The Physical Examination: An Atlas for General Practice

Having the privilege of editing the English language version of this book I have found the detailed thought, explanation and step-by-step instruction that this book provides most refreshing and stimulating. There are few publications indeed that provide a completely reliable companion to bedside and out-patient instruction for the medical student - and even fewer that enhance the established physician's techniques. Medical skills in the art and science of patient examination are normally learnt experimentally - time, personal instruction and constant repetition are necessary for them to be acquired. Even then it must be admitted by many that there are some techniques that are never fully understood, properly learnt or correctly concluded - and these errors are liable to a lifetime's repetition. This volume with its excellent photographs and illustrations takes the reader clearly and incontrovertibly step-by-step through every detail of all the procedures necessary for the standard forms of examination of a patient. It is a companion for every student and doctor who wishes to learn fully and completely these necessary skills and to improve the ones they already have. Dr Alexander D. G. Gunn, Director, University Health Service, Reading, Berks, UK 1982 Preface to the Dutch edition The idea of writing this book coincided almost them a superficial acquaintance with five or six exactly with the establishment of a 'skills 'fashions' and proficiency in none of them.

Content.- A Basic skill.- A 1 The technique of inspection.- A 2 The technique of auscultation.- A 3 The technique of percussion.- A 4 The technique of palpation.- B Basic examinatio.- B 1 Inspection of the body shape, posture and movement.- B 2 Inspection of the skin and mucous membranes.- B 3 Evaluation of the nutritional and hydration state.- B 4 Palpation of the skin.- B 5 Evaluation of the pulse.- B 6 Measurement of the blood pressure.- B 7 Evaluation of respiration.- B 8 Measurement of height and weight.- B 9 Measurement of length and weight of an infant.- B 10 Measurement of the body temperature rectally.- C Examination of the nervous syste.- C 1 Various aspects.- C 2 Signs of meningitis.- C 3 The twelve cranial nerves.- C 3.1 The olfactory and optic nerves.- C 3.2 The oculomotor, trochlear and abducens nerves.- C 3.3 The trigeminal nerve.- C 3.4 The facial and vestibulocochlear nerves.- C 3.5 The glossopharyngeal nerve, vagus, accessory and hypoglossal nerves.- C 4 Examination of the upper extremity.- C 4.1 The motor function of the arm.- C 4.2 The sensations of the arm.- C 4.3 The reflexes of the arm.- C 4.4 Coordination tests for the arm.- C 5 Examination of the lower extremity.- C 5.1 The motor function of the leg.- C 5.2 The sensations of the leg.- C 5.3 The reflexes of the leg.- C 5.4 Coordination tests for the leg.- C 6 Examination of the trunk.- C 6.1 The motor function of the trunk.- C 6.2 The sensations of the trunk.- C 6.3 Some trunk reflexes.- C 7 Short neurological examination.- D Examination of separate parts of the bod.- D 1 Examination of the head.- D 1.1 Inspection of the shape of the head.- D 1.2 Palpation of the skull.- D 1.3 Percussion of the skull.- D 1.4 Measurement of the circumference of the skull.- D 1.5 Inspection of the scalp.- D 1.6 Palpation of the lymph glands in the neck.- D 2 Examination of the eyes.- D 2.1 Inspection of the eyelids.- D 2.2 Inspection of the conjunctiva.- D 2.3 The fluorescein test.- D 2.4 Inspection of the cornea.- D 2.5 Inspection of the iris and lens.- D 2.6 Inspection of the fundus.- D 2.7 Inspection of the eye movement.- D 2.8 Assessment of the eye muscles.- D 2.9 Some eye reflexes.- D 2.10 Vision and colour vision.- D 2.11 The field of vision.- D 2.12 The intra-ocular pressure.- D 2.13 The lachrymal system.- D 3 Examination of the mouth and throat.- D 3.1 Inspection of the teeth.- D 3.2 Percussion of the teeth.- D 3.3 Inspection of the tongue.- D 3.4 Testing of taste.- D 3.5 Inspection of the mucous membranes.- D 3.6 Palpation of the cheeks.- D 3.7 Palpation of the floor of the mouth.- D 3.8 Inspection of the palate.- D 3.9 Palpation of the palate.- D 3.10 Inspection of the pharynx.- D 3.11 Inspection of the larynx.- D 3.12 Palpation of the larynx.- D 3.13 Examination of the voice.- D 4 Examination of the nose.- D 4.1 Inspection of the external nose.- D 4.2 Palpation of the external nose.- D 4.3 Inspection of the internal nose.- D 4.4 Palpation of the adenoids.- D 4.5 Percussion of the sinuses.- D 4.6 Palpation of the sinuses.- D 4.7 Examination of olfactory sense.- D 4.8 The patency of the nose.- D 5 Examination of the ears.- D 5.1 Inspection of the ear.- D 5.2 Palpation of the cartilage and external meatus of the ear.- D 5.3 Percussion of the mastoid process.- D 5.4 Palpation of the mastoid process.