Whenever possible the physical examination should be performed in privacy and with optimal conditions of lighting and heating. Privacy may be readily obtained in a patient's home. It may be more difficult to achieve in a hospital ward.
The examination couch should be of an adjustable height or a stool provided to facilitate access. It is useful if the couch has an adjustable back-rest. This is particularly valuable is the patient is unable to lie Hat without becoming breathless.
The part of the body being examined needs to be properly exposed and illuminated. The rest of the patient should be covered with a blanket or sheet, and care should be taken to prevent the patient becoming cold or unnecessarily embarrassed.
Not uncommonly a patient's relatives attend a consultation en masse. They should be tactfully asked to leave prior to the physical examination. However, sometimes if is helpful for one to remain behind, especially if the patient is a child or if there is a language problem. If a rectal or vaginal examination is lo be performed then the presence of a nurse or relative is essential.
The equipment that is required will depend upon the nature of the examination. The clinician will usually have a stethoscope, pen-torch and measuring tape. Other equipment such as an ophthalmoscope, auroscope. sphygmomanometer, tendon hammer, tuning fork, cotton wool. pins, disposable wooden spatula to use as a tongue depressor, disposable gloves, lubricant jelly and proctoscope, and facilities for obtaining blood samples and for testing urine should lie readily available. An accurate weighing machine and height scalcs (preferably a Harpenden stadiometer) should be standard equipment on a ward, outpatient department and a General Practice surgery. When visiting the patient's home the doctor will require a fairly wide range of similar equipment.
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This ebook provides an introductory explanation of the workings of the human body, with an effort to draw connections between the body systems and explain their interdependencies. A framework for the book is homeostasis and how the body maintains balance within each system. This is intended as a first introduction to physiology for a college-level course.