Split (1)

train · 126k rows

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Textbook Content Analysis

Provides useful aggregations showing document length statistics grouped by title, helping identify variations in content length across different documents.

Textbook Chunk Counts

Identifies the most frequently occurring titles in the training dataset, which could reveal common themes or topics that dominate the data.

Short Textbook Content Examples

Retrieves short content entries from the training dataset, useful for identifying very brief samples but providing limited analytical value beyond basic filtering.

id stringlengths 14 28	title stringclasses 18 values	content stringlengths 2 999	contents stringlengths 19 1.02k
Anatomy_Gray_900	Anatomy_Gray	to visualize either the bile duct (cholangiogram) or pancreatic duct (pancreatogram) (Fig. 4.119). If a stone is present, it can be removed with a stone basket or an extraction balloon. Usually, a sphincterotomy is performed before stone removal to ease its passage through the distal bile duct.	Anatomy_Gray. to visualize either the bile duct (cholangiogram) or pancreatic duct (pancreatogram) (Fig. 4.119). If a stone is present, it can be removed with a stone basket or an extraction balloon. Usually, a sphincterotomy is performed before stone removal to ease its passage through the distal bile duct.
Anatomy_Gray_901	Anatomy_Gray	In cases of biliary tree obstruction caused by benign or malignant strictures, a stent can be placed into the common bile duct or into one of the main hepatic ducts to allow opening of the narrowed segment. The patency of the newly inserted stent is confirmed by instillation of more contrast medium to demonstrate free ...	Anatomy_Gray. In cases of biliary tree obstruction caused by benign or malignant strictures, a stent can be placed into the common bile duct or into one of the main hepatic ducts to allow opening of the narrowed segment. The patency of the newly inserted stent is confirmed by instillation of more contrast medium to dem...
Anatomy_Gray_902	Anatomy_Gray	Simplified explanation to understanding the types of jaundice and their anatomical causes When red blood cells are destroyed by the reticuloendothelial system, the iron from the hemoglobin molecule is recycled, whereas the porphyrin ring (globin) compounds are broken down to form fat-soluble bilirubin. On reaching the ...	Anatomy_Gray. Simplified explanation to understanding the types of jaundice and their anatomical causes When red blood cells are destroyed by the reticuloendothelial system, the iron from the hemoglobin molecule is recycled, whereas the porphyrin ring (globin) compounds are broken down to form fat-soluble bilirubin. On...
Anatomy_Gray_903	Anatomy_Gray	This type of jaundice is usually produced by conditions where there is an excessive breakdown of red blood cells (e.g., in incompatible blood transfusion and hemolytic anemia). The complex biochemical reactions for converting fat-soluble into water-soluble bilirubin may be affected by inflammatory change within the liv...	Anatomy_Gray. This type of jaundice is usually produced by conditions where there is an excessive breakdown of red blood cells (e.g., in incompatible blood transfusion and hemolytic anemia). The complex biochemical reactions for converting fat-soluble into water-soluble bilirubin may be affected by inflammatory change ...
Anatomy_Gray_904	Anatomy_Gray	In the clinic From a clinical point of view, there are two main categories of spleen disorders: rupture and enlargement. This tends to occur when there is localized trauma to the left upper quadrant. It may be associated with left lower rib fractures. Because the spleen has such an extremely thin capsule, it is suscept...	Anatomy_Gray. In the clinic From a clinical point of view, there are two main categories of spleen disorders: rupture and enlargement. This tends to occur when there is localized trauma to the left upper quadrant. It may be associated with left lower rib fractures. Because the spleen has such an extremely thin capsule,...
Anatomy_Gray_905	Anatomy_Gray	The spleen is an organ of the reticuloendothelial system involved in hematopoiesis and immunological surveillance. Diseases that affect the reticuloendothelial system (e.g., leukemia or lymphoma) may produce generalized lymphadenopathy and enlargement of the spleen (splenomegaly) (Fig. 4.120). The spleen often enlarges...	Anatomy_Gray. The spleen is an organ of the reticuloendothelial system involved in hematopoiesis and immunological surveillance. Diseases that affect the reticuloendothelial system (e.g., leukemia or lymphoma) may produce generalized lymphadenopathy and enlargement of the spleen (splenomegaly) (Fig. 4.120). The spleen ...
