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Difference between revisions of "Physical examination"
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[[File:MMSA Checking Blood Pressure.JPG|thumb|A blood pressure check. (WC/Kilbosh)]] | |||
The '''physical examination''', also '''clinical examination''', in medicine is the art of acquiring information while looking fancy. The findings usually don't make the [[diagnosis]]. The [[clinical history|history]] is often far more important. | The '''physical examination''', also '''clinical examination''', in medicine is the art of acquiring information while looking fancy. The findings usually don't make the [[diagnosis]]. The [[clinical history|history]] is often far more important. | ||
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**Nasal flaring. | **Nasal flaring. | ||
**Cyanosis - lips, lingual frenulum. | **Cyanosis - lips, lingual frenulum. | ||
*Trachea midline? | *[[Trachea]] midline? | ||
*Accessory neck muscle use. | *Accessory neck muscle use. | ||
Peripheral: | Peripheral: | ||
*Clubbing (lung causes DDx: abscess, [[bronchiectasis]], [[cancer]], decreased O2, empyema, [[fibrosing alveolitis]]). | *[[Clubbing]] (lung causes DDx: abscess, [[bronchiectasis]], [[cancer]], decreased O2, empyema, [[fibrosing alveolitis]]). | ||
**Clubbing should be viewed with suspicion in patient with [[COPD]], as it should not be seen in the context of pure [[emphysema]].<ref>URL: [http://medicine.ucsf.edu/education/resed/Chiefs_cover_sheets/Clubbing.pdf http://medicine.ucsf.edu/education/resed/Chiefs_cover_sheets/Clubbing.pdf]. Accessed on: 23 September 2010.</ref> Clubbing in COPD is relatively rare; thus, in the context of COPD and smoking it should prompt a search for an occult [[lung cancer]].<ref>URL: [http://www.merck.com/mmhe/sec04/ch045/ch045a.html http://www.merck.com/mmhe/sec04/ch045/ch045a.html]. Accessed on: 23 September 2010.</ref> | **Clubbing should be viewed with suspicion in patient with [[COPD]], as it should not be seen in the context of pure [[emphysema]].<ref>URL: [http://medicine.ucsf.edu/education/resed/Chiefs_cover_sheets/Clubbing.pdf http://medicine.ucsf.edu/education/resed/Chiefs_cover_sheets/Clubbing.pdf]. Accessed on: 23 September 2010.</ref> Clubbing in COPD is relatively rare; thus, in the context of COPD and smoking it should prompt a search for an occult [[lung cancer]].<ref>URL: [http://www.merck.com/mmhe/sec04/ch045/ch045a.html http://www.merck.com/mmhe/sec04/ch045/ch045a.html]. Accessed on: 23 September 2010.</ref> | ||
*Cyanosis - fingernails. | *Cyanosis - fingernails. | ||
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===Palpation=== | ===Palpation=== | ||
*Trachea midline (may be deviated in tension pneumothorax). | *Trachea midline (may be deviated in tension [[pneumothorax]]). | ||
*Tactile fremitus (boy-o-boy or 99). | *Tactile fremitus (boy-o-boy or 99). | ||