Covers examination of the abdomen, liver, spleen, and kidneys. Techniques for light and deep palpation are covered as well as auscultating bowel sounds and inspecting for symmetry, scars, and striae. Additional attention is given to assessing for guarding and rebound tenderness as well as listening for and identifying abdominal and inguinal bruits.
- Approach to the patient
Discusses the approach to the patient emphasizing the knowledge, skills and procedures that contribute to an effective relations and quality patient care. Emphasis is on health history, documentation, communication, and patient/practitioner interaction.
- Breasts and axillae
Begins with a review of both female and male breast anatomy as well as techniques for examining the breast and axillae. Techniques for identifying masses and assessing risk factors for breast cancer are covered, including risk assessment tools and screening recommendations for mammography, clinical breast exam, and self-breast examination.
- Cardiovascular system
Begins with a review of the vascular structures of the neck as well as techniques to estimate the jugular venous pressure and how to assess the carotid upstroke. After reviewing the anatomy of the heart, techniques for determining the point of maximal impulse and auscultating heart sounds and murmurs are covered as well as palpating for heaves, lifts, and thrills.
- Examination of the skin
Focuses on how to approach and communicate with patients to prepare for clinical practice. Emphasis is on health history and documentation and communication and patient/practitioner interaction.
- Female genitalia, anus, and rectum
Covers examination of both the external and internal female genitalia. Techniques for performing a speculum and bimanual examination of the internal genitalia are covered as well as how to collect the Papaniculou smear. Special attention is given to patient privacy and preparation for the pelvic examination including draping and positioning the patient during the examination.
- General survey and vital signs
Covers techniques for assessing and describing the patient’s general appearance including level of consciousness, signs of distress, apparent state of health, and facial expression. Techniques for assessing the height, weight, and build of the patient are covered as well as measuring the patient’s vital signs. Special attention is given to assessing and managing pain.
- Head, eyes, and ears
Covers the examination and anatomy review of the head, eyes, and ears including techniques for examining the scalp as well as assessing facial expression, contours, and asymmetry. Assessing visual acuity, extraocular movements, pupilary reaction, and auditory acuity are also covered as well as how to properly perform a fundoscopic exam.
- Head-to-toe assessment (adult)
Covers the skilled comprehensive examination of an adult patient including patient comfort, vital signs, skin, HEENT, cranial nerves, neck, back, upper extremities, breasts, thorax and lungs, cardiovascular system, abdomen, peripheral vascular system, lower extremities, nervous system, and genital and rectal examinations.
- Head-to-toe assessment of the older adult
Focuses on adjusting interview techniques and office environment to meet the needs of older adults including adjusting pace and content as well as allowing time for the patient’s story. Attention is placed on the importance of functional assessment and screening for preventing falls.
- Male genitalia, hernias, rectum, and prostate
Reviews the anatomy of male genitalia and hernias as well as the rectum, anus, and prostate. Techniques for examining the external male genitalia as well as the anus, rectum, and prostate are covered. Special attention is given to assessing direct and indirect inguinal or femoral hernias as well as teaching the self-testicular examination.
- Musculoskeletal system
Covers examination of the mandible, shoulders, elbows, wrists and hands, spine, hips, knees, as well as ankles and feet. Assessing the range of motion, function, and soft tissue for each major joint is covered as well as how to asses joint pain and recognize the changes of inflammatory and degenerative joint disease and trauma.
- Nose, mouth, and neck
Covers identification and examination of the key anatomic structures of the nose, mouth, and neck. Techniques for examining the pharynx and thyroid gland are also covered. Special attention is given to the examination of lymph nodes.
- Pediatric head-to-toe assessment (child)
Covers the comprehensive examination of children with special attention placed on adapting to the child’s mood, behavior, and level of development. Special tips for assessing and engaging children as well as adjusting the sequence and style of the examination are also covered.
- Pediatric head-to-toe assessment (infant)
Covers the comprehensive examination of an infant patient focusing on how the examination differs from that of adults and even older children. Special attention is placed on the sequence of examination, flexibility of the clinician, and varying temperaments of the infant as well as tips for infant cooperation.
- Peripheral vascular system
Covers assessment of the arterial pulses including brachial, radial, femoral, popliteal, dorsalis pedis, and posterior tibial. Techniques for assessing the lower extremity venous system and the lymphatic system are also covered as is screening for peripheral arterial disease. Special attention is placed on assessment for chronic arterial insufficiency and venous insufficiency.
- The nervous system cranial nerves and motor system
Reviews the important principles guiding the neurologic examination. Identifying and testing the 12 cranial nerves is covered as well as testing the motor system, especially muscle strength, movement, bulk, tone, and cerebellar function.
- The nervous system sensory system and reflexes
Covers the assessment of pain, temperature, light touch, and vibratory sensations, as well as position sense and discriminative sensation. Attention is placed on deep tendon reflexes of the biceps, triceps, brachioradialis, knee, and ankle, as well as proper testing of the plantar response, or Babinski’s sign.
- Thorax and lungs
Begins with a review of the anatomy and physiology of the thorax and lungs. Techniques for examining the posterior and anterior chest wall are covered as well as inspection, palpation, percussion, and auscultation. Special attention is placed on the identification of percussion notes and breath sounds as well as health concerns related to smoking.