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Examination of varicose veins
راقي جدا
( يفضل مشهادته بعد قراءة الموضوع على browse's )
+1lipodermatosclerosis
Due to venous hypertension
Including
▪︎skin pigmentation
▪︎tenderness
▪︎skin induration
اطلاع ^--^ ⬇️
◇indicates that there is aprogressive replacement of the skin and subcutaneous fat by fibrous tissue
◇induration and an associated
inflammation caused by the fibrin deposition which proceeds the fibrosis
⚡️Modified couhg impulse test for hernia
-----------------------------
▪︎three fingers occlusion
▪︎deep ring occlusion test (by thumb )
اذا صار pulge معناها direct اذا مصار pulge معناها indirect
▪︎invagination test (by little finger)
اذا حسينة pulge بال tip of finger معناها indirect
اذا حسيناه بال volar aspect of finger معناها direct
⚡️proxymal myopathy occour in Graves disease (hyperthyroidism) & hypothyriodism
شلون نفحصة ؟
▪︎lower limbs
نطعدة على كرسي ونكله جتف ايدك ونخلي يكوم بدون ميسند رجلة بايدة مراح يكدر يكوم
▪︎upper limbs
-نخلي يجتف ايدة هوه وكاعد عل كرسي ونضغط على جتافة بايدنه ونكله ارفع جتفك (against resistance ) حنشوف اكو ضعف
- او نكلة مشط شعرك (او من الهستري ) نلكة عندة صعوبه
⚡️Risk factors for hernia
---------------------
▪︎chronic cough
▪︎constipation
▪︎BPH
▪︎obesity
▪︎job ( lifting heavy objects )
▪︎multiple pregnancy
▪︎trauma (blunt or penetrating)
▪︎previous surgery
▪︎marfan syndrome
⚡️inguinal canal د . موسى
▪︎deep ingianal ring = defect in fascia transversalis ( ring in shape)
▪︎Superfacial ring = defect in external oblique Aponeuroses ( triangular in shape)
⚡️Only 33% of insolinoma is seen by CT scan and abdominal ultrasound (65% seen by endoscopic US )
⚡️Peutz-Jeghers syndrome (PJS)
Diagnosed by 2 of 3
▪︎small intestine hamartoma
▪︎skin pigmentation
▪︎family history
⚡️Complication of mastectomy
♦️early
▪︎nerve injury
♧ long thoracic nerve
♧ subscubuler nerve
♧ intercostal nerves
▪︎axillary vein injury (most superfecial stracture in the Axila)
▪︎hematoma
▪︎seroma
▪︎wound infection
♦️late
▪︎lymphedema (>> lymphangiosarcoma )
▪︎depression
