Dr.Zyad shanshl session 5
Thursday, August 18, 2016
1
يرجى الرجوع لريمكس والمحاضرات للمعلومات الكاملة وهذه مالحظات فقط على السشن
Thyroid surgery
Hx:1-morphological part
-Neck symp.:-lump Hx
(in addition to –what make the pt to consultate *complication ---like bleeding into cysts
*sudden increase in size
*inability to control of the function by medications)
-ask in aggravating factor of thyroid lump about
عندمن تنشرين هدوم شيصير عندج
ومن
تنام
ين
يصير
عدنج
ضيق
بالنفس
.
2-Functional Hx :-according to the systems (in remix+lctures)
3-Patient Reaction :-any Invx done(its results)
-why the pt in the hospital
Don't forget asking about the drugs( it may mask symp)
*
:-any pt with resistant HT or palpitation <think about hyperthyroidism
-FNA can't differentiate bLt follicular adenoma & follicular Ca
-Previous exposure is imp. In thyroid pathology
*the most common type of goiter in Musol is diffuse goiter d/t iodine deficiency.
-history of week memory , hair loss ,double vision ,and loss of desire think about
hypothyroidism
-thyrotoxicosis the extreme of hyperthyroidism and myxedema coma the extreme of
hypothyroidism.
_most common presentation single nodule and the other nodules only shown in ultrasound
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Ex.: back to remix(Put in UR mind that sequence of inspection-palpation-auscult.)
-inspection
-3P(permission&explanation &handshaking -position(slight extended neck in sitting
postion)-Exposure)
-like remix but 1-general 2-hand 3-neck4-eye 5-inspect leg
Dr.Zyad shanshl session 5
Thursday, August 18, 2016
2
-result of inspection :there's a visible lump in R side of neck & measuring about 3*4cm
approximately ®ular &spherical in shape.
Avoid percussion w/t Dr.zyad shashl
*auscultate by bell of stethoscope.
)
redivac drain
(
Closed system drain
Work on negative pressure
Insicion of thyroid surgery called collar Insicion .
*
types of thyroid surgery
1
_
Lobectomy : removal of one lobe + isthmus
2
_
sub total : little tissue left on both sides.
3
_
near total : one lobe removed completely
&
and little
tissue left on the other side.
4
_
total : all the thyroid gland removed.
Follicular ca ( on blood ,single , bad prognosis )
Papillary ca. ( Lymphatic , multicentric , better prognosis )
Dr.Zyad shanshl session 5
Thursday, August 18, 2016
3
Dr.Zyad shanshl session 5
Thursday, August 18, 2016
4