A medical history is a report that includes information gained from a patient's medically

relevant recollections (e.g., symptoms, concerns, past diseases) and questioning

regarding their concerns. While a physician should generally take their time to take a
thorough history, situations such as medical emergencies may only provide enough
time for a short history to avoid delaying potentially vital interventions. Because it takes
some practice to distinguish between important and irrelevant information, it is best to
follow a set protocol in the beginning. Medical history provides the basis on which
diagnosis and treatment are developed. An uninterrupted setting in a quiet room with
only the examiner and the patient present ensures that patients can openly discuss their
concerns and reinforces the patient-physician relationship. This article provides an
overview of what a general medical history should cover. Depending on the patient's
concerns, additional and/or more targeted questions may be appropriate. See the
articles “Pediatrics: history and physical examination” and “OB/GYN: history and
physical examination” for further details about those patient groups.

Chief concern (CC)

History of present illness (HPI)
Past medical history (PMH) including preexisting illnesses, medication history,
and allergies
Family history (FH)
Social history (SH)
Review of systems (ROS)

Types of health history

o Problem-focused: only includes CC and brief HPI; usually taken in emergency
setting.
o Expanded problem-focused: includes CC, brief HPI, and pertinent ROS; usually
when patient is already under the ongoing care of a provider or presents with a
specific CC.
o Comprehensive: covers all key elements (mentioned above); usually performed on
new, nonemergency patients.

A thorough medical history is the basis for diagnosis. At the beginning of your clerkship,
it is recommendable that you take a history according to a standardized scheme that
 covers the key elements. The more experience you acquire in taking a patient's medical
history, the more you will be able to readily determine what areas to focus on.
It may be helpful to begin the interview with a few general questions about the patient's
life, e.g., profession and familial status, as they may serve as an icebreaker.
Chief concern
 Description: the main reason for the patient's visit [1]
 Goal: Record the chief concern clearly in the patient's own words, e.g.,“knee hurts,”
“upset stomach,” “runny nose.”
 When taking the patient's medical history, the first question should be as open as
possible in order to enable the patient to freely describe their concerns. Examples
include:
o ”How may I help you?”
o ”What brings you here today?”
History of present illness
 Description: a detailed description of the chief concern and progression of the
symptoms
 Goals
o Provide comprehensive details of the patient's present illness from the initial
symptoms or from the previous encounter.
o Determine which systems should be assessed carefully in the review of
systems and physical examination.
 Key elements
o Onset of symptoms (context and location)
o Quality and intensity of symptoms (scale from 1 to 10, with 1 indicating a low
amount and 10 the maximal intensity of symptoms)
o Course (sudden, gradual, constant, or on and off)
o Duration of symptoms
o Associated symptoms
o Factors that improve or exacerbate symptoms
o Triggers or the patient's own explanation of the cause of the symptoms
 Types of HPI
o Brief HPI: includes 1–3 elements
 Example: “Dull pain in left knee over the past 2 weeks.”
 o Extended HPI: includes ≥ 4 elements
 Example: “Dull pain in left knee over the past 2 weeks. Patient stated pain started
after his fall during the soccer game. The pain relieved by sitting, warm
compress, and ibuprofen and aggravated by walking or standing.”
To remember the key points for evaluating pain, the most common reason for patients
to see a physician, recall the mnemonic LIQOR AAA.
 LIQOR AAA
o Location
o Intensity (on a scale of 1 to 10)
o Quality (e.g., sharp, aching, burning, pressure-like pain)
o Onset
o Radiation
o Aggravating factors
o Alleviating factors
o Associated symptoms

