bed |S RD dIJNSLNL ae ONCE we eae LIBIdISIAN CRU ee Ci aD) Cc) DPSS ny es US WELL LS BS eeBATES’ Guide to Physical Examination AND HISTORY TAKING NINTH EDITION Lynn S. Bickley, MD Professor of Internal Medicine and Neuropsychiatry Texas ‘Tech Health Sciences Center Lubbock, Texas Peter G. Szilagyi, MD, MPH Professor of Pediatrics Chief, Division of General Pediatrics University of Rochester School of Medicine and Dentistry Rochester, New York PR recor winwaMs & WauxINs Aint ews Grgiy Danan "Bate «New ok ann Soest tangas Spey = TaeSevier Acquisions Edinr: Elizabeth Nieginski Ant Diner, Mlatrations: Brett MacNaughton, Serie Deeieoenal Baier Renee Gagliardi Interior Ubatrater: Ae Rains ‘Seno Predation Edo: Sanda ChesreyScheinin Marsfocuring Manager: William Alberti ‘SesorProduston Manager: Helen Ewan, Indes: Alesandea Nickerson, “Monagig Eciter]Prodvction: Eka Kors (Conpositr-Circle Graphics An Dinter: Joan Wendt Priner:R.R. Donneliey-Willard ‘Sth Edition Copyright © 2007 by Lippincom Williams & Wilkins. Copyright © 2003, 1999 by Lippincott Willams & Wilkin. Copyright © 1995, 1991, 987, 1983, 1979, 1974 by}.B. Lippincott Comp:ny All sights reserved, Tis book is protected by copyright. Nopartofitmaybe reproduced, sored ina rebel stern oF trained. in any form or by my mana - electronic, mechanical, photocopy, recording, or otherwise - without prior writen permission ofthe publisher, exept for bi quotaons embodied in itl ares and reviews and testing and evaluiion matcls rowed by poblheroinsmactors whose schols have adopted acompaning extnook Printed inthe United States of America, For {nfoumaion ite Lioineom Wiliams & Wilkin, 530 Wain Steet, Philadelphia PA 19106 Copyright © 2007, N. Sebiskveradze “Teanslation into Georgian ‘Published byarrangement with Lippincott Williams & Wilkins" Mates appeatingin this book prepared by individuals as part of ther offical duties as US, Goverment employees are not covered by the above-mentioned copyright. 937634321 Library of Congress Cataloging-in-Publication Data Biddy Lynn. bate gesewopbyel examination an history aing-9h ed. Lyn. Bile eter G. Szilagyi. p.iem Includes biblograpscal references andindex. ISBN 0-7817-6718-0 (alk. paper) 1. Physical diagnosis. 2 Medical history taking I. Seagyi, Peter G.I, Bates, Barbara, 1928-2001. I. Tile. IV. Tite: Guide to physical examination andhistory taking [DNLM: 1, Physical Examination-methods. 2. Medical History Taking-methods. WB 205 5836 2007), RC76.B38 2007 61607 54-de22 2005023366sJNSLAL JENGAIJIAN ‘ svdMJINIIAL x bIFZIdISISN eng . angen 3989A 3. LENTOBIN1. 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WB Sounders. 2005, Moore Kl, Daley AF, Rgur ANA, Cinically Oriented Anotomw, Sth 24. Bakimore, Uppincott Wilms & Usikins, 2006, MEDICINE, SURGERY AND GERIATRICS, Bailey H, Coin A (eds). Homiton Bailey's Demonstrations of Physical Signs in Cinco! Sxgery. 17th ed, Grstl, UK, Wrighe 1986, Borker LR, Burton JR, Zieve PD (eds). Principles of Ambulatory ‘Medicine, 6th ed, Philodelphio, Lippincott Wiltoms & Wikins 2003. Brunicord FC Sehworte St (eds). Schuort'sPrncoles of Surgery, 8th ed. New York, McGrow. Hil Medico, 2005, osselC, Lejpaig Al, Cohen HJ, Lorson €6, Meier DE, Goritric ‘Medicine: fin Evidence-bosed Rpprocch, ath ed. New York. Springer 2008 Cecil Fl, Goldmon L.Avsello DA. Cec Textbook of Medicine, 22nd ‘ed. Phiodephio, WS Sounders, 2004. Hozzord WR, Principles of Geriatric Medicine ond Gerontology, 5th ed, New York, M«Grows Hil Profession, 2008. Kosper DL, Horizon TR (eds), Hovsison's Principles of Internal ‘Medicine, 1éth ed. New York, McGrow-Hil, 2005, ‘Mandell Gt. Essential Fits of Infectious Diseoses, 3d ed Phiodel pio, Current Medcine, 2004 Mandell GL, Gordon 8, Bennett J€, Doin R (eds). Monde ooa00 8 Doug los, ond Bennet’ Principles and Praxtce of infectious Diseoses. 