This document discusses dysphagia, or difficulty swallowing, which can be caused by abnormalities in the oral, pharyngeal, or esophageal phases of swallowing. It describes oropharyngeal dysphagia, which usually results from issues in the mouth or throat, and esophageal dysphagia, which causes chest or abdominal symptoms. The evaluation of a dysphagia patient involves obtaining a history, performing a physical exam, and typically starting with a barium swallow test to identify any lesions. Further tests may include endoscopy, manometry, pH study, and imaging. Management depends on the underlying cause found.
Dysphagia is difficulty swallowing that can affect any part of the swallowing pathway from the mouth to the stomach. It is a common complaint seen in ENT clinics. Causes include congenital issues, trauma, infections, inflammation, motility disorders, neurological problems, tumors, and other miscellaneous conditions. Evaluation involves history, examination, blood tests, imaging like barium swallow and endoscopy, and specialized tests like manometry and pH monitoring. Treatment depends on the underlying cause.
Dysphagia is a common complication following anterior cervical discectomy and fusion (ACDF) surgery, with reported rates of dysphagia within the first week post-operatively ranging from 1-79% in studies. Risk factors for developing dysphagia may include increased age, pre-existing swallowing issues, multiple medical comorbidities, revision surgery, prolonged operative time, and smoking. While dysphagia usually improves over time, early speech language pathology (SLP) evaluation can help identify dysphagia and reduce risks of complications like aspiration pneumonia that result in longer hospital stays and higher costs.
The document discusses various causes of dysphagia and odynophagia, which are difficulties swallowing and pain with swallowing, respectively. It covers congenital causes, acquired traumatic, infectious, inflammatory, neurological, drug-induced, and age-related etiologies. Evaluation involves assessing history, performing physical exams, reviewing systems, and obtaining imaging studies and endoscopy. Management consists of addressing underlying causes, utilizing alternate feeding methods, reflux regimens, changing food consistencies, and swallowing therapies or procedures like dilation or myotomy depending on the specific cause.
Dysphagia is difficulty swallowing that can affect any part of the swallowing pathway from the mouth to the stomach. It is commonly seen in ENT clinics. There are two main types - oropharyngeal dysphagia involving preparation and transport of food in the mouth and throat, and esophageal dysphagia with food sticking in the lower throat or chest. Causes vary by age from foreign bodies in children to malignancy in the elderly. Evaluation involves history, examination, barium swallow, endoscopy and manometry. Treatment depends on the underlying cause but may include dilation, stenting or surgery.
This clinical skills workshop covered dysphagia evaluation and treatment. It reviewed swallowing anatomy and the three phases of swallowing (oral, pharyngeal, esophageal). Conditions that can lead to dysphagia were discussed for each phase. Evaluation methods like bedside swallow exams, FEES, and VFG were presented. Treatment options included rehabilitation to strengthen muscles and compensatory strategies like positioning, thickened liquids, and dietary modifications. Attendees participated in small groups to practice evaluating thickened liquids and compensatory strategies. The workshop aimed to improve identification of dysphagia and knowledge of treatment options.
Dysphagia, or difficulty swallowing, can be caused by many factors. An accurate diagnosis requires a detailed history, examination, and special investigations. Special investigations may include barium swallows, endoscopies, pH monitoring, manometry, and others depending on suspected causes. Causes can include neurological issues, infections, inflammation, tumors, motility disorders, and more. Determining the underlying cause is important for guiding appropriate treatment of a patient's dysphagia.
Dysphagia refers to difficulty swallowing and can be caused by problems in the oral cavity, pharynx, or esophagus. It is important to determine the location and characteristics of the dysphagia through history and physical examination to guide diagnostic testing and identify potential underlying causes. Common causes of dysphagia include peptic strictures from acid reflux, eosinophilic esophagitis, esophageal rings or webs, esophageal cancer, and achalasia. Evaluation involves barium swallow, endoscopy with possible biopsy, and other tests as needed to diagnose the specific condition causing a patient's swallowing difficulties.
Dysphagia refers to difficulty swallowing and can be classified as oropharyngeal or esophageal. Oropharyngeal dysphagia is caused by abnormalities of the striated muscles in the mouth, pharynx, and upper esophageal sphincter. Esophageal dysphagia is caused by disorders of the smooth esophageal muscles. Common causes of oropharyngeal dysphagia include neurological diseases, local structural lesions, and disorders of the upper esophageal sphincter. Common causes of esophageal dysphagia include neuromuscular disorders like achalasia, mechanical lesions, and motility abnormalities. A thorough history and physical exam, along with diagnostic tests, are used to
Dysphagia is difficulty swallowing that can affect any part of the swallowing pathway from the mouth to the stomach. It is a common complaint seen in ENT clinics. Causes include congenital issues, trauma, infections, inflammation, motility disorders, neurological problems, tumors, and other miscellaneous conditions. Evaluation involves history, examination, blood tests, imaging like barium swallow and endoscopy, and specialized tests like manometry and pH monitoring. Treatment depends on the underlying cause.
Dysphagia is a common complication following anterior cervical discectomy and fusion (ACDF) surgery, with reported rates of dysphagia within the first week post-operatively ranging from 1-79% in studies. Risk factors for developing dysphagia may include increased age, pre-existing swallowing issues, multiple medical comorbidities, revision surgery, prolonged operative time, and smoking. While dysphagia usually improves over time, early speech language pathology (SLP) evaluation can help identify dysphagia and reduce risks of complications like aspiration pneumonia that result in longer hospital stays and higher costs.
The document discusses various causes of dysphagia and odynophagia, which are difficulties swallowing and pain with swallowing, respectively. It covers congenital causes, acquired traumatic, infectious, inflammatory, neurological, drug-induced, and age-related etiologies. Evaluation involves assessing history, performing physical exams, reviewing systems, and obtaining imaging studies and endoscopy. Management consists of addressing underlying causes, utilizing alternate feeding methods, reflux regimens, changing food consistencies, and swallowing therapies or procedures like dilation or myotomy depending on the specific cause.
Dysphagia is difficulty swallowing that can affect any part of the swallowing pathway from the mouth to the stomach. It is commonly seen in ENT clinics. There are two main types - oropharyngeal dysphagia involving preparation and transport of food in the mouth and throat, and esophageal dysphagia with food sticking in the lower throat or chest. Causes vary by age from foreign bodies in children to malignancy in the elderly. Evaluation involves history, examination, barium swallow, endoscopy and manometry. Treatment depends on the underlying cause but may include dilation, stenting or surgery.
This clinical skills workshop covered dysphagia evaluation and treatment. It reviewed swallowing anatomy and the three phases of swallowing (oral, pharyngeal, esophageal). Conditions that can lead to dysphagia were discussed for each phase. Evaluation methods like bedside swallow exams, FEES, and VFG were presented. Treatment options included rehabilitation to strengthen muscles and compensatory strategies like positioning, thickened liquids, and dietary modifications. Attendees participated in small groups to practice evaluating thickened liquids and compensatory strategies. The workshop aimed to improve identification of dysphagia and knowledge of treatment options.
