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Cambridge University Press 978-1-107-62554-9 - Physical Examination for Surgeons: An Aid to the MRCS OSCE Edited by Petrut Gogalniceanu, James Pegrum and William Lynn Index More information Index Abbreviated Mental Test Score (AMTS), calcifications, 398 326 extraluminal gas, 397 abdomen soft tissues, 398 anatomical divisions, 35 abducens nerve testing, 332 bruits, 50–2 accessory nerve testing, 333 distension, 42 acellular dermal matrix (ADM), 94 emergency checklist, 457 Achilles tendon hernia location, 39–41 rupture assessment, 200 imaging, 47–8 See also abdominal acromioclavicular joint (ACJ), 142 x-ray injury, 419 CT, 48, 457–62 test, 147 MRI, 48 adenocarcinoma, parotid gland, 313 transabdominal ultrasound, 47 adnexal fullness, 106 inspection, 34–60 Adson’s test, 218 palpation, 34–7, 41–2 airway assessment, 474, 480, 491–3 percussion, 35 for intubation, 491–3 skin changes, 38 airway management, 474 ecchymosis causes, 50 Allen’s test, 215 abdominal aortic aneurysm (AAA), AMPLET, 479 208–11, 227, 461, 463 anaesthetic risk assessment, 21 history, 209 anal examination, 99–100 imaging, 211 Goodsall’s rule, 101 sign of imminent rupture, 464 angiogram, lower limb, 471–2 abdominal incisions, 61–8 ankle examination, 190–202 classification, 68 causes of pain, 201 abdominal pain movement assessment, 191, 195 anatomical origins, 43 Ottawa rule, 194 gynaecological causes, 53 palpation, 191, 193–4 inflammation, 44 skin changes, 192 non-surgical causes, 55 special tests, 191 surgical causes, 52 ankle joint, 195, See also ankle examination urine tests, 46 fractures, 443 visceral pain, 43 range of movement, 196 abdominal scars, 61–8 ankle x-ray, 444–8 easily missed scars, 68 anatomy, 444 abdominal x-ray, 47, 396–8 ankle–brachial pressure index (ABPI), 234 artefacts, 397 diabetic ulcers, 254 bowel gas pattern, 397 ankylosing spondylitis, 131 499 © in this web service Cambridge University Press www.cambridge.org Cambridge University Press 978-1-107-62554-9 - Physical Examination for Surgeons: An Aid to the MRCS OSCE Edited by Petrut Gogalniceanu, James Pegrum and William Lynn Index More information 500 Index anosmia, 334 auscultation, 11 anterior cruciate ligament (ACL) injury, abdomen, 35 184, 186 cardiac examination, 265–6 anterior drawer test groin, 70 ankle examination, 197 thorax, 259 knee examination, 148, 183 axilla, 91 anterior tibial pulse, 227 axillobifemoral bypass, 211 anus examination, 99–101 axillounifemoral bypass, 211 aorta aneurysm. See abdominal aortic Bartholin’s gland, 106 aneurysm (AAA); thoracic aortic Barton’s fracture, 427, 431 aneurysm basal cell carcinoma (BCC), 357 branches, 464 Battle’s incision, 64 CT examination, 463–8 bedside observations, 6 dissection, 464, 467 Bell’s phenomenon, 337 endoleaks, 467 benign paroxysmal positional vertigo endoprostheses, 464 (BPPV), 278 palpation, 45 Berry’s sign, 312 aphasia, 327 biceps muscle test, 148 apnoea test, 322 bicipital groove, 143 apprehension test, 148 bladder, CT examination, 470 arterial examination. See also abdominal bleeding risk assessment, 21 aortic aneurysm (AAA); carotid Boas’ sign, 49 artery examination bowel ischaemia, 397 lower limbs, 223–36 bowel obstruction, 397 arterial anatomy, 226 causes, 56 bruits, 233 large bowel, 399, 460 Buerger’s angle and test, 232 small bowel, 399, 460 bypass grafts, 228 brain CT, 451–4 causes of ischaemia, 236 brain death, 319–20 causes of pain, 235 branchial cyst, 314 investigations, 234 breast. See also mammography neurological examination, 234 causes of lumps, 96 skin changes, 223 chest x-ray and, 388 soft tissue changes, 224 focused systemic examination, 91 symptoms of disease, 225 implants, 93 tests, 224 inspection, 90 upper limbs, 212–13 lump assessment, 90 Allen’s test, 215 Paget’s disease, 93 arteriovenous fistula, 86, 88, 246 palpation, 90 complications, 88 post-mastectomy reconstruction, steal syndrome, 88 94 ascites scars, 91 causes, 57 breast cancer screening, 408 shifting dullness, 58 Brudzinski’s neck sign, 325 © in this web service Cambridge University Press www.cambridge.org Cambridge University Press 978-1-107-62554-9 - Physical Examination for Surgeons: An Aid to the MRCS OSCE Edited by Petrut Gogalniceanu, James Pegrum and William Lynn Index More information Index 501 bruits, 50–2, 233 movement assessment, 132–3 carotid, 204, 206 scars, 341 Buerger’s angle, 232 Spurling’s test, 133–4 Buerger’s test, 232 trauma patients, 474 burns, 367–70 cervical spine immobilisation, 474 acute, 368 cervical spine injuries, 138–9, 416 burn centre transfer criteria, 370 common fractures, 416 depth estimation, 369 unstable fractures, 417 life-threatening emergencies, 370 cervical spine x-ray, 416 management guidelines, 369 AP view, 415 size estimation, 370 bone, 415 cervix examination, 106 callosities, 192 chauffeur’s