Clinical Examination: A Practical Guide in Medicine Harmanjit Singh Hira
INDEX
Page numbers with f and t indicate figure and table, respectively.
A
Abdomen 470, 471, 474
of humans 23
Abdominal
hair 23, 24
muscles 65
organs 197f
pain 8, 187, 188, 361
reflex 303, 306
swelling 188
Abducens nerve 277, 279
Abnormal
EKG 165
hemoglobins 146
nipple discharge 422
RV motion 151
urine color 361
Absorption tests 494
Accentuating normal chest excursion 85
Accessory muscles 63
Achilles
tendon 307
tendonitis 412
Acid urine 240
Acidemia 110
Acne vulgaris 435, 437, 439f
Acquired causes of cauda equina syndrome 325
Acrocyanosis 372
Acromioclavicular syndrome 409
Acute
anterior wall infarct 173f
bowel
infarction 461
obstruction 209
chest pain 128
cranial-facial trauma 337
glomerulonephritis 147
lymphoblastic leukemia 355, 357, 387f
lymphocytic leukemia 361, 366, 370f, 374
monoarthritis 407
myeloblastic leukemia 387f
myelocytic leukemia 357
myeloid leukemia 361, 364, 373
myocardial infarction 166, 167, 173
pancreatitis 190, 192, 193f, 240
polyarthritis 408
pyelonephritis 235
renal failure 232, 234
rheumatic fever 157, 162
Addison's disease 43, 47, 146
Adductor tendinitis 411
Adrenaline 132
Adrenocorticotropin 494
Adventitious
lung sounds 105f
sounds 98
Age of menopause 8
Agnogenic myeloid metaplasia/myelofibrosis 359
Agranulocytosis 378
Alanine aminotransferase 219
Alkalemia 110
Alkaline phosphatase 218, 223, 224, 496
Allen test 106
Alopecia 191
areata 14, 23, 24
Alpha
fetoprotein 217, 492
waves 332f
Aminophylline 132
Aminotransferases 223, 224, 492
Ammonia 219, 492, 498
Amphoric breathing 93, 97
Anal
carcinoma 196
inflammatory lesion fissure 196
wink reflex 303, 306
Analysis of
arterial blood gases and acid-base disorders 106, 108
urine sample 238
Anarthria 268
Ancillary signs 325, 326
Androgenic hair 23
Anemia 188, 190, 354, 355, 361, 371
Aneroid manometer 18f
Angina pectoris 1
Anion gap acidosis 113
Anisocoria 276
Ankle
clonus 306
dorsiflexion 296, 302
jerk 310f
joints 407
plantar flexion 296, 302
Ankylosing spondylitis 413
Anosognosia 326
Anserine bursitis 412
Antalgic gait 268
Anterior muscle 301
Anti-mitochondrial antibodies 223, 224
Anuria 228
Aortic
dissection 5, 146
regurgitation 146
stenosis 131, 157
Aortography for renal artery stenosis 244
Aphasia 268
Aphonia 268
Appendicitis 461
Arachnodactyly 147
Argyll Robertson
pupil 325
sign 146
Arm
edema 30, 32
span 21
Armpit hair 23
Arrhythmias 131
Arterial
bruit 145, 209
pulse 136, 137
Arthralgia 397
Arthrogram of left shoulder joint 417f
Arthrography 414, 416
Arthroscopy 417
of shoulder joint 417f
Articular bones 395
Ascites 191, 194
Ash-leaf spots 261f
Aspartate aminotransferase 219
Assessment of
arterial pulse 138
nipple discharge 426
range of motion 402
Asymmetric septal hypertrophy 131
Ataxia 326, 372
Ataxic gait 267
Athetosis 301, 303
Athlete's foot 435, 438
Atrial
fibrillation 131, 171
flutter 167, 171
myxoma 154
relaxation 144
septal defect 145
tachycardia 167, 171, 171f
Atrioventricular nodal re-entrant tachycardia 172f
Atropine 132
Auscultation 78, 93, 154, 162
of abdomen 208f
Auscultatory percussion of chest 102
Austin flint murmur 157, 159
Automated blood count 379
Autonomic nervous system 258, 490
Avascular necrosis of hands 416f
Axillary hair 23
B
Babinski’s
reflex 306
sign 303, 306, 312, 326
Bacteremia 461
Bacterial
endocarditis 147
flora 241
meningitis 332
Baldness 23, 24
Ballottement of
knee joint 400
patella 406
Band
keratopathy 43, 4748f
in nails 25, 28
Barest Flicker of movement of muscle 293, 296
Barrel chest 79
Basal
cell carcinoma 441f
ganglia 255f, 341, 343
Basic biometrics measurement 14, 21
Beau's lines 25, 28, 28f
Bedside PFT 106, 108
Beevor's sign 306, 314f, 490
Bell tympany 99, 101
Benediction hand 326
Benedikt's syndrome 322, 322f
Benign rectal ulcer 196
Berger's wave 335
Beta waves 334f
Bicarbonate concentration 494
Biceps reflex 308, 310f, 311
Bicipital tendonitis 409
Big goiter 45f
Bigeminal pulse 140
Bilateral pedal edema 372
Bile synthesis 217
Biliary
disorders 461
ductal system 189, 223
type pain 189
Bilirubin 217, 223, 224, 492
Bimanual palpation 199, 201, 487
of kidney 235, 236f
of right kidney 201f
of spleen 203f
Bing sign 306, 326
Biot's respiration 447
Bisferiens pulse 140
Bleeding
