This document discusses injuries to the bladder and urethra, providing details on diagnosis and management. It notes that bladder injuries occur in 1.6% of blunt trauma victims and are usually associated with pelvic fractures. Gross hematuria is present in most bladder injury cases. Urethral injuries in males are divided into those affecting the posterior urethra associated with pelvic fractures, and anterior injuries from blunt or penetrating trauma. Diagnosis is via retrograde cystography or urethrography. Most extraperitoneal bladder ruptures are now managed non-operatively with catheter drainage, while intraperitoneal ruptures require surgical repair. Urethral injuries may be treated with immediate surgical closure, catheter drainage
URETHRAL INJURY- Trauma Surgery
#surgicaleducator #babysurgeon
Dear viewers,
Greetings from “Surgical Educator”
Today I have uploaded a video on URETHRAL INJURY- one more in Trauma Surgery. I haven’t talked elaborately but have included the essential minimum an undergraduate medical student should know. I have talked about anatomy, classification, etio-pathogenesis, symptoms, signs, investigations, grading, treatment, complications, treatment algorithm and case vignettes of urethral injuries. My aim is, after watching this video all of you should be able to arrive at a correct working diagnosis of the type of urethral injury and should also be able to institute immediate treatment to the patients if there is a need. The definitive urethroplasty should be done by a Urologist. You can watch the video in the following links:
surgicaleducator.blogspot.com
youtube.com/c/surgicaleducator
Thank you for watching the video.
Types of Urethral injury, Mechanism of Urethral injury, Classification of Urethral injury, Symptoms of Urethral injury, Signs of Urethral injury,
Investigations for Urethral injury, Grading of Urethral Injury, Treatment for Urethral injury, Complications of Urethral Injury
Bladder injuries are rare. But when present in cases of polytrauma they pose both a diagnostic as well as surgical challenge to the attending surgeon. Understanding the mechanisms underlying bladder injuries is pivotal in developing a diagnostic algorithm in order to avoid missing of any urologic injury. Once the extent and site of damage is diagnosed then prompt surgical intervention is the mainstay of treatment. The pathophysiology and management of bladder injuries is discussed in this paper.
Bladder injuries may result from blunt,Penetrating and Iatrogenic trauma.
Full bladder is more susceptible to injury than empty bladder.
Management varies from conservative to surgical aiming to directly repair the injury.
URETERAL INJURY
Ureteral injuries are often subtle, and clinicians must have a high index of suspicion for them. An unrecognized or mismanaged ureteral injury can lead to significant complications, including urinoma, abscess, ureteral stricture, and potential loss of ipsilateral kidney
URETHRAL INJURY- Trauma Surgery
#surgicaleducator #babysurgeon
Dear viewers,
Greetings from “Surgical Educator”
Today I have uploaded a video on URETHRAL INJURY- one more in Trauma Surgery. I haven’t talked elaborately but have included the essential minimum an undergraduate medical student should know. I have talked about anatomy, classification, etio-pathogenesis, symptoms, signs, investigations, grading, treatment, complications, treatment algorithm and case vignettes of urethral injuries. My aim is, after watching this video all of you should be able to arrive at a correct working diagnosis of the type of urethral injury and should also be able to institute immediate treatment to the patients if there is a need. The definitive urethroplasty should be done by a Urologist. You can watch the video in the following links:
surgicaleducator.blogspot.com
youtube.com/c/surgicaleducator
Thank you for watching the video.
Types of Urethral injury, Mechanism of Urethral injury, Classification of Urethral injury, Symptoms of Urethral injury, Signs of Urethral injury,
Investigations for Urethral injury, Grading of Urethral Injury, Treatment for Urethral injury, Complications of Urethral Injury
Bladder injuries are rare. But when present in cases of polytrauma they pose both a diagnostic as well as surgical challenge to the attending surgeon. Understanding the mechanisms underlying bladder injuries is pivotal in developing a diagnostic algorithm in order to avoid missing of any urologic injury. Once the extent and site of damage is diagnosed then prompt surgical intervention is the mainstay of treatment. The pathophysiology and management of bladder injuries is discussed in this paper.
