Book Reviews
Surface Anatomy: An Anatomical Basis of
Clinical Examination (3rd ed). John S.P. Lumley
(2002) Churchill Livingstone (an imprint of Elsevier
Australia - www.elsevier.com.au) ISBN 0 443 07045
8 softcover. 135 pages. RRP NZ$ 87.95
Purpose
A working knowledge of surface anatomy frequently
encountered in clinical practice is recognized
as an essential skill for physiotherapists. This
text provides a complete overview of the visible
and palpable anatomy likely to be used in daily
physiotherapy clinical practice.
Scope
Originally written with medical students in mind,
this new edition has been expanded to satisfy the
needs of health professionals including those of
physiotherapists. It includes new chapters on
radiological imaging, the spinal column as well as
a section on acupuncture.
Style
The book is a concise but comprehensive text
on surface anatomy accompanied by coloured
illustrations. A distinguishing feature of this surface
anatomy text is that the majority of illustrations, most
of which are colour photographs, are superimposed
with line drawings of the underlying structures. Many
of these illustrations are also accompanied by text
describing their anatomical features, with emphasis
on their clinical relevance.
Content
The first chapter is dedicated to anatomical
terminology and the convention of describing human
movement with reference to the anatomical position.
The remaining chapters are regionally organized
and cover all the major anatomical structures able
to be felt, seen or listened too. The accompanying
line drawings provide details of topographical
relationships including major muscle groups and
their bony attachments. The detailed line drawings of
all major superficial and deep dorsal muscle groups
of the vertebral column are of particular relevance
to physiotherapists. The chapter on acupuncture
includes both its nomenclature and the surface
identification of acupuncture channels, as well as
the location of acupuncture points.
Other features
Labelled radiological images of the skull, abdomen
and joints accompany the illustrations. All of the
chapters are colour coded for easy reference.
Summary
The book is a valuable reference text for the
undergraduate physiotherapy student. While the
book does not deal with the issue of anatomical
variation of surface landmarks it may be also be
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of use for physiotherapists undertaking research
and requiring a reference source for anatomical
landmarks in the normal individual.
Gillian M Johnson, Dip Phty, Dip Grad (Anat), MSc, PhD,
MNZCP Lecturer, School of Physiotherapy University of Otago,
Dunedin
Primary Orthopedic Care (2nd edition). Christy
L. Crowther (2003) Mosby (an imprint of
Elsevier Australia) www.elsevier.com.au email:
service@elsevier.com.au softcover, ISBN 0 323
02365 7 RRP $88 (incl GST)
New Zealand was among the first countries in the
western world to allow physiotherapists to assess
and treat patients autonomously. In many countries,
still, patients must be diagnosed by a medical
practitioner, and the physiotherapist simply follows
the prescription of therapy ordered by the doctor.
Until the late 1990’s physiotherapists in NZ were still
largely shielded from the responsibilities of primary
care by the ACC requirement that patients be referred
to physiotherapy by a medical practitioner. Now, with
full direct access, we can function as true primary
care practitioners; this brings with it a greater scope of
practice and greater responsibilities which, I believe,
the profession and schools of physiotherapy have
been slow to recognise the import of. Screening for
organic disease does not mean diagnosing medical
disorders; it means recognising when symptoms may
not be of muscluloskeletal origin, and thus referral
to an appropriate medical practitioner is indicated.
Even when referred from a doctor, we must be alert
to the possibility that a patient’s somatic aches and
pains may be of a more malign origin. Many are the
times that it is the physiotherapist who picks up, or
should have picked up, the clues.
This book is aimed at non-physician primary care
clinicians, particularly nurse practitioners. The
author and two other contributors are nurses, and an
orthopaedic surgeon contributed to one chapter. It is
not intended to provide in-depth content on anatomy,
pathology, or treatment, but rather is intended to give
an overview of commonly encountered conditions,
including signs & symptoms, and appropriate initial
management.
It covers many of the pathological conditions
that a patient could conceivably consult a
physiotherapist with, and that should be considered
and referred on appropriately if suspected.
Common fractures, stress fractures, ligamentous
injuries, rheumatologic conditions and various
osteochondrosis & osteonecrosis disorders, for
example, are succinctly described without excessive
medical detail. For the sports physiotherapist, there
are sections regarding conditions that may present
on tour, such as human bites and various infections,
but no dermatologic conditions. Appendices briefly
(very briefly) list important differential diagnoses
NZ Journal of Physiotherapy – March 2005. Vol. 33, 1
and their signs & symptoms, by body region, but
given the intended focus of this book, I really think
these are inadequate.
flags box, but the red flags box is not reprinted. The
authors’ own table of red flags does not address
important systems adequately.
Some important conditions appear to be missed
from the text, such as Legg-Calve-Perthes’ disease
of the hip and slipped capital femoral epiphysis. In
the low back pain section, information about how
to screen for important differential diagnoses such
as pain referred from abdominal aortic aneurism,
genito-urinary system infections, tumours, or other
organic disease is not adequately covered. For
spinal infection, the authors state this “must be
considered when persistent back pain of unknown
causes is the presenting system of a patient who
has contributing medical factors and history”, but
do not clarify what those factors or historical clues
might be. The algorithms from the US AHCPR
Clinical Practice Guideline on acute LBP are
reprinted, which make repeated reference to a red
The strengths of this book are the succinct descriptions
of common orthopaedic and related conditions,
arranged by body region. For the musculoskeletal
physiotherapist, I would expect these are already
well covered by texts already in their library. The
niche that this book could have filled regards the
essentials of screening and history taking, red flags,
and comprehensive signs and symptoms suggesting
organic disease or infection that would indicate
medical referral and facilitate early detection. While
the book is probably adequate for its principal intended
audience, my feeling is that, for the musculoskeletal
physiotherapist with primary care responsibilities,
this book does not adequately fill that niche.
J. Haxby Abbott, DipPhty, MScPT, DipGrad, MNZCP
New Zealand Society of Physiotherapists Inc
Conference 2006
Waipuna Lodge, Auckland
19-21 MAY 2006
Abstracts will be accepted from September 2005
For further information please contact janet@physiotherapy.org.nz
NZ Journal of Physiotherapy – March 2005. Vol. 33, 1
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