Pain scales
Another useful mnemonic to help remember the key points of HPI is COLD REARS SIT.
 COLD
o Character of chief complaint (severity, type)
o Onset
o Location
o Duration (+ progression)
 REARS
o Radiation
o Exacerbating factors or triggers
o Alleviating factors
o Related symptoms
o Severity
 SIT
o Sick contacts/Similar symptoms previously
o Insight into cause
o Treatments tried/Travel
 Notes
Feedback
Past medical history
[1][2]
 Description: a patient's health status prior to the current visit
 Goals
o Identifying important clues and contributing factors regarding the current concern.
o Developing a holistic approach to patient care
 Key elements
o Childhood illnesses
o Major adult illnesses
o Past surgical history, including type, date, and location of past surgical
procedures
o Medications
 Prescription drugs
 Over-the-counter drugs
 Herbal remedies
 Doses and frequencies
o Allergies
 Drugs or environmental factors
 Reaction to each allergen
 Food intolerance
o Prior injuries (e.g., motor vehicle accidents, falls)
o Prior hospitalizations and/or transfusions
o Immunizations
o Screening exams (e.g., Pap smear, mammogram, colonoscopy)
o Psychiatric illnesses, including any psychological intervention or hospitalization
To remember the key points of past medical history, recall the mnemonic PAM HITS
FOSS.
 PAM HITS FOSS
o Past medical history
o Allergies including drug names and associated adverse effects
o Medications, including over-the-counter as well as prescription medications, and
compliance
o Hospitalization in the past
 o Ill contacts
o Trauma
o Surgery
o Family history
o OB/GYN procedures
o Sexual history
o Social history
Notes
Feedback
Family history
 Description: a history of disease in first- and second-degree blood-relatives that
reaches back at least two generations
 Goals
o Detecting hereditary patterns of disease
o Identifying contagious diseases
o Analyzing risks and providing preventive measurements
 Key elements [2]
o Age and health status of first-degree blood relatives
o List of major medical conditions of first-degree blood relatives
 Age of onset
 Progression
o Genetic defects (e.g., cystic fibrosis, beta thalassemia, hemophilia, Huntington
disease, glycogen storage diseases)
o Living status of first-degree blood relatives
 If deceased, note age at death and cause of death
 If alive but ill, mention their diseases and prognosis
 If alive and in good health, note “alive and well (A&W)”
Notes
Feedback
Social history
 Description: a part of a medical history that addresses social aspects (e.g.,
occupation, socioeconomic status, drug use) of the patient's life that might be
pertinent to the current medical condition [2]
 Goals
o Getting to know a new patient as a person
o Acquiring enough information to support accurate decision-making and choosing an
appropriate treatment option
o Promoting healthy behaviors and lifestyle

Key elements
o Personal data (e.g., place of birth, history of childhood and adolescence, level of
education, and marital status)
o Occupation and current job
o Socioeconomic status and living situation
o Safety and health counseling on lifestyle hazards

Social support
o Diet
o Exercise and sports
o Sleep
o Stressors
o Interests and hobbies including recent travel and recreational activities
o Performance of ADLs and IADLs

Sexual history
 Current/past contraception methods (if any)
 Current/past sexual partners: male, female, or both
 History of postcoital vaginal bleeding
 History of sexual dysfunction (e.g., dyspareunia)
 History of sexually transmitted diseases
 Safer sex practices
 History of sexual abuse

Drug and alcohol use

 Alcohol
 Type of alcohol used (e.g., vodka, beer)
 Number of drinks per day/week including binge drinking
 Quantify size of glass/bottle per drink
  Time/date of last drink
 Tobacco use (quantity in pack-years)
 Recreational drug use
 Names of drugs used
 Frequency of use
 Time/date of last use
 IV drug use
[3]
o Religion and spiritual beliefs
Key points of social history: Sex, Drugs, Rock-n-roll (sexual history,
tobacco/alcohol/drug use, and how the patient “rolls," i.e., lifestyle and occupation).

Review of systems (ROS)

 Description: a list of questions, arranged by organ systems, to help establish the
causes of signs and symptoms
 Goals
o Systematic approach to establish the correlation of symptoms to organ systems
o Identifying potential or underlying concerns that the patient did not report while
taking an HPI or PMH
o Establishing positive and negative organ-specific findings
 Types
o Comprehensive: covers all organ systems; usually done during an initial general
health maintenance visit when the patient has no specific concerns.
o Focused: covers only the specific organ systems most likely to be connected to
the chief concern
You do not have to ask every question; tailor the questionnaire to the patient and
their chief concern (e.g., sexual history may not be relevant if the reason for the visit is
an ankle fracture follow-up). Use your best judgment about what to ask and what to
leave out, keeping in mind you generally have no more than 10–15 minutes per
interview.
ROS questionnaire [1]
Constitutional symptoms
General state of health including energy, strength, exercise tolerance?
Fever or chills?
Night sweats?
 Fatigue?
Changes in weight?
Changes in appetite?
Trouble sleeping?
Eye
Glasses or contacts?
Change in visual acuity?
Blurry or double vision?
Pain?
Photophobia?
Ability to see at night?
Ocular discharge/excessive tearing?
Flashing lights, floaters, or blind spots?
Yellowish discoloration of sclera?
Redness?
Glaucoma?
Cataracts?
Last eye exam?
Head and neck
Headache?
Neck stiffness?
Neck pain or tenderness?
Neck lumps?
Head injury?
Ear, nose, mouth, and throat (ENT)
Ears
o Hearing loss?
o Tinnitus (ringing in ears)?
o Earache?
o Ear discharge?

