Clinical anatomy cases: an integrated approach with physical examination and medical imaging PDF
Preview Clinical anatomy cases: an integrated approach with physical examination and medical imaging
Sagar Dugani, MD, PhD Jeffrey E. Alfonsi, BASc, MD Clinical Fellow, General Internal Medicine Clinical Fellow, Department of Medicine St. Michael's Hospital and University of Toronto Schulich School of Medicine and Dentistry Toronto, Ontario, Canada Western University London, Ontario, Canada Anne M. R. Agur, BSc (OT), Arthur F. Dalley II, PhD, FAAA MSc, PhD Professor, Department of Cell and Professor, Division of Anatomy, Department of Developmental Biology Surgery, Faculty of Medicine Adjunct Professor, Department of Orthopaedic Division of Physical Medicine and Rehabilitation, Surgery Department of Medicine Vanderbilt University School of Medicine Department of Physical Therapy, Department Adjunct Professor of Anatomy of Occupational Science and Occupational Belmont University School of Physical Therapy Therapy Nashville, Tennessee Division of Biomedical Communications, Institute of Medical Science Rehabilitation Sciences Institute, Graduate Department of Dentistry University of Toronto Toronto, Ontario, Canada Wolters Kluwer ® Philadelphia • Baltimore • New York • London Buenos Aires • Hong Kong· Sydney • Tokyo Acquisitions Editor: Crystal Taylor Product Development Editor: Greg Nicholl Marketing Manager: Michael McMahon Production Project Manager: Bridgett Dougherty Design Coordinator: Stephen Druding Art Director: Jennifer Clements Art Coordinator: Jonathan Dimes of JDimes Medivisual Communications Manufacturing Coordinator: Margie Orzech Prepress Vendor: SPi Global Copyright © 2017 Wolters Kluwer All rights reserved. This book is protected by copyright. No part of this book may be reproduced or transmitted in any form or by any means, including as photocopies or scanned-in or other electronic copies, or utilized by any informa tion storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews. Materials appearing in this book prepared by individuals as part of their official duties as U.S. government employees are not covered by the above-mentioned copyright. To request permis sion, please contact Wolters Kluwer at Two Commerce Square, 2001 Market Street, Philadelphia, PA 19103, via email at [email protected], or via our website at lww.com (products and services). 9 8 7 6 5 4 3 2 1 Printed in China Library of Congress Cataloging-in-Publication Data Names: Dugani, Sagar, editor. I Alfonsi, Jeffrey E., editor. I Agur, A. M. R., editor. I Dalley, Arthur F., II, editor. Title: Clinical anatomy cases: an integrated approach with physical examination and medical imaging/ [edited by] Sagar Dugani, Jeffrey E. Alfonsi, Anne M.R. Agur, Arthur F. Dalley II. Description: Philadelphia : Wolters Kluwer, [2017] I Includes index. Identifiers: LCCN 2016010368 I ISBN 9781451193671 Subjects: I MESH: Physical Examination I Diagnostic Imaging I Anatomy, Regional-methods I Clinical Medicine methods Classification: LCC RC78.7.D53 I NLM WB 200 I DOC 616.07/54-dc23 LC record available at http://lccn.loc.gov/ 2016010368 This work is provided "as is," and the publisher disclaims any and all warranties, express or implied, including any warranties as to accuracy, comprehensiveness, or currency of the content of this work. This work is no substitute for individual patient assessment based upon healthcare professionals' examination of each patient and consideration of, among other things, age, weight, gender, current or prior medical conditions, medication history, laboratory data and other factors unique to the patient. The publisher does not provide medical advice or guidance and this work is merely a reference tool. Healthcare professionals, and not the publisher, are solely respon sible for the use of this work including all medical judgments and for any resulting diagnosis and treatments. Given continuous, rapid advances in medical science and health information, independent professional verification of medical diagnoses, indications, appropriate pharmaceutical selections and dosages, and treatment options should be made and healthcare professionals should consult a variety of sources. When prescribing medication, healthcare professionals are advised to consult the product information sheet (the manufacturer's package insert) accompanying each drug to verify, among other things, conditions of use, warnings and side effects and identify any changes in dos age schedule or contraindications, particularly if the medication to be administered is new, infrequently used or has a narrow therapeutic range. To the maximum extent permitted under applicable law, no responsibility is assumed by the publisher for any injury and/or damage to persons or property, as a matter of products liability, negligence law or otherwise, or from any reference to or use by any person of this work. LWW.com My parents, Manda and Basavaraj Dugani, for their constant inspiration and support (Sagar Dugani) My wife Elizabeth, thank you for your love, smiles, patience, and support (Jeffrey E. Alfonsi) My husband Enno and my family Kristina, Erik, and