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Book Details
Abstract
A bestselling title for over 25 years, the updated seventh edition of Talley and O’Connor’s Clinical Examination is an essential read for all student clinicians.
Fully updated with the latest clinical data, including specially commissioned research, Clinical Examination addresses the core principles and clinical skills that underpin diagnosis for safe, effective medical practice.
Clinical Examination: A systematic guide to physical diagnosis, 7th edition breaks down each body system into a logical framework focusing on the history, clinical examination and correlation between physical signs and disease for each system. Helping students to navigate from first impressions through to the end of consultation, the text provides a patient-centred, evidence-based approach, making it the definitive resource for anyone embarking upon a medical career.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover\r | Cover | ||
| Clinical Examination: A Systematic Guide to Physical Diagnosis | iii | ||
| Copyright Page | iv | ||
| Table of Contents | vii | ||
| Foreword | v | ||
| Preface | xix | ||
| Acknowledgments | xx | ||
| Clinical methods: an historical perspective | xxiii | ||
| The Hippocratic oath | xxv | ||
| Credits: figures, boxes and tables | xxvi | ||
| SECTION 1: The general principles of history taking and physical examination | 1 | ||
| CHAPTER 1. The general principles of history taking | 3 | ||
| Bedside manner and establishing rapport | 3 | ||
| Obtaining the history | 4 | ||
| Introductory questions | 5 | ||
| Presenting (principal) symptom | 6 | ||
| History of the presenting illness | 6 | ||
| Drug and treatment history | 8 | ||
| Past history | 9 | ||
| Social history | 10 | ||
| Family history | 13 | ||
| Systems review | 14 | ||
| Skills in history-taking | 16 | ||
| References | 16 | ||
| CHAPTER 2. Advanced history taking | 18 | ||
| Taking a good history | 18 | ||
| The differential diagnosis | 18 | ||
| Fundamental considerations when taking the history | 19 | ||
| Personal history taking | 19 | ||
| Cross-cultural history taking | 20 | ||
| The ‘uncooperative’ or ‘difficult’ patient | 21 | ||
| Self-harming and Münchhausen’s syndrome | 22 | ||
| History taking for the maintenance of good health | 22 | ||
| The elderly patient | 23 | ||
| Evidence-based history taking and differential diagnosis | 25 | ||
| The clinical assessment | 25 | ||
| Concluding the consultation | 26 | ||
| References | 26 | ||
| CHAPTER 3. The general principles of physical examination | 28 | ||
| Clinical examination | 29 | ||
| How to start | 29 | ||
| First impressions | 29 | ||
| Facies | 30 | ||
| Weight, body habitus and posture | 33 | ||
| Hydration | 34 | ||
| The hands and nails | 35 | ||
| Temperature | 36 | ||
| Smell | 37 | ||
| Preparing the patient for examination | 37 | ||
| Evidence-based clinical examination | 38 | ||
| Introduction to the OSCE | 40 | ||
| References | 42 | ||
| SECTION 2: The cardiovascular system | 43 | ||
| CHAPTER 4. The cardiovascular history | 45 | ||
| Presenting symptoms | 45 | ||
| Risk factors for coronary artery disease | 52 | ||
| Drug and treatment history | 54 | ||
| Past history | 54 | ||
| Social history | 54 | ||
| Family history | 55 | ||
| References | 55 | ||
| CHAPTER 5. The cardiac examination | 57 | ||
| Examination anatomy | 57 | ||
| Positioning the patient | 60 | ||
| General appearance | 60 | ||
| Hands | 60 | ||
| Arterial pulse | 63 | ||
| Blood pressure | 67 | ||
| Face | 69 | ||
| Neck | 70 | ||
| Praecordium | 72 | ||
| The back | 84 | ||
| The abdomen | 84 | ||
| References | 85 | ||
| CHAPTER 6. The lower limb examination and peripheral vascular disease | 86 | ||
| Examination anatomy | 86 | ||
| Peripheral vascular disease | 87 | ||
| Acute arterial occlusion | 90 | ||
| Deep venous thrombosis | 91 | ||
| Varicose veins | 91 | ||
| References | 92 | ||
