Advanced Clinical Skills and Physical Diagnosis, 2nd Edition

, by Dale Berg (Thomas Jefferson University Hospital, Philadelphia)

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ISBN: 9781405104333 | 1405104333
Cover: Paperback
Copyright: 5/1/2004

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With nearly 200 photographs to enhance understanding of examination procedures and diagnoses, the new updated edition of Advanced Clinical Skills and Physical Diagnosis is guaranteed to be the only pocket reference you will need. Topics are organized in head to toe order with each chapter organized into three sections: Basic Examination, Advanced Examination, and Diagnoses. Over 200 black & white and color photographs enhance understanding of conditions and examination procedures. New features for the 2nd edition includes keys in each chapter which include tips on how to record findings and points to tell the attending or resident.

Preface

xvii

Contributors

xix

Vital Signs

Basic Examination

(3)

Measure temperature: auricular or oral probe

(1)

Measure temperature: rectal probe

(1)

Measure blood pressure: sphygmomanometer

(1)

Measure pulse rate and rhythm

(1)

Inspect respiratory pattern

(1)

Measure weight

(1)

Advanced Examination

(3)

Approach to a patient with a fever

(1)

Approach to a patient with elevated blood pressure

(3)

Diagnoses

(2)

Head, Ears, Nose, and Throat (Hent)

Basic Examination

(9)

Inspect auricles

(1)

Direct otoscopic examination: external ear canal

(1)

Direct otoscopic examination: tympanic membrane

(2)

Palpate and inspect external nose

(1)

Visually inspect oropharynx

(1)

Palpate and inspect gingiva

(1)

Visually inspect teeth

(1)

Palpate and visually inspect lips

(1)

Palpate and visually inspect tongue

(2)

Palpate and visually inspect soft and hard palates

(1)

Palpate and visually inspect posterior pharynx

(2)

Advanced Examination

(12)

Approach to a patient with bumps on, or painful, auricles

(1)

Approach to a patient with external canal problems

(1)

Approach to a patient with earache and/or tympanic membrane findings

(1)

Approach to a patient with a nose complaint

(1)

Approach to a patient with neck lumps and bumps

(1)

Approach to a patient with suspected hyperthyroidism

(2)

Approach to a patient with suspected hypothyroidism

(1)

Approach to a patient with oral cavity bumps and lesions

(1)

Approach to a patient with gingival lesions

(1)

Approach to a patient with tooth problems

(1)

Approach to a patient with a sore throat complaint

(1)

Approach to a patient with a headache

(2)

Approach to a patient with recent head trauma

(4)

Diagnoses

(12)

Eye

Basic Examination

(6)

Snellen chart: 20 feet

(1)

Snellen chart: 15 and 10 feet

(1)

Finger counting test: 3 feet, 2 feet, and 1 foot

(1)

Hand movement test: 3 feet, 2 feet, and 1 foot

(1)

Shine a light from 3 feet away to test light perception

(1)

Snellen chart: with eyeglasses on

(1)

Snellen chart: through pinhole

(1)

Visually inspect pupils in darkened room

(1)

Shine light into pupils

(1)

Observe accommodation-constriction of pupils

(1)

Visually inspect anterior chamber, lens, and iris using slit lamp or direct light

(1)

Administer extraocular eye movements examination

(1)

Test visual field by confrontation

(1)

Perform direct fundoscopic examination

(1)

Advanced Examination

(11)

Approach to a patient with a red eye

(1)

Approach to a patient with scleral/corneal findings

(1)

Approach to a patient with suspected cataract

(1)

Approach to a patient with potential chronic open angle glaucoma

(1)

Approach to a patient with suspected papilledema

(1)

Approach to a patient with yellow/white blotches on the retina

(1)

Approach to a patient with black or pigmented blotches on the retina

(1)

Approach to a patient with red blotches on the retina

(1)

Approach to a patient with diabetes and/or hypertension or vessel changes

(1)

Approach to a patient with periorbital structure abnormalities

(2)

Approach to a patient with strabismus

(1)

Approach to a patient with acute monocular blindness

(3)

Diagnoses

(11)

Cardiology

Basic Examination

(3)

Palpate chest wall

(1)

Auscult chest; note and grade intensity of murmur

(1)

Auscult murmur; note position in cycle and site where it is loudest

(2)

Auscult for radiation

(1)

Advanced Examination

(17)

Approach to a patient with a murmur of equal intensity at base and apex

(1)

Approach to a patient with a systolic murmur loudest at base

(5)

Approach to a patient with a diastolic murmur loudest at base

(1)

Approach to a patient with a diastolic murmur loudest at apex

(1)

Approach to a patient with a systolic murmur loudest at apex

(2)

Approach to a patient with second heart sound splitting

(1)

Approach to a patient with gallop/diastolic sounds

(1)

Approach to a patient with potential peripheral arterial disease

(2)

Approach to a patient with syncope or near syncope

(1)

Approach to a patient with peripheral edema/venous disease

(2)

Approach to a patient with suspected pericardial disease

(2)

Diagnoses

(9)

