Physical Examination: Complete Guide to Medical Exams & Tests

Why Do You Need a Physical Examination?

A physical examination helps doctors understand the cause of your symptoms, assess your overall health, and determine if additional tests are needed. The examination provides essential clinical information that blood tests and imaging alone cannot reveal, such as heart sounds, breath patterns, and physical abnormalities.

When you visit a healthcare provider, the physical examination is a fundamental part of the diagnostic process. While modern medicine has many sophisticated tests available, the physical examination remains irreplaceable for several important reasons. It allows doctors to directly observe your body's responses, feel for abnormalities, and listen to internal organs in ways that no machine can replicate.

The examination typically begins with your doctor asking questions about your symptoms, when they started, what makes them better or worse, and your medical history. This conversation, called taking a medical history, helps guide which parts of your body need to be examined most carefully. For example, if you come in with chest pain, your doctor will focus particularly on examining your heart, lungs, and circulatory system.

Physical examinations serve multiple purposes depending on the context. During a routine check-up, the goal is preventive—identifying potential health issues before they cause symptoms. When you have specific complaints, the examination becomes diagnostic, aimed at finding the cause of your problems. In follow-up visits, examinations help monitor how conditions are responding to treatment.

The information gathered during a physical examination often determines what additional tests, if any, are needed. Sometimes the examination alone is sufficient to make a diagnosis. Other times, it helps narrow down the possibilities, making subsequent tests more targeted and efficient. This approach saves time, reduces unnecessary testing, and helps ensure you receive appropriate care.

When physical examinations are particularly important

Certain situations call for especially thorough physical examinations. New or unexplained symptoms require careful evaluation to identify their source. Chronic conditions need regular monitoring to track disease progression and treatment effectiveness. Before surgery, comprehensive examinations ensure you're fit for the procedure. Annual check-ups provide opportunities for preventive screening appropriate to your age and risk factors.

How Does a Physical Examination Work?

A physical examination uses four main techniques: inspection (visual observation), palpation (feeling with hands), percussion (tapping to assess underlying structures), and auscultation (listening with a stethoscope). The doctor examines different body parts based on your symptoms, starting with vital signs and progressing to specific organ systems.

Understanding the methods doctors use during physical examinations can help demystify the process and make you more comfortable during your appointment. Each technique provides different types of information, and together they create a comprehensive picture of your health status.

Inspection involves carefully looking at your body, noting things like skin color, posture, breathing patterns, and any visible abnormalities. Doctors observe how you move, your facial expressions, and subtle signs that might indicate health problems. This begins the moment you walk into the examination room and continues throughout the visit.

Palpation means using the hands to feel different body parts. This technique can identify enlarged organs, tender areas, abnormal masses, and changes in tissue texture. Light palpation helps assess superficial structures, while deeper pressure examines internal organs like the liver, spleen, and kidneys. The doctor may ask if you feel pain during palpation, which provides important diagnostic clues.

Percussion involves tapping the body surface to evaluate underlying structures. Different sounds indicate different conditions—a hollow sound might suggest air-filled spaces, while dullness could indicate fluid or solid masses. This technique is particularly useful for examining the lungs and abdomen.

Auscultation uses a stethoscope to listen to internal sounds. Heart sounds, breath sounds, and bowel sounds all provide valuable diagnostic information. Abnormal sounds can indicate conditions ranging from heart valve problems to pneumonia to intestinal blockages.

What Body Parts Does the Doctor Examine?

The body parts examined depend on your symptoms. Common examinations include: eyes (vision, pupils), ears (hearing, ear canal), throat (tonsils, swelling), heart (rhythm, murmurs), lungs (breath sounds), abdomen (organs, tenderness), lymph nodes (swelling), skin (rashes, lesions), and nervous system (reflexes, coordination).