Dysphagia, or difficulty swallowing, can be caused by many factors. An accurate diagnosis requires a detailed history, examination, and special investigations. Special investigations may include barium swallows, endoscopies, pH monitoring, manometry, and others depending on suspected causes. Causes can include neurological issues, infections, inflammation, tumors, motility disorders, and more. Determining the underlying cause is important for guiding appropriate treatment of a patient's dysphagia.
Dysphagia refers to difficulty swallowing and can be caused by problems in the oral cavity, pharynx, or esophagus. It is important to determine the location and characteristics of the dysphagia through history and physical examination to guide diagnostic testing and identify potential underlying causes. Common causes of dysphagia include peptic strictures from acid reflux, eosinophilic esophagitis, esophageal rings or webs, esophageal cancer, and achalasia. Evaluation involves barium swallow, endoscopy with possible biopsy, and other tests as needed to diagnose the specific condition causing a patient's swallowing difficulties.
Dysphagia refers to difficulty swallowing and can be classified as oropharyngeal or esophageal. Oropharyngeal dysphagia is caused by abnormalities of the striated muscles in the mouth, pharynx, and upper esophageal sphincter. Esophageal dysphagia is caused by disorders of the smooth esophageal muscles. Common causes of oropharyngeal dysphagia include neurological diseases, local structural lesions, and disorders of the upper esophageal sphincter. Common causes of esophageal dysphagia include neuromuscular disorders like achalasia, mechanical lesions, and motility abnormalities. A thorough history and physical exam, along with diagnostic tests, are used to
Dysphagia refers to difficulty swallowing that can interfere with a patient's ability to eat and carry risks. It has many potential causes, including neurological conditions like stroke, muscular disorders, structural issues, infections, cancers and iatrogenic factors. A thorough history and examination aims to determine if the dysphagia is oropharyngeal or esophageal in nature, and its characteristics may provide clues to structural vs motility etiologies. Careful documentation of symptom onset, progression, relieving/exacerbating factors is important for diagnosis.
Neurogenic dysphagia is difficulty swallowing that develops in approximately 400,000 to 800,000 people per year due to neurological disorders or injuries. Dysphagia can be serious as it increases the risks of pneumonia, malnutrition, dehydration, and airway obstruction. The physiology of swallowing involves voluntary and reflex oral, pharyngeal, and esophageal phases. Central control of swallowing occurs in brainstem structures while cortical regions help with preparation and modulation. Common neurogenic causes of dysphagia include strokes and other brain injuries, motor neuron diseases like ALS, and inflammatory myopathies. Evaluation involves medical history, physical exam of swallowing functions, and sometimes imaging tests. Treatment depends on
Dysphagia, or difficulty swallowing, is common in the elderly due to aging changes and comorbidities. The prevalence of dysphagia increases from 15% in community settings to 40-68% in institutional settings. Diagnosis involves a medical history, physical exam, and may include videofluoroscopy or fiberoptic endoscopic evaluation of swallowing. Management is complex in geriatric patients and involves a multidisciplinary team utilizing compensatory techniques like diet modifications, swallowing maneuvers, and rehabilitation exercises. Palliative care aims to relieve suffering and improve quality of life through communication, symptom control, and psychosocial-spiritual support for patients and their families.
approach to Disphagia for medical studentsYahyia Al-abri
The document discusses dysphagia (difficulty swallowing) including the anatomy of the pharynx, phases of swallowing, types of dysphagia, causes, diagnosis, and treatment. It describes oropharyngeal dysphagia involving problems initiating a swallow versus esophageal dysphagia where food feels stuck after swallowing. Causes include mechanical obstruction from rings/webs, peptic strictures, cancer, and neuromuscular disorders like esophageal spasm, scleroderma, and achalasia. Evaluation involves history, examination, endoscopy, barium swallow, and manometry. Treatment depends on the underlying cause but may include dilation, acid suppression, botulinum toxin injections,
Evaluation of a patient with dysphagia: Difficulty in Swallowing.
Esophageal and Pre-esophageal causes.
-Abhinav Kumar, Kasturba Medical College, Mangalore
Prepared from book: "Diseases of Ear, Nose and Throat
Textbook by P. L. Dhingra" 6th Edition
https://books.google.co.in/books?id=0ByMBgAAQBAJ&lpg=PP1&pg=PA347#v=onepage&q&f=false
This document discusses the importance of taking a thorough history when evaluating a patient for dysphagia. It notes that history can help establish if dysphagia is present and determine the anatomical site and likely cause in 80% of cases. Specifically, the temporal factors and associated symptoms provide useful diagnostic clues. For example, a sudden onset of oropharyngeal dysphagia may indicate a stroke, while a gradual onset with heartburn could suggest a peptic stricture. A thorough history is essential to distinguish structural abnormalities from motor disorders and identify underlying conditions like Parkinson's disease.
This document outlines various disorders that can affect the preoesophageal, oral, and pharyngeal phases of swallowing, as well as the lumen, wall, and outside of the esophagus. It discusses diagnostic tests and investigations for esophageal disorders, including blood tests, radiography, manometry and pH studies, and oesophagoscopy. Manometry and pH studies help evaluate motility disorders, gastroesophageal reflux, and determine if esophageal spasms are spontaneous or acid-induced.
Dysphagia, or difficulty swallowing, can result from problems in the oral, pharyngeal, or esophageal stages of swallowing. The document discusses the physiology of swallowing and various neurological, muscular, and structural causes of dysphagia including strokes, Parkinson's disease, ALS, myasthenia gravis, and eosinophilic esophagitis. Treatment depends on the underlying cause but may include postural changes, diet modifications, feeding tubes, and treating any primary neurological or muscular disorders. Complications of untreated dysphagia include malnutrition, dehydration, aspiration pneumonia, and asphyxiation.
What is a dysphagia? What are the latest trends to deal with the case who has presented to you? This "Seminar Presentation" list some of the latest American College of Surgery guidelines, regarding the management of a case of dysphagia
Dysphagia (Surgery) - causes, Types and ApproachKabilan Selvan
This document provides information on dysphagia (difficulty swallowing). It discusses the anatomy and physiology of swallowing, types of dysphagia based on location and cause, common causes of oropharyngeal and esophageal dysphagia such as neurological conditions, tumors, and achalasia. The approach to a patient with dysphagia involves taking a thorough history, examination, and investigations like barium swallow, endoscopy, and manometry. Treatment depends on the underlying cause, and may include procedures like dilatation for strictures or myotomy for achalasia.
This document discusses non-malignant causes of dysphagia. It begins with anatomy of the oropharynx and esophagus, followed by causes of oropharyngeal and esophageal dysphagia including neurological, muscular, motility and structural issues. Specific motility disorders like achalasia, diffuse esophageal spasm and ineffective esophageal motility are explained. Other esophageal pathologies discussed include strictures, rings, webs, gastroesophageal reflux disease, Barrett's esophagus, diverticula and infectious esophagitis. Investigations and management of various conditions causing non-malignant dysphagia are summarized.
