The abdominal aorta begins at the diaphragm and ends by bifurcating into the common iliac arteries. It has various branches that supply blood to abdominal organs. Abdominal aortic aneurysm is a localized dilation of the abdominal aorta over 50% of its normal diameter, most commonly occurring in the infrarenal aorta. Aneurysms are usually asymptomatic but the risk of rupture increases with size. Rupture is a medical emergency while asymptomatic aneurysms over 5.5 cm are repaired surgically or through endovascular graft placement to prevent rupture. Medical management focuses on risk factor modification for small asymptomatic aneurysms.
4 BASIC TYPES OF DENSITY - air , water /soft tissues, metal /bone , fat
Two substances of the same density, in direct contact, cannot be differentiated from each other on an x-ray.
This phenomenon, the loss of the normal radiographic silhouette (contour), due to loss of difference in density is called the silhouette sign.
Imaging plays an important role in diagnosis and formulating differential diagnosis in case of Solitary pulmonary nodule. It helps in differentiating and predicting benign and malignant nodules.
This presentation is almost a complete Pictoral view of Radiograph chest.
This presentation will help radiologist in daily reporting.
This presentation will help physicians, surgeons, anesthetist and almost all medical professionals in diagnosing commonly presenting cardiac diseases.
This will also help all in preparaing TOACS examination.
4 BASIC TYPES OF DENSITY - air , water /soft tissues, metal /bone , fat
Two substances of the same density, in direct contact, cannot be differentiated from each other on an x-ray.
This phenomenon, the loss of the normal radiographic silhouette (contour), due to loss of difference in density is called the silhouette sign.
Imaging plays an important role in diagnosis and formulating differential diagnosis in case of Solitary pulmonary nodule. It helps in differentiating and predicting benign and malignant nodules.
This presentation is almost a complete Pictoral view of Radiograph chest.
This presentation will help radiologist in daily reporting.
This presentation will help physicians, surgeons, anesthetist and almost all medical professionals in diagnosing commonly presenting cardiac diseases.
This will also help all in preparaing TOACS examination.
COPD is associated with increased airway resistance, alveolar and pulmonary capillary destruction, air trapping, chronic hypoxemia and increased work of breathing. In an attempt to improve oxygenation of the blood, pulmonary vessels adjacent to underventilated alveoli tend to constrict (hypoxic reflex pulmonary vasoconstriction), increasing both pulmonary vascular resistance and the work of right heart i.e. COPD imposes chronic strain on the right side of heart resulting in cor pulmonale.
COPD is associated with increased airway resistance, alveolar and pulmonary capillary destruction, air trapping, chronic hypoxemia and increased work of breathing. In an attempt to improve oxygenation of the blood, pulmonary vessels adjacent to underventilated alveoli tend to constrict (hypoxic reflex pulmonary vasoconstriction), increasing both pulmonary vascular resistance and the work of right heart i.e. COPD imposes chronic strain on the right side of heart resulting in cor pulmonale.
Neha diwan presentation on aortic aneurysmNEHAADIWAN
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Discussion about different types of Aneurysm, details about Abdominal aorta aneurysm and brief discussion about some important peripheral aneurysms.
Includes approach to different forms of Abdominal aortic aneurysm, its management and complications related to the surgery.
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It is a three-dimensional space that houses various structures within the chest.
The mediastinum extends from the sternum (front of the chest) to the vertebral column (back of the chest) and from the superior thoracic aperture (top of the chest) to the diaphragm (bottom of the chest).
Understanding the anatomy of the mediastinum is crucial for healthcare professionals to interpret diagnostic findings and manage conditions affecting this central compartment of the thoracic cavity.
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- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
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Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
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Anti ulcer drugs and their Advance pharmacology ||
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Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
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Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
2. Anatomy :
The abdominal aorta is the largest artery in the
abdominal cavity. it is a continuation of the
thoracic aorta.
is a retroperitoneal structure that begins at the
hiatus of the diaphragm (the level of the T12
vertebra).
It is approximately 13cm long and ends at the
level of the L4 vertebra. At this level, the aorta
terminates by bifurcating into the right and left
common iliac arteries.
3. Relations :
• Running parallel to the aorta on its right-hand side : the
inferior vena cava, the cisterna chyli, the azygos vein, and
the para-aortic lymph nodes.
• Running on its left-hand side : the left sympathetic trunk and
the para-aortic lymph nodes.
• Anteriorly : the stomach, duodenum and pancreas.
• It is also crossed anteriorly by the splenic vein and the left
renal vein.
• Posteriorly: it is separated from the lumbar vertebrae by the
anterior longitudinal ligament and left lumbar veins.
4. Branches :
• Three single anterior visceral branches :
(coeliac trunk, superior mesenteric artery, inferior
mesenteric artery).
• Three paired lateral visceral branches :
(suprarenal, renal, gonadal arteries).
• Five paired lateral abdominal wall branches :
(inferior phrenic and four lumbar arteries).
• Three terminal branches :
(two common iliac arteries and the median sacral artery).
5. Celiac trunk (T12) :
1- left gastric artery.
2- splenic artery:
short gastric arteries (6)
splenic arteries.
left gastroepiploic a.
pancreatic arteries.
3- common hepatic artery:
right gastric a.
gastroduodenal artery: (right gastroepiploic a. and
superior pancreaticoduodenal a.)
hepatic artery proper: (right hepatic and left
hepatic a.)
