Table Of Content
S E I D E L ’ S G U I D E T O
P H YS I C A L
E X A M I N AT I O N
A N I N T E R P R O F E S S I O N A L
A P P R O A C H
9
TH EDITION
JANE W. BALL, DrPH, RN, CPNP BARRY S. SOLOMON, MD, MPH
Trauma Systems Consultant Associate Professor of Pediatrics
American College of Surgeons Assistant Dean for Student Affairs
Gaithersburg, Maryland Division of General Pediatrics and Adolescent
Medicine
JOYCE E. DAINS, DrPH, JD, RN,
The Johns Hopkins University
FNP-BC, FNAP, FAANP
School of Medicine
Professor and Director Advanced Practice
Baltimore, Maryland
Nursing
ROSALYN W. STEWART, MD, MS, MBA
Department of Nursing
The University of Texas MD Anderson Cancer Associate Professor of Pediatrics and Medicine
Center Departments of Pediatrics and Internal
Houston, Texas Medicine
The Johns Hopkins University
JOHN A. FLYNN, MD, MBA, MEd
School of Medicine
Clinical Director and Professor of Medicine
Baltimore, Maryland
Division of General Internal Medicine
The Johns Hopkins University
School of Medicine
Baltimore, Maryland
3251 Riverport Lane
St. Louis, Missouri 63043
SEIDEL’S GUIDE TO PHYSICAL EXAMINATION: ISBN: 978-0-323-48195-3
AN INTERPROFESSIONAL APPROACH
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Previous editions copyrighted 2015, 2011, 2006, 2003, 1999, 1995, 1991, and 1987.
Library of Congress Cataloging-in-Publication Data
Names: Ball, Jane (Jane W.), author. | Dains, Joyce E., author. | Flynn, John A. (Physician), author. |
Solomon, Barry S., author. | Stewart, Rosalyn W., author.
Title: Seidel’s guide to physical examination : an interprofessional approach/ Jane W. Ball, Joyce E. Dains,
John A. Flynn, Barry S. Solomon, Rosalyn W. Stewart.
Other titles: Guide to physical examination
Description: Ninth edition. | St. Louis, Missouri : Mosby, [2018] | Includes bibliographical references and
index.
Identifiers: LCCN 2017041250 | ISBN 9780323481953 (hardcover : alk. paper)
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/2017041250
Executive Content Strategist: Lee Henderson
Director, Content Development: Laurie Gower
Content Development Specialist: Heather Bays
Marketing Manager: Becky Ramsaroop
Publishing Services Manager: Jeff Patterson
Book Production Specialist: Carol O’Connell
Design Direction: Brian Salisbury
Printed in Canada
Last digit is the print number: 9 8 7 6 5 4 3 2 1
About the Authors
Jane W. Ball, DrPH, RN, CPNP
Jane W. Ball graduated from The Johns Hopkins Hospital director, she provided support to two
School of Nursing and subsequently received her master’s federal programs: Emergency Medical
and doctoral degrees in public health from The Johns Services for Children and the Trauma-
Hopkins University Bloomberg School of Public Health. Emergency Medical Services Systems
She began her nursing career as a pediatric nurse and Program. Dr. Ball serves as a consultant
pediatric nurse practitioner in The Johns Hopkins Hospital. to the American College of Surgeons’
Since completing her public health degrees, she has held Committee on Trauma to help states
many positions that enable her to focus on improving the improve their trauma care systems. She
healthcare system for children and adults, such as serving also serves as a consultant to Children’s National Medical
as the chief of Child Health for the Commonwealth of Center supporting the development of a project to expand
Pennsylvania Department of Health, Assistant Professor resources for the care of injured children. She is also the
at the University of Texas at Arlington School of Nursing, author of several pediatric nursing textbooks. Dr. Ball was
and executive director of the Emergency Medical Services recognized as a distinguished alumnus of The Johns
for Children National Resource Center based at Children’s Hopkins University in 2010.