Group 4 dysphagia 2016 version 3.1 validatedDennis Lee
This document discusses dysphagia (difficulty swallowing) including its anatomy, physiology, causes, investigation, and management. It covers the anatomy of the oropharynx and hypopharynx. The physiology section describes the three phases of swallowing - oral, pharyngeal, and esophageal. Common causes of dysphagia include presbyphagia, laryngopharyngeal reflux, xerostomia, tonsillitis, epiglottitis, oropharyngeal/hypopharyngeal malignancies, and pharyngeal pouches. Investigations include endoscopy, barium swallow, and manometry. Management is tailored based on the cause and resource availability,
This document discusses the approach to dysphagia, or difficulty swallowing. It defines oropharyngeal dysphagia as problems transporting food through the mouth and throat, and oesophageal dysphagia as food getting stuck in the lower throat, neck or chest. Various causes of dysphagia are outlined, including neurological diseases, external compression, motility disorders, and structural issues. A thorough history, examination, and investigations are recommended to determine the underlying cause. Treatment depends on the specific cause, but may include dilation, surgery, medications, or other approaches.
Dysphagia is a common symptom that requires early evaluation to determine if it is caused by issues in the oropharynx or esophagus. A thorough history and physical exam can identify 80-85% of causes, while tests like modified barium swallow, endoscopy, and manometry provide further information. Treatment depends on the underlying problem, such as dilation for strictures, surgery for obstructions, or lifestyle/medication changes for conditions like GERD. Early diagnosis and treatment can help address dysphagia's underlying cause.
The document discusses the approach to dysphagia. It begins by defining dysphagia as difficulty swallowing and odynophagia as swallowing causing pain. It then summarizes the stages of swallowing and lists various causes of dysphagia in the oral, pharyngeal, and esophageal phases. These include neurological, inflammatory, traumatic, neoplastic, and motility disorders. The document stresses the importance of a thorough history to determine the site and nature of swallowing problems to guide further diagnostic testing such as endoscopy or barium swallow.
The document provides information on various causes of dysphagia (difficulty swallowing). It discusses reflux esophagitis, the most common cause, describing symptoms like heartburn relieved by antacids. It also covers benign esophageal stricture, usually due to reflux, presenting with slowly progressive dysphagia. Achalasia is described as lack of LES relaxation, causing longstanding dysphagia and vomiting of stale food. Treatment options like pneumatic dilation are mentioned. Finally, it provides a clinical scenario of a patient with symptoms suggestive of reflux esophagitis.
This document discusses dysphagia (difficulty swallowing) in pseudobulbar palsy. It begins by defining bulbar palsy and pseudobulbar palsy, noting that bulbar palsy involves lower motor neuron lesions affecting bulbar muscles, while pseudobulbar palsy involves upper motor neuron lesions. It then describes the anatomy and physiology of swallowing, including the four phases. It discusses the causes, signs, and treatments of dysphagia. Key assessment tools mentioned include a video swallow study and 3-ounce water swallow test. The document provides an overview of dysphagia for health professionals.
This document discusses the examination of a case of dysphagia. It covers taking a thorough history, including details on age, sex, symptoms, and past medical history. A physical examination focuses on the mouth, neck, chest, abdomen, and spine. Special investigations like barium swallow, endoscopy, and manometry help identify potential causes, which can include issues in the mouth, pharynx, or esophagus, such as tumors, strictures, or hiatal hernias. Differential diagnosis considers various conditions that may be causing the dysphagia.
This document discusses dysphagia, or difficulty swallowing. It begins by defining dysphagia and explaining that it can be caused by issues in the oral, pharyngeal, or esophageal areas, and can be due to mechanical or motility problems. The document then covers taking a thorough history from patients, performing an examination looking for signs of illness, and common tests used to evaluate dysphagia like blood tests, imaging, and endoscopy. Finally, it lists several potential causes of dysphagia in the differential diagnosis, including mechanical blockages or obstructions in the lumen or wall, external pressure, motility disorders, and other issues like inflammation.
A C S0103 Perioperative Considerations For Anesthesiamedbookonline
This document discusses perioperative considerations for anesthesia. It notes advancements in modern surgical care and alterations in anesthetic management to maximize patient benefit. A preoperative evaluation is important to assess medical history and current medications. Certain medications may need to be adjusted or discontinued before surgery, such as MAOIs, oral anticoagulants, and some herbal supplements, to reduce risks of adverse reactions or bleeding complications during the procedure. The risks and options for anesthesia should be discussed with the patient.
Introdução aos escritos de Francisco de Assis. Extraído de http://www.estef.edu.br/arno/wp-content/uploads/2011/07/Escritos-o-caminho-at%C3%A9-Francisco.pdf acesso em 22 jul. 2011.
Dysphagia refers to difficulty swallowing that can interfere with a patient's ability to eat and carry risks. It has many potential causes, including neurological conditions like stroke, muscular disorders, structural issues, infections, cancers and iatrogenic factors. A thorough history and examination aims to determine if the dysphagia is oropharyngeal or esophageal in nature, and its characteristics may provide clues to structural vs motility etiologies. Careful documentation of symptom onset, progression, relieving/exacerbating factors is important for diagnosis.
Neurogenic dysphagia is difficulty swallowing that develops in approximately 400,000 to 800,000 people per year due to neurological disorders or injuries. Dysphagia can be serious as it increases the risks of pneumonia, malnutrition, dehydration, and airway obstruction. The physiology of swallowing involves voluntary and reflex oral, pharyngeal, and esophageal phases. Central control of swallowing occurs in brainstem structures while cortical regions help with preparation and modulation. Common neurogenic causes of dysphagia include strokes and other brain injuries, motor neuron diseases like ALS, and inflammatory myopathies. Evaluation involves medical history, physical exam of swallowing functions, and sometimes imaging tests. Treatment depends on
Dysphagia, or difficulty swallowing, is common in the elderly due to aging changes and comorbidities. The prevalence of dysphagia increases from 15% in community settings to 40-68% in institutional settings. Diagnosis involves a medical history, physical exam, and may include videofluoroscopy or fiberoptic endoscopic evaluation of swallowing. Management is complex in geriatric patients and involves a multidisciplinary team utilizing compensatory techniques like diet modifications, swallowing maneuvers, and rehabilitation exercises. Palliative care aims to relieve suffering and improve quality of life through communication, symptom control, and psychosocial-spiritual support for patients and their families.
approach to Disphagia for medical studentsYahyia Al-abri
The document discusses dysphagia (difficulty swallowing) including the anatomy of the pharynx, phases of swallowing, types of dysphagia, causes, diagnosis, and treatment. It describes oropharyngeal dysphagia involving problems initiating a swallow versus esophageal dysphagia where food feels stuck after swallowing. Causes include mechanical obstruction from rings/webs, peptic strictures, cancer, and neuromuscular disorders like esophageal spasm, scleroderma, and achalasia. Evaluation involves history, examination, endoscopy, barium swallow, and manometry. Treatment depends on the underlying cause but may include dilation, acid suppression, botulinum toxin injections,
Evaluation of a patient with dysphagia: Difficulty in Swallowing.
