Bates' Guide To Physical Examination and History Taking

Höfundur: Rainier P. Soriano (Útgáfa: 14)
Bates' Guide To Physical Examination and History Taking

Kaup valmöguleikar

Bates’ Guide to Physical Examination and History Taking 14th Edition er traust námsefni til að ná tökum á mati á sjúklingum og er sniðið að breytilegum þörfum nemenda og heilbrigðisstarfsfólks. Hvort sem þú ert að hefja feril í heilbrigðisþjónustu eða vilt efla klíníska færni þína tekur þessi uppfærða útgáfa mið af þróun og þörfum heilbrigðisþjónustu nútímans.

Nánar um bókina

Útgefandi
Wolters Kluwer Health
ISBN
9781975282288
Print ISBN
9781975218393
Format
ePub
Útgáfa
14
Höfundar
Rainier P. Soriano
Tungumál
English
Útgefið
2025-06-12
Prent takmörkun á líftíma
10
Prent takmörkun
2
Afritunar takmörkun
2

Kaflar

  • Cover
  • Title Page
  • Copyright
  • Dedication
  • Faculty Contributors
  • Preface
  • New Content and Features
  • Acknowledgments
  • Contents
  • List of Tables
  • UNIT 1: Foundations of Health Assessment
  • CHAPTER 1: Foundational Skills Essential to the Clinical Encounter
  • THE CLINICAL ENCOUNTER
  • APPROACH TO THE CLINICAL ENCOUNTER
  • STRUCTURE AND SEQUENCE OF THE CLINICAL ENCOUNTER
  • Stage 1: Initiating the Encounter
  • Stage 2: Gathering Information
  • Stage 3: Performing the Physical Examination
  • Stage 4: Explaining and Planning
  • Stage 5: Closing the Encounter
  • DISPARITIES IN HEALTH CARE
  • Social Determinants of Health
  • Racism and Bias
  • Cultural Humility
  • OTHER MAJOR CONSIDERATIONS
  • Spirituality
  • Medical Ethics
  • Decisional Capacity
  • Approach to a Clinical Ethical Dilemma
  • REFERENCES
  • CHAPTER 2: Interviewing, Communication, and Interpersonal Skills
  • ORGANIZING PATIENT–CLINICIAN COMMUNICATION STRATEGIES
  • ESTABLISHING THE FOUNDATION OF COMMUNICATION
  • Active (Attentive) Listening
  • BUILDING THE INTERACTION
  • Guided Questioning
  • STRENGTHENING THE RELATIONSHIP
  • Empathic Responses
  • Summarization
  • Transitions
  • Validation
  • Partnering
  • Empowering the Patient
  • Reassurance
  • ADDRESSING SENSITIVE TOPICS
  • PRACTICING LEGAL AND ETHICAL COMMUNICATION
  • Informed Consent
  • Collaborating with a Medical Interpreter
  • USING ADVANCED COMMUNICATION STRATEGIES
  • Appropriate Verbal Communication
  • Appropriate Nonverbal Communication
  • NAVIGATING COMPLEX DISCUSSIONS
  • Disclosing Serious News
  • Advance Care Planning
  • ENCOURAGING PATIENT SELF-EFFICACY
  • Motivational Interviewing (MI)
  • ENHANCING INTERPROFESSIONAL COMMUNICATION
  • MANAGING CHALLENGING PATIENT SITUATIONS AND BEHAVIORS
  • BEING PATIENT-CENTERED IN COMPUTERIZED CLINICAL SETTINGS
  • LEARNING COMMUNICATION SKILLS FROM STANDARDIZED PATIENTS
  • REFERENCES
  • CHAPTER 3: Health History
  • HEALTH HISTORY
  • Different Kinds of Health Histories
  • Determining the Scope of Your Patient Assessment: Comprehensive or Focused?
  • Subjective versus Objective Data
  • COMPONENTS OF THE ADULT HEALTH HISTORY
  • Initial Patient Information
  • Gather Information about the Patient’s Chief Concern or Presenting Concern
  • Gather Information about the Patient’s History of Present Illness
  • Gather Information about the Patient’s Past Medical History
  • Gather Information about the Patient’s Family History
  • Gather Information about the Patient’s Personal and Social History
  • Review of Systems
  • RECORDING YOUR FINDINGS
  • MODIFICATION OF THE CLINICAL INTERVIEW FOR VARIOUS CLINICAL SETTINGS
  • REFERENCES
  • CHAPTER 4: Physical Examination
  • ROLE OF THE PHYSICAL EXAMINATION IN THE ERA OF TECHNOLOGY
  • CONDUCTING CARDINAL TECHNIQUES OF EXAMINATION
  • Auscultating Through Clothing in Clinical Practice
  • BEGINNING THE PHYSICAL EXAMINATION
  • Reflecting on Your Approach
  • Optimizing the Examination Environment
  • Preparing Your Equipment
  • Enhancing Patient Comfort
  • Observing Standard and Universal Precautions
  • Optimizing the Sequence, Scope, and Positioning of Examination
  • Sequence of Examination
  • Positioning of Examination
  • Scope of Examination
  • PERFORMING A HEAD-TO-TOE PHYSICAL EXAMINATION
  • ADAPTING THE PHYSICAL EXAMINATION: SPECIFIC PATIENT CONDITIONS
  • RECORDING YOUR FINDINGS
  • REFERENCES
  • CHAPTER 5: Clinical Reasoning
  • DEVELOPING A DIFFERENTIAL DIAGNOSIS: MASTERING CLINICAL REASONING
  • CLINICAL REASONING PROCESS
  • BASIC STRUCTURE OF THE CLINICAL REASONING PROCESS
  • Step 1: Gathering Initial Patient Information
  • Step 2: Organizing and Interpreting Clinical Information
  • Step 3: Synthesizing Clinical Information and Developing the Problem Representation
  • Step 4: Generating Hypotheses by Searching for the Probable Cause of the Findings
  • Step 5: Testing Hypotheses and Establishing a Working Diagnosis
