logging in or signing up history taking in surgery satvarnan Download Post to : URL : Related Presentations : Let's Connect Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Copy embed code: Embed: Flash iPad Dynamic Copy Does not support media & animations Automatically changes to Flash or non-Flash embed WordPress Embed Customize Embed URL: Copy Thumbnail: Copy The presentation is successfully added In Your Favorites. Views: 976 Category: Entertainment License: All Rights Reserved Like it (0) Dislike it (0) Added: October 30, 2011 This Presentation is Public Favorites: 0 Presentation Description No description available. Comments Posting comment... Premium member Presentation Transcript History Taking In Surgery: History Taking In Surgery Gamal Khairy FRCS,MS College of Medicine KKUHSlide 2: History taking ? the key step in surgical diagnosis. Varies according to the complain ? specific histories ? surgical specialtyTwo types of history in surgical practice:: Two types of history in surgical practice: Out-pt or emergency room history ?specific complaint is pinpointed ? diagnosis Clerking of pt admitted for elective surgery object ? to assess that the treatment planned correctly indicated and pt is suitable for that operation.How to take the history ?: How to take the history ? Personal information : Age, sex, marital status, occupation, etc……History should be taken in the following order:: History should be taken in the following order: the present complaint (c/o). History of present complaint. Elaboration on the system involved. Systemic enquiry.History should be taken in the following order:: History should be taken in the following order: e. Past history ? surgical, medical f. Drug history g. Family history h. Social historySystemic Enquiry: Systemic Enquiry 1. GIT: Appetite, Vomiting, Regurgitation, etc. Respiratory System ? cough, haemoptysis, Dyspnea…. C.V.S: * Breathlessness, palpations, chest pain… * Peripheral vessels: Intermittent, claudication, rest pain. Urogenital system: micturition, loin pain supropubic pain. Nervous system: Tremor, fainting attacks, fits, weakness… Musculor skeletal ? muscle pains, joint swellingCommonest complains in Surgery: Commonest complains in Surgery Pain LumpThe history of pain: The history of pain - Site. - Onset. - Severity ? wake him up, need analgesics Rather than: mild, severe. - Nature: Buring, stabing, coliky. Progression ? - begin ç maximum, then remains steady. - steadily increase till maximum then gradual decline. Duration. Aggravating and releaving factors Radiation.The history OF A LUMP: The history OF A LUMP Duration How discovered Symptoms ? pain Changes ? ?in size Other lumps Any cause ? TraumaPhysical Examination: Physical Examination General Examination: - First part ? during taking history ? posture, speech,etc… - vital signs ? pulse, BP, tempExamination of the Head and neck: Examination of the Head and neck Eyes Pupil reaction to light Sclera à jaundice Conjuction à paller Movement à Exophthalmos FundoscopyExamination of the Head and neck (cont’d): Examination of the Head and neck (cont’d) Ears and Nose Usually forgotten on ex: External auditory canal Eardrum NostrilsExamination of the Head and neck (cont’d): Examination of the Head and neck (cont’d) Neck Jugular veins Trachea Lymph nodes ThyroidExamination of A LUMP : Examination of A LUMP Position Colour and texture of skin Temperature Tenderness Shape Size Surface Edge Consistency Pulsatile, compressibility (venous malformations) ReducibilityExamination of THE ABDOMEN : Examination of THE ABDOMEN PREPARATION: Warm and private room Good light Comfortable cough or bed Exposure: nipple to knee Get the patient to relax The position of the examiner FIG. 16.6 THE NAMES OF THE REGIONS OF THE ABDOMEN : FIG. 16.6 THE NAMES OF THE REGIONS OF THE ABDOMENTHE STEPS OF Examination : THE STEPS OF Examination Inspection Palpation Percussion AuscultationTHE STEPS OF Examination : THE STEPS OF Examination INSPECTION: Shape of abdomen Scars, sinuses & fistulae Distended veins Lumps Pigmentation MovementTHE STEPS OF Examination : THE STEPS OF Examination PALPATION: Superficial : Tenderness Rebound Ganding Deep palpation: Masses OrgansTHE STEPS OF Examination : THE STEPS OF Examination PERCUSSION: All abdomen à spec. over masses Fluid thrill Shifting dullnessTHE STEPS OF Examination : THE STEPS OF Examination AUSCULTATION: Bowl sounds Aorta and iliac anteries - Bruit Succusion splash: THANK YOU !!!!! You do not have the permission to view this presentation. In order to view it, please contact the author of the presentation.