Esophageal and Pre-esophageal causes.
-Abhinav Kumar, Kasturba Medical College, Mangalore
Prepared from book: "Diseases of Ear, Nose and Throat
Textbook by P. L. Dhingra" 6th Edition
https://books.google.co.in/books?id=0ByMBgAAQBAJ&lpg=PP1&pg=PA347#v=onepage&q&f=false
This document discusses the importance of taking a thorough history when evaluating a patient for dysphagia. It notes that history can help establish if dysphagia is present and determine the anatomical site and likely cause in 80% of cases. Specifically, the temporal factors and associated symptoms provide useful diagnostic clues. For example, a sudden onset of oropharyngeal dysphagia may indicate a stroke, while a gradual onset with heartburn could suggest a peptic stricture. A thorough history is essential to distinguish structural abnormalities from motor disorders and identify underlying conditions like Parkinson's disease.
This document outlines various disorders that can affect the preoesophageal, oral, and pharyngeal phases of swallowing, as well as the lumen, wall, and outside of the esophagus. It discusses diagnostic tests and investigations for esophageal disorders, including blood tests, radiography, manometry and pH studies, and oesophagoscopy. Manometry and pH studies help evaluate motility disorders, gastroesophageal reflux, and determine if esophageal spasms are spontaneous or acid-induced.
Dysphagia, or difficulty swallowing, can result from problems in the oral, pharyngeal, or esophageal stages of swallowing. The document discusses the physiology of swallowing and various neurological, muscular, and structural causes of dysphagia including strokes, Parkinson's disease, ALS, myasthenia gravis, and eosinophilic esophagitis. Treatment depends on the underlying cause but may include postural changes, diet modifications, feeding tubes, and treating any primary neurological or muscular disorders. Complications of untreated dysphagia include malnutrition, dehydration, aspiration pneumonia, and asphyxiation.
What is a dysphagia? What are the latest trends to deal with the case who has presented to you? This "Seminar Presentation" list some of the latest American College of Surgery guidelines, regarding the management of a case of dysphagia
Dysphagia (Surgery) - causes, Types and ApproachKabilan Selvan
This document provides information on dysphagia (difficulty swallowing). It discusses the anatomy and physiology of swallowing, types of dysphagia based on location and cause, common causes of oropharyngeal and esophageal dysphagia such as neurological conditions, tumors, and achalasia. The approach to a patient with dysphagia involves taking a thorough history, examination, and investigations like barium swallow, endoscopy, and manometry. Treatment depends on the underlying cause, and may include procedures like dilatation for strictures or myotomy for achalasia.
This document discusses non-malignant causes of dysphagia. It begins with anatomy of the oropharynx and esophagus, followed by causes of oropharyngeal and esophageal dysphagia including neurological, muscular, motility and structural issues. Specific motility disorders like achalasia, diffuse esophageal spasm and ineffective esophageal motility are explained. Other esophageal pathologies discussed include strictures, rings, webs, gastroesophageal reflux disease, Barrett's esophagus, diverticula and infectious esophagitis. Investigations and management of various conditions causing non-malignant dysphagia are summarized.
Group 4 dysphagia 2016 version 3.1 validatedDennis Lee
This document discusses dysphagia (difficulty swallowing) including its anatomy, physiology, causes, investigation, and management. It covers the anatomy of the oropharynx and hypopharynx. The physiology section describes the three phases of swallowing - oral, pharyngeal, and esophageal. Common causes of dysphagia include presbyphagia, laryngopharyngeal reflux, xerostomia, tonsillitis, epiglottitis, oropharyngeal/hypopharyngeal malignancies, and pharyngeal pouches. Investigations include endoscopy, barium swallow, and manometry. Management is tailored based on the cause and resource availability,
This document discusses the approach to dysphagia, or difficulty swallowing. It defines oropharyngeal dysphagia as problems transporting food through the mouth and throat, and oesophageal dysphagia as food getting stuck in the lower throat, neck or chest. Various causes of dysphagia are outlined, including neurological diseases, external compression, motility disorders, and structural issues. A thorough history, examination, and investigations are recommended to determine the underlying cause. Treatment depends on the specific cause, but may include dilation, surgery, medications, or other approaches.
Dysphagia is a common symptom that requires early evaluation to determine if it is caused by issues in the oropharynx or esophagus. A thorough history and physical exam can identify 80-85% of causes, while tests like modified barium swallow, endoscopy, and manometry provide further information. Treatment depends on the underlying problem, such as dilation for strictures, surgery for obstructions, or lifestyle/medication changes for conditions like GERD. Early diagnosis and treatment can help address dysphagia's underlying cause.
The document discusses the approach to dysphagia. It begins by defining dysphagia as difficulty swallowing and odynophagia as swallowing causing pain. It then summarizes the stages of swallowing and lists various causes of dysphagia in the oral, pharyngeal, and esophageal phases. These include neurological, inflammatory, traumatic, neoplastic, and motility disorders. The document stresses the importance of a thorough history to determine the site and nature of swallowing problems to guide further diagnostic testing such as endoscopy or barium swallow.
The document provides information on various causes of dysphagia (difficulty swallowing). It discusses reflux esophagitis, the most common cause, describing symptoms like heartburn relieved by antacids. It also covers benign esophageal stricture, usually due to reflux, presenting with slowly progressive dysphagia. Achalasia is described as lack of LES relaxation, causing longstanding dysphagia and vomiting of stale food. Treatment options like pneumatic dilation are mentioned. Finally, it provides a clinical scenario of a patient with symptoms suggestive of reflux esophagitis.
This document discusses dysphagia (difficulty swallowing) in pseudobulbar palsy. It begins by defining bulbar palsy and pseudobulbar palsy, noting that bulbar palsy involves lower motor neuron lesions affecting bulbar muscles, while pseudobulbar palsy involves upper motor neuron lesions. It then describes the anatomy and physiology of swallowing, including the four phases. It discusses the causes, signs, and treatments of dysphagia. Key assessment tools mentioned include a video swallow study and 3-ounce water swallow test. The document provides an overview of dysphagia for health professionals.
This document discusses the examination of a case of dysphagia. It covers taking a thorough history, including details on age, sex, symptoms, and past medical history. A physical examination focuses on the mouth, neck, chest, abdomen, and spine. Special investigations like barium swallow, endoscopy, and manometry help identify potential causes, which can include issues in the mouth, pharynx, or esophagus, such as tumors, strictures, or hiatal hernias. Differential diagnosis considers various conditions that may be causing the dysphagia.