Anatomy_Gray_906	Anatomy_Gray	In the clinic Vascular supply to the gastrointestinal system The abdominal parts of the gastrointestinal system are supplied mainly by the celiac trunk and the superior mesenteric and inferior mesenteric arteries (Fig. 4.129): The celiac trunk supplies the lower esophagus, stomach, superior part of the duodenum, and pr...	Anatomy_Gray. In the clinic Vascular supply to the gastrointestinal system The abdominal parts of the gastrointestinal system are supplied mainly by the celiac trunk and the superior mesenteric and inferior mesenteric arteries (Fig. 4.129): The celiac trunk supplies the lower esophagus, stomach, superior part of the du...
Anatomy_Gray_907	Anatomy_Gray	The inferior mesenteric artery supplies the rest of the transverse colon, the descending colon, the sigmoid colon, and most of the rectum. Along the descending part of the duodenum there is a potential watershed area between the celiac trunk blood supply and the superior mesenteric arterial blood supply. It is unusual ...	Anatomy_Gray. The inferior mesenteric artery supplies the rest of the transverse colon, the descending colon, the sigmoid colon, and most of the rectum. Along the descending part of the duodenum there is a potential watershed area between the celiac trunk blood supply and the superior mesenteric arterial blood supply. ...
Anatomy_Gray_908	Anatomy_Gray	Arteriosclerosis may occur throughout the abdominal aorta and at the openings of the celiac trunk and the superior mesenteric and inferior mesenteric arteries. Not infrequently, the inferior mesenteric artery becomes occluded. Interestingly, many of these patients do not suffer any complications, because anastomoses be...	Anatomy_Gray. Arteriosclerosis may occur throughout the abdominal aorta and at the openings of the celiac trunk and the superior mesenteric and inferior mesenteric arteries. Not infrequently, the inferior mesenteric artery becomes occluded. Interestingly, many of these patients do not suffer any complications, because ...
Anatomy_Gray_909	Anatomy_Gray	If the openings of the celiac trunk and superior mesenteric artery become narrowed, the blood supply to the gut is diminished. After a heavy meal, the oxygen demand of the bowel therefore outstrips the limited supply of blood through the stenosed vessels, resulting in severe pain and discomfort (mesenteric angina). Pat...	Anatomy_Gray. If the openings of the celiac trunk and superior mesenteric artery become narrowed, the blood supply to the gut is diminished. After a heavy meal, the oxygen demand of the bowel therefore outstrips the limited supply of blood through the stenosed vessels, resulting in severe pain and discomfort (mesenteri...
Anatomy_Gray_910	Anatomy_Gray	The etiology of cirrhosis is complex and includes toxins (alcohol), viral inflammation, biliary obstruction, vascular outlet obstruction, nutritional (malnutrition) causes, and inherited anatomical and metabolic disorders. As the cirrhosis progresses, the intrahepatic vasculature is distorted, which in turn leads to in...	Anatomy_Gray. The etiology of cirrhosis is complex and includes toxins (alcohol), viral inflammation, biliary obstruction, vascular outlet obstruction, nutritional (malnutrition) causes, and inherited anatomical and metabolic disorders. As the cirrhosis progresses, the intrahepatic vasculature is distorted, which in tu...
Anatomy_Gray_911	Anatomy_Gray	The liver is responsible for the production of numerous proteins, including those of the clotting cascade. Any disorder of the liver (including infection and cirrhosis) may decrease the production of these proteins and so prevent adequate blood clotting. Patients with severe cirrhosis of the liver have a significant ri...	Anatomy_Gray. The liver is responsible for the production of numerous proteins, including those of the clotting cascade. Any disorder of the liver (including infection and cirrhosis) may decrease the production of these proteins and so prevent adequate blood clotting. Patients with severe cirrhosis of the liver have a ...