| CHAPTER 7. Correlation of physical signs and cardiovascular disease | 93 | ||
| Cardiac failure | 93 | ||
| Chest pain | 94 | ||
| Pericardial disease | 96 | ||
| Systemic hypertension | 97 | ||
| Pulmonary hypertension | 98 | ||
| Innocent murmurs | 99 | ||
| Valve diseases of the left heart | 99 | ||
| Valve diseases of the right heart | 105 | ||
| Cardiomyopathy | 109 | ||
| Acyanotic congenital heart disease | 110 | ||
| Cyanotic congenital heart disease | 112 | ||
| ‘Grown-up’ congenital heart disease | 113 | ||
| References | 114 | ||
| CHAPTER 8. A summary of the cardiovascular examination and extending the cardiovascular examination | 115 | ||
| Extending the cardiovas cularphysical examination | 117 | ||
| SECTION 3: The respiratory system | 127 | ||
| CHAPTER 9. The respiratory history | 129 | ||
| Presenting symptoms | 129 | ||
| Other presenting symptoms | 133 | ||
| Treatment | 134 | ||
| Past history | 135 | ||
| Occupational history | 135 | ||
| Social history | 136 | ||
| Family history | 136 | ||
| References | 136 | ||
| CHAPTER 10. The respiratory examination | 138 | ||
| Examination anatomy | 138 | ||
| Positioning the patient | 138 | ||
| General appearance | 138 | ||
| Hands | 141 | ||
| Face | 142 | ||
| Trachea | 142 | ||
| Chest | 143 | ||
| The heart | 150 | ||
| The abdomen | 150 | ||
| Other | 150 | ||
| References | 151 | ||
| CHAPTER 11. Correlation of physical signs and respiratory disease | 152 | ||
| Respiratory distress: respiratory failure | 152 | ||
| Consolidation (lobar pneumonia) | 152 | ||
| Atelectasis (collapse) | 153 | ||
| Pleural effusion | 154 | ||
| Pneumothorax | 155 | ||
| Tension pneumothorax | 155 | ||
| Bronchiectasis | 155 | ||
| Bronchial asthma | 155 | ||
| Chronic obstructive pulmonary disease | 156 | ||
| Chronic bronchitis | 157 | ||
| Interstitial lung disease (ILD) | 157 | ||
| Tuberculosis | 158 | ||
| Carcinoma of the lung | 158 | ||
| Sarcoidosis | 159 | ||
| Pulmonary embolism (PE) | 159 | ||
| References | 160 | ||
| CHAPTER 12. A summary of the respiratory examination and extending the respiratory examination | 161 | ||
| Extending the respiratory physical examination | 163 | ||
| References | 170 | ||
| SECTION 4: The gastrointestinal system | 171 | ||
| CHAPTER 13. The gastrointestinal history | 173 | ||
| Presenting symptoms | 173 | ||
| Treatment | 180 | ||
| Past history | 180 | ||
| Social history | 180 | ||
| References | 181 | ||
| CHAPTER 14. The gastrointestinal examination | 182 | ||
| Examination anatomy | 182 | ||
| Positioning the patient | 183 | ||
| General appearance | 183 | ||
| Hands | 187 | ||
| Arms | 189 | ||
| Face | 190 | ||
| Neck and chest | 194 | ||
| Abdomen | 194 | ||
| Hernias | 208 | ||
| Rectal examination | 210 | ||
| Proctosigmoidoscopy | 213 | ||
| Other | 214 | ||
| Examination of the gastrointestinal contents | 214 | ||
| Urinalysis | 215 | ||
| References | 217 | ||
| CHAPTER 15. Correlation of physical signs and gastrointestinal disease | 219 | ||
| Examination of the acute abdomen | 219 | ||
| Liver disease | 221 | ||
| Portal hypertension | 221 | ||
| Hepatic encephalopathy | 222 | ||
| Dysphagia | 222 | ||
| Gastrointestinal bleeding | 223 | ||
| Inflammatory bowel disease | 223 | ||
| Malabsorption and nutritional status | 225 | ||
| References | 227 | ||
| CHAPTER 16. A summary of the gastrointestinal examination and extending the gastrointestinal examination | 228 | ||
| Extending the gastrointestinal examination | 230 | ||
| Imaging the gastrointestinal system | 230 | ||
| SECTION 5: The genitourinary system | 237 | ||
| CHAPTER 17. The genitourinary history | 239 | ||
| Presenting symptoms | 239 | ||
| Menstrual and sexual history | 243 | ||
| Treatment | 244 | ||
| Past history | 244 | ||
| Social history | 244 | ||
| Family history | 245 | ||
| References | 245 | ||
| CHAPTER 18. The genitourinary examination | 246 | ||
| Examination anatomy | 246 | ||
| The examination | 246 | ||