This document discusses dysphagia, or difficulty swallowing. It begins by defining dysphagia and explaining that it can be caused by issues in the oral, pharyngeal, or esophageal areas, and can be due to mechanical or motility problems. The document then covers taking a thorough history from patients, performing an examination looking for signs of illness, and common tests used to evaluate dysphagia like blood tests, imaging, and endoscopy. Finally, it lists several potential causes of dysphagia in the differential diagnosis, including mechanical blockages or obstructions in the lumen or wall, external pressure, motility disorders, and other issues like inflammation.
A C S0103 Perioperative Considerations For Anesthesiamedbookonline
This document discusses perioperative considerations for anesthesia. It notes advancements in modern surgical care and alterations in anesthetic management to maximize patient benefit. A preoperative evaluation is important to assess medical history and current medications. Certain medications may need to be adjusted or discontinued before surgery, such as MAOIs, oral anticoagulants, and some herbal supplements, to reduce risks of adverse reactions or bleeding complications during the procedure. The risks and options for anesthesia should be discussed with the patient.
Introdução aos escritos de Francisco de Assis. Extraído de http://www.estef.edu.br/arno/wp-content/uploads/2011/07/Escritos-o-caminho-at%C3%A9-Francisco.pdf acesso em 22 jul. 2011.
Este documento proporciona instrucciones para configurar Exchange 2010 con Thunderbird y DavMail. Explica cómo configurar los parámetros de DavMail, incluidas las opciones de correo electrónico, calendario, libreta de direcciones y registro. También describe cómo configurar Thunderbird para usar IMAP, SMTP, CalDAV y LDAP a través de DavMail para acceder a Exchange.
El documento es una invitación a un bautizo el 13 de diciembre de 6-9pm en 345 3rd Street, Red Suite en Altington, Washington. Se solicita confirmar la asistencia antes del 23 de noviembre contactando a Stephanie Bourne por correo electrónico o teléfono.
The document discusses how life has become more dependent on internet-connected devices and online services. It introduces Onubha as a communications gateway that can manage internet traffic, content delivery, security, and infrastructure resources. Onubha's components include a deep packet analyzer, bandwidth controller, firewall, SMS and voice capabilities. It aims to help organizations navigate the changing context of digital communications.
Información sobre los proyectos de introducción de alimentos agroecológicos en comedores escolares en las Islas Canarias, relacionados con el III Seminario de Experiencias en Circuitos Cortos de Comercialización organizado por Ecologistas en Acción en octubre de 2014 en Rivas Vaciamadrid (Madrid)
El documento habla sobre la música y cómo puede transmitir emociones y sentimientos. Invita al lector a compartir la presentación con amigos si les gustó y también ofrece la opción de suscribirse a un boletín para recibir más presentaciones de forma gratuita por correo electrónico.
The document provides information about Bhartiya Pashupalan Nigam Limited (BPNL), an organization established by the Government of India to promote commercialization of traditional animal husbandry. [BPNL] aims to set up Pashu Seva Kendras (PSKs) or Animal Service Centers across villages in India to provide livestock farmers training, quality inputs, and healthcare services. PSK managers will play a key role in operating the centers, creating awareness about modern practices, and ensuring access to inputs for farmers. The application form seeks details from interested individuals to set up and manage PSKs to achieve BPNL's goals.
Mibelle AG Bioquímica tiene el producto "Extract 800B323.I" que podría tener un efecto en la vida útil de los folículos pilosos humanos.
BIOalternatives llevaron a cabo un ensayo experimental con el fin de estudiar los efectos de supervivencia de pelo utilizando folículos pilosos humanos obtenidos por microdisección a partir de fragmentos de piel humana (lifting facial). la viabilidad, la longitud y la morfología de la raíz del pelo se analizaron en diversos momentos.
The National Library of the Republic of Moldova is the main state library located in Chisinau. It was established in 1832 and has grown to house over 2.5 million documents in 30 languages. The library acquires about 13-15 thousand new items annually through legal deposit requirements. It provides services to over 13,000 users each year and its collections can be accessed onsite, through interlibrary loans, or personal subscriptions. The library also publishes around 20 titles annually and works to standardize and support the library system across Moldova.
IMPLEMENTACIÓN DE DOS BIOMARCADORES PARA LA DETERMINACIÓN DE ACTIVIDAD APOPTÓ...utplcbcm1
La apoptosis es una muerte genéticamente controlada, que se activa para eliminar células embrionarias y enfermas, permitiendo el desarrollo y el buen funcionamiento del organismo sin afectar a las células normales. Debido a ello, este tipo de muerte se ha convertido en una de las mejores alternativas para el desarrollo de nuevos antineoplásicos capaces de activar esta vía de muerte, con el objetivo de evitar respuestas desfavorables en los pacientes que generalmente se desarrollan con la quimioterapia. Las técnicas que permiten determinar apoptosis han evolucionado a través de los años desde que Kerr, mediante el microscopio electrónico descubrió este modelo de muerte celular. En el CBCM de la UTPL, se han implementado dos de estas técnicas con la ayuda de los biomarcadores Caspasa 3 y Anexina V, permitiendo la determinación de la activación de caspasas y la externalización de la Fosfatidilserina respectivamente; eventos característicos que ocurre solo en condiciones apoptóticas. Para ello se empleó el modelo biológico RKO y el antineoplásico Doxorrubicina como agente inductor.
Palabras Clave: Apoptosis, Biomarcador, Anexina V, Caspasa 3.
Bomberos luchan contra el reloj para salvar a mineros atrapados en chileLeo Hormazabal
Bomberos y rescatistas luchan por salvar a 34 mineros atrapados en una mina en Chile. Los mineros disponen de oxígeno para 72 horas si lograron acceder a un refugio. Las familias esperan ansiosas noticias mientras el presidente Piñera señala que harán todo lo posible para rescatarlos.
Día Mundial de Oración 26 de Abril del 2016, te presentamos a parte de los Coordinadores/Staff a tiempo completo de Cru en Latinoamérica y El Caribe, toma un tiempo para agradecer a Dios y orar por cada una de las peticiones
El documento resume la disponibilidad y uso del agua potable en el mundo. Solo un 3% del agua total es potable y aproximadamente 1.8 millones de personas mueren cada año debido a enfermedades relacionadas con la falta de acceso a agua limpia. El documento también proporciona estadísticas sobre el consumo medio de agua potable para usos como duchas, lavado de manos y lavado de ropa.
El documento sugiere que cuando las personas envían mensajes y chistes a sus amigos en lugar de cartas más personales, no es porque no les importen, sino porque a veces no tienen mucho tiempo pero aún quieren mantener el contacto. Enviar mensajes breves es una forma rápida de demostrar que aún se preocupan por la otra persona y que siguen siendo importantes para ellos.