Nose
o Nosebleeds?
o Nose obstruction or discharge?
o Nose itching?
o Change in sense of smell?
o Postnasal drainage?
o Sinus pain?
o Hay fever?

Mouth and throat

o Dentures?
o Mouth sores?
o Change in sense of taste?
o Thrush?
o Sore throat?
o Halitosis?
o Change in voice?

Cardiovascular

Chest pain or tightness (on exertion or at rest)?

Palpitations (on exertion or at rest)?

Dyspnea (shortness of breath on exertion or at rest)?

Peripheral edema (leg or ankle swelling)?

Paroxysmal nocturnal dyspnea (sudden awakening from sleep with shortness of

breath)?

Orthopnea (shortness of breath when lying down)?

Syncope (dizziness, fainting spells)?

Cyanosis?
Respiratory
 Cough (dry or wet, productive)?

Sputum color, amount, and occurrence (e.g., green/yellow, bloody, particularly after
waking up)?

Asthma or wheezing?

Dyspnea (shortness of breath)?

Painful breathing?
Gastrointestinal

Dysphagia (swallowing difficulties)?

Nausea or vomiting?

Hematemesis (bloody vomiting)?

Change in appetite?

Abdominal pain?

Abdominal distention/bloating?

Early satiety?

Jaundice (yellow eyes or skin)?

Rectal pain?

Changes in bowel movement

o Diarrhea?
o Constipation?

Change in stool appearance

o Clay-colored stools?
o Acholic stools (pale/white)?
o Tar-colored (black) stools?
o Bloody stools?

Genitourinary
Urinary

Frequent or urgent urination?

Dysuria (burning or painful urination)?

Polyuria/oliguria?

Nocturia (excessive urination at night)?

Dribbling of urine?

Change in urinary strength?

Hematuria (blood in urine)?

Other changes in urine appearance (e.g., foamy, brown)?

Incontinence?
Genital

Female patients
o Last menstrual period?
o Irregular menses?
o Menopause?
o Vaginal dryness?
o Hot flashes?
o Vaginal discharge or bleeding?
o Genital lesions?
o Genital itching or rash?
o STDs?
o Dyspareunia (painful intercourse)?
o Pelvic pain?
o Contraceptive methods?
o Number of pregnancies?
o Last Pap smear and mammogram?

Male patients
o Dyspareunia (painful intercourse)?
o Penile discharge or bleeding?
o Genital lesions?
o Genital masses or pain?
o Genital itching or rash?
o STDs?
o Changes in libido and erectile dysfunction?
o Hernia?

Musculoskeletal

Muscle or joint pain?

Joint swelling?

Joint redness?

Joint stiffness?

Bony deformity?

Muscle weakness?

Muscle atrophy?

Cramps?
Trauma?

Back pain?
Integumentary system
Skin and hair

Pruritus (itching)?

Burning?

Dryness?

Rashes?

Sores?

Lumps?

Changes in pigmentation and skin color (e.g., yellowish discoloration of skin)?

Hair loss/gain?

Changes in nails (e,g, clubbing, ridges)?

Breast

Breast lumps or masses?

Swelling?

Nipple discharge?

Pain?

Dimpling or retraction?
Neurological

Change in memory?

Change in speech?

Recurring or frequent headaches?

Lightheadedness/dizziness?

Fainting?

Convulsions or seizures?

Sensory changes (e.g., paresthesia/numbness, tingling)?

Vertigo?

Tremor?

Paralysis (loss of strength)?

See neurological examination for more information.
Psychiatric

Stress?

Mood swings?

Depression?

Nervousness/anxiety?

Problems with concentration?

Unusual perception or hallucinations?

Insomnia (difficulty sleeping)?

Psychiatric disorder?
See mental status examination for more information.
Endocrine

Heat or cold intolerance?

Excessive sweating?

Weight gain or loss?

Change in appetite?

Polyuria (frequent urination)?

Menstrual irregularities?

Thyroid enlargement or tenderness?

Increased or decreased thirst?

Change in size of head or hands?

Hormone therapy?
Hematologic/lymphatic

Recurrent and easy bruising?

Recurrent bleeds on minor trauma?

