This document provides guidance on properly conducting and interpreting chest x-rays for cardiovascular diseases. It outlines how to ensure ideal exposure, centering and labeling of x-rays. It describes how to evaluate lung fields, the cardiovascular silhouette and other structures. Specific abnormalities are also discussed like pulmonary edema, pulmonary hypertension and various congenital heart diseases. Proper technique is emphasized to obtain diagnostic quality images for cardiovascular assessment.
This presentation is almost a complete Pictoral view of Radiograph chest.
This presentation will help radiologist in daily reporting.
This presentation will help physicians, surgeons, anesthetist and almost all medical professionals in diagnosing commonly presenting cardiac diseases.
This will also help all in preparaing TOACS examination.
This presentation is almost a complete Pictoral view of Radiograph chest.
This presentation will help radiologist in daily reporting.
This presentation will help physicians, surgeons, anesthetist and almost all medical professionals in diagnosing commonly presenting cardiac diseases.
This will also help all in preparaing TOACS examination.
The condition of your lungs. Chest X-rays can detect cancer, infection or air collecting in the space around a lung (pneumothorax). They can also show chronic lung conditions, such as emphysema or cystic fibrosis, as well as complications related to these conditions. Heart-related lung problems.
The condition of your lungs. Chest X-rays can detect cancer, infection or air collecting in the space around a lung (pneumothorax). They can also show chronic lung conditions, such as emphysema or cystic fibrosis, as well as complications related to these conditions. Heart-related lung problems.
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!
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
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
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
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
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
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
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
3. Proper exposure
A well penetrated chest X-ray is one
where the vertebrae are just visible
behind the heart.
Over exposure- black lung field
clear vertebral bodies
Underexposure- hazy lung field
4. Proper centering
The clavicle should be at the same level
Clavicles should be equidistant from
the midline.
5. Proper labeling
The side determination
◦ Label L or R
◦ Apex of heart on left
◦ Fundal gas shadow on left
◦ Right dome of diaphragm placed higher
than left
◦ Aortic knuckle on left
*(NOT for dextrocardia with Situs inversus)
6. How to read a chest x-ray
View (PA, AP, lat)
Exposure
Centralization
Position of trachea
Skeletal structures
Lung fields including blood vessels and pleura
Cardiovascular silhouette
Costophrenic and cardiophrenic angles
Soft tissue abnormalities
Final diagnosis or conclusion
7. Describe a normal chest x-ray
This is a PA view of the chest with normal
exposure, proper centering and without any
apparent bony abnormality.
The lung fields are clear with normal
bronchovascular markings; cardiovascular
silhouette is within normal limit with normal
cardiothoracic ratio.
Mediastinum, costophrenic and
cardiophrenic angles, domes of the
diaphragm and soft tissue shows no
abnormality.
8. Skeletal structure abnormalities
Kyphosis, scoliosis
Crowding or widely spaced ribs
Absence of clavicle
Erosion of clavicle
Rib erosion
Rib notching
Presence of cervical rib
12. Lung field
Accentuated pulmonary arteries
Distension of pulmonary arteries
Accentuation of bronchial pattern
Prominent lymphatic vessels
Thickened alveolar septum
13. Hilar shadows
PA, PV, bronchi, lymph gland,
lymphatics, connective tissue.
The lung field is divided in three zones
◦ Upper, middle and lower
◦ Do not corresponds with lobes of lung
16. Cardiothoracic ration
Ratio between max diameter of heart to
max internal diameter of chest.
Normal ≤ 1:2
2/3 of cardiac
shadow lies
on the left.
(a+b)/(c+d)
18. BORDERS OF HEART
Right border:
◦ SVC
◦ RA
Left border:
◦ Aortic arch
◦ Pulmonary trunk
or LPA (bay)
◦ LAA
◦ LV
19. Cardiac enlargement
Left atrial enlargement
◦ Straightening of the left border of heart.
