A physical examination, also known simply as a "physical," is a process in which a physician examines various organ systems and other parts of the body. As the standard tool used to monitor health and diagnose the source of many diseases, it represents the cornerstone of preventive medicine. It is far better to prevent a disease or condition than to treat it, and better to treat it early before it progresses.

A physical examination is usually the first step in helping to find and treat the source of what ails the patient. The purpose of a physical is to determine if there are signs of illness that can be detected by looking, touching and listening to the body.

The physical findings and the medical history obtained during a physical examination are important elements in making a diagnosis of many medical conditions. They may also indicate diseases for which the patient may be at high risk, such as diabetes, heart disease or certain cancers.

During a physical examination, the physician will assess a number of areas. A basic physical examination is standard whenever anyone visits a physician and includes the following elements:

• Vital signs (e.g., pulse, blood pressure)
• General appearance
• Eyes, ears, nose, throat and mouth
• Neck, particularly the thyroid gland and cervical lymph nodes
• Respiratory, cardiovascular and gastrointestinal systems (breathing, circulation and digestion)
• Breasts (women and men)
• Genitals (including men's prostate and women's pelvic area)
• Muscles, joints, bones and skin

A physical examination is a general health checkup that is used to diagnose illnesses or to provide preventive care in healthy individuals. Physical examinations have several purposes. They include:

• Disease screening
• Assessing risks for future health problems
• Assessing management of chronic diseases or conditions (e.g., allergies, asthma
• Suggesting tips for healthier lifestyle
• Updating vaccinations
• Building a physician-patient relationship

Patients visit a physician either in response to symptoms that may have arisen, or as a means of preventative care. A physical examination typically includes four phases:

• Inspection. The physician makes a visual overview of the patient, or of a specific body part.
  
  
• Palpation. The physician touches and or manipulates parts of the patient’s body. The purpose is to examine aspects of size, consistency, location and tenderness.
  
  
• Auscultation. The physician listens to sounds in the body, usually with the aid of a stethoscope. Frequently, this involves listening to a patient’s lungs, heart and intestines. The frequency, intensity, duration, number and quality of sounds are noted.
  
  
• Percussion. The physician taps body parts with fingers, hands or small instruments. The purpose is to examine aspects of size, consistency, borders and presence or absence of fluid in body organs.

In addition, a physician will examine a patient by assessing:

• Vital signs (e.g., temperature, pulse/heart rate, blood pressure)
• General appearance
• Eyes, ears, nose, throat and mouth
• Neck, particularly the thyroid gland and cervical lymph nodes
• Respiratory, cardiovascular and gastrointestinal systems
• Breast examination for women and men
  
• Genitals (including men’s prostate and women’s pelvic area)
  
• Muscles, joints, bones and skin
  
• Neurological and psychiatric condition

A routine physical examination normally begins with a review of the patient’s medical history by the physician. The physical examination offers an opportunity to speak to a physician about health concerns. Some patients find it helpful to bring a list of relevant questions for their physician to the appointment.

If it is a routine check-up with no pressing concerns or current symptoms, no preparation is necessary prior to the exam. However, the physician may request that certain information be gathered prior to the appointment. For example, information about a family history of disease in close relatives (including parents, siblings, grandparents, aunts and uncles) may help a physician to be watchful for symptoms related to the disease if it has a genetic component.

A patient with symptoms that may be of concern should describe them in detail to the physician. The description should include what the symptoms are, where they are located, when they began, what they feel like, whether they get worse or better over time, and any other patterns.

Also, if a patient complains of certain symptoms when making the appointment, the physician may request that certain items be prepared prior to the exam (e.g., a stool sample from a patient complaining of blood in the stool).

