Dr. med. Dirk Manski



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General Medical Examination (For Urologists)

The physical examination is presented as a checklist with possible (pathological) results. Special attention is given to important findings for urologists.

The scope of the examination varies according to the clinical situation. A patient with renal colic does not need a full neurological examination. On the other hand, all organ systems must be completely investigated for a medical report of a (urological) expert opinion in the interface between justice and medicine, e.g. before court trials.

General Impression

First Impression:

Pain-plagued or ill looking? Diagnostic facies? Jaundice? Pallor? Cyanosis? Concience? Smell?

Body Height and Weight:

recorded in meter (m) and kilogramm (kg). The body mass index (BMI) is defined as the body mass divided by the square of the body height. Normal value of BMI: 18.5--25 kg/m2.

Body Temperature:

Recorded in degrees Celsius. Differential diagnosis of fever.

Skin:

Hydration status? Gynecomastia? Jaundice? Pallor? Circulation? Uremic itching? Dermatoses?

Gait:

Antalgic gait? Walking aids? Palsy? Ataxia?

Mental status:

Cooperation or aggression? Alcohol? Dementia?

Examination of the Head and Neck

Cranial Nerves:

Rough examination of eyesight, smell, eye tracking, finger perimetry, facial sensitization, facial muscles, soft palate movement, shoulder lift, head turn and tongue movement.

Eyes:

Jaundice? Conjunctivitis?

Nose and Ears:

Gout tophi? Smell (uremia, alcohol, ..)?

Oral cavity:

Ulcers? Dehydration? Dental condition?

Thyroid:

Size? Tenderness?

Neck:

Palpable lymph nodes?

Chest Examination (Thorax)

Lungs:

Respiratory rate? Palpation and percussion: diaphragmatic excursion? Auscultation?

Heart:

Pulse rate? Heart rhythm? Blood pressure? Auscultation: murmurs?

Breast:

Breast lumps? Secretion? Gynecomastia?

Examination of the Abdomen

Inspection:

Scars? Hernia? Tumor?

Palpation:

Liver size? Palpable spleen? Resistance or tenderness of the abdomen? Costovertebral angle tenderness? Inguinal hernia?

Auscultation:

Bowel sounds? Abdominal systolic murmur?

Examination of the Musculoskeletal System

Spine:

Lateral flexibility? Finger-floor distance? Scoliosis? Tenderness on percussion?

Upper extremity:

Inspection of the hands (gout, rheumatism?). Radial and ulnar pulse? Rough assessment of flexibility and muscular strength. Triceps and biceps tendon reflex? Sensibility?

Lower extremity:

Inspection of the lower legs and feet (ulcers, varices?). Femoral, popliteal, dorsal pedis and tibialis posterior pulse? Rough assessment of flexibility and muscular strength. Patellar and Achilles tendon reflex? Sensibility?







Index: 1–9 A B C D E F G H I J K L M N O P Q R S T U V W X Y Z



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