Advanced Physical Examination

Study Course Description

Course Description Statuss:Approved

Course Description Version:4.00

Study Course Accepted:21.09.2023 17:07:31

Study Course Information
Course Code:		ISK_222		LQF level:		Level 7
Credit Points:		2.00		ECTS:		3.00
Branch of Science:		Clinical Medicine; Internal Medicine		Target Audience:		Medicine
Study Course Supervisor
Course Supervisor:		Valdis Ģībietis
Study Course Implementer
Structural Unit:		Department of Internal Diseases
The Head of Structural Unit:
Contacts:		Riga, 2 Hiprokrāta Street, iskrsu[pnkts]lv, +371 67042338
Study Course Planning
Full-Time - Semester No.1
Lectures (count)		1	Lecture Length (academic hours)		2	Total Contact Hours of Lectures		2
Classes (count)		4	Class Length (academic hours)		3	Total Contact Hours of Classes		12
Total Contact Hours								14
Full-Time - Semester No.2
Lectures (count)		1	Lecture Length (academic hours)		2	Total Contact Hours of Lectures		2
Classes (count)		5	Class Length (academic hours)		3	Total Contact Hours of Classes		15
Total Contact Hours								17
Study course description
Preliminary Knowledge:
Successful completion of the study course “Introduction to Clinical Medicine”. Successful completion of the study course “Medical Communication”. Skills in the subjective part of the clinical history acquired: an interview on the main complaint, current history of the disease, history of previous diseases and the screening of systems.
Objective:
Teach how to draft complete medical records: taking academic and clinical medical history and integrating them into clinical practice. Carry out a detailed patient assessment with physical examination methods: specific inspection, palpation, percussion and auscultation. Ensure the possibilities to use physical examination methods during the third year of study.
Topic Layout (Full-Time)
No.	Topic			Type of Implementation		Number	Venue
1	Taking in-depth medical history. Critical thinking.			Lectures		1.00	E-Studies platform
2	Specific physical examination.			Lectures		1.00	E-Studies platform
3	Extensive medical records.			Classes		2.00	clinical base
4	In-depth general physical examination.			Classes		2.00	clinical base
5	In-depth chest examination.			Classes		2.00	clinical base
6	In-depth abdominal examination.			Classes		2.00	clinical base
7	Critical thinking in clinical environment.			Classes		1.00	clinical base
Assessment
Unaided Work:
Students independently familiarise themselves with the requirements for each class and learn clinical manipulations using the recommended sources. Students are required to individually look up the latest information on patient physical examination methods using the sources advised by the department or the sources of their own choice. In order to evaluate the quality of the study course as a whole, the student must fill out the study course evaluation questionnaire on the Student Portal.
Assessment Criteria:
Full class attendance is required. Theoretical knowledge is assessed with the help of tests during lectures – 30% of the total assessment. Practical skills are assessed with the help of clinical cases – 70% of the total assessment.
Final Examination (Full-Time):		Exam
Final Examination (Part-Time):
Learning Outcomes
Knowledge:		On completion of the course students will know how to: • structurally interview and record patient medical history: academic and/or clinical; • perform in-depth physical examination according to the presented disease/condition; • make objective the patient's subjective experience with the condition; • think critically in a clinical environment.
Skills:		On completion of the course students will be able to: • engage in clinical reasoning and decision making; • communicate with patients, their relatives, colleagues, other persons involved in the process of health care; • specify the complaints, medical history, structurally interviewing and recording history data; • perform systematic physical examination using the method of inspection, palpation, percussion, auscultation and other derived methods.
Competencies:		1. Evaluate the acquired symptoms, linking them with pathological processes in the patient's body. 2. Able to analyse situations, substantiate, logically formulate and explain their own opinion.
Clinical Skills:
No.	Skill					Level
1	"Testing ott’s symptom					A - Beginner level
2	Ankle joint mobility test.					A - Beginner level
3	Anterior and lateral comparative percussion of lungs					A - Beginner level
4	Anterior and lateral fremitus pectoralis					A - Beginner level
5	Apex beat mobility test					A - Beginner level
6	Auscultation of lungs					A - Beginner level
7	Ballotation symptom in the knee joint					A - Beginner level
