even more. Outdoor air typically contains about
0.4 pCi/L of radon. There is no determined safe
level of radon. The public health goal is to lower
all indoor radon levels to 2 pCi/L or less, with the
eventual goal of lowering indoor radon levels to
those of outdoor radon levels.
Home test kits, available through state radon
offices and radon mitigation contractors, can
measure radon levels. Among the most common
methods for lowering indoor radon levels are
beneath-ground ventilation systems that collect
radon from under a house and release it via venti-
lation tubing into the outdoor air. These systems
often can accommodate any kind of foundation
(basement, slab, or slab with crawl space). Health
experts recommend initial radon testing with reg-
ular follow-up testing regardless of the level.
See also ENVIRONMENTAL HAZARD EXPOSURE; HEALTH
RISK FACTORS.
routine medical examination The examination
a doctor conducts to assess an individual’s health
status typically includes certain procedures and
tests that vary according to age and gender. A rou-
tine medical examination for adults consists of a
physical examination, PERSONAL HEALTH HISTORY,
general BLOODtests (complete blood count [CBC],
blood GLUCOSE, blood cholesterol), and URINALYSIS.
Depending on the person’s age, the doctor may
order other diagnostic procedures such as blood
tests for thyroid hormones, chest X-RAY, tuberculin
skin test, COLONOSCOPY, MAMMOGRAPHY, and BONE
DENSITYtesting.
Some of the devices the doctor may use to
assess physical health include
- ophthalmoscope to visualize the structures of
the EYE - otoscope to look at the structures of the outer
EARand the eardrum (TYMPANIC MEMBRANE) - STETHOSCOPE to listen to the HEART and LUNGS
(AUSCULTATION) - sphygmomanometer to measure the BLOOD
PRESSURE - thermometer to take the temperature
- REFLEXhammer to test reflexes and other neu-
rologic responses- tuning fork to screen hearing and to assess sen-
sory perception (neurologic function) in other
parts of the body
- tuning fork to screen hearing and to assess sen-
Each doctor has his or her pattern for conduct-
ing a physical examination. A common pattern is
to begin with vital signs and then go from head to
foot.
Vital signs The typical vital signs are PULSE, RES-
PIRATION RATE, temperature, blood pressure, height,
and weight. Temperature identifies whether there
is a FEVER. Height and weight help the doctor to
assess BODY MASS INDEX(BMI) and the likelihood of
certain health conditions that correlate to body
weight. Many doctors will take blood pressure
readings at the start and end of the examination,
because a person’s anxiety about the examination
may cause blood pressure to be artificially ele-
vated. The doctor will typically take the pulse at
each wrist and ankle, pressing against the pulse
point with two fingers, and may check the pulses
in the neck and groin as well. Respiration rate
includes a count of how many breaths the person
takes in a minute as well as an assessment of how
deep or shallow the breaths are.
Head, face, and neck The doctor looks in the
ears and the eyes, and may hold a tuning fork
near each ear as a basic hearing screen. Many doc-
tors use a SNELLEN CHARTto assess basic visual acu-
ity. When the doctor says, “Say ah,” the sound
causes the soft palate and related tissues at the
back of the MOUTHto elevate. This allows the doc-
tor to visualize the top of the THROAT. Sometimes
the doctor presses a tongue depressor against the
back of the mouth for a better view, which can
unintentionally activate the GAG REFLEX. The doc-
tor also looks at the structures of the mouth
including the tongue. Palpating the neck helps
identify thyroid nodules and enlargement; the
doctor usually will feel the neck twice, first with
the person sitting quietly and then when having
the person swallow.
ChestThe doctor listens to the heart and lungs
with a stethoscope, and may tap on the chest and
the back. The stethoscope allows the doctor to
hear the heart valves open and close and the
rhythm of the heart as it beats. It also lets the doc-
tor hear the sounds of air entering and leaving the44 Preventive Medicine