•Most common symptom of meckel's diverticulum in children is bleeding.
•Most common symptom of meckel's diverticulum in adult is intestinal obstruction.
#Surgery
•Most common symptom of meckel's diverticulum in adult is intestinal obstruction.
#Surgery
•Bacteremia👉🏼Presence of non multiplying bacteria in the blood.
•Septicemia👉🏼Presence of multiplying bacteria in the blood Plus leucocytosis.
•Toxemia👉🏼Presence of toxins in the blood.
•Pyemia👉🏼Presence of septic emboli in the blood.
#Surgery
•Septicemia👉🏼Presence of multiplying bacteria in the blood Plus leucocytosis.
•Toxemia👉🏼Presence of toxins in the blood.
•Pyemia👉🏼Presence of septic emboli in the blood.
#Surgery
📑 Epigastric pain plus
(Suggestive Dx)
📝 Epigastric pain + pain worse with food
👉 Gastric ulcer
📝 Epigastric pain + pain better with food
👉 Duodenal ulcer
📝 Epigastric pain + weight loss
👉 Gastric ulcer or cancer
📝 Epigastric pain +tenderness + radiation to back + relive by forward
👉 Pancretitis
📝 Epigastric pain + bad taste ,cough ,hoarse
👉 GERD
📝 Epigastric pain + nothing
👉 Non ulcer dyspepsia [ 90% of cases]
📝 Epigastric pain + diabetic and bloating
👉 Diabetic gastroparesis
📝 Epigastric pain+diabetic + middle or old age
👉 MI until proven otherwise
#Surgery
(Suggestive Dx)
📝 Epigastric pain + pain worse with food
👉 Gastric ulcer
📝 Epigastric pain + pain better with food
👉 Duodenal ulcer
📝 Epigastric pain + weight loss
👉 Gastric ulcer or cancer
📝 Epigastric pain +tenderness + radiation to back + relive by forward
👉 Pancretitis
📝 Epigastric pain + bad taste ,cough ,hoarse
👉 GERD
📝 Epigastric pain + nothing
👉 Non ulcer dyspepsia [ 90% of cases]
📝 Epigastric pain + diabetic and bloating
👉 Diabetic gastroparesis
📝 Epigastric pain+diabetic + middle or old age
👉 MI until proven otherwise
#Surgery
Seven steps of wound care management :
1/Assess
2/Cleanse
3/Protect
4/Fill
5/Cover
6/Secure
7/Evaluate.
#Surgery
1/Assess
2/Cleanse
3/Protect
4/Fill
5/Cover
6/Secure
7/Evaluate.
#Surgery
- Young boy, painful swollen warm left knee with no history of trauma, high fever 👉🏼acute septic arthritis.
#Surgery
#Surgery
-Old patient, hypertensive, diabetic, hematuria, solid mass in left loin 👉🏼Renal Cell Carcinoma.
#Surgery
#Surgery
-Old patient, shortness of breath, cachexia, mass in right iliac fossa 👉🏼Cancer caecum complicated by anemia.
#Surgery
#Surgery
-Old patient with chronic constipation and 5 days absolute constipation, fever, tachycardia, left iliac fossa tenderness 👉🏼Sigmoid volvulus.
#Surgery
#Surgery
-Old patient, frequency of urination, nocturia, post-micturation drippling, enlarged smooth prostate 👉🏼BPH.
#Surgery
#Surgery
Classification of neck fracture of femur
-Anatomically :
1-Intracapsular , danger than extra
2-Extracapsular fractures.
-Surgically :
Good prognosis
1- Incomplete fracture
2-Complete fracture without dislocation
Bad prognosis👉🏼
3-Complete fracture with partial dislocation
4-Complete fracture with complete dislocation.
#Surgery
-Anatomically :
1-Intracapsular , danger than extra
2-Extracapsular fractures.
-Surgically :
Good prognosis
1- Incomplete fracture
2-Complete fracture without dislocation
Bad prognosis👉🏼
3-Complete fracture with partial dislocation
4-Complete fracture with complete dislocation.
#Surgery
Rule of 2 for fracture during X ray :
1-Tow joints above and below the fracture
2-Tow times
3-Tow view
4-Tow sites.
#Surgery
1-Tow joints above and below the fracture
2-Tow times
3-Tow view
4-Tow sites.