Physical examinations can range from simply measuring blood pressure and listening to a patient’s heart to a more thorough exam, which usually includes the following:

• Height and weight measurements
  
  
• Vital statistics, including temperature, heart rate and blood pressure
  
  
• Examining the skin for any rashes, dryness, irritation, open sores, bleeding or abnormal color and checking moles for possible signs of skin cancer
  
  
• Checking the spine for proper alignment
  
  
• Listening to a patient’s lungs for evidence of fluid
  
  
• Examining the patient’s ears and hearing
  
  
• Checking for signs of swelling (edema) around the eyes, or in the hands or feet
  
  
• Checking the chest, breasts and abdomen for tender areas, lumps or enlarged organs, as well as signs of swelling
  
  
• Checking the eyes for clarity, movement and the pupils’ response to light, as well as the back of the eye (retina) and any signs of vision changes
  
  
• Looking at the teeth, gums and throat and asking about the patient’s oral health habits
  
  
• Checking the thyroid gland at the base of the neck while the patient swallows, as well as listening to the blood vessels in the neck
  
  
• Examining joints and muscles for tenderness, swelling or motor difficulties
  
  
• Feeling the lymph nodes under the arm, around the neck and in the cervical area for any swelling or pain
  
  
• Examining men’s prostate gland and testicles and women’s pelvic area
  
  
• Checking reflexes of some musculoskeletal systems (e.g., knee jerk, ankle)
  
  

The physician may also perform the following:

• Cholesterol test. A blood test that measures a person’s total cholesterol, low-density lipoprotein cholesterol (LDL“bad” cholesterol), high-density lipoprotein cholesterol (HDL“good” cholesterol) and triglycerides. High cholesterol levels can lead to a buildup of fatty deposits (plaques) in the arteries, a condition called atherosclerosis. This raises the risk of heart attack and stroke.
  
  
• Colon and rectal cancer screening. There are several different types of tests that can help screen for colon or rectal cancer. These include fecal occult blood tests (chemical check for blood hidden in stool), flexible sigmoidoscopy (examination of the lower portion of the colon with a thin, flexible tube called a sigmoidoscope), colon x-ray (examination in which the patient receives an injection of liquid barium, which looks bright white on x-rays and can help highlight irregularities), and colonoscopy (similar to the flexible sigmoidoscopy, except the entire colon is examined).
  
  
• Bone-density measurement. Scan of the lower back, hip area, wrist or heel that measures the density of bones. Many different types of scans can be used, including ultrasound, computed axial tomography (CAT) scan and dual energy x-ray absorptiometry (DEXA).
  
  

Once the physical examination is complete, the physician may decide that additional evaluation of the patient is warranted. The recommendation may be based on the patient’s medical history and any findings during the physical, even if symptoms are not present. Depending on the suspected condition, a number of tests may be ordered by the physician to aid or rule out the diagnosis of a condition.

In the past, experts have suggested that adult patients also receive regular physical examinations, even when they are feeling healthy. It was long argued that because some conditions do not present symptoms, especially in the early stages, a yearly exam was essential to good basic health.

However, in recent years this approach has been re-evaluated. Today, many experts are urging a less rigorous examination schedule. The U.S. Public Health Service’s Preventive Services Task Force now recommends that healthy adult patients forgo annual physical examinations in favor of individual testing every one to three years depending on medical history, sex, age, other risk factors and the state of health.

Recommended examinations for women include:

• Mammograms. Every one to two years after age 40.
  
  
• Pap smears. At least every three years after beginning sexual activity or after turning 21.
  
  
• Cholesterol checks. Beginning at age 45, or age 20 for those who have other risk factors for coronary heart disease.
  
  
• Blood pressure. Beginning at age 18.
  
  
• Blood test for diabetes. Every three years beginning at age 45, or age 18 for those at high risk, such as patients who are overweight, have a family history of diabetes or other risk factors.
  
  
• Colorectal cancer tests. Beginning at age 50 with a frequency that depends on the type of test in discussion with the patient’s physician.
  
  
• Osteoporosis tests. Beginning at age 65, or age 60 for women at increased risk for osteoporotic fractures.
  
  

The recommendations for men include the following:

• Cholesterol checks. Beginning at age 35, or age 20 for those who have other risk factors for coronary artery disease.
  
  
• Blood pressure. Beginning at age 18.
  
  
• Blood test for diabetes. Every three years beginning at age 45, or age 18 for those at high risk, such as patients who are overweight, have a family history of diabetes or other risk factors.
  
  
• Colorectal cancer tests. Beginning at age 50 with a frequency that depends on the type of test in discussion with the patient’s physician.
  
  
• Prostate cancer screening. Consult with a physician.

It should be noted that specific screening recommendations vary between health organizations. Individuals should consult with a physician to determine the screening schedule that is most appropriate for them.