Surgery( notes)

Signs and symptoms of internal hge after trauma: Nausea and vomiting🚫 Vision changes Tingling of hand Pain at site of trauma🚫 Lightheadedness=dizziness 🚫 Shortness of breath. العلامات الحمراء حصلتهن في مريض حصل عنده نزيف داخلي بعد15ساعة من الحادث وكان تحت الملاحظة، طبعا كان الحادث بسيط بس طلع المريض مسن ويأخذ اسبرين(دواء مميع للدم).

Upper limbs amputation vs lower limbs amputation🌹. https://www.google.com/imgres?imgurl=https%3A%2F%2Fi0.wp.com%2Fpost.healthline.com%2Fwp-content%2Fuploads%2F2022%2F01%2Famputation-1296x1168-body.png%3Fw%3D1155%26h%3D2454&imgrefurl=https%3A%2F%2Fwww.healthline.com%2Fhealth%2Famputation&tbnid=TjRXGjC0aJlAAM&vet=1&docid=fVgCJFYHsUSZPM&w=1155&h=1041&source=sh%2Fx%2Fim

levels of cervical lymph nodes which are used in staging of the cancers: - Level I: Submental and submandibular nodes - Level II: Upper jugular chain of nodes (upper cervical) - Level III Mid jugular nodes, - Level IV: Lower jugular behind lower border of SCm - Level V: Posterior triangle lymph nodes; nodes along spinal accessory nerve - Level VI: Central compartment lymph nodes #جراحة

Vasular notes Patients with ischemic ulcers should have👉absent pedal pulse. ➖➖➖ Most common site of atherosclerotic occlusion in the lower extremities is 👉 proximal superficial femoral artery. Most common site at which arterial emboli lodge is 👉common femoral bifurcation. The most important prognostic sign of acute ischemia of alimb is 👉 Muscle turgor. The most frequent cause of arterial embolism is 👉 Atrial fibrillation. Commonest cause of true aneurysm is👉 Atherosclerosis ➖➖➖➖➖➖➖➖ First thing to do it in case of acute lower limb ischemia is 👉 giving the patient heparin to avoid clot propagation. First thing to do it in case of diabetic patient come with on toe gangrene is 👉 chicking the pedal pulse. First drugs are described for Raynaud's disease is 👉 Calcium channel blocker. The primary therapy of Buerger disease is 👉 cessation of smoking. Acute ischemic leg +signs of emboli(acute history ) we do 👉Embolectomy. Acute ischemic leg + signs of thrombus (chronic history ) we do 👉 Thrombolize. Chronic ischemic leg +short occlusion we do 👉 angioplasty. Chronic ischemic leg + long occlusion we do 👉 Bypass graft.

What's the difference between a graft and a flap? A graft is just the skin without a blood supply, whereas a flap is transferred with its blood supply intact. With a flap, larger amounts of tissue can be used, including muscle if required. Some reconstructions need both a flap and a graft.

Dermoid cyst vs Epidermoid cyst 🌹.

Disarticulation vs Amputation Disarticulation 👉the separation of two bones at their joint. An amputation  👉is the surgical removal of part of the body, such as an arm or leg  may be  the amputation at joints or not at joints. ➖➖➖ In bedsores although the skin is under th pressure firstly the muscles die before skin. ➖➖➖ How are bedsores treated? 1/Removing pressure on the affected area. 2/Protecting the wound with medicated gauze or other special dressings. 3/Keeping the wound clean. 4/Ensuring good nutrition. 5/Removing the damaged, infected, or dead tissue (debridement) 6/Transplanting healthy skin to the wound area (skin grafts) ➖➖➖➖➖ To know any neck swelling you should know the 1/Duration 2/Course 3/Consistency 4/Anatomical sites Duration i n example as 7 day or any number  mostly indicate   👉inflammatory cause 7month 👉 neoplastic cause 7years 👉 congenital cause. ➖➖➖➖ The difference between a tumor and a neoplasm is that a tumor refers to swelling or a lump like swollen state that would normally be associated with inflammation, whereas a neoplasm refers to any new growth, lesion, or ulcer that is abnormal ➖➖➖ The best diagnostic  tool for cholecystitis is US. The best diagnostic tool for intestinal obstruction is plain abdominal X ray. ➖➖➖ في حالة الexamination للبطن الexposureيجب ان يكون الى وسط الفخذ  وذالك  لفحص الgenitalia   وكمان ربما يكون هناك abdominal  distintionبسبب  cancer of undescending testis. ➖➖➖ Drains is indicated for abscess  except Cold abscess Brain abscess Hydatid abscess ➖➖➖ Past scar +hernia    👉 I O علامات مهمة جداااا اول ما تبصر مريضك يشتكي  من علامات الI O د نصر القدسي الله يحفظه ويكرمة 🌹.