Previous blood transfusion and reactions?

Lymph node enlargement or tenderness?

 Vascular

Claudication (calf cramping) with walking or at rest?

Allergic/immunologic

Hay fever?

Seasonal allergies?

Hives or eczema?

Itching, runny nose, watery eyes?

At the end of history taking, ask the patient for their primary care physician (PCP).
Potential previous findings can be obtained from their PCP. Furthermore, interim or
discharge reports are sent to the PCP.

The physical examination is typically the first diagnostic measure performed after taking
the patient's history. It allows for an initial assessment of symptoms and is crucial for
determining the differential diagnoses and further steps. Ideally, a complete physical
examination should be performed for every patient. In practice, the physical examination
is usually tailored to specific patient concerns. Sensitivity and specificity of physical
examination findings vary widely. In some cases, a diagnosis is possible on the basis of
the physical examination alone. This article covers the basics of the physical
examination and links out to other articles for more specific examinations, including:
 Pediatric history taking and physical examination
 Gynecologic and obstetric history and physical examination
 Mental status examination
 Neurological examination
 Head and neck examination
 Lymph node examination
 Pulmonary examination
 Cardiovascular examination
 Abdominal examination
 Skin examination and nail examination

Approach
Systems
The following sections provide an overview of all the parts of a physical examination
that should be considered, including:
 General appearance
 Vital signs
 Skin and nails
 Head and neck
 Lymphatics
 Heart
 Lungs
 Abdomen
 Pelvic
 Neurological
 Musculoskeletal
 Psychiatric: See mental status examination for more information.
 Breast
 Obstetric: See prenatal care and childbirth articles for more information.
In some cases, more details can be found in the links provided.
Notes
Feedback
General appearance
 Assess physical, behavioral, and emotional state, including:
o Physical characteristics and appearance: body type, distinguishing characteristics
or abnormal formations/symmetry, development, race, personal hygiene
o Behavior: alert, active, lethargic, calm, agitated, combative, compliant
o Wellness: well, unwell
o Color: rosy, pale, flushed, jaundice
o Posture and gait
Notes
Feedback
Vital signs and measurements
Vital signs
 Temperature
 Heart rate
 Respiratory rate
 Blood pressure
 Oxygen saturation and supplemental oxygen device (see arterial blood gas
analysis and pulse oximetry)
Maximize tableTable Quiz

Normal vital signs at rest [4]

H Blood
ea pressure
rt Res (mmHg)
ra pira
Ox
te tory
Sy yg
(b rate
Age st en Tem
ea (bre
grou oli sat pera
ts ath Diasto
p c ura ture
p s lic pre
pr tio
er per ssure
es n
m min
su
in ute)
re
ut
e)
10 95 97.9°
67
Neon 0– 40– – F–
– 35–53
ate 20 60 10 100.
84
5 0% 4°F (
Infant 10 72 36.6
(1–12 0– 30– – –
37–56 38°C
mont 18 53 10
hs) 0 4 )

Toddl 98 22– 86 42–63

er (1– – 37 –
2 14 10
 Normal vital signs at rest [4]
H Blood
Res
ea pressure
pira
rt (mmHg) Ox
tory
ra Sy yg
rate
Age te st en Tem
(bre
grou (b oli sat pera
ath Diasto
p ea c ura ture
s lic pre
ts pr tio
per ssure
p es n
min
er su
ute)
m re
in
years
0 6
)
Presc
80 89
hoole
– 20– –
r (3–5 46–72
12 28 11
years
0 2
)
Scho 75 18–
ol- – 25
97
aged 11
–
child 8 57–76
11
(6–9
5
years
)
Pread 10 61–80
olesc 2–
ent 12
(10– 0
11
years
)
 Normal vital signs at rest [4]
H Blood
Res
ea pressure
pira
rt (mmHg) Ox
tory
ra Sy yg
rate
Age te st en Tem
(bre
grou (b oli sat pera
ath Diasto
p ea c ura ture
s lic pre
ts pr tio
per ssure
p es n
min
er su
ute)
m re
in
Adole
scent 11
(12– 0–
64–83
17 60 13
years – 12– 1
) 10 20
0 90
Adult –
60–89
s 13
9

Measuring Blood Pressure - Measuring Vital Signs

Body measurements
 Weight, height, and, possibly, BMI
 Children: head circumference; see also “Normal growth in infants and young
children”
Maximize tableTable Quiz

