Forwarded from معلومات طبية M. Information (彡 Dr_Thaalnoon_ALqahatani ⁞²⁰²³彡)
👍2
🔴Pneumothorax
▪︎Air Accumulation in Pleural Space (Between Visceral & Parietal Pleura)
🔹Causes Of Pneumothorax
📍1. Primary Sponetousnus :
▪︎Due To Apical Subpleural Blebs Rupture
▪︎No Hx Of Lung Disease
▪︎Mostly Occurs in Persons With :
🔻I. Cigarette & Cannabis Smokers
🔻II. Tall/Slim/Young Age Males (20-40 Years)
🔻III. Marfan Syndrome & Homocystinuria
📍2. Secondary Sponetousnus :
▪︎Hx Of Lung Disease Present
▪︎High Mortality Rate
▪︎Mostly Due To :
🔻I. COPD (Asthma Or Bullae Rupture in Emphysema)
🔻II. TB Infection & Lung Abscess
🔻III. Pulmonary Infarction
🔻IV. Lung Cancer
🔻V. Lung Fibrosis
🔻VI. Cystic Fibrosis
📍3. Traumatic ➡️ After Blunt Or Penetrating Or Iatrogenic Chest Trauma
📍4. Catamenial Pneumothorax ➡️ Pneumothorax Occurs At Time Of Menstruation In Women (Due To Endometriosis involving The Pleura)
🔹Types Of Sponetousnus Pneumothorax
📍1. Closed :
▪︎Air Accumulates Inside The Pleura Then The Leakage Stops
▪︎Spontaneous Air Absorption & Lung Re-Expansion in Days To Weeks
📍2. Open :
▪︎Air Moves Freely in & Out The Pleura
▪︎Seen in Emphysematous Bullae Rupture/TB Cavity/Lung Abscess
▪︎Risk Of Infection
📍3. Tension Pneumothorax (Most Dangerous) :
▪︎The Leakage Point Acts As One Way Valve Allow Air To Enter But Not Escape
▪︎Causing Large Amount Of Air Accumulation & Mediastinal Shift & Cardiovascular Compromise
🔹Clinical Features
📍1. Sudden Onset Unilateral Pleuritic Chest Pain & Dyspnea
📍2. Unilateral Decrease Or Absent Breath Sounds
📍3. Unilateral HyperResonant To Percussion
📍4. Unilateral Reduce Chest Expansion
📍5. Marked Tachycardia/Hypotension/Cyanosis/Tracheal Deviation Away (In Tension Pneumothorax)
🔹Dx Of Pneumothorax (By Chest Xray)
📍1. Visible Pleural Line
📍2. Absent Lung Markings At Periphery
📍3. Deep Sulcus Sign (Depression Of CostoPhrenic Angle)
*For Tiny Pneumothorax ➡️ Use Lateral Chest Xray
🔹Mx Of Pneumothorax
📍1. Give High flow Oxygen To All Patients
📍2. Mild Primary Sponetousnus (Lung Edge <2cm) ➡️ Resolve Spontaneously
📍3. Moderate To Large Primary Sponetousnus ➡️ Percutaneous Needle Aspiration Of Air
📍4. Secondary Sponetousnus (Chronic Lung Disease & Respiratory Distress Present) ➡️ InterCostal Tube Drainage & inpatient Observation
📍5. Tension Pneumothorax :
▪︎Immediate Insertion Of Blunt Cannula into The 2nd InterCostal Space Mid Clavicular Line
▪︎Then Chest Drain inserted into The 4th-5th-6th InterCostal Space Mid Axillary Line
#Surgery #cardiothoraxic
https://t.me/Surgery_Practice
▪︎Air Accumulation in Pleural Space (Between Visceral & Parietal Pleura)
🔹Causes Of Pneumothorax
📍1. Primary Sponetousnus :
▪︎Due To Apical Subpleural Blebs Rupture
▪︎No Hx Of Lung Disease
▪︎Mostly Occurs in Persons With :
🔻I. Cigarette & Cannabis Smokers
🔻II. Tall/Slim/Young Age Males (20-40 Years)
🔻III. Marfan Syndrome & Homocystinuria
📍2. Secondary Sponetousnus :
▪︎Hx Of Lung Disease Present
▪︎High Mortality Rate
▪︎Mostly Due To :
🔻I. COPD (Asthma Or Bullae Rupture in Emphysema)
🔻II. TB Infection & Lung Abscess
🔻III. Pulmonary Infarction
🔻IV. Lung Cancer
🔻V. Lung Fibrosis
🔻VI. Cystic Fibrosis