◦ Prominent LAA
◦ Double contour of rt border of heart (upper
outer border is LA)
◦ Widening of carinal angle
◦ Posterior displacement of barium filled
esophagus (rt lat view)
23. RA enlargement
enlarged, globular heart
narrow vascular pedicle
gross enlargement of the right atrial
shadow, i.e. increased convexity in the
lower half of the right cardiac border
34. description
This is a PA view of the chest with normal
exposure, proper centering and without any
apparent bony abnormality.
Lung fields shows bat-wing appearance of
confluent shadows which extends from the
hilum to mid and upper zones.
Cardiac silhouette is enlarged.
No mediastinal shifting, both CP angles are
obscured.
36. When there is redistribution of pulmonary blood flow
there will be an increased artery-to-bronchus ratio in the
upper and middle lobes
Artery-to-bronchus ratio
37. Stage II - Interstitial edema
When fluid leaks into the peripheral interlobular septa it is seen as
Kerley B or septal lines.
Kerley-B lines are seen as peripheral short 1-2 cm horizontal lines near
the costophrenic angles.
These lines run perpendicular to the pleura.
38. Stage III - Alveolar edema
This stage is characterized by continued fluid
leakage into the interstitium, which cannot be
compensated by lymphatic drainage.
This eventually leads to fluid leakage in the alveoli
(alveolar edema) and to leakage into the pleural
space (pleural effusion).
40. Pulmonary artery hypertension
Main pulmonary artery usually prominent
Right and left pulmonary arteries large and
taper rapidly
Peripheral pulmonary arteries are narrow and
inconspicuous
Diffuse oligemia of the lungs
43. Increase Qp (pulmonary flow)
Prominent MPA, RDPA
Pulmonary plethora
◦ Vascular markings of lung fields can be
traced up to lateral third of it.
End-on vessels (3 in rt, or 5 in both)
44. Cardiac temponade
there can be globular enlargement of the cardiac
shadow giving a water bottle configuration
widening of the subcarinal angle without other
evidence of left atrial enlargement may be an
indirect clue
lateral CXR may show a vertical opaque line
(pericardial fluid) separating a vertical lucent line
directly behind sternum (epicardial fat) anteriorly
from a similar lucent vertical lucent line (pericardial
fat) posteriorly; this is known as the Oreo cookie
sign
49. ASD
can be normal in early stages +/- when the ASD is
small signs of increased pulmonary flow (shunt
vascularity) enlarged pulmonary vessels
upper zone vascular prominence
vessels visible to the periphery of the film
eventual signs of pulmonary arterial hypertension
chamber enlargement right atrium
right ventricle
note: left atrium is normal in size
note: aortic arch is small to normal (narrow pedicle)
52. VSD
The chest radiograph can be normal with a small
VSD.
Larger VSDs may show cardiomegaly (particularly
left atrial enlargement although the right and left
ventricle can also be enlarged).
A large VSD may also show features of pulmonary
edema, pleural effusion and/or increased pulmonary
vascular markings
Wide pedicle
54. PDA
Chest radiographic features may vary depending on
whether it is isolated or associated with other cardiac
anomalies and with direction of shunt flow (right to
left or left to right).
Can have cardiomegaly (predominantly left atrial
and left ventricular enlargement if not complicated).
Obscuration of the aortopulmonary window and
features of pulmonary oedema may be evident
Wide pedicle
56. TAPVR
The right heart is prominent in TAPVR because of the
increased flow volume, but the left atrium remains
normal in size. Types I and II result in cardiomegaly.
The supracardiac variant (type I) can classically depict a
snowman appearance on a frontal chest radiograph, also
known as figure of 8 heart or cottage loaf heart 2-3.
The dilated vertical vein on the left,
brachiocephalic vein on top, and
superior vena cava on the right form the head of the
snowman; the body of the snowman is formed by the
enlarged right atrium
59. TOF
Plain films may classically show a "boot shaped"
heart with an upturned cardiac apex due to right
ventricular hypertrophy and concave pulmonary
arterial segment. Most infants with TOF however
may not show this finding .
Pulmonary oligemia due to decreased pulmonary
arterial flow. Right sided aortic arch is seen in 25%.