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اورام الجسم – لغة انجليزية – كتبته بنفسى-body swellings-English

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  • اورام الجسم – لغة انجليزية – كتبته بنفسى-body swellings-English


    اورام الجسم – لغة انجليزية – كتبته بنفسى-body swellings-English

    Duration of the swelling :- congenital swellings are present since birth. Painful swellings of days or weeks duration are likely to be inflammatory whereas painless swellings of months or years duration are possibly neoplastic. With painless swellings, the patient's statement may be deceptive for the swelling may have been present for a long time and only noticed recently by the patient…

    Mode of onset
    The swelling may follow trauma such as contusions and haematomas, or may arise in some pre-existing condition, such as scars and ulcers. Spontaneously developing swellings may be inflammatory or neoplastic but accidentally discovered swellings, being painless, are likely to be neoplastic ; carcinoma of the breast is a common example.

    Progress of the swelling
    The swelling may grow rapidly ( inflammatory), steadily ( malignant) or very slowly ( benign growth). Benign tumours may remain stationary for a long time but any subsequent rapid growth is suspicious of malignant transformation. Any diminution or fluctuation in size is suggestive of an inflammatory process. Recurrence after operation indicates malignancy or incomplete removal .

    It is also important to inquire about any changes in the characters of the swelling, such as redness or softening…

    Pain
    The presence of pain is of great diagnostic importance. Note especially the following features :-

    a) site :- is the pain localized to the swelling , arising in its neighbourhood, or referred away from the swelling? Radiating pain, pain arising in the swelling and shooting distally, suggests involvement of a nerve; the tumour may be arising in the nerve or merely compressing or infiltrating it …




    b) character :- chronic conditions usually give a dull aching type of pain varying in intensity from time to time, whereas acute inflammation are likely to give sharper and more severe pain.. throbbing pain suggests an inflammatory lesion with impending or frank suppuration….

    c) relation to the appearance of the swelling :- broadly speaking, pain before swelling suggests inflammation and swelling before pain indicates malignancy… the only exception is bone sarcoma in which a mild pain often precedes the appearance of the swelling… pain is absent in benign growths and early cancers… the appearance of pain in a benign tumour is suspicious of malignant change and in a carcinoma is suggestive of complications or inoperability…





    General symptoms

    These may be valuable in suggesting the pathological nature of the swelling :-

    a) inflammatory lesions may be associated with toxic symptoms such as fever, headache, anorexia, nausea, indigestion, constipation and oliguria.




    b) in tuberculous infections, there is often a history of wasting , loss of colour and strength, loss of appetite, evening pyrexia, night sweats and may be cough and haemoptysis.

    c) a history of penile sore, generalized enlargement of lymph nodes, cutaneous rash, mucous ulcers or repeated abortions may be obtained in syphilitic cases.

    d) Malignant disease may be associated with wasting cachexia or metastatic symptoms, such as cough, haemoptysis, jaundice or bone pains and swellings…

    genral examination
    signs of septic infection, tuberculosis, syphilis or malignant dissemination should be looked for ..

    local examination
    the local examination should be conducted in a definite order, otherwise important signs may be missed…

    inspection
    never put your hand on the swelling the moment you see it.. .. Use your eyes first to observe the following features :-

    1- number :- whether solitary or multiple.

    2- site :- note the anatomical region affected and the extent of the swelling in the horizontal and vertical directions or in the relation to neighbouring anatomical landmarks.

    3- size:- estimate the size in terms of common objects (pea, olive, lemon, orange or foetal head ) or better in conventional measurements ( millimeters, centimeters or inches).

    اشكال الاورام او اشكال و انواع الاورام
    4- shapes of swellings are rounded, ovoid, oblong, sausage shaped, reniform, horse shoe shaped, butterfly, pyriform, fusiform, hour-glass, club-shaped or irregular..





    5- surface :- whether smooth , lobulated, nodular, papillary, cauliflower-like, villous or irregular.


    6- Edge :- whether well- defined or ill- defined.. in circumscribed swellings note if sessile or pedunculated.



    7- skin :- the overlying skin may be normal, discoloured, stretched ; or the seat of dilated veins, peau d'orange, dimples, ulcers, scars or discharging sinuses…


    8- special signs :- these are looked for in certain cases, such as pulsations, impulse on coughing, movement on swallowing, distal pressure effects and behaviour on movement or muscle contration. Several of these are fully discussed under palpation…

    ملاحظات
    Notice – observations :-

    A pulsating swelling should be examined as follows :-
    1- note the site of the swelling
    2- note the mobility of the swelling , determine type of pulsation, try to separate the swelling from the related artery , feel the pulse beyond the swelling on the two sides , press the artery distal to the swelling, look for any pressure effects distal to the swelling
    3- examine these things :- thrill, crepitus, pitting on pressure , indentation , emptying on pressure , impulse on coughing
    ملاحظات
    Notice
    Percussion is used to determine the relation of the swelling ( over the swelling , around the swelling )

    سؤال
    Question
    اشرح اجابات الاسئلة التالية من خلال بحثك على الانترنت او سؤال استاذك ؟
    LOOK FOR ANSWERS TO THESE QUESTIONS:-

    How can we use Auscultation and transillumination in examining or discovering the type of the swelling ?

    Explain the special investigations that are connected with the swellings and may include Aspiration, radiography, blood examination and Biopsy ???



    Explain Acute swellings which include contusion , haematoma, erysipelas, cellulites????

    Explain chronic cystic swellings which include chronic abscess, cold abscess, sebaceous cyst, dermoid cyst ????
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