A list of 10 clinical pearls about the physical exam that will help you be a more effective intern, and deliver better patient care.
I know that some of these (e.g. tailor your exam to why the patient is in the hospital, don't shortchange exams on patients with disabilities) seem obvious, but I see these concepts forgotten or ignored all of the time. If I had a dime for every progress note whose exam was verbatim: "Chest - CTAB; Heart - RRR, nl S1 S2, no m/r/g; Abd - Soft, NT, ND, normal BS; Extremities - No c/c/e; Neuro - AAOx3, non-focal" irrespective of whether the patient was admitted for a stroke, arrhythmia, or bowel perforation...
A few references:
The lack of hypotension in the majority of patients with pericardial tamponade: [ Ссылка ]
The uselessness of auscultation of bowel sounds:
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Tips and exam strategies for patients with physical or cognitive disabilities:
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A wonderful, general resource for learning more about the physical exam:
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The video thumbnail incorporated a picture of a reflex hammer provided by user MacSeagull under CC BY SA 4.0 and downloaded from Wikimedia Commons July 2019.
