The Atlas of Emergency Medicine, Fifth Edition
By Kevin J Knoop, Lawrence B Stack, Alan B Storrow and R Jason Thurman
Contents
Foreword
Preface
Acknowledgments
Contributors
Media Credits
Part 1 Regional Anatomy
Chapter 1
Head and Facial Trauma
Christopher L. Stark
Scalp Laceration
Depressed Skull Fracture
Frontal Sinus Fracture
Basilar Skull Fracture
Herniation Syndromes
Nasal Injuries
Zygoma Fractures
Lefort Facial Fractures
Orbital Wall Fractures
Traumatic Exophthalmos
Mandibular Fractures
External Ear Injuries
Facial Nerve Injury
Penetrating Facial Trauma
Chapter 2
Ophthalmic Conditions
Manpreet Singh ■ Denise Whitfield
Pallor/Anemia
Osteogenesis Imperfecta
Conjunctival Icterus
Neonatal Conjunctivitis (Ophthalmia Neonatorum)
Bacterial Conjunctivitis
Viral Conjunctivitis
Allergic Conjunctivitis
Irritant/Chemical Conjunctivitis
Dacryocystitis
Dacryoadenitis
Pterygium/Pinguecula
Corneal Hydrops
Leukocoria/Cataract
Hordeolum/Chalazion
Scleritis
Episcleritis
Acute Angle-Closure Glaucoma
Anterior Uveitis (Iritis)
Endophthalmitis
Sympathetic Ophthalmia
Anisocoria
Herpes Zoster Ophthalmicus
Ocular Herpes Simplex
Corneal Ulcer
Afferent Pupillary Defect
Thyroid Eye Disease
Internuclear Ophthalmoplegia (Ino)
Horner Syndrome
Myasthenia Gravis
Third-Nerve Palsy
Sixth-Nerve Palsy
Chapter 3
Funduscopic Findings
David Effron ■ Beverly C. Forcier ■ Richard E. Wyszynski
Normal Fundus
Age-Related Macular Degeneration
Exudate
Roth Spots
Emboli
Central Retinal Artery Occlusion
Central Retinal Vein Occlusion
Hypertensive Retinopathy
Diabetic Retinopathy
Vitreous Hemorrhage
Retinal Detachment
Cytomegalovirus Retinitis
Papilledema
Optic Neuritis
Anterior Ischemic Optic Neuropathy
Glaucoma
Subhyaloid Hemorrhage In Subarachnoid Hemorrhage
Chapter 4
Ophthalmic Trauma
Kevin J. Knoop ■ James K. Palma
Corneal Abrasion
Subconjunctival Hemorrhage
Corneal Foreign Body/Rust Ring
Hyphema
Intraocular Foreign Body
Iridodialysis
Lens Dislocation
Penetrating Globe Injury
Globe Rupture
Traumatic Cataract
Eyelid Laceration
Impaled Foreign Body
Chemical Exposure
Chapter 5
Ear, Nose, And Throat Conditions
Edward C. Jauch ■ Gregory Hall ■ Kevin J. Knoop
Otitis Media
Bullous Myringitis
Cholesteatoma
Exostosis
Tympanic Membrane Perforation
Otitis Externa
Preauricular Sinus Abscess
Mastoiditis
Auricular Perichondritis
Herpes Zoster Oticus (Ramsay Hunt Syndrome)
Facial Nerve Palsy
Angioedema
Pharyngitis
Nasal Septal Conditions
Nasal Cellulitis
Diphtheria
Peritonsillar Abscess
Epiglottitis
Uvulitis
Sialoadenitis
Mucocele
Acute Sinusitis
Chapter 6
Oral Conditions
Edward C. Jauch ■ J. Amadeo Valdez
Tooth Subluxation
Tooth Impaction (Intrusive Luxation)
Tooth Avulsion
Tooth Fractures
Alveolar Ridge Fracture
Temporal Mandibular Joint Dislocation
Tongue Laceration
Vermilion Border Lip Laceration
Odontogenic Infections
Gingival Abscess (Periodontal Abscess)
Periapical Abscess
Pericoronal Abscess
Hard Palate Abscess
Buccal Space Abscess
Canine Space Abscess
Ludwig Angina
Parapharyngeal Space Abscess
Oral Conditions
