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this is strong medicines in turn crash-course and today Im giving you ten tips on the physical exam start your exam with an examination of the patients hands first there are many illnesses which are associated with hand findings but more importantly starting with the hand establishes physical connection between the patient and doctor without requiring the patient to reveal a part of their body that isnt already seen by every person they meet for patients who are not entirely comfortable being touched by a stranger this can help to ease them into it tailor your physical exams to the patients symptoms and past medical history every patient should neither get the same exam on admission nor the same exam on subsequent hospital days so if your patient was admitted for heart failure or an acute MI look at the jbp each day and if they were admitted for liver failure check every day for asterixis the patients heart rate should never be used as a primary indicator of volume status there ar