Medical examination is the sum of the diagnostic activities and procedures that are carried out and initiated by the doctor in the context of patient care. In a narrower sense, this is the so-called physical examination of the patient without aids or with only a few simple instruments such as stethoscope , reflex hammer or pupil lamp .
Depending on the circumstances, the examination can be purely symptom-related if the other complaints are not relevant at the time, or it can be a full-body examination , e.g. B. in unknown patients.
Depending on the specialty of the examining doctor, the physical exam will focus on specific organ systems, with a general physical exam being expected from each doctor. Although the significance of the purely physical examination has historically been very high, medical technology allows more precise results for many findings. For example, although it is very important to recognize a heart murmur, the exact cause of the sound can then be determined with an ultrasound, for example.
Physical ( clinical ) examination
Physical examination (also clinical examination ) is a term often used in medicine for the examination of a patient with one's own senses and simple aids. The orienting or rough examination of the entire body or its organ systems is also known as a whole-body examination .
The physical examination can be enhanced by device-assisted procedures . These include procedures such as
- the laboratory diagnostics ,
- X-ray examination ,
- Sonography ,
- Scintigraphy ,
- Endoscopy ,
- Computed tomography ,
- Magnetic resonance imaging (magnetic resonance imaging),
- Electrocardiogram (EKG),
- Rectoscopy ,
- Pathology ( biopsy and puncture ).
Most instrument-based examinations should not be routinely arranged, but should be justified in individual cases. In practice, a compromise will often be necessary. Electrocardiography and some laboratory tests are inexpensive, quick and not stressful, so that they are also performed routinely for certain patients.
Further investigations must be discussed on a case-by-case basis. The more expensive and stressful they are, the higher the hurdles should be for their use. You can of imaging are used, check the function of individual organ systems (eg. Pulmonary function testing , or both at the same time provide (eg.) Thyroid - scintigraphy ). In cases of uncertainty, a sample ( biopsy ) from a diseased organ is often necessary for a tissue examination.
Selection of the appropriate procedure
Several examination methods often compete with one another, such as computed tomography and ultrasound of the abdominal cavity in the diagnosis of gallstones. In these cases, the factors “stress for the patient”, “informative value” and “costs” should be used. The weighting of these factors is the subject of medical and social debates in the healthcare system in industrialized countries.