  • Step 6: Planning the Diagnostic and Treatment Strategy
  • CLINICAL DIAGNOSTIC ERRORS
  • CLINICAL REASONING: DOCUMENTATION
  • REFERENCES
  • CHAPTER 6: Clinical Documentation and Oral Presentation
  • NAVIGATING COMMUNICATION IN HEALTH CARE
  • Written Documentation in Electronic Health Records
  • Oral Presentations in Health Care
  • DOCUMENTING HISTORY AND PHYSICAL EXAMINATION NOTES
  • Initial Information
  • Source and Reliability
  • Chief Concern
  • History of Present Illness
  • Prior Health History
  • Family History
  • Social History
  • Review of Systems
  • Physical Examination
  • Assessment and Plan
  • CONDUCTING ORAL PRESENTATIONS FOR NEW PATIENTS
  • DOCUMENTING PROGRESS NOTES
  • ADDRESSING SPECIAL CONSIDERATIONS IN CLINICAL DOCUMENTATION
  • REFERENCES
  • CHAPTER 7: Health Maintenance and Screening
  • CONCEPT OF PREVENTIVE CARE
  • GUIDELINE RECOMMENDATIONS
  • United States Preventive Services Task Force Approach
  • SCREENING
  • BEHAVIORAL COUNSELING
  • Stages of Behavioral Change Model
  • Structured Counseling Models: Five As and FRAMES
  • IMMUNIZATION
  • SCREENING GUIDELINES FOR ADULTS
  • Screening for Substance Use Disorders, Including Misuse of Prescription and Illicit Drugs
  • Screening for Intimate Partner Violence in Females of Reproductive Age
  • Screening for Unhealthy Alcohol Use
  • Screening for Tobacco Use
  • Screening for Sexually Transmitted Infections: Syphilis, Chlamydia, and Gonorrhea
  • Screening for Human Immunodeficiency Virus
  • Screening for Prediabetes and Type 2 Diabetes
  • COUNSELING GUIDELINES FOR ADULTS
  • Counseling for Unhealthy Alcohol Use
  • Counseling for Tobacco Smoking Cessation
  • Counseling on Sexually Transmitted Infections
  • IMMUNIZATION GUIDELINES FOR ADULTS
  • Influenza Vaccine
  • Pneumococcal Vaccine
  • Respiratory Syncytial Virus Vaccine
  • COVID-19 Vaccine
  • Mpox Vaccine
  • Varicella Vaccine
  • Herpes Zoster Vaccine
  • Tetanus, Diphtheria, Pertussis Vaccine
  • Human Papillomavirus Vaccine
  • Hepatitis A Vaccine
  • Hepatitis B Vaccine
  • PREVENTIVE MEDICATION GUIDELINES
  • Prevention of Human Immunodeficiency Virus Infection: Pre-exposure Prophylaxis
  • PREVENTIVE CARE IN SPECIAL POPULATIONS
  • DISEASE-SPECIFIC RECOMMENDATIONS
  • REFERENCES
  • CHAPTER 8: Evaluating Clinical Evidence
  • INTRODUCTION
  • USING ELEMENTS OF THE HISTORY AND PHYSICAL EXAMINATION AS DIAGNOSTIC TESTS
  • EVALUATING DIAGNOSTIC TESTS: VALIDITY
  • Sensitivity and Specificity
  • Predictive Values
  • Prevalence of Disease
  • Likelihood Ratios
  • APPLYING CONCEPTS TO EVALUATING ABDOMINAL PAIN
  • APPLYING CONCEPTS TO SCREENING TESTS
  • Fagan Nomogram
  • Natural Frequencies
  • EVALUATING DIAGNOSTIC TESTS: REPRODUCIBILITY
  • Kappa Score
  • Precision
  • CRITICALLY APPRAISING THE CLINICAL EVIDENCE
  • Are the Results Valid?
  • What Are the Results?
  • How Can You Apply the Results to Patient Care?
  • COMMUNICATING CLINICAL EVIDENCE TO PATIENTS
  • REFERENCES
  • CHAPTER 9: Basic Principles and Techniques: Point-of-Care Ultrasound
  • POINT-OF-CARE ULTRASOUND
  • Goal of the Chapter
  • Enhancing Clinical Assessment: Insonation
  • SOUND WAVES AND ULTRASOUND BASICS
  • Sound Waves
  • Acoustic Impedance in Ultrasound Imaging
  • ULTRASOUND EQUIPMENT AND TECHNIQUE
  • Ultrasound Transducers
  • Image Acquisition
  • UNDERSTANDING IMAGING MODES
  • B-Mode (Brightness Mode)
  • M-Mode (Motion Mode)
  • Doppler Modes, Color, and Pulsed Wave
  • ULTRASOUND IMAGE OPTIMIZATION (“KNOBOLOGY”)
  • Machine Settings and Adjustments
  • REFERENCES
  • UNIT 2: Regional Examinations
  • CHAPTER 10: General Survey, Vital Signs, and Pain
  • HEALTH HISTORY: GENERAL APPROACH
  • Fatigue and Weakness
  • Fever and Night Sweats
  • Weight Change
  • Pain
  • PHYSICAL EXAMINATION: GENERAL APPROACH
  • TECHNIQUES OF EXAMINATION
  • Perform a General Survey
  • Measure Height and Weight
  • Assess Vital Signs
  • Measure Blood Pressure
  • Examine Arterial Pulses for Rate and Rhythm
  • Observe Respiratory Rate, Rhythm, Depth, and Effort
  • Measure Core Body Temperature
  • Assess for Acute and Chronic Pain
  • Consider Health Disparities in Pain
  • SPECIAL TECHNIQUES AND MANEUVERS
  • Measure Orthostatic Blood Pressures
  • Special Patient-Related Situations
  • Out-of-Office and Self-Monitoring of Blood Pressure
  • RECORDING YOUR FINDINGS
  • HEALTH PROMOTION AND COUNSELING: EVIDENCE AND RECOMMENDATIONS
  • Achieving Optimal Weight
  • REFERENCES
  • CHAPTER 11: Cognition, Behavior, and Mental Status
  • ANATOMY AND PHYSIOLOGY
  • HEALTH HISTORY: GENERAL APPROACH
  • Anxiety and Excessive Worrying
  • Depressed Mood
  • Memory Problems
  • Medically Unexplained Symptoms
  • PHYSICAL EXAMINATION: GENERAL APPROACH
  • TECHNIQUES OF EXAMINATION