| General appearance | 246 | ||
| Hands | 246 | ||
| Arms | 247 | ||
| Face | 248 | ||
| Neck | 248 | ||
| Chest | 249 | ||
| The abdominal examination | 250 | ||
| Rectal and pelvic examination | 251 | ||
| The back | 251 | ||
| Legs | 251 | ||
| Blood pressure | 252 | ||
| Fundi | 252 | ||
| Male genitalia | 252 | ||
| Pelvic examination | 254 | ||
| References | 256 | ||
| CHAPTER 19. A summary of the examination of chronic kidney disease and extending the genitourinary examination | 257 | ||
| Extending the genitourinary examination | 258 | ||
| Reference | 264 | ||
| SECTION 6: The haematological\rsystem | 265 | ||
| CHAPTER 20. The haematological history | 267 | ||
| Haematological disorders | 267 | ||
| Presenting symptoms | 267 | ||
| Treatment history | 268 | ||
| Past history | 269 | ||
| Social history | 269 | ||
| Family history | 269 | ||
| CHAPTER 21. The haematological examination | 270 | ||
| Examination anatomy | 270 | ||
| General appearance | 270 | ||
| Hands | 270 | ||
| Forearms | 272 | ||
| Epitrochlear nodes | 272 | ||
| Axillary nodes | 273 | ||
| Face | 274 | ||
| Cervical and supraclavicular nodes | 275 | ||
| Bone tenderness | 276 | ||
| The abdominal examination | 276 | ||
| Inguinal nodes | 277 | ||
| Legs | 277 | ||
| References | 278 | ||
| CHAPTER 22. A summary of the haematological examination and extending the haematological examination | 279 | ||
| Extending the haematological physical examination | 280 | ||
| SECTION 7: The rheumatological\rsystem | 289 | ||
| CHAPTER 23. The rheumatologicalhistory | 291 | ||
| Presenting symptoms | 291 | ||
| Treatment history | 295 | ||
| Past history | 295 | ||
| Social history | 295 | ||
| Family history | 295 | ||
| References | 296 | ||
| CHAPTER 24. The rheumatological examination | 297 | ||
| Examination anatomy | 297 | ||
| Principles of joint examination | 298 | ||
| Assessment of individual joints | 300 | ||
| References | 326 | ||
| CHAPTER 25. Correlation of physical signs and rheumatological disease | 327 | ||
| Rheumatoid arthritis | 327 | ||
| Seronegative spondyloarthritides | 329 | ||
| Gouty arthritis | 330 | ||
| Calcium pyrophosphate arthritis (pseudogout) | 331 | ||
| Calcium hydroxyapatite arthritis | 331 | ||
| Systemic lupus erythematosus | 331 | ||
| Chest | 333 | ||
| Systemic sclerosis (scleroderma) | 333 | ||
| Rheumatic fever | 336 | ||
| The vasculitides | 336 | ||
| Soft-tissue rheumatism | 336 | ||
| Nerve entrapment syndromes | 340 | ||
| References | 342 | ||
| CHAPTER 26. A summary of the rheumatological examination and extending the rheumatological examination | 343 | ||
| Extending the rheumatological system examination | 344 | ||
| References | 348 | ||
| SECTION 8: The endocrine system | 349 | ||
| CHAPTER 27. The endocrine history | 351 | ||
| Presenting symptoms | 351 | ||
| Past history | 353 | ||
| Social history | 353 | ||
| Family history | 353 | ||
| CHAPTER 28. The endocrine examination | 355 | ||
| The thyroid | 355 | ||
| The pituitary | 362 | ||
| The adrenals | 366 | ||
| References | 370 | ||
| CHAPTER 29. Correlation of physical signs and endocrine disease | 371 | ||
| Calcium metabolism | 371 | ||
| Osteoporosis and osteomalacia | 373 | ||
| Syndromes associated with short stature | 374 | ||
| Hirsutism | 375 | ||
| Gynaecomastia | 376 | ||
| Diabetes mellitus | 377 | ||
| Paget’s disease | 382 | ||
| References | 383 | ||
| CHAPTER 30. A summary of the endocrine examination and extending the endocrine examination | 384 | ||
| The endocrine examination: a suggested method | 384 | ||
| Extending the endocrine physical examination | 384 | ||
| SECTION 9: The nervous system | 391 | ||
| CHAPTER 31. The neurological history | 393 | ||
| Presenting symptoms | 393 | ||
| Past health | 397 | ||
| Medication history | 398 | ||
| Social history | 398 | ||
| Family history | 398 | ||
| References | 399 | ||
| CHAPTER 32. The neurological examination: the cranial nerves | 400 | ||
