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
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
-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
Or
-Leads to gastric outlet obstruction is called- Bouverte's syndrome.
#Surgery
Triple asessment of the breast:
1-History and examination
2-US and Mammography
3-Trucut biopsy.
Good exposure in breast examination is from umbilicus upward,Why?
-Because the lymph from the level of umbilicus upward comes to axilla.
#Surgery
1-History and examination
2-US and Mammography
3-Trucut biopsy.
Good exposure in breast examination is from umbilicus upward,Why?
-Because the lymph from the level of umbilicus upward comes to axilla.
#Surgery
•Murphy's Triad:
-It is associated with acute appendicitis, a medical emergency which presents with:
1-Lower right abdominal pain
2-Nausea and vomiting
3-Fever.
•Murphy's sign:
-It is useful for differentiating pain in the right upper quadrant.
-Typically, it is positive in acute cholecystitis, but negative in choledocholithiasis, pyelonephritis, and ascending cholangitis.
•Murphy's test
-It is a costovertebral angle (CVA) tenderness that results from touching the region inside of the costovertebral angle.
•Murphy's drip:
-It is a rectal infusion apparatus to administer the medical procedure of proctoclysis, also known as rectoclysis.
#Surgery
-It is associated with acute appendicitis, a medical emergency which presents with:
1-Lower right abdominal pain
2-Nausea and vomiting
3-Fever.
•Murphy's sign:
-It is useful for differentiating pain in the right upper quadrant.
-Typically, it is positive in acute cholecystitis, but negative in choledocholithiasis, pyelonephritis, and ascending cholangitis.
•Murphy's test
-It is a costovertebral angle (CVA) tenderness that results from touching the region inside of the costovertebral angle.
•Murphy's drip:
-It is a rectal infusion apparatus to administer the medical procedure of proctoclysis, also known as rectoclysis.
#Surgery
•Hartmann's procedure:
-It is the surgical resection of the rectosigmoid colon with closure of the anorectal stump and formation of an end colostomy.
•Hartmann's solution:
-Is Ringer's lactate solution.
•Hartmann's pouch:
-Dilated infandibulum of Gall bladder.
#Surgery
-It is the surgical resection of the rectosigmoid colon with closure of the anorectal stump and formation of an end colostomy.
•Hartmann's solution:
-Is Ringer's lactate solution.
•Hartmann's pouch:
-Dilated infandibulum of Gall bladder.
#Surgery
-Trauma to knee joint then after one to five days swelling is developed this indicates synovial effusion .
-Trauma to knee joint then after 5 minutes swelling is devloped this indicates hemarthrosis.
-Trauma to knee joint with wounds then after 2 weeks swelling is devloped with pain, tendrness, redness, fever ,limitation of movement this indicates abscess.
-Trauma to soft tissues then swelling is devloped this indicates hematoma.
#Surgery
-Trauma to knee joint then after 5 minutes swelling is devloped this indicates hemarthrosis.
-Trauma to knee joint with wounds then after 2 weeks swelling is devloped with pain, tendrness, redness, fever ,limitation of movement this indicates abscess.
-Trauma to soft tissues then swelling is devloped this indicates hematoma.
#Surgery
Surgical Triads
1. Shock Triad :
-Hypotention ( leading to hypoperfusion of tissues )+ tachycardia + low urine output.
2. Triad of death :
-Hypocoaugulopathy + acidosis + hypothermia.
3. Virchow Triad:
-Endothelial damage + venous stasis + hypercoagulability.
4. Charcot's Triad ( obstructive jaundice ) :
-Upper abdominal pain + fever + juandice.
-Reynold pentad = Charcot triad + shock + nervous disturbances "AMS".
5. Beck's Triad ( cardiac tamponade ):
-Hypotention + ↑ JVP + soft heart sounds.
6. Whipple's Triad ( insulinoma ) :
-Symptoms of hypoglycemia + FBS< 50 + relief after eating.
7. Cushing's Triad (↑ICP):
-Badycardia + irregular breathing + ↑pulse pressure
8. Samter's Triad :
-Asthma + aspirin allergy + nasal polyps.
9. Unhappy Triad ( knee major injury ) :
-Anterior cruciate lig +medial collateral ligament +medial meniscus.
