From prodding your neck to checking your reflexes, here’s what perplexing medical exams really reveal about your health.
When you walk into your doctor’s office, a few things are a given. You’ll step on a scale to record your weight, get a cuff wrapped around your arm to check your blood pressure, and hold out your wrist so the nurse can take your pulse.
Then, you expect the doctor will enter the room, bring out the stethoscope, and place it over your chest. No big surprise there: Your doc is listening to your heart and looking for issues with its function, like possible murmurs or an irregular rhythm.
But what about the exams that may come after that? The reason for each in-person test may not be as clear as the number on the scale.
“The types of in-office exams you’ll be given vary depending on your reason for seeing your doctor in the first place,” explains Aaron Clark, D.O., a family medicine physician at Ohio State University Wexner Medical Center.
That’s why the history part of the visit—when the doctor or nurse asks you questions about what brings you in, or any signs or symptoms you’ve been experiencing and for how long—is so important.
“Those questions help us develop what we call a differential diagnosis, or a list of possible things that might be causing you to feel this way,” Dr. Clark says. “We incorporate that into the physical exam and focus on the part we think is most likely where the problem may be.”
For instance, if you come in with cold complaints, your doctor will spend a good portion of the visit examining your head and neck area, but that’s not all they’ll do.
Every appointment includes some examinations that may seem weird to you, but each one tells your doctor vital information about your health. Here are 10 such examples—and the real reason why your doctor does each one.
Weird Exam #1: Your Doctor Puts a Stethoscope on Your Back
The stethoscope on your chest is obviously listening to your heart. But what about when your doctor moves it to the back of your body?
This helps doctors hear your lungs—especially the two lower lobes, which you can’t hear at all from the front of your body, explains Robin Maier, M.D., an assistant professor of family medicine at the University of Pittsburgh School of Medicine.
Your doctor will also instruct you to take deep breaths while they listen. Deep breaths use the entire lung and thus provide more information if something’s going on deep inside. They’re looking for abnormal sounds, which can point to a potential health problem.
“Coarse crackles are more consistent with a pneumonia or infectious process, while fine crackles are more consistent with the clear fluid that collects in your lungs when you have heart failure,” Dr. Maier explains. The difference may not be noticeable to you, but your doctor is trained to detect it.
Weird Exam #2: Your Doctor Puts the Stethoscope on Your Belly
If you come to your appointment with any kind of abdominal complaint—pain, bloating, or constipation—your doctor will probably put the stethoscope on your belly to take a listen. The goal: make sure everything sounds normal with your bowels.
“Sometimes, if there are no bowel sounds heard whatsoever, that can mean there’s an obstruction somewhere or that the person’s intestines aren’t working properly,” Dr. Clark says. “You can also hear problems with blood vessels sometimes.”
Your doctor will also gently press on different spots on your belly. The main reason for this is to check for areas of pain or tenderness, or even enlargement of organs like the spleen or liver.
Depending on which areas are tender or enlarged, this can indicate health problems like an infected gallbladder or appendix, or diverticulitis, an inflammation of small pouches throughout your large intestine.
One caveat: The pressing part of the exam becomes less effective if you’re overweight, since your doctor may not be able to feel your organs as well.
Weird Exam #3: Your Doctor Peers into Your Ear with a Lighted, Pointy Device
If you come to your doctor with ear or hearing complaints—or even something like dizziness—they will likely pull out the otoscope. This small, lighted device allows them to look inside your ear.
But first, your doctor will start by looking around the outside of your ear. Some signs of infection, such as swelling or discharge, can be seen externally with conditions like swimmer’s ear, Dr. Clark says. Then, your doctor will use the otoscope, which magnifies the tiny structures of your ear, to check out what’s inside.
This can show wax buildup—which can contribute to hearing difficulties—as well as damage to the eardrum, foreign bodies, or even infection.
Weird Exam #4: Your Doctor Prods Your Neck
Lots of complaints can prompt your doctor to check out your neck region, from cold or flu issues to general feelings of malaise or fatigue.
When your doctor is palpating the sides of your neck, they’re checking for swollen lymph nodes—also known as swollen glands, Dr. Clark says. They may also cup your chin in both hands to check out the lymph nodes in front of and behind your ears.
Lymph nodes are part of your immune system, and they tend to swell up if your body is fighting an infection. In the case of something infectious, your doctor will usually notice swelling on both sides.
A singular swollen lymph node can indicate something else, like cat scratch disease (a bacterial infection spread by cats), or in serious cases, even a cancer like lymphoma, Dr. Clark says.