A comprehensive physical examination can cover many different body systems, though the focus will depend on why you're visiting the doctor. During a routine annual check-up, most systems receive at least a basic evaluation. When you have specific symptoms, the examination concentrates on the relevant areas while still assessing your general health.

Examination of the Throat and Mouth

The doctor examines your mouth and throat using a light and tongue depressor—a flat stick that holds down your tongue. This allows clear visualization of your tonsils, the back of your throat, and the lining of your mouth. The doctor looks for signs of infection, inflammation, or other abnormalities.

In some cases, particularly if you're experiencing voice changes or swallowing difficulties, your doctor may need to examine deeper structures. This might involve using a small mirror or a flexible camera called a fiberlaryngoscope to see the base of your tongue, the epiglottis, and your vocal cords. These examinations are typically brief and cause only mild discomfort.

Examination of the Ears

Ear examination uses an instrument called an otoscope, which combines a light source with magnification to visualize the ear canal and eardrum (tympanic membrane). The doctor inserts the otoscope gently into your ear canal to check for earwax buildup, infection, or damage to the eardrum.

Sometimes earwax needs to be removed before a complete examination is possible. The doctor also assesses eardrum mobility—either by using a small puff of air or a device called a tympanometer that measures the eardrum's movement and middle ear pressure. These tests help identify conditions like middle ear infections or fluid behind the eardrum.

Examination of the Eyes

Basic eye examination involves checking how your pupils respond to light, assessing eye movement, and examining the external structures of the eye. Using a small flashlight or specialized instrument, the doctor can look at the front parts of your eye, including the cornea, iris, and lens.

For a more detailed examination, especially if you have vision problems or certain conditions like diabetes or high blood pressure, the doctor may examine your eye's internal structures. This includes looking at the retina and blood vessels at the back of the eye using an ophthalmoscope. Sometimes drops are used to temporarily dilate (widen) your pupils for a better view—this may cause temporary light sensitivity and blurred vision lasting a few hours.

Eye examination can reveal not just eye problems but also signs of systemic diseases. High blood pressure and diabetes, for example, cause characteristic changes in the blood vessels of the retina that can be seen during examination. This is why eye examinations are often included in routine health screenings.

Examination of Lymph Nodes and Glands

Lymph nodes are small, bean-shaped structures throughout your body that play a crucial role in your immune system. During examination, the doctor feels for enlarged lymph nodes in several locations: along your neck, in your armpits, and in your groin areas. Enlarged lymph nodes can indicate infection, inflammation, or sometimes more serious conditions.

The thyroid gland, located in your neck just above the collarbone, is also examined by palpation. The doctor feels for enlargement, nodules, or tenderness. Women may have their breasts examined to check for lumps or other changes, which is an important component of cancer screening.

Examination of the Heart

Heart examination primarily involves listening with a stethoscope, a technique called cardiac auscultation. The doctor listens at several specific locations on your chest to assess different heart valves and chambers. They evaluate your heart rate (how fast it beats), rhythm (whether beats are regular), and the quality of heart sounds.

The heart produces characteristic sounds when blood flows through it and when valves close. Changes in these sounds can indicate various conditions. Heart murmurs—extra or unusual sounds—may indicate valve problems, though some murmurs are completely benign and normal, especially in children and young adults.

Beyond listening, the doctor may also feel your chest to detect abnormal heart movements or vibrations. Additional tests such as electrocardiogram (ECG), echocardiogram (ultrasound of the heart), or other imaging may be ordered if the physical examination reveals abnormalities.

Examination of the Lungs

Lung examination involves listening to breath sounds with a stethoscope at multiple points on your chest and back. The doctor asks you to breathe deeply while they listen, which helps them hear sounds that might indicate problems. Normal breath sounds have a characteristic quality, while abnormal sounds can suggest various conditions.

Wheezing sounds may indicate airway narrowing from conditions like asthma or allergies. Crackling or rattling sounds can suggest fluid in the lungs, which might occur with heart failure or pneumonia. Diminished or absent breath sounds in certain areas could indicate collapsed lung, fluid around the lung, or severe airway obstruction.