Bladder injuries may result from blunt,Penetrating and Iatrogenic trauma.
Full bladder is more susceptible to injury than empty bladder.
Management varies from conservative to surgical aiming to directly repair the injury.
URETERAL INJURY
Ureteral injuries are often subtle, and clinicians must have a high index of suspicion for them. An unrecognized or mismanaged ureteral injury can lead to significant complications, including urinoma, abscess, ureteral stricture, and potential loss of ipsilateral kidney
The management of stoma constitute an important aspect of Surgical Nursing.
General staff Nurses that work in surgical ward is expected to have some practical knowledge of stoma therapy.
Some institutions have specialist stoma therapy nurses
Ureteral injury is one of the most serious complications of gynecologic surgery. Ureteral injury during laparoscopic surgery has become more common as a result of the increased number of laparoscopic hysterectomies and retroperitoneal procedures that are being performed.
Iatrogenic Ureteral Injuries in Non – Urological Surgeries: An Institutional ...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Kidneys are injured more often than any of the organs along the urinary tract from external trauma. If serious blunt or penetrating kidney injuries are not treated, complications, such as kidney failure or kidney loss, delayed bleeding, infection, and high blood pressure may result.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
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.
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
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
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the 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 lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
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. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
3. Bladder Injuries
Bladder injuries occur in
approximately 1.6% of blunt
abdominal trauma victims.
The vast majority of injuries are
associated with pelvic fractures.
The bladder rupture can occur into the
peritoneal cavity (intraperitoneal
bladder rupture) or outside the
peritoneal cavity (extraperitoneal
rupture
4. Bladder Injuries contd..
Bladder injuries are extraperitoneal in
approximately 60%, intraperitoneal in
approximately 30%,
Gross hematuria is the most common
sign, present in 77-100% of injuries.19
5. Urethral injuries
Uncommon in females
In females, urethral injuries occur almost exclusively as a result of pelvic
fracture and should be suspected in patients having labial edema and/or
blood in the vaginal vault during pelvic exam
Can be partial or complete
Injury to male urethra is divided into
1.Injuries to the posterior urethra (at or above
membranous urethra)
Almost exclusively associated with pelvic fractures
Occur between 1.5% -10% of pelvic fractures
Concomitant bladder injuries are present in 15% such urethral
injuries
2.Injuries to the anterior urethra(penile /bulbar urethra)
May be blunt/penetrating
Straddle injuries where the urethra is crushed between pubic bones
and a fixed object
6. Suspect a urethral rupture in the adult male
with a pelvic fracture with blood at the urethral
meatus(37-93%) and a high riding prostate
,perineal/genital haematoma and urinary
retention
These classic signs will not present in all
presentations
7. Diagnosis of urethral and bladder
injuries
American Urological Association- Urotrauma-
AUA guideline-2014
https://www.auanet.org/education/guidelines/u
rotrauma.cfm
Diagnostic imaging pathways(2013) -
http://www.imagingpathways.health.wa.gov.au
/index.php/imaging-
pathways/musculoskeletal-
trauma/trauma/lower-urinary-tract-
trauma#pathway
8.
9. Diagnostic imaging of bladder
injuries
Retrograde cystography (CT or
conventional) is critical as it can
determine the presence of an injury and
whether it is intraperitoneal or
extraperitoneal.
10. CT Cystographic Findings in Bladder
Injury
Type 1: Contusion
Bladder contusion is defined as an
incomplete or partial tear of the bladder
Type 2: Intraperitoneal Rupture
Intraperitoneal bladder rupture occurs in
approximately 10%–20% of major bladder
injuries.
CT cystography demonstrates intraperitoneal
contrast material around bowel loops,
between mesenteric folds, and in the
paracolic gutters
11. CT Cystographic Findings in
Bladder Injury contd..
