BROWSE's INTRODUCTION to the SYMPTOMS and SIGNS of SURGICAL DISEASE SIXTH EDITION

Browse's Introduction to the Symptoms & Signs of Surgical Disease is essential reading for all medical students learning the fundamentals of history taking and patient examination, when undertaking a surgical rotation, when preparing for their surgical exams and as they transition to postgraduate studies. Maintaining the engaging and readable style so central to Sir Norman Browse's early editions, the sixth edition of this classic text retains all the features beloved by generations of students while being fully revised and updated throughout in line with current surgical practice. Key Features: Current – fully revised and updated Accessible – highly structured and consistent layout, supplemented by tables and revision panels for rapid reference in the pressured run up to qualifying exams Beautifully illustrated – packed with an unrivalled collection of colour photographs and explanatory line diagrams, refreshed for this new edition Expert editors – with a wealth of clinical and teaching experience, supported by contributors new to this edition bringing a fresh approach Companion website – visit www.routledge.com/cw/gossage for digital resources to supplement this textbook including self-assessment material, video animations and an image library Now supplemented by online resources for the complete learning and revision package, this sixth edition remains indispensable for the clinical years of undergraduate study to postgraduate surgical training and beyond. Cover 1 Half Title 2 Title Page 4 Copyright Page 5 Contents 6 Obituary 8 Foreword 10 Contributors 12 1. History-taking and clinical examination 16 How to take the history 17 A detailed history of pain 24 Clinical examination 27 History and examination of a lump 44 History and examination of an ulcer 48 2. The heart, lungs and pleura 52 Introduction 52 Breathlessness 59 Pneumothorax 60 Pleural effusion 62 Mesothelioma 63 Empyema 64 Pulmonary embolism 65 Lung cancer 65 Heart failure 67 Valvular disease 69 Infective endocarditis 71 Congenital heart disease 72 Left atrial myxoma 75 Cough 75 Inhaled foreign body 77 Pneumonia 77 Lung abscess 78 Bronchiectasis 79 Chest pain 80 Chronic stable angina 82 Acute coronary syndromes 83 Aortic dissection 84 Mediastinal masses and tumours 86 Other symptoms/signs 86 Stridor 86 Haemoptysis 87 Distended neck veins 87 Chest and cardiac trauma 89 Chest wall abnormalities 90 Finger clubbing 92 Ankle swelling 92 Cyanosis 92 Horner’s syndrome 93 3. The brain, central nervous system and peripheral nerves 94 History 94 Neurological symptoms arising from cranial conditions 95 Neurological symptoms arising from spinal conditions 99 Neurological examination 99 Head and spine 100 Practical neurological examination 100 Specific intracranial conditions 112 Head injury 112 Brain tumours 116 Brain haemorrhage 118 Infections of the brain 119 Hydrocephalus 120 Peripheral nerve injury 121 4. The skin and subcutaneous tissues 126 Anatomy and function 126 Diagnosis of skin conditions 127 Congenital skin disorders 129 Genetic skin disorders 129 Non-genetic congenital skin disorders 131 Haemangiomas/lymphangiomas 132 Acquired dermatological conditions 136 Conditions of the skin caused by trauma including burns 136 Infections of the skin 142 Pruritus 152 Benign skin lumps 152 Benign subcutaneous swellings 160 Tumours of the skin appendages 165 Premalignant skin lesions 165 Malignant diseases of the skin 166 Other common skin conditions sometimes seen in surgical patients 177 The fingernails 178 The toenails 180 5. Major injuries 184 First aid 184 The primary survey and management at the site of the event 185 The primary survey in the emergency department 187 The secondary survey 191 General examination of a conscious patient 192 The secondary survey in the unconscious patient 197 Tertiary survey 198 Assessment of multiple casualties 198 6. Bones, joints, muscles and tendons 200 Common symptoms 200 General plan for examining the muscles, bones and joints of a limb 201 Examination of the muscles 204 Examination of the bones 205 Examination of the joints 208 General examination of the limb 209 Conditions of muscles 209 Conditions of fibrous tissue 212 Conditions of tendons and tendon sheaths 213 Conditions of bones 213 Fractures 213 Bone diseases and deformities 217 Abnormalities of bone metabolism 219 Infections of bone 221 Miscellaneous conditions of bone 223 Conditions of joints 230 Congenital/genetic disorders of bones and joints 237 7. Upper limb 240 The shoulder 240 Causes of shoulder pain 247 The elbow joint 253 Causes of elbow pain 255 The hand 259 Abnormalities and conditions of the hand 261 Fractures and dislocations of the upper limb 269 8. Lower limb 280 The hip 280 Symptoms 280 Plan for examination of the hip joint 281 Conditions causing pain in the hip 285 The knee joint 291 Symptoms 291 Plan for examination of the knee joint 291 Conditions causing knee pain 297 The foot and ankle 303 The ankle joint 303 The foot arches 303 Symptoms 303 Plan for examination of the foot and ankle 304 Congenital and acquired conditions of the foot and ankle 307 Fractures of the lower limb 314 Proximal femoral fractures 314 Dislocations of the hip 315 Fractures of the femoral shaft 316 Supracondylar fractures of the femur 316 Fractures of the knee, ankle and foot 317 9. Spine and pelvis 320 Symptoms of spinal disorders 320 Assessment of spinal