An aortic aneurysm is a dilation of the aorta wall at a weak point. The most common type is abdominal aortic aneurysm, which affects older males. Risk factors include atherosclerosis and smoking. Small aneurysms are monitored while larger aneurysms require surgery to replace the damaged segment. Aortic dissection occurs when blood tears the inner aortic layers, creating a false passageway. It is a medical emergency often presenting with severe chest pain and requires treatment to reduce blood pressure and prevent rupture. Both conditions carry risk of fatal hemorrhage and require lifelong monitoring.
Congenital heart disease (congenital heart defect) is one or more abnormalities in your heart's structure that you're born with. This most common of birth defects can alter the way blood flows through your heart.
An aneurysm is an enlargement of the artery. it is divided into 3type according to action, more pathology, etc. the treatment of this is commonly surgery some of the procedures also help full for the aneurysm like shutting procedure. the prevention n of this is avoid smoking, exercise...
Congenital heart disease (congenital heart defect) is one or more abnormalities in your heart's structure that you're born with. This most common of birth defects can alter the way blood flows through your heart.
An aneurysm is an enlargement of the artery. it is divided into 3type according to action, more pathology, etc. the treatment of this is commonly surgery some of the procedures also help full for the aneurysm like shutting procedure. the prevention n of this is avoid smoking, exercise...
Carotid artery disease is commonly seen in association with atherosclerosis and complicate the situation. clearcut guidelines with necessary surgical details are provided in presentations.
An aneurysm is an abnormal widening or ballooning of an artery due to weakness in the wall of the blood vessel. Aneurysms are dangerous because they may burst, spilling blood in the area surrounding the blood vessel. The disease can occur in the aorta, in a blood vessel in the brain, or in a peripheral blood vessel.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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!
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
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
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
3. DEFINITION
• An aneurysm is a localized sac or dilation
formed at a weak point in the wall of the
aorta.
• Because of the high pressure in the arterial
system, aneurysms can enlarge, producing
complications by compressing surrounding
structures
5. • A fusiform aneurysm is a diffuse dilation that
involves the entire circumference of the arterial
seg-ment.
• A saccular aneurysm is a distinct, localized out-
pouching of the artery wall.
• A dissecting aneurysm is created when blood
sepa-rates the layers of an artery wall, forming a
cavity between them.
• A false aneurysm (pseudoaneurysm) occurs
when the clot and connective tissue are outside
the arterial.
8. INCICENCE
• 1. Approximately 36.5 abdominal aortic
aneurysms are diagnosed per 100,000 individuals.
• Abdominal aneurysms are most common in
individu-als older than 50 years of age.
• They are more common in men than women, with
ratios of 2:1.
• Three fourth of true aortic aneurysm occur in
abdomen and one fourth in the thoracic aorta
• The average mortality rate for persons undergoing
elective abdominal aneurysm repair is 4 to 5
percent.
9. • Rupture of abdominal aortic aneurysm is
the 15th most common cause of death for
men in the United States.
• Fifty percent of all persons whose
aneurysms rupture before they can be
transported into the operating
room will die.
• For persons who undergo emergency
surgical repair mortality rate is also high,
around 54 percent.
10. ETIOLOGY
• Atherosclerosis
• Uncontrolled hypertension
• inherited or congenital syndromes, such as Marfan
syndrome or Ehlers-Danlos syndrome.
• Infection
• Tobacco use
• Anastomotic (postarteriotomy) and graft
aneurysms
• Blunt or sharp trauma, including operative trauma,
can damage the aortic wall.
11. PATHOPHYSIOLOGY
• Most commonly, atherosclerotic plaque collects
on the intimal surface of the aorta.