6. superior mesenteric artery (L1) :
inferior pancreaticoduodenal a.
jejunal and ileal arteries
right colic a.
middle colic a.
ileocolic a.
inferior mesenteric artery (L3) :
left colic a.
sigmoid arteries (2 or 3)
superior rectal a.
7.
8. The abdominal aorta is clinically divided into 2
segments:
• The suprarenal abdominal segment, inferior
to the diaphragm but superior to the renal
arteries.
• The Infrarenal segment, inferior to the renal
arteries and superior to the iliac bifurcation.
10. Definition :
AAA : is a localised, progressive and
permanent dilatation occurring in any portion of
infra-diaphragmatic aorta. with at least 50%
increase in diameter.
Most common site is infrarenal aorta.
Ectasia : dilatation <50% of normal diameter.
11. Classification :
According to wall :
• true aneurysm : containing the three layers of the
arterial wall (intima, media, adventitia) in the aneurysm
sac.
• false aneurysm (pseudoaneurysm) : having a single
layer of fibrous tissue as the wall of the sac. usually
occurs after trauma.
12. According to Location :
Infrarenal :
• below the renal arteries
• most common (95%).
• One-third of aneurysms extend into the iliac
arteries
Suprarenal :
• above the renal arteries (5%).
• Isolated suprarenal type is rare; it is usually
associated with thoracic and/or infrarenal types.
13. • Suprarenal AAA: The aneurysm involves the origins of one or more visceral arteries
but does not extend into the chest.
• Pararenal AAA: The renal arteries arise from the aneurysmal aorta but the aorta at
the level of the superior mesenteric artery is not aneurysmal.
• Juxtarenal AAA: The aneurysm originates just beyond the origins of the renal
arteries. There is no segment of nonaneurysmal aorta distal to the renal arteries, but
the aorta at the level of the renal arteries is not aneurysmal.
• Infrarenal AAA: The aneurysm originates distal to the renal arteries. There is a
segment of nonaneurysmal aorta that extends distal to the origins of the renal
arteries.
14. According to morphology :
• Fusiform : symmetrical enlargement involving whole
circumference of artery.
• Saccular : affect only part of the arterial circumference. have
higher risk of rupture.
15. According to size :
• Ectatic or mild dilatation : >2.0 cm and <3.0 cm
• Moderate : 3.0 - 5.0 cm
• Large or severe : >5.0 or 5.5 cm
According to symptoms :
• Asymptomatic.
• Symptomatic.
• Symptomatic ruptured.
16. Causes :
Atherosclerosis : most common cause (95%)
Familial aortic aneurysm (associated with 25% of
AAA). Marfan's, Ehler Danlos syndromes are related
genetically.
Others :
Syphilis, dissection, trauma, collagen diseases, infection,
arteritis, cystic medial necrosis.
Risk factors :
Age, male gender, white race, smoking and family history.
17. Asymptomatic Type :
It is found incidentally either on clinical
examination or on angiography or on
ultrasound.
Repair is required if diameter is over 5.5 cm on
ultrasound.
18. Symptomatic without Rupture :
Clinical features :
back pain or abdominal pain (Most common symptom).
Abdominal mass which is smooth, soft, non mobile, not
moving with respiration, above the umbilical level, resonant
on percussion.
Common in males ( 4:1 ); common in smokers.
GIT, urinary, venous symptoms can also occur.
Hypertension, diabetes, cardiac problems should be looked
for and dealt with.
19. 5% present as inflammatory aneurysm adherent
to ureters, left renal vein, inferior vena cava and
duodenum.
Aortocaval fistula presents as high output cardiac
failure with continuous bruit in abdomen and
lower limb edema.
Aortoenteric fistula is due to erosion of aneurysm
into 4th part of duodenum presenting as
gastrointestinal (GI) bleed, malaena, shock.
20. Symptomatic Ruptured Aortic
Aneurysm :
Rupture is most common and most lethal complication.
AAA rupture most commonly in left retroperitoneum.
It may be anterior rupture (20%) into the free peritoneal
cavity causing severe shock and death very early.
or posterior rupture (80%) with formation of
retroperitoneal haematoma of large size causing severe
back pain, hypotension, shock, absence of femoral
pulses and with a palpable mass in the abdomen.
21. Diagnosis :
Plain X-ray detects AAA in up to 70% cases.
CT angiogram (Ix of choice)
MRI and MRA is Ix of choice for diagnosis in
patients with renal insufficiency.
Ultrasound (preferred method of screening).
22. Management :
Medical Management :
It is done in :
low-risk abdominal aortic aneurysm (age below 70 years; active
physically without cardiac, respiratory, renal impairment and non
inflammatory aneurysm);
if aneurysm size is <5 cm.
if growth rate is <0.5 cm/year.
It includes risk factor modifications :
stopping smoking.
control of blood pressure and cholesterol.
NSAIDs & tetracycline may have potential to reduce aneurysmal
growth by inhibiting MMP (Matrix metalloproteinase).
23. Indications of repair of AAA :
Diameter 5.5 cm or more in men.
Symptomatic aneurysm.
For women and patients with greater than average rupture risk, AAA
diameter 4.5 to 5.0 cm.
Rate of expansion >1 cm/year
Atypical aneurysms (dissecting, pseudoaneurysm, mycotic, saccular
and penetrating ulcer) regardless of size.
Open surgical repair :
Transperitoneal & Retroperitoneal approach .
endo-aneurysmorrhaphy with intraluminal graft placement.