Cover
Acknowledgements
About the companion website
1 Examination of the cardiovascular system
1. Preparation
2. The peripheries
3. The precordium
4. To complete the examination
2 Examination of the respiratory system
1. Preparation
2. The peripheries
3. The chest
4. To complete the examination
3 Examination of the gastrointestinal system
1. Preparation
2. The peripheries
3. The abdomen
4. Examination of a stoma
5. Hernial orifices
6. To complete the examination
4 Examination of the genitourinary system
1. Preparation
2. End of bed inspection
3. The groin
4. Examination of a lump
5. To complete the examination
5 Examination of the neurological system – cranial nerves
1. Preparation
2. Inspection
3. Cranial nerve I (olfactory)
4. Cranial nerve II (optic): four aspects to test
5. Cranial nerves III (oculomotor), IV (trochlear), and VI (abducens)
6. Cranial nerve V (trigeminal)
7. Cranial nerve VII (facial)
8. Cranial nerve VIII (vestibular)
9. Cranial nerve IX (glossopharyngeal)
10. Cranial nerve X (vagus)
11. Cranial nerve XI (accessory)
12. Cranial nerve XII (hypoglossal)
13. To complete the examination
6 Examination of the neurological system – upper limb
1. Preparation
2. End of bed inspection
3. Tone
4. Power
5. Coordination
6. Reflexes
7. Sensation
8. To complete the examination
7 Examination of the neurological system – lower limb
1. Preparation
2. End of bed inspection
3. Tone
4. Power
5. Coordination
6. Reflexes
7. Sensation
8. To complete the examination
8 Examination of musculoskeletal system – the hands
1. Preparation
2. End of bed inspection
3. Inspection
4. Feel
5. Move
6. Sensation
7. To complete the examination
9 Examination of the musculoskeletal system – the shoulder
1. Preparation
2. End of bed inspection
3. Inspection
4. Feel
5. Move
6. The rotator cuff muscles
7. Special tests
8. To complete the examination
10 Examination of the musculoskeletal system – the knee
1. Preparation
2. End of bed inspection
3. Inspection
4. Feel
5. Move
6. Special tests
7. To complete the examination
11 Examination of the musculoskeletal system – the hip
1. Preparation
2. End of bed inspection
3. Inspection
4. Feel
5. Move
6. To complete the examination
12 Examination of the peripheral arterial system
1. Preparation
2. End of bed inspection
3. The peripheries
4. The lower limbs
5. Features of embolic versus thrombotic ischaemia
6. Buerger's test
7. To complete the examination
13 Examination of the peripheral venous system
1. Preparation
2. End of bed inspection
3. The peripheries
4. The lower limbs
5. Handheld Doppler ultrasound
6. Special tests
7. To complete the examination
14 Examination of the neck
1. Preparation
2. End of bed inspection
3. The peripheries
4. The neck
5. To complete the examination
15 Examination of the breast
1. Preparation
2. End of bed inspection
3. Inspection
4. Palpation
5. To complete the examination
Index
End User License Agreement