disorders 188
gums 361
time 389, 394, 497
Blister 22, 432, 434, 435
Bloating 187
Blood
brain barrier 249, 246
film 376, 379
pH 238
pressure 17, 141
supply of heart 123, 125
urea nitrogen 237
Bloody discharge from nipple 426f
Blue urine 239
Body
fluids 492t
hair 14, 22
Bone
density 419
marrow
aspirate 386f
aspiration and biopsy 381, 384
biopsy 389
examination 390
failure 355, 359, 361, 368, 371, 376
of thoracic cage 58, 61
Bony
developmental abnormality 146, 147
overgrowth of joints 401
Bouchard's nodes 403f, 456
Bowel sounds 207
Brachial pulse 137
Brachioradial delay 140
Brachioradialis reflex 309, 310f, 311
Brain 246, 253
Brawny edema 32
Breast 8, 13, 456, 457, 482
buds 474
cancer 421, 425, 426
disease 425
enlargement 43
Breathing swings 83
Bronchial
asthma 102, 103
sounds 93, 96
Bronchiectasis 102, 103
Bronchography 118, 120
Bronchophony 97, 98
Bronchoscopy 118
Bronchovesicular sounds 93, 97
Brown-Sequard
lesion 322
syndrome 323
Brudzinski sign 316, 316f, 318
Brushfield spots 468
Bucket handle movement 62f
Bulge sign 406
Bulging eyes 8
Bundle branch block 167
Burning feet 258
C
Café au lait spots 260, 261
Calciferols 494
Calcinosis cutis 14, 435, 439
Calcitonin 494
Calcium 237, 238
Caput medusae 194, 194f, 198f
Carbon monoxide 492
Carboxyhemoglobin 496
Carcinoid
hands 29
syndrome 146
Cardiac
axis 163, 164
catheterization and cine-angiography 176, 180
Cardiovascular
disorders 128
system 8, 10, 123, 232, 234, 481, 485
Carey Coombs murmur 157, 159
Carotid
artery palpation 151, 153
bruits 453
pulse 137
Carpal tunnel
induced atrophy 294f
syndrome 303, 336
Catecholamines 495
Cauda equina
nerves 323f
syndrome 323, 325
Causes of
cauda equina syndrome 325
dyspnea 71t
hemoptysis 70f
sinus tachycardia 139
and bradycardia 139t
Cavernous bronchial sound 93
Central
cyanosis 146
nervous system 246
venous pressure 14, 142, 144, 144f
Cephalohematoma 474
Cephaloplegia 318
Cerebellar function 472
Cerebellum 255, 263, 314, 490
Cerebral function 472
Cerebrospinal fluid 246, 249, 492t
Cerebrum 253
Cervical
and axillary lymph nodes 85, 86
cancer 8
venous hum 142, 145
Chaddock sign 326
Charcot-Marie-Tooth disease 262
Chart for visual acuity 264
Cherry red color of hands 29
Chest
hair 23
pain 9, 67, 69, 128
shape 79
skiagram 175
wall pain 70
Cheyne-Stokes breathing 447
Chilblain on tips of toes 443f
Cholangiography 223, 225
Choledocholithiasis 225
Cholestatic liver disease 216
Chorea 301, 303
Chronic
bronchitis 102, 103
chest pain 128
eosinophilic leukemia 359
granulocytic leukemia 386f
inflammation 32
leg edema 32
lymphocytic
leukemia 355, 358, 361, 367, 374
leukemic cells 387f
monoarthritis 407
myelogenous leukemia 355, 357, 359
myeloid leukemia 361, 365, 373
myeloproliferative diseases 359
neutrophilic leukemia 359
pancreatitis 190, 223f
polyarthritis 408
renal failure 234, 234f, 235
venous stasis 32
Chvostek's sign 30, 31, 191, 326
Cingulate gyrus 341, 343, 344f
Circulatory function tests 493t
Cirrhosis of liver 196
Classification of common adventitious lung sounds 100
Clonus 306, 308
Clotting time 389, 394
Clubbing 25, 26, 147
and hypertrophic pulmonary osteoarthropathy 73, 74
Coagulation tests 388, 392
Cogan sign 326
Coin test 99, 101
Cold palms 29
Collecting ducts 226
Color of normal urine 239
Complete
blood count 376
urinalysis 239
Complications of NG tube 213
Computed
abdominal tomography 223, 225
tomography 118, 119, 215
Concentration and dilution test 496
Condition of vessel wall 140
Conduction system of heart 123, 126
Confusion 229, 231, 372
Congenital causes of cauda equina syndrome 325
Congestive heart failure 131, 196
Conjunctiva 45
Conjunctival vessels 369
Connective tissue disease 41
Consciousness 349, 351
Constipation 11, 187
Continuous
adventitious lung sounds 99
murmurs 157, 160
Conventional tomography 118
Coombs’ test 389
Corneal
and conjunctival reflexes 303, 306
arcus 146
reflex test 445, 446
Coronary
artery
angiography 176, 180
calcification 179f
disease 128, 131
disease 128
vasospasm 128
Corpus callosum 254f, 344
Corrigan or water-hammer pulse 140
Cortical
release reflexes 458
sensory system 288, 289, 488
Costochondritis 128
Cough 7, 67
impulse 197199
Cranial nerves 256, 263, 269, 458, 459, 472, 488
C-reactive protein 413
Creatinine 238
Cremasteric reflex 303, 306
