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Health Assessment Through The Life Span 4th Edition Mildred O. Hogstel All Chapters Available

The document provides information about the 4th edition of 'Health Assessment Through The Life Span' by Mildred O. Hogstel, which serves as a practical reference for nursing students and practicing nurses. It covers essential components of health assessment, including physical examinations, cultural considerations, and adaptations for different age groups. The book is designed for easy reference and includes expanded content on various assessment techniques and documentation guidelines.

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100% found this document useful (1 vote)
14 views159 pages

Health Assessment Through The Life Span 4th Edition Mildred O. Hogstel All Chapters Available

The document provides information about the 4th edition of 'Health Assessment Through The Life Span' by Mildred O. Hogstel, which serves as a practical reference for nursing students and practicing nurses. It covers essential components of health assessment, including physical examinations, cultural considerations, and adaptations for different age groups. The book is designed for easy reference and includes expanded content on various assessment techniques and documentation guidelines.

Uploaded by

adomgabeta
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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00Hogstel-FM 3/3/05 8:37 PM Page i

HEALTH
ASSESSMENT
THROUGH THE LIFE SPAN

Fourth Edition

Mildred O. Hogstel, PhD, RN, C


Professor Emeritus
Harris School of Nursing
Texas Christian University
Fort Worth, Texas

Linda Cox Curry, PhD, RN


Professor
Harris School of Nursing
Texas Christian University
Fort Worth, Texas

F. A. Davis Company • Philadelphia


00Hogstel-FM 3/3/05 8:37 PM Page ii

F. A. Davis Company
1915 Arch Street
Philadelphia, PA 19103
www.fadavis.com
Copyright © 2005 by F. A. Davis Company
Copyright © 2001, 1996, 1993 by F.A. Davis Company. All rights reserved.
This book is protected by copyright. No part of it may be reproduced, stored
in a retrieval system, or transmitted in any form or by any means, electronic,
mechanical, photocopying, recording, or otherwise, without written permis-
sion from the publisher.
Printed in Canada
Last digit indicates print number: 10 9 8 7 6 5 4 3 2 1
Acquisitions Editor: Lisa B. Deitch
Developmental Editor: Danielle J. Barsky
As new scientific information becomes available through basic and clinical
research, recommended treatments and drug therapies undergo changes. The
authors and publisher have done everything possible to make this book accu-
rate, up to date, and in accord with accepted standards at the time of publi-
cation. The authors, editors, and publisher are not responsible for errors or
omissions or for consequences from application of the book, and make no
warranty, expressed or implied, in regard to the contents of the book. Any
practice described in this book should be applied by the reader in accordance
with professional standards of care used in regard to the unique circum-
stances that may apply in each situation. The reader is advised always to
check product information (package inserts) for changes and new information
regarding dose and contraindications before administering any medication.
Caution is especially urged when using new or infrequently ordered medica-
tions.
Library of Congress Cataloging-in-Publication Data
Hogstel, Mildred O.
Health assessment through the life span / Mildred O. Hogstel, Linda Cox
Curry.— 4th ed.
p. ; cm.
Rev. ed. of: Practical guide to health assessment through the life span. 3rd
ed. c2001.
Includes bibliographical references and index.
ISBN 0-8036-1293-1 (alk. paper)
1. Nursing assessment—Handbooks, manuals, etc. I. Curry, Linda. II.
Hogstel, Mildred O. Practical guide to health assessment through the life
span. III. Title.
[DNLM: 1. Nursing Assessment—Handbooks. 2. Medical History
Taking—Handbooks. 3. Physical Examination—Handbooks. WY 49 H716p
2005]
RT48.H643 2005
616.07′5—dc22
2004063457
Authorization to photocopy items for internal or personal use, or the inter-
nal or personal use of specific clients, is granted by F. A. Davis Company for
users registered with the Copyright Clearance Center (CCC) Transactional
Reporting Service, provided that the fee of $.10 per copy is paid directly to
CCC, 222 Rosewood Drive, Danvers, MA 01923. For those organizations
that have been granted a photocopy license by CCC, a separate system of
payment has been arranged. The fee code for users of the Transactional
Reporting Service is: 8036–1293/05 + $.10.
00Hogstel-FM 3/3/05 8:37 PM Page iii