  • Assess Appearance and Behavior Including Level of Consciousness
  • Assess Speech and Language
  • Assess Mood
  • Assess Thought Process and Perceptions
  • Assess Cognitive Function
  • Assess Higher Cognitive Functions
  • RECORDING YOUR FINDINGS
  • HEALTH PROMOTION AND COUNSELING: EVIDENCE AND RECOMMENDATIONS
  • Screening for Depression
  • Screening for Anxiety Disorders
  • Screening for Neurocognitive Disorders
  • REFERENCES
  • CHAPTER 12: Skin, Hair, and Nails
  • ANATOMY AND PHYSIOLOGY
  • Skin
  • Hair
  • Nails
  • Pilosebaceous Glands and Sweat Glands
  • HEALTH HISTORY: GENERAL APPROACH
  • Skin Lesions
  • Rashes and Itching (Pruritus)
  • Hair Loss or Alopecia
  • Nail Changes
  • DESCRIBING SKIN LESIONS
  • Primary Lesions
  • Other Features of Skin Lesions
  • PHYSICAL EXAMINATION: GENERAL APPROACH
  • Skin Examination Setup
  • TECHNIQUES OF EXAMINATION
  • Examine the Hair and Scalp—Seated
  • Examine the Head and Neck—Seated
  • Examine the Upper Back—Seated
  • Examine the Shoulders, Arms, and Hands—Seated
  • Examine the Chest and Abdomen—Seated
  • Examine the Anterior Thighs and Legs—Seated
  • Examine the Feet and Toes—Seated
  • Examine the Lower Back, Posterior Thighs, and Legs—Standing
  • Integrate a Full-Body Skin Examination
  • SPECIAL TECHNIQUES AND MANEUVERS
  • Instructing the Patient in Skin Self-Examination
  • Examining the Patient with Hair Loss
  • Evaluating the Patient Who Is Confined to a Bed
  • Modifications in Physical Examinations: Best Practices for Specialized Patient Populations
  • RECORDING YOUR FINDINGS
  • POINT-OF-CARE ULTRASOUND EXAMINATION
  • Distinguishing Between Cellulitis and Abscess
  • HEALTH PROMOTION AND COUNSELING: EVIDENCE AND RECOMMENDATIONS
  • Skin Cancer Epidemiology
  • Skin Cancer Prevention
  • Clinician Skin Cancer Screening
  • Skin Self-Examination
  • REFERENCES
  • CHAPTER 13: Head and Neck
  • ANATOMY AND PHYSIOLOGY
  • Head and Neck
  • Great Vessels
  • Midline Structures and Thyroid Gland
  • Cervical Lymph Nodes
  • HEALTH HISTORY: GENERAL APPROACH
  • Neck or Thyroid Mass or Lump
  • PHYSICAL EXAMINATION: GENERAL APPROACH
  • TECHNIQUES OF EXAMINATION
  • Examine the Hair
  • Examine the Scalp
  • Examine the Skull
  • Inspect Facial Contours
  • Inspect the Skin on the Head and Face
  • Palpate the Cervical Lymph Nodes
  • Examine the Trachea
  • Inspect the Thyroid Gland
  • Palpate the Thyroid Gland: Posterior Approach
  • Palpate the Thyroid Gland: Anterior Approach
  • Examine the Carotid Arteries and Jugular Veins
  • RECORDING YOUR FINDINGS
  • HEALTH PROMOTION AND COUNSELING: EVIDENCE AND RECOMMENDATIONS
  • Screening for Thyroid Dysfunction
  • Screening for Thyroid Cancer
  • REFERENCES
  • CHAPTER 14: Eyes
  • ANATOMY AND PHYSIOLOGY
  • Orbital Anatomy
  • Anterior Ocular Structures
  • Lacrimal Apparatus
  • Optical Structures
  • Posterior Ocular Structures
  • Visual Pathway and Fields
  • Autonomic Nerve Supply to the Eyes
  • Extraocular Muscles
  • HEALTH HISTORY: GENERAL APPROACH
  • Blurred Vision
  • Eye Redness or Pain
  • PHYSICAL EXAMINATION: GENERAL APPROACH
  • TECHNIQUES OF EXAMINATION
  • Test Visual Acuity
  • Assess Visual Fields
  • Test Color Vision and Contrast Sensitivity
  • Assess Eye Position and Alignment
  • Inspect the Eyebrows
  • Inspect the Eyelids and Eyelashes
  • Inspect the Lacrimal Apparatus
  • Inspect the Conjunctivae and Sclerae
  • Inspect the Cornea, Iris, and Lens
  • Inspect the Pupils
  • Assess the Pupillary Light Reactions
  • Assess the Pupillary Near Reaction
  • Assess Conjugate Movements
  • Test Extraocular Muscle Movements
  • Test for Convergence
  • Perform a Funduscopic Examination (Direct Ophthalmoscopy)
  • SPECIAL TECHNIQUES AND MANEUVERS
  • Assessing Eye Protrusion (Proptosis or Exophthalmos)
  • Examining for Nasolacrimal Duct Obstruction
  • Managing Foreign Body in the Eye
  • Testing for Functional Impairment of the Optic Nerves
  • Modifications in Physical Examinations: Best Practices for Specialized Patient Populations
  • RECORDING YOUR FINDINGS
  • HEALTH PROMOTION AND COUNSELING: EVIDENCE AND RECOMMENDATIONS
  • Visual Impairment
  • Screening for Glaucoma
  • UV-Related Eye Injuries
  • REFERENCES
  • CHAPTER 15: Ears and Nose
  • EAR: ANATOMY AND PHYSIOLOGY
  • External Ear
  • Middle Ear
  • Inner Ear
  • Hearing Pathways
  • Vestibular System and Equilibrium
  • NOSE: ANATOMY AND PHYSIOLOGY
  • Nasal Septum
  • Turbinates and Meatuses
  • Paranasal Sinuses
  • Olfaction Pathway
  • HEALTH HISTORY: GENERAL APPROACH
  • Hearing Loss
  • Earache and Ear Discharge
  • Ringing in the Ear (Tinnitus)
  • Dizziness and Lightheadedness
  • Nasal Discharge (Rhinorrhea) and Nasal Congestion
  • Nosebleed (Epistaxis)
  • PHYSICAL EXAMINATION: GENERAL APPROACH
  • EAR: TECHNIQUES OF EXAMINATION
