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Rhinophyma (Type 4 rosacea) 👆 😍 #Dermatology😍 لمتابعة كل جديد على قناتنا في التلجرام:-👇 @DERMATOLOGY_2ndBATCH

#Skin #lesions (1)👍 😍 #Dermatology😍 لمتابعة كل جديد على قناتنا في التلجرام:-👇 @DERMATOLOGY_2ndBATCH

Pityriasis versicolor #Skin #lesions (1)👍 😍 #Dermatology😍 لمتابعة كل جديد على قناتنا في التلجرام:-👇 @DERMATOLOGY_2ndBATCH

Complications of Fractures : #Orthopedic #Notes

5⃣ يتبع : Look for dangerous Complications of Fractures : 🔴HYPOVOLAEMIC SHOCK : Hypovolaemic shock is the commonest cause of death following fractures of major bones such as the pelvis and femur. Its frequency is on the increase due to a rise in the number of patients with multiple injuries. 🔴Internal haemorrhage : is more difficult to diagnose. It is usually massive bleeding in the body cavities such as chest or abdomen. Significant blood loss may occur in fractures of the major bones like the pelvis (1500–2000 ml), and femur (1000–1500 ml).

4⃣ يتبع : ASKING FOR AN X-RAY Before asking for an X-ray, the following points should be kept in mind: 🟡• Both, antero-posterior and lateral views should be requested in most situations. 🟡• Joint above and below should be included in the X-ray. 🟡• Special views show fractures better in some cases. #Orthopedic #Notes

3⃣ يتبع : 🪢IS IT A PATHOLOGICAL FRACTURE?! A pathological fracture must be suspected if: (i) the force producing the fracture is insignificant (trivial trauma). (ii) there is a history of pain or swelling in the affected bone prior to the occurrence of fracture. (iii) there is history suggestive of frequent fractures in the past (e.g., osteogenesis imperfecta) (iv) the patient is suffering from a debilitating systemic illness known to weaken bones (e.g., rheumatoid arthritis). #Orthopedic #Notes

❇️ Ability to keep using the limb after an injury is not conclusive of no fracture, especially in children. ❇️ملاحظة مهمة وقد تنسألو عليها ..

2⃣ يتبع: Examination: A proper exposure of the body part is crucial to an accurate examination. At times the findings are subtle, and comparison of the injured limb with the opposite normal extremity may be useful. Joints proximal and distal to the injured bone should always be examined. In a patient of road traffic accident with multiple injuries, it is wise to expose the patient completely and examine each body part in a systematic manner. One should look for the following signs: ⚫️• Swelling: Though most fractures are accompanied with swelling at the site, it can be a misleading sign as there may be minimal visible swelling in the presence of a serious fracture (e.g., fracture of the neck of the femur); on the other hand, a massive swelling may be present in the absence of a fracture (e.g., in cases of ligament sprain and muscle injuries). The swelling may be due to a haematoma, prominence of the bone ends or passive oedema. ⚫️• Deformity: An obvious deformity of a body part is a very specific sign of a fracture or dislocation. So characteristic is the deformity in some fractures and dislocations that a diagnosis can be made just by looking at the deformity ). Deformity may be absent if there is an impacted fracture. 🔵Tenderness: Pain elicited by direct pressure at the fracture site or by indirect pressure may suggest a fracture. Direct Pressure: A localised tenderness on a subcutaneous bone, elicited by gently running the back of the thumb (Fig-6.1a) may suggest an underlying fracture. The site of maximum tenderness helps in differentiating ligament injuries from that of fractures around a joint (e.g., ankle injuries). One may feel or hear a crepitus while eliciting tenderness. Indirect Pressure: It may be possible to elicit pain at the fracture site by applying pressure at a site away from the fracture. Some examples are given below: 🔵• Springing test: It may be possible to elicit pain from a fracture of the forearm bones by pressing the two bones towards each other at a distance away from the fracture ). 🔵• Axial pressure: An axial pressure along the second metacarpal may elicit pain in the scaphoid fossa, in a case of scaphoid fracture. 🔵• Bony irregularity: It is possible to feel bony elevations and depressions in fractures of subcutaneous bones such as the tibia. This is a definite sign of fracture. 🔵• Abnormal mobility: In any limb, movements occur only at joints. If one can elicit mobility at sites other than the joints (say in the middle of the arm), or an abnormal range of movement at a joint, a fracture or dislocation is definite. One may hear or feel a crepitus while doing this. 🔵• Absence of transmitted movements: Normally, if a bone is moved holding it at one end, the movement can be felt at the other end. This transmitted movement will be absent in case of a displaced fracture. In case the fracture is undisplaced or impacted, the movement will be transmitted even in the presence of a fracture. #Orthopedic #Notes

Presenting complaints in fracture : A patient with suspected fracture may present with the following complaints: 🟡• Pain: It is the commonest presenting complaint in cases of musculo-skeletal injury. The severity of pain has no bearing on the diagnosis. Sprains and strains can be as painful as fracture. 🟡• Swelling: Fractures are usually accompanied with swelling. The swelling may be slight if patient presents immediately after the injury; but in those presenting late, the whole limb may be swollen, mostly because of gravitational oedema. 🟡• Deformity: A fractured bone may result in deformity of that part of the body. 🟡• Loss of function: Following a fracture, the patient may* be unable to use the affected limb. #Orthopedic #Notes 1⃣

ملخص حلوو لمحاضرة اليوم تخدير #Summary @ANESTHESIOLoGY_2ndBTCH