Crystal-induced synovitis 417
CSF glucose level 333
Cullen's sign 192, 193f
Cushing's syndrome 43, 46, 47f
Cyanocobalamin 391, 393
Cyanosis 73, 145, 483
of nail beds 31f
Cyclic citrullinated peptide 413
D
D’Espine's sign 93, 97
Dalrymple's sign 326
De Quervain's tenosynovitis 410
Deep
breath test 106
inguinal lymph nodes 30
limbic system 341, 342
palpation 199, 200, 486
reflexes 472
respirations signify acidemia 232
tendon reflexes 306, 307, 309, 312, 474
Dehydration 33, 232
Delta waves 333f
Demonstration of
ankle clonus 311f
patellar clonus 311f
Silhouette sign of heart 118f
Dermatitis herpetiformis 191
Dermatome
of upper arm 292f
testing 291
Determination of glomerular filtration rate 241, 242
Dexa scan 420
Diabetes mellitus 240, 493
Diabetic
foot 43, 47
ulcer 47f
Diaphragm 63, 76, 77
Diaphragmatic excursion 91, 93
Diarrhea 11, 187
Diastolic murmur of
aortic regurgitation 159
of mitral stenosis 157, 159
Dicrotic pulse 140
Diencephalon 255
Different
layers of skin 430f
tendon reflexes 306
Diffuse distal sensory loss 290
Digestive system 8, 10, 183, 482
Digital clinical thermometer 15
Direct
antiglobulin test 389, 389f
bilirubin 218
Coombs’ test 388f, 389
Discontinuous adventitious lung sounds 99, 100
Disease of joint capsule 409f
Dissection of thoracic aorta 128
Dissociated sensory loss 322
Distal interphalangeal joints 399, 401f, 456
Distention of right internal jugular vein 14
Distinctive types of musculoskeletal involvement 399
Distribution of affected joints 399
Doll's eye
maneuver 326
reflex 445, 446
Doppler ultrasound 176
Dorsal column dysfunction 289
Dorsalis pedis
artery 138f
pulse 137, 138
Down syndrome 149, 149f
Downward displacement of tricuspid valve 144
Duke method 497
Dupuytren's contracture of hands 14, 29, 29f
Dysarhythmia 314
Dysarthria 268, 314, 317
Dysdiadochokinesis 314, 316
Dysmenorrhea 8
Dysphagia 11, 268
Dysphonia 268
Dyspnea 9, 10, 67, 71, 127
Dysrhythmia 316
Dystonias 303
Dysuria 8, 228, 229
E
Ecchymosis 22, 193f, 435, 436
Eczema atopic 444
Edema 10
distribution 32
of right foot 33f
Egophony 97, 98
Ehlers-Danlos syndrome 146
Ejection fraction 493
Elbow
extension 296, 300
flexion 296, 300
joints 404
Electrolytes 492
Elicitation of
abdominal reflex 305f
Babinski's sign 313
cremasteric reflex 305f
edema with pressure of thumb 233f
flapping tremors 34f
fluid thrill 206f
Hoffman reflex 313f
nystagmus 278f
Romberg's sign 284f
Eliciting
of Achilles tendon reflex 307f
patellar reflex 308f
Emphysema 102, 103
End-diastolic volume 493
Endocrine system 8, 13, 43, 482
Endoscopic
retrograde cholangiopancreatography 223
ultrasonography 223, 225
End-systolic volume 493
Enlarged urinary bladder 197
Enlargement of lymph nodes 372
Enthesis 396
Epidermis 430
Epistaxis or gum bleeding 372
Epithelial cells 239
Erect anteroposterior projection 116
Erysipelas 435, 442
Erythema
and warmth of joint 400
marginatum 149, 149f, 162f
nodosum 191
of joint 400f
Erythematous skin 193
Erythrocyte 496
sedimentation rate 378, 381, 413
Erythrocytosis 25
Erythropoietin 492
Escape rhythms 166, 167
Esophagus 184
Essential thrombocythemia 359
Excessive daytime sleepiness 67, 72
Excretory urography 241, 242
Exophthalmos 8
External
anatomy of heart 124f
genitalia 235
jugular distention 14
Extraocular muscles 445
F
Facial
hair 23
nerve 280
Facioscapulohumeral muscular dystrophy 336
Fascicular block 167, 169, 170f
Fasciculations 301, 303
Fatigue 189, 229, 231, 398
Fatty acid 498
Fecal
occult blood test 213
urobilinogen 218
Female
genitalia 470, 471
reproductive system 456, 457
sexual dysfunction 258
Ferritin 492
Fever 232
Fiberoptic
bronchoscopy 121
endoscopy 212, 213
Fibrillations 301, 303
Fibrosis fremitus 104
Field's stain 383
Finger nose test 314f
First heart sound 154
Flail chest 79, 82
Flapping tremors 30, 34, 73, 74
Flexors of fingers 296, 300
Fluid thrill 206
Fluoroscopy 118
Folic acid 389, 392
Follicle-stimulating hormone 495
Foot hair 23, 24
Forced
expiratory
time 108
volume time 106, 107
vital capacity 106
Friction rub 207, 209, 487
Frozen shoulder 409
Function of basal ganglia 341
Fundus
in glaucoma 275
of myopic eyes 275
Fundoscopy 272
Funnel shaped sternum 82f
Funny bone distribution 301
G
Gait 265, 316
Gallbladder 184, 196
Gamma-glutamyl transferase 219
