BATES’ Guide to Physical Examination History Taking AND THIRTEENTH EDITION Lynn S. Bickley, MD, FACP Clinical Professor of Internal Medicine School of Medicine University of New Mexico Albuquerque, New Mexico Peter G. Szilagyi, MD, MPH Professor of Pediatrics and Executive Vice-Chair Department of Pediatrics University of California at Los Angeles (UCLA) Los Angeles, California Richard M. Hoffman, MD, MPH, FACP Professor of Internal Medicine and Epidemiology Director, Division of General Internal Medicine University of Iowa Carver College of Medicine Iowa City, Iowa Guest Editor Rainier P. Soriano, MD Associate Professor of Medical Education, Geriatrics and Palliative Medicine Brookdale Department of Geriatrics and Palliative Medicine Associate Dean of Curriculum and Clinical Competence Icahn School of Medicine at Mount Sinai New York, New York Acquisitions Editor: Crystal Taylor Development Editor: Andrea Vosburgh Freelance Development Editor: Kelly Horvath Editorial Coordinator: Emily Buccieri Editorial Assistant: Parisa Saranj Marketing Manager: Phyllis Hitner Senior Production Project Manager: Alicia Jackson Team Lead, Design: Stephen Druding Art Director, Illustration: Jennifer Clements Illustrator: Body Scientific International Photography: Thibodeau Media Group Manufacturing Coordinator: Margie Orzech Prepress Vendor: Aptara, Inc. Thirteenth Edition Copyright © 2021 Wolters Kluwer. Copyright © 2017 Wolters Kluwer. Copyright © 2013, 2009 by Wolters Kluwer Health/Lippincott Williams & Wilkins. Copyright © 2007, 2003, 1999 by Lippincott Williams & Wilkins. Copyright © 1995, 1991, 1987, 1983, 1979, 1974 by J. B. Lippincott Company. All rights reserved. This book is protected by copyright. No part of this book may be reproduced or transmitted in any form or by any means, including as photocopies or scanned-in or other electronic copies, or utilized by any information storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews. Materials appearing in this book prepared by individuals as part of their official duties as U.S. government employees are not covered by the above-mentioned copyright. To request permission, please contact Wolters Kluwer at Two Commerce Square, 2001 Market Street, Philadelphia, PA 19103, via email at [email protected], or via our website at shop.lww.com (products and services). 9 8 7 6 5 4 3 2 1 Printed in China Library of Congress Cataloging-in-Publication Data Names: Bickley, Lynn S., author. | Szilagyi, Peter G., author. | Hoffman, Richard M., author. | Soriano, Rainier P., editor. Title: Bates’ guide to physical examination and history taking / Lynn S. Bickley, Peter G. Szilagyi, Richard M. Hoffman ; guest editor, Rainier P. Soriano. Other titles: Guide to physical examination and history taking Description: Thirteenth edition. | Philadelphia: Wolters Kluwer, [2021] | Includes bibliographical references and index. | Summary: “The thirteenth edition of Bates’ Guide to Physical Examination and History Taking is your comprehensive guide to learning to effectively conduct the health interview and physical examination. This section introduces you to the features and learning tools that will lead to successful health assessments, regional examinations, and working with special patient populations. At the start of every chapter, you will see a list of additional learning resources that complement the book in order to build your knowledge and confidence in history taking and examination. The Bates’ Visual Guide to Physical Examination offers over more than 8 hours of video content and delivers head-to-toe and systems-based physical examination techniques. When used alongside the book, you have a complete learning solution for preparedness for the boards and patient encounters”– Provided by publisher. Identifiers: LCCN 2020019448 | ISBN 9781496398178 (paperback) Subjects: MESH: Physical Examination–methods | Medical History Taking–methods Classification: LCC RC76 | NLM WB 205 | DDC 616.07/54–dc23 LC record available at https://lccn.loc.gov/2020019448 This work is provided “as is,” and the publisher disclaims any and all warranties, express or implied, including any warranties as to accuracy, comprehensiveness, or currency of the content of this work. This work is no substitute for individual patient assessment based upon healthcare professionals’ examination