal adjustments

• enema

lithotomy position best for:

female pelvic exams

sims position best for:

exams involving the rectum

jack-knife (proctologic) position best for:

• rectal exams

• sigmoidoscopy

trendelenburg position best for:

shock

Inspection

visual exam

Auscultation

listening to body sounds

palpation

touch

percussion

tapping or striking the body to hear sounds or feel vibrations

mensuration

process of measuring

manipulation

• moving of a patient’s body parts

• ROM of joints

Patient Education Topics:

• risk factors for disease

• how to administer medications

• how to perform diagnostic techniques

• teach the correct way to perform a diagnostic test

supine

lying flat on the back with arms at the sides

prone

lying flat on the abdomen with arms above head

fowlers

sitting with back of exam table at 90º

semi-fowler’s

seating, leaning against exam table at 45º

dorsal recumbent

lying flat on the back with knees bent

knee-chest

prone and bent at the waist, resting on knees, with arms above head

lithotomy

lying flat on table with buttocks at the end, feet resting in stirrups

sims

lying on the left side, left leg slightly flexed, right leg flexed at 90º angle

jack-knife (Proctologic)

lying over the exam table that is lifted in the middle

trendelenburg

legs elevated above head to force circulation to vital organs