National Medical Center in Washington, DC. As the center
Joyce E. Dains, DrPH, JD, RN, FNP-BC, FNAP, FAANP
As a board-certified family nurse practitioner with doctorates and Baylor College of Medicine. She
in both public health and law, Joyce E. Dains has had a has been instrumental in the education
rich and productive career in education and clinical practice. of nursing students, nurse practitioners,
She graduated as valedictorian from the New England Baptist medical students, and other healthcare
Hospital School of Nursing in Boston and subsequently professionals. As a family nurse prac-
earned a baccalaureate degree in nursing from Boston titioner, she has maintained a clinical
College, graduating magna cum laude; a master’s degree practice in a variety of primary care
in nursing from Case Western Reserve University; and settings. She is currently at the Uni-
a doctorate in public health from the University of versity of Texas MD Anderson Cancer Center where she
Texas–Houston. She also completed a post-graduate nurse is Director for Advanced Practice Nursing, a family nurse
practitioner program at the Texas Woman’s University. She practitioner in the Cancer Prevention Center, and chair, ad
earned her law degree at the University of Houston and interim, for the Department of Nursing. Dr. Dains is a
practiced law for a brief period. In addition to her current Fellow of the American Association of Nurse Practitioners
position, Dr. Dains has been in clinical practice, teaching, and is the recipient of other distinguished honors, including
and leadership positions at major universities and medical election to the National Academies of Practice. Dr. Dains
institutions including the Ohio State University, the Uni- is also the author of Elsevier’s Advanced Health Assessment
versity of Texas-Houston, the Texas Woman’s University, and Clinical Diagnosis in Primary Care.
John A. Flynn, MD, MBA, MEd
John A. Flynn completed his undergraduate work at Boston Office of Johns Hopkins Physicians,
College, graduating magna cum laude with a bachelor’s as well as the Associate Dean and
degree in mathematics. He attended medical school at the Executive Director of the Clinical
University of Missouri–Columbia where he was recognized Practice Association. He holds the
in 2004 with the “Outstanding Young Alumni” award. Dr. John A. Flynn Professorship in Medi-
Flynn completed his internship and residency at The Johns cine. Dr. Flynn also serves as the
Hopkins University School of Medicine, followed by a medical director of the spondyloarthri-
fellowship in rheumatology, and was selected to serve as tis program at The Johns Hopkins University and is the
an assistant chief of service for the Longcope Firm of the co-director of the Primary Care Consortium. He is a
Osler Medical Service. Dr. Flynn also completed a master’s founding member of the Vivien T. Thomas College within
degree in business administration at The Johns Hopkins The Johns Hopkins University School of Medicine Colleges
University. Dr. Flynn is currently the Vice President of the Advisory Program. Dr. Flynn is a Fellow with the American
iii
iv About the Authors
College of Rheumatology and a Diplomat of the American editor of Cutaneous Medicine: Cutaneous Manifestations of
Board of Rheumatology, as well as a Fellow to the American Systemic Disease and the first and second editions of the
College of Physicians. Dr. Flynn holds memberships in the Oxford American Handbook of Clinical Medicine. Dr. Flynn’s
American College of Physicians, the American College of clinical interest is arthritis and his research interests include
Rheumatology, the Spondyloarthritis Research and Treat- ambulatory education, the delivery of ambulatory care in
ment Network, and the Group for Research and Assessment an academic setting, and the care of patients with
of Psoriasis and Psoriatic Arthritis. He has served as an spondyloarthritis.
s
r
o
h
t Barry S. Solomon, MD, MPH
u
A
e Barry S. Solomon graduated from the University of Penn- director of The Johns Hopkins Chil-
h
t sylvania School of Medicine and completed his residency dren’s Center Harriet Lane Clinic, Dr.
t
u at the Children’s Hospital of Pittsburgh. He subsequently Solomon has developed a nationally
o
b completed a fellowship in general academic pediatrics at recognized and award-winning model
A
The Johns Hopkins University School of Medicine, during for delivering family-centered care in
which time he received a master of public health degree an urban pediatric primary care setting.