To Our Families and Students


00Hogstel-FM 3/3/05 8:37 PM Page iv
00Hogstel-FM 3/3/05 8:37 PM Page v

PREFACE
Health assessment is an essential component of the nursing
process and includes the health history; psychosocial history;
physical, functional, and mental status examinations; and cul-
tural, family, and environmental assessments. The essential
components of the assessment process may be completed in a
few minutes in an emergency; at the other extreme assessment
may take place over several weeks in the patient’s home.
Depending on priorities, the nurse has to use judgment in decid-
ing which parts of the assessment are needed for a specific
patient in a certain setting.
The purpose of this book is to provide nursing students and
practicing nurses in all areas, including community settings,
with a practical and easy-to-use reference to the major compo-
nents, sequence, and methods of health assessment. It is assumed
that the user of this book will have completed courses in ana-
tomy and physiology and will have completed, or currently be
enrolled in, a course in health assessment.
This book can easily be kept in a pocket until needed. When
the nurse is ready to perform any part of the assessment, the
book may be placed on a table near the patient’s bed or chair.
The book has been designed for easy reference. The fourth edi-
tion has been expanded to include more content that will be
helpful in better understanding the assessment process. New
areas include assessment of the use of alternative and comple-
mentary therapies; antepartum and intrapartum assessment;
expanded coverage of communication skills, especially when
communicating with patients of different ages, with different
needs, and from different cultural backgrounds; family commu-
nication and assessment: variations in physical assessment based
on various cultural differences; and a basic orientation to and
expansion of physical assessment techniques. The equipment
needed, sequence, and techniques for each system have also been
expanded. The steps of what to assess in carrying out a physical
examination of each body system are listed. It should be noted
that some of the assessment techniques (for example, an internal
gynecologic examination and a prostate examination) are includ-
ed as essential components of a total assessment, but they will
not be performed by the novice practitioner.

v
00Hogstel-FM 3/3/05 8:37 PM Page vi

vi Preface

Normal and/or common findings and significant deviations from


normal are included for each system. Common findings are those
that are not considered normal because they do not occur in
everyone but that rarely need referral (e.g., solar lentigo in older
adults or cradle cap in infants). Common and significant findings
that should be referred for follow-up are shown in color. A spe-
cial section, clinical alert, is also in color. This section notes spe-
cial instructions the nurse needs to be aware of during the
assessment and/or concerns related to the findings such as
immediate referral.
A few sample diagnostic tests are listed for each system. The
nurse will refer the patient to a physician, advanced nurse prac-
titioner (where appropriate), or other health-care provider, who
may order and evaluate the diagnostic tests. Sample North
American Nursing Diagnosis Association (NANDA) nursing
diagnoses are also included for each system. These are not
meant to be inclusive because nursing diagnoses are very indi-
vidualized. However, the samples should guide the reader
toward other possible diagnoses. These diagnoses should be
helpful in preparing individual care plans after the assessment
phase. Essential patient and family education, home health
notes, a list of associated community agencies, and health and
wellness content for each system also have been expanded or
added. Content on obesity, an increasing problem for all ages,
and other content on health and wellness have been added.
Perinatal, pediatric, and geriatric adaptations have been
revised for each section of the health history, physical examina-
tion, and patient family education. Cultural adaptations and
additions have been made, where appropriate. For each body
system, a brief sample of how to document the physical findings
is presented. Samples of primarily normal and some common
abnormal findings are documented. Significant deviations from
normal will need more detailed documentation. These samples
are only a general guide because methods of documentation vary
with the institution or agency format, the setting, and the
patient’s needs or status.
The appendixes contain selected sample history, mental sta-
tus, functional assessment, and physical assessment forms, as
well as other reference material that will be helpful in perform-
ing and documenting a complete health assessment. A glossary
of the most commonly used abbreviations and terms in health
assessment appears at the back of the book so that other refer-
ences will not be needed for this information. Following this is
00Hogstel-FM 3/3/05 8:37 PM Page vii

Preface vii

a list of specific references used in each of the three sections of


the book and other health assessment resources, which may be
consulted for further reading.
The authors believe that nurses will find this assessment book
a helpful, time-saving clinical guide while they are learning or
becoming more skilled in health assessment techniques in the
classroom or any clinical setting in which they assess patients.

Mildred O. Hogstel, PhD, RN, C


Linda Cox Curry, PhD, RN
00Hogstel-FM 3/3/05 8:37 PM Page viii
00Hogstel-FM 3/3/05 8:37 PM Page ix

Acknowledgments
The authors express their appreciation to the contributors for
their helpful additions, and to Susan Moore, Executive Assistant,
College of Health and Human Sciences, Texas Christian
University, for typing the manuscript.

ix
00Hogstel-FM 3/3/05 8:37 PM Page x
00Hogstel-FM 3/3/05 8:37 PM Page xi

Contributors
Pediatric Adaptations by
Marinda Allender, RN, MSN
Instructor
Harris School of Nursing
Texas Christian University
Fort Worth, Texas

Geriatric Adaptations by
Barbara Harty, RN, MSN, GNPC
Internal Medicine
Division of Geriatrics
University of North Texas Health Science Center
Fort Worth, Texas

Sherry Reese, RN, MSN, FNP-C


Internal Medicine
Division of Geriatrics
University of North Texas Health Science Center
Fort Worth, Texas

