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Q: physicals ( Answered 3 out of 5 stars,   0 Comments )
Subject: physicals
Category: Health
Asked by: susankemp-ga
List Price: $10.00
Posted: 19 Apr 2002 07:25 PDT
Expires: 26 Apr 2002 07:25 PDT
Question ID: 2041
What are the criteria/standards for annual physicals for adults?

Request for Question Clarification by skis4jc-ga on 19 Apr 2002 08:47 PDT
To help answer this question more specifically, it would be useful to know for 
which sex and age range you are looking for information.  Thank you!
Subject: Re: physicals
Answered By: skis4jc-ga on 19 Apr 2002 10:17 PDT
Rated:3 out of 5 stars
Dear Susankemp,

Hi!  Thank you for your inquiry!

The answer to your question, what are the criteria for annual physicals in 
adults, is somewhat dependent upon the patient’s age, sex, and risk factors for 
disease.  It is also questionable that a complete physical examination (CPE) 
needs to be done annually.  

Generally, a CPE starts at the head and proceeds all the way down to the toes.  
However, the precise procedure will vary according to the needs of the patient 
and the preferences of the medical examiner.

The following information is taken from the Hendrick AccessMed Online Health 
Information Library:

First, the examiner will observe the patient's appearance, general health, and 
behavior, along with measuring height and weight. The vital signs—including 
pulse, breathing rate, body temperature, and blood pressure—are recorded.
With the patient sitting up, the following systems are usually reviewed: 

·Skin. The exposed areas of the skin are observed; the size and shape of any 
lesions are noted. 
·Head. The hair, scalp, skull, and face are examined. 
·Eyes. The external structures are observed. The internal structures can be 
observed using an ophthalmoscope (a lighted instrument) in a darkened room. 
·Ears. The external structures are inspected. A lighted instrument called an 
otoscope may be used to inspect internal structures. 
·Nose and sinuses. The external nose is examined. The nasal mucosa and internal 
structures can be observed with the use of a penlight and a nasal speculum. 
·Mouth and pharynx. The lips, gums, teeth, roof of the mouth, tongue, and 
pharynx are inspected. 
·Neck. The lymph nodes on both sides of the neck and the thyroid gland are 
palpated (examined by feeling with the fingers). 
·Back. The spine and muscles of the back are palpated and checked for 
tenderness. The upper back, where the lungs are located, is palpated on the 
right and left sides and a stethoscope is used to listen for breath sounds. 
·Breasts and armpits. A woman's breasts are inspected with the arms relaxed and 
then raised. In both men and women, the lymph nodes in the armpits are felt 
with the examiner's hands. While the patient is still sitting, movement of the 
joints in the hands, arms, shoulders, neck, and jaw can be checked. 

Then while the patient is lying down on the examining table, the examination 

·Breasts. The breasts are palpated and inspected for lumps. 
·Front of chest and lungs. The area is inspected with the fingers, using 
palpation and percussion. A stethoscope is used to listen to the internal 
breath sounds. 

The head should be slightly raised for: 

·Heart. A stethoscope is used to listen to the heart's rate and rhythm. The 
blood vessels in the neck are observed and palpated. 

The patient should lie flat for: 

·Abdomen. Light and deep palpation is used on the abdomen to feel the outlines 
of internal organs including the liver, spleen, kidneys, and aorta, a large 
blood vessel. 
·Rectum and anus. With the patient lying on the left side, the outside areas 
are observed. An internal digital examination (using a finger), is usually done 
if the patient is over 40 years old. In men, the prostate gland is also 
·Reproductive organs. The external sex organs are inspected and the area is 
examined for hernias. In men, the scrotum is palpated. In women, a pelvic 
examination is done using a speculum and a Papamnicolaou test (Pap test) may be 
·Legs. With the patient lying flat, the legs are inspected for swelling, and 
pulses in the knee, thigh, and foot area are found. The groin area is palpated 
for the presence of lymph nodes. The joints and muscles are observed. 
·Musculoskeletel system. With the patient standing, the straightness of the 
spine and the alignment of the legs and feet is noted. 
·Blood vessels. The presence of any abnormally enlarged veins (varicose), 
usually in the legs, is noted. 

In addition to evaluating the patient's alertness and mental ability during the 
initial conversation, additional inspection of the nervous system may be 

·Neurologic screen. The patient's ability to take a few steps, hop, and do deep 
knee bends is observed. The strength of the hand grip is felt. With the patient 
sitting down, the reflexes in the knees and feet can be tested with a small 
hammer. The sense of touch in the hands and feet can be evaluated by testing 
reaction to pain and vibration. 
·Sometimes additional time is spent examining the 12 nerves in the head 
(cranial) that are connected directly to the brain. They control the sense of 
smell, strength of muscles in the head, reflexes in the eye, facial movements, 
gag reflex, and muscles in the jaw. General muscle tone and coordination, and 
the reaction of the abdominal area to stimulants like pain, temperature, and 
touch would also be evaluated.

Hendrick AccessMed Online Health Information Library,

An example of a typical physical examination form can be found at Georgetown 
Universities website for their college athletes: 

You can also download free physical examination forms from the U.S. General 
Services Administration website:

Also of possible interest in an excerpt from “Plainsense”, a general health 
“Many physicians still believe the annual physical is a necessary part of 
preventive healthcare. But, many professional groups -- the National Academy of 
Sciences, the American Medical Association, the Canadian Task Force on the 
Periodic Health Exam, and the U.S. Preventive Services Task Force, among 
others -- disagree. These groups feel that routine annual physicals for healthy 
adults are largely unnecessary. Instead, they recommend periodic health exams 
and age and risk-related tests designed to screen for specific medical 


Although a paid subscription is necessary to view most of the articles, there 
are a few that are free that give supporting evidence towards the AMA’s belief 
that the annual complete physical examination (CPE) is unnecessary.  To view an 
example of one of these, visit the following link to the American Medical 
Association’s homepage:

Please remember that this information is just an example of a typical adult 
annual physical, and that each physical will vary according to patient needs 
and practitioner preferences.

Thank you for using Google!

Best Regards,

Clarification of Answer by skis4jc-ga on 19 Apr 2002 10:20 PDT
Search terms used:
standard physical examination
complete physical examination
physical examination criteria
health questions
medical exam standards
annual adult physical

Request for Answer Clarification by susankemp-ga on 30 Apr 2002 10:52 PDT
Its not the age and sex so much as we're trying to figure out if
there's a standard we should consider in requiring staff member to
take physicals.  Should we say once a year, every other year?  By the
way I'm very impressed with the information you've sent so far.

Clarification of Answer by skis4jc-ga on 30 Apr 2002 11:42 PDT
Dear Susan,
Thank you for your clarification and I'm glad you liked the answer I
already posted.
I would say that it really depends on your staff, the individuals. 
For example, if you have a lot of generally young, healthy people, a
yearly physical is probably a bit more than necessary (referencing
from earlier answer - AMA agrees with this).  However, if you have a
large majority of elderly employees or a "less than healthy" office
(environment and employees), maybe yearly physicals would be a good
idea for your group.  The general rule of thumb is to not let more
than 3 years pass in-between complete physicals, and usually nobody
ever needs more than 1 per year.  So every other year *should* be
fine, but again, look at your group and ask them how they feel about
that to really know.  Also, ask yourself, how necessary/important is
it for you to know the physical health of your employees every year?
Hope this helps!
Have a wonderful day.
susankemp-ga rated this answer:3 out of 5 stars

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