Trench Mouth (Acute Necrotizing Ulcerative
Gingivitis)
Acid Tooth Erosion (Bulimia)
Thrush (Oral Candidiasis)
Oral Herpes Simplex Virus (Cold Sores)
Aphthous Ulcers (Canker Sores)
Strawberry Tongue
Black Hairy Tongue
Oral Exostoses
Gingival Hyperplasia
Oral Malignancies
Extravascular (Hemorrhagic) Oral Lesions
Methamphetamine-Induced Caries
Oral Cavity Piercing Complications
Chapter 7
Chest And Abdomen
Kevin S. Barlotta ■ Lawrence B. Stack ■ Kevin J. Knoop
Chest And Abdominal Trauma
Traumatic Asphyxia
Flail Chest
Lung Herniation
Sternoclavicular Dislocation
Clavicle Fracture
Tension Pneumothorax With Needle Thoracentesis
Cardiac Tamponade With Pericardiocentesis
Emergency Department Thoracotomy
Seat Belt Injury
Grey Turner Sign And Cullen Sign
Impaled Foreign Body
Abdominal Evisceration
Traumatic Abdominal Hernia
Nontraumatic Chest And Abdominal Conditions
Respiratory Retractions
Superior Vena Cava Syndrome
Supraclavicular Adenopathy
Jugulovenous Distension
Caput Medusae
Abdominal Hernias
Umbilical Hernia
Patent Urachal Duct
Sister Mary Joseph Node (Nodular Umbilicus)
Abdominal Distension
Abdominal Wall Hematoma
Pectus Deformities
Stoma Prolapse
Prune Belly (Eagle-Barrett) Syndrome
Sternoclavicular Joint Septic Arthritis
Breast Mass
Chapter 8
Urologic Conditions
Sarah Moore ■ Ryan Pedigo
Testicular Torsion
Torsion Of A Testicular Or Epididymal Appendix
Acute Epididymitis
Orchitis
Hydrocele
Pyocele
Testicular Tumor
Scrotal Abscess
Fournier Gangrene
Paraphimosis
Priapism
Urethral Rupture
Fracture Of The Penis
Penile Tourniquet
Straddle Injury
Balanoposthitis
Penile Zipper Injury
Varicocele
Penile Implant Complications
Chapter 9
Sexually Transmitted Infections And
Anorectal Conditions
Suzanne Dooley-Hash ■ Nicholas W.C. Herrman
Syphilis
Gonorrhea
Chlamydia
Genital Herpes
Lymphogranuloma Venereum
Chancroid
Condyloma Acuminata (Genital Warts)
Pediculosis Pubis
Anal Fissure
Anorectal Abscess
Hemorrhoids
Rectal Prolapse
Pilonidal Abscess
Rectal Foreign Body
Rectal Cancer
Chapter 10
Gynecologic And Obstetric Conditions
Suzanne Dooley-Hash ■ Kevin J. Knoop
Gynecologic Conditions
Vaginitis
Cervical Polyps
Bartholin Gland Abscess
Spontaneous Abortion
Genital Trauma And Sexual Assault
Vulvar Hematoma
Lichen Sclerosus
Lichen Planus
Cervical Cancer
Vulvar Cancer
Urethral Prolapse
Uterine Prolapse
Cystocele
Rectocele
Imperforate Hymen
Obstetric Conditions
Ectopic Pregnancy
Molar Pregnancy (Hydatidiform Mole)
Failed Intrauterine Pregnancy
Third-Trimester Blunt Abdominal Trauma
Emergency Vaginal Delivery
Emergency Delivery: Normal Vertex Delivery Sequence
Breech Delivery
Umbilical Cord Prolapse In Emergency Delivery
Shoulder Dystocia In Emergency Delivery
Postpartum Perineal Lacerations
Intrauterine Fetal Demise
Postoperative Complications Of Cesarean Section
Chapter 11
Extremity Trauma
Meghan Breed ■ Robert Warne Fitch
Acromioclavicular Joint Separation
Shoulder Dislocation
Elbow Fractures
Elbow Dislocation
Biceps Tendon Rupture
Forearm Fractures
Fractures Of The Distal Radius