problems 321 Examination of the cervical spine 321 Common conditions of the cervical spine 322 Examination of the thoracolumbar–sacral spine 325 Common conditions of the thoracolumbar–sacral spine 329 Fractures 336 Spine and pelvis 336 Cervical spine 337 Thoracolumbar spine 339 Minor fractures 340 Sacrum and coccyx 340 Pelvic fractures 341 10. The arteries, veins and lymphatics 344 The arteries 344 Clinical asse ssment of the arterial circu lation of the lower limb 344 Conditions of the arteries 350 Chronic arterial insufficiency of the lower limb 351 Pulsatile swellings (aneurysms) 358 Haemorrhage 362 Transient and permanent neurological weakness, paralysis and blindness 362 Cold, blue digits, hands and feet 365 Large limbs 368 Surgically correctable causes of hypertension 369 Intestinal ischaemia 369 The veins 369 Clinical assessment of the venous circulation of the lower limb 369 Lower limb venous disease 378 The lymphatics 384 Conditions affecting the lymph glands 384 11. The mouth, tongue and lips 388 Examination of the mouth, tongue and lips 388 Congenital orofacial abnormalities 388 Conditions of the lips, buccal mucosa and tongue 392 Conditions of the palate 403 Conditions of the tonsils 405 Conditions of the floor of the mouth 406 Conditions of the gums (gingivae) 408 Conditions of the jaw 409 12. The neck 414 History and examination of swellings in the neck 414 Cervical lymphadenopathy 415 Other neck swellings 415 The salivary glands 430 Conditions of the submandibular salivary gland 431 Conditions of the parotid gland 433 The thyroid 441 Symptoms of thyroid disease 441 Conditions of the thyroid gland 444 Parathyroid disease and symptoms 461 13. The breast 466 History and examination of breast disease 466 Presentation of breast disease 472 Carcinoma of the female breast 472 Benign breast tumours 476 Benign breast disease 477 Conditions of the nipple 479 Breast abscess 480 Pregnancy 481 The male breast 481 14. The abdominal wall, hernias and the umbilicus 484 Examination of the abdominal wall 484 Abdominal hernia 485 Inguinal hernia 486 Femoral hernia 495 Prevascular hernia 497 Umbilical hernia 498 Paraumbilical hernia 499 Epigastric hernia 500 Incisional hernia 501 Divarication of the recti 501 Rare abdominal hernias 502 Conditions of the umbilicus 502 15. The abdomen 506 Examination of the abdomen 506 Abdominal pain 511 Pathology of the acute abdomen 513 Inflammation of a viscus 513 Perforation of a viscus 514 Obstruction of a viscus/intestinal obstruction 514 Infarction of a viscus 516 Abdominal pain caused by haemorrhage 517 Extra-abdominal and medical conditions causing acute abdominal pain 519 Causes of acute upper abdominal pain 522 Acute central abdominal pain 527 Acute lower abdominal pain 529 Chronic abdominal pain 534 Chronic central abdominal pain 538 Chronic lower abdominal pain 541 Conditions presenting with dysphagia 543 Conditions presenting with vomiting 544 Conditions presenting with haematemesis or melaena 545 Conditions presenting with jaundice 545 Conditions presenting with diarrhoea 547 Abdominal masses 548 A mass in the right iliac fossa 556 A mass in the left iliac fossa 558 A lump in the groin 559 Abdominal distension 559 16. The rectum and anal canal 564 Applied anatomy 564 Symptoms of anorectal disease 564 Technique for digital ano-rectal examination 566 Sigmoidoscopy and proctoscopy 569 Conditions presenting with rectal bleeding 572 Conditions presenting with anal pain 576 Conditions presenting as an anal lump with or without pain 582 Prolapse of the rectum 583 Conditions presenting with pruritus ani 585 Conditions presenting with faecal incontinence 586 17. The kidneys, urinary tract and prostate 588 Symptoms of renal and urinary tract disease 588 Diseases of the urinary tract 590 Retention of urine 596 Conditons of the prostate gland 598 Conditons of the urethra 600 Trauma to the urinary tract 601 18. The external genitalia 604 Examination of the male genitalia 604 Conditions of the penis 607 Conditions of the scrotal skin 614 Conditions of the testes 616 Erectile dysfunction 628 Male infertility 628 Conditions of the female external genitalia 629 Intersex conditions 629 Index 632 __Browse's Introduction to the Symptoms & Signs of Surgical Disease__ is essential reading for all medical students learning the fundamentals of history taking and patient examination, when undertaking a surgical rotation, when preparing for their surgical exams and as they transition to postgraduate studies. Maintaining the engaging and readable style so central to Sir Norman Browse's early editions, the sixth edition of this classic text retains all the features beloved by generations of students while being fully revised and updated throughout in line with current surgical practice. * **Current** – fully revised and updated * **Accessible** – highly structured and consistent layout, supplemented by tables and revision panels for rapid reference in the pressured run up to qualifying exams * **Beautifully illustrated** – packed with an unrivalled collection of colour photographs and explanatory line diagrams, refreshed for this new edition * **Expert editors** – with a wealth of clinical and teaching experience, supported by contributors new to this edition bringing a fresh approach * **Companion website** – visit www.routledge.com/cw/gossage for digital resources to supplement this textbook including self-assessment material, video animations and an image library