Gastric
carcinoma 196, 381
juice 494
outlet obstruction 197
peristalsis 197, 199
Gastrointestinal
system 183, 232, 234
tests 494t
Genital tract disease 228
Gerbode's defect 145
Giemsa stain 383
Glabellar reflex 304f
Glasgow coma scale 448
Glia 246
Glomerulonephritis 135
Glossopharyngeal nerve 286
Glucagon 495
Glucose 492
Glycosuria 240
Goiter 8
Golfers elbow 410
Gouty tophi of distal interphalangeal joints of toes 407f
Gower sign 326
Grading of splenomegaly 204
Granulocytes 378
Granulocytopenia 378
Granulocytosis 378
Granulomatous disease 216
Graphesthesia 294
Grasp reflex 304f, 306
Graves’ disease 43, 45f, 49
Grey-Turner's sign 192, 193f
Gross enlargement of
gallbladder 199f
liver 199f
Growth
evaluation 21
hormone 495
Guillain-Barré syndrome 332, 336
Gustatory sweating 258
Gynecomastia 43, 48, 48f, 191
H
Hair follicles 22
Ham's test 496
Hamman's sign 161, 162
Hands and Osler nodes 147
Harrison’s
groove 470
sulcus 79
Head hair 22
Headache 257
Heart 456, 457, 471
block 139
failure 461
murmurs 8
sounds 154, 160
wall 123
Heberden's nodes 403f, 456
Heel to shin coordination test 317
Hem occult test 213
Hematemesis 361
Hematochezia 361
Hematological tests 496t
Hematuria 8, 228, 229, 361
Hemiballismus 301, 303
Hemiparetic gait 267
Hemoglobin 493, 496
electrophoresis 394
Hemoglobinuria 228
Hemolytic anemia 354, 355, 361, 363, 372
Hemoptysis 9, 67, 361
Hemorrhagic
cerebrospinal fluid 331f
pancreatitis 193f
Hemorrhoidal blood loss 361
Hepatic encephalopathy 191
Hepatitis
A 220
B 220
C 220
D 220
E 220
G 221
virus tests 216, 220
Hepatojugular reflex 142, 143
Herpes
labialis 435, 441, 441f
simplex encephalitis 332
zoster 435, 441
Heterochromia iridis 326
Hiatus hernia 128
High blood pressure 8
Hip
abduction 296, 301, 302
extension 296, 301
flexion 296, 301
joints 405, 410
Hissing or Kussmaul's breathing 85
Hoarseness of voice 10, 67, 72
Hoffman
reflex 315
sign 327
Holter monitoring 176
Homozygous disease 386f
Hooking method 202f
Hoover's sign 306, 315, 490
Horner's syndrome 317, 317f, 319
Housemaid knee 411
Hydropneumothorax 101
Hyperbilirubinemia 194
Hypereosinophilic syndrome 359
Hyperkalemia 167, 172
Hyperkinetic pulse 140
Hyperpigmentation of skin of cheek 47f
Hyperpigmented hands 29
Hypertrophic cardiomyopathy 131
Hypertrophy of clitoris 470
Hyperventilation syndrome 106
Hyperviscosity syndrome 355, 359, 361, 368, 371, 375
Hypoglossal nerve 286, 288
Hypokalemia 167, 172
Hypokinetic pulse 140
Hypopnea 447
Hypothermia 167, 173
Hypothyroidism 43, 49, 460
I
Iliopsoas bursitis 411
Imaginary
lines 76
thoracic areas 76
Imaging modalities 414
Immune system and skin 431
Impact of carotid artery 144
Increased
frequency of urine 228, 230
systemic estrogen levels 194
Indirect
antiglobulin test 389
bilirubin 218
calorimetry and body composition analysis 55
Coombs’ test 389
Infectious
arthritis 395
mononucleosis 41
Infective
arthritis 396
endocarditis 25
Inflammatory arthritis 397, 418f
Inguinal 36
area 207
canal 196, 197
Inner mitochondrial membrane 223
Innervation of lung and thoracic muscles 58, 65
Insertion of
nasogastric tube 210, 211
NS tube in stomach 211
Intensity of systolic murmur 158f
Intercostal muscles 64
Interlobular
artery 226
vein 226
Intermenstrual bleeding 8
Internal
anatomy of heart 125f
and external jugular veins 20f
jugular veins 142
Internuclear ophthalmoplegia 322
Interpretation of
chest skiagram 115
nerve conductions 339
Interpreting results of sensory testing 290
Interstitial pulmonary fibrosis 102, 103
Interventricular septum 179f
Intestinal
obstruction 197
peristalsis 199
Intracranial hemorrhage 337
Intravenous pyelography 243f
Intrinsic muscles of hand 299
Ipsilateral axilla 421
Iron
binding capacity 493
deficiency anemia 27f, 385f
Ischiogluteal bursitis 411
Itching 229, 231
J
Janeway's lesions 25, 28f, 29
Jaundice 11, 30, 33, 189, 372
and abdominal pain 189
Jaw jerk 327
Jenner's stain 383
Joint
deformity 400, 401
effusions 400
tenderness 400, 401
Jugular venous pressure 14, 20, 73, 75, 142
Jumper's knee 412, 412f
Junctional tachycardia 167, 172
JVP waves 142, 143
K
Kala-azar 387f
Kayser-Fleischer ring 260f, 327
Keloid 435, 440
Keratosis pilaris 14, 435, 438, 438f
Kernig's sign 316, 318
Knee
and ankle joints 411
extension 296, 302
flexion 296, 302