| Examination anatomy | 400 | ||
| General signs | 400 | ||
| The cranial nerves | 401 | ||
| Head and neck | 427 | ||
| References | 428 | ||
| CHAPTER 33. The neurological examination: speech and higher centres | 430 | ||
| Examination of speech | 430 | ||
| The cerebral hemispheres | 432 | ||
| References | 435 | ||
| CHAPTER 34. The neurological examination: the peripheral nervous system | 436 | ||
| Limbs and trunk | 436 | ||
| References | 461 | ||
| CHAPTER 35. Correlation of physical signs and neurological syndromes and disease | 462 | ||
| Upper motor neurone lesions | 462 | ||
| Lower motor neurone lesions | 464 | ||
| Motor neurone disease | 464 | ||
| Peripheral neuropathy | 464 | ||
| Guillain-Barré syndrome (acute inflammatory polyradiculoneuropathy) | 465 | ||
| Multiple sclerosis | 465 | ||
| Thickened peripheral nerves | 466 | ||
| Spinal cord compression | 466 | ||
| Important spinal cord syndromes | 466 | ||
| Myopathy | 470 | ||
| Dystrophia myotonica | 470 | ||
| Myasthenia gravis | 471 | ||
| The cerebellum | 473 | ||
| Parkinson’s disease | 475 | ||
| Other extrapyramidal movement disorders (dyskinesia) | 478 | ||
| The unconscious patient | 478 | ||
| References | 481 | ||
| CHAPTER 36. A summary of the neurological examination and extending the neurological examination | 483 | ||
| Diagnostic testing | 486 | ||
| CHAPTER 37. The psychiatric history and mental health examination | 491 | ||
| Obtaining the history | 491 | ||
| The mental state examination | 499 | ||
| The diagnosis | 499 | ||
| References | 504 | ||
| SECTION 10: Specialty examinations | 505 | ||
| CHAPTER 38. The eyes, ears, nose and throat | 507 | ||
| Eyes | 507 | ||
| Ears | 516 | ||
| Nose and sinuses | 520 | ||
| Mouth and throat | 522 | ||
| Common investigations | 526 | ||
| References | 528 | ||
| CHAPTER 39. The breasts | 529 | ||
| Examination anatomy | 529 | ||
| History | 529 | ||
| Examination | 530 | ||
| Evaluation of a breast lump | 531 | ||
| References | 532 | ||
| CHAPTER 40. The skin, nails and lumps | 533 | ||
| Examination anatomy | 533 | ||
| Dermatological history | 533 | ||
| General principles of physical examination of the skin | 535 | ||
| How to approach the clinical diagnosis of a lump | 536 | ||
| Correlation of physical signs and skin disease | 537 | ||
| The nails | 550 | ||
| References | 553 | ||
| CHAPTER 41. A system for the infectious diseases examination | 554 | ||
| Pyrexia of unknown origin | 554 | ||
| HIV infection and AIDS | 556 | ||
| References | 559 | ||
| CHAPTER 42. Assessment of the geriatric patient | 560 | ||
| History taking in geriatric patients: special considerations | 560 | ||
| Physical examination in geriatric patients: special considerations | 562 | ||
| References | 564 | ||
| CHAPTER 43. Assessment of the acutely ill patient | 565 | ||
| Initial assessment | 565 | ||
| Level of consciousness | 567 | ||
| Further examination | 567 | ||
| References | 568 | ||
| CHAPTER 44. Assessment of death | 569 | ||
| Assessment | 569 | ||
| Informing relatives | 570 | ||
| Completing the death certificate | 570 | ||
| Postmortem | 570 | ||
| Organ donation | 570 | ||
| APPENDIX I: Writing and presenting the history and physical examination | 571 | ||
| History | 571 | ||
| Physical examination (PE) | 571 | ||
| Provisional diagnosis | 571 | ||
| Problem list and plans | 572 | ||
| Continuation notes | 572 | ||
| Presentation | 572 | ||
| Suggested reading | 573 | ||
| APPENDIX II: A suggested method for a rapid screening physical examination | 574 | ||
| Hands and arms | 575 | ||
| Face | 575 | ||
| Front of the neck | 575 | ||
| Chest | 575 | ||
| Back of the chest and neck | 575 | ||
| Abdomen | 575 | ||
| Legs | 575 | ||
| Neurological examination | 575 | ||
| Completing the examination | 575 | ||
| APPENDIX III: The pre-anaesthetic medical evaluation (PAME) | 576 | ||
| The history | 576 | ||
| The examination | 577 | ||
| Index | 578 |