Amy for their support and encouragement (Anne M. R. Agur) Muriel, with love and appreciation for your continued patience and support (Arthur F. Dalley II) And. .. . . . to the anatomical donors: With sincere appreciation for all those who donate their bodies for anatomical study and research, without whom much anatomical study would not be possible. Anne M. R. Agur, BSc (On, MSc, PhD Christine J. Chung, MD Professor, Division of Anatomy, Department of Surgery, Department of Medicine, Division of Cardiology Faculty of Medicine Columbia University Medical Center Division of Physical Medicine and Rehabilitation, New York City, New York Department of Medicine Department of Physical Therapy, Department of Arthur F. Dalley II, PhD, FAAA Occupational Science and Occupational Therapy Professor, Department of Cell and Developmental Division of Biomedical Communications, Institute of Biology Medical Science Adjunct Professor, Department of Orthopaedic Rehabilitation Sciences Institute, Graduate Department Surgery of Dentistry Vanderbilt University School of Medicine University of Toronto Adjunct Professor of Anatomy Toronto, Ontario, Canada Belmont University School of Physical Therapy Jeffrey E. Alfonsi, BASc, MD Nashville, Tennessee Clinical Fellow, Department of Medicine Schulich School of Medicine and Dentistry Sagar Dugani, MD, PhD Western University London, Ontario, Canada Clinical Fellow, General Internal Medicine St. Michael's Hospital and University of Shamik Bhattacharyya, MD, MS Toronto Clinical Fellow Toronto, Ontario, Canada Department of Neurology Harvard Medical School Sebastian Heaven, MBBCh Neurology Resident Postgraduate Surgical Trainee Department of Neurology Department of Surgery, Orthopaedic Division Massachusetts General Hospital and Brigham and McMaster University Women's Hospital Orthopaedic Surgery Resident Boston, Massachusetts Department of Orthopaedic Surgery Nickolaus Biasutti, HBSc Hamilton Health Sciences MD Candidate, QMed 2018 Hamilton, Ontario, Canada Faculty of Health Sciences Queen's University Marilyn Heng, MD, FRCSC Kingston, Ontario, Canada Instructor Tanya Chawla, RCP, FRCR, FRCPC Department of Orthopaedic Surgery Harvard Medical School Assistant Professor Orthopaedic Surgeon Department of Medical Imaging Department of Orthopaedic Surgery University of Toronto Massachusetts General Hospital Staff Radiologist Boston, Massachusetts Department of Medical Imaging Mount Sinai Hospital Toronto, Ontario, Canada Aaron lzenberg, MD, FRCPC Lecturer Ernest Chiu, MD Division of Neurology, Department of Clinical Fellow, Division of Nephrology Medicine Department of Medicine University of Toronto University of Toronto Staff Neurologist Toronto, Ontario, Canada Sunnybrook Health Sciences Centre Kenneth B. Christopher, MD, SM Toronto, Ontario, Canada Assistant Professor Department of Medicine R. Phelps Kelley, AB, MD Harvard Medical School Resident Associate Physician Department of Radiology and Biomedical Division of Renal Medicine Imaging Brigham and Women's Hospital University of California, San Francisco Boston, Massachusetts San Francisco, California iv Contributors V Joshua P. Klein, MD, PhD Devraj Sukul, MD Associate Professor Fellow, Cardiovascular Medicine Department of Neurology Department of Internal Medicine Harvard Medical School University of Michigan Health System Chief, Division of Hospital Neurology Ann Arbor, Michigan Department of Neurology Brigham and Women's Hospital Piero Tartaro, MD, MScCH Boston, Massachusetts Lecturer Department of Medicine Kristen M. Krysko, MD, BSc University of Toronto Resident Physician Staff Gastroenterologist Department of Neurology Division of Gastroenterology University of Toronto Sunnybrook Health Sciences Centre Toronto, Ontario, Canada Toronto, Ontario, Canada Joshua M. Liao, MD Sarah M. Troster, MD Department of Medicine Clinical Fellow, Division of Rheumatology Perelman School of Medicine Department of Internal Medicine University of Pennsylvania University of Toronto Philadelphia, Philadelphia Toronto, Ontario, Canada Kelsey E. Mills, MD Obstetrician and Gynecologist Janice Wong, MD, MS Department of Obstetrics and Gynecology Clinical Fellow Victoria General Hospital Department of Neurology Victoria, British Columbia Harvard Medical School Neurology Resident Tri H. Nguyen, MD, MSc Department of Neurology Resident Brigham and Women's Hospital, Massachusetts General Physical Medicine and Rehabilitation Hospital University of Toronto Boston, Massachusetts Toronto, Ontario, Canada Michelle J. Yu, MD, PhD Gavin J. le Nobel, MD Pulmonary and Critical Care Medicine Resident University of California, San Francisco Otolaryngology Head and Neck Surgery San Francisco, California University of Toronto Toronto, Ontario, Canada Jonathan S. Zipursky, MD Resident Sunita Sharma, MD, MPH Department of Medicine Associate Professor St. Michael's Hospital Department of Medicine University of Toronto University of Colorado School of Medicine Toronto, Ontario, Canada Aurora, Colorado Molly Zirkle, MD, MED Samuel A. Silver, MD, FRCPC University of Toronto Assistant Professor Toronto, Ontario, Canada Department of Otolaryngology University