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INTRODUCTION Dr. Haydar Muneer GENERAL SURGERY

Introduction

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Page 1: Introduction

INTRODUCTION

Dr. Haydar Muneer

GENERAL SURGERY

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SURGERY MAY DEFINE AS

The art of treating lesions and malformations of the human body by manual operations The origin of the word surgery come from the Greek word cheirourgike (cheir – hand , ergein-work)

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• Evidence that the surgical assistance was provided can be found from the period around the year 4600 BC Babylon , ancient Egypt and India culture.

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• From 5th till 15th century the arab period affected the history of surgery

• Arabic surgeon AbuKasim describe the findings of the treatment of the surgical diseases in manual of several volumes

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• Italian-french period In 13th century first universities were medicine was taught were founded in Italy (Napoli)

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• The first scientific treatment in surgery comes from the work of French military surgeon Ambroise Pare(1510-1590) who revolutionised surgery by introducing dressing for wounds and ligatures for haemorrage

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• In 1846 William Morton ( 1819 -1868) a dentist introduced and demonstrated Ether Anaesthesia heralding the age of painless surgical practice.

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CASE HISTORY

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• Patients may present in two ways:

• electively, with chronic symptoms of variable duration; or• acutely, with life-threatening disorders.The pathways involved in management of the two are quite different.

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THE ACUTELY INJURED PATIENT.

A AirwayB BreathingC Cardiovascular systemD Neurological DefectsE Exposure to detect all injuries

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APPROACH TO HISTORY-TAKING

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• Establish a rapport with the patient: introduce yourself, shake hands

• Initiate the process by asking the patient to tell you what made him or her seek medical advice

• Listen without interruption to the patient as he or she relates

• the history of the presenting complaint(s). During this process make a mental note of the key symptoms

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• Wait for the answer before asking another question

• Obtain further details on specific symptoms, including duration, nature of severity and associations, by specific questions

• Briefly review the systems by key questions

• Obtain details of past medical history, including drug medication, surgical conditions, operations and exposure to general anaesthesia

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• Past medical incidents are

important because they may relate to the patient's current illness and may also influence management

• Obtain details of social history and habits, including alcohol consumption and smoking

• Obtain a brief family history

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• Do not interrupt the patient• Do not use medical

terminology• Do not ask ambiguous or

irrelevant questions• Do not use leading questions

in the first instance• Do not be abrupt or impatient

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• In this process there are dos and don'ts. The only way a student can verify that an accurate history has been obtained is to summarize the information for the patient to confirm. This is highly recommended until full proficiency in history-taking is obtained.

• The wrong information can be obtained if the technique is poor and the patient is confused by the interviewer

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Introduction Introduction Introduction Introduction

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