#Surgery
Classification of Fractures
-According to the Cause:
1-Traumatic fractures
2-Pathological fractures
3-Stress fractures.
-According to the Shape:
1-Transverse fractures
2-Oblique fractures
3-Spiral fractures
4-Segmetal fractures is
5-Comminuted fractures
6-Green stick fractures
7-Fractures dislocation.
-According to Soft tissues injury
1-Simple: close with no skin injury
2-Compound:open with skin injury
3-Complicated: there are injury to neurovascular structres.
•Most common sites for pathological fractures :
-Neck of femur then wrist then Lumbar vertebrae.
•Common causes of pathological fractures:
1-Osteporosis
2-Tumors
3-Bone cyst.
#Surgery
-According to the Cause:
1-Traumatic fractures
2-Pathological fractures
3-Stress fractures.
-According to the Shape:
1-Transverse fractures
2-Oblique fractures
3-Spiral fractures
4-Segmetal fractures is
5-Comminuted fractures
6-Green stick fractures
7-Fractures dislocation.
-According to Soft tissues injury
1-Simple: close with no skin injury
2-Compound:open with skin injury
3-Complicated: there are injury to neurovascular structres.
•Most common sites for pathological fractures :
-Neck of femur then wrist then Lumbar vertebrae.
•Common causes of pathological fractures:
1-Osteporosis
2-Tumors
3-Bone cyst.
#Surgery
Submandibular sialadenitis
◼️Sialadenitis is a term given to inflammation of the salivary gland.
◼️It may be viral or bacterial, viral infection is usually caused by mumps virus, bacterial infection is more common and is caused by an obstruction in the submandibular duct system
◼️Obstruction is usually caused by stones, salivary gland stones are most common in the submandibular gland as secretions are viscid and are more difficult to drain compared to the watery secretions of the parotids
◼️80% of submandibular gland stones are radio-opaque,and can be seen by inferior occlusal view,the above figure shows two stones, large arrow shows a small stone near the sublingual papilla small arrow shows a larger stone near the gland's hilum
◼️Clinical presentation depends on degree of obstruction,complete obstruction usually caused by stones at the ductal opening present with pain and swelling precipitated by meals partial obstruction present with infrequent symptoms with less pain and swelling.
#Salivary
#Surgery
◼️Sialadenitis is a term given to inflammation of the salivary gland.
◼️It may be viral or bacterial, viral infection is usually caused by mumps virus, bacterial infection is more common and is caused by an obstruction in the submandibular duct system
◼️Obstruction is usually caused by stones, salivary gland stones are most common in the submandibular gland as secretions are viscid and are more difficult to drain compared to the watery secretions of the parotids
◼️80% of submandibular gland stones are radio-opaque,and can be seen by inferior occlusal view,the above figure shows two stones, large arrow shows a small stone near the sublingual papilla small arrow shows a larger stone near the gland's hilum
◼️Clinical presentation depends on degree of obstruction,complete obstruction usually caused by stones at the ductal opening present with pain and swelling precipitated by meals partial obstruction present with infrequent symptoms with less pain and swelling.
#Salivary
#Surgery
High yield notes about salivary gland disorders
◼️80% of parotid tumors are benign, the commonest one is pleomorphic adenoma, 80% of parotid tumors arise in their superficial part.
◼️Pleomorphic adenoma has an incomplete capsule, enucleation of the tumor results in recurrence in most cases as seeds of cells are likely left behind.
◼️Medial displacement of the tonsil can be caused by enlargement of the deep part of parotid gland, a part of the parotid gland loops around the mandibular ramus.
◼️Salivary gland stones are commonest in the submandibular gland.
◼️Parotid gland stones are less common because its secretions are watery and its duct drains more easily compared to the viscid secretions of the submandibular gland and its up sloping duct making drainage more difficult.
◼️Plunging ranulas occur only in the sublingual gland because its the only salivary gland which secretes continuously.
◼️Although generally rare, the majority of tumors arising in the sublingual gland are malignant (90%).
◼️The vast majority of minor salivary gland tumors are malignant.
◼️Drainage of an abscess in the parotid gland should be done by Hilton's method to safeguard the facial nerve.
#Salivary
#Surgery
◼️80% of parotid tumors are benign, the commonest one is pleomorphic adenoma, 80% of parotid tumors arise in their superficial part.
