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these photos have nothing to do with this post!
she's still limping but i'm hoping that once the incision has totally healed, the limp will go away. i'm happy to say that rocky (looking deceptively sweet and innocent in this photo) has no medical issues. ...
Hi,could I have your input on this case, just answer what you know ...
20. What antibiotic will you give preoperatively? why? What is the cost of your preferred antibiotic? 21. What incision will you make? What is McBurney鈥檚 incision? 22. What is gridiron incision? Rocky Davis incision? ...
Mostly links with a couple of book reviews and other news
COLORADO (US)—A melting ice patch high in the Rocky Mountains close to Yellowstone National Park has uncovered an atlatl—a spearlike hunting weapon lost [...] Read More. Editor's Page. Heterotopic ossification following spinal cord ...
Queries 5
Appendicitis
37 APPENDICITIS
Alden H. Harken M.D.
1. What is the classic presentation of acute appendicitis?
Show answer
Periumbilical pain that migrates to the right lower quadrant (RLQ) in a patient who is anorexic.
2. Where is McBurney’s point?
Show answer
One third the distance between the anterosuperior iliac spine and the umbilicus.
3. What is McBurney’s point?
Show answer
The point of maximal tenderness in acute appendicitis.
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Incoming search terms
appendicitis vs crohns, appendicitis with toa, mcburney boston cop, rockey davis incision, rocky-davis incision who named it, toa vs appendicitis, transverse incision name in appendectomy,Trauma To The Colon & Rectum. Colon Trauma
28 TRAUMA TO THE COLON AND RECTUM
W. Andrew Lawrence M.D., Jon M. Burch M.D.
COLON TRAUMA
1. How do most colon injuries occur?
Show answer
Nearly all (> 95%) colon injuries are caused by penetrating trauma from gunshot, stab, iatrogenic, or sexual injury. Blunt colonic trauma is rare and usually results from seat belts during motor vehicle accidents.
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Incoming search terms
colonic injury grade, iatrogenic colon injury, trauma dos colons, trauma of the colon,Trauma To The Colon & Rectum. Rectal Trauma
RECTAL TRAUMA
9. How do rectal injuries occur?
Show answer
Similar to colon injuries, most rectal injuries result from penetrating trauma. Blunt pelvic fractures should be assessed with a strong suspicion for rectal (and urethral) injury.
Incoming search terms
colon rectal trauma, rectal injuries, trauma of the colon, colon trauma and antibiotics, demetriades d penetrating colon injuries requiring resection: diversion or primary anastomosis? an aast prospective multicenter study, principles of rectal trauma, recovery time for rectal trauma, rectal trauma, rectum trauma, suspection rectal injury, thorough examination in rectal trauma, trauma colorectal, trauma de recto extraperitoneal, trauma to the colon,Blunt Abdominal Trauma
23 BLUNT ABDOMINAL TRAUMA
David J. Ciesla M.D., Ernest E. Moore M.D.
1. What elements of the history are important in evaluating a patient with suspected blunt abdominal trauma (BAT)?
Show answer
First, the mechanism of injury (e.g., motor vehicle collision, automobile-pedestrian accident, fall) is important. In motor vehicle accidents, note the position of the victim in the car, velocity of impact (high, moderate, low), type of accident (front, lateral, or rear impact; side swipe; rollover), and type of restraint used (shoulder restraint, air-bag, lap belt). Information about damage to the vehicle, such as a broken windshield or bent steering wheel, may raise suspicion of cervical and chest injuries. In a fall, it is important to note the distance fallen and the site of anatomic impact. Vertical landing on the feet or in a sitting position causes a different pattern of injury than lateral landing on the side. Serial vital signs and mental status are always important.
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What Does Postoperative Fever Mean?
10 WHAT DOES POSTOPERATIVE FEVER MEAN?
Alden H. Harken M.D.
1. What is a fever?
Show answer Normal core temperature varies between 36°C and 38°C. Because we hibernate a little at night, we are cool (36°C) just before rising in the morning; after revving our engines all day, we are hot at night (38°C). A fever is a pathologic state reflecting a systemic inflammatory process. The core temperature is > 38°C but rarely > 40°C.
Anorectal Disease. Anorectal Abscess & Fistula In Ano
ANORECTAL ABSCESS AND FISTULA IN ANO
5. What is the most common cause of anorectal abscess?
Show answer
Ninety percent result from cryptoglandular infection.
6. What are the four potential anorectal spaces used to classify anorectal abscesses?
Show answer
1. Perianal (area of the anal verge)
2. Ischiorectal (area lateral to the external sphincter muscles, extending from the levator ani muscles to the perineum)
3. Intersphincteric (area between the internal and external sphincter muscles, continuous inferiorly with the perianal space and superiorly with the rectal wall)
4. Supralevator (area superior to the levator ani muscles, inferior to the peritoneum, and lateral to the rectal wall)
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, anorectal disease, purpose of a seton for a fistula in ano,What Is Pulmonary Insufficiency?
5 WHAT IS PULMONARY INSUFFICIENCY?
Alden H. Harken M.D.
