Skip to main content
Top

2023 | OriginalPaper | Hoofdstuk

7. Initial general examination

Auteurs : Dr J. A. H. Eekhof, R. J. M. Claessen

Gepubliceerd in: Physical Diagnostics

Uitgeverij: Bohn Stafleu van Loghum

share
DELEN

Deel dit onderdeel of sectie (kopieer de link)

  • Optie A:
    Klik op de rechtermuisknop op de link en selecteer de optie “linkadres kopiëren”
  • Optie B:
    Deel de link per e-mail

Abstract

The doctor should observe the patient constantly during the consultation, watching how the patient behaves and thus forming a general impression of them. This process is partly conscious and partly unconscious. This chapter discusses the aspects that a doctor can observe. These observations are based on both objective data (blood pressure, oxygen saturation, abdominal girth, etc.) and more subjective information (behaviour, odour, affect, etc.). The doctor’s observations yield a general impression that can be useful to diagnosis, treatment and contact with the patient.
Bijlagen
Alleen toegankelijk voor geautoriseerde gebruikers
Literatuur
1.
go back to reference Rutten GEHM, Damoiseaux RAMJ, Olde Hartman TC, editors. Het geneeskundig process [The medical process]. 7th ed. Houten: Bohn Stafleu van Loghum; 2019. Rutten GEHM, Damoiseaux RAMJ, Olde Hartman TC, editors. Het geneeskundig process [The medical process]. 7th ed. Houten: Bohn Stafleu van Loghum; 2019.
2.
go back to reference Kuks JBM, Snoek JW, editors. Leerboek klinische neurologie [Textbook of clinical neurology]. 18th ed. Houten: Bohn Stafleu van Loghum; 2016. Kuks JBM, Snoek JW, editors. Leerboek klinische neurologie [Textbook of clinical neurology]. 18th ed. Houten: Bohn Stafleu van Loghum; 2016.
3.
go back to reference Deth R van. Psychiatrie. Van diagnose tot behandeling [Psychiatry: from diagnosis to treatment]. 6th edition. Houten: Bohn Stafleu van Loghum; 2019. Deth R van. Psychiatrie. Van diagnose tot behandeling [Psychiatry: from diagnosis to treatment]. 6th edition. Houten: Bohn Stafleu van Loghum; 2019.
4.
go back to reference Hengeveld MWJ. Het psychiatrisch onderzoek [Psychiatric examination]. 2nd edition. Leusden: De Tijdstroom; 2009. Hengeveld MWJ. Het psychiatrisch onderzoek [Psychiatric examination]. 2nd edition. Leusden: De Tijdstroom; 2009.
5.
go back to reference Gjorup T, Hendriksen C, Bugge PM, Jensen AM. Global assessment of patients – a bedside study. II. Inter-observer variation and frequency of clinical findings. J Intern Med. 1990;228:147–50. Gjorup T, Hendriksen C, Bugge PM, Jensen AM. Global assessment of patients – a bedside study. II. Inter-observer variation and frequency of clinical findings. J Intern Med. 1990;228:147–50.
6.
go back to reference Jones AE, Aborn LS, Kline JA. Severity of emergency department hypotension predicts adverse hospital outcome. Shock. 2004;22:410–4.CrossRefPubMed Jones AE, Aborn LS, Kline JA. Severity of emergency department hypotension predicts adverse hospital outcome. Shock. 2004;22:410–4.CrossRefPubMed
7.
go back to reference Gjorup T, Hendriksen C, Bugge PM, Jensen AM. Global assessment of patients – a bedside study. I: The influence of physical findings on the global assessment. J Intern Med. 1989;226:123–5. Gjorup T, Hendriksen C, Bugge PM, Jensen AM. Global assessment of patients – a bedside study. I: The influence of physical findings on the global assessment. J Intern Med. 1989;226:123–5.
8.
go back to reference Breivik H, Borchgrevink PC, Allen SM, Rosseland LA, Romundstad L, Hals EK, et al. Assessment of pain. Br J Anaesth. 2008;101:17–24.CrossRefPubMed Breivik H, Borchgrevink PC, Allen SM, Rosseland LA, Romundstad L, Hals EK, et al. Assessment of pain. Br J Anaesth. 2008;101:17–24.CrossRefPubMed
9.
go back to reference McInerny TK, Adam HM, Campbell DE, et al. American academy of pediatrics textbook of pediatric care (Chapter 180: odor (unusual urine and body)). 2nd edition. Pediatric Care Online. McInerny TK, Adam HM, Campbell DE, et al. American academy of pediatrics textbook of pediatric care (Chapter 180: odor (unusual urine and body)). 2nd edition. Pediatric Care Online.
10.