Weird Exam #5: Your Doctor Asks You to Open Up and Say “Ahh”
Cold or flu symptoms, like a sore throat or problems swallowing, can prompt your doctor to check out your mouth and throat area.
Your doctor is most interested in the appearance of your throat and tonsils—say, if the area is showing swelling or redness, which can indicate an infection. They may also find spots or streaks of white, which can indicate tonsil stones or pus from an infection, Dr. Maier says.
Unlike what you may have heard, pus in your throat doesn’t automatically point to a bacterial infection—which can be treated with antibiotics—like strep throat. It still could be viral—which can’t be treated with antibiotics. That’s why even if your doctor notices white spots in your throat, they’ll likely still order a strep test before beginning antibiotics.
But why do you have to say “ahh?” For a very simple reason: It contracts the muscles in the back of the throat, giving your doc a better view.
Weird Exam #6: Your Doctor Asks You to Remove Your Shoes
If you have diabetes, this is probably going to be part of every doctor’s visit. That’s because diabetes can cause diabetic neuropathy, or nerve damage, which can make you lose sensation in your feet, Dr. Clark says.
As a result, you may not notice cuts or blisters. Plus, diabetes can lead to decreased blood flow, so sores can take longer to heal. Your doctor will want to check out your feet to make sure there are no potential problems that can escalate.
Even if you don’t have diabetes, your doctor may still want to examine your feet if you complain about swelling.
“If both lower extremities are equally swollen, that usually indicates a larger issue, like congestive heart failure, or a kidney or liver problem,” Dr. Clark says. “If just one leg is swollen, it might be a blood clot.”
Your doctor may also ask you to take off your shoes if they’re concerned about your circulation.
“They may check your pulse in both feet to make sure you have good blood flow going in and out of your extremities,” Dr. Clark says.
Weird Exam #7: Your Doctor Looks Deep into Your Eyes
Your eyes really are the window to your soul, and they can tell your doctor a lot about your well-being. For example, redness in the white part of your eye can indicate a viral or bacterial infection. In rare cases, a red, painful eye can also point to glaucoma, Dr. Clark says.
Yellowing of your sclera—the white, outer layer of your eyeball—can indicate body-wide problems outside of your eyes. It may be a sign of jaundice, which occurs when there’s too much of a pigment called bilirubin in your blood, and can indicate liver disease.
Weird Exam #8: You Track Your Doctor’s Finger
This is a test to make sure the muscles that control your eyes are working properly, Dr. Clark says.
“Sometimes, you can have a stroke where the nerves that affect the muscles of the eye are damaged, and then when you’re doing that exam, you will notice the eyes aren’t moving in the way you would expect them to,” he says. “That might give you a clue there may have been a neurological injury to the brain.”
These nerves in your brain are called your cranial nerves, and the follow-my-finger test isn’t the only seemingly strange exam that checks them out. There are actually 12 cranial nerves with different functions, and each has its own test. Others you may be asked to do include things like stick your tongue out to see if it comes out straight, puff your cheeks up like a pufferfish, or wrinkle your forehead.
Weird Exam #9: Your Doctor Taps Your Knee
When your doctor taps your knee with that little hammer-like device, they’re checking your deep tendon reflexes to see if your nervous system is functioning properly, Dr. Maier says. You doctor may also test your reflexes in other places, like your elbow, ankle, or ribs.
“There is a whole range of normal,” she explains. “There are people who have almost no reflexes and people who have very brisk reflexes—and they are all normal.”
What would be a red flag, though, is if they’re not symmetrical. For example, if your reflex when tapped on your left knee is significantly delayed compared to your right, that can indicate a neurological problem. Problems with your reflexes could mean a stroke, injury to the nerves that control sensation and movement, or even an issue with your spinal cord.
Weird Exam #10: Your Doctor Asks You to Turn Your Head and Cough
It’s a mainstay for men’s exams, especially if they mention abdominal pain or swelling, scrotal pain, or even difficulty passing bowel movements, Dr. Clark says. With this test, your doctor will check for a bulge in your scrotum while you turn your head and cough.
Your doctor is looking for an inguinal hernia, which occurs when part of your intestine comes through a weak spot in your lower abdominal muscle. Hernias can become more common as men age, since muscle loss and weight gain can increase your risk.
Coughing can make the hernia more prominent, so your doctor would be more likely to feel it when you strain. As for the “turn your head” part?
“So they don’t cough on me,” Dr. Clark says. “It’s just a courtesy.”
Given a different exam not on this list? Don’t be afraid to ask your doctor what it’s for and what your results mean. Feel free to write down any information, or ask them to write it down for you. Check out more ways to make the most of your doctor visit.
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