1. What is pulmonary insufficiency?
how answer
The alveolar-capillary surface of the lung is the size of a singles tennis court. The purpose of the lung is to match alveolar ventilation (Va) to blood flow (Q). Mismatching leads to pulmonary insufficiency.
2. How is Va/Q mismatching characterized?
Show answer
Shunt: decreased ventilation relative to regional blood flow; pulmonary arterial (unoxygenated) blood “shunts” by hypoventilated alveoli
Dead space: decreased pulmonary regional blood flow relative to ventilation
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Hypertrophic Pyloric Stenosis
82 HYPERTROPHIC PYLORIC STENOSIS
Denis D. Bensard M.D.
1. What is pyloric stenosis?
Show answer
Hypertrophic pyloric stenosis (HPS) is idiopathic thickening and elongation of the pylorus that produces gastric outlet obstruction. HPS is the most common surgical cause of nonbilious vomiting in infants. Offspring of an affected parent have an increased incidence of HPS (10%); the highest rate (20%) occurs in boys born to affected mothers.
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Incoming search terms
fluid resuscitation in infantile hypertrophic pyloric stenosis,Anorectal Disease. Pilonidal Sinus Disease
PILONIDAL SINUS DISEASE
29. What is the most common clinical presentation of a pilonidal sinus?
Show answer
Pain and swelling in the sacrococcygeal region, which typically are associated with a (sometimes several) chronic draining sinus tract.
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pilonidal sinus and anorectal pain,Surgical Infectious Disease. Prophylaxis
PROPHYLAXIS
17. Should systemic antibiotic prophylaxis be used in elective colon resection?
Show answer
Yes, beyond any statistical shadow of a doubt. At least two dozen clinical trials have been carried out using placebo controls against a variety of antibiotics, principally those active against at least the anaerobic-predominant flora, and nearly all have shown a reduction in infectious complications in the antibiotic group. Never again should this point need repeating, and no patient should be placed at risk when systemic antibiotic prophylaxis has been established as the standard of care. No new clinical trials against placebo in this group of patients with known risk can be performed ethically given the confirmed risk reduction.
Other risk groups (e.g., cesarean section after membrane rupture) besides patients undergoing colon resection have been standardized by trials in large patient populations and have shown similar risk reduction. The benefit of prophylaxis has been demonstrated. In other groups of patients that cannot be standardized because of unusual contamination factors or unique factors of host resistance impairment, guidelines for rational prophylaxis should follow similar principles.
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Surgical Infectious Disease
15 SURGICAL INFECTIOUS DISEASE
Glenn W. Geelhoed M.D., M.P.H., DTMH
1. Have modern antibiotic developments controlled many, if not most, of the problems of surgical infection?
Show answer
No. In seriously ill surgical patients in intensive care unit (ICU) settings, the problems of sepsis have increased and remain among the principal causes of death in ICU patients, especially those with multiple organ failure and impairments of host defense. Antibiotic treatment may change the biographical sketch of the flora associated with patients’ deaths but cannot overcome the multiple causes of failing host resistance to infection that accompany barrier breeches to microbial invasion and the inflammatory and immunologic responses to the “usual suspects.”
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Kidney & Pancreas Transplantation
90 KIDNEY AND PANCREAS TRANSPLANTATION
Thomas E. Bak M.D., Michael E. Wachs M.D., Igal Kam M.D.
1. What are the most common indications for kidney transplantation?
Show answer
End-stage renal disease (ESRD) caused by hypertension, diabetes, glomerulonephritis, and polycystic kidney disease.
Surgical Wound Infection
13 SURGICAL WOUND INFECTION
Steven L. Peterson D.V.M., M.D.
1. Why should we worry about surgical wound infection?
Show answer
Approximately 30 million patients undergo surgery each year in the United States, and 20% of these patients acquire at least one nosocomial infection in the postoperative period. Infections at surgical sites are the third most common form of these infections and complicate 1-12% of all operations. The risk of death is four times higher in patients who develop wound infections, and each infection costs $12,000-30,000 to treat.
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abdominal wound infection overview, define wound evisceration, how to clean a surgical wound spillage, http://www acssurgery com/abstracts/acs/acs0102 htm, iv antibiotic duration deep wound infection, list of common incisional wound infections, nutritional status and ssis, what steps can be taken to prevent wound infection and dehiscence, when does dehiscenceoccur, when should an infected laparotomy wound be reopened and cleaned?,Imperforate Anus
84 IMPERFORATE ANUS
Frederick M. Karrer M.D., Denis D. Bensard M.D.
1. What is imperforate anus?
Show answer
It is a congenital defect in which the opening of the anus is absent or misplaced, usually fistulizing anteriorly to the perineum or genitourinary (GU) tract. Anorectal malformations range from slight anterior malpositioning of the anus to complex cloacal deformities. Children with anorectal malformations commonly have other congenital anomalies, such as the VACTERL association.
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Abernathy’s Surgical Secrets, Updated Edition (Book w / Student Consult)
Author / s: Harken Alden H., Abernathy Charles, Moore Ernest Eugene
Year: 2004
Pages: 473
Publishers: Elsevier Mosby; 5th Bk & Acc edition
ISBN: 0323034160