Weight Body Mass

status Index (BMI)
Underweigh < 18.5
t kg/m2
 Weight Body Mass
status Index (BMI)
Normal
18.5–24.9
or healthy
kg/m2
weight
≥ 25–29.9
Overweight
kg/m2
Class 30–34.9
I obesity kg/m2
Class 35–39.9
II obesity kg/m2
Class III
≥ 40 kg/m2
obesity
Notes
Feedback
Skin and nails
 Skin
o Inspect skin appearance and examine skin lesions as needed, taking notes of
location, size, colors, texture, shape, and distribution.
o See skin examination, benign skin lesions, and classic pathologic hand findings.
 Nails
o Inspect and palpate nails (fingers and toes) and look for abnormal changes to
color, shape, or structures.
o See nail exam and alterations of the nails for interpretation of findings.

Anatomical structure of the nail

Head, eyes, ears, nose, throat (HEENT)

 Head, face, and neck: inspect, palpate head, sinuses, neck, and lymph nodes
 Eyes: pupillary response, ocular movements (H), visual acuity with Snellen
chart, fundoscopic exam (see examination of the eye)
 Ears: inspect, palpation, otoscopic exam ± Rinne/Weber
 Nose: inspect
 Throat and mouth: open and say “ahh,” stick out tongue, palpate thyroid gland
 See head and neck examination for more details.

Examination of the Thyroid - Clinical Examination Weber and Rinne Test

- Clinical Examination
Notes
Feedback
Lymphatics
 Examine different locations (cervical, axillary, and groin areas)
 Inspection: look for visible enlargement
 Palpation of lymph nodes for:
o Swelling
o Tenderness
o Mobility
o Irregularity
 See lymph node examination.

Examination of the Lymph Nodes - Clinical Examination Lymph nodes of

the head and neck Palpable lymph nodes of the axillary region Superficial
inguinal lymph nodes

Heart
 Auscultation of Aortic, Pulmonic, Tricuspid, Mitral (APTM), and carotids areas
o Auscultate on the skin rather than clothing!
 Jugular venous pulse (see clinical assessment of central venous pressure)
 Pulses (see pulse examination)
 Edema (pitting vs. nonpitting)
 In cardiovascular examination, percussion and palpation (e.g., point of maximal
impulse, heave, thrills) only play a minor role.
 See cardiovascular examination for a thorough examination.

Cardiovascular Examination - Clinical Examination of the Heart Peripheral

Arterial Examination - Clinical Examination Examination of the Jugular Venous

Pressure - Clinical Examination Testing the Hepatojugular Reflux - Clinical

Examination Modified Allen Test - Clinical Examination Anatomical

locations and auscultatory sites for heart valves Sites of palpation for pulse

measurements Pitting edema of lower leg

Notes
Feedback
Lungs and chest wall
 Inspection: breathing pattern, shape of thorax, sputum
 Palpation: tenderness, symmetry, tactile fremitus (“ninety-nine”)
 Percussion: hyperresonant or dull
 Auscultate (would be enough if the case is not pulmonary)
 Egophony (auscultate with ee-aa)
 See pulmonary examination for a thorough examination.

Examination of the Lungs - Clinical Examination Surface anatomy of the

lungs Lung movement during respiration Tactile fremitus

Percussion and auscultation of the lung
Notes
Feedback
Abdomen
 Inspection
 Auscultation
 Percussion
 Palpation and rebound
 Check for signs: Murphy sign, McBurney, Rovsing sign, Psoas sign, obturator sign
 Costovertebral angle tenderness
 See abdominal examination.

Examination of the Abdomen - Clinical Examination Examination of the

Liver - Clinical Examination Examination of the Spleen - Clinical Examination

Ascites: Shifting Dullness - Clinical Examination Murphy Sign - Clinical

Examination Abdominal regions Signs of appendicitis Signs of
appendicitis: pain provocation maneuvers
Notes
Feedback
Pelvic
 Female
o External genital exam: check for any abnormalities of the vulva, labia (e.g.,
swelling, irritation, ulcers)
o Internal genital exam: includes the sterile speculum exam, cervicovaginal swab
o Bimanual pelvic exam: by introducing two fingers of one hand in the
patient's vagina while pressing on the abdomen with the other hand the physician
to examine patient's uterus and adnexa (e.g., their localization, size, tenderness
during manipulation, presence of masses)
o Rectovaginal pelvic exam: allows for the palpation of the rectovaginal septum
palpation in patients with suspected pelvic masses (e.g., colorectal cancer)
o For other common instrumental diagnostic procedures used for the examination
of an OB/GYN patient, see diagnostic procedures in gynecology.
 Male
o Inspection
 Hair pattern or any signs of lice or nits
 Presence of circumcision (uncircumcised patients should be examined with
the foreskin retracted)
 Lesions, rashes, or edema of the penis, scrotum, or perineum
o Palpation of penis, scrotum, and both testicles
o Hernia examination (see palpation of the inguinal canal)
o Prostate examination (see digital rectal examination)
As a student, you should only perform breast, pelvic, and prostate exams under the
supervision of a senior physician!

