University Of Pamplona, Conceptos Básicos de Lengua Extranjera – Inglés I

Teacher: Edgar H. Lizcano Lizcano Program: “Pre-Medico”

Objective: Identify words, verbs, structures, tenses, nouns, adjectives, forms, and keys on
Common Medical Translations Texts.

Text: Physical examination, From Wikipedia, the free encyclopedia

Intervention.

A physical examination, medical examination, or clinical examination (more popularly

known as a check-up) is the process by which a medical professional investigates the
body of a patient for signs of disease. It generally follows the taking of the medical history
— an account of the symptoms as experienced by the patient. Together with the medical
history, the physical examination aids in determining the correct diagnosis and devising
the treatment plan. This data then becomes part of the medical record.

A Cochrane Collaboration meta-study found that routine annual physicals did not
measurably reduce the risk of illness or death, and conversely, could lead to over-
diagnosis and over-treatment. The authors concluded that routine physicals were unlikely
to do more good than harm.[1]

Routine physicals are physical examinations performed on asymptomatic patients for

medical screening purposes. These are normally performed by a pediatrician, family
practice physician, nurse practitioner, or other primary care provider. This routine physical
exam usually includes the HEENT evaluation.

Comprehensive physical exams, also known as executive physicals, typically include

laboratory tests, chest x-rays, pulmonary function testing, audiograms, full body CAT
scanning, EKGs, heart stress tests, vascular age tests, urinalysis, and mammograms or
prostate exams depending on gender.[2][3]

Pre-employment examinations are screening tests which judge the suitability of a worker
for hire based on the results of their physical examination.[4] This is also called pre-
employment medical clearance. Many employers believe that by only hiring workers
whose physical examination results pass certain exclusionary criteria, their employees
collectively will have fewer absences due to sickness, fewer workplace injuries, and less
occupational disease.[4]

A small amount of low-quality evidence in medical research supports the idea that pre-
employment physical examinations can actually reduce absences, workplace injuries, and
occupational disease.[4]

Employers should not routinely request that workers x-ray their lower backs as a condition
for getting a job.[5] Reasons for not doing this include the inability of such testing to predict
future problems, the radiation exposure to the worker, and the cost of the exam.[5]
Insurance exams. These are physicals performed as a condition of buying health
insurance or life insurance.

Uses: Diagnosis

Physical examinations are performed in most healthcare encounters. For example, a

physical examination is performed when a patient visits complains of flu-like symptoms.
These diagnostic examinations usually focus on the patient's chief complaint.

Screening. General health checks, including physical examinations performed when the
patient reported no health concerns, often include medical screening for common
conditions, such as high blood pressure. A Cochrane review found that general health
checks did not reduce the risk of death from cancer, heart disease, or any other cause,
and could not be proved to affect the patient's likelihood of being admitted to the hospital,
becoming disabled, missing work, or needing additional office visits. The study found no
effect on the risk of illness, but did find evidence suggesting that patients subject to routine
physicals were diagnosed with hypertension and other chronic conditions at a higher rate
than those who were not. Its authors noted that studies often failed to consider or report
possible harmful outcomes (such as unwarranted anxiety or unnecessary follow-up
procedures), and concluded that routine health checks were "unlikely to be beneficial" in
regards to lowering cardiovascular and cancer morbidity and mortality.[1]

Establishing doctor-patient relationship

In addition to the possibility of identifying signs of illness, it has been described as a ritual
that plays a significant role in the doctor-patient relationship that will provide benefits in
other medical encounters.[6]

Format and interpretation

A physical examination may include checking vital signs, including temperature

examination, Blood pressure, pulse, and respiratory rate. The healthcare provider uses the
senses of sight, hearing, touch, and sometimes smell (e.g., in infection, uremia, diabetic
ketoacidosis). Taste has been made redundant by the availability of modern lab tests. Four
actions are taught as the basis of physical examination: inspection, palpation (feel),
percussion (tap to determine resonance characteristics), and auscultation (listen).

What is checked?

While elective physical exams have become more elaborate, in routine use physical
exams have become less complete. This has led to editorials in medical journals about the
importance of an adequate physical examination.[7][8]

Although providers have varying approaches as to the sequence of body parts, a

systematic examination generally starts at the head and finishes at the extremities. After
the main organ systems have been investigated by inspection, palpation, percussion, and
auscultation, specific tests may follow (such as a neurological investigation, orthopedic
examination) or specific tests when a particular disease is suspected (e.g. eliciting
Trousseau's sign in hypocalcemia).

With the clues obtained during the history and physical examination the healthcare
provider can now formulate a differential diagnosis, a list of potential causes of the
symptoms. Specific diagnostic tests (or occasionally empirical therapy) generally confirm
the cause, or shed light on other, previously overlooked, causes.

Physicians at Stanford University medical school have introduced a set of 25 key physical
examination skills that were felt to be useful.[9]

While the format of examination as listed below is largely as taught and expected of
students, a specialist will focus on their particular field and the nature of the problem
described by the patient. Hence a cardiologist will not in routine practice undertake
neurological parts of the examination other than noting that the patient is able to use all
four limbs on entering the consultation room and during the consultation become aware of
their hearing, eyesight and speech. Likewise an Orthopaedic surgeon will examine the
affected joint, but may only briefly check the heart sounds and chest to ensure that there is
not likely to be any contraindication to surgery raised by the anaesthetist. A primary care
physician will also generally examine the male genitals but may leave the examination of
the female genitalia to a gynecologist.

A complete physical examination includes evaluation of general patient appearance and

specific organ systems. It is recorded in the medical record in a standard layout which
facilitates others later reading the notes. In practice the vital signs of temperature
examination, pulse and blood pressure are usually measured first.

Graphic……………………………………………………….

History. The executive physical format was developed from the 1970s by the Mayo Clinic
and is now offered by other health providers, including Johns Hopkins University,
EliteHealth and Mount Sinai in New York City. Executive physicals are also the primary
service of concierge doctors, who say that they do a more thorough examination for a cash
premium on top of the insurance coverage.[10]

Society and culture

A physical examination may be provided under health insurance cover, required of new
insurance customers. This is a part of insurance medicine. In the United States, physicals
are also marketed to patients as a one-stop health review, avoiding the inconvenience of
attending multiple appointments with different healthcare providers.[11][12]