joints 406
reflex of
left side 310f
right side 310f
Koilonychia 25, 26
of nails 27f
Koplik's spots 465, 466f
Kussmaul’s
breathing 83
respiration 447
Kyphoscoliosis 71
Kypnosis 79, 81
L
Lactic dehydrogenase 217, 219, 493
Laparoscopy 213
Large
intestine 184, 185
mammary glands in males 43
Lateral
decubitus projection 118
epicondylitis 410
medullary syndrome 321, 323
Latissimus dorsi 63
Left
atrial enlargement 174, 174f
bundle branch block 167, 169, 169f
ventricle enlargement 175f
ventricular hypertrophy 131, 174
Leg
hair 23, 24
ulcers 372
Leishman stain 383
Leishmania Donovani bodies 387f, 391
Length of sternum 470
Lens sublaxation 146
Lepromatous leprosy 442
Leprosy skin patch 435, 442
Leptomeningeal malignancies 334
Lethargy 188
Leukemias 361, 366, 370
Leukocytes 492, 496
Leukonychia 26, 27f
Lhermitte's sign 327
Lid
edema 146
lag 43, 49
Limitation of motion 398
Lipiduria 239, 241
Listen for bruits 207
Liver 184
and gallbladder 11, 202
biopsy 216, 221
dullness 206
functions tests 216, 217
LMN facial palsy 281f
Lobes of cerebral cortex 254t
Location of
carotid arteries 153f
posterior tibial artery 138f
trachea 88f
Loops of Henle 226
Loss of
appetite 229, 231
consciousness 257
motility 323f
Lower
extremity edema 195
thoracic vertebrae 93
Luteinizing hormone 495
Lulunae of nails 25
Lumbar puncture 327329, 334
Lung 232, 234, 471
and pleura 59
borders 76, 78
crackles in obstructive chronic bronchitis 102
fissures 76
volumes 497
Lupus erythematosus 41
Lymph
adenopathy 369
glands of
body 34f
head and neck 75f
nodes 30, 34, 73, 75, 467
Lymphadenitis 41
Lymphadenopathy 41
Lymphatic drainage 58, 65
Lymphocytic pleocytosis 328
Lymphoma 355, 360, 368, 376
Lymphoproliferative disorders 379f
M
Macule 22, 432
Maculopapular
rash 22, 433
skin rashes 437f
Magnetic resonance
cholangiopancreatography 223
imaging 118, 176, 181, 213, 338
Malabsorption syndrome 191
Male
genitalia 470, 471
genitourinary system 456, 457
Manometry 213, 216
Mantoux test 114
Manual blood count 380
Marcus-Gunn pupil 270, 277
Marfan's syndrome 146148
Match test 106, 109
Mean corpuscular
hemoglobin 391
volume 391
Medial epicondylitis 410
Mediastinal crunch 161, 162
Mediastinum 59
Mees's lines 25, 28, 28f
Megaloblastic bone marrow 386f
Melanonychia 25, 27
Meninges 246, 247, 263, 317, 490
Meningitis 461
Mental status 445, 458, 460
Metabolic
alkalosis 113, 131
and endocrine tests 494t
Method of
deep palpation 200f
indirect percussion on chest 92
light palpation 200
palpating liver 202f
palpation of
liver and gallbladder 202
spleen 203
Metromenorrhagia 361
Micrognathia 474
Migraine 187
Milkmaid's grip 327
Mitral
stenosis 154, 177f
valve
obstruction 154
prolapse 8, 128
valvulitis 157
Mixing test 389, 394
Modified Allen test 109, 109f
Moebius sign 327
Mongolian
slant 468
spots 465
Mantoux test 106
Moon face in Cushing's disease 146
Motor system 263
Movements of chest 79
Muehrcke's lines 25, 28f
Multiple
cotton-wool spots 193f
sclerosis 332
Muscle
asymmetry 295
bulk and appearance 295
cramps 229, 231
Musculoskeletal
disorders 67
system 8, 13, 395, 456, 458, 491
Myasthenia gravis 131
Mycobacterium tuberculosis 106
Myelin 246, 247
Myeloproliferative diseases 355, 358, 361, 367, 375
Myerson's sign 327
Myocardial infarction 2, 131, 461
Myoclonus 301, 303
Myoglobin 493
Myoglobinuria 228
Myositis 329
Myxedema 32
N
Nail
bed
erythema 25, 27
pallor 25, 27
growth after death 24
Narcolepsy 329
Nasogastric tube 210, 211
Nausea and vomiting 187, 229, 231
Neck stiffness 316
Nephron 226
Nephrotic syndrome 233f
Nerve conduction study 337
Nervous system 245
Neurocutaneous system 319
Neurocysticercosis 339
Neurofibromatosis 260, 261
Neurologic system 458
Neuronopathy 329
Neurons 246
Neurovascular system 319
Nevus araneus 14
Nipple retraction 426
Nocturia 8, 228
Nocturnal dyspnea 8
Nodular lepromatous leprosy 442
Nodule 22, 432, 434
on breast 434f
Non-anion gap acidosis 113
Noncortical sensory system 287, 288
Noninflammatory arthritis 397
Nonpitting edema 32
Nonrespiratory pain 71
Noonan's syndrome 146
Normal
breath sounds 93, 95, 209
cardiac cycle 155f
fundus 272f, 274
kidneys 235
Normocellular bone marrow 386f
Notation of lung sounds 104
Nuchal rigidity 317
Numbness and paresthesia 258
Nutrition screening 55
Nylen-Bárány sign 280, 327