Chest/Lungs

Basic Examination

(7)

Percuss lung fields

(1)

Feel for tactile fremitus

(2)

Auscult lung fields

101

(1)

Inspect mucous membranes

102

(1)

Observe patient's positioning

102

(1)

Inspect chest wall

103

(1)

Inspect sternocleidomastoid muscles

104

(1)

Inspect thoracic spine

104

(1)

Inspect intercostal muscles

105

(1)

Inspect abdomen for movements during respiration

105

(1)

Visually inspect expectorated sputum

105

(1)

Inspect fingers for signs of clubbing

105

(1)

Advanced Examination

106

(4)

Approach to a patient with consolidation or effusion

106

(1)

Approach to a patient with suspected congestive heart failure

106

(1)

Approach to a patient with obstructive lung disease

107

(3)

Diagnoses

110

(5)

Abdomen

Basic Examination

115

(6)

Auscult abdomen

115

(1)

Perform general visual inspection of abdomen

115

(1)

Palpate abdominal quadrants

116

(3)

Palpate abdomen for rebound tenderness

119

(1)

Perform liver scratch test

119

(2)

Advanced Examination

121

(10)

Approach to a patient with abdominal masses

121

(1)

Approach to a patient with suspected hepatomegaly

122

(1)

Approach to a patient with suspected splenomegaly

123

(1)

Approach to a patient with abdominal pain

124

(2)

Approach to a patient with abdominal enlargement

126

(1)

Approach to a patient with anorectal dysfunction

127

(4)

Diagnoses

131

(7)

Neurology

Basic Examination

138

(15)

Assess strength (power) and/or patterns of weakness in specific muscles

138

(1)

Assess tone during passive range of motion

138

(1)

Check reflexes: wrist extensor, triceps, patellar, Achilles

139

(2)

Perform Jendrassik's maneuver

141

(1)

Perform Romberg's test

142

(1)

Assess arm movements with gait

142

(1)

Assess gait

142

(1)

Test vibratory sensation

143

(1)

Superficial pain assessment

144

(2)

Assess cranial nerves: CN I to XII

146

(7)

Advanced Examination

153

(15)

Approach to a patient with weakness

153

(4)

Approach to a patient with tremor

157

(1)

Approach to a patient with suspected dementia

158

(1)

Approach to a patient with a waddling gait

159

(1)

Approach to a patient with a poker gait

159

(1)

Approach to a patient with a spastic/scissors gait

160

(1)

Approach to a patient with a steppage gait

160

(1)

Approach to a patient with an ataxic, cerebellar gait

160

(3)

Approach to a patient with an ataxic, proprioceptive gait

163

(1)

Approach to a patient with an ataxic, vestibular gait

164

(1)

Approach to a patient with a parkinsonian gait

164

(4)

Diagnoses

168

(9)

Finger, Thumb, Hand, and Wrist

Basic Examination

177

(5)

Test sensation of hands, wrists, and fingers

177

(1)

Observe active abduction of digits

177

(1)

Observe active dorsiflexion of hand at wrist

177

(1)

Test the tip-to-tip ``OK'' sign

177

(1)

Perform active and passive range of motion of all joints

178

(2)

Examine skin color: Allen's test

180

(2)

Advanced Examination

182

(14)

Approach to a patient with finger dysfunction/trauma

182

(3)

Approach to a patient with thumb dysfunction/trauma

185

(3)

Approach to a patient with hand and wrist dysfunction

188

(1)

Approach to a patient with suspected ulnar neuropathy

189

(3)

Approach to a patient with suspected radial neuropathy

192

(1)

Approach to a patient with suspected median neuropathy

192

(4)

Diagnoses

196

(4)

Elbow

Basic Examination

200

(3)

Inspect active and passive range of motion: flexion and extension

200

(1)

Inspect active and passive range of motion, supination, and pronation

200

(1)

Palpate structures in and around elbow

200

(3)

Advanced Examination

203

(4)

Approach to a patient with medial (ulnar) elbow pain

203

(1)

Approach to a patient with posterior elbow pain

204

(1)

Approach to a patient with lateral (radial) elbow pain

204

(3)

Diagnoses

207

(3)

Shoulder

Basic Examination

210

(12)

Inspect and palpate shoulder structures

210

(1)

Passive crank test

210

(1)

Active crank test

210

(2)

Assess the motor function of each nerve root

212

(1)

Observe range of motion in shoulder

212

(1)

Observe active range of motion

213

(5)

Perform Apley scratch test from bottom

218

(3)

Perform Apley scratch test from top

221

(1)

Advanced Examination

222

(6)

Approach to a patient with anterior shoulder pain

222

(1)

Approach to a patient with lateral shoulder pain

223

(2)

Approach to a patient with neck and shoulder pain

225

(3)

Diagnoses

228

(5)

Hip/Back

Basic Examination

233

(4)

Perform active range of motion of the hip

233

(1)

Perform active range of motion of the spine

233

(1)

Observe gait

233

(1)

Inspect erect back

234

(1)

