Physical Exam: Why Does Your Doctor Do That?

Give You an Exam Each Year

Your physical exam alerts your doctor to signs and symptoms of health problems.

You may not look forward to your annual doctor's visit, but the yearly exam can play a crucial part in your ongoing health. Your doctor knows this, and uses that time to check for any symptoms or signs of health problems—and catch them while there's still time to do something about them.

Yearly physical examinations can help spot high blood pressure, STIs including HIV/AIDS, and high cholesterol. They're good ways to remember your immunization schedule, too. But perhaps the most important job of the yearly doctor's visit is to screen for a variety of cancers, many of which are more easily treated—with better survival odds—if they are found early.

Press Your Tummy

By prodding your abdomen, your doctor can spot signs of trouble in your liver, stomach, and intestines.

Your abdomen is important to your health. It's where your liver, stomach, intestines and other vital organs live. So your doctor will prod a bit, testing to make sure everything is healthy. This is to make sure nothing is too tender, too big, or too firm.

Along with the tummy-touching, a doctor will want to examine your skin, the shape of your abdomen, and how it moves as you breathe in and out. The doctor will probably also listen to the abdomen, as some bowel problems can be heard with a stethoscope.

Poke Something Into Your Ear

Using an otoscope, your doctor can spot various hearing problems.

Doctors use a device called an otoscope (or auriscope) to peer into your ears. If your hearing is troubled or you have an ear ache, this handy device can literally shed light on the problem. Remember—ear canals are dark places! That's why doctors cast light on them and magnify them in this way.

Some of the problems a doctor may spy with an otoscope include too much ear wax, swollen ear canals, irritated eardrums, and fluid that may signal infection. Beyond helping your doctor see, many otoscopes live a dual life as air-puffers. A doctor can puff a little air into your ear to find out if you've been having troubles with pressure differences between the middle ear and the atmosphere.

Press Your Tongue Down Like That

With a tongue depressor, your doctor can spot inflamed tonsils, periodontal disease, and other ailments.

A mouth can say a lot about your health without even speaking. Doctors know this, so looking into your mouth with a tongue depressor and a flashlight or head lamp is typical during physical examination.

So what can looking into your mouth tell your doctor? Well, if your tongue has a growth or a white spot, it may lead to cancer. Your throat and the back of your mouth can suggest how healthy your teeth are too. Your tonsils could be inflamed, which happens when you have acute tonsillitis. Abscesses may be spotted as well. Dental problems like periodontal disease or cracked, broken or missing teeth can be addressed. Whitish coatings of oral surfaces or the presence of other lesions may indicate signs of infection or other underlying health problems.

Light Up Your Eyes

By shining a light in your eyes, a doctor can detect glaucoma, diabetes, and other problems.

We usually don't want bright lights flashed into our eyes. During a doctor's visit, though, this can save you from huge problems down the road. By shining a light in your eye, a doctor can watch to see how much your pupil gets smaller (constricts). Your doctor is looking to make sure those tiny black spots in the center of your eye stay round, and that each eye reacts to the light in the same way. By doing this test, a doctor can check for high blood pressure, glaucoma, diabetes, or certain eye problems.

Listen to Your Heart, Lungs, and Neck

Your doctor listens to your lungs, neck, and heart with a stethoscope during your typical exam.

A doctor's stethoscope is so important that these handy hearing devices are immediately recognized by most people. A stethoscope magnifies sounds like your heart beat. Making sure your heart is in good working order is perhaps the primary job of a stethoscope. It is also used to listen to your lungs and neck.

Heart:

By listening carefully to your heartbeat, a doctor can know right away if you have a heart murmur, which is another word for an unusual wooshing or swishing sound in your heart. Most murmurs are normal, but some can indicate problems such as a fever, anemia, high blood pressure, or an overactive thyroid. Murmurs can also indicate a variety of problems with heart valves. The stethoscope can let the doctor know immediately if the heart is not beating normally.

Lungs

The stethosope can let your doctor hear sounds like crackles, rales (sounds like rattling or crumpling cellophane) or detect no sounds in the lungs where some should be present. The various sounds can help your doctor screen for and/or diagnose lung problems.

Neck

By listening to the sides of the neck with a stethoscope, your doctor can screen for carotid narrowing by detecting a carotid bruit, an abnormal swooshing sound in the carotid artery.

Squeeze That Cuff Around Your Arm

Blood pressure monitors are a vital tool in the yearly physical exam.

It's important to get your blood pressure checked regularly. To do that, a doctor or nurse cuffs your upper arm and tightens it. This is to measure how much force your veins are using to pumping your blood.

This is the only convenient, reliable way to watch out for high blood pressure, because the condition is known for showing few symptoms. That's how it earned the nickname “the silent killer.” High blood pressure can raise your risk of stroke, heart failure, and heart attacks, but it is manageable with medication and lifestyle changes.

If you have been assessed as having high blood pressure, you will want to check your own blood pressure at home regularly between doctor visits. The American Heart Association recommends tracking your medication, your blood pressure level, and to bring any questions to the doctor if they occur to you.

Telling You to Turn Your Head and Cough

Your doctor checks for hernias as part of a routine physical exam.

When your doctor asks you to cough, it means you're being checked for a hernia. Coughing tightens your stomach muscles, and when that happens someone with an inguinal hernia may find that a part of their intestines or abdominal fat starts bulging through the lower abdomen. Your doctor can feel this by placing a hand on your scrotum while you cough.