◼️Pleomorphic adenoma has an incomplete capsule, enucleation of the tumor results in recurrence in most cases as seeds of cells are likely left behind.
◼️Medial displacement of the tonsil can be caused by enlargement of the deep part of parotid gland, a part of the parotid gland loops around the mandibular ramus.
◼️Salivary gland stones are commonest in the submandibular gland.
◼️Parotid gland stones are less common because its secretions are watery and its duct drains more easily compared to the viscid secretions of the submandibular gland and its up sloping duct making drainage more difficult.
◼️Plunging ranulas occur only in the sublingual gland because its the only salivary gland which secretes continuously.
◼️Although generally rare, the majority of tumors arising in the sublingual gland are malignant (90%).
◼️The vast majority of minor salivary gland tumors are malignant.
◼️Drainage of an abscess in the parotid gland should be done by Hilton's method to safeguard the facial nerve.
#Salivary
#Surgery
Sublingual gland
◼️It is the smallest of the three major paired salivary glands.
◼️The gland lies in the floor of the oral cavity immediately lateral to the submandibular duct (Wharton's duct) and associated lingual nerve (see previous post).
◼️The sublingual gland lies directly against the medial surface of the mandible making a shallow groove called sublingual fossa, it is above the anterior 1/3 of mylohyoid muscle. (see above fig).
◼️The superior surface of the gland raises a fold of mucosa at the floor of oral cavity known as the sublingual fold, which is easily visible, the gland is drained by numerous minor sublingual ducts that opens onto the crest of the sublingual fold.
◼️Occasionally the anterior portion of the gland is drained by a major sublingual duct that opens together with Wharton's duct besides the base of the lingual frenulum.
#Salivary
#Surgery
◼️It is the smallest of the three major paired salivary glands.
◼️The gland lies in the floor of the oral cavity immediately lateral to the submandibular duct (Wharton's duct) and associated lingual nerve (see previous post).
◼️The sublingual gland lies directly against the medial surface of the mandible making a shallow groove called sublingual fossa, it is above the anterior 1/3 of mylohyoid muscle. (see above fig).
◼️The superior surface of the gland raises a fold of mucosa at the floor of oral cavity known as the sublingual fold, which is easily visible, the gland is drained by numerous minor sublingual ducts that opens onto the crest of the sublingual fold.
◼️Occasionally the anterior portion of the gland is drained by a major sublingual duct that opens together with Wharton's duct besides the base of the lingual frenulum.
#Salivary
#Surgery
Submandibular gland
◼️It is smaller than the parotid gland, but larger than the sublingual gland.
◼️On each side, the submandibular gland consists of two parts, the superficial part is outside the bounderies of the oral cavity and it lies beneath the mylohyoid muscle (see fig), it has a greater volume than the deep part of the gland.
◼️The deep part loops around the posterior margin of mylohyoid muscle to enter the floor of the oral cavity, it is lateral to the base of the tongue lying on the outer surface of hyoglossus muscle.
◼️The deep part makes an impression on the inner aspect of the mandible, which is known as the submandibular fossa.
◼️The submandibular duct (Wharton's duct) emerge from the medial aspect of the deep part, and passes forwards in the floor to open beside the base of the lingual frenulum.
◼️The lingual nerve (a sensory nerve from the mandibular nerve) passes beneath the submandibular duct crossing it from a lateral to a medial direction (see above fig).
#Salivary
#Surgery
◼️It is smaller than the parotid gland, but larger than the sublingual gland.
◼️On each side, the submandibular gland consists of two parts, the superficial part is outside the bounderies of the oral cavity and it lies beneath the mylohyoid muscle (see fig), it has a greater volume than the deep part of the gland.
◼️The deep part loops around the posterior margin of mylohyoid muscle to enter the floor of the oral cavity, it is lateral to the base of the tongue lying on the outer surface of hyoglossus muscle.
◼️The deep part makes an impression on the inner aspect of the mandible, which is known as the submandibular fossa.
◼️The submandibular duct (Wharton's duct) emerge from the medial aspect of the deep part, and passes forwards in the floor to open beside the base of the lingual frenulum.
◼️The lingual nerve (a sensory nerve from the mandibular nerve) passes beneath the submandibular duct crossing it from a lateral to a medial direction (see above fig).
#Salivary
#Surgery