📍3. Traumatic ➡️ After Blunt Or Penetrating Or Iatrogenic Chest Trauma
📍4. Catamenial Pneumothorax ➡️ Pneumothorax Occurs At Time Of Menstruation In Women (Due To Endometriosis involving The Pleura)
🔹Types Of Sponetousnus Pneumothorax
📍1. Closed :
▪︎Air Accumulates Inside The Pleura Then The Leakage Stops
▪︎Spontaneous Air Absorption & Lung Re-Expansion in Days To Weeks
📍2. Open :
▪︎Air Moves Freely in & Out The Pleura
▪︎Seen in Emphysematous Bullae Rupture/TB Cavity/Lung Abscess
▪︎Risk Of Infection
📍3. Tension Pneumothorax (Most Dangerous) :
▪︎The Leakage Point Acts As One Way Valve Allow Air To Enter But Not Escape
▪︎Causing Large Amount Of Air Accumulation & Mediastinal Shift & Cardiovascular Compromise
🔹Clinical Features
📍1. Sudden Onset Unilateral Pleuritic Chest Pain & Dyspnea
📍2. Unilateral Decrease Or Absent Breath Sounds
📍3. Unilateral HyperResonant To Percussion
📍4. Unilateral Reduce Chest Expansion
📍5. Marked Tachycardia/Hypotension/Cyanosis/Tracheal Deviation Away (In Tension Pneumothorax)
🔹Dx Of Pneumothorax (By Chest Xray)
📍1. Visible Pleural Line
📍2. Absent Lung Markings At Periphery
📍3. Deep Sulcus Sign (Depression Of CostoPhrenic Angle)
*For Tiny Pneumothorax ➡️ Use Lateral Chest Xray
🔹Mx Of Pneumothorax
📍1. Give High flow Oxygen To All Patients
📍2. Mild Primary Sponetousnus (Lung Edge <2cm) ➡️ Resolve Spontaneously
📍3. Moderate To Large Primary Sponetousnus ➡️ Percutaneous Needle Aspiration Of Air
📍4. Secondary Sponetousnus (Chronic Lung Disease & Respiratory Distress Present) ➡️ InterCostal Tube Drainage & inpatient Observation
📍5. Tension Pneumothorax :
▪︎Immediate Insertion Of Blunt Cannula into The 2nd InterCostal Space Mid Clavicular Line
▪︎Then Chest Drain inserted into The 4th-5th-6th InterCostal Space Mid Axillary Line
#Surgery #cardiothoraxic
https://t.me/Surgery_Practice
Telegram
Surgical Practice Dr. alqhatani
- تابعة لقناة معلومات طبية:
@M_Information11
- قروب للمناقشة الطبية:
@M_Information21
- بوت التواصل :
@Alqhatani_bot
- صارحني :
http://t.me/SY8Bot?start=wiRwSie0ew
🚫 نحلل النقل ولا نحلل حذف الروابط🚫
@M_Information11
- قروب للمناقشة الطبية:
@M_Information21
- بوت التواصل :
@Alqhatani_bot
- صارحني :
http://t.me/SY8Bot?start=wiRwSie0ew
🚫 نحلل النقل ولا نحلل حذف الروابط🚫
Intestinal obstruction notes
❇️ The earliest symptom of IO
Pain
❇️ The most common cause of IO
Adhesive intestinal obstruction
❇️ The most common cause of IO in newborn
Jejuno-ileal atresia or stenosis
❇️ The most common cause of IO in old age
Malignancy
❇️ The most common cause of IO in infants
Intussusception
❇️ The main predisposing factor of intussusceptum
Partial obstruction
❇️ The most common type of Infantile intussusception
Idiopathic type
❇️ The most common intussusception
Ileo-cecal intussusception
❇️ The most vulnerable type to gangrene
Ileo-colic type
❇️The most common source of gas in Intestinal obstruction
Swallowed (68%)
❇️ The most common source of fluid in Intestinal obstruction
Secreted (8L)
❇️ Vomiting is early & most copious in
Jejunal obstruction
❇️ Absolute constipation mean
NO feces, NO flatus
❇️ IO is associated with
hypokalaemia & hyponatraemia
.............................................