fracture, 432 candidiasis, vaginal, 105 chest CT, 455–6 cardiac examination, 264–9 airway, 455 cardiac scars, 267 circulation and mediastinum, 456 cardiac symptoms, 265 diaphragm, 456 differentiation of murmurs, 267 lungs, 456 preparation for, 265 chest drain, 258, 475 carotid artery endarterectomy (CAE) chest examination. See thorax scars, 204–5 examination carotid artery examination, 203–4 chest x-ray, 386–95 bruits, 204 abdominal pain and, 47 causes of, 206 airway, 387 neurological deficit, 205 bones, 388 causes of, 206 breast, 388 palpation, 203 circulation, 388 carotid bifurcation, 204 danger areas, 388 pulsatile neck mass causes, 207 diaphragm, 388 stenosis, 205 foreign objects, 389 carotid–carotid bypass, 267 Chevrier’s test, 242 carotid–subclavian bypass, 216, 267 chevron incision, 65 carpal fractures, 431 Chilaiditi’s sign, 388 carpal tunnel compression, 380 chondrodermatitis helicis nodularis, 274 examination for, 380 chronic liver disease, signs of, 29 cauda equina syndrome (CES) chronic venous disease, 239, See also assessment, 346 venous system examination CEAP classification, 239 chronic venous hypertension, 237 cerebral perfusion assessment, 475 claudication, 18 cervical lymphadenopathy, 259 arterial versus neurogenic, 225 cervical spine examination, 130–1, See clay shoveler’s fracture, 416 also spine injury assessment clonus, 345 bony contours, 132 closed kinetic chains, 128 causes of cervical pain, 137 cognitive function assessment, 326–7 initial observations, 131 Coleman block test, 196 © in this web service Cambridge University Press www.cambridge.org Cambridge University Press 978-1-107-62554-9 - Physical Examination for Surgeons: An Aid to the MRCS OSCE Edited by Petrut Gogalniceanu, James Pegrum and William Lynn Index More information 502 Index Colles’ fracture, 427, 431 infections, 488 colostomy, 80 kidney function, 488 common femoral artery assessment, 468 lines, tubes and drains, 488 computed tomography (CT), 449–50 nutrition, 488, 490 abdomen, 48, 457–62 Crohn’s disease, 27 extra-abdominal changes, 462 crural vessels, 233 intestines, 458, 460–1 cubital tunnel compression, 380 pelvic viscera, 458 Cullen’s sign, 50 peritoneum, 458 Cusco’s speculum, 104 retroperitoneum, 458, 461–2 cyanotic limb causes, 221 upper abdominal organs, 458–60 aorta, 463–8 DeBakey classification of aortic brain, 451–4 dissection, 467 chest, 451–4 deep venous thrombosis, 245 general principles, 459 prophylaxis in critically ill patients, 487 head, 456–9 dental examination, 305, See also KUB (kidneys, ureter, bladder), 469–70 intra-oral examination lower limb angiogram, 471–2 dental occlusion, 305 reconstruction, 450 relevance to nose and sinus virtual colonoscopy, 450, 459 examination, 285 conductive hearing loss, 337 tooth notation, 304 consciousness level assessment, 322–4, dermatome testing, 342, 345 477 desmoid tumours, 40 consent form, 24–5 diabetes coracoclavicular ligament injury, 419 arterial investigations, 234 corns, 192 critically ill patients, 487 cortical localising features, 328 dial test, 185 Cottle’s manoeuvre, 283 diaphragm, 388, 456 cough reflex, 495 DIEP (deep inferior epigastric artery cough sign, 43–4 perforator) flap, 95 cranial nerve deficits, trauma patients, digital rectal examination, 76, 100 303 cauda equina syndrome assessment, 346 cranial nerve examination, 333 diplopia, 336 critically ill patients, 11, 485–90 Dix–Hallpike manoeuvre, 278 abdomen examination, 487 Dolan’s lines, 412 airway assessment, 485, 489 dorsalis pedis pulse, 227 blood transfusion, 490 drug history (DH), 17 breathing and ventilation, 485, 489 Dunphy’s sign, 43 cardiovascular assessment, 486 Dupuytren’s contracture, 375 diabetes, 487 scars, 376 DVT prophylaxis, 487 dysphasia assessment, 327 fluid balance, 487 gastrointestinal assessment, 487 ear examination, 271–80, 297 haemorrhage, 488 flexible nasendoscopy, 277 history, 485 hearing tests, 272, 276 © in this web service Cambridge University Press www.cambridge.org Cambridge University Press 978-1-107-62554-9 - Physical Examination for Surgeons: An Aid to the MRCS OSCE Edited by Petrut Gogalniceanu, James Pegrum and William Lynn Index More information Index 503 otoscopy, 271, 274 fever, differential diagnosis, 331 patient positioning, 272 fibula fractures, 443 pinna abnormalities, 273 finger assessment, 373 Ehlers–Danlos syndrome, 361 deformities, 375 elbow examination, 152–3 finger clubbing, 256 special tests, 153 causes, 32 elbow x-ray, 424–5 fitness for surgery, 21–2 anatomy, 424 Fitzpatrick classification of skin colour, bony ossification centres in children, 357 425 flaps, 362–6 fractures, 424–5 classification, 363–4 elephant trunks of Rogers, 413 free flaps, 365 Elevated Arm Stress Test (EAST), 220 common cutaneous donor sites, 365 endovascular aneurysm
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