BATCH 23 MEDICAL UST #دفعة الدكتور حسن العريفي

☘ Types of gall bladder stone : Cholesterol Mixed Black Brown pegment . 🌱infective stone formation :by 3 ways 1. Bacteria secrete glucourondase enzymes that convert bilirubin to unconjugated _ ca bind to unconjugated bilirubin to form ca billirbunate or ca carbonate.... 2..Or by epithelial debris act as nucleus around stone 3.or by change of pH of bile ____ perceptation of insoluble content. 🌱Nerve supply of gallbladder Autonomic.1. vagus 2. Splanchnic nerve .. 🌱Def of peptic ulcer. 🌱type of jaundice. Pre hepatic .hepatic. Post hepatic 🌱investigation of GBS . 🌱charcot triad: Recurrent attack of fever ,rigor .pain . Jaundice. Blood supply of GB. Cystic artery

💥If pt with chest tube after 10 days and there is air bubble it main there is plurobronchial fistula . If there is pus just that is mean there is encysted empyma نقول للمريض يجلس في البيت و فيه ال chest tube لأنها بتحتاج وقت طويل ومتى ما وقف ال pus يرجع للمستشفى علشان يبعدوا .. If the pt after 14 days without any discharge but he has sever dyspnea that is mean he has fibrosis ( decortication)

#Surface anatomy of the #liver Upper border by drawing line from the RT fifth rib in the mid clavicular line to lt fifth intercostal space in the midclavicular line The lower border by drawing line from the Rt ninth costal cartilage in the midlavicular plane to the lt fifth intercostal space in the midvlavicular plane..

#What is the difference between radiated and reffered pain...?! Reffered pain : Pain occured at location other than the site of the painful stimulus Radiated pain :  pain begins in one place and travels to another location along the path of a nerve

DD of neck swelling A rtery: carotid artery aneurysm, subclavian artery aneurysm, chemodectoma N erves: neurofi broma, schwannoma L ymphatics: lymphangioma (simple, cavernous, cystic hygroma) L ymph nodes: infective, neoplastic (primary or metastatic), granulomatous S alivary glands: infective, autoimmune, neoplastic L arynx: laryngocele P harynx: pharyngeal pouch B ranchial arch remnant: branchial cyst/sinus/fi stula S kin/superfi cial fascia: lipoma, epidermal cyst, abscess, dermoid cyst By the age *In children : think about inflammatory or congenital : thyroglossal cysts, branchial cleft cysts, cystic hygromas, and lym- phadenitis. If malignancy is diagnosed in paediatric neck lumps, it is usually a lymphoma or sarcoma, or sometimes a papillary thyroid carcinoma. *In adults over 40 years in the absence of signs of infection, a lateral neck mass in an adult is lymphadenopathy due to metastatic carcinoma ( usually squamous) until proven otherwise.

Treatment of grave's disease

Symptoms of grave's disease

Grave's disease (diffuse hyperthyrodism)

Thyroglossal cyst "congenital" Treatment : excision by sistrunk's operation

Toxic "malignant" Using radio isitope studies

Nerves related to thyroid gland * superior laryngeal nerve .. (High tone .. Cricothyroid muscle .. Tension of vocal cords)

venous drainage

Arterial supply

Posterior triangle Contents : 1. Vessels Occepital a. + transverse cervival a. + suprascapular a. + subclavian a. + external jugular v. 2. Nerves Accessory nerves + brachial plexus + cervical nerves 3. Muscles Inferior belly of omohyoid 4. Lymph nodes