Physical examination and clinical signs

Otoscopes

Otoscopes (auriscopes) are hand-held instruments with a light, ear speculum, and magnifying lens for examining the ear canal and tympanic membrane; first integrated by Bruton in 1862, class I FDA-exempt, with pneumatic and digital telemedicine variants.

Otoscopy

Otoscopy is a clinical examination using an otoscope, combining light, speculum, and magnifying lens, to inspect the ear canal and tympanic membrane and diagnose ear conditions.

Pallor conjunctiva

Pallor conjunctiva (conjunctival pallor), ICD-11 MC16, is paleness of the inner eyelid lining used as a bedside sign of anemia; likelihood ratio about 4.5 when present, high specificity but low screening sensitivity.

Palpation

Palpation is the physical examination technique of feeling the body with fingers or hands, one of four exam methods (inspection, palpation, percussion, auscultation), used for pulses, swelling, temperature, tenderness, and guiding diagnosis and treatment.

Pelvic examination

Pelvic examination, also called pelvic exam or gynecological examination, is a physical exam of the vulva, vagina, cervix, and uterus using inspection, speculum, and bimanual palpation; recommended for symptoms, disputed as routine screening.

Percussion (medicine)

Percussion (medicine): bedside tapping of the chest or abdomen to judge underlying air, fluid, or solid. Discovered by Auenbrugger 1761, popularized by Corvisart 1808; notes include tympany, resonance, dullness.

Perfusion Index

Perfusion index (PI, PPI): pulse-oximetry-derived ratio of pulsatile to non-pulsatile blood flow at the sensor site; values under 0.3% signal very low perfusion, 2–5% good perfusion; predicts fluid responsiveness and anesthetic hypotension.

Photoplethysmogram

Photoplethysmogram (PPG): noninvasive optical signal of arterial blood volume changes, basis of pulse oximetry and wearable heart-rate sensors; transmission or reflectance mode, green/red/IR light, used for heart rate, SpO2, rhythm screening.

Physical examination

Physical examination: bedside assessment using inspection, palpation, percussion, and auscultation. Covers exam structure, sign accuracy (median LR+ 3.4), the annual check-up debate, Medicare wellness visits, POCUS, and OSCE-based certification.

Physical performance testing

Physical performance testing is a set of standardized clinical assessments in which patients perform quantified physical tasks, such as the SPPB and Timed Up and Go, to measure strength, balance, and mobility.

Pivot-shift test

The pivot-shift test is a clinical knee examination maneuver assessing rotational instability of the anterior cruciate ligament, most specific but least sensitive for confirming ACL rupture.

Planimetry (medicine)

Planimetry is a clinical method that measures the surface area of wounds, ulcers, burns, and skin lesions from traced or photographed outlines to track healing.

Pneumatic otoscopy

Pneumatic otoscopy is a diagnostic examination in which a pneumatic otoscope puffs air against the eardrum to judge its movement, directly testing for middle ear effusion.

Pronator drift

Pronator drift is a bedside neurological examination maneuver in which pronation and downward drift of one outstretched arm indicate a contralateral upper motor neuron lesion.

Pulmonary auscultation

Pulmonary auscultation is a physical examination method in which a stethoscope placed on the chest wall detects abnormal breath sounds, supporting diagnosis of pneumonia, heart failure, and pneumothorax.

Pulse oximetry screening

Pulse oximetry screening is a noninvasive pre-discharge newborn test measuring oxygen saturation to detect critical congenital heart disease, adopted by all US states by 2018.

Pupillometry

Pupillometry, also called quantitative pupillometry, is a diagnostic method that measures pupil size and light reflex dynamics with handheld infrared devices, used to assess neurological status and intracranial pressure in critically ill patients.

QT interval

QT interval: ECG span from QRS onset to T-wave end, measuring ventricular depolarization and repolarization. Corrected to QTc via Bazett or Fridericia formulas; QTc over 500 ms signals torsades de pointes risk.

Quantitative sensory testing

Quantitative sensory testing (QST) is a standardized, non-invasive psychophysical method measuring detection and pain thresholds for thermal, mechanical, and vibratory stimuli to assess sensory nerve function.

Rebound tonometry

Rebound tonometry is a handheld method of measuring intraocular pressure by bouncing a lightweight disposable probe off the cornea, usable in children and by glaucoma patients at home.

Relative afferent pupillary defects

Relative afferent pupillary defects (RAPD), also called Marcus Gunn pupil, is an asymmetry in the afferent sensory limb of the pupillary light reflex caused by disease.

René Laennec

René Théophile Hyacinthe Laënnec (1781–1826), French physician at Paris's Hôpital Necker, invented the stethoscope in 1816 and founded mediate auscultation through his 1819 treatise De l'Auscultation Médiate.

Retinoscopy

Retinoscopy, also known as skiascopy, is an objective refraction technique that measures refractive error and derives an eyeglass prescription by observing the retinal light reflex.

Review of systems

Review of systems (ROS): structured symptom inventory by organ system, part of the medical history, distinct from the HPI. 14 systems; problem pertinent, extended (2–9), or complete (10+); no longer counted for CMS billing since 2021.

Rhinomanometry

Rhinomanometry is a diagnostic technique measuring nasal airflow and pressure simultaneously to quantify nasal airway resistance in Pa/cm³/s, most often by active anterior rhinomanometry.