The purpose of the physical examination is to iden...
The purpose of the physical examination is to identify physical signs of diseases. The significance of these objective indications of diseases is enhanced when they confirm a functional or structural change already suggested by the patient’s history. At times, however, physical signs may be the only evidence of a disease. The physical examination should be methodical and thorough, with consideration given to the patient’s comfort and dignity. Although attention is often directed by the history to the diseased organ or part of the body, the examination of a new patient must extend from head to toe in an objective search for abnormalities. Unless the physical examination is systematic and is performed consistently from patient to patient, important segments may be omitted inadvertently. The results of the examination, like the details of the history, should be recorded at the time they are elicited -- not hours later, when they are subject to the distortions of memory. Skill in physical diagnosis is acquired with experience, but it is not merely the technique that determines success in eliciting signs of a disease. The detection of a few scattered petechiae, a faint diastolic murmur, or a small mass in the abdomen is not a question of keener eyes and ears or more sensitive fingers, but of a mind alert to those findings. Because physical findings can change with time, the physical examination should be repeated as frequently as the clinical situation warrants.