The document discusses various types of abdominal incisions used in surgery. It describes incisions like vertical incisions (median, paramedian), transverse incisions (Kocher, McBurney), and pelvic incisions (Pfannenstiel, Maylard). The ideal incision allows easy access to structures, can be extended if needed, and heals with minimal scarring. Factors like the surgery type, target organ, and patient characteristics influence the choice of incision. Complications can include hematoma, wound infections, and hernia.
Establishing the need for a surgical intervention
Confirmation of relevant physical findings and review of the clinical history and laboratory investigations that support the need of surgical intervention
Type of approach- Benefits & Risks of surgical procedure
The incision site- ease of surgery as well as cosmetic considerations
Type of anesthesia
Establishing the need for a surgical intervention
Confirmation of relevant physical findings and review of the clinical history and laboratory investigations that support the need of surgical intervention
Type of approach- Benefits & Risks of surgical procedure
The incision site- ease of surgery as well as cosmetic considerations
Type of anesthesia
An incision in the abdomen is an opening or a cut made by the surgeon. An incision in the abdomen is an opening or a cut made by the surgeon. It is done to permit access to abdominal organs for surgery. The selection of an incision depends on. Underlying condition prompting the surgery.
Mastectomy is the removal of the whole breast. There are five different types of mastectomy: "simple" or "total" mastectomy, modified radical mastectomy, radical mastectomy, partial mastectomy, and subcutaneous (nipple-sparing) mastectomy.
Prostatectomy Surgery abroad in India info on cost Prostatectomy Surgery India,Prostatectomy male Surgery hospitals India,Prostatectomy surgeons India.
Colles fracture is the fracture at the distal end of radius, at its
cortico cancellous junction(about 2cm from the distal articular
surface).
It is not just the fracture of distal radius but the fracture
dislocation of the inferior radio-ulnar joint.
different type of lower limb amputation with indication, peri-operative care, surgical steps, post op care complication and different type of prosthesis
An incision in the abdomen is an opening or a cut made by the surgeon. An incision in the abdomen is an opening or a cut made by the surgeon. It is done to permit access to abdominal organs for surgery. The selection of an incision depends on. Underlying condition prompting the surgery.
Mastectomy is the removal of the whole breast. There are five different types of mastectomy: "simple" or "total" mastectomy, modified radical mastectomy, radical mastectomy, partial mastectomy, and subcutaneous (nipple-sparing) mastectomy.
Prostatectomy Surgery abroad in India info on cost Prostatectomy Surgery India,Prostatectomy male Surgery hospitals India,Prostatectomy surgeons India.
Colles fracture is the fracture at the distal end of radius, at its
cortico cancellous junction(about 2cm from the distal articular
surface).
It is not just the fracture of distal radius but the fracture
dislocation of the inferior radio-ulnar joint.
different type of lower limb amputation with indication, peri-operative care, surgical steps, post op care complication and different type of prosthesis
'Surgical Incisions on Abdominal Wall', a Surgical Anatomy Seminar by 1st yr MBBS students of Venkateswara Institute of Medical Science, Galraula, UP. India
An abdominal surgery is a surgical repair, resection, or reconstruction of organs inside the abdominal cavity. These surgical wounds made over the abdomen are known as abdominal incisions.
These power-point presentation is precisely made to cover all the aspects of surgical incision required in physiotherapy.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
2. Surgical Incision is a cut made through the skin to facilitate an
operation or precedure.
It should be the aim of the surgeon to employ the type of
incision considered to be the most suitable for that particular
operation to be performed.
In doing so, three essentials should be achieved:
1.Accessibility
2.Extensibility
3.A reliable closure
3. Principles
Incision should be long enough for good exposure
Splitting is better than cutting
Avoid cutting of nerves and vessels
Retract muscle, abdominal organs towards neurovascular
bundle
Insert DT through a separate incision
Transverse incisions better than vertical incisions
Close the wound layer by layer
4. Choice of incision
Depend upon
Type of surgery [elective/emergency]
Target organ
Surgeons own experience and preference and
Previous surgery.
5. The ideal incision allows:
ease of access to the desired structures
can be extended if needed
ideally muscles should be split rather
than cut
heals quickly with minimal scarring
6. Langer’s Line
Langer’s Line
correspond to the
natural orientation
of collagen fibers in
the dermis, and are
generally parallel to
the orientation of the
underlying muscle
fibers
Incisions made
parallel to Langer's
lines may heal better
and produce less
scarring than those
that cut across.
8. Vertical Incisions
1)Median Incision
vertical incision which follows
the linea alba.
It may be,
upper midline incision;
lower midline incision
single incision.
