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Importance of Physical Exams

The Importance of Physical Examinations

Dr. Jeff Mollins, D.C.

The single most important element in the diagnosis of an injured patient is the physical examination. This exam is also essential in assessing a treatment regimen and documentation of all injuries sustained. Dr. Mollins performs a very careful and comprehensive physical examination on every single patient. A physical examination is defined as the process by which a health care professional Physical Examinations | Brooklyn | New York City (NYC)investigates the body of a patient for signs of disease. It generally follows the taking of the medical history-an account of the symptoms as experienced by the patient. Together with the medical history, the physical examination aids in determining the correct diagnosis and devising the treatment plan. This data then becomes part of the medical record, crucial in documentation.

There are many important aspects to the physical examination. The following represents the key elements to Dr. Mollins’ initial physical examination.

  1. Observation – Dr. Mollins begins his physical examination the minute he views his new patient. Careful observation of the patient while they enter the examination room is crucial. Close observation allows Dr. Mollins to see if the patient is in pain. The patient may be favoring one side as they walk. This is usually to protect an injured part of the body. This is called “guarded ambulation” or an “antalgic gait” and must be indicated in the patient records. Next, Dr. Mollins watches as his patient gets on and off the examination table. Injured patients will gingerly arise and descend from the exam table. This guarded behavior also indicates injury and must be documented as well.
  2. Inspection – The next step as part of a comprehensive physical examination is inspection. Dr. Mollins carefully evaluates his patient with his eyes. He will inspect for swelling, bruising, and/or abrasions. He will view the spine and try to determine if there is a scoliosis (curvature). Muscle spasm can also be determined by the well trained eye (Dr. Mollins has been practicing for over 25 years).
  3. Palpation – This is a method of feeling with the fingers or hands as a diagnostic aid, to examine the size, consistency, texture, location, and tenderness of a body part. Dr Mollins uses palpation to assess the texture of a patients tissue (such as swelling or muscle tone), to locate the spatial coordinates of particular anatomical landmarks (ie. to assess range and quality of joint motion), and assess tenderness through tissue deformation (ie. provoking pain with pressure or stretching).
  4. Range of Motion – This refers to the distance and direction a joint can move to its full potential. Each specific joint has a normal range of motion that is expressed in degrees. When there is injury to a specific area (commonly due to an accident), there will be a limited range of motion. The joint will have a reduction in its ability to move. Dr. Mollins performs a range of motion examination on areas of the body affected by injury. He carefully measures the ranges of motion using an instrument called a goniometer. He typically measures each area three times and takes the average to Physical Examinations | Brooklyn | New York City (NYC)insure accuracy. Once a limitation in range of motion is determined, Dr. Mollins can then assess both location and severity of injury. Range of motion is measured in degrees, so Dr. Mollins can also determine improvement by performing subsequent evaluations and comparing them to their predecessors.
  5. Orthopedic Tests – These are designed to evaluate individuals for musculoskeletal impairment. These tests enable Dr. Mollins to identify a specific area of injury and aid in the diagnosis and treatment plan of the injured individual. Orthopedic tests are specific for the upper and lower extremities as well as the spine. Most orthopedic tests stress areas to be evaluated in an effort to evaluate pain, joint play, and muscle extensibility. Orthopedic testing is a crucial element to a comprehensive physical examination.
  6. Neurological Evaluation – This is a systemic examination that surveys the functioning of nerves delivering sensory information to the brain and motor commands (peripheral nervous system) and impulses back to the brain for processing and coordinating (central nervous system). When back and neck pain are involved, a neurological examination is essential. Quite often, disc pathology such as herniation’s or bulges (resulting from accidents) will affect nerves. Dr. Mollins performs a thorough neurologic exam on every patient. Reflex testing, sensation, and muscle strength are just some of the tests that are performed. A careful, concise, neurological examination can help rule out many disease processes.

A comprehensive physical examination is a powerful tool utilized by Dr. Mollins to diagnose injured patients. Once a diagnosis is achieved, a proper treatment regimen can begin. An accurate physical examination is also crucial to documentation of injuries which is so important when treating patients injured in all kinds of accidents.

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