🔥Difference between Simple & strangulated Intestinal obstruction
🔻Simple
Intermittent colicky pain
+long free interval
🔻Strangulated
Attacks of colicky pain
+short interval of
constant dull aching pain
🔥Direction of volvolus
🔻Volvolus of cecum
Clockwise direction
🔻Sigmoid Volvolus
Anti-clockwise direction
❇️ Signs in Intestinal obstruction ⬇️
☄ Red currant jelly stool
Intussusception
☄ Blood on gloves
Volvolus sigmoid (Sup rectal vein)
Mesentric vascular occlusion
☄Dead silent abdomen
Paralytic ileus
☄Valvulae conniventes
Intestinal obstruction at level of jejunum
☄ Gas in GB or biliary tree in Intestinal obstruction
Gallstone ileus
☄ Dance's sign
Emptiness on Rt iliac fossa
Intussusception
☄Multiple fluid levels Diagnostic for
Intestinal obstruction
☄Claw sign on Barium enema
Intussusception
☄Bird's peak deformity
Volvolus sigmoid
☄Ace of spades
Volvolus sigmoid
☄Inverted U shape on X-ray
Volvolus Sigmoid
☄Sudden onset of Abd-Pain
+infant draws his legs & screams
Intussusception
#Intestinal obstruction
#surgery
https://t.me/Surgery_Practice
❇️ The earliest symptom of IO
Pain
❇️ The most common cause of IO
Adhesive intestinal obstruction
❇️ The most common cause of IO in newborn
Jejuno-ileal atresia or stenosis
❇️ The most common cause of IO in old age
Malignancy
❇️ The most common cause of IO in infants
Intussusception
❇️ The main predisposing factor of intussusceptum
Partial obstruction
❇️ The most common type of Infantile intussusception
Idiopathic type
❇️ The most common intussusception
Ileo-cecal intussusception
❇️ The most vulnerable type to gangrene
Ileo-colic type
❇️The most common source of gas in Intestinal obstruction
Swallowed (68%)
❇️ The most common source of fluid in Intestinal obstruction
Secreted (8L)
❇️ Vomiting is early & most copious in
Jejunal obstruction
❇️ Absolute constipation mean
NO feces, NO flatus
❇️ IO is associated with
hypokalaemia & hyponatraemia
.............................................
