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5 / 1 0 / 1 2 4
1 / 2 0my . s o -‐‑ n e t . n e t . t w / h s i n g l i n 2 0 0 2 / a r t i c l e / a r t i c l e 2 _ 4 . h t ml
6/1( )
1 ����On Foley
Foley, , ….BI, , ….3M
2 ����On NG tube
NG tube, 50c.c. ,
3 ����NG tube size
16 , . irrigation, 14 irrigation
NG
, NG( , ),
30 , NG .
4 ����ABG
22 , , 10 .
5 ����
Nylon 3.0, Nylon 4.0, Nylon 5.0 6.0
Nylon , Dexon
6 ����SSD ( )
, , ,
, SSD . .
, , , 綁
, , 綁 .
7 ���� consciousness?
” ”. ” ?”, ” ?”,
. case, ” !”, “ ”…
, , ,
!
8 ����
5 / 1 0 / 1 2 4
2 / 2 0my . s o -‐‑ n e t . n e t . t w / h s i n g l i n 2 0 0 2 / a r t i c l e / a r t i c l e 2 _ 4 . h t ml
Normal saline , BI .
xylocain Normal saline
9 ����
Intern 啟 3F , , station
, , .
10
Intern, ,
, ” ”…( ), !
6/2( )
(1)��� Raccoon eye
Raccoon eye , suspect
(2)��� Battle’s sign
Battle’s sign , suspect ,
(3)��� Monteggia fracuture
fracture of the proximal ulna can be associated with dislocation of the radial head.
(3)Mon����� ���*DO
(4)��� Galeazzi fracture
fracture of the distal half of the radius can be associated with disruption of the distal radioulnar
joint. ( reverse Monteggia fracture)
(5)��� Greenstick fracture
children. One side of the fracture has broken and one side is bent. incomplete
break. It will involve only one side of bone. It is because the bone of children is more
pliable( ) than adults.
5 / 1 0 / 1 2 4
3 / 2 0my . s o -‐‑ n e t . n e t . t w / h s i n g l i n 2 0 0 2 / a r t i c l e / a r t i c l e 2 _ 4 . h t ml
5 / 2 0my . s o -‐‑ n e t . n e t . t w / h s i n g l i n 2 0 0 2 / a r t i c l e / a r t i c l e 2 _ 4 . h t ml
(4)���Penicillin testThe skin is observed closely for signs of a reaction, usually swelling and redness of the site - acontrolled hive with so-called wheal and flare. Results are usually obtained within about 20minutes, and several suspected allergens can be tested at the same time.
A positive cough sign (ie, sharp pain in the RLQ elicited by a voluntary cough) may be helpful inmaking the clinical diagnosis of localized peritonitis. Similarly, RLQ pain in response topercussion of a remote quadrant of the abdomen, or to firm percussion of the patient's heel,suggests peritoneal inflammation.
5 / 1 0 / 1 2 4
6 / 2 0my . s o -‐‑ n e t . n e t . t w / h s i n g l i n 2 0 0 2 / a r t i c l e / a r t i c l e 2 _ 4 . h t ml
The most common causes of luminal obstruction are fecaliths and lymphoid follicle hyperplasia
<from Moore p.251>The nerve supply to the cecum and appendix derives from the sympathetic and parasympatheticnerves from the superior mesenteric plexus. The sympathetic nerve fibers originate in the lower thoracic part of the spinal cord.
5 / 1 0 / 1 2 4
9 / 2 0my . s o -‐‑ n e t . n e t . t w / h s i n g l i n 2 0 0 2 / a r t i c l e / a r t i c l e 2 _ 4 . h t ml
The parasympathetic nerve fibers derive from the vagus nerves.
Afferent nerve fibers from the appendix accompany the sympathetic nerves to the T10 segment of
In an adult, where the rare possibility of malignancy could be present, an abdominal and pelvic CT scanmight be helpful. Again, complete removal of the urachus is important. Simple needle or other drainageof the cyst will result in recurrence in at least one-third of patients, since the linings and structures arestill present. Surgery is sometimes indicated.
(8)����Staghorn stone , KUB .
5 / 1 0 / 1 2 4
1 9 / 2 0my . s o -‐‑ n e t . n e t . t w / h s i n g l i n 2 0 0 2 / a r t i c l e / a r t i c l e 2 _ 4 . h t ml
(9)���� OG tube, NG tube , , endo on ,
, , ,
.
(10)Foley , on Foley ,
, ” on Foley ?”, penis,
, VS R, ,
,
, on Foley
6/16 ( )
(1)���� KUB, bladder stone phleboliths
(2)���� tumor coffee-ground vomiting
GIST Gastrointestinal Stromal Tumor
(3)���� , ,
.
(4)����Vena ,
(5)���� , irrigation, ,
, , .( infection ,irrigation bacteria )
(6)���� , 10cm , tension
, 2-0 Nylon , Dexon.
(7)���� , burn center, .
(8)���� , allergy history NSAID ,
Demerol
(9)���� EKG, , filter
(10) KUB Plain abdomen, β-hCG
, , , .
6/17 ( )
5 / 1 0 / 1 2 4
2 0 / 2 0my . s o -‐‑ n e t . n e t . t w / h s i n g l i n 2 0 0 2 / a r t i c l e / a r t i c l e 2 _ 4 . h t ml