Unit The Medical Examination

3
UNIT 3: THE MEDICAL EXAMINATION

LEARNING OBJECTIVES

By the end of the unit, students will be able to

● Describe how temperature and blood pressure are calculated

● Role-play a dialogue between a patient and someone taking temperature

and blood pressure
● Ask and answer questions in order to take a medical history

● Classify family-related health problems

● Identify certain patients' illnesses and conditions

VOCABULARY
Medical check-up, Temperature, Blood, Pressure, Degrees, Celsius, Patient,
Armpit, Measurement, Systolic, Diastolic

GRAMMAR
Polite request and useful questions

SUMMARY
In this unit you learn how to talk about some medical examinations. You also
learn the importance of family in health and role play a dialogue at the doctor’s
office.
 PREPARATION TASK

A.-Choose one of the following websites and be prepared to

explain the medical examination.
1. BODY TEMPERATURE
2. BMI
3. BLOOD PRESSURE

https://www.uofmhealth.org/health-library/hw198785

DISCUSSION

1. Do you know any medical examinations?

2. Who would need a medical examination?
3. What are the procedures of a medical examination or check-up?

B.-Read this text about the Medical Examination and answer the questions that
follow.
Physical examination is the process of evaluating objective anatomic findings using
observation, palpation, percussion, and auscultation. The information obtained must be
thoughtfully integrated with the patient's history and pathophysiology. Moreover, it is a
unique situation in which both patient and physician understand that the interaction is
intended to be diagnostic and therapeutic. The physical examination, thoughtfully
performed, should capture 20% of the data necessary for patient diagnosis and
management.

The Context
Information pertinent to the physical examination can be learned from observation of
speech, gestures, habits, gait, and manipulation of features and extremities.
Interactions with relatives and staff are often revealing.

The Physician–Patient Interaction

Aside from the hospital room and office, physical examination may occur in a variety of
other settings where it is difficult to establish privacy and quiet. The best resource
available to the physician to set the stage for the physical examination is to
communicate respect and a genuine interest in the patient's welfare. The patient
should be addressed politely and asked to perform the required maneuvers of the
examination, a technique far preferable to imperative language such as, "I want you to.
…" Patients should be prepared for unpleasant portions of the examination.
1. Aside from explanations and reassurance, it is not necessary to maintain a
continuous conversation with the patient during the examination.
2. Avoid embarrassing the patient.
3. Be certain that draping material is used appropriately and that personal areas
are not subjected to undue exposure.
 4. The patient may benefit from a brief summary of relevant findings and may
require reassurance about what has and has not been found.

The Materials
⮚ The single most useful device for optimal performance of the physical
examination is an inquisitive and sensitive mind.
⮚ Next most useful is mastery of the techniques of observation, palpation, percussion, and
auscultation.

The Examination
The clinically significant physical examination is a flexible entity that should vary with
the needs of the patient. Periodic examinations for health assessment need to be
comprehensive, as do most hospital admission examinations.
Answer the following questions

1. What methods are used to perform a medical examination?

The methods used to perform a medical examination are observation, palpation, percussion, and
auscultation.
2. What is the purpose of the medical examination?
The purpose of the medical examination is to obtain objective anatomic findings that can be
integrated with the patient's history and pathophysiology in order to aid in diagnosis and
management.
3. Where do medical examinations take place?
Why is it important to show respect? physical examinations can take place in a variety of settings,
including the hospital room, office, and other settings where privacy and quiet may be difficult to
establish. It states that it is important to show respect because the interaction is intended to be
diagnostic and therapeutic, and the patient should feel comfortable and at ease.
4. What do you think about the four recommendations in order to perform a
medical examination?
The four recommendations from the text for performing a medical examination
are:

• Aside from explanations and reassurance, it is not necessary to maintain a continuous

conversation with the patient during the examination.
• Avoid embarrassing the patient.
• Be certain that draping material is used appropriately and that personal areas are not
subjected to undue exposure.
• The patient may benefit from a brief summary of relevant findings and may require
reassurance about what has and has not been found.
• This recommendation allows to provide adequate medical care
5. What is a comprehensive assessment?
refers to a periodic examination for health assessment that needs to be thorough, as well as
most hospital admission examinations.
 BLOOD PRESSURE AND TEMPERATURE

1. If the blood pressure is 134/78, what is the figure for systolic blood pressure?

● The figure for systolic blood pressure is 134

2. Using the chart above, what is the correct blood pressure for an average 40
year old?

● The correct blood pressure for an average 40 year old is 126/84.

