Annual Physical Exam: The Basics
The physical exam is an essential part of any doctor’s visit. Surprisingly, though, there are no absolutes in a routine physical. A good doctor may be thorough or brief, according to your individual circumstances, any new medical concerns you may have, and his or her personal style. A good doctor will spend time listening to your concerns and providing counseling for your particular needs.
This is your chance to mention any complaints or concerns about your health. Your doctor will also likely quiz you about important behaviors, like smoking, excessive alcohol use, sexual health, diet, and exercise, The doctor will also check on your vaccination status and update your personal and family medical history.
- Blood pressure: less than 120 over 80 is a normal blood pressure. Doctors define high blood pressure (hypertension) as 140 over 90 or higher.
- Heart rate: Values between 60 and 100 are considered normal. Many healthy people have heart rates slower than 60, however.
- Respiration rate: Around 16 is normal. Breathing more than 20 times per minute can suggest heart or lung problems.
- Temperature: 98.6 degrees Fahrenheit is the average, but healthy people can have resting temperatures slightly higher or lower.
Your doctor gathers a large amount of information about you and your health just by watching and talking to you. How is your memory and mental quickness? Does your skin appear healthy? Can you easily stand and walk?
Listening to your heart with a stethoscope, a doctor might detect an irregular heartbeat, a heart murmur, or other clues to heart disease.
Using a stethoscope, a doctor listens for crackles, wheezes, or decreased breath sounds. These and other sounds are clues to the presence of heart or lung disease.
Head and Neck Exam
Opening up and saying “ah” shows off your throat and tonsils. The quality of your teeth and gums also provides information about your overall health. Ears, nose, sinuses, eyes, lymph nodes, thyroid, and carotid arteries may also be examined.
Your doctor can use a range of examination techniques including tapping your abdomen to detect liver size and presence of abdominal fluid, listening for bowel sounds with a stethoscope, and palpating for tenderness.
Nerves, muscle strength, reflexes, balance, and mental state may be assessed.
Skin and nail findings could indicate a dermatological problem or disease somewhere else in the body.
- Most coughs and bronchitis
- Sore throats, unless caused by strep
Each time you take antibiotics, you increase the chances that bacteria in your body will be able to resist them. Later, you could get or spread an infection that those antibiotics cannot cure.
When you take antibiotics, follow the directions carefully. It is important to finish your medicine even if you feel better. Do not save antibiotics for later or use someone else’s prescription.
Your blood pressure reading uses these two numbers, the systolic and diastolic pressures. Usually they are written one above or before the other. A reading of:
- 120/80 or lower is normal blood pressure
- 140/90 or higher is high blood pressure
- Between 120 and 139 for the top number, or between 80 and 89 for the bottom number is prehypertension
High blood pressure usually has no symptoms, but it can cause serious problems such as stroke, heart failure, heart attack and kidney failure.
You can control high blood pressure through healthy lifestyle habits, such as losing weight and reducing sodium in your diet, and taking medicines, if needed.
Blood pressure medicines work in different ways to lower blood pressure. Some remove extra fluid and salt from the body to lower blood pressure. Others slow down the heartbeat or relax and widen blood vessels. Often, two or more medicines work better than one.
CARDIOVASCULAR DISEASE MANAGEMENT
A common cause of heart disease is blockage of the coronary arteries; which are the blood vessels that supply blood to the heart. This blockage is known as coronary artery disease and it’s the major reason people have heart attacks.
You can help reduce your risk of heart disease by taking certain steps to control factors that may increase your risks:Control your blood pressure
- Lower your cholesterol
- Don’t smoke
- Get plenty of exercise
- Scheduling regular EKG’s
You can lower your cholesterol by exercising and consuming more fruits and vegetables. Medication is also needed to help lower one’s cholesterol.
Healthy eating is a cornerstone of any diabetes management plan.
What to do:
- Keep to a schedule.
- Make every meal well-balanced.
- Eat the right amount of foods.
- Coordinate your meals and medication.
Physical activity is another important part of your diabetes management plan. When you exercise, your muscles use sugar for energy. Regular physical activity also improves your body’s response to insulin.
What to do:
- Talk to your doctor about an exercise plan.
- Keep an exercise schedule.
- Know your numbers.
- Check your blood sugar level.
- Stay hydrated.
- Be prepared.
- Adjust your diabetes treatment plan as needed.