10. Sandbolm Triad ( hemobilia ) :
-Obstructive jaundice + biliary colic + melena.
11. Dieulafoy triad ( acute appendicitis ) :
-Hyperasthesia + tenderness + guarding over McBurney point.
12. Bergman triad ( fat emboli syndrome ) :
-Petechia + dyspnea + mental changes.
13. Meckler triad (Boerhaav syndrome ):
-Hematemesis + abdominal &chest pain + emphysema.
14. Saint triad :
-Hiatal hernia + gall stones + diverticulosis.
15. Tetany triad :
-Convulsion + carpopedal spasms + stridor.
16. Plummer-Vinson triad :
-Dysphagia + Iron DA + esophageal webs.
#Surgery
1. Shock Triad :
-Hypotention ( leading to hypoperfusion of tissues )+ tachycardia + low urine output.
2. Triad of death :
-Hypocoaugulopathy + acidosis + hypothermia.
3. Virchow Triad:
-Endothelial damage + venous stasis + hypercoagulability.
4. Charcot's Triad ( obstructive jaundice ) :
-Upper abdominal pain + fever + juandice.
-Reynold pentad = Charcot triad + shock + nervous disturbances "AMS".
5. Beck's Triad ( cardiac tamponade ):
-Hypotention + ↑ JVP + soft heart sounds.
6. Whipple's Triad ( insulinoma ) :
-Symptoms of hypoglycemia + FBS< 50 + relief after eating.
7. Cushing's Triad (↑ICP):
-Badycardia + irregular breathing + ↑pulse pressure
8. Samter's Triad :
-Asthma + aspirin allergy + nasal polyps.
9. Unhappy Triad ( knee major injury ) :
-Anterior cruciate lig +medial collateral ligament +medial meniscus.
10. Sandbolm Triad ( hemobilia ) :
-Obstructive jaundice + biliary colic + melena.
11. Dieulafoy triad ( acute appendicitis ) :
-Hyperasthesia + tenderness + guarding over McBurney point.
12. Bergman triad ( fat emboli syndrome ) :
-Petechia + dyspnea + mental changes.
13. Meckler triad (Boerhaav syndrome ):
-Hematemesis + abdominal &chest pain + emphysema.
14. Saint triad :
-Hiatal hernia + gall stones + diverticulosis.
15. Tetany triad :
-Convulsion + carpopedal spasms + stridor.
16. Plummer-Vinson triad :
-Dysphagia + Iron DA + esophageal webs.
#Surgery
-WBC's increase normally after operation and it is due to surgical trauma within 48 hours, but after 48h it is called pathological rising of WBC.
#Surgery
#Surgery
Most common eponymous surgical procedures :
Name of procedure ➡️ used for treatment of.
1. Nissen fundoplication ➡️ GERD other fundoplications include ➡️Toupet , Dor , Belsy fundoplications
2. Ramstedt's pyleroplasty ➡️congenital pyloric stenosis
-In adults there are➡️ Bilroth's 1&2 , heineke-mikulicz , Polya , Jaboulay's
3. Heller's myotomy ➡️ Achalasia
4. Ivor-Lewis ➡️ esophagogastric resection for cancer
5. Collis ➡️ lengthening of esophagus for esophageal stricture to do nissen fundoplication
6. Roux-en-Y ➡️ small intestine anastomosis in many GIT procedures
7. Whipple's ➡️ pancreatic adenocarcinoma
8. Kasai ➡️ pediatric biliary atresia
9. Hastedt's ➡️ inguinal hernia , radical mastectomy
10. Hartmann's ➡️ rectosigmoid cancer removal + closure of rectal stump + colostomy
11. Miles , Paul ➡️ rectal cancer
12. Mayo repair ➡️ Umbilical hernia
13. Silo repair ➡️ omphalocele , gastroischesis
14. Lord's ➡️ hemorrhoids , scrotal hydrocele
15. Jaboulay-Winkemann ➡️ scrotal hydrocele
16. Foley , Anderson-hynes ➡️ UPJ obstruction
17. Lodd's ➡️ small intestine malrotation in infants
18. Sistrunk ➡️ thyroglossal cyst
19. Killian ➡️ frontal sinusitis
20. Hadfield's ➡️ breast ductal ectasia
21. Moh's ➡️ basal cell carcinoma &squamous cell carcinoma of skin
22. Homan's ➡️ ligation of femoral vein to prevent PE from DVT
23. Trendelenburg ➡️ Pulmonary embolectomy of PE
24. Greenfield filter ➡️ IVC filter to prevent PE from DVT
25. Bankart repair ➡️ recurrent shoulder dislocation
#Surgery
Name of procedure ➡️ used for treatment of.