from The Johns Hopkins University Bloomberg School of Many of the clinic’s patients and fami-
Public Health. Barry is currently an associate professor of lies experience significant social and
pediatrics in the Division of General Pediatrics and Ado- financial challenges associated with living in poverty. In
lescent Medicine in the School of Medicine. His clinical collaboration with hospital and community partners, sup-
work, research, teaching, and advocacy efforts relate to ported by philanthropic organizations, Dr. Solomon has
addressing the social and emotional needs of urban youth brought an array of wrap-around services to the clinic.
and caregivers through educational curricula, clinic-based Programming includes an on-site safety resource center,
interventions, and innovations in primary care delivery. mental health services for children and adolescents, a
For many years he worked closely with colleagues in the maternal mental health clinic, parenting groups, and a
Women and Children’s Health Policy Center in the Bloom- help desk to connect families with community resources
berg School of Public Health on the Dyson Community (Health Leads©). Dr. Solomon is also an active clinical
Pediatrics Training Initiative National Evaluation, a longi- teacher and research mentor to medical students, residents,
tudinal study assessing the impact of integrating community- fellows, and junior faculty interested in addressing social
based experiences and child advocacy skills into residency determinants of health through primary care redesign. His
training. Dr. Solomon has a joint appointment in the academic career and personal mission have been centered
Department of Health, Behavior and Society in the Bloom- on providing high-quality, family-centered primary care,
berg School of Public Health, where he conducts research while training new generations of health professioals to
with faculty in the Center for Injury Research and Policy become advocates for vulnerable populations.
to prevent childhood injury. For the past 10 years, as medical
Rosalyn W. Stewart, MD, MS, MBA
Rosalyn W. Stewart began her career at the University of and practice of medicine. She is associ-
Texas Medical Branch where she earned her medical degree ate director of the Longitudinal
and subsequently completed her combined internal medi- Ambulatory Clerkship, a clinical clerk-
cine–pediatrics residency and a master of science degree ship devoted to primary care and
in preventive medicine. She is currently an associate profes- systems of health practice. She focuses
sor in internal medicine and pediatrics at The Johns Hopkins her efforts on assembling a cadre of
University and is also a member of the faculty in the excellent teachers, training the very best
Bloomberg School of Public Health and The Johns Hopkins students of medicine in continuity of
School of Nursing. She completed a master of business patient care, and developing new curricula for the education
administration degree with an emphasis on health care. of the best clinicians. Her goal is to create physician leaders
She practices both general internal medicine and general who will serve as primary care systems–level change agents
pediatrics. Her academic focus is on medical education, and will provide effective, longitudinal, comprehensive,
primary care, and health disparities. She holds many posi- coordinated, person-focused care for the underinsured
tions centered on these interests and has been recognized inner-city patient.
for her ability to carry forth the Osler philosophy, discipline,
Reviewers
Susan M. Beidler, PhD, MBE, APRN, FAANP Dian Colette Davitt, RN, PhD
Department of Nursing Professor Emeritus
Briar Cliff University Department of Nursing
Sioux City, Iowa Webster University
St. Louis, Missouri
Craig S. Boisvert, DO
Professor and Chair of Clinical Sciences Lucinda Drohn, RN, MSN
West Virginia School of Osteopathic Medicine School of Nursing
Lewisberg, West Virginia Liberty University
Lynchburg, Virginia
Diane Bridge, EdS, RN, MSN
School of Nursing Jason Ferguson, BPA, AAS NREMT-Paramedic
Liberty University EMS Program Head
Lynchburg, Virginia Central Virginia Community College
Lynchburg, Virginia
Amber B. Carriveau, DNP, FNP-BC
MSN Program Renee Fife, MSN, CPNP
Bellin College Professor Emeritus
Green Bay, Wisconsin College of Nursing