Nystagmus 279, 372
O
Obstructive
and restrictive lung diseases 106
coronary disease 128
Ocular movements and fundus 42
Occult blood tests 213
Oculocephalic reflex 445, 446, 446f
Oculomotor nerve 274, 275
Oculovestibular reflex 446, 447f
Olecranon bursitis 410
Olfactory nerve 269
Oligodendrocytes 246, 248
Oliguria 228, 229
Onycholysis 25, 26
of nail 27f
Ophthalmoscope 264, 264f
Oppenheim sign 326
Opsoclonus 328
Optic nerve 270
Optokinetic nystagmus 280, 328
Oral squamous cell cancer 30
Organs of digestive system 183f
Orthopnea 130, 131
Orthostatic hypotension 258
Osler's nodes 147, 148f
Osmotic fragility 496
Osteoarthritis 413
Osteoarthrosis 453
Osteoporosis 396
Oxygen
saturation 19, 493
tension 493
P
Pacemaker sounds 161
Paget's disease 412, 413
Painless jaundice 189
Pallid hands 29
Palmar
erythema 14, 29, 30
reflex 306
Palmomental reflex 304f, 306
Palpate peripheral arteries 137
Palpation of
axillary region 425
breast and axilla 424
groins 199, 204, 487
precordium 151, 152
radial pulse 17f
thyroid gland 44f
urinary bladder 236f
Palpation technique of breast 424
Pancreas 184
Pancreatic
cancer 190
duct 225f
function tests 222
panniculitis 193
Pancreatitis 128
Panic disorders 10
Pap smear 8
Papilledema 275
Papular lesion of skin 433f
Papule 22, 432, 433
Paracentesis 213
Paradoxical motion 79
Paralytic ileus 196
Parkinson's disease 324f, 341
Paroxysmal nocturnal dyspnea 130
Partial
cord transection 322
Horner syndrome 317
thromboplastin time 389, 394, 497
Parts of
basal ganglia 343f
limbic system of brain 342f
stethoscope 94f
vertebra 61f
Patellar
reflex 308, 309
tendonitis 412, 412f
Pathologic reflexes 472
Pathological nystagmus 279
Peach fuzz body hair 23
Peak expiratory flow 106, 108
Peau d’orange skin of left breast 423f
Pectoralis major muscle 65
Pectus
carinatum 79, 81
excavatum 79, 81, 82
Pedal edema 30
Pellagra 191
Pemberton's sign 74
Pendular knee jerk reflex 314, 316f, 317
Peptic ulcer 381
disease 461
Percussion of
abdomen 206
chest wall 91
mediastinum 91, 94
Percutaneous
suction needle biopsy 221
transthoracic needle biopsy 118, 122
Pericardial
friction rub 161, 162
knock 161, 162
Pericarditis 3
Peripheral
cyanosis 29, 146
edema 127, 135, 191
nerve distribution 291
neuropathy 336
vessels 472
Peritonitis 197209
Pes cavus deformity 262, 320
Petechiae 22, 435, 436
Phalen sign 328
Pheochromocytomas 240
Phobias 351
Pigeon chest 79
Pigmented nevus 465
Pinpoint pupils 447
Pitting
edema 32
nails 25, 26
Plasma volume 492
Plasmodium falciparum 354
Platelet
and coagulation disorders 355
count 237
disorders 361, 363, 369, 373
numbers 237
Platypnea 131
Pleocytosis 328
Pleural rub 99
Pleuritic pain 69
Plexiform neurofibroma 261
Pleximeter 92
Pneumomediastinum 86f
Pneumonia 128, 461
Pneumothorax 102, 105, 128
Pollakiuria 228, 229
Polycythemia 25, 370
vera 355, 358, 359, 367
Polymorphonuclear cells 328
Polyneuropathy 329
Polyuria 8, 228
Popliteal pulse 138
Portal hypertension 194f, 196
Positional nystagmus 280
Posterior
pituitary gland 242
tibial pulse 138
Postmenopausal bleeding 8
Postprandial blood pressures 317
Prefrontal cortex 341, 343
Premenstrual tension 8
Prepatellar bursitis 411
Pretibial myxedema 43, 49
Primary
biliary cirrhosis 223
headache 257
optic atrophy 274f
Primitive reflexes 303, 304f, 305, 474
Pripheral edema 135
Problems of breast examination 427
Progestrone 495
Prognostic nutrition index 55
Prominent veins 86, 196
Prostate-specific antigen 493
Prosthetic valve sounds 161
Prothrombin time 217, 497
Pruritus 188, 189
Pseudoathetosis 302f, 303
Pseudoptosis 46, 319
Psoriasis 443
Psoriatic arthritis 399
Psuedohypoparathyroidism 43, 48f
Ptosis
and lid lag 46, 319
of eyelid 274f
Pubic hair 23, 24
Puffiness of face 233
Pulmonary
edema 232
embolism 6
function tests 106, 107
hypertension 7, 134
valve
disease 146
murmurs 157, 160
Pulse
pressure 140
and pulse volume 140
rate 138
volume 139
Pulsus
alternans 140
paradoxus 141
parvus et tardus 140
Pupils 274, 276
Purpura 22, 435, 437
Purtscher retinopathy 193, 193f
Pustule 22
on index finger 433f
Pyoderma gangrenosum 191
Pyramids 226
Pyruvic kinase deficiency 381
Pyuria 228, 230, 241
Q
QRS complex 164
QT interval 164, 165
Quadrants of abdomen 195f
Quadratus lumborum 63
Quiet breathing 63
R
Radial pulse 137