↓
• This plaque formation will cause degenerative
changes in the media
↓
• The destruction of the medial layer of a segment
of the aorta leads to loss of elasticity, weakening
↓
• Dilation of the aorta
12. CLINICAL MANIFESTATION
THORACIC AORTIC ANEURYSMS
• Pulse and BP difference in upper extremities
• Pain and pressure symptoms
• Constant pain because of pressure
• Intermittent and neuralgic pain
• Dyspnea,
• Abnormal pulsation apparent on chest
13. CONTINUED……..
• Hoarseness, voice weakness, or complete
aphonia,
• Dysphagia
• Dilated superficial veins on chest
• Cyanosis
• Distended neck veins and edema of the head
and leg
• Decreased venous drainage
• Ipsilateral dilatation of pupils
14. ABDOMINAL ANEURYSM
• Asymptomatic
• Abdominal pain is most common, either
persistent or intermittent often localized
in middle or lower abdomen to the left of
midline
• Lower back pain
• Feeling of an abdominal pulsating mass
• Thrill, auscultated as a bruit
15. CONTINUED……
• Hypertension
• Distal variability of BP, pressure in arm greater
than thigh
• Thrombi may form and and then
embolize,traveling to other arteries and
causing ischemia to affected limb
• If rupture, will present with hypotension
and/or hypovolemic shock
20. PROGNOSIS
• With early diagnosis and treatment the
prognosis is good
• When the aneurysm ruptures survival rate
drops dramatically to below 50 percent
21. COLLABORATIVE CARE
• Early treatment and detection is
imperative
• If aneurysm is larger than 5-6cm or
increasing aneurysm by 0.5 cm over a six
month period surgical repair is the
treatment
• For individuals with small aneurysm less
than 4cm conservative therapy is initiated
• Coronary and carotid artery should be
assessed for atherosclerotic disease
23. OPEN SUGERY
1. Incising the diseased seg-ment of the aorta;
2. Removing intraluminal thrombus or plaque;
3. Inserting a synthetic graft (dacron or
polytetrafluoroethylene), which is sutured to the
normal aorta proximal and distal to the
aneurysm; and
4. Suturing the native aortic wall around the graft so
that it will act as a protective cover
• If the iliac arteries are also aneurysmal, the entire
diseased segment is replaced with a bifurcation
graft.
27. ENDOVASCULAR GRAFTING
• Endovascular grafting involves the
transluminal placement and attachment of a
sutureless aortic graft prosthesis across an
aneurysm
28. COMPLICATIONS OF ENDOVASCULAR
GRAFTING
• bleeding,
• hematoma,
• wound infection at the femoral insertion site;
• distal
• ischemia or embolization; dissection or
perforation of the aorta;
29. CONTINUED……….
• Graft thrombosis; graft infection; break
of the attachment system;
• Graft migration; proximal or distal graft
leaks; delayed rupture
• Bowel ischemia.
30. NURSING DIAGNOSIS
• Ineffective Tissue Perfusion related to
aneurysm or aneurysm rupture or dissection
• Risk for Infection related presence of
prosthetic vascular graft and invasive lines
• Acute Pain related to pressure of aneurysm
on nerves and postoperatively
•
31. PATIENT EDUCATION AND HEALTH
MAINTENANCE
• Instruct patient about medications to control
BP and the importance of taking them.
• Discuss disease process and signs and
symptoms of expanding aneurysm or
impending rupture,
• For postsurgical patients, discuss warning
signs of postoperative complications (fever,
inflammation of operative site, bleeding, and
swelling).
32. CONTINUED……..
• Encourage adequate balanced intake for wound
healing.
• Encourage patient to maintain an exercise schedule
postoperatively.
• Instruct patient that due to use of a prosthetic graft
to repair the aneurysm, he will require prophylactic
antibiotic use for invasive procedures, including
routine dental examinations and dental cleaning
33. EVALUATION: EXPECTED OUTCOMES
• TISSUE COLOR, SENSATION, AND
TEMPERATURE NORMAL; NONTENDER,
NONSWOLLEN, AND INTACT
• NO SIGNS OF INFECTION
• REPORTS CONTROL OF PAIN WITH
MEDICATION
36. DEFINITION
• Aortic dissection, occurring most
com-monly in the thoracic aorta, is the
result of a tear in the intimal (innermost
lining of the arterial wall) that allows
blood to enter between the intima and
media, thus creating a false lumen
37.
