What Is the  Terrible (aka “Unhappy”) Triad of the Knee?

-A combination of MCL, ACL, and medial meniscus injuries.

#Surgery

Technique for examination of thyroglossal cyst and name of operation:


-Elicit fluctuation by Paget’s method or test.
-It may appear as firm or tense cystic.
-Some cysts are too small to fluctuate.

-Sistrunk’soperation is the surgery of choice:
consists of removal of the  thyroglossal cyst along with  the  entire thyroglossal tract up to the foramen cecum. The central part of the body of the hyoid bone (1cm) is excised during the process of excision of the tract , to prevent recurrence.

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What is Curtain sign?

Curtain sign is—deep fascia/ parotid sheath is attached above to the zygomatic bone and so swelling arising from parotid gland cannot be moved up beyond zygomatic bone wherein deep fascia acts like a curtain to prevent its further mobility.

-It's seen in pleomorphic adenoma.

#Surgery

-Swelling superficial to deep fascia of parotid can be moved beyond the level of the zygomatic bone above.

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Amount of secretions of gut.

#Medicine

Stomas.

#Surgery

Stoma examination.

#Surgery

•Why is indirect inguinal hernia more common in right side ?

Due to delayed descend of right testis , slower closure of a patent processus vaginalis on the right side compared to the left.

It's almost about one month difference.

#Surgery

Acute appendicitis vs mesenteric adenitis.

#Appendix
#Surgery

Rule in  suture of wounds

Any wound covered  by dressing should be  covered  by suitable  antibiotics، and if the wound is not covered by dressing and no AB  is prescribed then  should be cleaned  by povidine- iodine  at least tow time per day

How to differentiate between acute appendicitis and mesenteric lymph  adenitis ?

-In mesenteric lymph adenitis the patient has shifting tenderness ( the patient hasPain localize tothe RIF, When he terns to the other side the pain  shift with the direction of the movement) also the patient may have tonsillitis.

#Appendix
#Surgery

How to differentiate between acute appendicitis and gastroenteritis?

-If abdominal  pain precedes  vomiting it indicates acute appendicitis, but if vomiting precedes abdominal  pain  it indicates gastroenteritis.

#Appendix
#Surgery

Examination of an Incision 

By inspection:

Site, side, length, direction, the healing by primary or secondary intention,  relation to deep structures  any signs of complication of incision as hematoma, discharge, swelling, redness..etc

-If there's dressing, comment on:
Site, side, dry or wet, clear in colour or red, yellow...

-Do not forget to say to the examiner:
"I shoud to expose the dressing".


#Surgery

Difference between small and large bowels obstruction on X-ray.

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Types of wounds.

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-Gall stone may obstruct the ileum leading to what called- Gall stone ileus.
Or
-Leads to gastric outlet obstruction  is called- Bouverte's syndrome.

#Surgery

•Difference between submandibular lymph node and submandibular gland swelling:

1. Nodes usually are multiple while gland single swelling
2. Node could be over rided the body of mandible while the gland is not
3. Gland could be palpated bimanually
(From the skin and from the floor of tongue )
4.gland swelling and pain may increase during induce sour food while node show no changes
5. As the most common cause of submandibular gland swelling is duct stone we may feel it by palpation.

#Surgery

Canula.

#Surgery

-Beware After 4–6 hours, the acid in the peritoneal cavity becomes diluted and the pain and guarding decrease.
-Patients think they are improving, but they are in fact getting worse.
-The peritonitis is progressing and hypervolaemia is developing.
-An increasing tachycardia and absent bowel sounds associated with increasing abdominal distension and sunken eyes indicate that the patient is becoming extremely ill.

-Browse notes
#Surgery

-Para umbilical hernia is any hernia within 3cm around umbilicus so any hernia beyond 3cm away from umbilicus is not termed para umbilical hernia.


-Epigastric hernia is misdiagnosed as heartburn because in early cases of epigastric hernia, the main complaint is epigastric pain and not mass.


#Surgery

•The most complications of GIT problems are:

-Hemorrhage
-Bleeding
-Stricture.

•And the first line in treatment of these complications is insertion of Ryle's tube.

#Surgery