Patient Scenario Showing the Value of the Scientific Method

Biology -- Patient Scenario

What are the components of physical examination? Describe each component.

Physical examination consists of 5 basic components after obtaining a patient's description of the history of his/her systems. First, the provider observes the patient for physical signs of disease and evaluates such factors as mobility, posture, facial expression, alertness, responsiveness to stimuli and changes in skin color (Jarvis, 2011, pp. 33, 127-9). Secondly, one must take a patient's vital signs, including blood pressure, heart rate, breathing rate and temperature, and compare the patient's results with the reference ranges (Jarvis, 2011, pp. 136-150). Third, one must perform auscultation, using a stethoscope to listen to the patient's lungs, heart and bowel (Jarvis, 2011, p. 118). Fourth, one performs percussion by tapping on the patient's chest and abdomen to listen for sounds indicating normal conditions, fluid, excess air, size of the lungs and size of the affected area (Jarvis, 2011, p. 116). Fifth, one performs palpation, using the fingers to apply pressure in body regions and on organs to determine the sizes of organs, their consistency, shape, tenderness and any foreign masses (Jarvis, 2011, p. 115). The combination of listening to the patient's history of symptoms and these 5 steps helps the provider narrow the possible causes of disorder and to order appropriate imaging tests and lab work.

2. Mr. Smith's blood pressure was 160/100 mmHg. How does a medical provider take or measure blood pressure? What do the top (numerator) and bottom (denominator) numbers mean in the biological sense? What is the significance the size of these two numbers? Is Mr. Smith's blood pressure within normal range? Explain how you concluded whether Mr. Smith's blood pressure is/is not within normal range.

Blood pressure is taken with the use of a sphygmomanometer, an inflatable cuff with an attached pressure gauge that measures blood pressure in millimeters of mercury (mm Hg), and a stethoscope (WebMD, LLC, n.d.). The cuff is wrapped around the patient's upper arm, forearm or wrist (depending on the cuff size) and is inflated to a pressure known to be higher than the patient's systolic pressure, as the provider uses a stethoscope to listen to the blood moving through the patient's artery. As the cuff is deflated, the provider hears the systolic blood pressure, which is a "whooshing" noise, and reads the pressure gauge. After the whooshing noise, the provider hears the diastolic blood pressure and reads the pressure gauge (WebMD,…