38.
39. CLASSIFICATION
Type A dissections
• Include types I and II of DeBakey's
classification
• Involve the ascending aorta or the ascending
and descending aorta
• Are the most common and lethal type
• Require immediate surgicaL treatment
40. CONTINUED……….
Type B dissections
• Do not involve the ascending aorta
• Begin distal to the subclavian artery and
extend downward into the descending and
abdominal aorta
• Are also known as type III of DeBakey's
classifi-cation
• often initially treated with medical therapy
41. INCIDENCE
• They are three times more common in men than in
women
• most commonly in the 50- to 70-year-old age group
• Approximately 60,000 cases are diagnosed each
year in the United States.
42. ETIOLOGY
• Marfan syndrome
• Congenital heart disease
• A history of hypertension
• Pregnancy
• Trauma
• Iatrogenic injuries
• Atherosclerosis
43. Continued…………
• A rupture may occur through adventitia or
into the lumen through the intima,
• Allows blood to reenter the main channel
• Resulting in chronic dissection or occlusion
of branches of the aorta.
• As the heart contracts, each systolic
pulsation causes increased pressure on the
damaged area, which further increases the
dissection
44. • The dissection of the aorta may progress
backward in the direction of the heart,
obstructing the openings to the coronary
arteries or producing hemopericardium
(effusion of blood into the pericardial sac) or
aortic insufficiency,
• it may extend in the opposite direction,
causing occlusion of the arteries supplying the
gastrointestinal tract, kidney, spinal cord, and
legs
45. • Sudden onset of pain that is described as severe and
tearing. The pain is typically associated with
diaphor-esis.
• The typical patient with acute aortic dissection usually
has sudden, severe pain in the anterior part of the
chest or intra scapular pain radiating down the spine
into the abdomen or legs
• Location of the pain depends on the site of the
dissec-tion.
• Typically, the pain is localized to either the front or the
back of the chest.
• The pain may migrate along the direction of the
dis-section.
46. • Cardiac tamponade
• Hypertension or hypotension
• Absence of peripheral pulses
• Aortic regurgitation from damage to the aortic
valve
• Pulmonary edema
• Neurologic findings are due to dissection of major
arteries.
• Carotid artery obstruction produces hemiplegia or
hemi anesthesia.
• Spinal cord ischemia can cause paraplegia.
• Compression of adjacent structures
47. DIAGNOSTIC EVALUATION
• Health history and physical examination
• ECG-Left hypertrophy
• Chest x-ray
• CT scan
• Transesophageal echocardiogram (TEE)- A
transesophageal echocardiogram (TEE) can
identify dissections that are closest to the aortic
root
• Angiogram
• Magnetic resonance imaging (MRI)
49. NURSING MANAGEMENT
• Bed rest
• Pain relief with narcotics Control of blood
pressure
• trimethaphan (Arfonad)
• sodium nitroprusside (Nipride) Control of
myocardial contractility
• propranolol (Inderal)
• labetalol (Normodyne) Aortic resection and
repair
50. Continued…
• Type A dissections usually are repaired
surgically
• Type B dissections often are managed
medically
51. SURGICAL TREATMENT
• Surgical treatment is indicated in several
circumstances:
• (1) location of dissection in ascending aorta,
• (2) development of ischemic complication,
• (3) poor response to medical management
with continued pain,
• (4) aneurysmal degeneration
• (5) in selected Stanford type B patients
53. NURSING MANAGEMENT
• Provide semi fowlers position-to maintain bp that
maintains vital organ perfusion
• Narcotics and tranquilezers should be administered
• Continous iv infusion of antihypertensive agents
• Should check for increasing pain, peripheral pulses
• The physician is also notified of persistent
coughing,sneezing, vomiting, or systolic blood pressure
above 180 mm Hg because of the increased risk for
hemorrhage
• Fluids are important to maintain blood flow through
the arterial repair site and to assist the kidneys with
excreting intravenous contrast agent and other
medications used during the procedure