Anatomy_Gray_912	Anatomy_Gray	The poorly functioning liver cells (hepatocytes) are unable to break down blood and blood products, leading to an increase in the serum bilirubin level, which manifests as jaundice. With the failure of normal liver metabolism, toxic metabolic by-products do not convert to nontoxic metabolites. This buildup of noxious c...	Anatomy_Gray. The poorly functioning liver cells (hepatocytes) are unable to break down blood and blood products, leading to an increase in the serum bilirubin level, which manifests as jaundice. With the failure of normal liver metabolism, toxic metabolic by-products do not convert to nontoxic metabolites. This buildu...
Anatomy_Gray_913	Anatomy_Gray	The hepatic portal system drains blood from the visceral organs of the abdomen to the liver. In normal individuals, 100% of the portal venous blood flow can be recovered from the hepatic veins, whereas in patients with elevated portal vein pressure (e.g., from cirrhosis), there is significantly less blood flow to the l...	Anatomy_Gray. The hepatic portal system drains blood from the visceral organs of the abdomen to the liver. In normal individuals, 100% of the portal venous blood flow can be recovered from the hepatic veins, whereas in patients with elevated portal vein pressure (e.g., from cirrhosis), there is significantly less blood...
Anatomy_Gray_914	Anatomy_Gray	When the pressure in the portal vein is elevated, venous enlargement (varices) tend to occur at and around the sites of portosystemic anastomoses and these enlarged veins are called: varices at the anorectal junction, esophageal varices at the gastroesophageal junction, and caput medusae at the umbilicus. Esophageal va...	Anatomy_Gray. When the pressure in the portal vein is elevated, venous enlargement (varices) tend to occur at and around the sites of portosystemic anastomoses and these enlarged veins are called: varices at the anorectal junction, esophageal varices at the gastroesophageal junction, and caput medusae at the umbilicus....
Anatomy_Gray_915	Anatomy_Gray	Esophageal varices are susceptible to trauma and, once damaged, may bleed profusely, requiring urgent surgical intervention. In the clinic Surgery for obesity is also known as weight loss surgery and bariatric surgery. This type of surgery has become increasingly popular over the last few years for patients who are una...	Anatomy_Gray. Esophageal varices are susceptible to trauma and, once damaged, may bleed profusely, requiring urgent surgical intervention. In the clinic Surgery for obesity is also known as weight loss surgery and bariatric surgery. This type of surgery has become increasingly popular over the last few years for patien...
Anatomy_Gray_916	Anatomy_Gray	There are a number of surgical options to treat obesity. Surgery for patients who are morbidly obese can be categorized into two main groups: malabsorptive procedures and restrictive procedures. There are a variety of bypass procedures that produce a malabsorption state, preventing further weight gain and also producin...	Anatomy_Gray. There are a number of surgical options to treat obesity. Surgery for patients who are morbidly obese can be categorized into two main groups: malabsorptive procedures and restrictive procedures. There are a variety of bypass procedures that produce a malabsorption state, preventing further weight gain and...
Anatomy_Gray_917	Anatomy_Gray	The other type of the procedure, sleeve gastrectomy, is increasing in popularity because it can be used in patients deemed to be at high risk for gastric bypass surgery. It involves reduction of the gastric lumen by removing a large portion of the stomach along the greater curvature. Any overweight patient undergoing s...	Anatomy_Gray. The other type of the procedure, sleeve gastrectomy, is increasing in popularity because it can be used in patients deemed to be at high risk for gastric bypass surgery. It involves reduction of the gastric lumen by removing a large portion of the stomach along the greater curvature. Any overweight patien...
Anatomy_Gray_918	Anatomy_Gray	Any overweight patient undergoing surgery faces significant risk and increased morbidity, with mortality rates from 1% to 5%. In the clinic At first glance, it is difficult to appreciate why the psoas muscle sheath is of greater importance than any other muscle sheath. The psoas muscle and its sheath arise not only fro...	Anatomy_Gray. Any overweight patient undergoing surgery faces significant risk and increased morbidity, with mortality rates from 1% to 5%. In the clinic At first glance, it is difficult to appreciate why the psoas muscle sheath is of greater importance than any other muscle sheath. The psoas muscle and its sheath aris...