  • Examine the Auricle and Surrounding Tissue and Palpate the Tragus and Mastoid
  • Examine the Ear Canals and Tympanic Membranes (Otoscopy)
  • Test Auditory Acuity (Gross Hearing)
  • Test for Conductive versus Sensorineural Hearing Loss
  • EAR: SPECIAL TECHNIQUES AND MANEUVERS
  • Modifications in Physical Examinations: Best Practices for Specialized Patient Populations
  • NOSE AND PARANASAL SINUS: TECHNIQUES OF EXAMINATION
  • Inspect the Anterior and Inferior Surfaces of the Nose
  • Test for Nasal Obstruction
  • Inspect the Nasal Cavity and Mucosa
  • Inspect the Nasal Septum
  • Inspect the Nasal Turbinates and Meatuses
  • Palpate the Paranasal Sinuses
  • RECORDING YOUR FINDINGS
  • HEALTH PROMOTION AND COUNSELING: EVIDENCE AND RECOMMENDATIONS
  • Screening for Hearing Loss
  • REFERENCES
  • CHAPTER 16: Throat and Oral Cavity
  • ANATOMY AND PHYSIOLOGY
  • Mouth, Gingiva, and Teeth
  • Tongue
  • Gustation Pathway
  • Pharynx
  • HEALTH HISTORY: GENERAL APPROACH
  • Sore Throat
  • Bleeding or Swollen Gums
  • Hoarseness
  • Malodorous Breath (Halitosis)
  • PHYSICAL EXAMINATION: GENERAL APPROACH
  • TECHNIQUES OF EXAMINATION
  • Inspect the Lips and Oral Mucosa
  • Palpate the Oral Mucosa
  • Inspect the Gingiva and Teeth
  • Inspect the Roof and Floor of the Mouth
  • Inspect the Tongue
  • Test the Hypoglossal Nerve
  • Palpate the Tongue
  • Inspect the Soft Palate, Anterior and Posterior Pillars, Uvula, Tonsils, and Pharynx
  • Test the Vagus Nerve
  • SPECIAL TECHNIQUES AND MANEUVERS
  • Modifications in Physical Examinations: Best Practices for Specialized Patient Populations
  • RECORDING YOUR FINDINGS
  • HEALTH PROMOTION AND COUNSELING: EVIDENCE AND RECOMMENDATIONS
  • Oral Health
  • Screening for Oral and Pharyngeal Cancer
  • REFERENCES
  • CHAPTER 17: Thorax and Lungs
  • ANATOMY AND PHYSIOLOGY
  • Surface Anatomy: Vertical Axis
  • Surface Anatomy: Chest Circumference
  • Lungs, Fissures, and Lobes
  • Trachea and Major Bronchi (Tracheobronchial Tree)
  • Pleurae
  • Mechanics and Physiology of Breathing
  • Breath Sounds (Lung Sounds)
  • HEALTH HISTORY: GENERAL APPROACH
  • Shortness of Breath (Dyspnea) and Wheezing
  • Cough
  • Blood-Streaked Sputum (Hemoptysis)
  • Chest Pain/Discomfort
  • Daytime Sleepiness, Snoring, and Disordered Sleep
  • PHYSICAL EXAMINATION: GENERAL APPROACH
  • TECHNIQUES OF EXAMINATION
  • Survey the Thorax and Respiration
  • Inspect the Thorax
  • Palpate the Thorax
  • Assess for Thoracic Expansion (Lung Excursion)
  • Assess for Tactile Fremitus
  • Percuss the Thorax
  • Posterior Chest
  • Anterior Chest
  • Identify Extent of Diaphragmatic Excursion
  • Auscultate the Lungs for Breath Sounds
  • Auscultate for Adventitious (Added) Sounds
  • Assess Transmitted Voice Sounds
  • SPECIAL TECHNIQUES AND MANEUVERS
  • Clinically Assess Pulmonary Function
  • Assess Forced Expiratory Time
  • Identify a Fractured Rib
  • Modifications in Physical Examinations: Best Practices for Specialized Patient Populations
  • RECORDING YOUR FINDINGS
  • POINT-OF-CARE ULTRASOUND EXAMINATION
  • Detecting Congestive Heart Failure, Pneumothorax, and Pleural Effusion
  • HEALTH PROMOTION AND COUNSELING: EVIDENCE AND RECOMMENDATIONS
  • Lung Cancer
  • Latent Tuberculosis
  • Obstructive Sleep Apnea
  • REFERENCES
  • CHAPTER 18: Cardiovascular System
  • ANATOMY AND PHYSIOLOGY
  • Mediastinum, Heart, and Great Vessels
  • Conduction System
  • Heart as a Pump
  • Cardiac Circulation
  • Cardiac Cycle
  • Arterial Pulses and Blood Pressure
  • Jugular Venous Pressure and Pulsations
  • Relation of Cardiac Findings to the Chest Wall
  • Heart Sounds
  • Heart Murmurs
  • HEALTH HISTORY: GENERAL APPROACH
  • Chest Pain
  • Palpitations
  • Shortness of Breath
  • Swelling (Edema)
  • Fainting (Syncope)
  • PHYSICAL EXAMINATION: GENERAL APPROACH
  • TECHNIQUES OF EXAMINATION
  • Measure Blood Pressure and Heart Rate
  • Identify Jugular Venous Pressure
  • Auscultate for Carotid Bruits
  • Palpate the Carotid Arteries
  • Inspect the Precordium
  • Palpate the Precordium
  • Auscultate the Precordium
  • Auscultate for S1 and S2
  • Auscultate for Splitting of Heart Sounds
  • Auscultate for Heart Murmurs
  • SPECIAL TECHNIQUES AND MANEUVERS
  • Bedside Maneuvers to Identify Murmurs and Heart Failure
  • Modifications in Physical Examinations: Best Practices for Specialized Patient Populations
  • RECORDING YOUR FINDINGS
  • POINT-OF-CARE ULTRASOUND EXAMINATION
  • Assessing Left Ventricular Systolic Function
  • HEALTH PROMOTION AND COUNSELING: EVIDENCE AND RECOMMENDATIONS
  • Background
  • Screening for Hypertension
  • Initiating Statin Therapy for Primary Prevention
  • Promoting Lifestyle Changes and Risk Factor Modification
  • Addressing Excessive Dietary Sodium