El transistor de Unijuntión (UJT) se utiliza como generador de pulsos de disparo para SCR y TRIACs. Consta de dos cristales semiconductoras unidos por una zona P-N. Funciona disparándose cuando la tensión en el emisor supera la tensión intrínseca, lo que reduce la resistencia entre las bases y genera un pulso. Esto permite usar el UJT para generar pulsos en diente de sierra que controlen la velocidad de motores u otros dispositivos de potencia.
SIDO is the nodal development agency for small and medium enterprises in India, established in 1954 under the Ministry of Small Scale Industries. It operates through 30 Small Industries Service Institutes across the country. SIDO provides services like training, technology development, product testing, and consultancy to help small businesses grow. It has developed expertise in several industrial technologies like tool manufacturing, robotics, and electronics. SIDO also offers international consultancy and has helped set up tool rooms in other countries.
This document provides information about open esophageal surgical procedures, including cricopharyngeal myotomy and excision of Zenker's diverticulum. It describes the preoperative evaluation and optimization of patients, including imaging, endoscopy, and nutritional support. The surgical technique is explained in 4 steps: 1) incision and dissection of the pharyngeal pouch, 2) myotomy of the cricopharyngeus muscle and esophagus, 3) freeing or excising the diverticulum using a stapler, and 4) drainage/closure. Postoperative care involves monitoring for complications such as recurrent laryngeal nerve injury, fistula, hematoma, and infection.
Dysphagia is an important problem in surgical patients. I have discussed Introduction, Zenker's diverticulum, GERD, Achalasia Cardia and Carcinoma Esophagus. If you watch all these videos together, i assure you that you will become confident in managing a case of dysphagia.
This document provides an overview of dysphagia (difficulty swallowing). It defines dysphagia and discusses its two main types: oropharyngeal dysphagia, which involves difficulty initiating swallowing, and esophageal dysphagia, which involves food feeling hindered in the esophagus. Common causes, diagnostic tools, and treatment options are described for both types. The gold standard tests are videofluoroscopic swallowing study for oropharyngeal dysphagia and endoscopy for esophageal dysphagia. Treatments include diet modification, swallowing therapy, and surgery in some cases.
Hirschsprung's diseasedelayed pssage of meconium ,abdominal distension , repe...FarsanaM
Hirschsprungs disease, I n newborn ; delayed pssage of meconium ,abdominal distension , repeated vomiting,constipation or gas, diarrhoea,in older children chronic constipation, abdominal distension, failure to thrive, also called as Aganglionic megacolon occures due to absence of ganglion cells in myeneteric and submucosal lpexus.Results in failure in relaxation of the internal anus sphincture and affected bowel
Dysphagia, or difficulty swallowing, can be caused by issues with the esophagus. The document discusses several diseases and conditions that cause dysphagia by obstructing the esophagus, including achalasia, esophageal cancer, and reflux esophagitis. It provides details on symptoms, diagnostics, and treatment for each condition. Esophageal spasms, tumors, diverticula, strictures, and foreign bodies can also obstruct the esophagus and cause dysphagia. The document examines each of these conditions and how they impact swallowing.
This document discusses a 67-year-old man who presented with dysphagia for 9 months. Examination and labs were normal. A gastroscopy revealed an epiphrenic diverticulum of the esophagus. Epiphrenic diverticula are usually caused by motility disorders like achalasia. Surgical resection with myotomy has been the standard treatment but minimally invasive approaches are now preferred. For this patient, given his age and medical history, repeated pneumatic dilatation provided effective symptom relief without risks of surgery.
Zenker diverticulum is the most common type of esophageal diverticulum, located in the pharyngoesophageal area. It is caused by a dysfunctional sphincter that increases pressure and forces the mucosa and submucosa to herniate through the esophageal musculature. Symptoms include dysphagia, fullness in the neck, belching, and regurgitation of undigested food. Diagnosis is typically made through barium swallow or endoscopy, and surgical diverticulectomy is the primary treatment to remove the diverticulum.
GIT 4th indication for upper GI endoscopy.Shaikhani.
Upper gastrointestinal endoscopy has diagnostic, therapeutic, and screening indications. Diagnostically, it is used to detect diseases causing dyspepsia like gastric cancer, investigate upper GI bleeding, diagnose dysphagia, remove foreign bodies, assess GERD, detect esophageal varices, and diagnose celiac disease. Therapeutically, it treats upper GI bleeding, removes foreign bodies, dilates strictures, treats achalasia, places stents, treats GERD, eradicates Barrett's esophagus, inserts feeding tubes, and performs bariatric procedures. Screening indications include detecting Barrett's esophagus, portal hypertension, and cancers of the esophagus and stomach in high-risk patients
GERD ~It is most common common benign conditions of stomach and esophagusJayaPrakash78548
GERD ~Gastroesophageal reflux (GER) occurs when intragastric pressure is greater than the high-pressure zone of the distal esophagus. This can develop under two conditions
1.)the LES resting pressure is too low (i.e., hypotensive LES).
2.the LES with normal resting pressure inappropriately relaxes in the absence of peristaltic contraction of the esophagus (i.e., spontaneous LES relaxation)
~ Not all GER is pathologic—in fact, it is a normal physiologic process that occurs even in the setting of a normal LES.
~Heartburn, regurgitation, and water brash are the three typical esophageal symptoms of GERD.
~Heartburn and regurgitation are the most common presenting symptoms. Heartburn is specific to GERD and described as an epigastric or retrosternal caustic or stinging sensation.
~it does not radiate to the back and is not described as a pressure sensation
~ Regurgitation of gastric contents to the oropharynx and mouth can produce a sour taste that patients will describe as either acid or bile. This phenomenon is referred to as water brash.
•Esophageal impedance monitoring identifies episodes of nonacid reflux
•Impedance catheters use electrodes placed at 1-cm intervals to detect changes in the resistance to flow of an electrical current (i.e., impedance)
•Impedance increases in the presence of air and decreases in the presence of a liquid bolus
•pH-impedance catheters can determine the direction of movement of esophageal acid exposures
~frequent drinking of water
~posture of sitting lean forward with their lungs inflated to vital capacity
~ This maneuver flattens the diaphragm, narrows the anteroposterior diameter of the hiatus, and increases the LES pressure to counteract GER.
~yellowing of teeth
~injected oropharyngeal mucosa
Both peptic strictures and LA class C and D esophagitis can be considered pathognomonic for GERD
patients found to have LA class A and B esophagitis should undergo pH testing to confirm abnormal distal esophageal acid exposure.
Endoscopic evaluation should also include an assessment of the GEJ flap valve
In hiatus hernia craniocaudal and lateral dimensions are measured
•immediate side effects of ppi are rare but long term usage causes side effects
•long term side effects of ppi are
1)loss of bone density
2)risk of fracture, dementia, myocardial infarction
3)micronutrient (magnesium, iron, B-12) deficiencies
4)Clostridioides difficile infection
5)kidney disease
• judicious prescription of PPIs for well-established indications is prudent.