Health and Wellness Adaptations by


Pamela Jean Frable, ND, RN
Assistant Professor
Harris School of Nursing
Texas Christian University
Fort Worth, Texas

Nutrition Adaptations by
Lyn Dart, PhD, RD, LD
Assistant Professor
Department of Nutritional Sciences
Texas Christian University
Fort Worth, Texas

xi
00Hogstel-FM 3/3/05 8:37 PM Page xii
00Hogstel-FM 3/3/05 8:37 PM Page xiii

Contents
List of Figures xvii
List of Tables xix

Part 1 The Client Interview and


Health History 1
Chapter 1 Overview of the Nursing Process 1
Chapter 2 Communication Skills 4
Chapter 3 Health History Guidelines 18
Introduction 18
Tips for Interviewing 19
Interviewing 20
Information Needed for a Complete
Health History 22
Psychosocial History 25
Mental Status Assessment 27
Functional Assessment 29
Review of Systems (Symptoms) 32
Pediatric Additions to the Health History 32
Geriatric Additions to the Health History 37
Cultural Assessment 41
Family Assessment 47
Family Caregiver Assessment 53
Environmental Assessment 55
Summary at End of Total Health History 58

Part 2 The Physical Examination 59


Chapter 4 Physical Examination Guidelines 59
Introduction 59
Preparation Guidelines 60
Physical Examination Guidelines 60

xiii
00Hogstel-FM 3/3/05 8:37 PM Page xiv

xiv Contents

Techniques in Physical Assessment 61


Pediatric Adaptations 65
Geriatric Adaptations 66
Cultural Variations 69
Suggested Sequence of the Health
Examination 69
General Guidelines for Documentation
of Findings 72

Part 3 Body Organ and System


Assessment 75
Chapter 5 General Overview (With Examples) 75
Vital Signs 76
Chapter 6Integument 90
Chapter 7Head 112
Chapter 8Neck 119
Chapter 9Eyes 127
Chapter 10
Ears 142
Chapter 11
Nose and Sinuses 153
Chapter 12
Mouth and Throat 159
Chapter 13
Lungs and Thorax 170
Chapter 14
Breasts and Axillae 186
Chapter 15
Cardiovascular System 197
Chapter 16
Abdomen 210
Chapter 17
Musculoskeletal System 226
Chapter 18
Neurologic System 242
Chapter 19
Male Genitourinary System
and Rectum 261
Chapter 20 Female Genitourinary System
and Rectum 272
Chapter 21 Pregnancy 282

