Bates' Guide to Physical Examination and History Taking / Edition 10

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The Tenth Edition of this classic text provides the best foundation for performing physical examinations and taking patient history. The book features a beautiful full-color art program and a clear, simple two-column format, with highly visual step-by-step examination techniques on the left and abnormalities with differential diagnoses on the right.

This edition's health promotion sections have been extensively updated and expanded in all chapters, with new and revised national guidelines, pertinent screening tools, and more information about ways to help patients prevent disease and optimize their health across all settings and age groups. Detailed information on pain assessment is now included in the general survey, vital signs, and pain chapter. A new chapter presents assessment of mental health status and behavior to encompass the psychosocial dimensions of care. Evidence-based content has been increased, with pertinent findings, avenues for research, and references/suggested readings added across the entire book. More than 50 new line drawings and photos have been added.

A bound-in CD-ROM and companion Website include 5 Approach to Patient videos, 15 Head-to-Toe Examination videos, 25 Assessment videos, heart and breath sounds, the Center for Disease Control's pediatric growth chart, journal articles, Nursing Professional Roles and Responsibilities, and the fully searchable text. An Instructor's Resource DVD-ROM and online instructor resources are also available.

This classic text:now completely revised and updated:maintains the easy-to-use format that is the hallmark of earlier editions. Comprehensive yet to-the-point, and with emphasis throughout on clinical thinking, it provides the best foundation for learning to perform physical examination and history taking. Students learn to ask the right questions, and to understand the answers. A logical two-column format places examination procedures and proper techniques on the left side, and common abnormalities and possible interpretations on the right. Highly visual, it now features hundreds of new images. Illustrations are strategically placed adjacent to relevant information to enhance understanding. Tables of abnormalities appear at the end of each chapter, enabling the reader to compare and contrast abnormal findings.

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Editorial Reviews

From The Critics
Reviewer: Carole A. Kenner, RNC, DNS, FAAN(University of Oklahoma College of Nursing)
Description: This text is as the title suggests a guide to physical examination and history taking. It is aimed at the student that is just learning the foundational assessment, physical examination skills. This is the ninth edition with the previous one published in 2003.
Purpose: The purpose is to assist the beginning level health professional student with conducting history and physicals. It is meant to help the student apply clinical reasoning through its pedagogy. These are worthy objectives and are met.
Audience: The audience is the student in the health professions. This is according to the author and reviewer. The author is well known and highly credible.
Features: The book begins with the foundations of physical examination and moves into the regional examinations, and finally ends with life span examinations. The chapters are according to body systems and follow a head to toe approach. The list of tables at the beginning of the text helps the reader find specific information quickly. The companion CD is a wonderful addition to supplement the print material. Use of color photos help reinforce the content and are great for visual learners.
Assessment: The other book on the market that is similar is Seidel's Guide to Physical Examination, 6th edition, 2006, published by Elsevier. The Bates' book offers test generator and comprehensive manual including an image bank accompanying ready materials in a learning management system whereas Seidel's has a fully integrated online package. However, Bates' bookis very good and the newest edition more information on the older adult and the pediatric client-two very needed areas. It also increased the content on the skin and mental status. Again, these are needed areas. All and all this text is a very good beginning guide for students and is easy to use for faculty. It would be a welcomed addition to a student's library.
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Product Details

  • ISBN-13: 9780781780582
  • Publisher: Lippincott Williams & Wilkins
  • Publication date: 12/31/2008
  • Edition description: Tenth, North American Edition
  • Edition number: 10
  • Pages: 992
  • Product dimensions: 8.80 (w) x 10.90 (h) x 1.50 (d)

Meet the Author

Lynn S. Bickley, MD is the Associate Professor of Medicine at the University of Rochester School of Medicine and Dentistry, Rochester, New York.

Robert A. Hoekelman, MD is the Professor Emeritus of Pediatrics at the University of Rochester School of Medicine and Dentistry, Rochester, New York.