go back to reference Campisi G, Musciotto A, Di Fede O, et al. Halitosis, could it be more than bad breath? Intern Emerg Med. 2011;6:315–9.CrossRefPubMed Campisi G, Musciotto A, Di Fede O, et al. Halitosis, could it be more than bad breath? Intern Emerg Med. 2011;6:315–9.CrossRefPubMed
11.
go back to reference Shirasu M, Touhara K. The scent of disease: volatile organic compounds of the human body related to disease and disorder. J Biochem. 2011;150:257–66.CrossRefPubMed Shirasu M, Touhara K. The scent of disease: volatile organic compounds of the human body related to disease and disorder. J Biochem. 2011;150:257–66.CrossRefPubMed
14.
go back to reference Ruzsányi V, Péter KM. Breath acetone as a potential marker in clinical practice. J Breath Res. 2017;11(2): 024002.CrossRefPubMed Ruzsányi V, Péter KM. Breath acetone as a potential marker in clinical practice. J Breath Res. 2017;11(2): 024002.CrossRefPubMed
16.
go back to reference Mitchell S, Ayesh R, Barrett T, Smith R. Trimethylamine and foetor hepaticus. Scand J Gastroenterol. 1999;34:524–8.CrossRefPubMed Mitchell S, Ayesh R, Barrett T, Smith R. Trimethylamine and foetor hepaticus. Scand J Gastroenterol. 1999;34:524–8.CrossRefPubMed
18.
go back to reference De Vries H, Bastiaans JF, Van Itterrsun FJ. Gewichtsverlies [Weight loss]. In: De Jongh TOH, De Vries H, Knottnerus BJ, et al. Diagnostiek van alledaagse klachten [Diagnosing everyday symptoms]. 5th edition. Houten: Bohn Stafleu van Loghum; 2021. De Vries H, Bastiaans JF, Van Itterrsun FJ. Gewichtsverlies [Weight loss]. In: De Jongh TOH, De Vries H, Knottnerus BJ, et al. Diagnostiek van alledaagse klachten [Diagnosing everyday symptoms]. 5th edition. Houten: Bohn Stafleu van Loghum; 2021.
19.
go back to reference Williamson DF. Descriptive epidemiology of body weight and weight change in U.S. adults. Ann Intern Med. 1993;1:646–9. Williamson DF. Descriptive epidemiology of body weight and weight change in U.S. adults. Ann Intern Med. 1993;1:646–9.
20.
go back to reference Aylsworth AS. Clinical aspects of defects in the determination of laterality. Am J Med Genet. 2001;101:345–55.CrossRefPubMed Aylsworth AS. Clinical aspects of defects in the determination of laterality. Am J Med Genet. 2001;101:345–55.CrossRefPubMed
21.
go back to reference Boron FBE. Medical physiology. Philadelphia, PA: Elsevier Saunders; 2005. Boron FBE. Medical physiology. Philadelphia, PA: Elsevier Saunders; 2005.
22.
go back to reference Santosa S, Jensen MD. Why are we shaped differently, and why does it matter? Am J Physiol. 2008;295:E531–5. Santosa S, Jensen MD. Why are we shaped differently, and why does it matter? Am J Physiol. 2008;295:E531–5.
24.
go back to reference Van Wayenburg C, Binsbergen J. Ondervoeding [Malnutrition]. Huisarts Wet. 2011;54:133–7.CrossRef Van Wayenburg C, Binsbergen J. Ondervoeding [Malnutrition]. Huisarts Wet. 2011;54:133–7.CrossRef
25.
go back to reference Pischon T, Boeing H, Hoffmann K, et al. General and abdominal adiposity and risk of death in Europe. New Engl J Med. 2008;359:2105–20.CrossRefPubMed Pischon T, Boeing H, Hoffmann K, et al. General and abdominal adiposity and risk of death in Europe. New Engl J Med. 2008;359:2105–20.CrossRefPubMed
26.
go back to reference Ostrowska B, Rozek-Mroz K, Giemza C. Body posture in elderly, physically active males. Aging Male. 2003;6:222–9.CrossRefPubMed Ostrowska B, Rozek-Mroz K, Giemza C. Body posture in elderly, physically active males. Aging Male. 2003;6:222–9.CrossRefPubMed
27.
go back to reference Van Aken MO, Feelders RA, De Jong FH, Pereira AM, Lamberts SWJ, De Herder WW. Syndroom van Cushing [Cushing’s syndrome]. I. Nieuwe ontwikkelingen in de diagnostiek [New developments in diagnosis]. Ned Tijdschr Geneeskd. 2006;150:2359–64.PubMed Van Aken MO, Feelders RA, De Jong FH, Pereira AM, Lamberts SWJ, De Herder WW. Syndroom van Cushing [Cushing’s syndrome]. I. Nieuwe ontwikkelingen in de diagnostiek [New developments in diagnosis]. Ned Tijdschr Geneeskd. 2006;150:2359–64.PubMed
28.
go back to reference Hamer JPM, Pieper PG, Van den Brink RBA. Anamnese en lichamelijk onderzoek van hart en arteriën [History-taking and Physical Examination of the Heart and Arteries]. Houten: Bohn Stafleu van Loghum; 2014. Hamer JPM, Pieper PG, Van den Brink RBA. Anamnese en lichamelijk onderzoek van hart en arteriën [History-taking and Physical Examination of the Heart and Arteries]. Houten: Bohn Stafleu van Loghum; 2014.
