Clinical Skills Examination Procedures: Afrikaans & Xhosa

Physical examination techniques: The techniques of physical examination are in themselves simple, and easy to master. All that is necessary is that you observe carefully, pay attention to detail, and practice repeatedly. Physicians do vary in their techniques of examination. Shown here are a single set of techniques which are both simple to employ and reliable. Your tutors may however make use of slightly different techniques themselves. We suggest that, initially at least, you learn to use the techniques shown here confidently, so as not to become confused. Practice of your examination technique is essential, and you need to see as many patients who demonstrate abnormal physical signs as possible so that you can learn to recognise them. The following material is covered under the four examinations

• General Examination: preparing the patient for examination, describing the patient’s appearance, looking for pointers to the problem around the bedside, examination for general features of illness, examination for features of specific illnesses, taking the pulse, assessing warmth, perfusion, hydration and temperature, inspecting the hands, eyes, mouth and pharynx, looking for lymphadenopathy, and inspecting the legs.
• Abdominal Examination: preparing the patient for the examination, looking for some signs of abdominal disease on a focused “general” examination, inspecting the abdomen, light palpation for areas of tenderness, detecting peritonism, determining the position and size of the liver by percussion and palpation, determining the position and size of the spleen by percussion and palpation, confirming the presence of ascites, other features of portal hypertension, examining the iliac fossae and suprapubic region, detecting enlarged kidneys, identifying other abdominal masses, and listening for bowel sounds.
• Respiratory examination: preparing the patient for the examination, looking for some signs of respiratory disease on a focused general examination, looking at the pattern of breathing, assessing the degree of expansion of the chest and its symmetry by inspection and by palpation, assessing the position of the trachea, percussing the chest for dullness and resonance, listening to the breath sounds by auscultation.

Cardio vascular examination: getting your patient into the right position, general assessment, assess the pulse, measure the blood pressure, measure the jugular venous pressure, palpation of the praecordium, palpation of the apex, auscultation of the heart, and look for signs of heart failure.
 
 
Translation and augmentation: Becoming a Doctor (BaDr) team Original English version: Department of Medicine The project was funded by the South Africa-Norway Tertiary Education Development Programme (SANTED) and facilitated by the Centre for Higher Education Development (CHED).
 
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