6th ed. Philocelphio, Esevier-Churchil Uvingstone, 2008. Mondell Gt Nildven D, los of AIDS, 3rd ed. Philadelaho, Current Medicine, 2001 ‘Orient JM, Sopiro 1D (eds). Sopira's At & Science of Beckie Diognoss, 3rd e6, Phiodelphio, Lppinccet Wiloms & Wilkens, 2005, Tounsond CM, Sobiston DC (ed). Sabiston Textbook of Surgery The BiologiolBosis oF Madern Surgical Prostce, 17thed, Phlodelphio, sever WB Sounders, 2004, oungkin €9, Davis MS, Women's Heoth:F Primary Core Clinical Guide, 3rd ed. Upper Saddle River, NJ, Peorson/Prentice Holl, 2008, HEALTH PROMOTION AND COUNSELING Agency for Healthcare Research ond Quality. Ginilan's Hondbook of Preventive Services: Put Prevention late Proctice, Bnd ed, Rucilable et: Aepi/husinu onepr.gou! liniclppiphond. htm, Re-cessed Moy 15, 2005. Fmerion Pubs Health Fssociotion, Pubic Heakh Links (For publi heath professionals). Acie ot http: uwuLopho org) pubic health Feessed Moy 16, 2005, AlvesteinD. Preventive services: mmuriaction ond chemoprevention, Geriotrcs 60:35-39, 2008. Netional Guideline Cleotinghouse. Agency fo Heothcore Research end Quolty (AHAQ), Avotoble ot tp unwasohea govktini’ ps3dichtm Pecessed Moy 1S, 2005. Notional Quolty Measures Cleeringhouse. Agency Tor Heaitrcore Research ond Quality (AHAQ), Avoilcbie ot: hetp/uruns ‘quokrymecsutes.ohvg.gou. Pecessed Moy 15, 9005 US. Preventive Servces Task Force. Guide to Cisco Preventive Services, 3¢d ed, Avolloble ot: httpfiuxsuzohra gavin! «ps3dia, tm. Recessed My 15. 205. Zimmerman Fk; meron eodemy of Fomily Physons Advisory Committee on Immunization Prastices, American College of Ob-stetriions ond Gynecologists, The 2004 recommended ‘du im-munizetion schedule. Fm Fom Physcion 68:2453. 12456, 2008. senaerone a2anzeNe enamonca> 2eNENsDAN edeMsIC29Nb eHme 2X96dHNICMIONG ALSMANS Te ae pen bd ghn Buaagncn> n, acdnhesPs Bahyb36> 075 63362895 % > 85. shyBa, = Bbdnor eoyahecsh>0 Bshoad 89> tne. ase nb aijbnarénls brbgmerin Byron 852 OshxayG> Gpy6o8y5 SmyBn- sh ohoo 38> ynbhnby76, sh shab ensbesmeshn. 239090. ian magegin RoBnareneze, brengbn9e%. sh she {shesso gabe 4386207610 goh8>. Bas9c0, B3{s6n, sshyre abmhszhIC% EsEadzha, 83h13963. astm sa0hs698 | ‘bond EsEeaaqeeb Izhelogscgagnd bensbmds: shos eagadyemb> 36 bndyaho33, ‘candcab B5peaen 768, Oshy336> 290605» bsbby. 4noy mba, aba6ygB> 162- 1 $apBron shxa36> 6ys6e> aro.bers6. y096a e> oAhyBeybA sh nbnGyD> 3h Sho pfnbsggen 6y96-Osenb syeIbrd BphdBmd30mo> Leainjghin mhgobingdn, gahgeo aa6agsechn Gnesdm estons630nb y2h783. 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B36 srezhn bysazbn. ohn, sbhmababs bse Seancdn, chm es ean Bh336n CIM) Boomer 9989 $5309 Bahancde: UBhsay4 scashSsunren Berhamabntb30n Sphdbmb ios “anon: hyaeypozine Baboeneaeindith Board (ome RoEsE3hab gsagennda ha bron 1) ekoges bros gps 36 2) fmghdn Fs6sbsen: hams 3b Sayre es B9hx3649 gedrbsboe arBarhoe Fo€sbaybos 63F306300, Be = Iwrubsen. 36 Grhascsha, sesboerynhainb bases sEsbosse mb. 39 633 220900 sensnsann esems2ea9nU-V>a2~2030KSNOCAMOHISNS ee ANATOMY AND PHYSIOLOGY Agur AMA, Dolley AF. Gront JC, Boileau JC. Gren’ Atlos of Arotomy, Ith ed. Phiodelphio, Uppincott Uiioms & Wikins, 2005, Berne AM. Physiology, Sth ed. St.Louis, Mosby, 2008, Buje LM, Krueger GA, Netter FH. Netter’ Ilustroted Humon Pathology. Teterboro, NJ, Ikon Learning Systems, 2005. Gray H, Stoncring 5, Elis, H, Berkovite BKB, Groy’s Fnctomy: The Anotomicol Bosis of Clinic! Proctice, 39th ed. New York, lsever-Churchill Uvingstone, 2005, Guyton AC. Hall JE, Textbook of Medical Physiology, ith ed. Phlodelphio, WB Sounders, 2005, ‘Moore KL Dalley Ff gue AM, Clnicoly Oriented Anatomy, Sth ed. Baltimore, Lippincott Wiioms & Uikins, 2006. MEDICINE, SURGERY AND GERIATRICS Boiley H, Clin A (eds). Homiton Boley's Demonstrations of Phys-al Signs in Cincol Surgery, 17th ed, Brito, UK, right, 1986. Borker \R, Gurton JA, Zieve PD (eds). Principles of Ambulatory Medicine, 6th ed. Philadelphia, Lippincott Willams & Wilkins, 2003 Bruicorc FC, Schworz SI (eds). Schwons's Principles of Surgery, ‘8th ed. New York, MeGrow Hil Medico, 2005. ossei, Leipzig AM, Cohen HJ, Lorson €8, Meier DE. Geriatric ‘Medicine: An Evidence-besed Approach, ath ed. New York, Springer, 2003, Cecil Al, Gotdmon L, Ausiello DA. Cec Textbook of Medicine, 28nd ‘ed, Phiedelphio, WB Sounders, 2004 Hoz20rd WR. Principles of Geriatric Medicine ond Gerontology, Sth ed. New York, MeGrow-Hil Professionol 2008. Kosper DL, Horison TA (eds). Horison's Principles of Interrol ‘Medicine, 6th ed. 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