The doctor also uses percussion—tapping on your chest and back—to assess the lungs. Normal lung tissue produces a resonant sound because it's filled with air, while fluid or solid masses produce a duller sound. This technique helps identify conditions like pleural effusion (fluid around the lungs) or consolidation (lung tissue filled with infection or inflammation).

Examination of Blood Pressure

Blood pressure measurement is a fundamental vital sign that provides important information about your cardiovascular health. The measurement consists of two numbers: systolic pressure (when the heart contracts and pumps blood) and diastolic pressure (when the heart relaxes and refills with blood).

The measurement is taken using a cuff wrapped around your upper arm that temporarily restricts blood flow. As the cuff deflates, the doctor or nurse either listens with a stethoscope or uses a digital monitor to determine when blood starts flowing again (systolic) and when flow becomes unrestricted (diastolic). Normal blood pressure is generally considered to be below 120/80 mmHg.

Your blood pressure may be measured multiple times and in different positions (sitting, standing) to get an accurate picture. Factors like stress, recent caffeine intake, or physical activity can temporarily affect readings, which is why doctors often prefer measurements taken when you're relaxed.

Examination of the Abdomen

Abdominal examination typically requires you to lie on your back on the examination table. The doctor uses inspection, palpation, percussion, and auscultation to assess the organs within your abdomen. They look for visible abnormalities, feel for tenderness or masses, tap to assess organ size, and listen to bowel sounds.

Abdominal pain can have many causes, from minor digestive issues to serious conditions requiring immediate attention. The location and characteristics of tenderness during examination help narrow down the possibilities. Certain organs—including the liver, spleen, and kidneys—can be felt during deep palpation when enlarged.

The doctor listens to your abdomen with a stethoscope to assess bowel sounds. Normal bowel sounds indicate active digestion, while absent sounds might suggest intestinal obstruction, and hyperactive sounds could indicate diarrhea or early obstruction. Unusual sounds over blood vessels might indicate arterial problems.

Examination of the Rectum and Genitals

Rectal examination involves the doctor inserting a gloved, lubricated finger into the rectum. While this may feel uncomfortable or embarrassing, it's an important examination that can identify problems not detectable by other means. In men, rectal examination allows assessment of the prostate gland. In both sexes, it can identify hemorrhoids, rectal masses, and sources of bleeding.

Gynecological examination is typically not part of a routine check-up but may be performed if you have symptoms affecting your reproductive organs or for cancer screening. This involves examination of the vagina and cervix using a speculum, and possibly manual examination of the uterus and ovaries.

For men, genital examination includes visual inspection and palpation of the penis, scrotum, and testicles. This helps identify conditions such as hernias, varicoceles, or testicular abnormalities. While these examinations may feel awkward, they're routine medical procedures performed to protect your health.

Examination of the Nervous System

Neurological examination assesses how well your brain, spinal cord, and peripheral nerves are functioning. This can include testing reflexes, muscle strength, sensation, coordination, and balance. The specific tests performed depend on your symptoms.

Common components of neurological examination include:

• Reflex testing: Using a small rubber hammer to test reflexes in the knees, ankles, and arms
• Strength testing: Pushing or pulling against the doctor's resistance to assess muscle power
• Sensation testing: Checking your ability to feel light touch, pinprick, or vibration
• Coordination tests: Touching your nose with your finger or walking heel-to-toe
• Balance tests: Standing with eyes closed or on one foot
• Cranial nerve testing: Checking vision, facial sensation and movement, hearing, and other functions

These tests help identify problems ranging from pinched nerves to more serious conditions affecting the brain or spinal cord. If abnormalities are found, additional testing such as CT scans or MRI may be recommended.

