Physical examination

Last updated: July 21, 2022

Summarytoggle arrow icon

The physical examination is typically the first diagnostic measure performed after taking the patient's history. It allows for an initial assessment of symptoms and is crucial for determining the differential diagnoses and further steps. Ideally, a complete physical examination should be performed for every patient. In practice, the physical examination is usually tailored to specific patient concerns. Sensitivity and specificity of physical examination findings vary widely. In some cases, a diagnosis is possible on the basis of the physical examination alone. This article covers the basics of the physical examination and links out to other articles for more specific examinations, including:

Approachtoggle arrow icon


  • Determine a working diagnosis or differentials, and further diagnostic and management steps.
  • Adjust approach from full to focused physical examination as needed based on medical history, patient condition, and findings.

Preparing for the examination [1][2][3]

  • Provide optimal conditions for the examination:
    • Find a comfortable and quiet place.
    • Ensure privacy: Ask other patients and possibly even family members (depending on patient preference and extent of exam) to leave the room.
  • Disinfect hands prior to touching the patient.
  • Introduce yourself and your title and explain the procedure.
  • Always address patient by his/her name (ask first if it is unknown).
  • During the examination, inform the patient about further steps.
  • Examination tools include:
    • Pens
    • Stethoscope
    • Penlight
    • Tongue depressor
    • Reflex hammer
    • If necessary, otoscope and ophthalmoscope

Basic techniques

  • Inspection
  • Palpation
  • Percussion
  • Auscultation
  • Functional examination


Approaches to the physical examination vary greatly and depend on a number of factors, including personal, specialty, and institutional preferences, as well as the reason for the visit or patient's chief concerns, condition, medical history, frequency of past visits, and time available. An example of a full exam sequence could consist of:

The physical examination should be tailored to the purpose of visit, patient history, and allotted time in a focused assessment by body systems.

Systemstoggle arrow icon

The following sections provide an overview of all the parts of a physical examination that should be considered, including:

In some cases, more details can be found in the links provided.

General appearancetoggle arrow icon

  • Assess physical, behavioral, and emotional state, including:
    • Physical characteristics and appearance: body type, distinguishing characteristics or abnormal formations/symmetry, development, race, personal hygiene
    • Behavior: alert, active, lethargic, calm, agitated, combative, compliant
    • Wellness: well, unwell
    • Color: rosy, pale, flushed, jaundice
    • Posture and gait

Vital signs and measurementstoggle arrow icon

Vital signs

Normal vital signs at rest [4]
Age group

Heart rate

(beats per minute)

Respiratory rate

(breaths per minute)

Blood pressure


Oxygen saturation

Systolic pressure Diastolic pressure
Neonate 100–205 40–60 67–84 35–53 95–100% 97.9°F–100.4°F (36.6–38°C)
Infant (1–12 months) 100–180 30–53 72–104 37–56
Toddler (1–2 years) 98–140 22–37 86–106 42–63
Preschooler (3–5 years) 80–120 20–28 89–112 46–72
School-aged child (6–9 years) 75–118 18–25 97–115 57–76
Preadolescent (10–11 years) 102–120 61–80
Adolescent (12–17 years) 60–100 12–20 110–131 64–83
Adults 90–139 60–89

Body measurements

  • Weight, height, and, possibly, BMI
  • Children: head circumference; see also “Normal growth in infants and young children”
Weight status Body Mass Index (BMI)
Underweight < 18.5 kg/m2
Normal or healthy weight 18.5–24.9 kg/m2
Overweight ≥ 25–29.9 kg/m2
Class I obesity 30–34.9 kg/m2
Class II obesity 35–39.9 kg/m2
Class III obesity ≥ 40 kg/m2

Skin and nailstoggle arrow icon

Head, eyes, ears, nose, throat (HEENT)toggle arrow icon

Lymphaticstoggle arrow icon

  • Examine different locations (cervical, axillary, and groin areas)
  • Inspection: look for visible enlargement
  • Palpation of lymph nodes for:
    • Swelling
    • Tenderness
    • Mobility
    • Irregularity
  • See lymph node examination.

Hearttoggle arrow icon

Lungs and chest walltoggle arrow icon

Abdomentoggle arrow icon

Pelvictoggle arrow icon

As a student, you should only perform breast, pelvic, and prostate exams under the supervision of a senior physician!

Neurologicaltoggle arrow icon

Musculoskeletaltoggle arrow icon

Breasttoggle arrow icon

Referencestoggle arrow icon

  1. Sapra A, Malik A, Bhandari P. Vital Sign Assessment. StatPearls. 2021.
  2. Bickley L. Bates' Guide to Physical Examination and History-Taking. Lippincott Williams & Wilkins ; 2012
  3. Evaluation and Management Services. Updated: August 1, 2017. Accessed: December 8, 2019.
  4. Swartz MH. Textbook of Physical Diagnosis E-Book. Elsevier Health Sciences ; 2014

Icon of a lock3 free articles remaining

You have 3 free member-only articles left this month. Sign up and get unlimited access.
 Evidence-based content, created and peer-reviewed by physicians. Read the disclaimer