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  #1  
Old 09-29-2015
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Default physical examination

hey guys ..

I wanted to know how do u practice physical examination? do we have to perform entire palpation, percussion, auscultation of a particular system of interest or do everything of all the systems?
pls help me... i am really confused..
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  #2  
Old 03-03-2016
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Default PE

You only need to perform PE that is relevant to your individual case.
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  #3  
Old 03-14-2016
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are we supposed to do GPE on each and every case?
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  #4  
Old 06-06-2017
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is there any seperate group for philly CS on facebook for june/july 2017
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  #5  
Old 06-08-2017
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Your question is a little vague but here is my go at it.

I haven't taken step 2 yet but I can tell you what was required of us here in Argentina where we put A LOT of emphasis on physical examination (because we are often stuck in situations where we cannot rely on having the machinery) and how we practiced for it. I hope this has some direct carryover for the prep for step 2.

So you have to know the most important aspects of the physical examination of every system. For example, when examining the abdomen, at least the way it was taught us, there is a certain order in which you examine it; observation, palpation, percussion, and auscultation. So thus we practice it in this order. Then we practice doing all of these on one another and on patients, always looking for the most important aspects and see if we can remember the most important manuevours. This includes all the maneuvers to recognize the hepatic border, the spleen, Cecum, sigmoid colon etc. If possible to practice these with patients than all the better but if not than we used to practice on each other and see and feel how it is normal (since we were all healthy) and sort of say outloud what we would find if the person had: splenomegally, hepatomegally, ileus, etc. Of course we would constantly try to tie what we found or imagined we found in one system to the next (for an example when we had our cardiovascular physical examination exam we would, of course, do the hepatic reflux maneuver and even if the person you would practice with is totally healthy you would state (for the purpose of learning) that if s/he had right side heart failure you would see the jugular vein distension blah blah blah.

The cardiovascular physical exam is a bit harder since you really have to hone in on recognizing the murmur and it's different parts. For this, we actually often used youtube and other online sources since they sort of simulate it. Of course, we would practice on each other stating the different auscultation points and what valve they mainly pertain to.

Final point. There were times when I would have no one to practice with. So, I would simulate doing the physical exam on something, on anything. To be honest, it helped.

So in summary, it is hard to practice. Better if you have patients to practice with, but can be done with other med students or by yourself as well.

If you read in Spanish I can recommend some great books on physical examination since over here it really is a perfected art (because of necessity).

Hope this helped.
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  #6  
Old 06-08-2017
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You will get an idea from the specific case, but always have in your mind a "basic" physical exam that you will perform (ie. always check tongue and pharynx, maybe lymph nodes, complete chest auscultation, abdominal auscultation, and palpation) and to that you add whatever you think might be appropriate for the case.
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