1. Nissen fundoplication ➡️ GERD other fundoplications include ➡️Toupet , Dor , Belsy fundoplications
2. Ramstedt's pyleroplasty ➡️congenital pyloric stenosis
-In adults there are➡️ Bilroth's 1&2 , heineke-mikulicz , Polya , Jaboulay's
3. Heller's myotomy ➡️ Achalasia
4. Ivor-Lewis ➡️ esophagogastric resection for cancer
5. Collis ➡️ lengthening of esophagus for esophageal stricture to do nissen fundoplication
6. Roux-en-Y ➡️ small intestine anastomosis in many GIT procedures
7. Whipple's ➡️ pancreatic adenocarcinoma
8. Kasai ➡️ pediatric biliary atresia
9. Hastedt's ➡️ inguinal hernia , radical mastectomy
10. Hartmann's ➡️ rectosigmoid cancer removal + closure of rectal stump + colostomy
11. Miles , Paul ➡️ rectal cancer
12. Mayo repair ➡️ Umbilical hernia
13. Silo repair ➡️ omphalocele , gastroischesis
14. Lord's ➡️ hemorrhoids , scrotal hydrocele
15. Jaboulay-Winkemann ➡️ scrotal hydrocele
16. Foley , Anderson-hynes ➡️ UPJ obstruction
17. Lodd's ➡️ small intestine malrotation in infants
18. Sistrunk ➡️ thyroglossal cyst
19. Killian ➡️ frontal sinusitis
20. Hadfield's ➡️ breast ductal ectasia
21. Moh's ➡️ basal cell carcinoma &squamous cell carcinoma of skin
22. Homan's ➡️ ligation of femoral vein to prevent PE from DVT
23. Trendelenburg ➡️ Pulmonary embolectomy of PE
24. Greenfield filter ➡️ IVC filter to prevent PE from DVT
25. Bankart repair ➡️ recurrent shoulder dislocation
#Surgery
-The most common site of atherosclerotic occlusion in the lower extremities is the proximal superficial femoral artery.
-The most common site at which arterial emboli lodge in lower extremities is common femoral bifurcation.
-The most important prognostic sign of acute ischemia of limb is Muscle turgor.
-The most frequent cause of arterial embolism is Atrial fibrillation.
-The most common cause of true aneurysm is Atherosclerosis.
#Surgery
-The most common site at which arterial emboli lodge in lower extremities is common femoral bifurcation.
-The most important prognostic sign of acute ischemia of limb is Muscle turgor.
-The most frequent cause of arterial embolism is Atrial fibrillation.
-The most common cause of true aneurysm is Atherosclerosis.
#Surgery
-First thing to do it in case of acute lower limb ischemia is giving the patient heparin to avoid clot propagation.
-First thing to do it in case of diabetic patient come with on toe gangrene is chicking the pedal pulse.
-First drug described for Raynaud's disease is Calcium channel blocker.
#Surgery
-First thing to do it in case of diabetic patient come with on toe gangrene is chicking the pedal pulse.
-First drug described for Raynaud's disease is Calcium channel blocker.
#Surgery
-The primary therapy of Buerger disease is cessation of smoking.
-Acute ischemic leg +signs of emboli (acute history ) , should do Embolectomy.
-Acute ischemic leg + signs of thrombus (chronic history ) , Thrombolize.
-Chronic ischemic leg +short occlusion, we do angioplasty.
-Chronic ischemic leg + long occlusion , we do Bypass graft.
#Surgery
-Acute ischemic leg +signs of emboli (acute history ) , should do Embolectomy.
-Acute ischemic leg + signs of thrombus (chronic history ) , Thrombolize.
-Chronic ischemic leg +short occlusion, we do angioplasty.
-Chronic ischemic leg + long occlusion , we do Bypass graft.
#Surgery