Applied basic science for basic surgical training

660 Pages·2011·17.959 MB·English

by  Andrew T. Raftery

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
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First edition 2000
Second edition 2008
Main edition ISBN: 978-0-08-045140-4
International edition ISBN: 978-0-08-045139-8
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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
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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