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Applied basic science for basic surgical training PDF

660 Pages·2011·17.959 MB·English
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APPLIED BASIC SCIENCE FOR BASIC SURGICAL TRAINING For Elsevier Commissioning editor: Laurence Hunter Development Editor: Ailsa Laing Senior Project manager: Jess Thompson Project manager: Tracey Donnelly Designer: Erik Bigland Illustration Manager: Merlyn Harvey Illustrator: HL Studios APPLIED BASIC SCIENCE FOR BASIC SURGICAL TRAINING SECOND EDITION EDITED BY Andrew T. Raftery BSc MD CIBiol MIBiol FRCS Consultant Surgeon, Sheffi eld Kidney Institute, Sheffi eld Teaching Hospitals NHS Trust, Northern General Hospital, Sheffi eld; Member (formerly Chairman) of the Court of Examiners, Royal College of Surgeons of England; Formerly Examiner MRCS Royal College of Surgeons of Edinburgh; Formerly Member of Panel of Examiners, Intercollegiate Specialty Board in General Surgery; Honorary Senior Clinical Lecturer in Surgery, University of Sheffi eld, UK EDINBURGH LONDON NEW YORK PHILADELPHIA ST LOUIS SYDNEY TORONTO 2008 Note Knowledge and best practice in this fi eld are constantly changing. As new research and experience broaden our knowledge, changes in practice, treatment and drug therapy may become necessary or appropriate. Readers are advised to check the most © Harcourt Publishers Limited 2000 current information provided (i) on procedures featured or (ii) by © 2008, Elsevier Limited. All rights reserved. the manufacturer of each product to be administered, to verify No part of this publication may be reproduced, stored in a the recommended dose or formula, the method and duration of retrieval system, or transmitted in any form or by any means, administration, and contraindications. It is the responsibility of electronic, mechanical, photocopying, recording or otherwise, the practitioner, relying on their own experience and knowledge without the prior permission of the Publishers. Permissions of the patient, to make diagnoses, to determine dosages and may be sought directly from Elsevier’s Health Sciences Rights the best treatment for each individual patient, and to take all Department, 1600 John F. Kennedy Boulevard, Suite 1800, appropriate safety precautions. To the fullest extent of the law, Philadelphia, PA 19103-2899, USA: phone: ((cid:2)1) 215 239 3804; neither the Publisher nor the Editor assumes any liability for fax: ((cid:2)1) 215 239 3805; or, e-mail: healthpermissions@elsevier. any injury and/or damage to persons or property arising out or com. You may also complete your request online via the Elsevier related to any use of the material contained in this book. homepage (http://www.elsevier.com), by selecting ‘Support and The Publisher contact’ and then ‘Copyright and Permission’. First edition 2000 Second edition 2008 Main edition ISBN: 978-0-08-045140-4 International edition ISBN: 978-0-08-045139-8 British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging in Publication Data A catalog record for this book is available from the Library of Congress The Publisher’s policy is to use paper manufactured from sustainable forests Printed in China PREFACE I am grateful to the publishers for the invitation special pathology of the systems which a basic surgical to produce a second edition of Applied Basic trainee would be expected to know. Several new Science for Basic Surgical Training. Despite the authors have been taken on for the second edition and considerable changes to education and examination, many of the chapters have been updated, especially the requirement of any future surgeon to possess the chapters on immunology, basic microbiology, a comprehensive knowledge of the applied basic the endocrine system, the locomotor system and the sciences remains the core of surgical training; a fact breast. An attempt has been made to indicate the that is universally acknowledged by the organisations clinical relevance of the facts and the reason for most closely involved in the shaping of the surgical learning them. All authors are experts in their fi eld curriculum. Candidates will need to acquire a and many of them are, or have been, experienced knowledge of basic science which will allow them to examiners at the various Royal Colleges. There remains understand the principles behind the management of some repetition and overlap between chapters which patients and the practical procedures that they will be has been retained where it was considered necessary expected to carry out as basic surgical trainees. for the smooth continuity of reading a particular section, rather than cross-referring to other sections of the Although this book has been written to encompass the book. Although this book was written with basic surgical basic anatomy, physiology and pathology required by training in mind, it should provide a rapid revision for the syllabus of the Royal Colleges and the Intercollegiate basic science for the intercollegiate speciality exams Surgical Curriculum Project, it also contains the and may even stimulate the motivated undergraduate necessary information required for