Basma - Data - Sem 8

Revisions anatomy + begnin + DD بشكل تجميعات حلوة ومخططات ة رسم 🫠❤️ #surg_breast

Revisions anatomy + begnin + DD بشكل تجميعات حلوة ومخططات ة رسم 🫠❤️ #surg_breast

chest tube « 5th intercostal space midaxillary line is best another way is 2nd intercostal space midclavicualr line but associated with higher failure

يعني بالنظر بس عشان لو اتسألت أوسكي How does the testis maintain its temperature: 1- normally outside the body 2- scrotum has sweat glands and no fat 3- muscles << Dartos ms توسع وتضيق Scrotal wall contracts << tighter wrinkled scrotum << less surface area << retain the heat Cremastric تطلع وتنزل In cold << Contract to bring the testis closer to the body more heart In hot weather <

In varicocele << warm blood ف اشمعنا spermatogenesis يتأثر وtestosterone لا؟ Sertoli cells are sensitive to temperature so: 1- Decreased inhibin << +ve feedback << elevated FSH 2- decreased spermatogenesis and infertility Lydig cells are less sensitive so testosterone is maintained along with 2ry sexual characters

Never forget to do *abdominal CT* in varicocele to exclude *RCC*

Never Never كمان مرة Never to be congenital >> Femoral & direct inguinal جه منها واحدة في ٥٨

كفاية الوقتي تعبت🙂

Truss contraindicated in femoral & paraumbilical .

The ttt or recurrent hernia >> hernioplasty.

Partially reducible >> Interparietal & sliding .

حد يأكدلي إن كله تمام

Wide neck >> infantile umbilical & Direct inguinal Narrow neck & high rate of complications >> Adult paraumbilical & femoral & indirect inguinal & Epigastric hernia

Infantile inguinal hernia is intraoperative finding. U/S is diagnostic in interparietal and spigegilian hernia .

Posterior sinus.. bluish margin and undermined edge << T.B Anterior sinus .. punched out .. loss of sensation<< syphilis

Female fatty multipara>> paraumbilical hernia . Elder female & repeated pregnancies >> Divercation of recti .

☆☆Femoral hernia & obturator hernia are more common in female .

4 types of hernia through defect in linea alba ? ▪︎Incisional hernia if midline incision and vertical. ▪︎Fatty hernia of linea alba ( no peritoneal sac) & True epigastric hernia . ▪︎Divercation of recti . ▪Adult paraumbilical ( more above umbilicus )

▪︎Indirect inguinal hernia is painless except complicated & mild pain early due to stretch of inguinal ring. ▪︎In epigastric hernia may dyspepsia and epigastric pain. ▪︎In adult paraumbilical pain is common due to intestinal obstruction & dragging by large hernia .

Testicular torsion Hemorrhagic red infarct 180 << vein 360 << vein and artery Investigation << Duplex US Nuclear testicular scan: Red spots < acute epididymo-orchitis Cold spots < torsion Urgent explorations is a must once suspected Don’t forget: 1- anti shock measures 2- consent 3- fixing the contra-lateral testis D.Dx with 1- Acute epididymo-orchitis Feverish and positive prehn’s sign 2- strangulated hernia Manifestations of acute intestinal obstruction Persistent vomiting, absolute constipation And swelling separate from testis