Palpation of the inguinal canal in a male patient

Notes
Feedback
Neurological
 Levels of consciousness
 Mental status exam
o Orientation: name, place, date
o Memory: recent, distant
o Concentration: world, naming (show pen), unopened letter on the ground that is
stamped and addressed - what would you do?
 Cranial nerve examination
 Sensory function (pinprick, dull, proprioception)
 Motor function (upper motor neuron injury vs. lower motor neuron injury)
 Tendon reflexes
 Coordination (finger-nose, rapid alternating)
 Gait assessment
 Romberg test
 Meningeal signs
 See Neurological examination.

Asymmetrical Tonic Neck Reflex - Clinical Examination Babinski Reflex

in Infants - Clinical Examination Epley maneuver (left side) Epley

maneuver (right side) Dix-Hallpike maneuver (left side) Dix-Hallpike

maneuver (right side) Deep tendon reflexes Brudzinski sign

Straight leg raise tests Kernig sign

Notes
Feedback
Musculoskeletal
 General considerations
o The musculoskeletal exam is typically tailored to the patient's concern.
o Procedures include:
 Gross inspection
 Assess mobility (compare to unaffected side)
 Perform percussion and palpation (tenderness)
 Assessment of strength
 See orthopedic examination findings.
 Back/spine
o Inspect for malalignments (such as scoliosis)
o Assess spine mobility.
o Lightly percuss the entire curvature of the spine with the fist.
 Shoulder (see orthopedic shoulder examination)
o Drop arm test
o Neer test (supraspinatus/rotator cuff tear)
 Elbow
o Palpate for lateral or medial tenderness.
o See elbow dislocation.
 Wrist: Tinel sign, Phalen sign
 Hand (see alterations of the hand)
 Knee
o Check for edema (tap patella after milking).
o Anterior/posterior drawer tests
o Varus and valgus stress test (MCL/LCL stability)
o See signs of meniscus injury.
o See knee ligament injuries.
o See osteoarthritis of the hip and knee.
 Hip
o Have the patient lie down and perform:
 Joint ROM (flexion/extension, internal/external rotation, adduction/abduction)
 Straight leg test
o For further examination of the hip:
 See osteoarthritis of the hip and knee.
 See developmental dysplasia of the hip.
 See “Clinical features” of hip fractures.

Inspection of the Shoulder Region - Part 1 - Clinical Examination

Palpation of the Shoulder Region - Part 2 - Clinical Examination Impingement

Syndrome - Neer Test Knee Joint - Range of Motion - Clinical Examination

 Tinel sign in carpal tunnel syndrome Phalen maneuver and reverse

Phalen maneuver McMurray test Pivot Shift Test - Clinical Examination

Pivot shift test Straight leg raise tests

Breast
 Inspection
o Skin changes such as erythema, dimpling, scaling
o Nipple discharge
 Palpation
o Breast masses
o Breast tenderness
o Performed while the patient is supine and with hands behind the head. Palpate in
a concentric circle, verticle strip method, or “spokes of a wheel” method
 Axillary examination: see palpation of the axillary lymph nodes
 For more details: See “Clinical features” in benign breast conditions and breast
cancer articles.

Local findings in breast cancer

Notes
Feedback
References
1.
Bickley L. Bates' Guide to Physical Examination and History-Taking. Lippincott Williams
& Wilkins; 2012
2.
Evaluation and Management
Services. https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-
MLN/MLNProducts/Downloads/eval-mgmt-serv-guide-ICN006764.pdfUpdated: July 31,
2017. Accessed: December 7, 2019.
3.
Swartz MH. Textbook of Physical Diagnosis E-Book. Elsevier Health Sciences; 2014
4.
Sapra A, Malik A, Bhandari P. Vital Sign Assessment. StatPearls. 2021. pmid:
31985994. Open in Read by QxMD