Purdue University Northwest
Laura H. Clayton, RN, PhD, CNE Hammond, Indiana
Department of Nursing Education
Shepherd University Sarah J. Flynn, MD, MPhil
Shepherdstown, West Virginia Darwin College
University of Cambridge
Shirlee Cohen, MPH, ANP-BC, NPP, CCRN Cambridge, England
DNP Candidate
College of Nursing Rebecca A. Fountain, RN, PhD
University of New Mexico Assistant Professor
Albuquerque, New Mexico College of Nursing and Health Sciences
University of Texas at Tyler
Tonya A Collado, RN, MSN Tyler, Texas
St. Elizabeth School of Nursing
University of Saint Francis Brian Garibaldi, MD
Lafayette, Indiana Pulmonary and Critical Care Medicine
Department of Medicine
Amy Culbertson, DNP, MSN, BSN, FNP Johns Hopkins University
Assistant Professor Baltimore, Maryland
School of Nursing & Health Sciences
Georgetown University Deanna Hanisch, MA
Washington, District of Columbia Office of Information Technology
Johns Hopkins University
Pamela Darby, RN, MSN, ACNS-BC, FNP-C Baltimore, Maryland
Clinical Instructor
Department of Nursing Alicia C. Henning, RN, BSN, SANE
Angelo State University Member of American College of Forensic Examiners
San Angelo, Texas Member of International Association of Forensic Nurses
Breckenridge Memorial Hospital
Hardinsburg, Kentucky
v
vi Reviewers
Nancy J. Kern, EdD, MSN, FNP-C, AGPCNP-C, APRN Susan D. Rymer, RN, MSN
School of Nursing Assistant Professor
Spalding University School of Nursing
Louisville, Kentucky Bellin College
Green Bay, Wisconsin
Pamela L King, PhD, MSN, FNP, PNP
Marlene Sefton, PhD, APRN, FNP-BC
School of Nursing
Spalding University Clinical Assistant Professor
Louisville, Kentucky College of Nursing, Department of Health System
Sciences
Rs Carla Lynch, BSN, MS University of Illinois at Chicago
e
w Clinical Assistant Professor of Nursing Chicago, Illinois
e
vi School of Nursing
e The University of Tulsa Pamella Stockel, RN, PhD, CNE
R
Tulsa, Oklahoma Associate Professor of Nursing
Loretto Heights School of Nursing
Duane F. Napier, RN, MSN Regis University
Captio Department of Nursing Denver, Colorado
The University of Charleston
Ruthann Taylor, MS, CRNP, NP-C, AGPCNP-BC, GCNS-
Charleston, West Virginia
BC, OCN, CME
Grace M. Nteff, DNP, MS, BSN Passan School of Nursing
School of Nursing Wilkes University
Clayton State University Wilkes-Barre, Pennsylvania
Morrow, Georgia
Karen Vanbeek, MSN, CCNS
Elizabeth Oakley, DHSc, MSPT Assistant Professor of Nursing
Department of Physical Therapy School of Nursing
Andrews University Bellin College
Berrien Springs, Michigan Green Bay, Wisconsin
Natacha Pierre, DNP, FNP-BC Joy Turner Washburn, RN, EdD, WHNP-BC
Health Systems Sciences Department Kirkhof College of Nursing
University of Illinois at Chicago College of Nursing Grand Valley State University
Chicago, Illinois Allendale, Michigan
Kristin Ramirez, RN, MSN, ACNS-BC Lynn Wimett, EdD, MS, BSN
Assistant Clinical Professor of Nursing Professor of Nursing
Department of Nursing Loretto Heights School of Nursing
Angelo State University Regis University
San Angelo, Texas Denver, Colorado
Anita K. Reed, RN, MSN John Zampella, MD
Department Chair Adult and Community Health Department of Dermatology
Practice New York University
Remington, Indiana New York, New York
Susan K. Rice, RN, PhD, CPNP, CNS
Professor
College of Nursing
University of Toledo
Toledo, Ohio
Preface
Seidel’s Guide to Physical Examination: An Interprofessional specific body systems and body parts, with each chapter
Approach was a landmark text when first published, in divided into four major sections:
part because of the interprofessional team of nurse practi- • Anatomy and Physiology
tioner and physician authors. The use of interprofessional • Review of Related History
authors has continued through all editions, and the current • Examination and Findings
team of nurse practitioner and physician authors brings the • Abnormalities
strengths of their respective disciplines to help students of all Each of these sections begins with consideration of the
health disciplines learn to conduct a patient-centered inter- adult patient and ends, when appropriate, with variations
view and perform a physical examination. This text is written for infants, children, and adolescents; pregnant persons;
primarily for students beginning their careers as a healthcare older adults; and individuals with disabilities.
