The aims of this Website are to:
- Demonstrate a system of examination of the body, including the assessment of function, and the use of common clinical tools
- Display observable and palpable anatomy of relevance to clinical practice
- Examine radiological images and their associated anatomy
- Illustrate points for vascular access and injection of local anaesthetic
- Consider the anatomy of common clinical procedures, tendon and joint injections, surgical incisions and access points for minimally invasive surgery
- Highlight and selectively illustrate common disease entities
- Include tables and appendices on practical areas of clinical management
- Provide a glossary of common medical terms
There is no single right way to examine a patient, as this is adapted to the patient’s condition, and each speciality has its own preferred approach. Whereas anatomy is most easily worked out and understood through a regional approach, medicine is taught primarily by system, and systemic examination crosses regional boundaries, requiring joined up anatomy. In this text, a regional order is followed but it is linked to a systemic approach. The chest includes the cardiovascular and respiratory systems, and the abdomen, the alimentary and urogenital systems. The musculoskeletal system includes the muscles of the back and limbs, and the nervous and vascular systems are considered as separate entities.
The text for each system is brief, to make it easier to read, understand and remember. Sections start with essential anatomy and the muscle details are tabulated. There follows a summary of frequently encountered diseases; this has been highlighted in blue; additional information is integrated into the text and tables. The bulk of the book is a fully illustrated method of clinical examination. Further sections consider vascular access and local anaesthetic techniques; incisions and practical procedures are placed with the relevant system.
The illustrations are predominantly photographs of clinical examination, emphasising this important aspect of diagnosis. Clinical examination is linked to its anatomy, considering observation, palpation, percussion and auscultation. With muscles, their active, passive and resisted movements are examined, and in joints, the traditional order of look, feel, move and measure, is followed by imaging.
The number of anatomical and medical terms is initially daunting to a student. Appendix 1 considers the terms used for anatomical description. An extensive glossary is intended to ease your induction; it covers medical terms in the text, but not all those from the tables. It provides a useful bedside aid but use an online medical dictionary to define other terms and the diseases you encounter.
The website lays emphasis on clinical examination, but Appendix 2 includes historical notes for each system. Appendix 3 considers the tools of examination, the examination of lumps and ulcers, and includes a method of diagnosis. Everyone loves tables, even if it’s only to complain of their content or decry their inclusion. The diagnostic tables are not for the whingers, but for those who like facts and lists to hang their information on; they include practical useful information to help you sort out common problems.
Although the information presented provides a logical approach to diagnosis, there must be flexibility to adapt this approach, to match the patient’s presenting condition. Clinical examination generally commences with the hands followed by the head and neck, and then examine from top to toe. You are encouraged to develop your own method of assessment, based on the guidelines provided in the text. Training in clinical examination should begin with self-examination, and examining peers and models, before approaching a patient.