By Wolfgang Stehr (ed.)
Written through citizens for citizens, the up to date sixth variation of this best-selling guide provide you with precisely the info you want to conquer the majority of demanding situations you come across in the course of your surgical residency. With its pocket-size and easy-reference structure, this source allows you to fast entry the precise guidance...at the suitable time...about what to do and the way to do it. No resident can be with no this crucial surgical consultant!
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With the patient in the sitting position, support the patient’s arm and palpate each axilla to detect adenopathy (see section IX). b. Palpate each breast while the patient is supine with her ipsilateral hand placed behind her head. 27 3 PHYSICAL EXAMINATION OF THE SURGICAL PATIENT Physical Examination of the Surgical Patient 28 Perioperative Care c. Palpate the nipple for discharge. d. Masses—location, size, shape, consistency, mobility, and tenderness D. PERCUSSION 1. Technique a. The surface of the body is struck to emit sounds that vary in quality according to the density of the underlying tissue.
Coronary artery disease, congestive heart failure (CHF), presence of arrhythmias, peripheral vascular disease, or severe hypertension 2. Goldman cardiac risk in noncardiac surgery a. Computation of the cardiac risk index (Table 4-1) b. General concepts (Table 4-2) (1) Class III and IV patients warrant routine preoperative cardiology consultation. (2) Class IV typically restricted to life-saving procedures only. (3) Twenty-eight of the 53 points are potentially correctable before surgery. (4) Index correctly classiﬁed 81% of the cardiac outcomes.
VII. GENITOURINARY A. INSPECTION 1. Signs of injury a. Blood at the male penile meatus or female urethra, gross hematuria b. Contusion, lacerations, ecchymoses on perineum c. Scrotal hematoma B. 1. a. b. c. PALPATION Vaginal examination Cervical discharge, cervical pain on movement Palpation of uterine, ovarian masses Lacerations, blood in vaginal vault VIII. MUSCULOSKELETAL A. INSPECTION 1. Skin a. Color and perfusion b. Lacerations, open wounds PHYSICAL EXAMINATION OF THE SURGICAL PATIENT D. 1.
The Mont Reid Surgical Handbook by Wolfgang Stehr (ed.)