examinations and student who thirsts for more knowledge. I just hope that assessments not only in the UK but internationally. it sells as well as the fi rst edition! The book is divided into two sections, the fi rst covering Andrew T Raftery the basic principles of pathology and microbiology Sheffi eld and the second covering the anatomy, physiology and 2007 v ACKNOWLEDGEMENTS I am extremely grateful to the publishers and in chapter. Last, but by no means least, I would like particular to Laurence Hunter, Commissioning Editor, to thank Denise Smith for typing and re-typing the Ailsa Laing, Development Editor and Tracey Donnelly, manuscript and my wife Anne for collating, organising Project Manager, for their support and help with this and helping to fi nalise the manuscript. I could not have project. I am also grateful to my fellow authors for completed the task without them. their time and effort in ensuring that their manuscripts were produced on time. I am particularly grateful to Dr Andrew T Raftery Paul Zadik, Consultant Microbiologist at the Northern Sheffi eld General Hospital, Sheffi eld, for reading and correcting 2007 the bacteriology section of the basic microbiology vi CONTRIBUTORS John R Benson MA DM(Oxon) FRCS(Eng) FRCS(Ed) Richard L M Newell BSc MB BS FRCS Consultant Breast Surgeon, Cambridge Breast Unit, Clinical Anatomist, School of Biosciences, University of Addenbrookes Hospital, Cambridge, UK Wales, Cardiff, UK; Honorary Consultant Orthopaedic Surgeon, Royal Devon and Exeter Health Trust, Exeter, Julian L Burton MB ChB(Hons) MEd ILTM UK; Former member of the Court of Examiners, Royal Clinical Lecturer in Histopathology, Senate Award College of Surgeons of England Fellow (Learning and Teaching), Academic Unit of Pathology, School of Medicine, Sheffi eld, UK M Andrew Parsons MB ChB FRCPath Senior Lecturer and Honorary Consultant in Ken Callum MS FRCS Ophthalmic Pathology, Royal Hallamshire Hospital, Emeritus Consultant Vascular Surgeon, Derbyshire Sheffi eld, UK; Director, Ophthalmic Sciences Unit, Royal Infi rmary, Derby, UK; Former Member of the University of Sheffi eld; Examiner, Royal College of Court of Examiners, Royal College of Surgeons of Ophthalmologists England Jake M Patterson MB ChB MRCS(Ed) Christopher R Chapple BSc MD FRCS (Urol) Clinical Research Fellow in Urology, Royal Hallamshire Consultant Urological Surgeon, Royal Hallamshire Hospital, Sheffi eld; Department of Engineering Hospital, Central Sheffi eld University Hospitals, Materials, The Kroto Research Institute, University of Sheffi eld, UK; Director of the Postgraduate Offi ce of Sheffi eld, Sheffi eld, UK the European Association of Urology (The European School of Urology) Clive R G Quick MA MS FDS FRCS Consultant Surgeon, Hinchingbrooke Hospital, Andrew Dyson MB ChB FRCA Huntingdon and Addenbrooke’s Hospital, Cambridge; Consultant Anaesthetist, Nottingham University Former member of the Court of Examiners, Royal Hospitals Trust, Nottinghamshire, UK College of Surgeons of England; Associate Lecturer, University of Cambridge, Cambridge, UK William Egner PhD MB ChB MRCP MRCPath Consultant Immunologist, Northern General Hospital, Ravishankar Sargur MD MRCP DipRCPath Sheffi eld, UK Specialist Registrar in Clinical Immunology, Department of Immunology, Northern General Barnard J Harrison MB BS MS FRCS FRCS(Ed) Hospital, Sheffi eld, UK Consultant Endocrine Surgeon, Royal Hallamshire Hospital, Sheffi eld, UK Timothy J Stephenson MA MD MBA FRCPath Consultant Histopathologist, Royal Hallamshire David E Hughes BMedSci MB ChB PhD MRCPath Hospital, Sheffi eld, UK; Member of the Histopathology Consultant Histopathologist, Department of Pathology, Examiners Panel, Royal College of Histopathologists Royal Hallamshire Hospital, Sheffi eld, UK Jenny Walker ChM FRCS Samuel Jacob MB BS MS (Anatomy) Consultant Paediatric Surgeon, Paediatric Surgical Senior Lecturer, Department of Biomedical Science, Unit, Children’s Hospital, Sheffi eld, UK University of Sheffi eld, Sheffi eld, UK; Member of the Court of Examiners, Royal College of Surgeons of England vii This page intentionally left blank CONTENTS SECTION 1 GENERAL PATHOLOGY AND SECTION 2 SPECIFIC SYSTEMS MICROBIOLOGY 8. Nervous system 176 Samuel Jacob & Andrew T Raftery 1. Cellular injury 2 Julian L Burton 9. Cardiovascular system 224 Ken Callum & Andrew Dyson 2. Infl ammation 19 Timothy J Stephenson 10. Haemopoietic and lymphoreticular system 283 3. Thrombosis, embolism and infarction 40 Andrew T Raftery Ken Callum 11. Respiratory system 301 4. Disorders of growth, differentiation and Andrew Dyson & Andrew T Raftery morphogenesis 51 M Andrew Parsons 12. Locomotor system 339 Richard L M Newell 5. Neoplasia 88 13. Head and neck 404 David E Hughes Samuel Jacob 6. Immunology 113 14. Endocrine system 452 William Egner & Ravishankar Sargur Barnard J Harrison 7. Basic microbiology 149 15. Breast 479 Andrew T Raftery Clive R G Quick & John R Benson 16. Paediatric disorders 493 Jenny Walker 17. Alimentary system 513 Andrew T Raftery 18. Genitourinary system 575 Jake M Patterson & Christopher R Chapple Index 615 ix

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