This document discusses management of chest trauma. It covers common causes of chest injuries including gunshots, explosions, and crashes. It describes the organs in the chest cavity and how to assess a casualty for chest injuries by examining their breathing, neck, chest wall, and lung sounds. Open and tension pneumothoraces are discussed as well as how to perform a needle decompression in the field to relieve pressure in the chest from a tension pneumothorax. Proper management of chest wounds and decompression of tension pneumothoraces are essential for stabilizing chest trauma patients.
there is the introduction part of the torso trauma,
check out my next ppts for further more about torso trauma.
contents are in following order...
introduction
mechanism of injury
junctional zones of torso
tension pneumothorax
cardiac temponade
massive hemothorax
etc.
check out all slides
there is the introduction part of the torso trauma,
check out my next ppts for further more about torso trauma.
contents are in following order...
introduction
mechanism of injury
junctional zones of torso
tension pneumothorax
cardiac temponade
massive hemothorax
etc.
check out all slides
Shock is a life-threatening condition that occurs when the body is not getting enough blood flow. The Lack of blood flow means that the cells and organs do not get enough oxygen and nutrients to function properly. Multiple organs can suffer damage as a result
Understanding the 'Thoracic Outlet Syndrome' as per Ayurveda and its Ayurveda management. An effort by Department of Kayachikitsa, Government Akhandanand Ayurveda College, Bhadra, Ahmedabad, Gujarat, India.
Title: Sense of Taste
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 structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
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.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
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ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
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- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
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- Prix Galien International Awards Ceremony
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Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
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
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
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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.
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8. Determine the MOI
Penetrating trauma.
– GSW or stab wounds
– Concentrates forces over smaller area
– Bullet trajectories unpredictable
Blunt trauma.
– Force distributed over larger area
– Visceral injuries occur from:
• Deceleration
• Compression
• Sheering forces
• Bursting
CMAST 8
9. Assess the Casualty
Identify signs and symptoms:
– Assess mental status (AVPU)
– Assess the airway
– Assess the breathing
– Assess the circulation
CMAST 9
16. Assess the Chest Wall
Compare both
sides of the chest
at the same time
when assessing for
asymmetry.
CMAST 16
17. Chest Physiology
Chest normally has negative pressure.
Penetrating wound creates a positive
pressure in chest cavity.
Air will enter the easiest route. If a hole in
the chest is smaller than 2/3 the size of the
trachea, air will enter through the trachea
preferentially and not through the hole in
the chest.
CMAST 17
18. Open Pneumothorax
Caused by penetrating
thoracic injury.
May present as a
“sucking chest wound”
if > 2/3 diameter of the
trachea.
CMAST 18
22. Open Pneumothorax
Management:
– Ensure an open airway
– Close the chest wall defect, both entrance
and exit with an occlusive
dressing, petrolatum gauze or Asherman
Chest Seal®
– Place the casualty in the sitting position
– Monitor respirations after an occlusive
dressing is applied
CMAST 22
25. Tension Pneumothorax
One-way valve
created from
penetrating trauma.
Air enters thoracic
space
but cannot escape.
Pressure builds:
CMAST 25
26. Tension Pneumothorax
If after sealing the open pneumothorax, the
casualty develops progressive difficulty
breathing, consider this a tension pneumothorax
and perform a needle chest decompression.
If no capability of NCD exists and the casualty
continues to have progressive respiratory
distress, remove the occlusive dressing and
stick a gloved finger into the open wound and
attempt to “burp” the wound.
CMAST 26
27. Tension Pneumothorax
Air pushes over heart
and collapses lung
Air
outside
lung from
wound Heart compressed not able
to pump well
CMAST 27
28. Tension Pneumothorax
Clinical presentation:
– Anxiety, agitation, apprehension
– Diminished or absent breath sounds
– Increasing dyspnea with cyanosis
– Tachypnea
– Hyperresonance to percussion on affected
side
– Hypotension, cold clammy skin
– Casualty begins to deteriorate rapidly
CMAST 28
29. Tension Pneumothorax
Clinical presentation (cont’d):
– JVD and cyanosis
– Decreased lung compliance (intubated)
– Tracheal deviation (late)
* These signs are hard to detect in a combat
environment.
CMAST 29
30. Tension Pneumothorax
Management:
– Ensure an open airway
– Decompress the affected side
Indications:
– Penetrating chest wound with progressive
respiratory distress
CMAST 30
32. Needle Chest Decompression
Prep the area with an
antimicrobial agent.
Insert a 14 ga. Catheter at
a 90 angle over the top of
the 3rd rib, into the 2nd ICS
at the MCL.
Needle should be long
enough to enter the chest
cavity (2½ – 3 inches).
CMAST 32
33. Needle Chest Decompression
If a tension pneumothorax is
present, a “hiss of air” may be
heard escaping from the chest cavity.
Remove the needle, leave the catheter in place.
CMAST 33
34. Needle Chest Decompression
Tape the catheter hub to the chest wall.
The casualty's condition should rapidly
improve.
Evacuate ASAP.
CMAST 34
35. Needle Chest Decompression
Questions:
– Over top or bottom
of rib? Why?
– What if casualty doesn't have
a tension pneumothorax and you perform
NCD?
• Already has hole(s) in chest
• Probably larger than diameter of 14 ga. needle
• No additional damage
CMAST 35
36. Needle Chest Decompression
Questions:
– Will lung re-inflate after pressure is released
from chest cavity?
– No; to re-inflate the lung you must have a
chest tube with suction and or positive
pressure ventilation.
CMAST 36
37. Needle Chest Decompression
Questions:
– So if the NCD does not re-inflate the lung
what does it do?
– We are simply converting a tension
pneumothorax to a standard pneumothorax;
this is much more survivable than a tension
pneumothorax.
CMAST 37
38. Needle Chest Decompression
Complications:
– Insertion of the needle over the top of the rib
prevents laceration of the intercostal vessels
or nerve which can cause hemorrhage or
nerve damage.
CMAST 38
39. Summary
Injuries to the chest are fewer in nature
secondary to modern body armor;
however, it doesn't protect 100%.
Penetrating wounds to the chest can be
rapidly fatal if not identified early and
treated appropriately.
CMAST 39