Insulin and other diabetes medications are designed to lower your blood sugar level. The effectiveness of medications depends on the timing and size of the dose.
What to do:
- Store insulin properly.
- Report problems to your doctor.
- Be cautious with new medications.
DOT, EMPLOYMENT, SPORTS, AND SCHOOL PHYSICALS
An electrocardiogram (EKG or ECG) is a test that checks for problems with the electrical activity of your heart. An EKG translates the heart’s electrical activity into line tracings on paper.
Why It Is Done?
An electrocardiogram (EKG or ECG) is done to:
- Check the heart’s electrical activity.
- Find the cause of unexplained chest pain, which could be caused by a heart attack, inflammation of the sac surrounding the heart (pericarditis), or angina.
- Find the cause of symptoms of heart disease, such as shortness of breath, dizziness, fainting, or rapid, irregular heartbeats (palpitations).
- Find out if the walls of the heart chambers are too thick (hypertrophied).
- Check how well medicines are working and whether they are causing side effects that affect the heart.
- Check how well mechanical devices that are implanted in the heart, such as pacemakers, are working to control a normal heartbeat.
- Check the health of the heart when other diseases or conditions are present, such as high blood pressure, high cholesterol, cigarette smoking, diabetes, or a family history of early heart disease.
EYE TESTINGAn eye examination is a battery of tests assessing vision and ability to focus on and discern objects, as well as other tests and examinations pertaining to the eyes. Health care professionals often recommend that all people should have periodic and thorough eye examinations as part of routine primary care.Eye examinations may detect potentially treatable blinding eye diseases, ocular manifestations of systemic disease, or signs of tumors or other anomalies of the brain.
Family planning includes a wide variety of methods that are not birth control. It is most usually applied to couples who wish to limit the number of children they have and to control the timing of pregnancy. Family planning may encompass sterilization, as well as abortion.
FOCUS ON PREVENTIVE CARE
- See your doctor for regular screenings , not just when you are sick
- Maintain a healthy weight
- Eat a variety of healthy foods, and limit calories and saturated fat
- Be physically active
- Control your blood pressure and cholesterol
- Quit smoking
- Protect yourself from too much sun
HEALTH CHECKS FOR CHILDREN
Your child should have blood pressure measurements regularly, starting at around 3 years of age. High blood pressure in children needs medical attention. It may be a sign of underlying disease. If not treated it may lead to serious illness.
Lead can harm your child, slowing physical and mental growth and damaging many parts of the body. The most common way children get lead poisoning is by being around old house paint that is chipping or peeling. Some authorities recommend lead tests at 1 and 2 years of age. If you can answer “yes” to any of the questions below, your child may need lead tests earlier and more often than other children. Has your child:
- Lived in or regularly visited a house built before 1950? (This could include a day care center, preschool, the home of a babysitter or relative, etc.)
- Lived in or regularly visited a house built before 1978 (the year lead-based paint was banned for residential use) with recent, ongoing, or planned renovation or remodeling?
- Had a brother or sister, housemate, or playmate followed or treated for lead poisoning?
Vision and Hearing
Your child’s vision should be tested before starting school, at about 3 or 4 years of age. Your child may need vision tests as he or she grows. Some authorities recommend hearing testing beginning at 3 to 4 years of age.
Vision Warning Signs
- Eyes turning inward (crossing) or outward
- Not doing as well in school work as before
- Blurred or double vision
Hearing Warning Signs
- Poor response to noise or voice
- Slow language and speech development
- Abnormal sounding speech
Special Warning: Listening to very loud music, especially with earphones, can permanently damage your child’s hearing.
Your child may need other tests to prevent health problems. Some common tests are:
- Anemia (Blood) Test- Anemia is having less than the normal number of red blood cells or less hemoglobin than normal in the blood. Your child may need to be tested for anemia when he or she is still a baby (usually around the first birthday). Children may need this test as they get older.
- Cholesterol (Blood) Test- Children (2 years and older) may need this test especially if they have a parent with high cholesterol or a parent or grandparent with heart disease before age 55. If a family history is not available, testing may be needed if your child is obese or has high blood pressure.
- Tuberculosis (TB) Skin Test- Children may need this test if they have had close contact with a person who has TB, live in an area where TB is more common than average (such as a Native American reservation, a homeless shelter or an institution) or have recently moved from Asia, Africa, Central America, South America, the Caribbean, or the Pacific Islands.
