Physical Exams

Physical Exams

An “Executive Physical” need not be limited to business executives.  Anyone wanting or needing a thorough medical evaluation for any reason is welcome to schedule a physical exam.

Intended as a head-to-toe assessment, we start with blood work and assess the head, eye, ears, nose, and throat, then work our way down to feet and toes, addressing heart, lungs, GI and urinary systems and more. As needed, we can add specialty testing to clarify concerns.

Sports physicals for High School athletes require Arizona Interscholastic Association (AIA) forms to be completed.  Several forms are involved:

Form 157a – The Annual Preparticipation Physical Evaluation: To be completed and signed by the student athlete, parent/guardian, and the physician;

Form 157b – Annual Preparticipation Physical Examination: To be completed by the examining physician;

Form 157c – Mild Traumatic Brain Injury/Concussion Statement and Acknowledgment: To be signed by the student-athlete and parent/guardian.

These physicals are relatively brief and result in a minimum of discomfort.  An EKG is generally not required but may be requested by a parent/guardian.

Sports Physicals for Community College Athletes are more comprehensive than a High School physical.  Some colleges or college districts may have special documents which need to be completed, and many colleges or districts require an EKG as part of the physical.

Camp Physicals generally match the physical exam provided for high school student-athletes, but without the AIA paperwork (unless specifically requested).

An EKG, also called an ECG, is an electrocardiogram.  This involves placing electrodes on the chest, wrists, and ankles to measure electrical activity in the heart.

The electrical conduction system of the heart is very straight-forward, that is, consistent from person to person.  The signal starts in the Sinoatrial Node (SA node).  This node beats – unless interrupted by some pathology – from Day 22 after fertilization to the end of life.  The signal is transmitted through the heart muscle to the Atrioventricular Node.  The signal then moves across the Bundle of His, to the Bundle Branches (on either side of the ventricular septum), eventually spreading out in the Purkinje Fibers.  This activity provides a distinctive, measurable pattern captured in the EKG.

Thus, by recording the pattern it can be determined if the electrical signal is normal, or if some event is interfering with the electrical control of the heart.  A typical recording will demonstrate clearly the start of the SA signal, and the passage of the electrical signal to the AV node, Bundle of His and Bundle Branches.  On a recording, we note it as the “P” wave, “QRS” deflection, and the “T” wave. 

Frankly, most of the time when we do an EKG for a patient, it merely confirms the heart is working perfectly normally.  However, changes in these patterns indicate potential issues in the heart.  For example, if the “P” wave is absent, it tells us the SA Node is not functioning.  If the “T” wave is inverted, it suggests an imbalance of certain electrolytes.  Both are fixable conditions by a cardiologist (heart specialist). If the “QRS” is wider than normal, it suggests problems in moving the electrical signal from the AV Node to the Bundle Branches.  This requires the immediate attention of a cardiologist.

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