Forwarded from Quick Notes
-The only effective treatment of Retrosternal goiter is surgery.
-The antithyroid drugs in pre-operative preparation or treatment are contraindicated, Why?
-Because they will lead to ↓in thyroid hormones levels which lead to feedback activation of TSH that causes increased thyroid growth and size with more obstruction at neck without effect on hormone levels!!
So they use BB as Propranolol.
#Surgery
-The antithyroid drugs in pre-operative preparation or treatment are contraindicated, Why?
-Because they will lead to ↓in thyroid hormones levels which lead to feedback activation of TSH that causes increased thyroid growth and size with more obstruction at neck without effect on hormone levels!!
So they use BB as Propranolol.
#Surgery
Forwarded from Quick Notes
Note
The parotid gland is innervated by the auriculotemporal nerve, which is a branch of the mandibular division of trigeminal nerve, this branch provide sensory innervation and carries postganglionic parasympathetic nerve fibres to the parotid gland for secretomotor activity, these fibres originate in the otic ganglion associated with the mandibular nerve, the preganglionic nerve fibres comes from the glossopharyngeal nerve.
#Salivary
#Surgery
The parotid gland is innervated by the auriculotemporal nerve, which is a branch of the mandibular division of trigeminal nerve, this branch provide sensory innervation and carries postganglionic parasympathetic nerve fibres to the parotid gland for secretomotor activity, these fibres originate in the otic ganglion associated with the mandibular nerve, the preganglionic nerve fibres comes from the glossopharyngeal nerve.
#Salivary
#Surgery
Forwarded from Quick Notes
Remember:
-Best diagnostic modality for parotid swelling: FNAC.
-Open incisional biopsy is contraindicated; due to tumor cell implantation and formation of parotid fistula.
-Best imaging investigation for salivary gland neoplasms: MRI.
#Salivary_glands
-Best diagnostic modality for parotid swelling: FNAC.
-Open incisional biopsy is contraindicated; due to tumor cell implantation and formation of parotid fistula.
-Best imaging investigation for salivary gland neoplasms: MRI.
#Salivary_glands
Forwarded from Quick Notes
Recognizing acute cholecystitis on US:
-The presence of gallstones, possibly impacted in the neck of the gallbladder or cystic duct) (Fig. 21-5)
-Thickening of the gallbladder wall (>3 mm) (see Fig. 21-5, A)
-Pericholecystic fluid (fluid around the gallbladder) (see Fig. 21-5, B)
- A positive sonographic Murphy sign (A positive Murphy sign in this case is pain that is elicited by compression of the gallbladder with the US probe).
•In the presence of gallstones and gallbladder wall thickening, US has a positive predictive value for acute cholecystitis as high as 94%.
#Surgery
-The presence of gallstones, possibly impacted in the neck of the gallbladder or cystic duct) (Fig. 21-5)
-Thickening of the gallbladder wall (>3 mm) (see Fig. 21-5, A)
-Pericholecystic fluid (fluid around the gallbladder) (see Fig. 21-5, B)
- A positive sonographic Murphy sign (A positive Murphy sign in this case is pain that is elicited by compression of the gallbladder with the US probe).
•In the presence of gallstones and gallbladder wall thickening, US has a positive predictive value for acute cholecystitis as high as 94%.
#Surgery
Quick Notes
Recognizing acute cholecystitis on US: -The presence of gallstones, possibly impacted in the neck of the gallbladder or cystic duct) (Fig. 21-5) -Thickening of the gallbladder wall (>3 mm) (see Fig. 21-5, A) -Pericholecystic fluid (fluid around…
Some examiners need to tell them what is the most important US finding ,Thinking of GB wall.
Forwarded from Quick Notes
Quick Notes
Comparison between amebic and pyogenic liver abscess. #Surgery
They are among DDx of hepatic hydatid cyst .
Forwarded from Quick Notes
Methods to elicit MURPHY’S SIGN:
1)Patient in upright/sitting position, the right hand of the examiner curls up under the right costal margin (or extended fingers with moderate pressure) of the patient at the tip of the ninth rib and patient is requested to take a deep breath. If the gallbladder is inflamed, the patient will experience pain (winces with pain and catch the breath) as the gallbladder descends and contacts the palpating hand.
2)The extended and abducted left thumb is placed in right subcostal region without pressing deep; the patient is requested to take a deep breath.This is elicited in lying down supine position. Called Moynihan’s modification of eliciting Murphy’s sign.
3)Identify the right Midclavicular line then descend to the right costal margin and put your one or two fingers there, as that site is the anatomical position of GB fundus.
4)From linea semilunaris and ascend to right costal margin. This isn't good in obese patients.
5)A line from left ASIS to the umblicus and other from the umblicus to the right costal margin tip of 9th costal cartilage. It's called Grey Turner line.
6)From the RIF and ascend upward, this facilitates the detection if there is also hydropes of GB. د. رمزي
7)Sonographic Murphy’s sign is eliciting same sign using sonographic transducer. It is more sensitive and more accurate.
