1 The body
In the Clinic Determination of skeletal age 14
Bone marrow transplants 15
Bone fractures 16
Avascular necrosis 16
Osteoporosis 17
Epiphyseal fractures 18
Degenerative joint disease 22
Joint replacement 24
The importance of fascias 25
Muscle paralysis 26
Muscle atrophy 26
Muscle injuries and strains 26
Atherosclerosis 27
Varicose veins 28
Anastomoses and collateral circulation 28
Lymph nodes 31
Dermatomes and myotomes 37
Referred pain 48
Clinical Case Appendicitis 50
2 Back In the Clinic
Spina bifida 74
Vertebroplasty 74
Scoliosis 75
Kyphosis 76
Variation in vertebral numbers 76
The vertebrae and cancer 77
Osteoporosis 77
Back pain 79
Herniation of intervertebral discs 79
Joint diseases 80
Ligamenta flava 82
Vertebral fractures 82
Surgical procedures on the back 84
Nerve injuries affecting superficial back musdes 99
Lumbar cerebrospinal fluid tap 106
Herpes zoster 109
Back pain—alternative explanations 110
Clinical Casts Sciatica versus lumbago 118
Cervical spinal cord injury 118
Psoas abscess 119
Dissecting thoracic aneurysm 119
Sacral tumor 120
3 Thorax
In the Clinic Axillary tail of breast 141
Breast cancer 141
Cervical ribs 150
Collection of sternal bone marrow 152
Rib fractures 152
Surgical access to the chest 160
Thoracostomy (chest) tube insertion 160
Intercostal nerve block 160
Pleural effusion 167
Pneumothorax 167
Imaging the lungs 178
High-resolution lung CT 178
Bronchoscopy 178
Lung cancer 179
Pericarditis 184
Pericardial effusion 184
Constrictive pericarditis 184
Valve disease 197
Clinical terminology for coronary arteries 201
Heart attack 202
Classic symptoms of heart attack 203
Are heart attack symptoms the same in men and women? 203
Common congenital heart defects 203
Cardiac auscultation 204
Cardiac conduction system 206
Ectopic parathyroid glands in the thymus 212
Venous access for central and dialysis lines 215
Using the superior vena cava to access the inferior vena cava 215
Coarctation of the aorta 217
Thoracic aorta 217
Aortic arch and its anomalies 217
Abnormal origin of great vessels 217
The vagus nerves, recurrent laryngeal nerves, and hoarseness 221
Esophageal cancer 224
Esophageal rupture 225
Clinical Cases Cervical rib 241
Lung cancer 242
Chest wound 242
Myocardial infarction 243
Broken pacemaker 246
Coarctation of the aorta 247
Aortic dissection 247
Pneumonia 249
Esophageal cancer 250
Venous access 251
4 Abdomen
In the Clinic Surgical incisions 278
Laparoscopic surgery 279
Cremasteric reflex 299
Masses around the groin 301
Peritoneum 305
The greater omentum 308
Epithelial transition between the abdominal esophagus and stomach 315
Duodenal ulceration 315
Examination of the upper gastrointestinal tract 316
Examination of the bowel lumen 316
Examination of the bowel wall and extrinsic masses 316
Meckel's diverticulum 318
Computed tomography (CT) scanning and magnetic resonance imaging (MRI) 318
Carcinoma of the stomach 318
Appendicitis 322
Congenital disorders of the gastrointestinal tract 325
Bowel obstruction 326
Diverticular disease 327
Annular pancreas 336
Pancreatic cancer 336
Segmental anatomy of the liver 339
Gallstones 341
Jaundice 341
Spleen disorders 342
Vascular supply to the gastrointestinal system 351
Hepatic cirrhosis 356
Surgery for obesity 365
Psoas muscle abscess 371
Diaphragmatic hernias 372
Hiatus hernia 373
Urinary tract stones 380
Urinary tract cancer 381
Nephrostomy 382
Kidney transplant 383
Investigation of the urinary tract 385
Abdominal aortic stent graft 389
Inferior vena cava filter 391
Retroperitoneal lymph node surgery 393
Clinical Cases Traumatic rupture of the diaphragm 410
Chronic thrombosis of the inferior vena cava 410
Liver biopsy in patients with suspected liver cirrhosis 411
Hodgkin's lymphoma 412
Inguinal hernia 413
Ureteric stone 413
Intraabdominal abscess 414
Complications of an abdominoperineal resection 415
Carcinoma of the head of the pancreas 417
Cava I obstruction 418
Diverticular disease 418
Endoleak after endovascular repair of abdominal aortic aneurysm 419
Metastatic lesions in the liver 420
5 Pelvis and perineum
In the Clinic Bone marrow biopsy 444
Pelvic fracture 446
Common problems with the sacro-illac joints 448
Pelvic measurements In obstetrics 454
Defecation 456
EpisJotomy 460
Digital rectal examination 462
Carcinoma of the colon and rectum 462
Bladder stones 465
Suprapubic catheterization 466
Bladder cancer 466
Bladder inflection 469
Urethral catheterization 469
Testicular tumors 470
Vasectomy 472
Prostate problems 474
Ovarian cancer 477