🔥Difference between Simple & strangulated Intestinal obstruction
🔻Simple
Intermittent colicky pain
+long free interval
🔻Strangulated
Attacks of colicky pain
+short interval of
constant dull aching pain
🔥Direction of volvolus
🔻Volvolus of cecum
Clockwise direction
🔻Sigmoid Volvolus
Anti-clockwise direction
❇️ Signs in Intestinal obstruction ⬇️
☄ Red currant jelly stool
Intussusception
☄ Blood on gloves
Volvolus sigmoid (Sup rectal vein)
Mesentric vascular occlusion
☄Dead silent abdomen
Paralytic ileus
☄Valvulae conniventes
Intestinal obstruction at level of jejunum
☄ Gas in GB or biliary tree in Intestinal obstruction
Gallstone ileus
☄ Dance's sign
Emptiness on Rt iliac fossa
Intussusception
☄Multiple fluid levels Diagnostic for
Intestinal obstruction
☄Claw sign on Barium enema
Intussusception
☄Bird's peak deformity
Volvolus sigmoid
☄Ace of spades
Volvolus sigmoid
☄Inverted U shape on X-ray
Volvolus Sigmoid
☄Sudden onset of Abd-Pain
+infant draws his legs & screams
Intussusception
#Intestinal obstruction
#surgery
https://t.me/Surgery_Practice
Telegram
Surgical Practice Dr. alqhatani
- تابعة لقناة معلومات طبية:
@M_Information11
- قروب للمناقشة الطبية:
@M_Information21
- بوت التواصل :
@Alqhatani_bot
- صارحني :
http://t.me/SY8Bot?start=wiRwSie0ew
🚫 نحلل النقل ولا نحلل حذف الروابط🚫
@M_Information11
- قروب للمناقشة الطبية:
@M_Information21
- بوت التواصل :
@Alqhatani_bot
- صارحني :
http://t.me/SY8Bot?start=wiRwSie0ew
🚫 نحلل النقل ولا نحلل حذف الروابط🚫
❤3👍1
❇️ Any young woman come with Single duct bloody discharge is =
👉 Duct papilloma until proven otherwise
❇️ Any young Girl come with Mobile breast lump = 👉 fibroadenoma until proven otherwise
#breast_Note
https://t.me/Surgery_Practice
👉 Duct papilloma until proven otherwise
❇️ Any young Girl come with Mobile breast lump = 👉 fibroadenoma until proven otherwise
#breast_Note
https://t.me/Surgery_Practice
👍1
Hartmann's pouch =
Anonymous Quiz
68%
Infundibulum of the neck of gall bladder
6%
Body of gall bladder
14%
The dilated terminal part of hepatico-pancreatic duct
12%
None of the above
👏1
Callot's triangle is formed by all the following EXCEPT
Anonymous Quiz
16%
Cystic duct
22%
Cystic artery
10%
Common hepatic duct
53%
Common bile duct
Lymphatic drainage of gall bladder ends evantually in:
Anonymous Quiz
15%
Superior mesentric LNs
19%
Inferior mesenteric LNs
58%
Celiac LNs
8%
Common iliac LNs
The spiral valve of Heister is formed by the folded mucosa of:
Anonymous Quiz
18%
Gall bladder
47%
Cystic duct
18%
Common hepatic duct
18%
Common bile duct
The most common cause for chronic cholecystitis is:
Anonymous Quiz
80%
Gall bladder stones
14%
Stasis gall bladder
4%
Bacterial infection
2%
Cholecystitis glandularis proliferans
Haemolytic conditions are the predisposing factor of ...
Anonymous Quiz
2%
Cholesterol stone
13%
Mixed stoone
78%
Pigment stone
7%
Ca carbonate stone
彡 Dr_Thaalnoon_ALqahatani ⁞²⁰²³彡
Haemolytic conditions are the predisposing factor of ...
هذه الخيارات نفسها لهذه الأسئلة اللي تحت ⬇️
Which of the followings is a criteria of ch. inflammation of GB ?
Anonymous Quiz
5%
Loss of normal serosal luster
5%
Enlarged cystic LN
3%
Cobweb appearance of the GB bed
88%
All of the above
Which of the followings is false about conservative treatment of chronic cholecystitis ?
Anonymous Quiz
11%
Restriction of fat.
26%
We give the patient choleretics.
43%
Success rate is 85% after 2 years.
20%
Recurrence rate is 50% within 5 years.
The most common cause of hemorrhage during the operation is injury of which of the following vessels ?
Anonymous Quiz
5%
Portal vein
41%
Rt hepatic artery
54%
Cystic artery
The most common cause of calcular obstructive jaundice is:
Anonymous Quiz
13%
1ry CBD stone (💡brown pigment stone)
84%
Migrating stone from the gall bladder
0%
Kladskin tumor
3%
Cancer head of pancreas
The most common site for stone impaction in calcular obstructive jaundice:
Anonymous Quiz
11%
Common hepatic duct
14%
Retroduodenal portion of CBD
19%
Supraduodenal portion of CBD
57%
Ampulla of Vater