  • REFERENCES
  • CHAPTER 19: Peripheral Vascular System
  • ANATOMY AND PHYSIOLOGY
  • Arterial System
  • Venous System
  • Lymphatic System
  • Transcapillary Fluid Exchange
  • HEALTH HISTORY: GENERAL APPROACH
  • Pain and/or Swelling of Legs with Intermittent Claudication
  • Pain and/or Swelling in Legs without Claudication
  • Abdominal, Flank, or Back Pain
  • PHYSICAL EXAMINATION: GENERAL APPROACH
  • TECHNIQUES OF EXAMINATION
  • Inspect the Upper Extremities
  • Palpate the Radial Pulse
  • Palpate the Brachial Pulse
  • Palpate for Epitrochlear Nodes
  • Examine the Abdominal Aorta
  • Palpate the Superficial Inguinal Nodes
  • Inspect the Lower Extremities
  • Assess the Temperature of the Feet and Legs
  • Palpate the Femoral Pulse
  • Palpate the Popliteal Pulse
  • Palpate the Posterior Tibial Pulse
  • Palpate the Dorsalis Pedis Pulse
  • Palpate for Pitting Edema
  • Palpate for Venous Tenderness or Cords
  • SPECIAL TECHNIQUES AND MANEUVERS
  • Assess for Peripheral Arterial Disease Using the Ankle–Brachial Index
  • Evaluate Arterial Perfusion of the Hand Using the Allen Test
  • Modifications in Physical Examinations: Best Practices for Specialized Patient Populations
  • RECORDING YOUR FINDINGS
  • POINT-OF-CARE ULTRASOUND EXAMINATION
  • Detecting Nonpalpable Pulses
  • Detecting Deep Venous Thrombosis
  • HEALTH PROMOTION AND COUNSELING: EVIDENCE AND RECOMMENDATIONS
  • Screening for Lower Extremity Peripheral Artery Disease
  • Screening for Abdominal Aortic Aneurysm
  • REFERENCES
  • CHAPTER 20: Breasts and Axillae
  • ANATOMY AND PHYSIOLOGY
  • Breast
  • Axilla
  • HEALTH HISTORY: GENERAL APPROACH
  • Breast Lump or Mass
  • Breast Discomfort or Pain
  • Nipple Discharge
  • PHYSICAL EXAMINATION: GENERAL APPROACH
  • TECHNIQUES OF EXAMINATION
  • Inspect the Breasts of Individuals Assigned Female at Birth in Four Views
  • Palpate the Breasts
  • Inspect the Axillae
  • Palpate the Axillary Lymph Nodes
  • Inspect the Breasts of Individuals Assigned Male at Birth
  • SPECIAL TECHNIQUES AND MANEUVERS
  • Modifications in Physical Examinations: Best Practices for Specialized Patient Populations
  • RECORDING YOUR FINDINGS
  • HEALTH PROMOTION AND COUNSELING: EVIDENCE AND RECOMMENDATIONS
  • Breast Cancer in Individuals Assigned Female at Birth
  • Breast Cancer in Individuals Assigned Male at Birth
  • REFERENCES
  • CHAPTER 21: Abdomen
  • ANATOMY AND PHYSIOLOGY
  • Abdominal Division Methods and Contents
  • Physiology of the Abdominal Organs
  • HEALTH HISTORY: GENERAL APPROACH
  • Abdominal Pain
  • Epigastric Pain
  • Right Upper Quadrant Abdominal Pain
  • Left Upper Quadrant Abdominal Pain
  • Right Lower Quadrant Abdominal Pain
  • Left Lower Quadrant Abdominal Pain
  • Hypogastric (Suprapubic) Pain
  • Nausea and Vomiting
  • Hematemesis
  • Hematochezia and Melena
  • Dysphagia and/or Odynophagia
  • Diarrhea
  • Constipation
  • Jaundice
  • PHYSICAL EXAMINATION: GENERAL APPROACH
  • TECHNIQUES OF EXAMINATION
  • Inspect the Abdomen
  • Auscultate for Bowel Sounds
  • Auscultate for Abdominal Bruits
  • Percuss the Abdomen
  • Palpate Lightly in All Four Abdominal Quadrants
  • Palpate Deeply in All Four Abdominal Quadrants
  • Estimate Liver Size by Percussion
  • Palpate the Liver Edge
  • Percuss for Splenic Enlargement
  • Palpate for the Splenic Edge
  • Palpate for Aortic Pulsations
  • SPECIAL TECHNIQUES AND MANEUVERS
  • Assessing Possible Peritonitis
  • Assessing Possible Ascites
  • Identifying Abdominal Organs and Masses in the Presence of Ascites
  • Assessing for Abdominal Wall Mass
  • Assessing Possible Appendicitis
  • Assessing Possible Acute Cholecystitis
  • Assessing Possible Renal Colic or Pyelonephritis
  • Assessing Ventral Hernias
  • Assessing for Urinary Bladder Distention
  • Modifications in Physical Examinations: Best Practices for Specialized Patient Populations
  • RECORDING YOUR FINDINGS
  • POINT-OF-CARE ULTRASOUND EXAMINATION
  • Ultrasound Technique
  • Assessing the Liver Size
  • Evaluating the Gallbladder
  • Evaluating for Intraperitoneal Free Fluid (FF)
  • HEALTH PROMOTION AND COUNSELING: EVIDENCE AND RECOMMENDATIONS
  • Viral Hepatitis A
  • Viral Hepatitis B
  • Viral Hepatitis C
  • Colorectal Cancer
  • REFERENCES
  • CHAPTER 22: Anus and Rectum
  • ANATOMY AND PHYSIOLOGY
  • HEALTH HISTORY: GENERAL APPROACH
  • Bloody Stool (Hematochezia)
  • Pain on Defecation
  • Anal and Perianal Lesions
  • PHYSICAL EXAMINATION: GENERAL APPROACH
  • TECHNIQUES OF EXAMINATION
  • Properly Position the Patient
  • Inspect the Sacrococcygeal and Perianal Areas
  • Inspect the Anus
  • Perform a Digital Rectal Examination
  • SPECIAL TECHNIQUES AND MANEUVERS
  • Perform a Prostatic Examination (When Indicated)
  • Perform a Rectovaginal Examination (When Indicated)