Carpal And Carpometacarpal Dislocations
Scaphoid Fracture
Clenched Fist Injury (Fight Bite)
Boxer’s Fracture
Peripheral Nerve Injury
Bennett And Rolando Fractures
Boutonnière And Swan-Neck Deformities
Gamekeeper’s Thumb (Skier’s Thumb)
Phalangeal Dislocations
Mallet Finger And Jersey Finger
Compartment Syndrome
High-Pressure Injection Injury
Subungual Hematoma
Hip Dislocation
Hip Fracture
Knee Extensor Injuries
Patellar Dislocations
Knee Dislocation
Femur Fracture
Tibial-Fibular Fractures
Fracture Blisters
Achilles Tendon Rupture
Ankle Dislocation
Ankle Fracture
Ankle Sprain
Calcaneus Fracture
Fractures Of The Fifth Metatarsal Base
Lisfranc Fracture-Dislocation
Amputations
Chapter 12
Extremity Conditions
Kathryn Ritter ■ Robert Warne Fitch
Cellulitis
Felon
Gangrene
Gas Gangrene (Myonecrosis)
Necrotizing Fasciitis
Ingrown Toenail (Onychocryptosis)
Lymphangitis
Lymphedema
Olecranon And Prepatellar Bursitis
Palmar Space Infection
Tenosynovitis
Thrombophlebitis
Paronychia
Subclavian Vein Thrombosis
Cervical Radiculopathy
Digital Clubbing
Phlegmasia Dolens
Deep Venous Thrombosis
Dupuytren Contracture
Achilles Tendonitis
Ganglion (Synovial) Cyst
Raynaud Disease
Arterial Embolus
Morel-Lavallée Lesion
Contrast Extravasation
Legg-Calvé-Perthes Disease
Slipped Capital Femoral Epiphysis
Chapter 13
Cutaneous Conditions
Matthew Hardin
Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis
Erythema Multiforme
Drug Eruptions
Fixed Drug Eruption
Autoimmune Bullous Diseases
Immune Thrombocytopenia
Thrombotic Thrombocytopenic Purpura
Infective Endocarditis
Erysipelas
Erythema Migrans
Rocky Mountain Spotted Fever
Disseminated Gonococcus
Ecthyma Gangrenosum
Nongenital Herpes Simplex Infections
Herpes Zoster
Scabies
Hidradenitis Suppurativa
Dissecting Cellulitis Of The Scalp
Livedo Reticularis
Cutaneous Small-Vessel Vasculitis
Sweet Syndrome
Pyoderma Gangrenosum
Erythema Nodosum
Squamous Cell Carcinoma
Basal Cell Carcinoma
Melanoma
Urticaria And Dermatographism
Allergic Contact Dermatitis
Atopic Dermatitis
Nummular/Xerotic Eczema
Dyshidrotic Eczema
Id Reaction (Disseminated Eczema)
Lip Licker’s Dermatitis
Dermatophyte Infections
Tinea (Pityriasis) Versicolor
Onychomycosis
Intertrigo
Hot Tub Folliculitis/Pseudomonas Hot-Foot Syndrome
Pyogenic Granuloma
Seborrheic Dermatitis
Psoriasis
Pityriasis Rosea
Stasis Dermatitis
Uremic Frost
Jaundice
Porphyria Cutanea Tarda
Vitiligo
Melasma
Abdominal Striae (Striae Atrophicae)
Part 2 Specialty Areas
Chapter 14
Pediatric Conditions
Ashish Shah ■ Brad Sobolewski ■ Matthew R. Mittiga
Newborn Conditions
Erythema Toxicum Neonatorum
Salmon Patches (Nevus Simplex)
Neonatal Jaundice
Neonatal Milk Production (Witch’s Milk)
Neonatal Mastitis
Umbilical Granuloma
Hypertrophic Pyloric Stenosis
Intestinal Malrotation With Volvulus
Rashes And Lesions
Erythema Infectiosum (Fifth Disease)
Roseola Infantum (Exanthem Subitum)
Impetigo
Measles
Varicella (Chickenpox)
Herpes Zoster
Hand, Foot, And Mouth Syndrome
Cold Panniculitis (Popsicle Panniculitis)