8	Blumberg's symptom					A - Beginner level
9	Bronchophonia on the back					A - Beginner level
10	Colon descendens palpation					A - Beginner level
11	Demonstration of murphy's symptom					A - Beginner level
12	Detection of ascites					A - Beginner level
13	Detection of ascites (by means of palpation)					A - Beginner level
14	Detection of gallbladder projection site					A - Beginner level
15	Determination of a vessels bundle width					A - Beginner level
16	Determination of the chauffard's triangle					A - Beginner level
17	Determination of the left border of heart relative dullness					A - Beginner level
18	Determination of the superior border of heart relative dullness					A - Beginner level
19	Elbow joint palpation					A - Beginner level
20	Examination of muscle-induced rigidity of the abdominal wall					A - Beginner level
21	Examination of the elbow joint active flexion					A - Beginner level
22	Examination of the elbow joint extension					A - Beginner level
23	Examination of the elbow joint passive flexion					A - Beginner level
24	Examination of the elbow joint pronation					A - Beginner level
25	Examination of the elbow joint supination					A - Beginner level
26	Examination of the hip joint testing active abduction					A - Beginner level
27	Examination of the hip joint testing external rotation					A - Beginner level
28	Examination of the hip joint testing flexion					A - Beginner level
29	Examination of the hip joint testing internal rotation					A - Beginner level
30	Examination of the hip joint testing passive abduction					A - Beginner level
31	Fallen’s symptom					A - Beginner level
32	Gallbladder palpation - checking for Volsky's symptom					A - Beginner level
33	Gallbladder palpation - examination of a svirksic symptom					A - Beginner level
34	Gallbladder palpation - examination of Courvoisier's symptom					A - Beginner level
35	Gallbladder palpation - examination of the saccharine symptom					A - Beginner level
36	Heart auscultation (hemodynamic order)					A - Beginner level
37	Heart auscultation (topographic order)					A - Beginner level
38	Heart auscultation (traditional)					A - Beginner level
39	Height of lung's apex in the front					A - Beginner level
40	Height of the lung's apex on the backside					A - Beginner level
41	Hygienic Hand Disinfection					A - Beginner level
42	Liver percussion					A - Beginner level
43	Mayo-Robson's point detection					A - Beginner level
44	Orthner symptom					A - Beginner level
45	Palpation of apex beat					A - Beginner level
46	Palpation of apex beat					A - Beginner level
47	Palpation of caput pancreatis					A - Beginner level
48	Palpation of colon transversum					A - Beginner level
49	Palpation of corpus pancreatis					A - Beginner level
50	Palpation of spleen					A - Beginner level
51	Palpation of the abdominal surface					A - Beginner level
52	Palpation of the ankle joint					A - Beginner level
53	Palpation of the liver					A - Beginner level
54	Palpation of the terminal ileum					A - Beginner level
55	Percussion and palpation of bladder					A - Beginner level
56	Percussion of spleen					A - Beginner level
57	Pleural and intercostal pains					A - Beginner level
58	Posterior fremitus pectoralis					A - Beginner level
59	Posterior lungs comparative percussion					A - Beginner level
60	Schober’s symptom					A - Beginner level
61	Shoulder joint examination abduction					A - Beginner level
62	Shoulder joint examination active extension					A - Beginner level
63	Shoulder joint examination active abduction					A - Beginner level
64	Shoulder joint examination active external rotation					A - Beginner level
65	Shoulder joint examination active flexion					A - Beginner level
66	Shoulder joint examination active internal rotation					A - Beginner level
67	Shoulder joint examination passive abduction					A - Beginner level
68	Shoulder joint examination passive extension					A - Beginner level
69	Shoulder joint examination passive external rotation					A - Beginner level
70	Shoulder joint examination passive flexion					A - Beginner level
71	Shoulder joint examination passive internal rotation					A - Beginner level
72	Testing the fist symptom					A - Beginner level
73	The width of the apices of the lungs					A - Beginner level
74	Tomayer’s symptom					A - Beginner level
75	Topographic percussion of the lung's inferior edge					A - Beginner level
76	Triangle symptom					A - Beginner level
77	Wrist movement test.					A - Beginner level
Bibliography
No.	Reference
Required Reading
1	Bates’ guide to physical examination and history taking / Lynn S. Bickley, Peter G. Szilagyi. 2017
2	The Merck Manual of Patient Symptoms: A Concise, Practical Guide to Etiology, Evaluation, and Treatment. 1st Edition, 2008 (akceptējams izdevums)