Imaging the ovary 477
Hysterectomy 478
Tubal ligation 479
Carcinoma of the cervix and uterus 480
The recto-uterine pouch 481
Pudendal block 491
Prostatectomy and impotence 495
Abscesses in the ischio-anal fossae 504
Hemorrhoids 504
Urethral rupture 512
Clinical Cases Varicocele 527
Sciatic nerve compression 528
Pelvic kidney 528
Left common iliac artery obstruction 529
Iatrogenic ureteric injury 530
Ectopic pregnancy 530
Uterine tumor 531
Uterine fibroids 532
6 Lower limb
In the Clinic Pelvic fractures 553
557 Intertrochanteric fractures 558
Femoral shaft fractures 558
Varicose veins 569
Deep vein thrombosis 569
Vascular access to the lower limb 573
Trendelenburg's sign 577
Intramuscular injections 581
Compartment syndrome 590
Muscle injuries to the lower limb 599
Peripheral vascular disease 603
7 Upper limb
Femoral neck fractures
Soft tissue injuries to the knee 613
Degenerative joint disease/osteoarthritis 614
Examination of the knee joint 614
Anterolateral ligament of the knee 615
Achilles tendon rupture 623
Neurological examination of the legs 625
Footdrop 633
Fracture of the talus 638
Ankle fractures 641
Bunions 645
Morton's neuroma 661
Ginical Cases Varicose veins 672
Knee joint injury 673
Fracture of neck of femur 676
Deep vein thrombosis 677
Ruptured calcaneal tendon 678
Popliteal artery aneurysm 679
Anterior talofibular ligament tear 680
In the Clinic Fracture of the proximal humerus 705
Fractures of the clavicle and dislocations of the acromioclavicular and sternoclavicular joints 711
Dislocations of the glenohumeral joint 712
Rotator cuff disorders 712
Inflammation of the subacromial (subdeltoid) bursa 713
Quadrangular space syndrome 720
'Winging* of the scapula 727
Imaging the blood supply to tfie upper limb 737
Trauma to the arteries of the upper limb 737
Subdavian/axillary venous access 737
Injuries to the brachial plexus 747
Breast cancer 749
Rupture of biceps tendon 755
Blood pressure measurement 756
Radial nerve injury in the arm 763
Median nerve injury in the arm 763
Supracondylar fracture of the humerus 766
Pulled elbow 766
Developmental changes in the elbow joint 767
Fracture of the head of radius 768
Tennis" and "golfer's* elbow (epicondylitis) 768
Elbow arthritis 768
Ulnar nerve injury at the elbow 768
Construction of a dialysis fistula 770
Fractures of the radius and ulna 774
Transection of the radial or ulnar artery 783
Fracture of the scaphoid and avascular necrosis of the proximal scaphoid 797
Carpal tunnel syndrome 798
Snuffbox 801
De Quervain's syndrome 802
Tenosynovitis 802
Trigger finger 802
Alien's test 814
Venipuncture 814
Ulnar nerve injury 816
Radial nerve injury 818
Clinical Cases Shoulder problem after falling on an outstretched hand 829
Winged scapula 829
Brachial plexus nerve block 830
Complication of a fractured first rib 830
Median nerve compression 831
Immobilizing the extensor digitorum muscle 831
Torn supraspinatus tendon 832 How to examine the hand 833
Shoulder joint problem 834
8 Head and neck
In the Clinic Medical imaging of the head 871
Fractures of the skull vault 872
Hydrocephalus 877
Cerebrospinal fluid leak 878
Meningitis 878
Brain tumors 878
Stroke 883
Endarterectomy 885
Intracerebral aneurysms 885
Scalp and meninges 890
Head injury 891
Types Ы intracranial hemorrhage 891
Emissary veins 893
Concussion 893
Clinical assessment of patients with head inji Treatment of head injury 893
Cranial nerve lesions 901
Overview of cranial nerves 901
Parotid gland 913
Facial nerve MU palsy (Bell's palsy) 921
Trigeminal neuralgia 921
Scalp laceration 926
Orbital fracture 928
Homer's syndrome 931
Examination of the eye 940
Glaucoma 948
Cataracts 948
Ophthalmoscopy 949
High-definition optical coherence tomography 951
Examination of the ear 957
Swimmer's ear 957
Surfer's ear 958
Tympanic membrane perforation 958
Mastoiditis 961
Ungual nerve injury 987
Dental anesthesia 989
Fascial planes of the head and neck 1004
Central venous access 1005
Jugular venous pulse 1013
Thyroid gland 1020
Thyroidectomy 1021
Thyroid gland pathology 1021
Ectopic parathyroid glands 1022
Recurrent laryngeal nerve palsy 1034
Clinical lymphatic drainage of the head and neck 1040
Tracheostomy 1065
Laryngoscopy 1065
Deviated nasal septum 1077
Clinical Cases Multinodular goiter 1129
Parotid duct calculus 1130
Extradural hematoma 1131
Stenosis of the internal carotid artery 1132
Posterior communicating artery aneurysm 1133
Recurrent epistaxis 1133
Complication of orbital fracture 1134
Pituitary macroadenoma 1135