By Aida Lai
Anatomy and pathology are key components in clinical education, however the volume scientific scholars need to study inside of them can appear overwhelming. This publication is helping scholars achieve a company seize of the evidence they need to comprehend sooner than they input their scientific years. It encompasses the center fundamentals of the key organ platforms within the physique and offers them in a memorable, easy-to-read shape. The e-book covers the historical past and data which are clinically appropriate to, and more often than not encountered in, end-of-semester assessments and offers a high-quality training for scientific years. it's a superb source for all clinical scholars wishing to realize and keep anatomy and pathology wisdom in a time-effective demeanour.
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Extra resources for Essential Concepts in Anatomy and Pathology for Undergraduate Revision
Subclavian a. supplied by retrograde blood ﬂow from vertebral a. through carotid a. • Occurs when there is excessive demand from upper limb • Symptoms: transient cerebral ischaemia • Management: surgical bypass Atrial fibrillation • Common causes: – acute MI – hypertension – HF – hyperthyroidism – pulmonary embolism – COPD • Symptoms: – dyspnoea – palpitations – chest pain – dizziness • Signs: – irregularly irregular pulse • Complications: – thromboembolism • Investigations: – ECG (absent P-waves) – echocardiogram – thyroid function tests • Management: – electrical cardioversion – anticoagulation Dextrocardia • Heart displaced to the RHS • Can be associated with situs inversus (in which positions of the major visceral organs are reversed) 38 ESSENTIAL CONCEPTS IN ANATOMY AND PATHOLOGY • Signs: – displaced apex beat to RHS • Investigations: – CXR – ECG Pericarditis • Inﬂammation of serous pericardium • Mostly caused by viral infection (coxsackie virus, herpes) • Other causes: – bacterial infection (staphylococcus, pneumococcus) – fungal infection – acute MI – rheumatic fever – trauma – drug induced – uraemia – metastatic (lymphoma, breast cancer) – post-radiation • Complications: – cardiac tamponade • Symptoms: – central chest pain that radiates to the arms; pain relieved by sitting forward • Signs: – pericardial friction rub • Investigations: ECG (ST elevation, T-wave inversion, PR interval depression) • Management: – NSAIDs Myocarditis = acute inﬂammation of myocardium • Mostly caused by viral infection • Other causes: – bacterial infection – fungal infection – idiopathic – drugs (penicillin) – sarcoidosis • Pathological features: – diffuse inﬁltration of lymphocytes (viral infections) – diffuse inﬁltration of polymorphonuclear cells (bacterial infections) • Symptoms: – fever – pain CARDIOVASCULAR SYSTEM 39 – fatigue – exertional dyspnoea – palpitations • Investigations: – raised levels of cardiac enzymes in blood – viral Ab titres in blood – ECG – PCR (viral RNA) Infective endocarditis • Endocardial infection leading to inﬂammation • Usually in sites of underlying valvular/endocardial damage • Risk factors: – congenital valve disease – rheumatic heart disease – prosthetic valve implants – septal defects – IV drug users – haemodialysis – immunosuppression • Symptoms: – fever – malaise – anorexia • Signs: – peripheral septic embolisation: splinter haemorrhage, Roth spots on retina, Osler nodes on soles and palms – ﬁnger clubbing – heart murmur • Common causative organisms: – Staphylococcus aureus – Streptococcus viridans – coagulase-negative staphylococci (prosthetic valve patients) • Pathological characteristic: vegetation of platelets and ﬁbrin • Investigations: – serum CRP levels – blood sample collection and culture within 24-hour period before initiating antibiotic treatment – transthoracic echocardiography (TTE) – transoesophageal echocardiography (TOE) – ECG • Management: – IV antibiotics – surgery if infection is persistent • Complications: – valvular incompetence 40 ESSENTIAL CONCEPTS IN ANATOMY AND PATHOLOGY – – – – – myocarditis anaemia glomerulonephritis septicaemia (fever, weight loss) septic emboli (stroke, infarctions) Cardiac tamponade • • • • Fluid accumulates in pericardial space Causes acute heart failure Usually follows trauma to thoracic region Heart is constricted in conﬁned space → venous ﬁlling is restricted → cardic output is reduced → shock occurs • Symptoms: – fall in BP – shock – jugular venous distension • Diminished heart sounds • Investigations: – CXR (enlarged heart) – ECG – echocardiogram – cardiac catheterisation Coronary artery disease • Greater than 75% occlusion leads to ischaemia Angina pectoris = pain during physical exertion due to ischaemia of myocardium (a) Stable angina (predictable pain when there is increased demand from the heart) – atheromatous stenosis in coronary arteries (b) Unstable angina (unpredictable pain which may occur at rest) – obstruction of coronary artery due to plaque rupture + thrombosis • Symptoms: retrosternal chest pain radiating to L.
Attachments of internal oblique muscle – origin: lateral two-thirds of inguinal ligament, anterior two-thirds of iliac crest, lateral edge of thoracolumbar fascia to rib 12 – insertion: lower three ribs, xiphoid process, linea alba, pubic crest, pectineal line – muscle ﬁbre direction: superomedial – nerve SS: ventral primary rami of T7–T11, iliohypogastric n. (L1), ilioinguinal n.
SS by L. gastric a. of coeliac trunk. – venous drainage to L. gastric v. and azygos system – innervated by vagus n. and sympathetic n. – lymphatic drainage: post. mediastinal nodes 58 ESSENTIAL CONCEPTS IN ANATOMY AND PATHOLOGY • Nine quadrants of the abdomen: – RUQ (R. hypochondrium), epigastrium and LUQ (L. hypochondrium) – R. ﬂank, umbilical and L. ﬂank – RLQ (R. iliac), suprapubic and LLQ (L. iliac) • Usual causes of RUQ pain: – peptic ulceration, gastritis, hepatitis, pneumonia (R. lung), cholangitis, cholecystitis • Usual causes of epigastric pain: – peptic ulceration, drug-induced gastritis, gastric reﬂux, biliary colic, acute pancreatitis, abdominal aortic aneurysm (AAA), oesophagitis, angina/MI • Usual causes of LUQ pain: – acute pancreatitis, MI, splenic infarction, gastric reﬂux, peptic ulceration, pneumonia (L.