professional. To help you get organized, each chapter starts with a
The core message of the book is that patients are our preview of physical examination components discussed.
central focus and must be served well. Learning how to The Anatomy and Physiology sections begin with the
take a history and perform a physical examination is neces- physiologic basis for the interpretation of findings, as well
sary, but does not provide a full understanding of your as the key anatomic landmarks to guide physical examina-
patients. The relationship with your patients and the tion. The Review of Related History sections detail a specific
development of trust most often begins with conversation. method of inquiry when a system or organ-related health
Patients will more comfortably share personal and sensitive issue is discovered during the interview or examination.
information when you develop a rapport and build trust. The Examination and Findings sections list needed equip-
Such a relationship helps you obtain reliable information ment and then describe in detail the procedures for the
enabling you to serve your patients well. You are, after all, examination and the expected findings. These sections
learning the stories of individuals with unique experiences encourage you to develop an approach and sequence that
and cultural heritage, and our interaction with them involves is comfortable for you and, also for the patient. In some
far more than the sum of body parts and systems. The art chapters advanced examination procedures are described
and skills involved in history taking and the physical for use in specific circumstances or when specific conditions
examination are common to all of us, regardless of our exist. Sample documentation of findings conclude these
particular health profession. sections. You will note that the terms “normal” and “abnor-
mal” are avoided whenever possible to describe findings
because, in our view, these terms suggest a value judgment
Organization
that may or may not prove valid with experience and
The achievement of a constructive relationship with a additional information. The Abnormalities sections provide
patient begins with your mastery of sound history taking an overview of diseases and associated problems relevant
and physical examination. Chapter 1 offers vital “getting to to the particular system or body part. The Abnormalities
know you” guidelines to help you learn about the patient sections include tables clearly listing pathophysiology in
as the patient learns about you. Chapter 2 stresses that one column and patient subjective and objective data in
“knowing” is incomplete without the mutual understanding another column for selected conditions. Full-color photos
of cultural backgrounds and differences. Chapter 3 gives an and illustrations are often included.
overview of examination processes and the equipment you Chapter 24 details the issues relevant to the sports
will need. participation evaluation. Chapter 25 provides guid-
Chapter 4 assists with the process of analyzing the ance for integrating examination of all body systems
information collected during the history and physical into an organized sequence and process. Chapter 26
examination, and using clinical reasoning to support deci- provides guidelines for the change in standard exami-
sion making and problem solving. Chapter 5 provides nation approaches in emergency and life-threatening
guidance on recording the information collected into the situations. This information is only a beginning and is
patient’s written or electronic health record with particular intended to be useful in your clinical decision making.
emphasis on the Problem Oriented Medical Record (POMR) You will need to add other resources to your base of
and the use of SOAP (Subjective findings, Objective findings, knowledge.
Assessment, and Plan). The appendices and companion Evolve website content
Chapters 6 through 8 introduce important elements of provide clinical tools and resources to document observa-
assessment: vital signs and pain; mental status; and growth, tions or problems and complete the physical examination,
development, and nutrition. Chapters 9 through 23 discuss preserving a continuous record.
vii
viii Preface
Special Features gay, bisexual, and transgender patients has been inte-
grated into several chapters.
The basic structure of the book—with its consistent chapter • The emergency or life-threatening situations chapter
organization and the inclusion of special considerations has been updated.
sections for infants, children, adolescents, pregnant persons, • The sports participation chapter includes recommenda-
and older adults—facilitates learning. tions for assessing and managing patients with sports-
• Differential Diagnosis Tables—a hallmark of this text— related concussions.
appear throughout the text.
