Physical Examinations IV

Source: Joseph H. Donroe, Rachel Liu; Yale School of Medicine, USA Point of care ultrasound (POCUS) is used by clinicians for diagnosis, ongoing monitoring, and/or procedural guidance at the time of patient care. Many medical schools are now teaching POCUS as a part of their basic clinical skills training, in addition to history, physical exams, and clinical reasoning. Besides being an independent skill, POCUS is also an incredibly useful tool for augmenting the teaching and learning of the...

Source: Joseph H. Donroe, Rachel Liu; Yale School of Medicine, USA Point of Care Ultrasound or POCUS is easy to use, has enhanced mobility due to the smaller equipment needed, and may be carried out in a variety of settings. It is also far safer and cheaper than imaging techniques like computer tomography. POCUS can be helpful when certain physical exam findings are difficult to appreciate by palpation, percussion, or auscultation and can facilitate learning elements of the cardiac, pulmonary,...

Source: Joseph H. Donroe, Rachel Liu; Yale School of Medicine, USA Vascular diseases make up most cases of emergency hospitalization and carry a high mortality risk. Point-of-care ultrasound or POCUS enables accurate diagnosis of these diseases and shortens the time between detection of the cause and selection of appropriate treatment strategies, thus, reducing the patient mortality rate. POCUS offers a safe, low-cost, and less invasive bedside tool for examining arteries and veins, besides its...

Source: Yetsa Tuakli-Wosornu1,2, Jaideep Talwalkar1; 1Yale School of Medicine, 2University of Pittsburgh In addition to the regular checks of a physical exam, examinations for patients who use wheelchairs should be adapted to address their specific needs. This ensures that the patient's mobility, injury risk, and quality of life are not threatened by extended periods of sitting, potentially without proper weight shifts. Such examination needs healthcare providers that understand these...

Source: Carmen Black, Matthew Goldenberg, and Jaideep Talwalkar; Yale School of Medicine The mental status exam is a clinical evaluation of emotional, perceptual, and cognitive functioning that spans both the fields of psychiatry and neurology. Developing skill in the psychiatric portions of the examination are important to describe salient aspects of the patient's mental state that may be observed during routine history and/or physical exam. Proficiency in the cognitive portions of this...

Source: Yetsa Tuakli-Wosornu1,2, Jaideep Talwalkar1; 1Yale School of Medicine, 2University of Pittsburgh In the United States, 25% of the general population suffers from one or another type of disability. Ambulatory disabilities, or mobility impairments, represent the most common subcategory, comprising 14% of the country's populace. Different mobility-assistive devices, ranging from canes to scooters, enable increased independence and improved quality of life for those suffering from mobility...

Source: Heather Collette and Jaideep Talwalkar; Yale School of Medicine The newborn exam is important in establishing a baby's baseline health status as they enter the world. Newborn providers have the unique opportunity to evaluate a patient for the very first time. They are also tasked with identifying congenital anomalies that require early intervention to promote a long and healthy life for the child. Many newborn anomalies, such as heart defects, are noted on prenatal ultrasound. However,...

Source: Heather Collette and Jaideep Talwalkar; Yale School of Medicine The key to a successful exam of a toddler or preschool-age child is building rapport and trust between them and the provider. Toddlers, in particular, may be wary of strangers and unwilling to cooperate with the physical exam, which is expected age-appropriate behavior. In order to provide good care and create a comfortable patient experience, clinicians need to tailor their interaction to the child's developmental stage.

Source: Heather Collette and Jaideep Talwalkar; Yale School of Medicine  The adolescent module will focus on techniques to promote a trusting provider-patient relationship and foster healthcare autonomy as teenagers approach adulthood. While most of the basic components of the physical exam in adolescents are similar to those in adults, there is an added focus on pubertal development through the use of the Sexual Maturity Rating scale. Important adolescent psychosocial screening questions,...

Source: Jennifer A. Ouellet and Jaideep Talwalkar; Yale School of Medicine To meet the needs of older adults, all health professionals should be well acquainted with the history and physical examination considerations unique to this population. Physical examination plays an important role in the older patient to detect physiologic changes of aging, risk factors, and signs of pathology. While most of the general principles of the standard examination for adults apply to older patients, there are...