- D 5.5 Evaluation of hearing.- D 5.6 The whisper test.- D 5.7 The tuning fork examination.- D 5.8 Screening audiometry.- D 5.9 Assessment of the Eustachian tubes.- D 6 Examination of the head and neck.- D 6.1 Inspection of the neck.- D 6.2 Palpation of the cervical vertebrae.- D 6.3 Palpation of the glands in the neck.- D 6.4 Palpation of the common carotid artery.- D 6.5 Palpation of the thyroid gland.- D 6.6 Measurement of the circumference of the neck.- D 6.7 Auscultation of the common carotid artery.- D 6.8 Auscultation of the thyroid gland.- D 6.9 Evaluation of the functioning of the cervical portion of the spinal column.- D 7 Examination of the thorax.- D 7.1 Inspection of the skin of the thorax.- D 7.2 Inspection of the shape of the thorax.- D 7.3 Palpation of the thorax.- D 7.4 Measurement of the thorax circumference.- D 7.5 Percussion of the lungs.- D 7.6 Auscultation of the lungs.- D 7.7 Respiratory movements and expansion of the lungs.- D 7.8 Determination of the boundary between the lungs and the liver.- D 7.9 Inspection of the heart region.- D 7.10 Palpation of the heart region.- D 7.11 Percussion of the heart region.- D 7.12 Auscultation of the heart region.- D 7.13 Central venous pressure.- D 7.14 Circulation time.- D 7.15 Recording an electrocardiogram.- D 7.16 Examination of the breasts.- D 7.17 Palpation of the axilla.- D 8 Examination of the abdomen.- D 8.1 Inspection of the abdomen.- D 8.2 Auscultation of the abdomen.- D 8.3 Percussion of the abdomen.- D 8.4 Palpation of the abdomen.- D 8.5 Palpation of the liver and gall bladder.- D 8.6 Palpation of the spleen.- D 8.7 Palpation of the other intra-abdominal organs and structures.- D 8.8 Palpation of the groin.- D 8.9 Rectal examination.- D 9 Examination of the internal and external genitalia.- D 9.1 Secondary sexual characteristics.- D 9.2 Inspection of the pubic hair.- D 9.3 Inspection of the female external genitalia.- D 9.4 Palpation of the labia majora.- D 9.5 Speculum examination.- D 9.6 Preparation of a cervical smear.- D 9.7 Vaginal examination.- D 9.8 Inspection of the male external genitalia.- D 9.9 Palpation of the penis.- D 9.10 Palpation of the scrotum.- D 10 Examination of a pregnant woman.- D 10.1 Inspection of the vulva and vagina.- D 10.2 Palpation of the pelvic cavity.- D 10.3 Determination of the position of the uterine fundus.- D 10.4 Position of the fetus in utero.- D 10.5 Auscultation of the fetal heart sounds.- D 11 Examination of the trunk.- D 11.1 Inspection of the trunk at rest.- D 11.2 Palpation of the trunk.- D 11.3 Inspection of the active movements of the trunk.- D 11.4 Palpation of the moving trunk.- D 11.5 Passive movements of the trunk.- D 11.6 Some specific trunk function tests.- D 12 Examination of the arm.- D 12.1 Examination of the peripheral circulation of the arm.- D 12.2 Measurement of the circumference of the arm.- D 13 Examination of the shoulder girdle.- D 13.1 Inspection of the shoulders at rest.- D 13.2 Palpation of the shoulders at rest.- D 13.3 Inspection of the active movements of the shoulder.- D 13.4 Palpation of the moving shoulder.- D 13.5 Passive movements of the shoulder.- D 14 Examination of the elbow.- D 14.1 Inspection of the elbow at rest.- D 14.2 Palpation of the elbow at rest.- D 14.3 Inspection of the active movements of the elbow.- D 14.4 Palpation of the moving elbow.- D 14.5 Passive movements of the elbow.- D 15 Examination of the wrist, hand and fingers.- D 15.1 Inspection of the hand at rest.- D 15.2 Palpation of the hand at rest.- D 15.3 Inspection of the active movements of the hand.- D 15.4 Palpation of the moving hand.- D 15.5 Passive movements of the hand.- D 16 Examination of the leg.- D 16.1 Peripheral circulation in the leg.- D 16.2 Examination of the veins.- D 16.3 Measurement of the leg circumference.- D 16.4 Evaluation of the gait.- D 17 Examination of the hip.- D 17.1 Inspection of the hip at rest.- D 17.2 Palpation of the hip at rest.- D 17.3 Inspection of the active movements of the hip.- D 17.4 Palpation of the moving hip.- D 17.5 Passive movements of the hip.- D 17.6 Some specific hip function tests.- D 18 Examination of the knee.- D 18.1 Inspection of the knee at rest.- D 18.2 Palpation of the knee at rest.- D 18.3 Inspection of the active movements of the knee.- D 18.4 Palpation of the moving knee.- D 18.5 Passive movements of the knee.- D 18.6 Some specific knee function tests.- D 19 Examination of the ankle, foot and toes.- D 19.1 Inspection of the ankle, foot and toes at rest.- D 19.2 Palpation of the ankle, foot and toes at rest.- D 19.3 Inspection of the active movements of the ankle, foot and toes.- D 19.4 Palpation of the moving ankle, foot and toes.- D 19.5 Passive movements of the ankle, foot and toes.- A Basic skills.- B Basic examination.- C Examination of the nervous system.- D Examination of separate parts of the body.