• Evidence-Based Practice in Physical Examination boxes
Our Ancillary Package
are reminders that our clinical assessment—as much
as possible—should be supported by research. Seidel’s Physical Examination Handbook is a concise, pocket-
e • Risk Factors boxes highlight modifiable and nonmodifi- sized companion for clinical experiences. It summarizes,
c
a able risk factors for a variety of conditions. reinforces, and serves as a quick reference to the core content
f
e
r • Functional Assessment boxes help students to consider of the textbook.
P
specific physical problems and to evaluate their effect Student Laboratory Manual for Seidel’s Guide to
on patient function. Physical Examination is a practical printed workbook that
• Patient Safety boxes offer guidance about ways to helps readers integrate the content of the textbook and
promote patient safety during the physical examination ensure content mastery through a variety of engaging
or about patient education that supports safe practices exercises.
at home. Instructor Resources on the companion Evolve website
• Sample Documentation boxes at the end of each Examina- (http:/evolve.elsevier.com/Seidel) include an extensive
tion and Findings section model good documentation electronic image collection and a PowerPoint lecture slide
practice. collection that includes integrated animations, case studies,
and a series of audience response questions. In addition,
TEACH provides learning objectives, key terms, nursing
New to This Edition
curriculum standards, content highlights, teaching strate-
The entire book has been thoroughly updated for this gies, and case studies. Also available on the Evolve website
edition. This includes the replacement of illustrations of are two thoroughly revised Test Banks, in ExamView®
abnormal findings with updated photos and the use of new format, which faculty can use to create customized exams
full-color photos and drawings to replace one- and two-color for medical, allied health, or nursing programs. Together
illustrations in the eighth edition. There are approximately these resources provide the complete building blocks needed
1200 illustrations in addition to the numerous tables and for course preparation.
boxes that have traditionally given readers easy access to Student Resources on the companion Evolve website
information. Among the many changes: include a wide variety of activities, including audio clips
• Evidence-Based Practice in Physical Examination boxes of heart, lung, and abdominal sounds; video clips of selected
have been thoroughly updated. These boxes focus on examination procedures; animations depicting content and
the ongoing need to incorporate recent research into processes; 270 NCLEX-style review questions; and download-
clinical practice and decision making. able student checklists and key points.
• Clinical Pearls boxes have been updated and revised. Also available is the thoroughly revised and expanded
• The Abnormalities section is now in two columns to online course library titled Health Assessment Online, which
better show the relationship between the summary is an exhaustive multimedia library of online resources,
of the pathophysiology and patient data, both subjec- including animations, video clips, interactive exercises,
tive and objective, associated with the condition or quizzes, and much more. Comprehensive self-paced learning
disorder. modules offer flexibility to faculty or students, with tutorial
• The Techniques and Equipment chapter includes updated learning modules and in-depth capstone case studies for
recommendations for Standard Precautions. each body system chapter in the text. Available for individual
• The Recording Information: Documentation chapter has student purchase or as a required course supplement,
been revised to add a focus on electronic health records Health Assessment Online unlocks a rich online learning
and recording information electronically. experience.
• The Growth, Measurement, and Nutrition chapter, This edition is also available on Elsevier eBooks on
integrates two separate chapters to better demonstrate VitalSource. Easy-to-use, interactive features let you make
the interdependence of nutrition, growth, and health. highlights, share notes, run instant searches, and much
• Updated cancer screening controversies and summary more. You can access your eBook online through Evolve
evidence are included in the abdomen, breast, and or with apps for PC, Mac, iOS, Android, and Kindle Fire.
prostate chapters. The existing physical examination video series com-
• Information about sensitive and respectful approaches prises 14 examination videos, each of which features an
to history taking and physical examination of lesbian, examination of a specific body system with animations and
Preface ix
illustration overlays to demonstrate examination techniques
Acknowledgments
in greater depth, and a fifteenth “Putting It All Together”
video that shows a head-to-toe examination of an adult The ninth edition of our textbook is possible only because of
along with appropriate life span variations. The series the professionalism and skills of so many others who really
includes three special topics: Effective Communication and know how to fashion a book and its ancillaries so that it is
Interviewing Skills, Physical Examination of the Hospitalized maximally useful to you. First, there are those instructors
Patient, and Putting It All Together: Physical Examination and students who have so thoughtfully and constructively
of the Child. All 18 videos in this video series are offered offered comment over the years. Improvements in content
in two formats: streaming (online) and networkable (for and style are often the results of their suggestions.