HIV AND STD TESTING
HIV stands for human immunodeficiency virus. It kills or damages the body’s immune system cells. AIDS stands for acquired immunodeficiency syndrome. It is the most advanced stage of infection with HIV.
HIV most often spreads through unprotected sex with an infected person. It may also spread by sharing drug needles or through contact with the blood of an infected person. Women can give it to their babies during pregnancy or childbirth.
The first signs of HIV infection may be swollen glands and flu-like symptoms. These may come and go a month or two after infection. Severe symptoms may not appear until months or years later.
A blood test can tell if you have HIV infection. There is no cure, but there are many medicines to fight both HIV infection and the infections and cancers that come with it.
Sexually transmitted diseases (STDs) are infections that you can get from having sex with someone who has the infection. The causes of STDs are bacteria, parasites and viruses. There are more than 20 types of STDs, including:
- Genital herpes
Most STDs affect both men and women, but in many cases the health problems they cause can be more severe for women. If a pregnant woman has an STD, it can cause serious health problems for the baby.
If you have an STD caused by bacteria or parasites, it can be treated with antibiotics or other medicines. If you have an STD caused by a virus, there is no cure. Sometimes medicines can keep the disease under control.
Your immune system helps your body fight germs by producing substances to combat them. Once it does, the immune system “remembers” the germ and can fight it again. Vaccines contain germs that have been killed or weakened. When given to a healthy person, the vaccine triggers the immune system to respond and thus build immunity.
Flu is a respiratory infection caused by a number of viruses. The viruses pass through the air and enter your body through your nose or mouth. The flu can be serious or even deadly for elderly people, newborn babies and people with certain chronic illnesses.
Symptoms of the flu come on suddenly and are worse than those of the common cold. They may include:
- Body or muscle aches
- Sore throat
The main way to keep from getting the flu is to get a yearly flu vaccine. If you get the flu, your health care provider may prescribe medicine to help your body fight the infection and lessen symptoms.
Tetanus is a serious illness caused by tetanus bacteria. The bacteria live in soil, saliva, dust and manure. The bacteria usually enter the body through a deep cut, like those you might get from cutting yourself with a knife or stepping on a nail.
The infection causes painful tightening of the muscles, usually all over the body. It can lead to “locking” of the jaw, which makes it impossible to open your mouth or swallow. If this happens, you could die of suffocation.
If you get tetanus, there is usually a long course of treatment. The tetanus vaccine can prevent tetanus but its protection does not last forever. Adults should get a tetanus shot, or booster, every 10 years. If you get a bad cut or burn, see your doctor, you may need a booster.
- Your sex, age and race
- What you eat and drink
- Medicines you take
- How well you followed pre-test instructions
Moles tend to develop over time and increase in number with age. Sometimes moles grow in areas that become irritated. Moles are removed through physical procedures, such as shaving, excisions, or lasers after local anesthesia to the area. Mole removal is performed in an aesthetically precise fashion to assure the best result. Some moles are very deep in the skin and require an excision with sutures.
Nebulizers use oxygen, compressed air or ultrasonic power to break up medical solutions and suspensions into small aerosol droplets that can be directly inhaled from the mouthpiece of the device.
PRIMARY CARE FOR ALL AGES
Primary care practices provide health promotion, disease prevention, health maintenance, counseling, patient education, diagnosis and treatment of acute and chronic illnesses in a variety of health care settings.
How Does a Pregnancy Test Work?
- Woman should have a Pap smear ever 2 years to check for cervical cancer.
- If you are over age 30 or your Pap smears have been negative for 3 times in a row, your doctor may tell you that you only need a Pap smear every 3 years.
- If you or your sexual partner have other new partners, then you should have a Pap smear every 2 years.
- After age 65-70, most women can stop having Pap smears as long as they have had three negative tests within the past 10 years.
- If you have a new sexual partner after age 65, you should begin having Pap smear screening again.
Skin tags tend to occur in areas under higher friction, such as around the neck, in the armpits, or in the groin. They are benign, but in many cases, become very irritating and painful to the client. Skin tags are removed by snip excision, freezing (cryotherapy) or electrocautery with very little recovery time.
SUTURES FOR LACERATIONS
- Common warts, which often appear on your fingers
- Plantar warts, which show up on the soles of your feet
- Genital warts, which are a sexually transmitted disease
- Flat warts, which appear in places you shave frequently