What’s my doctor looking for during a physical exam?

Have you ever wondered what your doctor is looking for when poking and prodding you during an exam?

Often, that answer depends on why you’re seeing the doctor in the first place. If you’re coming for an annual physical or preventive wellness care visit, your primary care doctor will evaluate your current health status. They may look in your ears, for example, but not expect to find anything wrong.

Why annual checkups are necessary

Annual physical exams are particularly important. When you and your healthcare provider can spot problems when they first arise, such as high blood pressure, high glucose levels or high cholesterol, they’re easier to resolve.

It’s possible for any one of these problems to occur without your knowing – you might not feel any different. That’s why health screenings for blood pressure, glucose levels, cholesterol and other health measures are often part of an annual physical.

An annual physical is also a chance to discuss screenings, vaccinations and your overall wellness.

When your physical exam targets a problem

If you see your doctor for a “problem-focused visit” with a specific complaint, such as an earache or sore throat, then the physician will want to take a closer look at those areas to try to determine the problem.

During the exam, the doctor considers the entire person by asking some questions to narrow down causes: What are your symptoms? How long have you had these symptoms? Where does it hurt? Have you been having a fever? Night sweats?

If you’re complaining of a cold, the physician will focus on your head and neck area and won’t be looking at your toes. But if you come in with foot pain, that’s where the exam will focus.

Here’s a rundown of what’s happening during an exam at your doctor’s office:

Neck

For a general complaint of not feeling well, a physician will feel the patient’s neck, trying to determine if the thyroid gland or lymph nodes and lymph glands are swollen, which could indicate an underlying infection.

An enlarged thyroid gland, also known as a goiter, could indicate problems with the thyroid, including fatigue and difficulty swallowing.

A single swollen lymph node could be a sign of an infection in that particular lymph node, or it could signal a type of cancer called lymphoma. If the patient has multiple swollen lymph nodes, that could indicate a cold.

Ears

If you come in with an earache, the doctor will examine the outside and inside of the ear to assess hearing and look for infection or fluid behind the ear drum. Swelling in the ear canal or discharge such as pus or blood could mean swimmer’s ear.

Using a lighted magnifying tool called an otoscope, the physician will look for wax buildup or foreign bodies in the ear canal and any holes in the eardrum. Along with ear pain, dizziness may be a symptom of an ear problem.

Eyes

When you’re asked to follow your doctor’s finger with your eyes, this is testing the muscles that control your eyes. Especially in older patients, this test can provide a clue that there may be a neurological problem such as a stroke, since these cranial nerves are connected to the muscles that control your eyes.

Your physician will also look at the clear covering of your eyes. If it’s red, that could indicate an infection or glaucoma. If the white part of your eye (sclera) is yellowing, that could mean an underlying liver condition or jaundice.

Mouth and throat

If you have a cold or a sore throat, the physician will use a tongue depressor to look inside your mouth and at the back of your throat, especially your tonsils. If the tonsils are red, swollen or covered with white spots, or you’re having sinus drainage at the back of your throat, that could mean a strep throat infection.

Also, if your tongue has a white coating on it, that could mean you have a yeast infection of the mouth, also known as thrush. This is more commonly seen in babies and elderly patients.

If the doctor asks you to stick out your tongue to see if it’s straight or crooked, that’s an example of a cranial nerve test that can be an early indicator of possible neurological problems, such as a small stroke or a brain tumor.

Lungs

Using a stethoscope, the doctor will listen for normal lung sounds while the patient breathes deeply and normally. Wheezing sounds could indicate bronchitis or fluid in the lungs or pneumonia.

Knees

When the physician taps on your knees for a deep tendon reflex check, this is actually part of the neurological examination that could indicate a stroke, brain tumor or a problem with the spinal cord. The reflex should be equal, symmetrical and appropriate, not hyper or diminished.

Abdomen

For complaints of abdominal pain, the doctor will press on the patient’s stomach, looking for areas of tenderness, and may ask the patient to point to the area of pain. Certain areas of pain could indicate an enlarged liver or spleen.

Something to keep in mind is that it can be more challenging for your doctor to get a good sense of enlarged organs by pressing on your belly if you’re obese.

Tenderness in the abdomen could indicate a variety of ailments, depending on where it’s located and whether the person has male or female reproductive organs. Tenderness could be a sign of an infected appendix, colon or gall bladder or appendix. For some, it could be a sign of an enlarged ovary.

The doctor may also use a stethoscope to listen to bowel sounds. Are they present? Are they normal? An absence of bowel sounds could mean there’s an obstruction or another problem with the intestines.

For people with male reproductive organs, an additional test may be performed if there are complaints of abdominal pain, swelling in the lower abdomen, scrotal pain or change in bowel movements.

During the exam, patients are asked to turn and cough while the doctor presses on the lower part of the abdomen. This allows the physician to determine if they have a specific type of hernia that occurs when a weakness in the abdominal wall causes the intestines to slide toward the scrotum.