Examination of the Back and Joints

Musculoskeletal examination assesses the health of your bones, joints, muscles, and connective tissues. The doctor looks for signs of swelling, redness, warmth, or deformity. They test the range of motion in your joints and assess muscle strength.

If you have back pain, the examination may include tests that stretch the sciatic nerve to check for disk problems, assessment of spinal curvature and mobility, and evaluation of muscle tightness or spasm. Joint problems are assessed by checking for tenderness, swelling, and comparing function between the right and left sides.

Examination of the Skin

Skin examination involves visually inspecting your skin for abnormalities such as rashes, unusual moles, infections, or other changes. Certain skin findings may indicate systemic diseases—for example, certain rashes can suggest allergic reactions, autoimmune conditions, or infections.

Suspicious skin lesions may be examined more closely with a dermatoscope (a special magnifying instrument) or sampled for laboratory analysis. Skin biopsies can be performed in the office using local anesthesia if needed. Regular skin examinations are particularly important for people at higher risk of skin cancer.

Examination of the Feet

Foot examination is particularly important for people with diabetes, circulation problems, or nerve conditions. The doctor checks the pulses in your feet to assess blood flow, tests sensation to identify nerve damage (neuropathy), and inspects the skin for sores, calluses, or other problems.

Poor circulation or nerve damage in the feet can lead to serious complications, including slow-healing wounds and increased infection risk. Early detection through regular foot examinations allows for preventive care and can prevent serious problems. The doctor may also assess your gait (how you walk) to identify balance issues or joint problems.

What Happens After the Examination?

After the physical examination, your doctor will discuss their findings, explain any diagnoses, and recommend a treatment plan or additional tests if needed. Most physical examinations cause no lasting discomfort. If any part of the examination was uncomfortable or concerning, discuss this with your doctor.

Most physical examinations are well-tolerated and cause no significant discomfort. Any brief discomfort during the examination—such as pressure during abdominal palpation or the coldness of a stethoscope—resolves immediately. If you experienced anything that felt too uncomfortable, it's important to tell your doctor so they can adjust their approach for future visits.

After examining you, your doctor will explain what they found and what it means. They may be able to diagnose your condition based on the examination alone, or they may recommend additional tests to confirm their suspicions or gather more information. Common follow-up tests include blood tests, imaging studies (X-rays, ultrasound, CT, or MRI), or referrals to specialists.

This is an excellent time to ask questions about anything you didn't understand, express concerns about the diagnosis or treatment plan, and ensure you understand the next steps. Don't hesitate to ask your doctor to explain things in simpler terms if medical jargon is confusing.

How Can You Participate in Your Healthcare?

Active participation in your healthcare leads to better outcomes. Before your appointment, prepare a list of symptoms, current medications, and questions. During the examination, ask about what the doctor is doing and what they find. Afterward, ensure you understand the diagnosis, treatment plan, and when to follow up.

Being an active participant in your healthcare leads to better outcomes and greater satisfaction with your care. Preparation before your appointment makes the visit more efficient and ensures important information isn't forgotten.

Before your appointment, consider writing down your symptoms including when they started, what makes them better or worse, and how they affect your daily life. List all medications you take, including over-the-counter drugs and supplements. Note any allergies, previous surgeries, and family medical history that might be relevant. Write down questions you want to ask.

During the examination, you have the right to understand what's happening. Ask your doctor to explain what they're checking for and what they find. If something is uncomfortable, say so. If you don't understand something, ask for clarification. Your questions and observations provide valuable information that helps with diagnosis and treatment.

After the examination, make sure you understand your diagnosis (if one is made), the recommended treatment or tests, warning signs to watch for, and when you should return for follow-up. If you're unsure about anything, ask before leaving. Many people find it helpful to take notes or bring a family member to help remember important information.

If you have hearing difficulties or don't speak the local language fluently, you have the right to request interpreter services. Good communication is essential for quality healthcare, and assistance should be available to ensure you fully understand your care.