Inspect reversal lumbar lordosis

234

(1)

Palpate structures of hip and back

234

(1)

Percuss spinous processes

235

(1)

Perform Fabere (Patrick's) test

235

(1)

Actively extend knee

236

(1)

Actively dorsiflex foot

236

(1)

Actively plantarflex foot

236

(1)

Test Achilles reflex

236

(1)

Perform sensory examination

236

(1)

Advanced Examination

237

(7)

Approach to a patient with hip trauma

237

(1)

Approach to a patient with hip pain or decreased range of motion, or both

238

(1)

Approach to a patient with lower back pain

238

(3)

Approach to a patient with suspected ankylosing spondylitis

241

(3)

Diagnoses

244

(4)

Knee

Basic Examination

248

(5)

Inspect varus/valgus

248

(1)

Perform a passive range of motion examination

248

(1)

Examine for ballotable patella and bulge sign

248

(1)

Inspect for fluid displacement

248

(2)

Measure Q angle

250

(1)

Locate condyles and anterior tibial spine

251

(2)

Advanced Examination

253

(11)

Approach to a patient with anterior knee pain

253

(1)

Approach to a patient with posterior knee/popliteal fossa complaints

254

(1)

Approach to a patient with medial knee pain

254

(3)

Approach to a patient with lateral knee pain

257

(1)

Approach to a patient with knee laxity/clicking/locking

258

(6)

Diagnoses

264

(6)

Foot/Ankle

Basic Examination

270

(4)

Assess passive range of motion at tibiotalar and subtalar joints

270

(1)

Actively dorsiflex great toe

270

(1)

Actively plantarflex ankle

270

(1)

Actively dorsiflex ankle

270

(2)

Actively evert foot

272

(1)

Actively invert ankle

272

(1)

Inspect anterior compartment muscles

272

(1)

Perform sensory examination of dorsal foot

272

(1)

Perform sensory examination of plantar foot

273

(1)

Check reflexes: Achilles

273

(1)

Advanced Examination

274

(11)

Approach to a patient with foot/ankle trauma

274

(3)

Approach to a patient with an anterior foot complaint

277

(2)

Approach to a patient with lateral midfoot/ankle pain

279

(1)

Approach to a patient with a plantar foot complaint

280

(1)

Approach to a patient with posterior heel/foot pain

280

(2)

Approach to a patient with medial ankle/foot pain

282

(1)

Approach to a patient with lower extremity swelling

283

(2)

Diagnoses

285

(6)

Dermatology

Basic Examination

291

(3)

Visually inspect and palpate skin lesions

291

(3)

Advanced Examination

294

(27)

Approach to a patient with purple lesions

294

(2)

Approach to a patient with pink/red lesions

296

(4)

Approach to a patient with cellulitis

300

(1)

Approach to a patient with a suspected erythema

301

(1)

Approach to a patient with a suspected exanthem

302

(1)

Approach to a patient with nonpigmented, flesh-colored lesions

302

(2)

Approach to a patient with hypopigmented lesions in skin and hair

304

(2)

Approach to a patient with pigmented lesions

306

(2)

Approach to a patient with ulcerating/erosive skin lesions

308

(2)

Approach to a patient with plaque and plaque-like lesions

310

(1)

Approach to a patient with urticaria

311

(1)

Approach to a patient with vesicular lesions

312

(1)

Approach to a patient with bullous lesions

312

(3)

Approach to a patient with pustules/purulent lesions

315

(1)

Approach to a patient with hair loss

316

(1)

Approach to a patient with fingernail and/or toenail complaints

316

(5)

Diagnoses

321

(16)

Gynecology and Obstetrics

Basic Examination

337

(10)

Inspect breast and nipples

337

(1)

Palpate axilla

337

(1)

Palpate breasts

338

(2)

Inspect and palpate external genitalia

340

(2)

Examine vagina and vaginal mucosa using speculum

342

(1)

Examine cervix using speculum

342

(1)

Obtain a Papanicolaou smear

343

(1)

Perform bimanual examination

344

(1)

Examine rectovaginal area

344

(3)

Advanced Examination

347

(5)

Approach to a patient with vulvar/external genitalia lesions

347

(1)

Approach to a patient with urinary incontinence

347

(1)

Approach to a patient with a vaginal complaint

348

(4)

Diagnoses

352

(7)

Male Genitalia

Basic Examination

359

(2)

Palpate scrotum and groin

359

(2)

Advanced Examination

361

(4)

Approach to a patient with scrotal mass or tenderness

361

(1)

Approach to a patient with a penile complaint

361

(4)

Diagnoses

365

(4)

References

369

(2)

Index

371

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Advanced Clinical Skills and Physical Diagnosis, 2nd Edition

Summary

Author Biography

Table of Contents

Supplemental Materials

FREE SHIPPING

Rent More, Save More! Use code: BBRENTAL

5% off 1 book, 7% off 2 books, 10% off 3+ books

Advanced Clinical Skills and Physical Diagnosis, 2nd Edition

Summary

Author Biography

Table of Contents

Supplemental Materials

Digital License