Friday, September 21, 2012

How To Do A Physical Examination?

First of all, congratulations and welcome to the 5th year you guys. I guess this year's gonna be more tough than the previous. More clinical skills to be learn, not to mention the endless medical facts that you need to memorize. May Allah ease us all insyaAllah.

For your information, the medical students in Malaysia already learn and apply the techniques since their 3rd year already. I bet they already master the skill, unlike us a 5th year who knows nothing yet. However, no need to worry because we still have time to learn and practice if we start now. Practice makes perfect as they said, right?

Before examining the patient, we should take the history at first. It's not that difficult to do actually. However,   since there's a language barrier, I guess it is difficult after all. Be it in Egypt or even in Malaysia. Just because you're in Malaysia doesn't mean that all the patients speak Malays. You've got to remember that we are a multi-racial country. So try to learn some of their language or ask for someone that can help you translate.

Okay, here are the general steps :

1. Introduce yourself

This step is very important. Give the patient a proper introduction and ask for their permission at first. If you're going to have to remove their clothes, do consider their modesty. Do it in a closed area and cover them until you're going to do the palpation.

2. Inspection

Carefully observe the patient at first and don't rush to see any specific part. See if whether there's cyanosis/pallor/flush/scar/dypsnoea. 

The Hand

- Skin : The palm and dorsum, sign of palmar erythema, Dupytren's, etc2

<---Palmar erythema = Reddening of thenar and hypothenar muscle

<---Dupytren's contracture (Remember forensic's!!!)

- Nails : Clubbing? Koilonychia? Other nails deformity [ Click Here ]

- Muscles : wasting of thenar or hypothenar?

- Joints
- Bony Deformities
- Elbows

3. Palpation

4. Auscultation

to be continue....

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