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.

#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.

#Surgery

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

-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

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

Remember:

Umbilical Hernia:

-It may be seen normally in some children and may close spontaneously by 2 years.

-The following conditions are usually associated with umbilical hernia:

• Down's syndrome
• Cretinism
• Hurler's syndrome
• Hunter's syndrome.

#Pediatrics

Arcuate line:

-A crescentic line that is situated between upper 2/4 &lower 1/2 of posterior wall of rectus sheath.

#Surgery

Can Appendicitis Present with No Abdominal Pain?

-Yes. In some cases, a retrocecal appendicitis may not cause any abdominal pain. If the appendix is completely separated from the anterior abdominal peritoneum, then the patient will not develop any localizing symptoms.

#Surgery

Remember:

Epigastric hernia is more common in men.
Para-umbilical hernia is more common in women.

#Surgery

Nice summary for Management of urinary tract stones.


Conservative treatment:
-High fluid intake with or without diuretics.
-Analgesics.
-Antispasmodic agents.
-Urinary antiseptics, regular follow-up to monitor stone descent.

#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

-Portal vein consists of SMV and splenic vein.

-It begins behind the head of pancreas and in front of IVC, ends at porta
-hepatis.
-About 3inch length.
-About 0.8-1.2 cm diameter.


Direct tributaries:
Portal vein drains the whole. intra-abdominal alimentary tract and anterior abdominal wall:

- Left and right gastric veins.
-Small pancreatic & duodenal veins.
-Para-umbilical veins into left branch of portal vein.
- Splenic vein.
-SMV.
-Cystic vein.

Pressure: 10 - 20 cmH2O (7 - 11 mmHg).

#Surgery

Umbilical hernia

◼️It is mostly symptomless.
◼️Strangulation under 3 years of age is rare.
◼️There is no sex predilection, but there is major racial difference because this hernia is 8 times more common in black children than white children.
◼️In 95% of cases in those under 2 years of age, the hernia will spontaneously resolve, because the vast majority of cases resolve on its own, Do nothing but reassurance of the parents.
◼️If it persist at 2 years or more (only in 5%) it will likely not resolve and this herniorrhaphy is indicated.
◼️The operation entails a curved skin incision under the umbilicus with isolated of the sac which is either reduced or transfixed with sutures, the defect in the linea alba is closed.

#Hernia
#Surgery

VENTRAL HERNIA:

-Any protrusion through abdominal wall with the exception of hernia through the inguinofemoral region is defined as ventral hernia.
-Incisional hernia (80%) and primary defects in abdominal fascia which can cause umbilical hernia, epigastric hernia, paraumbilical hernia or Spigelian hernia are grouped under ventral hernia.

#Surgery

RECURRENT HERNIA (Inguinal)

-Incidence is 10%.
-If recurrence is within 3 years it is called as early.
-If it is after 3 years it is late.

#Surgery

What is the conjoint tendon?

-Aponeurotic attachments of the “conjoining” of the internal oblique and transversus abdominis to the pubic tubercle.

#Surgery