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Read an Excerpt

Chapter 20: Clinical Thinking: From Data to Plan

You should then be ready to establish a working definition of the problem. Make this at the highest level of explicitness and certainty that the data allow. You may be limited here to a symptom, such as "pleuritic chest pain, cause unknown." At other times you can define a problem explicitly in terms of structure, process, and cause. Examples include "pneumococcal pneumonia, right lower lobe," and "hypertensive cardiovascular disease with left ventricular enlargement, congestive heart failure, and sinus tachycardia."

Difficulties and Variations

Limitations of the Medical Model. Although medical diagnosis is based rimarily on identifying abnormal structures, disturbed processes, and specific causes, you will frequently see patients whose complaints do of fall neatly into these categories. Some symptoms defy analysis, and you may never be able to move beyond simple descriptive categories such as "fatigue" or "anorexia." Other problems relate to the patient's ' e rather than to the body. Events such as loss of a job or loved one eaten a person and may increase the risk of subsequent illness. Iden- ing such life events, evaluating a person's responses to them, and or king out a plan to help the person cope with them are just as apropriate as dealing with the pharyngitis or duodenal ulcer. Health maintenance has become an increasingly important and legitimate item problem lists for patients. Plans may include, for example, updating immunizations, advice on nutrition, exploring feelings about an import life event, and recommendations for seat belts or exercise.

Single Versus Multiple Problems. One of the greatestdifficulties faced y the student is deciding whether to cluster the patient's symptoms d signs into one or into several problems. The patient's age may help, ' ce young people are more likely to have single diseases while older people tend to have multiple ones. The timing of symptoms is often use1. An episode of pharyngitis 6 weeks ago is probably unrelated to ver, chills, chest pain, and cough today. To use timing effectively, you need to know the natural history of various diseases. A yellowish disarge from the penis followed in 3 weeks by a painless penile ulcer, for ample, suggests two problems, gonorrhea and primary syphilis. A pee ulcer followed in 6 weeks by a maculopapular skin rash and generalized lymphadenopathy, on the other hand, suggests two stages of the me problem: primary and secondary syphilis.

Involvement of different body systems may help you to cluster the items of data. While symptoms and signs within a single system can often be exlpained by one disease, manifestations in different, apparently unrelated stems often require more than one explanation. Again, a knowledge of 's ease patterns is necessary. You might decide, for example, to group a tient's high blood pressure and sustained thrusting apical impulse tother with the flame-shaped retinal hemorrhages, place them in the cardiovascular system, and label the constellation "hypertensive cardiovascular disease with hypertensive retinopathy" You will probably develop another explanation for the diarrhea and left lower quadrant tenderness.

Some diseases affect more than one body system. As you gain in knowledge and experience, you will become increasingly adept at recognizing such multisystem conditions and at building plausible explanations that link together their seemingly unrelated manifestations. In trying to explain the productive cough, hemoptysis, and weight loss reported by a 60-year-old man who has smoked cigarettes for 40 years, you probably even now would postulate lung cancer as a likely cause. You might even support this hypothesis by your observation of clubbed fingernails. With time you will also recognize that his other symptoms and signs can be linked to the same diagnosis. The dysphagia is caused by extension of the cancer to his esophagus; the pupillary inequality is a Horner's syndrome caused by pressure on the cervical sympathetic chain; and the jaundice results from metastases to the liver.

In another case of multisystem disease, a man's fever, weight loss, chronic diarrhea, dysphagia, white-coated tongue, generalized lymphadenopathy, and purplish skin nodules can all be explained by AIDS. The clinician who has not already explored the patient's risk factors for this disease should do so.

An Unmanageable Array of Data. In trying to understand a patient's problems, the clinician often is confronted with a relatively long list of symptoms and signs and an equally long list of potential explanations or labels. As already suggested, you can tease out separate clusters of observations and deal with them one cluster at a time.