•operative technique (LARS)
1)short gastric vessel ligation and mobilisation of gastric fundus
2)left crus dissection by incision at phrenoesophageal ligament
3)right crura dissection
4) The esophagus is mobilized in the posterior mediastinum to obtain a minimum of 3 cm of intra abdominal esophagus
5)fundoplocation is done
If an anterior fundoplication is to be performed (e.g., Thal or Dor), there is no need to disea
This summary provides the key details from the document in 3 sentences or less:
Laparoscopic Nissen fundoplication is described as a minimally invasive procedure for gastroesophageal reflux disease. It involves placing 5 trocar ports for instruments and a camera, dissecting the gastrohepatic ligament, wrapping the fundus of the stomach around the lower esophagus, and suturing it in place to create an anti-reflux valve. Proper trocar placement is emphasized to allow adequate exposure and retraction of tissues while avoiding injury to nearby structures like blood vessels.
1. Radiation therapy for head and neck cancer can cause dysphagia both during and after treatment through damage to the muscles, nerves, and soft tissues involved in swallowing. During treatment, inflammation and edema can cause pain and difficulty swallowing food.
2. After treatment, fibrosis of the soft tissues is the main cause of long-term dysphagia. Excess transforming growth factor beta activates connective tissue growth factor, which causes unchecked scar tissue formation instead of normal wound healing. This results in stiff, non-functional tissues.
3. Symptoms of radiation-induced dysphagia include pain with swallowing, inability to swallow, coughing or choking during meals, weight loss,
The esophagus connects the hypopharynx to the stomach and functions to transport food and fluid. Gastroesophageal reflux occurs when stomach contents reflux into the esophagus. This can be caused by increased stomach pressure or decreased lower esophageal sphincter tone. Chronic reflux can lead to esophagitis and complications like strictures or Barrett's esophagus. Diagnostic tests include endoscopy, pH monitoring, and manometry. Treatment involves lifestyle modifications and medications to reduce acid production like PPIs.
This document provides an overview of the esophagus, including its anatomy, physiology, common diseases, and diagnostic testing. Key points include:
- The esophagus connects the pharynx to the stomach and propels food through peristaltic contractions. It has three sections - cervical, thoracic, abdominal.
- Gastroesophageal reflux disease is common, caused by backflow of gastric acid into the esophagus. Risk factors include obesity, smoking, diet.
- Esophageal tears can range from superficial mucosal tears to full perforations, which require urgent treatment due to risk of mediastinitis and sepsis.
- Diagnostic tests include barium swallow,
Foreignbodies and chemical burns of the esophagus.pptxRamya569989
This document discusses foreign bodies and chemical burns of the esophagus. It outlines the signs and symptoms, which include pain, dysphagia, and dyspnea. Diagnostic findings may include identifying the foreign body on x-ray. Treatment involves endoscopy and removal devices. Bougienage procedures use dilators to facilitate passage. Chemical burns are often caused by swallowing acids or bases and result in inflammation that can cause strictures requiring dilation or even esophagectomy and colon interposition.
This document provides an overview of dysphagia (difficulty swallowing) including the anatomy, physiology of swallowing, types, causes, and approach to dysphagia. It discusses the physiology of deglutition controlled by the parasympathetic and sympathetic nervous systems. It describes the different phases of swallowing. There are two main types of dysphagia - oropharyngeal and esophageal. Oropharyngeal dysphagia can be caused by structural issues, problems with propulsion, or neurogenic/myogenic issues. Esophageal dysphagia can be caused by extra luminal issues, problems in the esophageal wall, or issues in the esophageal lumen. The document outlines the approach
The document discusses hiatal hernia, which occurs when part of the stomach bulges through an opening in the diaphragm. It outlines the causes, symptoms, diagnosis through imaging and endoscopy, differential diagnosis, and treatment options including medication, surgery to repair the diaphragm and prevent reflux, and post-operative care. The prognosis is generally good if the hernia is repaired and complications like aspiration pneumonia are managed.
This document discusses intestinal obstruction, including:
1) Intestinal obstruction occurs when air and secretions cannot pass through the intestines due to mechanical compression or gastrointestinal paralysis.
2) Clinical evaluation of a patient with suspected intestinal obstruction involves assessing their history of present illness, previous surgeries or illnesses, and performing a physical exam.
3) Key physical exam findings that suggest intestinal obstruction include abdominal pain, distention, nausea, vomiting, and failure to pass gas. The pattern and severity of pain can provide clues to the level and type of obstruction.
This case presentation describes a patient with a long history of regurgitation and dysphagia who was ultimately diagnosed with achalasia and an associated epiphrenic diverticulum. The patient underwent surgery involving mobilization and resection of the diverticulum followed by an esophageal myotomy and Dor fundoplication. Post-operatively, the patient's symptoms resolved and he was discharged after a few days on a soft diet.
Acs0522 procedures for benign and malignant biliary tract disease-2005medbookonline
This document discusses procedures for benign and malignant biliary tract diseases. It provides guidance on preoperative evaluation and management of biliary obstruction. Specific considerations are given to infection, renal dysfunction, impaired immunity, malnutrition, and coagulation issues. The document outlines operative planning details such as patient positioning, exposure techniques, and guidelines for biliary anastomoses including suture placement and techniques for difficult access situations.
This document discusses the anatomy and surgical procedure of splenectomy. It describes:
- The spleen's highly variable arterial blood supply, which can take bundled or distributed patterns. This variability impacts the difficulty of surgery.
- The splenic artery typically branches off the celiac axis but can originate from other nearby arteries in rare cases.
- Additional branches of the splenic artery before it enters the spleen, including short gastric and pancreatic arteries.
- A history of splenectomy beginning in the 16th century and its increasing use through the 20th century for trauma and hematologic disorders.
- The development of laparoscopic splenectomy in the early 1990s and ongoing refinement of minim
Gastrostomy is commonly used as a temporary procedure to avoid discomfort from prolonged nasogastric suction after major abdominal surgery. It can also be used permanently when the esophagus is obstructed to nonresectable cancer. The Stamm gastrostomy is most common temporary procedure where a catheter is placed through the stomach wall and anchored to the skin. The Janeway gastrostomy is a permanent alternative where a flap of stomach is brought through the abdominal wall and attached to form a mucosal lined tube to prevent regurgitation. Postoperative care involves gradual advancement to oral intake as the stomach heals and functions return to normal.
This document describes the Billroth I gastric resection procedure, which involves removing part of the stomach and reattaching it to the duodenum. Key steps include transecting the stomach, attaching it to the duodenum using a circular stapler, and closing the gastrotomy site. The procedure aims to control peptic ulcers by combining hemigastrectomy with vagotomy while restoring normal gastrointestinal continuity. Postoperative care focuses on gradual advancement of oral intake and monitoring for complications.