Disarticulation vs Amputation Disarticulation 👉the separation of two bones at their joint, either traumatically by way of injury or by a surgeon during arthroplasty. An amputation 👉is the surgical removal of part of the body, such as an arm or leg may be the amputation at joints or not at joints.

Appendicitis tomography criteria. Arrowhead sign and ceacal bar sign in case of appendicitis 🌹. https://www.google.com/imgres?imgurl=https%3A%2F%2Flookaside.fbsbx.com%2Flookaside%2Fcrawler%2Fmedia%2F%3Fmedia_id%3D1503475079835979&imgrefurl=https%3A%2F%2Fm.facebook.com%2FKiran15675%2Fphotos%2Fa.631785723671590%2F1503475079835979%2F&tbnid=Boo7fkbga6cRsM&vet=1&docid=yXJu8SyeJTWvKM&w=1080&h=1080&itg=1&source=sh%2Fx%2Fim

Appendicitis notes.. 🔴CT abdomen is the most accurate initial imaging modality for appendicitis. 🔴Symptoms of appendicitis: ● Periumbilical colic ● Pain shifting to the right iliac fossa ● Anorexia ● Nausea 🔴Signs to elicit in appendicitis ● Pointing sign ● Rovsing’s sign ● Psoas sign ● Obturator sign 🔴Clinical signs in appendicitis Pyrexia Localised tenderness in the right iliac fossa Muscle guarding and Rebound tenderness 🔴 While abdominal ultrasound can confirm the diagnosis of acute appendicitis, normal ultrasound findings do not reliably rule out appendicitis. 🔴Risk factors for perforation of the appendix : Extremes of age Immunosuppression Diabetes mellitus Faecolith obstruction Pelvic appendix Previous abdominal surgery 🔴Hamburger sign: If there is no loss of appetite, appendicitis is unlikely. 🔴Sings of peritonitis: rebound tenderness, rigidity, and guarding

In case of acute appendicitis Pain Vomiting Fever. Murphy's Triad

how to differentiate between acute appendicitis and mesenteric lymph adenitis ? in mesenteric lymph adenitis the patient has shifting tenderness ( the patient has Pain localize to the RIF…. When he tern to the other side … the pain shift with the direction of the movement) also the patient has tonsillitis.

How to differentiate between acute appendicitis and gastroenteritis??? If abdominal pain precedes vomiting it indicates acute appendicitis, but if vomiting precedes abdominal pain it indicates gastroenteritis.

When would you find appendicitis and diarrhea??? In retro ilial appendix

When would you find appendicitis and jaundice??? In portal pyemia

acute appendicitis vs mesenteric adenitis. المصدر👇 https://www.google.com/search?q=acute+appendicitis+vs+mesenteric+adenitis&client=ms-android-verizon&prmd=inv&sxsrf=ALiCzsaLUnfrzl9yQdyFWkNBDnvleo2Utg:1658862435503&source=lnms&tbm=isch&sa=X&ved=2ahUKEwih3suRoJf5AhXTtqQKHeO1CuMQ_AUoAXoECAIQAQ#imgrc=aPV3_m7z2zirwM 10:1pm.

How to deffrentiate between sub-hepatic acute appendicitis and acute cholycycstis????? By tow things 1-type of the patient In acute appendicitis : the patient is young , slim. In acute cholycysstis: female , fatey , fertile, fortie, fair 2- hyperesthesia in appendicitis: hyperesthesia in the tringle of shirine In cholycytisits : hyperesthesia in the on the back( boass sign)

how to differentiate between acute appendicitis and renal colic? 🌺Acute appendicitis : the patient loathy to move, ask him to cough he develops pain 🌺Renal colic: rolling on the bed , coughing doesn’t elicit pain .

Q/ What is the most dangerous type of appendicitis ? why ?  Post-ileal type is considered the most dangerous type because : 1. No shift of pain which is misdiagnosed as gastroenteritis 2. No omental localization👉peritonitis 3. Affection of iliocaecal vein 👉 Portal pyemia 4. Affection of appendicular artery👉gangrene

In acute appendicitis …thers no great increase in body temp…it relatively reach 38 -38.5 If greater think of complication or other Ddx.