Herpetic Gingivostomatitis
Meningococcemia
Summer Penile Syndrome
Staphylococcal Scalded Skin Syndrome
Scarlet Fever (Scarlatina)
Blistering Distal Dactylitis
Henoch-Schönlein Purpura (Iga Vasculitis)
Serum Sickness–Like Reaction
Superficial (Strawberry) Hemangioma
Orbital And Preseptal (Periorbital) Cellulitis
Branchial Cleft Cyst
Thyroglossal Duct Cyst
Cystic Hygroma
Cat-Scratch Disease
General Conditions
Epiglottitis
Retropharyngeal Abscess
Button (Disk) Battery Ingestion
Nasal Foreign Body
Membranous (Bacterial) Tracheitis
Dactylitis (Hand-Foot Syndrome)
Hair Tourniquet
Failure To Thrive
Nursing Bottle Caries
Nursemaid’s Elbow (Radial Head Subluxation)
Ileocolic Intussusception
Hydrocele Of The Testis
Inguinal Hernia
Pinworm Infection (Enterobiasis)
Lice
Oral Frenulum Tear
Oculogyric Crisis
Setting-Sun Phenomenon (Sundowning)
Kawasaki Disease
Chapter 15
Child Abuse
Daniel M. Lindberg ■ Antonia Chiesa ■ Angie L. Miller
Physical Abuse
External Findings
Abusive Head Trauma
Skeletal Findings
Visceral Findings
Sexual Abuse
Child Sexual Abuse Exam And Genital Findings
Injuries And Findings Indicative Of Genital Or Anal
Trauma, Abuse, Or Infection
Mimics Of Abuse: Accidental Trauma
Mimics Of Abuse: Medical Conditions
Chapter 16
Environmental Conditions
Ken Zafren ■ R. Jason Thurman ■ Ian D. Jones
High-Altitude Pulmonary Edema
High-Altitude Retinal Hemorrhage
High-Altitude Cerebral Edema
Hypothermia
Frostbite
Pernio
Immersion Injury (Trench Foot)
Ultraviolet Radiation Exposure
Lightning Injuries
Large Terrestrial Animal Attacks
Coral Snake Envenomation
Pit Viper Envenomation
Tropical Snake Envenomations
Gila Monster Envenomation
Black Widow Spider Envenomation
Brown Recluse Spider Envenomation
Scorpion Envenomation
Ticks
Hymenoptera Envenomation
Caterpillar, Mite, And Centipede Envenomation
Skeeter Syndrome
Middle Ear Squeeze
Mask Squeeze
Stingray Envenomation
Sea Urchin Envenomation
Coelenterate Envenomation
Marine Dermatitis
Scorpionfish Sting
Cone Snail Envenomation
Sea Snake Envenomation
Cephalopod Envenomation
Erysipeloid
Toxicodendron And Other Plant Exposures
Sporotrichosis
Chapter 17
Toxicological Conditions
Saralyn R. Williams ■ R. Jason Thurman
Amphetamine Toxicity
Designer Drugs: “Bath Salts” And “Spice”
Cocaine Toxicity
Levamisole-Induced Vasculitis
Anticholinergic (Antimuscarinic) Toxidrome
Cholinergic Toxidrome
Opioid Toxicity
Desomorphine (Krokodil)
Acetaminophen Poisoning
Salicylate Poisoning
Toxic Alcohol Ingestion
Tricyclic Antidepressant Poisoning
Poisoning By Β-Blocker And Calcium Channel Blocker
Agents
Inhalant Abuse
Methemoglobinemia
Cellular Asphyxiants
Vancomycin-Induced Red Man Syndrome
Botulism
Anticoagulants
Caustic Ingestion
Hydrofluoric Acid Burns
Arsenic Poisoning
Iron Poisoning
Lead Poisoning
Mercury Poisoning
Mushroom Ingestion
Cardiac Glycoside Plant Ingestion
Houseplants With Calcium Oxalate Crystals
Plants With Belladonna Alkaloids
Peyote Ingestion
Toxalbumin Ingestion
Pokeweed
Chapter 18
Wounds And Soft-Tissue Injuries
