d. Motor. Muscle mass, strength; deeptendon reflexes. Pathological or primitive reflexes.

e. Sensory. Touch, pain, vibration. Heat and cold as indicated.

III. Routine laboratory studies—see Appendix A for normal ranges.

A. Hematology:

1. Complete blood count—detects presence of anemia, infection, allergy, and leukemia.

2. Prothrombin time—increase may indicate need for vitamin K therapy.

3. Serology (VDRL)—determines presence of syphilis; false-positive result may indicate collagen dysfunction.

B. Urinalysis:

1. Specific gravity—measures ability of kidney to concentrate urine. Fixed specific gravity indicates renal tubular dysfunction.

2. Albumin and pus—indicate renal infection.

3. Sugar and acetone—presence indicates metabolic disorder.

C. Chest x-ray—detects tuberculosis or other pulmonary dysfunctions, as well as changes in size or configuration of heart.

D. Electrocardiogram (ECG)—detects rhythm and conduction disturbances, presence of myocardial ischemia or necrosis, and ventricular hypertrophy.

E. Blood chemistries—detect deviation in electrolyte balance, presence of tissue damage, and adequacy of glomerular filtration.

IV. Preventive Care

A. Checkup visits recommended every 1 to 3 years until age 65 and then yearly thereafter. See Table 7-1 for suggested timelines.

B. Individuals with special risk factors may need more frequent and additional types of preventive care.