You can also analyze a given group of observations by asking key questions, the answers to which steer your thinking in one direction and allow you to ignore others temporarily. For example, you may ask what produces and relieves a person's chest pain. If the answer is exercise and rest, respectively, you can concentrate on the cardiovascular system (and possibly the musculoskeletal system as well) and put aside the gastrointestinal tract. If the pain results from eating quickly and is relieved by regurgitating the food, you logically concentrate on the upper gastrointestinal tract. A series of such discriminating questions forms a branching logic tree or algorithm and is helpful in collecting data, analyzing them, and reaching conclusions that probably explain them.

Quality of the Data. Virtually all the information with which the clinician works is subject to error. Patients forget symptoms, misremember the sequence in which they occurred, hide important but embarrassing facts, and shape their stories toward what interviewers seem to want to hear. Clinicians misunderstand their patients, overlook some relevant information, fail to ask the one key question, jump to premature diagnostic conclusions, or forget to examine the genitals of a patient with asymptomatic testicular carcinoma. You can avoid some of these errors by being thorough, by keeping an open mind as you gather data, and by analyzing any mistakes that you might make...

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Table of Contents

Unit I - Foundations of Health Assessment

1 Overview of Physical Examination and History Taking
2 Interviewing and the Health History
3 Clinical Reasoning, Assessment, and Plan

Unit II - Regional Examinations

4 General Survey, Vital Signs, and Pain
5 Behavior and Mental Status
6 The Skin, Hair, and Nails
7 The Head and Neck
8 The Thorax and Lungs
9 The Cardiovascular System
10 The Breasts
11 The Abdomen
12 The Peripheral Vascular System
13 Male Genitalia and Hernias
14 Female Genitalia
15 The Anus, Rectum, and Prostate
16 The Musculoskeletal System
17 The Nervous System

Unit III - Special Populations

18 Infants Through Adolescents
19 The Pregnant Woman
20 The Older Adult

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  • Anonymous

    Posted July 28, 2013

    We need this book for our Advance Assessment Class for our Bache

    We need this book for our Advance Assessment Class for our Bachelor's in Nursing. Has nice illustrations and it appears to contain vital information. I have yet to start the class, and unfortunately if I wait until it starts I may not be able to review this book, but having taken my first assessment class for the Associate's, I am able to compare with the Jarvis Textbook we used back then; which is another great book, this textbook will be more than helpful.

    1 out of 1 people found this review helpful.

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  • Posted December 7, 2009

    I Also Recommend:

    Bates Guide to Physical Examination

    Excellent illustrations and photographs.
    Excellent organization of the chapters whereby the information related to the pathological process and the physical examination parts are all color coded.
    Nice outline of key additional information on the margins.

    1 out of 1 people found this review helpful.

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  • Anonymous

    Posted February 21, 2010


    This book has a ton of great information and is a fairly easy to read in getting the information you need in a timely manner. Also has great reference charts and images. A good clinical reference to have in your library.

    0 out of 1 people found this review helpful.

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  • Anonymous

    Posted December 24, 2009

    Essential Reference Book

    This book is a fantastic reference book but was not particularly necessary for Intro to Physical Exam Classes, but useful.

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  • Anonymous

    Posted September 26, 2009

    Wonderful for learning a complete physical exam and history!

    This book is excellent for learning how to take a complete history of a patient, explaining signs and symptoms to watch for during each part of the complete physical examination, and for many other things I have not even gotten to within the book. It is easy to understand and ellaborates on difficult topics to help the reader understand each point.

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  • Anonymous

    Posted August 15, 2009

    The Alpha and Omega of Physical Exam guides!

    You really can't go wrong with Bates'. An excellent guide to every aspect of physical examinations, presently easily enough for a beginning medical student, yet comprehensive enough to teach more experienced practitioners often overlooked or poorly understood aspects of physical exam. The book has plenty of high quality colorful photos and is presented in a very organized fashion making it easy to find exactly the aspect of the exam you're looking for. This book really should be in the library of every physician.

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