  • RECORDING YOUR FINDINGS
  • REFERENCES
  • CHAPTER 23: Pelvis and Genitourinary System: Penis, Scrotum, and Prostate
  • ANATOMY AND PHYSIOLOGY
  • Pelvis
  • Urogenital System
  • Prostate
  • Pelvic Floor Muscles
  • Groin or Inguinal Area
  • Blood, Lymphatic, and Nerve Supplies
  • Micturition Cycle
  • Sexual Development and Function
  • HEALTH HISTORY: GENERAL APPROACH
  • Lower Urinary Tract Storage Symptoms
  • Lower Urinary Tract Voiding Symptoms
  • Lower Urinary Tract Postmicturition Symptoms
  • Urinary Incontinence
  • Penile Discharge or Lesions
  • Scrotal or Testicular Pain, Swelling, or Lesions
  • Erectile Dysfunction
  • PHYSICAL EXAMINATION: GENERAL APPROACH
  • TECHNIQUES OF EXAMINATION
  • Inspect the Penile Skin, Prepuce, and Glans
  • Inspect the Urethral Meatus
  • Palpate the Shaft of the Penis
  • Inspect the Scrotum
  • Assess for Groin Hernias
  • Palpate Each Testis
  • Palpate the Epididymis
  • Examine the Spermatic Cord
  • SPECIAL TECHNIQUES AND MANEUVERS
  • Evaluating a Suspected Inguinal Hernia
  • Evaluating a Suspected Femoral Hernia
  • Assessing for Scrotal Contents by Transillumination
  • Performing a Testicular Self-Examination
  • Modifications in Physical Examinations: Best Practices for Specialized Patient Populations
  • Palpate the Posterior Surface of the Prostate Gland
  • Assess the Prostate’s Size, Shape, Symmetry, Mobility, and Consistency
  • RECORDING YOUR FINDINGS
  • HEALTH PROMOTION AND COUNSELING: EVIDENCE AND RECOMMENDATIONS
  • Prostate Cancer
  • REFERENCES
  • CHAPTER 24: Pelvis and Genitourinary System: Vulva, Vagina, Uterus, and Adnexa
  • ANATOMY AND PHYSIOLOGY
  • Pelvis
  • Pelvic Floor
  • Vulva
  • Vagina
  • Uterus
  • Cervix
  • Adnexa
  • Micturition Cycle
  • Menstrual Cycle
  • Menarche and Menses
  • Menopause
  • HEALTH HISTORY: GENERAL APPROACH
  • Painful Menstruation (Dysmenorrhea)
  • Absence of Menses (Amenorrhea)
  • Abnormal Uterine Bleeding
  • Pelvic Pain
  • Vulvovaginal Symptoms
  • Urinary Incontinence
  • PHYSICAL EXAMINATION: GENERAL APPROACH
  • Positioning
  • Prepare the Equipment
  • TECHNIQUES OF EXAMINATION
  • Assess Sexual Maturity (Adolescents)
  • Inspect the Vulva
  • Insert the Vaginal Speculum
  • Inspect the Cervix
  • Inspect the Vagina
  • Obtain Specimens for Cervical Cytology (Pap Smears)
  • Perform a Bimanual Examination
  • Assess the Pelvic Floor Muscles for Strength and Tenderness
  • Perform a Rectovaginal Examination (if Indicated)
  • SPECIAL TECHNIQUES AND MANEUVERS
  • Assessing Labial Swelling
  • Assessing for Urethritis
  • Assessing for Suspected Inguinal Hernia
  • Assessing for Suspected Femoral Hernia
  • Modifications in Physical Examinations: Best Practices for Specialized Patient Populations
  • RECORDING YOUR FINDINGS
  • POINT-OF-CARE ULTRASOUND EXAMINATION
  • Estimating Bladder Volume
  • HEALTH PROMOTION AND COUNSELING: EVIDENCE AND RECOMMENDATIONS
  • Cervical Cancer
  • Menopause and Hormone Replacement Therapy
  • Urinary Incontinence
  • REFERENCES
  • CHAPTER 25: Musculoskeletal System: Neck, Shoulders, and Upper Extremities
  • ANATOMY AND PHYSIOLOGY: GENERAL MUSCULOSKELETAL SYSTEM
  • Vertebral Spine
  • Sacrococcygeal Spine
  • Joints
  • HEALTH HISTORY: GENERAL APPROACH
  • Musculoskeletal Problems
  • PHYSICAL EXAMINATION: GENERAL APPROACH
  • Inspection (Look)
  • Palpation (Feel)
  • Range of Motion (Move)
  • Special Maneuvers (Stress)
  • REGIONAL MUSCULOSKELETAL EXAMINATIONS
  • ANATOMY: TEMPOROMANDIBULAR JOINT
  • HEALTH HISTORY: GENERAL APPROACH
  • Jaw Pain
  • TECHNIQUES OF EXAMINATION
  • Inspect the Face and Temporomandibular Joint
  • Palpate the Temporomandibular Joint
  • Palpate the Muscles of Mastication
  • Assess Temporomandibular Joint Range of Motion
  • ANATOMY: CERVICAL SPINE (NECK)
  • HEALTH HISTORY: GENERAL APPROACH
  • Neck Pain or Stiffness
  • TECHNIQUES OF EXAMINATION
  • Inspect the Neck and Posture
  • Palpate the Muscles of the Neck
  • Palpate the Neck and Surrounding Structures
  • Assess Cervical Spine (Neck) Range of Motion
  • Perform Special Maneuvers for the Cervical Spine (If Indicated)
  • ANATOMY: SHOULDER
  • HEALTH HISTORY: GENERAL APPROACH
  • Shoulder Pain
  • TECHNIQUES OF EXAMINATION
  • Inspect the Shoulder and Associated Structures
  • Palpate the Shoulder and Associated Structures
  • Assess Shoulder Range of Motion
  • Perform Special Maneuvers for the Shoulder (If Indicated)
  • ANATOMY: ELBOW
  • HEALTH HISTORY: GENERAL APPROACH
  • Elbow Pain
  • TECHNIQUES OF EXAMINATION
  • Inspect the Elbow Joint
  • Palpate the Elbow Joint and Adjoining Structures
  • Assess Elbow Range of Motion
  • Perform Special Maneuvers for the Elbow Joint (If Indicated)
  • ANATOMY: WRIST AND HAND
  • Wrist Structure
  • Hand Structure
