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MAX DOCTOR DREENA KELLY REVEALS WHAT YOUR GP DOES IN A CHECK-UP UP TO?

Have you ever wondered what GPs are up to when they prod and listen to your body? Our easy-to-follow guide explains it all - it's just what the doctor ordered.

CHEST

The doctor will sound your chest by tapping in specific places across the back and front, testing for resonance.

A uniform hollow sound indicates normality, a dull sound can indicate infection, or fluid on the lungs.

Next, the doctor will listen to your breathing with a stethoscope. Normal breathing gives a low sound and high-pitched sounds suggest lung damage or pnuemonia.

Wheezing can indicate asthma and crackling can indicate infection, or water on the lungs.

Muffled vibrations can indicate diseases like emphysema or even lung cancer. The shape of your chest shows congenital deformity, underlying infection or bone disease.

An "abnormal" shape can lead to lung disease because the patient cannot breathe efficiently.

The shape of the chest can change with chronic lung conditions, known as emphysema.

GLANDS

LYMPH glands in the armpits, neck and groin can be swollen because of any infection, and occasionally indicate more serious conditions, such as leukaemia.

PULSE

THE doctor will feel the pulse, either in the wrist or in the carotid artery in the neck, for 15 seconds. The number of beats is then multiplied by four to get the number of beats per minute.

A normal adult rate is between 60 and 80 beats per minute. A much higher rate indicates a heart disorder.

A weak rhythm is a symptom of shock, heart failure or internal bleeding.

A fast, weak or irregular beat is a symptom of hyperthermia (overheating), while a slow pulse may indicate low blood pressure or thyroid problems. An occasional fast pulse (palpitations) is nothing to worry about.

STOMACH

WHEN carrying out complete abdominal examinations, the doctor will also look at the hands, face and the skin.

The mouth will also be inspected for signs of gastro-intestinal disease.

Inspection of the abdomen often begins with identifying surgery scars and any unusual markings. These include enlarged blood vessels, which may indicate liver disease and swellings, which may suggest enlarged organs, such as the liver or spleen.

Other swellings can indicate extra fluid, gas or even pregnancy.

An enlarged liver will be apparent on the right side of the stomach and an enlarged spleen on the left. If the kidneys are enlarged, the doctor will be able to tell by examining either side of the belly button.

The lower stomach is examined when looking for an enlarged bladder or ovaries.

If the doctor suspects appendicitis, he will press the McBurney's point, which is two-thirds of the way between the navel and the hip-bone.

If the doctor feels an unusual lump, he may tap it to produce a vibration and allow him to work out its size and nature.

A clear, short resonance indicates good health, while a muffled response is a clue that there may be something else wrong. Finally he will listen to your stomach for bowel sounds which may indicate blockages.

EYES

THE conjunctiva membrane on the lower lid can indicate anaemia if it is pale. If the whites of the eyes are yellowish, it may be jaundice. Bulging eyes indicate an over-active thyroid gland.

FACE

THE colour of the face may indicate many conditions, such as anaemia or malnutrition.

Blue discolouration can indicate Cyanosis, and yellowness may be jaundice.

The doctor will also look for rashes, which can indicate infections such as impetigo or dermatological conditions, such as eczema.

EARS

DOCS check the inside of the ear using an otoscope. They are looking for a build-up of wax, or a perforated eardrum. Pale earlobes may indicate anaemia.

Lumps and bumps around the ears can sometimes indicate gout.

THROAT

A TONGUE depressor is used to show up pus, inflamed tonsils, or a swollen throat, which can be a sign of laryngitis.

HANDS

FROM your hands, the doctor may be able to diagnose underlying conditions.

Arthritis can be determined by an inspection of the joints, muscles and skin and the colour of the nails can indicate conditions such as anaemia, low oxygen levels and liver disease.

Little pitting defects in the nails are characteristic of psoriasis. One of the most revealing can be the yellow discolouration on specific fingers brought about by cigarette smoking.

When the doctor wishes to examine your Respiratory or Cardiovascular Systems, he may well start by looking at your hands, face and eyes because respiratory or cardiac disease can leave tell-tale signs in these areas.

HEART

THE doctor will place the stethoscope over each of the four heart valves when testing your ticker.

A healthy heart will produce a regular "lubb-dubb" sound, as the heart pumps out blood and refills.

From this the doctor will be able to tell your heart rate and how hard your heart is beating. A murmuring sound may indicate a faulty valve.

There are different sounds for different murmurs located in alternate positions across the chest. Being able to recognise these murmurs is often one of the greatest challenges to the medical student.
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Article Details
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Title Annotation:Features
Author:Kelly, Dreena
Publication:Daily Record (Glasgow, Scotland)
Date:Jan 7, 1998
Words:841
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