Retrosternal goiter:
-Common in short neck individuals and males with strong pretracheal muscles
Types:
1.Substernal—part of nodule palpable in lower neck
2.Plunging—on increased intrathoracic pressure gland forced into neck
3.Intrathoracic goiter.
Classes:
1-Primary: rare, congenital.
2-Secondary: more common, acquired as in a large MNG.
#Surgery
-Common in short neck individuals and males with strong pretracheal muscles
Types:
1.Substernal—part of nodule palpable in lower neck
2.Plunging—on increased intrathoracic pressure gland forced into neck
3.Intrathoracic goiter.
Classes:
1-Primary: rare, congenital.
2-Secondary: more common, acquired as in a large MNG.
#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
-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
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
Remember:
-Celsius, Fahrenheit and Kelvin are the three common temperature scales.
-F° denotes for Fahrenheit , this is considered an American"US" system.
-C° means Celsius, it's used by UK "British system "and rest of the world.
Celsius is invented in 1742 by the Swedish astronomer Anders Celsius.
#Surgery
-Celsius, Fahrenheit and Kelvin are the three common temperature scales.
-F° denotes for Fahrenheit , this is considered an American"US" system.
-C° means Celsius, it's used by UK "British system "and rest of the world.
Celsius is invented in 1742 by the Swedish astronomer Anders Celsius.
#Surgery
Remember:
Imp.
-In taking history in patients with hernia or varicocele, do not forget to ask about other swellings and features that suggest congenital weaknesses of mesenchyme such as Varicose veins, flat foot, piles, visceroptosis, muscle weakness..etc
-Because mesenchyme gives cells of convective tissues such as muscles of walls of blood vessels" varicocele, varicose veins, piles", fibrous tissue " hernia, ligaments "flat foot due to weaknesses of ligaments"..etc
-Also in examination examine if there is manifestations of weak mesenchymal syndrome, such as above plus:
-Rising test if there is recti diverication due to poor muscles.
-Also Malgaign's sign, bulge of multiple swellings in hernial regions"phantom hernia"
-Visceroptosis by local examination.
#Surgery
Imp.
-In taking history in patients with hernia or varicocele, do not forget to ask about other swellings and features that suggest congenital weaknesses of mesenchyme such as Varicose veins, flat foot, piles, visceroptosis, muscle weakness..etc
-Because mesenchyme gives cells of convective tissues such as muscles of walls of blood vessels" varicocele, varicose veins, piles", fibrous tissue " hernia, ligaments "flat foot due to weaknesses of ligaments"..etc
-Also in examination examine if there is manifestations of weak mesenchymal syndrome, such as above plus:
-Rising test if there is recti diverication due to poor muscles.
-Also Malgaign's sign, bulge of multiple swellings in hernial regions"phantom hernia"
-Visceroptosis by local examination.
#Surgery
What is Slipped capital femoral epiphysis?
-Displacement of the metaphysis of the femoral neck from the epiphysis of the femoral head through the growth plate/physis.
-Likely due to obesity and overloading of the physis, less commonly due to a weakened growth plate from an endocrinological disorder; the femoral neck displaces anteriorly and superiorly relative to the femoral epiphysis;
-Typically presents at age 10–16 years.
#Surgery
-Displacement of the metaphysis of the femoral neck from the epiphysis of the femoral head through the growth plate/physis.
-Likely due to obesity and overloading of the physis, less commonly due to a weakened growth plate from an endocrinological disorder; the femoral neck displaces anteriorly and superiorly relative to the femoral epiphysis;
-Typically presents at age 10–16 years.
#Surgery
What Is the Treatment of Extremity Compartment Syndrome?
-Treatment is immediate decompressive fasciotomy of all the compartments of the affected limb.
Goal: first save life,save limb.
#Surgery
-Treatment is immediate decompressive fasciotomy of all the compartments of the affected limb.
Goal: first save life,save limb.
#Surgery
What Is the Terrible (aka “Unhappy”) Triad of the Knee?
-A combination of MCL, ACL, and medial meniscus injuries.
#Surgery
-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.
#Surgery
-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
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
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
#Surgery
Forwarded from Quick Notes
•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
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
Forwarded from Quick Notes
Forwarded from Quick Notes
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
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
Forwarded from Quick Notes
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
-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
Forwarded from Quick Notes