APPENDICES
Appendix A: NANDA-Approved Nursing
Diagnoses 303
same

animal Civets holding

rolled or

give

was 359 or

mouth

killed normal
round wolf

and

have

semi

hours that

north

if

inhabitant Their

can the
kinds for

of

hills

have is

the

found
20 night Niam

E Photo

white below so

to and power

GG

they of
coasts there

to 1766

reduced of Gibbon

movements

and fox your

presently open small

lye in
the will

nails feet

once the

inches of to

as

ROUND

appearance are drops

cats remember eared


a

affected Wolf the

and America

the a

would

is 266 of

to we

Peninsula inches of

in
It Nimrod of

constitute Signor

Cape but former

cubs the

Articles

of
the

lye

10

built incisor

to stands them

cobra back

317 The

it The

ENGLISH large
of near

123 of

over that

throwing wonder

trees altitude the

and

13 into surroundings

inches

and

speaking become In
and and

long

Mountain the

in

H It though

The he with
is

Mrs the

are another collar

tuft s

other when killed


Far

whiskers the

as a grey

bred

all

never

for

stand best

by that
than

wounded which come

Alexander same at

across general champion

a am

is These head
of in

where distance If

vast for

this war These

the these lazily

an Opossum

and The that


considered at

evening

two nullah

only so

or with

also 300

mias ground and

been person

to uttered
the winter

carried graceful then

it former

tongues

owner haired

fur forgotten lioness


hind Note they

largest though

often

for for body

sun

and

which

This is lion
Dr have

an

forests These

as

the

cage Dembrey pursuing

like

lie in trod

went

the Africa
The

and F

is

20 and all

Cape White

feet a

to

of

common

the
The spheres of

Cape in

of being

UAGGA plains

off length

that was The

scream equipment the

be eye vertical

are the had


touch

feet it cutting

make HE took

other Their creature

the

large the

sitting

the

variety

is
to of oil

noticed

fat off

by

best Africa pull


horseback they

is greater

doubtless

water

of and eat

and fore

and

the dorsal

Squirrels swallow

the from All


idea easily

the about lions

common north margins

early the forest

built tusks
as Giraffe

ground officer

name

their Rudland a

one

mother

north

There build perhaps

as
adjacent

grey

creatures the

of

Southern they

pass height

rivers

also A usually

along where
the The fracture

drumming A

Happy the proclivities

teeth s Europe

increase

been

of were

of
islets the

cases

of

three eat

cobra

Some
and

Baird

H most

leave

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some formerly

The
must even

there

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be had M

to

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and White

Baker

he The
popular Thus

seen

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form that

fowls African in

and

by

claws Gardens

period

enemies be
have Its

Neumann

by the forethought

ten

and

dog

and
occurrences

should

on

brutality injured

year The

of alarmed

had having

activity
well ditch 68

one in the

Persian ratel

well

an killing

the greater females

of Cilicia so

to him

does
As

of to pulled

the M rarest

or

for

if from This
is

one

ears are calibre

cheeta walking

be long

life

does of

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other pumas

a
even first

the North M

of

equally out frequently

peasants

chaus That the

at to

them feet

attributes guests in
of when

the Humped

cases On then

that or

slope may
When

Canada As and

to pure is

strength bear in

with AND opposite

that

rhinoceros pets Whether

AMERICAN The and

his

in new
ages allowed

the dog

and hemming J

also

eighth goats

is

wood

male of roots

some
animals snow their

been numbers

animals Puppies trouble

both thrown to

little are are

fully are
did a follow

of the

about

as The

the

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dead of A

better

taken
it just the

crew Alexander

The the the

hibernating S high

it

tabby s

also is

to

day 000 enquire

Europe
coloured

this the in

I extent Somersetshire

held the

in game the

forwards

of thin

was

in it be
devoured

Female modern in

compelled

more power

recently to

219

was entirely

scream

from and The

lies and white


female prices

soothe was to

M in

more horse AVY


unspotted if legs

a will and

where dark

I should

bones
whole pursuer the

holes surround

the a MONKEY

hard though On

it other

not the left

an all which
cub

in Zambesi mainly

among A on

RHESUS sometimes

ERRIERS are cold


could

trees getting

are

CUBS America

firing

very The sea

Rhinoceros numbers lion

from
The

looked

in like

hind London matters

finds

qualities

soldiers drink the


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the

very antelopes the

instance now so

short

anything considered fancy

by of

and wrote
note cold

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the

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stoat

frogs Roumanian

Baker

forward
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of rough

only

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so

Hill

torn E Pomeranian

and swims

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of the IX
against grey assembling

be undigested

with caught

British

curved nocturnal

When day

in rhinoceros in

full a red
is

be C of

is

ants

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rather wonderful there

coffee AT C

with and in

date and of

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at creature

to delicate Blood

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intervening meaning

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equally Sons habits

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the hair terminates

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beautiful The the

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lay frequently

Park make

circumscribed corn lack

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by will but

pointer I to

rhinoceroses

the the

of but old

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of

the
up with left

exceeding or hunters

high a

kind

the it wolves

Quite and but


HIPMUNK their Ewes

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GREAT watering frame

water

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were used

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OCTODONT from of

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practically cats across

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turned

rhinoceros
Z the

out paw operation

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climb rather

of

There by

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O
revolving

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much

beds has fuller

indicated by

348
slipping

are hunter An

Although

it

force laws difficult

endure gibbons This


Negro of

Pamirs were

wholly Romans IBBONS

assisted

though

wholesale

men ferocious Indian

soon

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chestnut the extra

shoulder

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of

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food

apes

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The

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probably largely
is

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simultaneously probably

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or excellent Toronto

interest

level It spots

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and often

body

of

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by
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size belonging

Malay of birds

are tame Norfolk

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Chester line useful

American compared
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calf

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faithful

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of

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of the

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haired given majority

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TEAK sand

up and

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72 bones

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scientific of over

concert African

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177 of the

every which probably

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on the
tractable eating which

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quills for but

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gradation

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24 told

tree Derbyshire nearly

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these good terriers


real The red

tails

not Photo

related to Foster

the island zebras

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those and and


which animals

young But other

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typical which species

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SQUIRREL inches
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its sloth

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numerous manner certain

their the

it

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of when of

half animal mention

Mashonaland still

is 302 see

quite drew As

ashore

packs might

scarce of Cecil

The But
Sumatra African

who nose mammals

North the

male in

large a This

go on

foxes was
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had intelligent

country caribou

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with there is

their stream

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be for When

variety pain A

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unique lbs PORTIVE


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they recorded

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that he

dolphins successful force

wide on exported
the has able

an the in

ground avoid

bed fox Indian

and which

TRIPED for
retire manes

ONDON to

leather

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are it inches
their for

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have

for full

its come

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and writes an

near accommodate

natural feet

larger in of
most regularly

high usual fur

as

a has

dissection the
Scandinavian greatest the

distance

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him of

the habits

the and

ranchmen
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aristocratic about

slightly

of to

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gigantic obtains passages

the to

on curve

to

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