29.
go back to reference Klungel OH, De Boer A, Paes AH, et al. Estimating the prevalence of hypertension corrected for the effect of within-person variability in blood pressure. J Clin Epidemiol. 2000;53:1158–63.CrossRefPubMed Klungel OH, De Boer A, Paes AH, et al. Estimating the prevalence of hypertension corrected for the effect of within-person variability in blood pressure. J Clin Epidemiol. 2000;53:1158–63.CrossRefPubMed
30.
go back to reference Netea RT, Thien T. Blood pressure measurement: we should all do it better! Neth J Med. 2004;62:297–303.PubMed Netea RT, Thien T. Blood pressure measurement: we should all do it better! Neth J Med. 2004;62:297–303.PubMed
31.
go back to reference The Task Force for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH). ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018;2018(39):3021–104. The Task Force for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH). ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018;2018(39):3021–104.
32.
go back to reference Kleefstra N, Houweling ST, Meyboom-de Jong B, Bilo HJ. Weinig nut van bloeddrukmeting aan beide armen; longitudinale studie naar interarmbloeddrukverschillen en de reproduceerbaarheid daarvan bij patiënten met diabetes mellitus type 2 [Measuring blood pressure has little value: longitudinal study of interarm blood pressure differences and their reproducibility in patients with type 2 diabetes]. Ned Tijdschr Geneeskd. 2007;151:1509–14.PubMed Kleefstra N, Houweling ST, Meyboom-de Jong B, Bilo HJ. Weinig nut van bloeddrukmeting aan beide armen; longitudinale studie naar interarmbloeddrukverschillen en de reproduceerbaarheid daarvan bij patiënten met diabetes mellitus type 2 [Measuring blood pressure has little value: longitudinal study of interarm blood pressure differences and their reproducibility in patients with type 2 diabetes]. Ned Tijdschr Geneeskd. 2007;151:1509–14.PubMed
33.
go back to reference Clark CE, Taylor RS, Shore AC, Ukoumunne OC, Campbell JL. Association of a difference in systolic blood pressure between arms with vascular disease and mortality: a systematic review and meta-analysis. The Lancet. 2012;379:905–14.CrossRef Clark CE, Taylor RS, Shore AC, Ukoumunne OC, Campbell JL. Association of a difference in systolic blood pressure between arms with vascular disease and mortality: a systematic review and meta-analysis. The Lancet. 2012;379:905–14.CrossRef
34.
go back to reference Pickering TG, Miller NH, Ogedegbe G, et al. American Heart Association; American Society of Hypertension; Preventive Cardiovascular Nurses Association. Call to action on use and reimbursement for home blood pressure monitoring: executive summary: a joint scientific statement from the American Heart Association, American Society of Hypertension, and Preventive Cardiovascular Nurses Association. Hypertension. 2008;52:1–9. Pickering TG, Miller NH, Ogedegbe G, et al. American Heart Association; American Society of Hypertension; Preventive Cardiovascular Nurses Association. Call to action on use and reimbursement for home blood pressure monitoring: executive summary: a joint scientific statement from the American Heart Association, American Society of Hypertension, and Preventive Cardiovascular Nurses Association. Hypertension. 2008;52:1–9.
36.
go back to reference Edmonds ZV, Mower WR, Lovato LM, Lomeli R. The reliability of vital sign measurements. Ann Emerg Med. 2002;39:233–7.CrossRefPubMed Edmonds ZV, Mower WR, Lovato LM, Lomeli R. The reliability of vital sign measurements. Ann Emerg Med. 2002;39:233–7.CrossRefPubMed
37.
go back to reference Deakin CD, Low JL. Accuracy of the advanced trauma life support guidelines for predicting systolic blood pressure using carotid, femoral, and radial pulses: observational study. BMJ (Clinical research ed). 2000;321(7262):673–4.CrossRefPubMed Deakin CD, Low JL. Accuracy of the advanced trauma life support guidelines for predicting systolic blood pressure using carotid, femoral, and radial pulses: observational study. BMJ (Clinical research ed). 2000;321(7262):673–4.CrossRefPubMed
