 I tried my best to do this presentation comprehensible.  I answered the questions in the best way I can, my sources were the net, and doctors.  The pictures in this presentation are not the ones came in the previous exams we just took the questions from the students and we put similar pictures from net.  Please if you find any mistakes or even you find better answers don’t hesitate to tell me or Nojod Al amri

Man with a big swelling in the back of his head of few months duration a) List 3 things u can see them by inspection: b) DDx: c) 2 early or immediate – local – complications of the surgery

1- List 3 things u can see them by inspection: *Round or spherical mass *well defined *smooth surface *intact skin 2- Give DDx:  Lipoma  Sebaceuos cyst  Abscess  Lymph nodes  Heamatomas  Sarcoma  Osteoma

3- Give 2 early or immediate – local – complications of the surgery : { dr. Kurdi gal el so2al maloosh ma3na :D } 1- wound infection 2- bleeding 3- excessive skin removal. 4-heamatoma 5- chyle leak 6- sutures dehiscence

Q.describe? Q.give 3 D.D?

1- Describe what you see  Round facial mass  In the right cheek  Smooth surface  Mention the size  Mention the skin changes ( redness,discharge…etc) 2- give 3 D.D  Salivary glands enlargement ( tumors, inflammation, stones..)  Teeth abscess  Mumps  Lipoma ??

describe? D.D?

1- Describe what you see?  Red mass in the head  Spherical in shape  Mention the size  Mention skin changes 2- What is your D.D?  Hemangioma  Hematoma  ???

give DDx? Examine ??

DDX : Lipoma,, Abscess Trauma-induced edema/hematoma Insect bite Examination: 5ps ( present your self, have permission, proper exposure, privacy, position of the patient) By inspection : site size shape symmetry skin changes

By palpation :  Temperature  Tenderness  Mobility (assessed in 2 planes)  Contour ( defined or nor)  Consistency ( firm, hard, soft, rubbery)  Tethering and attachment to underlying skin and subcutaneous tissues  Confirm what you see by inspection. By Percussion: resonance and dullness By auscultation :Bruits Special tests: Fluctuation ( done in 2 perpendicular planes)  Fluid thrill, resonance and dullness, trans-illumination test ( done in dark room or with cone)

STCP SiteTemperatureColorPermission SizeTendernessConsistencyPresent your self ShapeTetheringContourPrivacy SurfaceCompressibilityPosition Skin changesAlways Compare Proper Exposure SymmetryPulsatile Skin and subcutaneous attachments to the Lump ( done by mobility and contraction of the underlying muscles) Bruit

Examination of supra-clavicular region  Ma adri wesh yebi el so2al :D But I would do a complete neck examination concentrating on lymphadenopathy..  Ensure the 5 p’s By inspection :  Symmetry  Skin changes  Scars  deformity  Visible masses  Any thing you see abnormal in that area describe it, or even in the neck

By palpation:  Stand behind the patient  Bend patient’s neck to the left if u want to palpate the left Supra- clavicular region and vice versa with the right region, the aim is to make the area flexible not tense  Feel any palpable lymph nodes and their composition.  Temperature  Tenderness By percussion :  Percuss over the supra-clavicular region  Clavicle  Sternum  Lungs By Auscultation :  Auscultate for any possible lung apices cancer with bell and diaphragm of the stethoscope

*give differential diagnosis?  Sebaceous cyst  Carbuncle  Folliculitis  Lipoma  Sebaceous carcinoma Pic of Swelling appears in the scalp in between the hair