institutional purchase). While the authors have provided the content, it must
be accessible to the reader. A textbook needs a style that
ensures readability, and our partners at Elsevier have made e
Our Core Values c
that happen. Lee Henderson, our Executive Content Strate- a
f
e
In the ninth edition of Seidel’s Guide to Physical Examination: gist, provided oversight and guidance with the eye of an r
P
An Interprofessional Approach, we have made every attempt experienced editor along with strategies to meet the changing
to consider patients in all of their variety and to preserve environment of print and electronic publishing. The whole
the fundamental messages explicit in earlier editions. These textbook revision is a demanding project requiring effective
include the following: teamwork. Courtney Sprehe, Jennifer Hermes, and Saman-
• Respect the patient. tha Dalton, our Content Development Specialists, maintained
• Achieve the complementary forces of competence and professional skill and calm while obtaining chapter reviews,
compassion. editing chapters, and moving the project forward. Heather
• The art and skill essential to history taking and physical Bays did a spectacular job of keeping everything moving
examination are the foundation of care; technologic with her qualitative eye for detail and design throughout.
resources complement these processes. Brian Salisbury’s design is visually appealing and showcases
• The history and physical examination are inseparable; the content.
they are one. We also want to recognize the indispensable efforts of
• The computer and technology compliments you. Your the entire marketing team led by Becky Ramsaroop, as well
care and skills are what builds a trusting, fruitful relation- as the sales representatives, who make certain that our
ship with the patient. message is honestly portrayed and that comments and
• That relationship can be indescribably rewarding. suggestions from the field are candidly reported. Indeed,
We hope that you will find this a useful text and that it will there are so very many men and women who are essential
continue to serve as a resource as your career evolves. to the creation and potential success of our ninth edition,
and we are indebted to each of them.
The remarkable teaching tools we call the ancillaries
Dedication
need special attention. These are the laboratory manual,
We dedicate the ninth edition of this text to two original handbook, TEACH, test banks, Health Assessment Online,
authors, Henry M. Seidel, MD, and William Benedict, MD, and video series, all demanding an expertise—if they are
who served on seven and six editions, respectively. Both to be useful—that goes beyond that of the authors. Frances
physicians had academic appointments at The Johns Donovan Monahan offers hers for the laboratory manual.
Hopkins University School of Medicine for decades and Joanna Cain offers hers for the Power Point slides, nursing
made important contributions to patient care and medical test bank NCLEX review questions, student checklists, and
student education in their specialties of pediatrics and key points; Jennifer Hermes offers hers for TEACH; and
endocrinology/internal medicine, respectively. Frank Bregar offers his for the advanced practice test bank.
As original authors they contributed greatly to the initial The careful attention to all asset development is
text design as well as to its ongoing development. Both overseen by Jason Gonulsen. The development of Health
Dr. Seidel and Dr. Benedict understood the importance of Assessment Online is led by Frances Donovan Monahan;
communication, sensitivity, compassion, and connection Chris Lay; Nancy Priff, Glenn Harman, and Paul Trumbore’s
with patients. This text was one of the earliest collabora- efforts are essential to the success of the video series.
tions of a physician and nurse author team, in this case to And finally—our families! They are patient with our
develop a text targeted to students of medicine, nursing, necessary absences, support what we do, and are unstinting
and other allied health professions. The ability of these in their love. They have our love and our quite special thanks.
physicians to mesh their visions with that of the nurse
authors and to collaborate as an effective team allowed the Jane W. Ball, DrPH, RN, CPNP
authors to shape this text and share important values with Joyce E. Dains, DrPH, JD, RN, FNP-BC, FNAP, FAANP
students. John A. Flynn, MD, MBA, MEd
This text was renamed in Henry Seidel’s honor for the Barry S. Solomon, MD, MPH
eighth edition as Seidel’s Guide to Physical Examination. Rosalyn W. Stewart, MD, MS, MBA
