By Lynn S Bickley; Peter G Szilagyi; Barbara Bates
Read Online or Download Bates' pocket guide to physical examination and history taking PDF
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Extra resources for Bates' pocket guide to physical examination and history taking
Dentition good. Tongue midline, with 3 × 4 mm shallow white ulcer on red base on undersurface near tip; tender but not indurated. Tonsils absent. Pharynx without exudates. Neck. Neck supple. Trachea midline. Thyroid isthmus barely palpable, lobes not felt. Lymph Nodes. Small (<1 cm), soft, nontender, and mobile tonsillar and posterior cervical nodes bilaterally. No axillary or epitrochlear nodes. Several small inguinal nodes bilaterally, soft and nontender. Thorax and Lungs. Thorax symmetric with good excursion.
Genitalia. External genitalia without lesions. Mild cystocele at introitus on straining. Vaginal mucosa pink. Cervix pink, parous, and without discharge. Uterus anterior, midline, smooth, not enlarged. Adnexa not palpated due to obesity and poor relaxation. No cervical or adnexal tenderness. Pap smear taken. Rectovaginal wall intact. qxd 9/3/08 2:29 PM Page 25 Clinical Reasoning, Assessment, and Recording Your Findings 25 Rectal. Rectal vault without masses. Stool brown, negative for occult blood.
Last chest x-ray, 1986, St. Mary’s Hospital; unremarkable. Cardiovascular. No known heart disease or high blood pressure; last blood pressure taken in 2003. No dyspnea, orthopnea, chest pain, palpitations. Has never had an electrocardiogram (ECG). Gastrointestinal. Appetite good; no nausea, vomiting, indigestion. Bowel movement about once daily, *though sometimes has hard stools for 2 to 3 days when especially tense; no diarrhea or bleeding. No pain, jaundice, gallbladder or liver problems. qxd 9/3/08 2:29 PM Page 23 Clinical Reasoning, Assessment, and Recording Your Findings 23 Urinary.