Anatomy_Gray_919	Anatomy_Gray	In the clinic To understand why a hernia occurs through the diaphragm, it is necessary to consider the embryology of the diaphragm. The diaphragm is formed from four structures— the septum transversum, the posterior esophageal mesentery, the pleuroperitoneal membrane, and the peripheral rim—which eventually fuse togeth...	Anatomy_Gray. In the clinic To understand why a hernia occurs through the diaphragm, it is necessary to consider the embryology of the diaphragm. The diaphragm is formed from four structures— the septum transversum, the posterior esophageal mesentery, the pleuroperitoneal membrane, and the peripheral rim—which eventual...
Anatomy_Gray_920	Anatomy_Gray	Hernias may also occur through the central tendon and through a congenitally large esophageal hiatus. Morgagni’s and Bochdalek’s hernias tend to appear at or around the time of birth or in early infancy. They allow abdominal bowel to enter the thoracic cavity, which may compress the lungs and reduce respiratory functio...	Anatomy_Gray. Hernias may also occur through the central tendon and through a congenitally large esophageal hiatus. Morgagni’s and Bochdalek’s hernias tend to appear at or around the time of birth or in early infancy. They allow abdominal bowel to enter the thoracic cavity, which may compress the lungs and reduce respi...
Anatomy_Gray_921	Anatomy_Gray	In the clinic At the level of the esophageal hiatus, the diaphragm may be lax, allowing the fundus of the stomach to herniate into the posterior mediastinum (Figs. 4.147 and 4.148). This typically causes symptoms of acid reflux. Ulceration may occur and may produce bleeding and anemia. The diagnosis is usually made by ...	Anatomy_Gray. In the clinic At the level of the esophageal hiatus, the diaphragm may be lax, allowing the fundus of the stomach to herniate into the posterior mediastinum (Figs. 4.147 and 4.148). This typically causes symptoms of acid reflux. Ulceration may occur and may produce bleeding and anemia. The diagnosis is us...
Anatomy_Gray_922	Anatomy_Gray	In the clinic Urinary tract stones (calculi) occur more frequently in men than in women, are most common in people aged between 20 and 60 years, and are usually associated with sedentary lifestyles. The stones are polycrystalline aggregates of calcium, phosphate, oxalate, urate, and other soluble salts within an organi...	Anatomy_Gray. In the clinic Urinary tract stones (calculi) occur more frequently in men than in women, are most common in people aged between 20 and 60 years, and are usually associated with sedentary lifestyles. The stones are polycrystalline aggregates of calcium, phosphate, oxalate, urate, and other soluble salts wi...
Anatomy_Gray_923	Anatomy_Gray	The diagnosis of urinary tract stones is based upon history and examination. Stones are often visible on abdominal radiographs. Special investigations include: ultrasound scanning, which may demonstrate the dilated renal pelvis and calices when the urinary system is obstructed. This is the preferred way of imaging in p...	Anatomy_Gray. The diagnosis of urinary tract stones is based upon history and examination. Stones are often visible on abdominal radiographs. Special investigations include: ultrasound scanning, which may demonstrate the dilated renal pelvis and calices when the urinary system is obstructed. This is the preferred way o...
Anatomy_Gray_924	Anatomy_Gray	an intravenous urogram, which will demonstrate the obstruction, pinpoint the exact level of the stone is currently less often used because access to low-dose CT KUB has increased. In the clinic Most tumors that arise in the kidney are renal cell carcinomas. These tumors develop from the proximal tubular epithelium. App...	Anatomy_Gray. an intravenous urogram, which will demonstrate the obstruction, pinpoint the exact level of the stone is currently less often used because access to low-dose CT KUB has increased. In the clinic Most tumors that arise in the kidney are renal cell carcinomas. These tumors develop from the proximal tubular e...
Anatomy_Gray_925	Anatomy_Gray	Renal cell tumors (Figs. 4.157 and 4.158) are unusual because not only do they grow outward from the kidney, invading the fat and fascia, but they also spread into the renal vein. This venous extension is rare for any other type of tumor, so, when seen, renal cell carcinoma should be suspected. In addition, the tumor m...	Anatomy_Gray. Renal cell tumors (Figs. 4.157 and 4.158) are unusual because not only do they grow outward from the kidney, invading the fat and fascia, but they also spread into the renal vein. This venous extension is rare for any other type of tumor, so, when seen, renal cell carcinoma should be suspected. In additio...
