Wednesday, January 16, 2013

The Physical Exam

Image from http://www.nysoa.org - fundus of the eye.
Today we were introduced to the physical exam. In the second semester of the M1 year, we learn how to do the "core" physical exam. This includes: General Appearance, Vital Signs, Eyes, Ears, Nose, Mouth, Lymph Nodes of the Head and Neck, Anterior Thyroid, Posterior Thorax and Back, Axillae, Anterior Thorax, Heart and Great Vessels of the Neck, Abdomen, Inguinal Area, Upper Extremities, Lower Extremities, Deep Tendon Reflexes, and Standing Examination.

By the end of the semester, we will perform this 1-hour-long core physical exam on a paid patient actor in front of a preceptor that will grade us on each item in the 190+ (or so) item list. To pass the assessment, students must successfully complete at least 92% of the items on the exam checklist. They tell me this is easier than it sounds, as "most" students pass on their first try. Here's hoping!

Today, we started with the general appearance (Does patient look stressed/healthy/fatigued, etc.), vital signs, eyes, and ears. Click here for a PDF with what, exactly, is included in each portion of the physical exam. While I technically know how to do the sections we reviewed and practiced today, I had the hardest time ever seeing the fundus of the eye using the ophthalmoscope. It was crazy hard.

Wife, get ready to be blinded, because I need to practice this. A lot.

6 comments:

Anonymous said...

Link to your PE list doesnt work.

Bekah said...

My poor family. Daniel has the easiest eyes to see anything. I still can't see anything with my left eye...

We did our final exam on our partner. Start coming up with subtle hints if you forget something. ;)

And yes, you will be amazed at how you get the routine and most things flow. Do I remember it now, though? Ummm...

Justin said...

@Anonymous - Thanks! I fixed it. :)

@Bekah - Thanks for that, haha! Wife will soon have great sympathy for your family :)

Nicole said...

I guess I have to pay you back for all the times I practiced doing Health Assessment things with you... :)

Susan said...

On that physical exam list....I've never had a doctor "moisten the tongue depressor"...but it's a good idea!

NoLongerSilent said...

OMGosh it seems like examining the eye is one of the most difficult things LOL. Having a willing partner is so important, and it seems like females are a little more cooperative than the males :) . My class partner and my husband both were difficult and couldn't handle me using the light to look into their eye for longer than a second LOL. But things do get better over time. I just can't wait to become a pro.

Also, we've had to do the mock physical exams and I was so nervous. But once again with time you learn how to become calmer and interact with the patient. It's an amazing experience and feels so official hahahaha. At the end of this term we'll be doing male and female sensitive exams O_o. Let the craziness begin.

Well I'm excited for you. I'm sure you'll do very well.

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