  • HEALTH HISTORY: GENERAL APPROACH
  • Wrist and Hand Pain
  • TECHNIQUES OF EXAMINATION
  • Inspect the Wrist
  • Inspect the Hand
  • Palpate the Wrist
  • Palpate the Hand
  • Assess Wrist, Fingers, and Thumb Range of Motion
  • Perform Special Maneuvers for the Wrist and Hand (If Indicated)
  • RECORDING YOUR FINDINGS
  • HEALTH PROMOTION AND COUNSELING: EVIDENCE AND RECOMMENDATIONS
  • REFERENCES
  • CHAPTER 26: Musculoskeletal System: Lumbosacral Spine, Hips, and Lower Extremities
  • ANATOMY: LUMBOSACRAL SPINE
  • HEALTH HISTORY: GENERAL APPROACH
  • TECHNIQUES OF EXAMINATION
  • Observe the Gait
  • Observe the Pelvic Alignment
  • Palpate the Lumbosacral Spine and Adjoining Structures
  • Assess Lumbosacral Spine Range of Motion
  • Perform Special Maneuvers on the Lumbosacral Spine Joint (If Indicated)
  • ANATOMY: HIP JOINT
  • HEALTH HISTORY: GENERAL APPROACH
  • TECHNIQUES OF EXAMINATION
  • Inspect the Hip Joint
  • Palpate the Anterior Hip Landmarks
  • Palpate the Posterior Hip Landmarks
  • Assess Hip Joint Range of Motion
  • Perform Special Maneuvers on the Hip Joint (If Indicated)
  • ANATOMY: KNEE
  • HEALTH HISTORY: GENERAL APPROACH
  • TECHNIQUES OF EXAMINATION
  • Inspect the Gait
  • Inspect the Knee and Surrounding Structures
  • Palpate the Knee and Adjoining Structures
  • Assess Knee Range of Motion
  • Perform Special Maneuvers on the Knee Joint (If Indicated)
  • ANATOMY: ANKLE JOINT AND FOOT
  • HEALTH HISTORY: GENERAL APPROACH
  • Ankle Pain or Swelling
  • Foot Pain
  • TECHNIQUES OF EXAMINATION
  • Inspect the Ankle and Foot
  • Palpate the Ankle, Foot and Surrounding Structures
  • Assess Ankle and Foot Range of Motion
  • Perform Special Maneuvers on the Ankle and Foot (If Indicated)
  • SPECIAL TECHNIQUES AND MANEUVERS
  • Analyzing Gait
  • Measuring Leg Length
  • Describing Limited Joint Motion
  • Screening for Scoliosis
  • Detecting Knee Joint Effusions
  • Modifications in Physical Examinations: Best Practices for Specialized Patient Populations
  • RECORDING YOUR FINDINGS
  • POINT-OF-CARE ULTRASOUND EXAMINATION
  • Detecting Joint Fluid
  • HEALTH PROMOTION AND COUNSELING: EVIDENCE AND RECOMMENDATIONS
  • Osteoporosis: Burden of Disease and Risk Factors
  • Osteoporosis: Screening Recommendations
  • Osteoporosis: Assessing Fracture Risk
  • REFERENCES
  • CHAPTER 27: Nervous System
  • ANATOMY AND PHYSIOLOGY
  • Central Nervous System
  • Peripheral Nervous System
  • Motor Pathways
  • Spinal Reflexes: Muscle Stretch Response
  • Sensory Pathways
  • HEALTH HISTORY: GENERAL APPROACH
  • Headache
  • Dizziness or Lightheadedness
  • Weakness
  • Numbness or Abnormal or Absent Sensation
  • Fainting and Blacking Out (Near-Syncope and Syncope)
  • Seizures
  • Tremors or Involuntary Movements
  • PHYSICAL EXAMINATION: GENERAL APPROACH
  • TECHNIQUES OF EXAMINATION: MENTAL STATUS
  • Assess Mental Status
  • TECHNIQUES OF EXAMINATION: CRANIAL NERVES
  • Test for Cranial Nerve I—Olfactory
  • Test for Cranial Nerve II—Optic
  • Test for Cranial Nerves II and III—Optic and Oculomotor
  • Test for Cranial Nerves III, IV, and VI—Oculomotor, Trochlear, and Abducens
  • Test for Cranial Nerve V—Trigeminal
  • Test for Cranial Nerve VII—Facial
  • Test for Cranial Nerve VIII—Vestibulocochlear
  • Test for Cranial Nerves IX and X—Glossopharyngeal and Vagus
  • Test for Cranial Nerve XI—Spinal Accessory
  • Test for Cranial Nerve XII—Hypoglossal
  • TECHNIQUES OF EXAMINATION: MOTOR SYSTEM
  • Assess the Motor System for Body Position, Involuntary Movements, and Muscle Characteristics
  • Test Abduction at the Shoulder
  • Test Flexion and Extension at the Elbow
  • Test Flexion and Extension at the Wrist
  • Test Extension and Abduction of the Fingers
  • Test for Adduction and Abduction of the Thumb
  • Test Flexion and Extension at the Hips
  • Test Adduction and Abduction at the Hips
  • Test Flexion and Extension at the Knee
  • Test Dorsiflexion and Plantar Flexion of the Ankle
  • TECHNIQUES OF EXAMINATION: REFLEXES
  • Elicit the Biceps Reflex (C5, C6)
  • Elicit the Triceps Reflex (C6, C7)
  • Elicit the Brachioradialis Reflex (C5, C6)
  • Elicit the Quadriceps (Patellar) Reflex (L2–L4)
  • Elicit the Achilles (Ankle) Reflex (Primarily S1)
  • Test for Clonus (if indicated)
  • Assess Plantar Responses
  • Elicit Superficial Stimulation Reflex
  • TECHNIQUES OF EXAMINATION: SENSORY SYSTEM, COORDINATION, STATION, AND GAIT
  • Assess Sensation
  • Test Coordination (Rapid Alternating Movements)
  • Test Coordination (Point-to-Point Movements)
  • Perform Gait Assessment
  • Assess Station (Romberg Test)
  • SPECIAL TECHNIQUES AND MANEUVERS
  • Detecting Meningeal Irritation
  • Assessing for Lumbosacral Radiculopathy
  • Detecting Asterixis (Flapping Tremor)