This condition can be present at birth, or it may be caused by straining, such as when you lift a heavy object. It can cause pain and discomfort by itself, and it can also lead to more serious problems. Your doctor will probably encourage you to undergo surgery, the only effective treatment for this issue.

That explains the coughing part. But why turn your head? That's actually pretty simple. Your doctor doesn't want to be coughed on!

Track Your Height and Weight

Keeping track of your weight is one way your doctor assesses your overall health.

Tracking your height and weight helps your doctor assess your body mass index (BMI). This is an estimate of your total body fat, and can tell your doctor if you're at a heightened risk for high blood pressure, heart disease, gallstones, type 2 diabetes and other ailments.

This is also a good way to track your weight from year to year. Your doctor can see whether you've been losing weight or gaining it, and recommend helpful medical advice either way.

Draw Blood

High cholesterol and kidney disease are some of the problems blood tests can recognize.

Sometimes our bodies don't show many symptoms when they're sick. The blood can tell the story that may not be obvious from any other source. Signs of liver disease, thyroid disease, and kidney disease can be picked up from bloodwork, as can high cholesterol and other medical problems.

It's never enjoyable to learn that your body isn't functioning the way it should, but blood tests can tell you early, which can save you from much more serious health complications down the road. Discovering what ails you early can also save you money in the long run.

Tap Your Kneecap

Thyroid problems can be spotted using a nerve reflex test.

You've probably seen your doctor pull out that funny, triangular, rubber hammer before. And you know what comes next—a firm tap below the kneecap and (usually) your leg jerks up. But not always. Sometimes this reflex test finds a problem with your reflexes rooted in your nerves. The nerves to your legs are carried through your lower back, and sometimes compression will hamper or slow your reflexes. So even though your doctor isn't anywhere near your back when tapping that tendon, this exercise may actually unearth a lower back problem. This test can also detect thyroid problems, as delayed relaxation after testing is found in about 75% of patients with hypothyroidism.

Tap Your Back

Thumping your back can tell your doctor if you have emphysema.

You may wonder why your doctor is thumping your back like a ripe melon. That tapping action has a name: “percussion.” And just like a drum, your lungs have air that carries sound. That sound can let your doctor know if there is liquid inside your lungs, which can happen if you are sick. Fluid in your lungs can signify emphysema, heart failure, or cancer.

Track Your Heart Rate

Your heartbeat can show how generally healthy you are.

How fast your heart beats can reveal a lot about your health. And tracking it over time can help your doctor anticipate future problems.

A normal resting heart rate is 60 to 100 beats per minute (BPM). This can vary depending on a lot of things, like how much caffeine you've had recently, how active you've been in the last two hours, and whether or not you're anxious or stressed.

Usually a low resting heart rate suggests good physical fitness. But that's not always the case. A heart rate that is at the very low end of the range or below can signify something is wrong with the way your heart is transmitting electrical signals. This is more likely if you also notice fatigue and occasional dizziness.

If your heartbeat is regularly at our above the high end of this range, you may be at a higher risk of heart disease. It can even signify you're more likely to die at a younger age than average. All those heartbeats take their toll. Exercise helps reduce your resting heart rate, though, as does maintaining a healthy cholesterol level.

Slide a Finger ‘Up There’

Using a digital rectal exam, your doctor can spot signs of colorectal cancer.

Yeah, this one is a little awkward. You probably dread being digitally penetrated by your doctor. But getting a digital rectal examination (DRE) should be a very small worry compared to developing colorectal cancer, which is one thing this test can detect.

Catching colorectal cancer early makes a huge difference in outcome. The five-year survival rate of colorectal cancer patients is 90% if the cancer is found at or before the “local” stage, when it is confined to one colon or rectal wall. Other tests should be used for a complete screening, but the DRE is one important and relatively easy way to test for this.

But the DRE is not limited to spotting colorectal cancer. For women, this test can detect abnormalities in the uterus and ovaries, including other cancers. Men benefit from this procedure as it ensures prostate health as well, and can detect prostate cancer.

Take Urine Samples

Different urine colors can be signs of kidney inflammation, diabetes, and other health issues.

Peeing in a cup is a routine part of an annual physical examination. Your doctor knows that urine can reveal a lot about your body. Everything from the color to the odor can give off clues about your health, but lab results of the chemical composition of urine offer even more information.

If your urine is very dark, you may be dehydrated. If it is flaky or cloudy, that may be a sign of a urinary tract infection. And if protein is discovered in the urine, that can be a sign of kidney inflammation. Diabetics may be tipped off to high blood pressure if ketones are found in the urine. Nitrite and white blood cells (leukocytes) can be signs of bacterial infection. Bladder problems and kidney stones can also be spotted through this test.

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REFERENCES:

  • American Cancer Society: “Colorectal cancer: catching it early.”
  • American Heart Association: “Partner With Your Doctor to Treat High Blood Pressure.”
  • Canadian Medical Association Journal: “A classic sign of hypothyroidism: a video demonstration.”
  • CDC: “Regular Check-Ups Are Important.”
  • Harvard Medical School: “Your resting heart rate can reflect your current—and future—health.”
  • Michigan Medicine, University of Michigan: “Digital Rectal Examination (DRE),” “Nerve Function Tests for Evaluating Low Back Problems.”
  • NIH: "Inguinal hernia," “Percussion.”
  • PubMed Health: “Understanding urine tests.”
  • WebMD: “What Are Heart Murmurs?”
  • University of Bristol Faculty of Health Sciences: “The oral examination.”
  • University of Texas Department of Otorhinolaryngology: “How to Examine the Ears.”
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