of Toronto Laura E. Smith, MD Toronto, Ontario, Canada Instructor in Medicine Harvard Medical School Instructor in Medicine Internal Medicine Brigham and Women's Hospital Boston, Massachusetts Daniel Souza, MD, MSc Instructor Department of Radiology Harvard Medical School Staff Radiologist Department of Radiology Brigham and Women's Hospital Boston, Massachusetts FACULTY Andrew F. Payer, PhD Professor Medical Education Francine Anderson, PhD, PT College of Medicine Chair of Anatomy University of Central Florida School of Osteopathic Medicine Orlando, Florida Campbell University Buies Creek, North Carolina Danielle Royer, PhD Assistant Professor Rebecca Brown, MPAS, PA-C Department of Cell and Developmental Biology Assistant Coordinator University of Colorado Denver Le Moyne College Denver, Colorado Syracuse, New York Brett Szymik, PhD Thomas R. Gest, PhD Assistant Professor Professor of Anatomy Georgia Regents University/University of Georgia Department of Medical Education Medical Partnership Texas Tech University Health Sciences Center Athens, Georgia El Paso, Texas Ljubisa Terzic, MD Douglas J. Gould, PhD Associate Professor Professor of Neuroscience and Vice Chair Canadian College of Naturopathic Medicine Department of Biomedical Sciences Toronto, Ontario Oakland University William Beaumont School of Medicine Shanna Williams, PhD Rochester, Michigan Assistant Professor School of Medicine Robert Hage, MD, PhD, DLO, MBA University of South Carolina Professor Greenville, South Carolina St. George's University St. George's, Grenada, West Indies STUDENTS Jon Jackson, PhD Visiting Professor Joshua Agranat St. George's University Boston University School of Medicine St. George's, Grenada, West Indies AmierAhmad Eileen Kalmar, PhD University of Southern Florida College of Medicine Assistant Professor-Clinical College of Medicine David Ballard The Ohio State University Louisiana State University Health Columbus, Ohio Shreveport School of Medicine H. Wayne Lambert, PhD William Blair Professor Lake Erie College of Osteopathic Medicine Department of Neurobiology and Anatomy West Virginia University School of Medicine Lucas Carlson Morgantown, West Virginia University of Maryland School of Medicine Octavian Calin Lucaciu, MD, PhD William Gentry Associate Professor Oceania University of Medicine Canadian Memorial Chiropractic College Toronto, Ontario Benjamin Heyen University of Kansas Medical School vi Reviewers vii Christopher Jacob Julianne Matthews Becker Professional Education Northeastern Ohio Medical University Ross University School of Medicine Francesca Nichols Christen Johnson University of Utah School of Medicine Wright State University Boonshoft School of Medicine Jennifer Townsend Zuhal Kadhim UCSF School of Medicine University of Toronto Samuel Windham Bryan Klosky University of Missouri-Columbia School of Medicine Shenendoah University School of Pharmacy Kristen Wilde Porcha Leggett Indiana University School of Medicine Ross University School of Medicine Michael Wu Jason Lipof University of Hawaii, John A. Burns School of Medicine George Washington University School of Medicine Medical education is evolving. Yet, today, many topics are often taught in isolation, and trainees are presented with the daunting task of integrating various concepts in medicine. Several years ago, we experienced that three key topics-anatomy, physical examination, and medical imaging-were fragmented through different stages of medical education and that trainees lacked a single resource to integrate these topics. This fragmentation gave rise to the idea of Clinical Anatomy Cases as a way to amalgamate all three concepts into a single resource. Clinical Anatomy Cases uses a highly graphical approach to describe seven anatomical regions. The introductory chapter outlines our integrated approach and provides the fundamentals of the physical examination, medical imaging modalities, and commonly used statistical concepts. The seven anatomical regions continue this integrated approach and lead the reader through several common clinical presentations and diseases. Where relevant, we also include a concise list of dif ferential diagnoses and high-yield clinical pearls. We decided to create this resource as it addresses a gap in our approach to education. We remain confident that this integrated resource will appeal to medical students, residents, and stu dents in health disciplines including nursing, physical therapy, occupational therapy, dentistry, and physician assistants program. In addition to being beneficial to students, this book will also serve as a convenient resource for faculty members to include in their courses or integrated curricula. Further, the topics presented here complement the clinical focus of related Wolters Kluwer publica tions such as Clinically Oriented Anatomy and Essential Clinical Anatomy. We hope that this book generates additional resources that integrate various aspects of medical education. KEY TO ICONS USED IN CLINICAL CASES • = Family Medicine = Emergency Medicine = Obstetrics and Gynecology = Surgery = Internal Medicine viii
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