SIGNIFICANCE-it is favored
In diagnostic laparotomy, as it
allows wide access to abdominal
Cavity.
9. Advantages:
almost bloodless
no muscle fibers are divided
no nerves are injured
good access to upper
abdominal viscera
very quick to make as well as
to close
can be extended full lenght of
abdomen curving around
umblical scar.
Disadvantages
Care needs to be taken just above the
umbilicus where the falciform ligament is
Midline scar
Bladder injury
10. Upper midline incision
From xiphoid to above
umbilicus.
Division of the peritoneum
is best performed at the
lower end of the
incision,just above the
umbilicus ,so that the
falciform ligament can be
seen and avoided
11. Lower midline incision
From the umbilicus superiorly to
the pubis symphysis inferiorly
Allow access to pelvic organs
the peritoneum should be opened
in the uppermost area to avoid
injury to the bladder
13. Paramedian Incisions
placed 2 to 5 cm lateral to
midline over median aspect
of bulging transverse
convexity of rectus muscle.
14. Advantages
Provides access to lateral structures
Avoids injury to nerves,limits trauma to rectus muscle.
Permits good restoration of abdominal wall function
Can be extended by slanting the upper end of the
incision medially towards the xiphoid process if
required
Disadvantages
Time consuming.
Incision needs to be closed in layers
Difficult extension superiorly as limited by the costal
margin
Tends to strip the muscles of their lateral blood and
nerve supply resulting in atrophy of the muscle medial
to the incision
15. Transverse Incisions
Advantages
better cosmetically
Stronger than vertical
Less painful
Good access to upper GI structures
More advantageous in children b/c of more
transverse length of abdomen.
Disadvantages
Limited exposure to the organs
17. Kocher Subcostal Incision
It affords excellent exposure
to gall bladder and biliary
tract and can be made on left
side to afford access to
spleen.
İs started at midline ,2 to 5
cm below the xiphoid,and
extends downwarda,
outwards and paralel to and
about 2.5 cm below costal
margin
Especially used in
cholecystectomy
There are two modifications
Chevron (rooftop)modification
Mercedes benz modification
18. Chevron (rooftop)
modification
The incision may be continued
across the midline into double
kocher’s incision or rooftop
appearance which provide
excellent access to upper
abdomen particularly in those
with broad costal margin
Uses-
• total gastrectomy
• total oesophagectomy
• extensive hepatic resection
• bilateral adrenectomy
19. Mercedes benz
modification
Consists of bilateral low kocher’s incision
with upper midline
incision upto the xiphisternum.
Provides excellent access to the upper
abdominal viscera mainly the
diaphragmatic
hiatuses
20. Transverse Muscle dividing
In newborn and infants, this incision is preferred bcs more
abdominal exposure is gained per lenght of incision than with
vertical exposure
Because infants’ abdomen longer transverse than vertical girth.
Also true of short, obese adult
21. McBurney grid iron(muscle
splitting)incision
İncision of choice most
appendicectomies
The level and lenght of
incision will vary
according to thickness of
abd. wall and suspected
position of apendix.
22. is made at the junction of middle third and
outer third of a line running from umblicus
to anterior superior iliac spine,McBurney
point.
Originally placed the incision obliquely
from above laterally to below medially.
Also used in left lower quadrant to deal
with certain lesion of sigmoid colon such
as drainage of diverticular abscess.
The level and length of the incision vary
according to
Thickness of abdominal wall
Suspected position of the appendix
23. Lanz incision
It is a variation of
McBurneys
incision that is
made the same
point but in
transverse plane.
It gives
cosmetically good
scar
24. Rutherford-Morrison Incision
Oblique Muscle
Cutting Incision
Extension of
McBurney incision by
division of oblique
fossa
Can be used for right
and left sided colonic
resection, caecostomy
or sigmoid colostomy
26. • Used frequently by
gynecologist and
urologist for access to
pelvic organ, bladder,
prostate and for c-
section.
• is usually 12 cm long
and is made in skin
fold approximately 5
cm above symphysis
pubis.
27. Maylard Transverse Muscle Cutting Incision
gives excellent exposure to
pelvic organ
Skin incision is placed above
but parallel to traditional
placement of Pfannenstiel
incision
30. Thoracoabdominal Incisions
• Either right or left
• Converts pleural and
peritoneal cavities
into one common
cavity
• Thereby gives
excellent exposure
31. • Right incision may be particularly useful
in elective and emergency hepatic
resections
• Left incision may be used in resection of
lower end of esophagus and proximal
portion of stomach.
• Incision is extended along line of 8th
intercostal space,the space immediately
distal to inferior pole of scapula.