A thorough physical examination begins with a detailed history from the patient, according to the University of California, San Diego. Ask the patient the reason for his visit; discuss the nature, severity and duration of any symptoms he reports, and determine if they are getting worse, better or staying the same. In some cases, it is helpful to do a review of systems, asking specific questions about each organ system to determine if problems exist.
Next, review the patient's vital signs, including the temperature, heart rate, blood pressure and respiratory rate. These are crucial to identifying acute medical issues as well as chronic conditions such as hypertension, explains UCSD. Many clinicians also check the patient's oxygen saturation, which helps assess cardiovascular and lung health.
The rest of the physical exam proceeds in an orderly fashion, beginning with the head and neck. Visually inspect the oral cavity, and use an otoscope to examine the ears. Then palpate the lymph nodes in the neck, and examine the thyroid gland. Proceed to the chest, and use a stethoscope to auscultate the lungs while the patient takes slow, deep breaths. Note the lung sounds, the character of the respirations and any physical abnormalities in the chest or spine, states UCSD. Use a stethoscope to listen to the heart tones, listening carefully for murmurs or rubs, and check for distension of the jugular vein. If possible, locate the point of maximum impact by placing the palm of your hand on the left side of the patient's chest.
Next, palpate and auscultate the abdomen, noting any distension or abnormal bowel sounds. Examine the extremities, checking for swelling, discoloration and the condition of the nails. Finish the exam by completing a brief neurological assessment and depression screening tool, UCSD reports.