This document describes the Billroth I procedure for gastroduodenostomy. It involves extensive mobilization of the stomach and duodenum to allow for an end-to-end anastomosis between the stomach and duodenum, restoring normal continuity of the gastrointestinal tract. The stomach is divided and sutured closed, then sutured to the duodenum in layers to create the gastroduodenal connection. Postoperative care focuses on gradual advancement of diet and monitoring for gastric retention to support healing and prevent complications.
Gastrostomy is commonly used as a temporary procedure to avoid discomfort from prolonged nasogastric suction after major abdominal surgery. It can also be used permanently when the esophagus is obstructed to nonresectable cancer. The Stamm gastrostomy is most common temporary procedure where a catheter is placed through the stomach wall and anchored to prevent leakage. The Janeway gastrostomy is a permanent alternative where a flap of stomach is brought through the abdominal wall and lined with mucosa to form a permanent opening, preventing regurgitation. Postoperative care involves gradual advancement to oral intake as the stomach and bowel recover function.
Gastrojejunostomy is a surgical procedure that connects the stomach directly to the jejunum. It is indicated for patients with duodenal ulcers complicated by pyloric obstruction or nonresectable stomach or pancreatic cancers causing obstruction. The procedure involves opening the stomach and jejunum, suturing them together to form a stoma, then closing in multiple layers. Postoperatively, gastric emptying is monitored and diet advanced gradually to ensure proper healing.
This document provides guidance on treating a perforated ulcer or subphrenic abscess. It describes:
1) Preparing patients preoperatively by administering IV fluids/antibiotics and gastric suction.
2) Closing perforations by suturing the ulcer and reinforcing it with omentum, or sealing it if too indurated.
3) Draining subphrenic abscesses extraperitoneally by making incisions below the costal margin or through the 12th rib bed and inserting drains into the abscess cavity.
A C S0105 Postoperative Management Of The Hospitalized Patientmedbookonline
This document discusses postoperative management of surgical patients. It describes the different levels of postoperative care including same-day surgery, the surgical floor, telemetry ward, and intensive care unit. Factors determining a patient's disposition include their preoperative health, procedure performed, and postoperative clinical status. The document also discusses common postoperative orders related to tubes, drains, oxygen therapy, and wound care to guide nursing staff.
Postoperative pain is a complex experience involving sensory, emotional, and mental components. Effective pain management is important for patient comfort and recovery. Guidelines for postoperative pain treatment have been developed for specific procedures. Multimodal analgesic regimens targeting multiple pathways are recommended over reliance on opioids alone to prevent tolerance and hyperalgesia. Nonpharmacological complementary therapies can be combined with drug treatments to enhance pain control.
The document discusses the approach to a patient experiencing ongoing bleeding. It outlines the following key steps:
1. First consider the possibility of a technical cause like an unligated vessel and examine for injuries.
2. If no technical cause is found, check the patient's temperature and perform laboratory tests. Hypothermia can cause coagulopathy.
3. Evaluate test results along with the patient's history for clues to underlying causes like platelet dysfunction, coagulation factor deficiencies, or inherited bleeding disorders. Treat the specific condition while continuing evaluation.
A C S0812 Brain Failure And Brain Deathmedbookonline
This document discusses brain failure and brain death. It defines different levels of impaired consciousness from cloudy consciousness to coma. It describes how brain failure results from cardiac arrest and the challenges of restarting the brain after lack of oxygen. It outlines the criteria for diagnosing brain death, including absence of brain stem reflexes and apnea testing. It also discusses the evolution of determining death as technology has allowed life support to prolong vital signs indefinitely.
This document summarizes key points about surgical treatment of early rectal cancer and care of elderly surgical patients. It discusses that radical resection for early rectal cancer achieves excellent local control but has risks, while local excision may be preferable but has a higher local recurrence rate. Adjuvant therapy after local excision may help address this. It also notes that the elderly population is growing and physiologic changes with aging, like cardiac function decline, must be considered in surgical planning and risk assessment for elderly patients. Functional status is more important than age alone.
This document provides information on parotidectomy surgery and the Fundamentals of Laparoscopic Surgery (FLS) program.
It describes the technique for parotidectomy surgery, including identifying and dissecting around the facial nerve. It notes that most parotid tumors are benign and complications are usually temporary facial nerve paralysis.
It then discusses the development of the FLS program to standardize laparoscopic surgery training. The program includes cognitive training and manual skills assessment. Many residency programs and hospitals now require surgeons to complete the FLS. A large grant will help make the program more accessible to residency programs.
This document summarizes an article about volunteer surgeons providing care to wounded soldiers in Iraq and Afghanistan. It discusses the senior visiting surgeon program established by the American College of Surgeons that allows surgeons to volunteer their time. The volunteer rotation described involved caring for patients at Landstuhl Regional Medical Center in Germany as part of the complex medical evacuation process bringing wounded soldiers from war zones to the United States for further treatment and recovery.
1. The document discusses various sources of data for benchmarking surgical outcomes, including public reporting programs, public use administrative databases, and clinical registries. It notes limitations of using administrative data including problems with accuracy, completeness, and clinical precision of coding.
2. Clinical registries like the National Surgical Quality Improvement Program (NSQIP) and the Society of Thoracic Surgeons database are described as better sources of benchmarking data as they provide risk-adjusted outcomes while protecting individual hospital and surgeon confidentiality.
3. Limitations of all surgical benchmarking sources include small sample sizes, lack of generalizability between databases, and lack of external auditing to ensure accuracy and completeness of submitted data.
This document discusses organ procurement from cadaveric donors. It describes the coordination between donor and recipient activities, including matching organs to recipients based on factors like blood type, medical urgency, and waiting time. The evaluation of donor organs is outlined for different organs. Careful donor management aims to optimize organs while respecting donor dignity.
Hand-assisted laparoscopic surgery (HALS) is a hybrid technique that provides many of the advantages of traditional open surgery and laparoscopic colectomy. HALS employs a special access device that allows the surgeon to place a hand in the abdomen to assist with retraction, dissection, and visualization while maintaining pneumoperitoneum and laparoscopic instrumentation through trocars. Studies have shown HALS results in shorter operative times and lower conversion rates to open surgery compared to traditional laparoscopic colectomy while preserving similar short-term clinical outcomes. HALS may help expand the use of minimally invasive approaches for complex colectomies by providing an easier transition from open surgery than traditional laparoscopic techniques.
The document summarizes the evolution of trauma surgery training and practice in the United States. It discusses how trauma surgery originated in large city hospitals but has since expanded to regional trauma centers. It also notes changes in surgical training away from generalist models towards increased specialization. Trauma surgery is increasingly encompassing broader emergency general surgery duties due to workforce shortages, while training programs emphasize specialized rather than broad skills.
This document provides reference values for many common clinical chemistry analytes measured in various specimens like plasma, serum, urine, and whole blood. The analytes include metabolic panels, lipids, proteins, electrolytes, vitamins, and more. Reference ranges are given in conventional and SI units for each analyte. The purpose is to provide clinicians with the normal expected ranges to interpret laboratory results at the Massachusetts General Hospital.