قسم الـ( Practical Surgery) _الدفعة السادسة

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رسلها لطلاب حالات مشتشفى الجمهوري قسم النساء

رسلها لطلاب حالات مشتشفى الجمهوري قسم النساء

رجال حالتين appendicitis ثلاث حالات Truma حالتين diabetic foot حاله coma نساء حالتين Truma Anal fissur Piles Gall bladder stone Appendicitis Intestinal obstruction حالات مستشفى الكويت

اصحاب الجراحه.... هذا تلخيص بأربع صفحات يشمل كل ما يطلبه الدكاترة بإختبار العملي لحالات: Cellulitis Erysipelas Necrotizing fasciitis Compartment syndrome.

Lung hydatid cyst&chest ex. د.محمد الشهاري المعدل.pdf 🔻موضوع مهم وبتختبروا عليه عملي

حق الـ clinical approach of trauma The art of history taking.

د. محمد الشهاري ● Ulcer examination. ● Hernia examination. #Clinical_Surgery

Examination of Thyroid gland د.الشهاري تفريغ الدكتورة/ ليالي الحكمي #_الدفعة_11_طب_بشري_جامعة_الحديدة

Bed Sores.pdf

المفروض هذا السلايد يحل المشكلة الأزلية😂

ملف فخم لانواع الـ incision #جراحة_عملي

🔥من أفضل الكتب لل differential diagnosis. #جراحة_عملي

⭕ most common in surgery

🧑‍⚕️ Approach to the Trauma Patient (ATLS) 🧤Preparation & Tools : 1- Gloves 2- Gown 3- ATLS protocol 4- Full trauma team readiness ✨Primary Survey " ABCDE "✨ ☁️A – Airway with Cervical Spine Immobilization · Assess airway patency → if patient can talk, airway is patent. · If secretions present → suction. 🫧Airway adjuncts: -Oropharyngeal airway (OPA) -Nasopharyngeal airway (NPA) -Chin lift / Jaw thrust (without cervical movement if C-spine injury suspected). 🫧Definitive airway (Endotracheal Intubation) – Indications: 1- Airway obstruction 2- Shock 3- Apnea 4- Massive maxillofacial trauma 5- Altered mental status 6- Expanding/pulsatile neck hematoma 7-Subcutaneous emphysema / tracheal injury 🫧Cricothyroidotomy → Contraindicated in children < 11 years. ❄️Before intubation → 6 Ps (Rapid Sequence Intubation "RSI" ) : 1. Preparation: - Equipment (ETT, laryngoscope, suction, O₂ source, LMA, tracheostomy set, torch, drugs, monitor, IV access). 2. Position: -Sniffing position with occiput elevation (~10 cm) unless cervical spine injury. 3. Preoxygenation: - 100% O₂ for 3–5 min (to avoid hypoxia & brain damage). 4. Pretreatment/Paralytics & Sedatives: e.g., Midazolam, Propofol . 5. Placement of tube: - Intubate. 6. Post-intubation confirmation: -Bilateral chest auscultation , chest movement , portable chest X-ray. ☁️B – Breathing : Look, Listen, and Feel for : 1- chest movement 2- breath sounds 3- air entry 🫧Assess for : 1- Cyanosis 2- Respiratory distress 3-Absent breath sounds 🫧Manage life-threatening conditions (e.g., tension pneumothorax → needle decompression + tube thoracostomy). ☁️C – Circulation 🫧Check: Pulse, BP, capillary refill, temperature, active bleeding. 🫧Control external bleeding (direct pressure, tourniquet if severe). 🫧Insert 2 large-bore IV lines → fluid resuscitation. 💡Note : ·If shock persists after fluids → consider FAST (E-FAST ultrasound) for internal bleeding. ·Pelvic binder if unstable pelvic fracture. ·If chest cause suspected → tube thoracostomy. ☁️D – Disability (Neurological) ·Assess GCS (Glasgow Coma Scale) ·Check for hypoglycemia, stroke, intoxication. ☁️E – Exposure & Environment : 🫧Fully expose patient to look for hidden injuries. ·Prevent hypothermia (warm blankets) . ✨Secondary Survey✨ 🪧History: " AMPLE " (Allergies, Medications, Past history, Last meal, Events/Mechanism of injury). 🪧Examination (head-to-toe) : 🫧Head: scalp lacerations, subgaleal hematoma, skull fracture signs. 🫧Face : raccoon eyes, panda eyes, periorbital ecchymosis , nasal deviation, epistaxis. 🫧Neck: JVP, swelling, tracheal deviation, surgical scars. 🫧Chest: symmetry, scars, visible veins, nipple position, breath sounds. 🫧Abdomen: distension, contour, striae, scars , etc... 🫧Pelvis & limbs: deformities, open fractures, distal pulses, motor/sensory function. 🪧Investigations: 🫧Labs: CBC, electrolytes, ABG, coagulation profile. 🫧Imaging: X-ray (C-spine, chest, pelvis), FAST, CT (if stable). ✍🏻/ أنوار المنتصر #الدكتور_اشرف_الفقيه #مستشفى_الشرطة #Group_C #اللجنة_العلمية_للدفعة_السادسة