  • Assessing Scapular Winging
  • Evaluating Neurologic Status in Comatose Patients
  • Modifications in Physical Examinations: Best Practices for Specialized Patient Populations
  • RECORDING YOUR FINDINGS
  • HEALTH PROMOTION AND COUNSELING: EVIDENCE AND RECOMMENDATIONS
  • Preventing Cerebrovascular Disease
  • Aspirin Chemoprophylaxis
  • Screening for Atrial Fibrillation
  • Screening for Asymptomatic Carotid Artery Stenosis
  • REFERENCES
  • UNIT 3: Special Populations
  • CHAPTER 28: Children: Infancy Through Adolescence
  • INTRODUCTION
  • GENERAL PRINCIPLES OF CHILD DEVELOPMENT
  • SURVEILLANCE OF DEVELOPMENT
  • KEY COMPONENTS OF HEALTH PROMOTION
  • NEWBORNS AND INFANTS
  • HEALTH HISTORY: GENERAL APPROACH
  • SURVEILLANCE OF DEVELOPMENT
  • PHYSICAL EXAMINATION: GENERAL APPROACH
  • Newborns
  • Infants
  • TECHNIQUES OF EXAMINATION: NEWBORNS AND INFANTS
  • Apgar Score
  • Gestational Age and Birth Weight
  • General Survey
  • Somatic Growth
  • Vital Signs
  • Skin
  • Head
  • Eyes
  • Ears
  • Nose
  • Mouth and Pharynx
  • Neck
  • Thorax and Lungs
  • Heart
  • Peripheral Vascular System
  • Breasts
  • Abdomen
  • Penis, Testes, and Scrotum
  • Vulva and Vagina
  • Rectum and Anus
  • Musculoskeletal System
  • Nervous System
  • RECORDING YOUR FINDINGS
  • HEALTH PROMOTION AND COUNSELING: EVIDENCE AND RECOMMENDATIONS
  • PRESCHOOL-AGE AND SCHOOL-AGE CHILDREN
  • HEALTH HISTORY: GENERAL APPROACH
  • SURVEILLANCE OF DEVELOPMENT: EARLY CHILDHOOD, 1 TO 4 YEARS
  • SURVEILLANCE OF DEVELOPMENT: MIDDLE CHILDHOOD, 5 TO 10 YEARS
  • PHYSICAL EXAMINATION: GENERAL APPROACH
  • TECHNIQUES OF EXAMINATION
  • Somatic Growth
  • Vital Signs
  • Skin
  • Head
  • Eyes
  • Ears
  • Nose and Sinuses
  • Mouth and Pharynx
  • Neck
  • Thorax and Lungs
  • Heart and Vascular System
  • Abdomen
  • Penis and Scrotum
  • Vulva and Surrounding Structures
  • Rectum and Anus
  • Musculoskeletal System
  • Nervous System
  • RECORDING YOUR FINDINGS
  • HEALTH PROMOTION AND COUNSELING: EVIDENCE AND RECOMMENDATIONS
  • Children 1 to 4 Years
  • Children 5 to 10 Years
  • ADOLESCENTS
  • HEALTH HISTORY: GENERAL APPROACH
  • HEEADSSS Assessment
  • SURVEILLANCE OF DEVELOPMENT: 11 TO 20 YEARS
  • Gender and Sexual Identity Formation among Adolescents
  • PHYSICAL EXAMINATION: GENERAL APPROACH
  • TECHNIQUES OF EXAMINATION
  • SPECIAL TECHNIQUES AND MANEUVERS
  • Assessing for Scoliosis
  • Conducting Sports Preparticipation Physical Evaluation
  • RECORDING YOUR FINDINGS
  • HEALTH PROMOTION AND COUNSELING: EVIDENCE AND RECOMMENDATIONS
  • REFERENCES
  • CHAPTER 29: Pregnant Persons
  • ANATOMY AND PHYSIOLOGY
  • Anatomic Changes
  • Physiologic Hormonal Changes
  • HEALTH HISTORY: GENERAL APPROACH
  • Initial Prenatal Visit
  • Subsequent Prenatal Visits
  • PHYSICAL EXAMINATION: GENERAL APPROACH
  • TECHNIQUES OF EXAMINATION
  • Position the Pregnant Individual
  • Prepare the Examining Equipment
  • Conduct a General Inspection
  • Measure Height, Weight, and Vital Signs
  • Inspect the Head and Neck
  • Inspect, Percuss, and Auscultate the Thorax and Lungs
  • Examine the Heart
  • Examine the Breasts
  • Examine the Abdomen
  • Examine the External Genitalia
  • Inspect the Internal Genitalia
  • Examine the Internal Genitalia
  • Consider Examining the Anus, Rectum, and Rectovaginal Septum
  • Examine the Extremities
  • SPECIAL TECHNIQUES
  • Leopold Maneuvers
  • RECORDING YOUR FINDINGS
  • HEALTH PROMOTION AND COUNSELING: EVIDENCE AND RECOMMENDATIONS
  • Screening for Infectious Diseases
  • Genetic Testing and Aneuploidy Screening
  • Screening for Medical Conditions Associated with Pregnancy
  • Screening for Perinatal Depression
  • Intimate Partner Violence Screening
  • Rh(D) Incompatibility Screening
  • Screening and Counseling for Unhealthy Behaviors
  • Counseling for Healthy Weight and Weight Gain in Pregnancy
  • Interventions to Prevent Perinatal Depression
  • Breastfeeding or Chestfeeding
  • Immunizations in Pregnancy
  • Preventive Medications
  • Unintended Pregnancy
  • REFERENCES
  • CHAPTER 30: Older Adults
  • ADDRESSING THE CHALLENGES OF GLOBAL AGING
  • DEFINING OLDER ADULTHOOD
  • ANATOMIC AND PHYSIOLOGIC CHANGES IN OLDER ADULTS
  • COMMUNICATING EFFECTIVELY WITH OLDER ADULTS
  • GERIATRIC 5Ms
  • HEALTH HISTORY: APPLYING THE 5Ms FRAMEWORK
  • Mind
  • Mobility
  • Medications
  • Multicomplexity
  • Matters Most
  • ADJUSTMENTS IN PHYSICAL EXAMINATION TECHNIQUES FOR OLDER ADULTS
  • GERIATRIC ASSESSMENT: APPLYING THE 5Ms FRAMEWORK
  • Mind
  • Mobility
  • Medications
  • Multicomplexity
  • Matters Most
  • HEALTH PROMOTION AND COUNSELING: EVIDENCE AND RECOMMENDATIONS
  • When to Screen
  • Immunizations
  • Cancer Screening
  • Elder Abuse
  • Household Safety and Falls Prevention
  • REFERENCES
  • Index