Chan W. Park ■ Michael L. Juliano ■ Dana Woodhall
Wound Cleaning And Irrigation
Wound Assessment
Wound Foreign Bodies
Traumatic Wounds
Ear Lacerations
Lip Lacerations
Tendon Lacerations
Animal Bite Wounds
Fishhook Injuries
Simple Wound Closures
Complex Wound Closures
Wound Care Complications
Burns
Electrical Injury
Decubitus Ulcers
Chapter 19
Clinical Forensic Medicine
William S. Smock ■ Lawrence B. Stack
Gunshot Wounds
Pattern Injuries Of Domestic Violence, Assault, And Abuse
Sharp-Force-Pattern Injuries
Blunt-Force Pattern Injuries
Strangulation Injuries
Thermal-Pattern Injuries
Chapter 20
Hiv Conditions
Stephen P. Raffanti ■ Anna K. Person
Primary Hiv Infection
Immune Reconstitution Inflammatory Syndrome (Iris)
Oral Hairy Leukoplakia
Candidiasis Associated With Hiv
Kaposi Sarcoma
Toxoplasma Gondii Infection
Pneumocystis
Cryptococcal Infections
Histoplasmosis
Cytomegalovirus Infections
Herpes Zoster
Eosinophilic Folliculitis
Herpes Simplex Virus
Scabies
Molluscum Contagiosum
Dermatophyte (Tinea) Infections
Thrombocytopenia
Drug Reactions
Acute Necrotizing Ulcerative Gingivitis
Chapter 21
Tropical Medicine
Shannon M. Langston ■ Brian D. Bales
Free-Living Ameba Infection
Anemia In The Tropics
Anthrax
Ascariasis
Chagas Disease
Cholera
Cutaneous Larva Migrans
Cysticercosis
Dengue Fever
Dracunculiasis
Elephantiasis
Epidemic Meningitis
Goiter
Hydatid Cyst
Leech Bites
Leishmaniasis
Leprosy
Leptospirosis
Malaria
Mumps
Mycetoma
Myiasis
Nontuberculosis Mycobacteria Infections
Protein-Energy Malnutrition—Kwashiorkor And
Marasmus
Rabies
Schistosomiasis
Tetanus
Trachoma
Traditional Medicine In The Tropics
Tropical Sporotrichosis
Tuberculosis
Tungiasis
Zika Virus
Chapter 22
Airway
Steven J. White ■ Kevin High ■ Lawrence B. Stack ■ Richard M. Levitan
Airway Maxim One
Airway Maxim Two
Airway Maxim Three
Airway Maxim Four
Airway Maxim Five
Laryngoscopic Orotracheal Intubation
Oropharynx And Airway Decontamination Strategies
Bougie-Assisted Intubation
Video-Assisted Intubation—Storz C-Mac
Video-Assisted Intubation—Mcgrath Mac Edl
Laryngeal Mask Airway (Lma)
Digital (Tactile) Intubation
Intubating Laryngeal Airway (Ila)
King Laryngeal Tube
Nasal Flexible Fiberoptic Intubation
Cricothyrotomy (Seldinger Technique)
Scalpel-Finger-Bougie Cricothyrotomy
Chapter 23
Ecg Abnormalities
Maite A. Huis In ‘T Veld ■ Amal Mattu ■ R. Jason Thurman
Part 1: St-T Abnormalities
Acute St-Segment Elevation Myocardial Infarction
Acute Anterior Myocardial Infarction
Acute Inferior Myocardial Infarction
Acute Right Ventricular Myocardial Infarction
Acute Posterior Myocardial Infarction
Left Main Lesion
Sgarbossa Criteria For Ami In Setting Of Lbbb
Subendocardial Ischemia
Hyperacute T Waves
Wellens Waves
Early Repolarization
Left Ventricular Aneurysm
Acute Pericarditis
Part 2: Conduction Disturbances
First-Degree Av Block
Type 1 Second-Degree Av Block (Mobitz I, Wenckebach)
Type 2 Second-Degree Av Block (Mobitz Ii)
Third-Degree (Complete) Av Block
Qt Interval Abnormalities
Right Bundle Branch Block
Left Bundle Branch Block
