Important knowledge

#End_of_surgery_rotation

اسئله اليوم Fall from hight focused hx Parotid swelling focused exam Exam of stoma نجيب Exam of cervical lymphnodes نجيب Focused hx of recurrent Vomiting نجيب Duodenal atresia (اطفال) Hip dislocation + supracondylar humeral fracture (كسور) Hiatus hernia (اشعه) Kub pelvic stone (بولية) Gcs case + ix + tx + cause (عصبيه)

هاي الچيك ليست ردّها ألنا د علي عادل مرة خاف تجي بما أنو اليوم جابوا وحدة هيچ.. Post Operative checklist: 1- pre operative complaint 2- surgery details (type, anesthesia, timing, complications during operation/anesthetic complications, blood transfusion) 3- Recovery 4- Day zero ask about: - fever - SOB (Most important)-> possible causes: spontaneous pneumothorax, iatrogenic injury, aspiration - cough - pain - chest pain - N&V (most common) - bleeding 5- Ask about drains and their details (including folley) 6- mobility 7- pass motion, flatus, urine 8- oral intake

⚡️محطات شرحها د علي عادل بالسشنات ( غير موجودة في الكتاب ) وكال انو مهمه وممكن تجي جيك لست

⚡️history of trauma ♦️Motor vehicle accidents (بيها نقص ) 1) helmet لابس خوذة او لا 2) لابس كسارات برجله وبيدة او لا ؟ 3)velocity 4) mechanism of accident 5) mechanism of injury 6) نكمل اللست من نقطة ٥ الى ٨

⚡️history of trauma ----------------- ♦️FFH 1) the height الارتفاع الوكع منه [Scaffold سكلة ] 2)injury during fall ? مثلا من ديوكع طخ بحافة السكلة وشكت ايدة او بطنة 3) على شنو وكع ؟ على ايدة ، ضهر ، رجل ... 4) type of ground whic fall on 5) نكمل نفس اللستة الاولى من نقطة ٥ الى ٨

⚡️History of trauma ------------------ ♦️RTA 1) site of victim ▪︎inside car ونذكر وين بالسيارة سايق ، صدر ، الخانة الخلفية؟ ▪︎out side car ( passenger) 2) setbelt لابس او لا ؟ *most common cause of death is ejection from car 3) airbags طكت او لا ؟ متطك اذا مالابس حزام الامان 4)Type of car / cars 5) mechanism of RTA 6) speed of car / cars 7) mechanism of injury to victims وين نضرب؟ شلون نشمر ؟ داخل السيارة او خارجها واذا نشمر على شنو وكع ؟! واكو اصابات نتيجة السقوط ؟ 8) نكمل نفس اللستة السابقة من نقطة 5 الى 8

⚡️History of trauma ( checklist علي عادل ) ------------- مهم OSCE ----------- ♦️penetrating injury ( stab wound , pullet injury) 1) C.C > Penetrating wound لتكول stap wound او pullet او gunshot 2) type of penetrating injury ♧ pullet ♧ stab wound 3) ▪︎ if stap wound : ♧Type of Knife ♧ direction of injury ♧ number of stabs ♧ input & output? ( rare) ▪︎If pullet injury ♧ type of firearm ( low velocity vs high velocity) ♧ distance ♧direction ♧ number of pullet ♧ input & output? 4)symptoms ▪︎Bleeding ▪︎pain ▪︎vomiting ▪︎S.O.B (chest or diaphragmatic injury) ▪︎headache ▪︎loss of conscious ( may have head trauma) ▪︎disability ( ميكدر يحرك ايد او رجل ميكدر يمشي) ▪︎other injuries (as head trauma ) 5) first aid measures 6) mode of delivery 7) injury to hospital time 8) measures at hospital ------------ ▪︎causes of decrease level of conscious after trauma? ♧ shock ♧ head injury ♧ alcoholic ♧ hypoglycemia

جواب سوال ال drain ( منشور سابقا )

⚡️اي مريض يجيك للطوارئ عندة اعراض مال basal skull fracture ممنوع منعا باتا تحطلة NG tube او endotrachial tube لانو ممكن يفوت بال fracture

Facial nerve branches

⚡️Abdominal US finding in infant with biliary atresia (peadiatric) --------- 1) small, shrunken gallbladder 2) polysplenia 3) Triangular cord sign

⚡️Complex regional pain syndrome ( sudeck's atrophy ) Common sites : ▪︎Colles’ Fracture ▪︎Distal tibia and fibula fractures

Cause / ischemia due to compartment syndrome

Volkmann's Ischemic Contracture

⚡️mnemonic to read chest x ray (د.سالي ) ------------------- ABCDE A-Airways(Trachea+Lung field+Hilum) B- Bones and soft tissue C-Cardiac shadow and mediastinum D-Diaphragm + costophrenic angles E-Everything else ( accessories )

⚡️خطوات الحل في اسالة د سعد 1- view (AP, Lateral,sagital,.. ) 2- Immaging modality (X ray , CT, MRI) 3- Labeled or not ? 4- skeletally mature or not? 5- showing (bones in pictures) 6- findings Management 1- ABC (التفاصيل مطلوبه في ال spine وال pelvis ) 2- reduce (closed or open ) [skip if the # not displaced ] 3- hold ( internal or external fixation (spinal fixation in spine )] 4- exercise

صورة مكررة

🔴CSF ▪︎Normal CSF volume = 100 - 150 mL (50 in ventricles, 25 around brain,75 around spinal cord) ▪︎CSF production is constant at 35 cc/hr (500-750 cc/day) & Replaced 3 Times/Day 🔰Pathway Of CSF ▪︎produced By the Choroid plexus in Lateral Ventricles ▪︎By Foreman of Monro To 3rd Ventricle  ▪︎By aqueduct of sylvius To 4th ventricle ▪︎by foramen of Lushka and foramen of Majindi To Subarchnoid Space ▪︎Absorbed by Arachnoid Villi To Superior Sagittal Sinus To Venous Circulation 🔰Methods of access To CSF 1. Lumbar puncture (L3-L4 Or L4-L5) 2. Cisternal puncture 3. Ventricular puncture 4. Cervical Puncture 5. Foramen Magnum Puncture 🔰Contraindications Of Lumbar Puncture ▪︎Absolute 1.Increase ICP BY SOL (Tumour) ▪︎Relative 1.Puncture Site Infection 2.Increase ICP For Other Reasons 3.Bleeding Disorders 4.Anticoagulants 5.Spinal Surgery 6.Spinal Deformity 🔰Indications For Access To CSF ▪︎Diagnostic 1.CSF Analysis 2.Measure CSF Pressure 3.Neuroradiological Procedures ▪︎Therapeutic 1.Injection of AB Or Chemotherapy Into CNS 2.CSF Drinage 🔰Indications for CSF analysis 1. CNS Infections 2. Subarachnoid hemorrhage 3. Demyelinating and degenerative disorders 4. Cytological examination in CNS Tumors