Radiculopathy 329
Radiography of urinary tract 242, 243
Radionuclide bone scanning 417
Radiopaque calculi 243
Rectal palpation 235
Rectum and anus 471
Recurrent angina pectoris 128
Red blood cell
count 391
volume 492
Red scaly patches skin of calf 443f
Reflex hammer 264
Regular rhythm 163, 164
Reiter's syndrome 418f
Renal
artery 226
stenosis 237
biopsy 242, 243
calculus stag horn type 243f
colic 228, 230
functions tests 242, 496t
pelvis 226
pyramids 226
vein 226
Respiratory
acidosis 113
alkalosis 113
rate 16
system 7, 8, 58, 481
Results of bone density test 420
Retinal hemorrhages 273f, 275
Retraction of nipple 427f
Retrocalcaneal bursitis 412
Retrograde ejaculation 258
Reverse pulsus paradoxsus 141
Reversed differential cyanosis 146
Rheumatic nodules 150f
Rheumatic
fever 8
nodules 149
Rheumatoid
arthiritis 41, 395, 401, 402, 404f, 416f
nodules 404f
Rib
deformity 79, 81
fracture 86
Right
atrial enlargement 174, 174f
atrium and right ventricle 124
bundle branch block 167, 168
upper quadrant 196, 225
ventricle enlargement 175f
ventricular
failure 145
hypertrophy 174
Rinne test 270, 282, 284
Roger sign 328
Romberg's test 270, 285
Rooting reflex 304f, 305
Rotator cuff
tear 408
tendonitis 408
Rouleaux formation 379f
Ruptured
abdominal aorta 193f
ectopic pregnancy 193f
S
Sacral
edema 32
nerve roots 293
Salivary glands 183, 184
Sarcoidosis 461
Scabies 435, 440
Scalene muscles 64
Schamroth's window test 25, 26
Schizophrenia 341
Scissor gait 268
Sclera 45
Scleral icterus 191, 192
Scoliosis 79
Scoring system of hand grip test 403t
Scratch sign test 99, 101
Screening tests for
acute polyarthritis 414
chronic polyarthritis 414
diffuse arthralgias and myalgias 414
Sebaceous gland 435
Seborrheic dermatitis 191
Secondary
headache 257
optic atrophy 275
Secretin test 494
Self breast examination 422
Sensorimotor rhythm 335
Sensory
pathways 321
system 447, 448
Septic arthritis 413, 418f
Sequential inspiratory wheezes 99, 101
Serum
albumin 237, 238
amylase 222
biochemistry 237
enzymes 218
ferritin 389, 391, 393
iron 389, 393
lipase 222, 223
Severe
anhidrosis 258
necrotizing pancreatitis 192
Shoulder
abduction 301
adduction 296, 300
joints 404, 408
Shuffling gait 267
Sick sinus syndrome 166, 167
Sickle hemoglobin disease 386f
Signs of
cauda equina syndrome 325
degenerative or mechanical joint disease 401
hypocalcemia 30, 31, 483
uremia 232, 233
Silhouette sign 115, 117
Simian line 30f
Simulating kyphosis 81
Single photon emission computed tomography 340
Sinoatrial block 166, 166f, 167
Sinus
arrest 166, 166f, 167
arrhythmia 163, 164
bradycardia 166, 167
tachycardia 167, 170, 171f
Skeletal system 319
Skin 192, 232, 233
cancer 14, 435, 441
color and texture 146
rashes
of purpura 438f
on back 432f
surface 197, 486
Sleep apnea syndrome 83
Small intestine 184, 185, 196
Snellen chart 264, 265f, 271f
Snoring sound 100
Snout reflex 303, 305
Soft tissue deformity 79, 83
Specific
gravity of urine 496
reflex testing 309
strength testing 296
Spermatozoa 239, 241
Spider
angioma 14, 435, 441, 441f
angiomata 194f
nevi 465
nevus 14
Spinal
accessory nerve 286, 287
cord 246, 251, 252f
Spine 405
Spinothalamics 291
Spiritual belief system 5
Spleen 184, 186, 203
Splinter hemorrhage 25, 28, 147
Spontaneous vestibular nystagmus 280
Sputum 9, 67, 68
Steinberg sign 148f
Stellwag's sign 328
Stereognosis 293
Sternal
aspiration 384, 389
tenderness 372
Sternomastoid muscles 64
Sternum 61
Stethoscope 94
Stomach 184, 185, 206
Straight-leg raising sign 316, 318
Stranguria 228, 229
Strength of muscle 293, 295
Streptococcal pharyngitis 41
Structure of
kidney 227f
nail 25f
skin 430
Subacromial bursitis 409
Subarachnoid hemorrhage 332
Subcutaneous emphysema 85, 86
Subendocardial infarction 173
Succussion splash 99, 101, 208, 209
Sucking reflex 303, 304f, 305
Superficial reflexes 303, 305, 472
Superior vena cava syndrome 369
Supine anteroposterior projection 116
Supraventricular tachycardias 167, 170
Surface marking of heart 123
Suspected hepatic neoplasm 216
Sustained hand grip 317
Sweat glands 22
Swelling 86
Symmetry of joint involvement 399
Symptoms of
cauda equina syndrome 325
gallbladder diseases 188, 189
joint disease 397
liver diseases 188
pancreas diseases 190
splenomegaly 190
uremia 229, 231
Synovial