List of Illustrations

Chapter 1
1. Figure 1.1 Tendon xanthomata – usually indicates hypercholesterolemia.
2. Figure 1.2 Splinter haemorrhages – may be seen in infective endocarditis.
3. Figure 1.3 Xanthelasma – usually indicates hypercholesterolaemia.
4. Figure 1.4 Corneal arcus – usually indicates hypercholesterolaemia.
5. Figure 1.5 (a) Measurement of JVP: anatomy of the jugular veins and measuring t...
6. Figure 1.6 Auscultation of the precordium.
7. Figure 1.7 Checking that S1 matches with the carotid pulse in the neck.
Chapter 2
1. Figure 2.1 Finger clubbing.
2. Figure 2.2 Assessing for CO₂ retention flap (at least 15 seconds).
3. Figure 2.3 Assessing lung expansion.
4. Figure 2.4 (a and b) Suggested areas for percussion and auscultation.
5. Figure 2.5 Chest percussion technique.
Chapter 3
1. Figure 3.1 Koilonychia (spooning or concave appearance of the nail caused by se...
2. Figure 3.2 Palmar erythema (can be associated with liver failure).
3. Figure 3.3 Palpating Virchow’s node (Troisier's sign).
4. Figure 3.4 Spider naevi (can be normal finding; five or more is considered a si...
5. Figure 3.5 Common abdominal scars.
6. Figure 3.6 Palpation of the abdomen.
7. Figure 3.7 Palpation for an abdominal aortic aneurysm.
8. Figure 3.8 Common abdominal masses.
9. Figure 3.9 Loop ileostomy.
Chapter 4
1. Figure 4.1 Position for examination of the groin.
2. Figure 4.2 Palpation of the testes.
3. Figure 4.3 Examination of a testicular lump.
4. Figure 4.4 Classification of testicular lumps.
Chapter 5
1. Figure 5.1 Testing for visual inattention.
2. Figure 5.2 Testing cranial nerve XI: showing the prominence of the left sternoc...
Chapter 6
1. Figure 6.1 Normal position testing for extrapyramidal drift.
2. Figure 6.2 Supinator reflex technique.
3. Figure 6.3 Biceps reflex technique.
4. Figure 6.4 Triceps reflex technique.
5. Figure 6.5 Dermatones.
6. Figure 6.6 Testing a dermatome.
Chapter 7
1. Figure 7.1 Testing tone in the leg.
2. Figure 7.2 Testing tone in the knee.
3. Figure 7.3 Coordination testing in the leg.
4. Figure 7.4 Technique for the knee reflex.
Chapter 8
1. Figure 8.1 Telangietasia.
2. Figure 8.2 Sclerodactyly.
3. Figure 8.3 Gouty tophi.
4. Figure 8.4 Correct technique for palpating the DIPs and PIPs.
5. Figure 8.5 ‘Prayer’ movement.
6. Figure 8.6 Inverse ‘prayer’ movement.
7. Figure 8.7 Testing wrist extension.
8. Figure 8.8 Testing strength of adduction.
9. Figure 8.9 Froment's test.
Chapter 9
1. Figure 9.1 Surface anatomy of the shoulder.
2. Figure 9.2 Hawkin's test.
Chapter 10
1. Figure 10.1 Patellar tap test.
2. Figure 10.2 Drawer sign.
3. Figure 10.3 Lachman's test.
Chapter 11
1. Figure 11.1 Inspect the front.
Chapter 12
1. Figure 12.1 Measuring temperature using backs of the hands.
2. Figure 12.2 Measuring capillary refill time.
3. Figure 12.3 Palpating dorsalis pedis.
4. Figure 12.4 Technique for Doppler ultrasound.
5. Figure 12.5 Buerger’s test.
Chapter 13
1. Figure 13.1 Venous anatomy.
2. Figure 13.2 (a and b) Doppler examination of venous incompetence.
Chapter 14
1. Figure 14.1 Neck examination.
2. Figure 14.2 Assessing for movement of a thyroglossal mass on tongue protrusion.
3. Figure 14.3 (a and b) Location of the cervical lymph nodes and a systematic app...

Medical Student
Survival Skills

Clinical Examination

Philip Jevon RN BSc(Hons) PGCE

Academy Manager/Tutor
Walsall Teaching Academy, Manor Hospital, Walsall, UK

Elliot Epstein FRCP

Consultant Physician, Senior Academy Tutor
Walsall Healthcare NHS Trust, Manor Hospital, Walsall, UK

Sarah Mensforth FRCP

SpR in GU Medicine (West Midlands)
Walsall Healthcare NHS Trust, Manor Hospital, Walsall, UK

Caroline MacMahon FRCOG

SpR in Obstetrics & Gynaecology (West Midlands)
Walsall Healthcare NHS Trust, Manor Hospital, Walsall, UK

Consulting Editors

Jonathan Pepper BMedSci BM BS FRCOG MD FAcadMEd

Consultant Obstetrics and Gynaecology, Head of Academy
Walsall Healthcare NHS Trust, Manor Hospital, Walsall, UK

Jamie Coleman MBChB MD MA(Med Ed) FRCP FBPhS

Professor in Clinical Pharmacology and Medical Education / MBChB Deputy Programme Director
School of Medicine, University of Birmingham, Birmingham, UK

This edition first published 2020
© 2020 by John Wiley & Sons Ltd.

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Library of Congress Cataloging‐in‐Publication Data

Names: Jevon, Philip, author. | Epstein, Elliot (Consultant physician), author. | Mensforth, Sarah, author. | MacMahon, Caroline, author.
Title: Medical student survival skills. Clinical examination / Philip Jevon, Elliot Epstein, Sarah Mensforth, Caroline MacMahon.
Other titles: Clinical examination
Description: Hoboken, NJ : Wiley‐Blackwell, 2020. | Includes index. | Identifiers: LCCN 2018060339 (print) | LCCN 2018061661 (ebook) | ISBN 9781118842041 (Adobe PDF) | ISBN 9781118842034 (ePub) | ISBN 9781118842010 (pbk.)
Subjects: | MESH: Physical Examination | Handbook
Classification: LCC RC78.7.D53 (ebook) | LCC RC78.7.D53 (print) | NLM WB 39 | DDC 616.07/54–dc23
LC record available at https://lccn.loc.gov/2018060339