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    Surgery Extra Notes

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    rohalawi
    This document provides information on various anatomical structures and clinical topics. It lists retroperitoneal organs like the pancreas, ureter, and kidney. It also discusses toxic megacolon as an indication for surgery in ulcerative colitis patients, acute diverticulitis management, common bile duct stones, blood transfusion risks, the FAST exam, Horner's syndrome, damage control surgery principles, and criteria for sepsis, SIRS and qSOFA.

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    Surgery Extra Notes

    Uploaded by

    rohalawi
    14 views2 pages
    This document provides information on various anatomical structures and clinical topics. It lists retroperitoneal organs like the pancreas, ureter, and kidney. It also discusses toxic megacolon as an indication for surgery in ulcerative colitis patients, acute diverticulitis management, common bile duct stones, blood transfusion risks, the FAST exam, Horner's syndrome, damage control surgery principles, and criteria for sepsis, SIRS and qSOFA.

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    This document provides information on various anatomical structures and clinical topics. It lists retroperitoneal organs like the pancreas, ureter, and kidney. It also discusses toxic megacolon as an indication for surgery in ulcerative colitis patients, acute diverticulitis management, common bile duct stones, blood transfusion risks, the FAST exam, Horner's syndrome, damage control surgery principles, and criteria for sepsis, SIRS and qSOFA.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    14 views2 pages

    Surgery Extra Notes

    Uploaded by

    rohalawi
    This document provides information on various anatomical structures and clinical topics. It lists retroperitoneal organs like the pancreas, ureter, and kidney. It also discusses toxic megacolon as an indication for surgery in ulcerative colitis patients, acute diverticulitis management, common bile duct stones, blood transfusion risks, the FAST exam, Horner's syndrome, damage control surgery principles, and criteria for sepsis, SIRS and qSOFA.

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    © All Rights Reserved
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    Download as docx, pdf, or txt
    of 2

    Meckel D.

    RETROPERITONEAL ORGANS
    MCC: PUKIDADAS
    Adult: Obstruction Pancreas (except tail)
    Pedia: Bleeding Ureter
    Kidney
    Toxic Megacolon in UC IVC
    Only indication for surgery in UC pt. Duodenum (2nd-4th)
    Long hx of bloody diarrhea Ascending colon
    Inc abdominal pain Descending colon
    Vomiting Aorta (abdominal)
    Fever Suprarenal glands
    Tender, guarding, rigid abdomen
    ‼️Note: Rectum
    ACUTE DIVERTICULITIS Superior: peritoneal
    Initial mngt: IV fluid, Antibiotic, drainage Middle: Retroperitoneal
    + free air=Lapcole Inferior: Extraperitoneal
    Sx: LLQpain
    Dehydratedvomiting xxxx TRIANGLES AND THYROIDECTOMIES:
    SIMON'S TRIANGLE - used to identify RLN
    MC type of Fistula in anu: Lat: Common carotid a.
    Intersphincteric Med: Esophagus**
    Sup: Inferior thyroid a.
    COMMON BILE DUCT STONE
    POC to Confirm dx: MRCP BEAHR'S - also used to identify RLN.
    If sure ka masyado na may stone:ERCP- Lat/base: CCA
    Gold standard Sup: ITA
    B4 ERCP dpt nkta m na sa UTZ Med/lower arm: RLN**

    Kalkikrein activates Brady JOLL'S: - used to identify SLN (external


    ACE inactivates brady branch)
    Brady:Increase vasoD, permeability,pain Lat: upper pole of the thyroid/superior
    thyroid vessels
    BURN: Sup: strap muscles/investing layer
    MC Fatal infection:Pneumonia Med: midline of the neck
    MC Infection:UTI floor: cricothyroid

    BLOOD TRANSFUSION: For Palpatory BP:


    MCC:Allergic rxn Caroti6 artery - >60 mmHg
    MC transmitted:CMV Femora7 artery - >70 mmHg
    MCC to much trans:TRALI R8dial artery - > 80 mmHg

    FAST:HSPP
    Hepatorenal, Splenorenal
    Pelvic,Pericardial
    EOMs Lethal Triad for Bloody Vicious Cycle
    All are innervated by CN III except!  Coagulopathy
    SO4 LR6 - SOLAR  Acidosis
    ‼ Superior oblique - CN IV  Hypothermia
    ‼ Lateral rectus - CN VI *if these conditions are met, surgery must
    be stopped and resuscitation must be
    Some generalities on actions: started
    ‼ Both of the obliques are ABDUCTORS Goal of damage control surgery:
    ‼ "SUPERIOR" muscles INTORT  Control surgical bleeding
    ‼"INFERIOR" muscles EXTORT  Limit GI spillage
    *return patient to OR within 24-48 hrs
    Horner syndrome once they clinically improve
    Triad of MAP
    1. Miosis SIRS vs qSOFA
    2. Anhidrosis qSOFA (≥2 points = escalate therapy or
    3. Ptosis investigats organ dysf)
    ‼ Also termed oculosympathetic paresis,  RR ≥ 22 cpm
    occurs when the sympathetic ganglion  GCS <15
    ➡fibers are interrupted like from the  SBP <100 mmHg
    hypothalamus (first order neurons),
    cervical ganglion, etc. SIRS criteria (≥2 - sepsis)
    ‼ Can be acquired (iatrogenic, or due to  Temp ≥38C or ≤36C
    systemic/local diseases), or congenital.  HR ≥90 bpm
     RR ≥20 cpm / mech vent / PaCO ≤32
    mmHg
     WBC ≥12,000/uL or ≤4,000/uL or
    ≥10% bands

    SEPSIS & SSI


    • Target glucose control
    SSI: <200 mg/dl
    SEPSIS: <180 mg/dl
    • Target MAP >65 mmHg

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