 |
Patient Centered Medicine 2
September 2, 2008
|
Transfer from the History
to
the Physical Examination
Myles Sheehan, S.J., M.D. |
TRANSFER FROM THE HISTORY TO THE PHYSICAL
EXAMINATION
and
HEENT and LUNG EXAM REVIEW
Lecture: 1:15 p.m., Tobin Hall (190)
Assignment
Before lecture, view:
1. HEENT and Lung Exam Videos are on the same web-page. Follow this link
or use your CD from PCM 1. (http://www.meddean.luc.edu/lumen/MedEd/MEDICINE/PULMONAR/pdself/menu_f.htm
2.
Answer the questions
from the assigned readings linked here. Come prepared to discuss in Small Group
3.
Computer Assisted Lessons
A.General Appearance
B. Head and Neck
C. Lung Exam
Reading Assignment
1. Bates' Guide to Physical Examination and History
Taking, 8th ed., pp. 27-29, 56-57, 72-79, 91-93, 144, 156-167, 220-233
OR
Bates' Guide to Physical Examination and History Taking, 9th ed., pp. 31-31,
103-111, 177, 189-200, 252-266, 851-852
Key Concepts and Learning Objectives
KNOWLEDGE
- Identify the elements that make up the general appearance
of a patient.
- Recognize elements of the patient's general appearance
that raise questions about the patient that should be pursued with focused
historical questioning and/or targeted physical examination.
- Explain how to assess the ability of a patient to perform
activities of daily living (ADLs) and instrumental activities of daily living
(IADLs).
SKILLS
- Demonstrate a smooth transition from the history to the physical
examination. Use the criteria described in step 2 of the Basic Screening Exam
(BSE).
- Communicate in a succinct and compelling manner, both
verbally and in writing, the general appearance of a patient.
- Integrate elements of functional assessment in history
and physical and recognize deficits in functional independence in the overall
evaluation of a patient.
- Demonstrate attention to the overall appearance in order
to guide the history and physical examination, allow for better understanding
of a patient's condition, and guide further evaluation.
Small Group Session: Immediately following the lecture SDLs, Seminar Rooms, or CSC
(330)
| Equipment Required: |
Otoscope and ear speculums
Stethoscope |
| Objectives |
Teaching Methods |
General Appearance
- Identify characteristics of a patient's physical appearance, comfort
level and hygiene as per step 2 of the
Basic Screening Examination
Details.
- Describe a patient's general appearance.
- Write up a patient's general appearance.
HEENT Exam
- Perform HEENT exam steps 7, 15, 16, 18, 19, 20, 23, 24 and 25 of
the
Basic Screening Examination
Details.
- Write up HEENT exam
LUNG Exam
- Perform LUNG exam steps 26, 28, and 29 of the
Basic Screening Examination
Details
- Write up LUNG exam
|
General Appearance
- Brief Q&A to review the major concepts learned from
the readings and lectures.
- Co-facilitators review adjectives and phrases that describe a
patient's general appearance.
- Co-facilitators demonstrate how to write up a patient's general appearance.
HEENT Exam
- Brief discussion to review HEENT exam steps.
- Co-facilitators review HEENT exam steps and ensure understanding by all.
- Student practice on each other
- Co-facilitators demonstrate how to write up the HEENT exam.
- Ear simulator with normal and abnormal findings. One simulator
available in CSC room 330 for practice.
LUNG Exam
- Brief discussion to review LUNG exam steps.
- Co-facilitators review LUNG exam steps and ensure understanding by all.
- Students practice on each other
- Co-facilitators demonstrate how to write up the LUNG exam.
|