1)Patient in upright/sitting position, the right hand of the examiner curls up under the right costal margin (or extended fingers with moderate pressure) of the patient at the tip of the ninth rib and patient is requested to take a deep breath. If the gallbladder is inflamed, the patient will experience pain (winces with pain and catch the breath) as the gallbladder descends and contacts the palpating hand.
2)The extended and abducted left thumb is placed in right subcostal region without pressing deep; the patient is requested to take a deep breath.This is elicited in lying down supine position. Called Moynihan’s modification of eliciting Murphy’s sign.
3)Identify the right Midclavicular line then descend to the right costal margin and put your one or two fingers there, as that site is the anatomical position of GB fundus.
4)From linea semilunaris and ascend to right costal margin. This isn't good in obese patients.
5)A line from left ASIS to the umblicus and other from the umblicus to the right costal margin tip of 9th costal cartilage. It's called Grey Turner line.
6)From the RIF and ascend upward, this facilitates the detection if there is also hydropes of GB. د. رمزي
7)Sonographic Murphy’s sign is eliciting same sign using sonographic transducer. It is more sensitive and more accurate.
Forwarded from Quick Notes
Quick Notes
Methods to elicit MURPHY’S SIGN: 1)Patient in upright/sitting position, the right hand of the examiner curls up under the right costal margin (or extended fingers with moderate pressure) of the patient at the tip of the ninth rib and patient is requested…
The sign is described by John murphy, a professor of surgery chicago USA.
Forwarded from Quick Notes
Quick Notes
Methods to elicit MURPHY’S SIGN: 1)Patient in upright/sitting position, the right hand of the examiner curls up under the right costal margin (or extended fingers with moderate pressure) of the patient at the tip of the ninth rib and patient is requested…
حومش يعجبه نسوي بالطريقة الثانية.
Forwarded from Quick Notes
When to stop the drugs before surgery in thyroid operation?
If the patient is posted for surgery tomorrow morning
1.Stop carbimazole today night
2.Stop Lugol’s iodine today night
3.Propranolol to be given tomorrow morning also.
After surgery:
1.Stop carbimazole and Lugol’s iodine
2.Continue the propranolol for 7 days to handle the thyroxine released during surgery and to prevent peripheral T4 to T3 conversion.
#Surgery
If the patient is posted for surgery tomorrow morning
1.Stop carbimazole today night
2.Stop Lugol’s iodine today night
3.Propranolol to be given tomorrow morning also.
After surgery:
1.Stop carbimazole and Lugol’s iodine
2.Continue the propranolol for 7 days to handle the thyroxine released during surgery and to prevent peripheral T4 to T3 conversion.
#Surgery
Forwarded from Quick Notes
Associated Anomalies with undescended testis:
-Epididymal anomalies and patent processus vaginalis upto 90%.
-Renal Anomalies in10% cases (Renal hypoplasia, agenesis,horseshoe kidney, PUJ obstruction)
-Hypospadias.
#Surgery
-Epididymal anomalies and patent processus vaginalis upto 90%.
-Renal Anomalies in10% cases (Renal hypoplasia, agenesis,horseshoe kidney, PUJ obstruction)
-Hypospadias.
#Surgery
Forwarded from Quick Notes
Remember:
Development of the Thyroid Gland:
-The thyroid gland begins to develop during the third week as an entodermal thickening in the midline of the floor of the pharynx between the tuberculum impar and the copula.
-By the seventh week, it reaches its final position in relation to the larynx and trachea.
-The thyroid gland develops from a median down growth of a column of cells from the pharyngeal floor between the first and second pharyngeal pouches (subsequently marked by the foramen caecum of the tongue).
#Surgery
Development of the Thyroid Gland:
-The thyroid gland begins to develop during the third week as an entodermal thickening in the midline of the floor of the pharynx between the tuberculum impar and the copula.
-By the seventh week, it reaches its final position in relation to the larynx and trachea.
-The thyroid gland develops from a median down growth of a column of cells from the pharyngeal floor between the first and second pharyngeal pouches (subsequently marked by the foramen caecum of the tongue).
#Surgery
Forwarded from Quick Notes
Forwarded from Quick Notes
What is the bone that has not articulation with any bone?
-The hyoid bone is a mobile single bone found in the midline of the neck below the mandible and abides the larynx.
-It does not articulate with any other bones.
#Surgery
-The hyoid bone is a mobile single bone found in the midline of the neck below the mandible and abides the larynx.
-It does not articulate with any other bones.
#Surgery
Forwarded from Quick Notes
INDICATIONS OF CBD EXPLORATION:
1. History of charcot’s triad
2. USG proven stones in CBD
3. Dilated CBD (>1cm)
4. OTCshows filling deffect
5. Palpable stones in CB.
#Surgery
1. History of charcot’s triad
2. USG proven stones in CBD
3. Dilated CBD (>1cm)
4. OTCshows filling deffect
5. Palpable stones in CB.
#Surgery