Type 3: Interstitial Injury
Interstitial bladder injury is rare and is
defined as an intramural or partial-
thickness laceration with intact serosa
Type 4: Extraperitoneal Rupture
Extraperitoneal rupture is the most
common type of bladder injury (80%–
90% of cases)
17. Management of bladder injuries
Since the 1980s, clinicians manage
most extraperitoneal bladder ruptures
non-operatively with catheter drainage,
while intraperitoneal ruptures are
surgically repaired.
18. Diagnosis and management of urethral
injuries
Diagnosis is made by retrograde urethrography.
Immediate surgical closure of urethral injuries is
recommended primarily in penetrating injuries of the anterior
urethra.
Straddle injuries of the anterior urethra are initially treated
with suprapubic (SP) or urethral urinary drainage and are at
high risk for delayed stricture formation.
Attempts at immediate sutured repair of posterior urethral
injury of posterior urethral injury are associated with
unacceptably high rates of erectile dysfunction and urinary
incontinence
Traditional management of pelvic fracture urethral injury
(PFUI) is placement of a suprapubic tube (SPT) and delayed
urethroplasty to reconnect the ruptured urethra
19. Diagnosis and management ..
As endoscopic equipment and techniques
have improved over the past two decades,
primary realignment (PR) of posterior urethral
ruptures has become more common. Primary
realignment refers to advancing a urinary
catheter across the ruptured urethra.
The goal of PR is to allow a partial urethral
injury to heal while diverting the urine via the
catheter, or to align both ends of the
disrupted urethra so that they heal in the
correct position as the pelvic hematoma is
reabsorbed.
20.
21.
22.
23. Urethra, trauma. Retrograde urethrogram reveals a type III
urethral tear at the urogenital diaphragm (solid arrow) and
a type IV urethral disruption at the bladder neck (dashed
arrow).
24. Retrograde urethrogram reveals a type I urethral injury
with minimal stretching and slight luminal irregularity of the
posterior urethra. No extravasation of contrast material is
present.
25. Straddle injury. Retrograde urethrogram shows a type V
urethral injury with extravasation of contrast material from
the distal bulbous urethra
26. References
Gomez RG, Ceballos L, Coburn M et al: Consensus statement on bladder injuries. BJU
Int 2004; 94: 27.
Brandes S and Borrelli J, Jr.: Pelvic fracture and associated urologic injuries. World J
Surg 2001; 25: 1578.
Morey AF, Iverson AJ, Swan A et al: Bladder rupture after blunt trauma: guidelines for
diagnostic imaging. J Trauma 2001; 51: 683.
Bjurlin MA, Fantus RJ, Mellett MM et al: Genitourinary injuries in pelvic fracture
morbidity and mortality using the National Trauma Data Bank. J Trauma 2009; 67: 1033.
Martinez-Pineiro L, Djakovic N, Plas E et al: EAU Guidelines on Urethral Trauma. Eur
Urol 2010; 57: 791.
Koraitim MM: Pelvic fracture urethral injuries: evaluation of various methods of
management. J Urol 1996; 156: 1288.
Koraitim MM: Effect of early realignment on length and delayed repair of postpelvic
fracture urethral injury. Urology 2012; 79: 912.
Balkan E, Kilic N and Dogruyol H: The effectiveness of early primary realignment in
children with posterior urethral injury. Int J Urol 2005; 12: 62.
Jordan G, Chapple C, Heyns C, eds. Urethral Strictures: Société Internationale
d'Urologie; 2010.
Leddy L, Voelzke B and Wessells H: Primary realignment of pelvic fracture urethral
injuries. Urol Clin North Am 2013; 40: 393.
Brandes SB, Buckman RF, Chelsky MJ et al: External genitalia gunshot wounds: a ten-
year experience with fifty-six cases. J Trauma 1995; 39: 266.