Anatomy_Gray_926	Anatomy_Gray	Treatment for most renal cancers is surgical removal, even when metastatic spread is present, because some patients show regression of metastases. Transitional cell carcinoma arises from the urothelium. The urothelium is present from the calices to the urethra and behaves as a “single unit.” Therefore, when patients de...	Anatomy_Gray. Treatment for most renal cancers is surgical removal, even when metastatic spread is present, because some patients show regression of metastases. Transitional cell carcinoma arises from the urothelium. The urothelium is present from the calices to the urethra and behaves as a “single unit.” Therefore, wh...
Anatomy_Gray_927	Anatomy_Gray	In the clinic A nephrostomy is a procedure where a tube is placed through the lateral or posterior abdominal wall into the renal cortex to lie within the renal pelvis. The function of this tube is to allow drainage of urine from the renal pelvis through the tube externally (Fig. 4.160). The kidneys are situated on the ...	Anatomy_Gray. In the clinic A nephrostomy is a procedure where a tube is placed through the lateral or posterior abdominal wall into the renal cortex to lie within the renal pelvis. The function of this tube is to allow drainage of urine from the renal pelvis through the tube externally (Fig. 4.160). The kidneys are si...
Anatomy_Gray_928	Anatomy_Gray	The indications for such a procedure are many. In patients with distal ureteric obstruction the back pressure of urine within the ureters and the kidney significantly impairs the function of the kidney. This will produce renal failure and ultimately death. Furthermore, a dilated obstructed system is also susceptible to...	Anatomy_Gray. The indications for such a procedure are many. In patients with distal ureteric obstruction the back pressure of urine within the ureters and the kidney significantly impairs the function of the kidney. This will produce renal failure and ultimately death. Furthermore, a dilated obstructed system is also ...
Anatomy_Gray_929	Anatomy_Gray	An ideal place to situate the transplant kidney is in the left or the right iliac fossa (Fig. 4.161). A curvilinear incision is made paralleling the iliac crest and pubic symphysis. The external oblique muscle, internal oblique muscle, transversus abdominis muscle, and transversalis fascia are divided. The surgeon iden...	Anatomy_Gray. An ideal place to situate the transplant kidney is in the left or the right iliac fossa (Fig. 4.161). A curvilinear incision is made paralleling the iliac crest and pubic symphysis. The external oblique muscle, internal oblique muscle, transversus abdominis muscle, and transversalis fascia are divided. Th...
Anatomy_Gray_930	Anatomy_Gray	donor artery is anastomosed to the recipient external iliac artery and similarly for the venous anastomosis. The ureter is easily tunneled obliquely through the bladder wall with a straightforward anastomosis.	Anatomy_Gray. donor artery is anastomosed to the recipient external iliac artery and similarly for the venous anastomosis. The ureter is easily tunneled obliquely through the bladder wall with a straightforward anastomosis.
Anatomy_Gray_931	Anatomy_Gray	The left and right iliac fossae are ideal locations for the transplant kidney because a new space can be created without compromise to other structures. The great advantage of this procedure is the proximity to the anterior abdominal wall, which permits easy ultrasound visualization of the kidney and Doppler vascular a...	Anatomy_Gray. The left and right iliac fossae are ideal locations for the transplant kidney because a new space can be created without compromise to other structures. The great advantage of this procedure is the proximity to the anterior abdominal wall, which permits easy ultrasound visualization of the kidney and Dopp...
Anatomy_Gray_932	Anatomy_Gray	After an appropriate history and examination of the patient, including a digital rectal examination to assess the prostate in men, special investigations are required. Cystoscopy is a technique that allows visualization of the urinary bladder and urethra using an optical system attached to a flexible or rigid tube (cys...	Anatomy_Gray. After an appropriate history and examination of the patient, including a digital rectal examination to assess the prostate in men, special investigations are required. Cystoscopy is a technique that allows visualization of the urinary bladder and urethra using an optical system attached to a flexible or r...