Left Anterior Fascicular Block
Left Posterior Fascicular Block
Trifascicular Block
Ashman Phenomenon
Part 3: Rhythm Disturbances
Junctional Escape Rhythm
Ventricular Escape Rhythm
Paced Rhythm
Atrial Fibrillation
Atrial Flutter
Multifocal Atrial Tachycardia
Supraventricular Tachycardia (Svt)
Svt With Aberrancy
Ventricular Tachycardia
Ventricular Flutter
Polymorphic Ventricular Tachycardia
Ventricular Fibrillation
Part 4: Structural Abnormalities
Dextrocardia
Left Ventricular Hypertrophy
Right Ventricular Hypertrophy
Left Atrial Hypertrophy
Right Atrial Hypertrophy
Hypertrophic Cardiomyopathy
Brugada Syndrome
Wolff-Parkinson-White Syndrome
Part 5: Ecg Abnormalities Of Noncardiac Origin
Hypothermia
“Cerebral” T Waves
Hyperkalemia
Hypokalemia
Pulmonary Embolism
Pericardial Effusion
Digoxin Effect, Toxicity
Tricyclic Antidepressant Effect
Limb Lead Reversal
Low Voltage
Chapter 24
Emergency Ultrasound
Jeremy S. Boyd ■ Myles Melton ■ Jordan D. Rupp ■ Robinson M. Ferre
Emergency Ultrasound: Introduction
Trauma Ultrasound
Pericardial (Subxiphoid View)
Right Upper Quadrant (Morison’s Pouch)
Left Upper Quadrant (Perisplenic View)
Suprapubic
Thorax (Right And Left)
Cardiac Ultrasound
Subxiphoid Cardiac (Subcostal View)
Parasternal Long-Axis View (Psla)
Parasternal Short-Axis View (Pssa)
Apical Four-Chamber View (Ap4)
Subxiphoid Long-Axis (Ivc)
Lung Ultrasound
Abdominal Aorta Ultrasound
Deep Venous Thrombosis Ultrasound
Ultrasound-Guided Resuscitation
Gallbladder Ultrasound
Renal And Bladder Ultrasound
Pregnancy Ultrasound
Procedural Guidance: Ultrasound-Guided Venous
Access
Procedural Guidance: Ultrasound-Guided Nerve Blocks
Procedural Guidance: Thoracentesis/Paracentesis
Ocular Ultrasound
Soft-Tissue Ultrasound
Chapter 25
Microscopic Findings And Bodily Fluids
Camiron L. Pfennig ■ B. Ethan Brown
Urinalysis
Synovial Fluid Analysis
Gram Stain
Dark-Field Examination For Treponema Pallidum
Vaginal Fluid Wet Mount
Potassium Hydroxide Mount For Candida Albicans
Stool Examination For Fecal Leukocytes
Skin Scraping For Dermatoses And Infestations
Cerebrospinal Fluid Examination—India Ink
Preparation For Cryptococcus Neoformans
Wright Stain—Thin Smear For Malaria
Ferning Pattern For Amniotic Fluid
Peripheral Blood Smear
Tape Test For Enterobius Vermicularis Eggs
Tzanck Preparation For Herpes Infection
Acid-Fast Stain For Mycobacterium
Bodily Fluids
Stool
Emesis
Sputum
Urine
Synovial Fluid
Cerebral Spinal Fluid
Peritoneal Fluid
Blood
Chapter 26
Rheumatologic Conditions
Timothy Bongartz ■ Jodi A. Dingle
Gout
Systemic Lupus Erythematosus
Inflammatory Myopathies
Small-Vessel Vasculitis And Purpura
Rheumatoid Arthritis
Juvenile Idiopathic Arthritis
Acute Rheumatic Fever
Giant Cell Arteritis
Chapter 27
Mental Health Conditions
Brian D. Bales ■ Max Hensel
Trichotillomania
Skin Picking Disorder (Neurotic Excoriations)
Self-Harm Behavior (Nonsuicidal And Suicidal Selfharm)
Substance Use Disorders
Alcohol Use Disorder
Nicotine Use Disorder
Eating Disorders
Delusional Infestation
Index