3. Using the chart above, what is the blood pressure of a newborn baby?

● The correct blood pressure for a newborn baby is 80/46.

Summarize the text in your own words

 You can write your notes here

Then practice the pronunciation of the following words

1. Medical check-up
2. Temperature
3. Blood
4. Pressure
5. Degrees
6. Celsius
7. Patient
8. Armpit
9. Measurement
10. Systolic
11. Diastolic

DISCUSSION

1. What medical examinations did you read about?

2. Who would need a medical examination?
3. What are the procedures of a medical examination or check-up?

PRONUNCIATION

PRACTICE SAYING THESE TEMPERATURES

1) 36.6 ° C 4) 38.3 ° C
2) 35.2 ° C 5) 37 ° C
3) 37.4 ° C 6) 37.9 ° C

GRAMMAR: POLITE REQUESTS

When you go for a medical checkup, the doctor will ask you to do certain things,
like open your mouth or breathe deeply. He will ask you to do these things in a
polite way, so he will probably say: Could you breathe deeply?

COMPLETE THESE REQUESTS

Could _ you _ open _ your mouth for
me please?
 Would_ you just mind putting this
under your tongue?

could you keep your cough and hold for a minute?

Can _ I just _ take _out the thermometer?

MAKING POLITE
REQUESTS
We use Can/Could you + infinitive Can you open your mouth, please?
when we Could you lift up your arm for me,
ask somebody to do something for us please?
We use Would you mind + gerund Would you mind opening your mouth,
when we please?
make a polite request

USEFUL QUESTIONS
We use questions in the present tense How many units of alcohol do you
to ask about habits or conditions. consume
per week?
How many cigarettes do you smoke a
day?
Do you have any allergies?
Are you allergic to any medicine?
Is there any history of high blood
pressure in
your family?
We use questions in the present Have you ever smoked?
perfect to ask about history of previous Have you ever had high blood
habits and pressure?
conditions.
CONTROLLED PRACTICE: AT THE
DOCTOR’S

Bob is at the doctor’s office. The doctor

is taking his temperature and blood
pressure. Read the following dialogue
DOCTOR DEB: So Bob,
how are you feeling today?
BOB: I feel terrible. I think I have a fever.

DOCTOR DEB: I need to examine your first. Would you mind putting this in your mouth?
BOB: What is it?
DOCTOR DEB: it’s a thermometer. It is used to measure your temperature. Could
you please say Ahhh
BOB: Aaaaaahhhhhh
DOCTOR DEB: It says you have a temperature of 37 degrees Celsius. Now I need
to measure your blood pressure. Could you put this around your arm and relax
your hand.
BOB: Ok
DOCTOR DEB: Let’s see. Your blood pressure is
140 over 92 BOB: Is that ok? Or it is high?
DOCTOR DEB: It’s a bit high for your age. How many units of alcohol do you
consume per week?
BOB: Just a couple of glasses of wine.

DOCTOR DEB: Is there any history of high blood pressure in

your family? BOB: Not that I know of.
ROLE PLAY: Now work with a partner and perform a dialogue. Follow these prompts
STUDE STUDE
NT A NT B
Ask how the patient is feeling Bad / mentions 2 symptoms
Examine/ open mouth / put Agree.
thermometer
under / tongue
Ask / say Aaahhhh Say Aaahhhh
Temperature: 38.3 ° C. Now / blood Agree
pressure
/hold up / arm
Blood pressure : 135/89 Ask: High? Low?
Answer. Ask / smoke / drink 20 cigarettes a day / 1 bottle of wine a
week
Ask /history / high blood pressure Yes. Father

TASK: FAMILY
HISTORY AND BACKGROUND
CHECK

What is a family-related problem?

What are the most common family-related problems?