Anatomy_Gray_933	Anatomy_Gray	An IVU is one of the most important and commonly carried out radiological investigations (Fig. 4.162). The patient is injected with iodinated contrast medium. Most contrast media contain three iodine atoms spaced around a benzene ring. The relatively high atomic number of iodine compared to the atomic number of carbon,...	Anatomy_Gray. An IVU is one of the most important and commonly carried out radiological investigations (Fig. 4.162). The patient is injected with iodinated contrast medium. Most contrast media contain three iodine atoms spaced around a benzene ring. The relatively high atomic number of iodine compared to the atomic num...
Anatomy_Gray_934	Anatomy_Gray	Nuclear medicine is an extremely useful tool for investigating the urinary tract because radioisotope compounds can be used to estimate renal cell mass and function and assess the parenchyma for renal scarring. These tests are often very useful in children when renal scarring and reflux disease is suspected. In the cli...	Anatomy_Gray. Nuclear medicine is an extremely useful tool for investigating the urinary tract because radioisotope compounds can be used to estimate renal cell mass and function and assess the parenchyma for renal scarring. These tests are often very useful in children when renal scarring and reflux disease is suspect...
Anatomy_Gray_935	Anatomy_Gray	For many years the standard treatment for repair was an open operative technique, which involved a large incision from the xiphoid process of the sternum to the symphysis pubis and dissection of the aneurysm. The aneurysm was excised and a tubular woven graft was sewn into place. Recovery may take a number of days, eve...	Anatomy_Gray. For many years the standard treatment for repair was an open operative technique, which involved a large incision from the xiphoid process of the sternum to the symphysis pubis and dissection of the aneurysm. The aneurysm was excised and a tubular woven graft was sewn into place. Recovery may take a numbe...
Anatomy_Gray_936	Anatomy_Gray	Further developments and techniques have led to a new type of procedure being performed to treat abdominal aortic aneurysms—the endovascular graft (Fig. 4.165). The technique involves surgically dissecting the femoral artery below the inguinal ligament. A small incision is made in the femoral artery and the preloaded c...	Anatomy_Gray. Further developments and techniques have led to a new type of procedure being performed to treat abdominal aortic aneurysms—the endovascular graft (Fig. 4.165). The technique involves surgically dissecting the femoral artery below the inguinal ligament. A small incision is made in the femoral artery and t...
Anatomy_Gray_937	Anatomy_Gray	In the clinic Deep vein thrombosis is a potentially fatal condition where a clot (thrombus) is formed in the deep venous system of the legs and the veins of the pelvis. Virchow described the reasons for thrombus formation as decreased blood flow, abnormality of the constituents of blood, and abnormalities of the vessel...	Anatomy_Gray. In the clinic Deep vein thrombosis is a potentially fatal condition where a clot (thrombus) is formed in the deep venous system of the legs and the veins of the pelvis. Virchow described the reasons for thrombus formation as decreased blood flow, abnormality of the constituents of blood, and abnormalities...
Anatomy_Gray_938	Anatomy_Gray	The consequences of deep vein thrombosis are twofold. Occasionally the clot may dislodge and pass into the venous system through the right side of the heart and into the main pulmonary arteries. If the clots are of significant size they obstruct blood flow to the lung and may produce instantaneous death. Secondary comp...	Anatomy_Gray. The consequences of deep vein thrombosis are twofold. Occasionally the clot may dislodge and pass into the venous system through the right side of the heart and into the main pulmonary arteries. If the clots are of significant size they obstruct blood flow to the lung and may produce instantaneous death. ...
Anatomy_Gray_939	Anatomy_Gray	In certain situations it is not possible to optimize the patient with prophylactic treatment, and it may be necessary to insert a filter into the inferior vena cava that traps any large clots. It may be removed after the risk period has ended. In the clinic From a clinical perspective, retroperitoneal lymph nodes are a...	Anatomy_Gray. In certain situations it is not possible to optimize the patient with prophylactic treatment, and it may be necessary to insert a filter into the inferior vena cava that traps any large clots. It may be removed after the risk period has ended. In the clinic From a clinical perspective, retroperitoneal lym...