effusion of knee joint 406
fluid
analysis 417
of knee joint 406
hypertrophy 400, 401
membrane 395
Synovitis 395
Syphilis 41
Systolic
bruit 209
systolic ejection sounds 161
murmur 157
of aortic stenosis 158
of mitral regurgitation 158
T
Tachyarrhythmias 132, 139
Tachycardia bradycardia syndrome 166, 167
Tactile fremitus 85, 90
Tandem gait 314, 317
Technique for
elicitation 32
evaluation of edema 32
palpation of
axillary nodes 38f
epitrochlear lymph nodes 39f
radial artery pulse 16
Technique of
elicitation 281
lymph nodes palpation 30, 37
musculoskeletal examination 402
palpation of breast 424f
percussion 205
self-breast examination 422f
triceps reflex 309, 311
Telencephalon 253, 255
Temporal
lobes 341, 343
pattern of arthritis 399
Temporomandibular joint 453, 456
Tennis elbow 410, 410f
Terry's nails 25, 27
Testicular
atrophy 191
pain 8
Testing
ankle plantar flexion 300f
knee
extension 299f
flexion 300f
Testing of
ankle extension 300f
biceps reflex 308
brachioradialis reflex 309f
crude touch 288f
elbow
extension 298f
flexion 297f
flexors muscles of hand 297f
gag reflex 285f
graphesthesia 291f
hip
abduction 299f
adduction 299f
extension 299f
hypoglossal nerve 287f
intrinsic muscles of hand 296f
masseter muscles 278f
sense of position 288f
shoulder
abduction 298f
adduction 298f
steriognosis 291f
wrist
extension 297f
flexion 297f
Testosterone 495
Tests
for liver diseases 216
in gallbladder diseases 224
of stool 498t
of urine analysis 498t
Thermometer 14
Theta waves 332f
Thickening of nails 25, 26
Thomas test 405
Thoracentesis and needle biopsy of pleura 118, 120
Thoracic
cage landmarks 76
expansion and movements 86, 89
skeleton 77f
Thoracoplasty 789
Thorax 470
Thought process 350
Three methods for systematic examination of breast 424
Thrombin clotting time 389, 394, 497
Thyroid
gland 453
stimulating hormone 495
Tinel sign 328
Tone of muscles 295, 297
Total
bilirubin 218
iron binding capacity 389, 393
serum protein 237
Trachea 60
and apex beat of heart 86
Tracheal bifurcation 76
Tracheobronchial pain 70
Transcortical aphasias 265, 268
Transmission of breath sounds 96
Traumatic tap 333
Trendelenburg sign 328
Trepopnea 131
Triangle of auscultation 96
Triceps
reflex 309f, 310f
skin-fold thickness 55
Tricuspid
regurgitation 157, 160
stenosis 145
Trigeminal nerve 277
Trigger finger and trigger thumb 410
Trisection of pulse 138
Trochanteric bursitis 411
Trochlear nerve 270, 277
Trombone tongue 329
Trouble shooting 312
Trousseau sign 30, 31, 191
Tuberculosis 41, 461
Tubular
bronchial breathing 97
reabsorption 496
Tullio phenomenon 329
Tuning fork 264
Turner's syndrome 149
Typical skin rash 436f
U
Ulnar
deviation 404
neuropathy 336
Umbilical hernia 199f
Underarm hair 23
Unine analysis 239
Uremic
encephalopathy 232
frost 234
Ureter 226
Uric acid 493
Urinary
bladder 235
incontinence 258
retention 258
system 8, 11, 226, 482, 487
tract disorders 232
Urine
analysis 238
bilirubin 218
urobilinogen 218
Use of nasogastric tube 210, 211
V
Vaginal discharge 8
Valgus deformitity of knee joints 402f
Valvular dysfunction 131
Varicose veins 8
Vellus hair 23
Venereal or kidney disease 8
Venous hum 207, 209
Vertebrae 61
Vertebral foramen 61f
Vertical strips 424
Vesicle 22, 432, 433
Vestibular nystagmus 280
Vestibulocochlear nerve 281
Vigorous small intestinal peristalsis 197
Vinyl mandelic acid 495
Viral meningitis 332
Visual
acuity 41, 270, 445, 446
field testing 272
fullness of upper abdomen. 234
Vital signs 14, 73, 192
Vocal
cords 60
fremitus 86, 90
Vomiting 11
Von Graefe's sign 43, 329
W
Walker’ sign 148f
Wasting of intrinsic muscles of hand 262f
Water deprivation test 241, 242
WBC
count 237
numbers 237
Weber’s
syndrome 321, 324
test 270, 282, 283
Weiss’ sign 30, 31
Wenckebach phenomenon 167, 168f
Whistles and grunts 85
White blood cell
diseases 355, 357, 364
disorders 364
White cells 377
Whitish-grayish plaque 43
Whoop murmur 159
Wilms’ tumor 234
Wright’s
mini peak flow meter 108f
stain 383
Wrist
extension 296, 300
flexion 296, 300
joints 404
X
Xanthelasma 146, 147f
Xanthochromia 328, 333
of cerebrospinal fluid 331f
Y
Yellow nail 27, 28f
syndrome 25
Z
Z-score 420
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Chapter Notes

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