39.
go back to reference Beijaart R. Percutane zuurstofsaturatiemeting [Transcutaneous oxygen saturation measurement]. Huisarts Wet. 2019;9:50–5. Beijaart R. Percutane zuurstofsaturatiemeting [Transcutaneous oxygen saturation measurement]. Huisarts Wet. 2019;9:50–5.
41.
go back to reference Torp KD, Modi P, Simon LV. Pulse oximetry. 2020, Jul 10. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020. Torp KD, Modi P, Simon LV. Pulse oximetry. 2020, Jul 10. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020.
42.
go back to reference Kelly AM, McAlpine R, Kyle E. How accurate are pulse oximeters in patients with acute exacerbations of chronic obstructive airways disease? Respir Med. 2001;95(5):336–40.CrossRefPubMed Kelly AM, McAlpine R, Kyle E. How accurate are pulse oximeters in patients with acute exacerbations of chronic obstructive airways disease? Respir Med. 2001;95(5):336–40.CrossRefPubMed
43.
go back to reference De Vries H, Van Agtmael MA, Bastiaans JF. Koorts bij volwassenen [Fever in adults]. In: De Jongh TOH, De Vries H, Knottnerus BJ, et al. Diagnostiek van alledaagse klachten [Diagnosing everyday symptoms]. 5th edition. Houten: Bohn Stafleu van Loghum; 2021. De Vries H, Van Agtmael MA, Bastiaans JF. Koorts bij volwassenen [Fever in adults]. In: De Jongh TOH, De Vries H, Knottnerus BJ, et al. Diagnostiek van alledaagse klachten [Diagnosing everyday symptoms]. 5th edition. Houten: Bohn Stafleu van Loghum; 2021.
44.
go back to reference Singh M, Pai M, Kalantri SP. Accuracy of perception and touch for detecting fever in adults: a hospital-based study from a rural, tertiary hospital in Central India. Trop Med Int Health. 2003;8:408–14.CrossRefPubMed Singh M, Pai M, Kalantri SP. Accuracy of perception and touch for detecting fever in adults: a hospital-based study from a rural, tertiary hospital in Central India. Trop Med Int Health. 2003;8:408–14.CrossRefPubMed
45.
go back to reference Teng CL, Ng CJ, Nik-Sherina H, et al. The accuracy of mother’s touch to detect fever in children: a systematic review. J Trop Pediatr. 2008;54:70–3.CrossRefPubMed Teng CL, Ng CJ, Nik-Sherina H, et al. The accuracy of mother’s touch to detect fever in children: a systematic review. J Trop Pediatr. 2008;54:70–3.CrossRefPubMed
46.
go back to reference Dodd SR, Lancaster GA, Craig JV, et al. In a systematic review, infrared ear thermometry for fever diagnosis in children finds poor sensitivity. J Clin Epidemiol. 2006;59:354–7.CrossRefPubMed Dodd SR, Lancaster GA, Craig JV, et al. In a systematic review, infrared ear thermometry for fever diagnosis in children finds poor sensitivity. J Clin Epidemiol. 2006;59:354–7.CrossRefPubMed
47.
go back to reference Van Staaij BK, Rovers MM, Schilder AG, Hoes AW. Accuracy and feasibility of daily infrared tympanic membrane temperature measurements in the identification of fever in children. Int J Pediatr Otorhinolaryngol. 2003;67:1091–7.CrossRefPubMed Van Staaij BK, Rovers MM, Schilder AG, Hoes AW. Accuracy and feasibility of daily infrared tympanic membrane temperature measurements in the identification of fever in children. Int J Pediatr Otorhinolaryngol. 2003;67:1091–7.CrossRefPubMed
–.
go back to reference De Jongh TOH, De Vries H, Knottnerus, et al. Diagnostiek van alledaagse klachten [Diagnosing everyday symptoms]. 5th edition. Houten: Bohn Stafleu van Loghum; 2021. De Jongh TOH, De Vries H, Knottnerus, et al. Diagnostiek van alledaagse klachten [Diagnosing everyday symptoms]. 5th edition. Houten: Bohn Stafleu van Loghum; 2021.
–.
go back to reference Van der Meer JWM, Postma CT, Blockmans DE, De Rooij SEJA. Anamnese en lichamelijk onderzoek [History-taking and physical examination]. 9th ed. Houten: Bohn Stafleu van Loghum; 2019.CrossRef Van der Meer JWM, Postma CT, Blockmans DE, De Rooij SEJA. Anamnese en lichamelijk onderzoek [History-taking and physical examination]. 9th ed. Houten: Bohn Stafleu van Loghum; 2019.CrossRef
Metagegevens
Titel
Initial general examination
Auteurs
Dr J. A. H. Eekhof
R. J. M. Claessen
Copyright
2023
Uitgeverij
Bohn Stafleu van Loghum
DOI
https://doi.org/10.1007/978-90-368-2931-1_7