of each patient and consideration of, among other things, age, weight, gender, current or prior medical conditions, medication history, laboratory data and other factors unique to the patient. The publisher does not provide medical advice or guidance and this work is merely a reference tool. Healthcare professionals, and not the publisher, are solely responsible for the use of this work including all medical judgments and for any resulting diagnosis and treatments. Given continuous, rapid advances in medical science and health information, independent professional verification of medical diagnoses, indications, appropriate pharmaceutical selections and dosages, and treatment options should be made and healthcare professionals should consult a variety of sources. When prescribing medication, healthcare professionals are advised to consult the product information sheet (the manufacturer’s package insert) accompanying each drug to verify, among other things, conditions of use, warnings and side effects and identify any changes in dosage schedule or contraindications, particularly if the medication to be administered is new, infrequently used or has a narrow therapeutic range. To the maximum extent permitted under applicable law, no responsibility is assumed by the publisher for any injury and/or damage to persons or property, as a matter of products liability, negligence law or otherwise, or from any reference to or use by any person of this work. shop.lww.com This book is dedicated to you, the ever-constant student, teacher, and practitioner of this continuously evolving art and science of medicine. Faculty Reviewers and Additional Contributors GEORGE A. ALBA, MD Instructor, Pulmonary and Critical Care Medicine Department of Medicine Massachusetts General Hospital Harvard Medical School Boston, Massachusetts CATHERINE A. BIGELOW, MD Maternal-Fetal Medicine Subspecialist Minnesota Perinatal Physicians Allina Health Minneapolis, Minnesota Y. JULIA CHEN, MD Clinical Fellow Department of Pediatric Surgery Johns Hopkins University School of Medicine Baltimore, Maryland SUZANNE B. COOPEY, MD Assistant Professor, Harvard University Faculty of Medicine Division of Surgical Oncology Massachusetts General Hospital Boston, Massachusetts CHRISTOPHER T. DOUGHTY, MD Instructor, Neurology Department of Neurology, Division of Neuromuscular Disorders Harvard Medical School/Brigham and Women’s Hospital Boston, Massachusetts RALPH P. FADER, MD Child and Adolescent Psychiatry Fellow Department of Psychiatry New York-Presbyterian New York, New York RAISA GAO, MD, FACOG Assistant Professor Department of Obstetrics, Gynecology, and Reproductive Science Icahn School of Medicine at Mount Sinai New York, New York SARAH GUSTAFSON, MD Assistant Clinical Professor, Pediatrics Division of Pediatric Hospital Medicine, Harbor-UCLA David Geffen School of Medicine at UCLA Los Angeles, California ALEXANDER R. LLOYD, MD Resident Physician Department of Physical Medicine and Rehabilitation University of Pittsburgh Medical Center Pittsburgh, Pennsylvania CHRISTOPHER C. LO, MD Instructor Stein and Doheny Eye Institutes, Department of Orbital and Oculofacial Plastic Surgery University of California at Los Angeles Los Angeles, California S. ANDREW MCCULLOUGH, MD Assistant Professor, Clinical Medicine Assistant Director, Graphics Laboratory Department of Medicine, Division of Cardiology Weill Cornell Medicine New York, New York MATTHEW E. POLLARD, MD Fellow, Male Reproductive Medicine and Surgery Scott Department of Urology Baylor College of Medicine Houston, Texas KATELYN O. STEPAN, MD Fellow, Head and Neck Surgical Oncology and Microvascular Reconstruction Otolaryngology—Head and Neck Surgery Washington University School of Medicine in St. Louis St. Louis, Missouri JOSEPH M. TRUGLIO, MD, MPH Assistant Professor of Internal Medicine, Pediatrics and Medical Education Program Director, Internal Medicine and Pediatrics Residency Departments of Internal Medicine and Pediatrics Icahn School of Medicine at Mount Sinai New York, New York ADDITIONAL CONTRIBUTORS PAUL J. CUMMINS, PhD Assistant Professor, Medical Education Department of Medical Education, The Bioethics Program Icahn School of Medicine at Mount Sinai New York, New York ROCCO M. FERRANDINO, MD, MSCR Resident Physician Department of Otolaryngology—Head and Neck Surgery