1 2 3 4 5
VOCABULARY
Use the keywords to fill in the blanks

Coronary stroke diabetes jaundice

heart disease

anemia hepatitis b alcoholism chain smoker

 1. Coronary heart disease An illness that affects the heart.
2. Stroke When blood stops flowing to the brain
3. Diabetes When the sugar in the blood is too high and the body is unable to
regulate it.
4. Jaundice_When the skin color becomes discolored, due to the breakdown of
too many blood cells.
5. Hepatitis B _A virus which affects the liver. It is contacted through sexual
intercourse and sharing needles.
6. Hihg blood presure When the arteries and veins become thinner, the heart has
to work harder to pass blood around the body.
7. Alcoholism_Being addicted to alcohol
8. Chain smoker A person who smokes too much tobacco
9. Hereditary desease Diseases passed from parent to child.
10. anemia When blood cells don’t carry enough oxygen.
11. coeliac disease When your blood cells attack healthy cells due to a
gluten protein
12. drug adidiction When a patient becomes dependent on substance abuse.

READ FOR COMPREHENSION

Read the description and diagnose the patients below using vocabulary from the reading.
 1. cystic fibrosis

2. anemia

3. coeliac disease

4. color blindness

LISTEN FOR DETAILS

Listen to
the
dialogue
and fill in
the blanks
SPEAKING
Listen to the dialogue and fill in the blanks
DOCTOR: Hi, Mr. Hopes. I just need to double check your medical history. Is there any history of
(1) in your family?

PATIENT: My father died of a (2) _

DOCTOR: Any history of a (1) or brain-related illness?
PATIENT: None that I know of.
DOCTOR: Do you have any (1) to medicine or food?
PATIENT: Only a slight (1) to nuts.
DOCTOR: Do you consume (1) at all?
PATIENT: Only moderately, about 1-2 drinks a week.
DOCTOR: Have you ever (1) before?
PATIENT: Yup, I smoked until I was twenty.
DOCTOR: How many a day?
PATIENT: I smoked twenty cigarettes a day
DOCTOR: When did you give it up?
PATIENT: Last year
DOCTOR: Any (1) in your family?
PATIENT: My father was a (1) _
DOCTOR: Any (1) in your family
PATIENT: Only when I was born.
DOCTOR: That’s not a problem. Most babies get it when they are born. Any history of (1) -
?
PATIENT: None that I know of. I don’t think so.
ROLE PLAY
What are the questions you may ask a patient who needs a check-up? Write as many
questions as you can.

Age duration of allergies drinking

marriage habits

smoking diabetes in childhood surgery

habits the family illnesses

travel work exercise vaccinations

addictions sleeping last

habits check-
 FOLLOW UP READING COMPREHENSION
Read this text and answer the questions which follow

Your Family Health History & Genetics

It is important for parents to
learn as much as they can about their family
health history in order to have a complete
record for your child throughout his or her life.

Family Health History Plays a Major Role In:

● Identifying familial and hereditary disorders

● Determining inheritance patterns and

recurrence risks for known and
suspected genetic disorders
● Identifying those at risk for a genetic disorder

● Identifying those not at risk for a genetic disorder

● Providing information necessary for appropriate genetic counseling

● Providing an important adjunct to patient management of all childhood

diseases, such as growth problems and asthma
Ideally a family history is recorded at your child first visit to the pediatrician, as
well as a
mother’s first prenatal visit. A family history should also be updated yearly with
each well-child visit.

Questions Your Pediatrician May Ask About Family History :

● Are there any health problems that are known to run in your family, or
that close relatives have been told are genetic? If so, what are these
conditions?
● Is there anyone in the family who had cancer, heart disease, or other adult-
onset health problem at an early age, such as between 20 and 50?
● Does/did anyone in the family have intellectual disability, learning problems, or
have to go to a special school?
● Have there been any early deaths in the family, including stillbirths, infant
deaths, multiple miscarriages, or shortened life span?
● What is your ethnic background? Some genetic conditions are more common
in certain geographic, ethnic, and racial groups.
● Have any relatives had extreme or unexpected reactions to medications or therapy?
 QUESTIONS

1) Why is it important to know about your family health history?

2) Explain the following expressions:
hereditary disorders
genetic disorders
genetic counseling
growth problems

3) Who records your family history for the first time in your life?
4) Classify the questions you may be asked about family history into the
following categories

Hereditary problems Ethnic problems

1.
Adaptado de Shu-Chuan Liang, Adrian Maskery