Genitourinary signs
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This document discusses various genitourinary signs seen on imaging studies. It describes the "Bear's paw sign" seen with xanthogranulomatous pyelonephritis and the "Onion ring appearance" seen with testicular epidermoid tumors. It also mentions the "Koala bear sign" seen with pelvic inflammatory disease and tubo-ovarian abscesses, as well as kissing ovaries seen with pelvic endometriosis. Deep pelvic endometriosis and locations of utricle cysts and Mullerian duct cysts are also outlined.
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This document summarizes key anatomical variations of the sphenoid sinus that can impact trans-sphenoid pituitary surgery. It describes variations in pneumatization degree, type of pneumatization, sellar bulge prominence, septation, and intercarotid distance that are evaluated on preoperative CT and MRI to assess surgical complexity. Examples of imaging findings of each variation are also provided.
Pediatrics signs
This document provides information on various pediatric signs and diseases that can be identified on imaging studies. It lists different basal ganglia and striatal involvements that can be seen with various genetic diseases and conditions like CO poisoning. It also lists nasal masses, hip dysplasia, skull lesions, vertebral abnormalities, and heart and lung signs that can indicate different diseases. Common pediatric radiological findings are described that can help diagnose conditions such as mucopolysaccharidosis, sickle cell anemia, neuroblastoma, osteopetrosis, achondroplasia, and others. Respiratory signs seen in conditions like meconium aspiration, bronchopulmonary dysplasia, and HMD are also detailed.
Msk signs edited
This document contains medical images and descriptions of various musculoskeletal signs and pathologies. It discusses imaging findings and classifications for conditions like:
- Adhesive capsulitis showing thickened ligaments.
- SLAC and SNAC wrist classifications.
- Femoroacetabular impingement presentations.
- Charcot neuroarthropathy acute and chronic stages.
- Various tendon injuries and ligamentous injuries patterns.
It provides comparisons of imaging findings between similar conditions like fibrous dysplasia and osteofibrous dysplasia. Assessment techniques for foot deformities like clubfoot and flatfoot are also outlined.
Vascular malformations of the head and neck
This document discusses soft tissue vascular lesions of the head and neck. It defines different types of vascular lesions including hemangiomas, arterial malformations, venous malformations, lymphatic malformations, and mixed malformations. For each type, the document provides descriptions, classifications where relevant, examples of MRI appearances, and treatment approaches. Key differences highlighted include hemangiomas having a sizable parenchymal component unlike vascular malformations, and distinguishing high flow from low flow lesions based on the presence or absence of flow voids on MRI sequences.
Infrapatellar fat pad abnormalities
This document provides a classification of abnormalities that can occur in the infrapatellar fat pad, including benign tumors, cysts, ganglia, recesses, bursae, and overuse/impingement syndromes. Specific conditions mentioned include para-articular chondroma, localized villonodular synovitis, synovial hemangioma, parameniscal cysts, Hoffa's recesses, Hoffa's ganglion, infrapatellar bursitis, Hoffa's fat pad impingement, and cyclops lesions. The document also provides brief descriptions and imaging characteristics of some of these conditions.
Chest signs
This document lists and describes various chest signs seen on imaging that can indicate different medical conditions. Some examples provided are the polo mint sign indicating acute pulmonary embolism, the gloved finger sign seen in allergic bronchopulmonary aspergillosis, and the tree in bud appearance commonly seen with tuberculosis infections. Different patterns such as reticulation, cysts, nodules and crazy paving are described along with the conditions they may suggest such as fibrosis, sarcoidosis or pneumonia. Specific signs for conditions like silicosis, round atelectasis, and congenital heart defects are also defined.
Git signs
This document provides a list of over 50 gastrointestinal signs seen on imaging with brief descriptions. Some of the signs included are:
- Windsock sign which indicates intraluminal duodenal diverticulum.
- Cobblestone sign seen in Crohn's disease which is characterized by a granular mucosa.
- String sign seen in Crohn's disease presenting as longitudinal ulcers.
- Pearl necklace sign seen with adenomyomatosis of the gallbladder appearing as dilated biliary radicles.
- Hourglass or collar sign indicating a diaphragmatic hernia.
The document serves as a reference for various imaging findings or "signs" seen in gastrointestinal diseases and
Pet ct technique
PET-CT combines functional PET imaging with anatomical CT imaging. A PET-CT scan involves fasting for 4-6 hours before injection of 18F-FDG tracer, followed by a whole body scan 40-60 minutes later lasting 13-17 minutes. Standardized uptake values (SUVs) are used to measure tracer uptake in tissues, with values over 2.5 suggesting malignancy. Dual time scanning one hour later can identify if SUV increases by 10% indicating malignancy or remains the same/decreases indicating benignity. Reference tissues like blood pools and livers are used to compare lesion uptake values to determine if they are higher, suggesting malignancy, or equal/lower, suggesting benignity.
Csf flowmetry
This document describes the process and parameters analyzed in quantitative cerebrospinal fluid (CSF) flow studies using phase contrast MRI. CSF flow is analyzed both qualitatively and quantitatively by measuring flow velocities and calculating stroke volume in the cerebral aqueduct. Elevated stroke volume is indicative of normal pressure hydrocephalus, while reduced values suggest cerebral atrophy. Key parameters including peak systolic and diastolic velocities, mean systolic flow, duration of CSF systole, and aqueduct stroke volume are calculated to differentiate normal, hyperdynamic, and hypodynamic CSF circulation.
Deformity correction
This document discusses methods for measuring alignment in the lower limbs, including the knee and hip joints. It outlines several key anatomical lines used as references, such as the mechanical axis of the femur and tibia. Joint orientation lines and angles are important for assessing malalignment. Measuring these lines and angles helps evaluate deformities and plan corrective procedures like osteotomies, which are performed at the center of rotation angle.
Arfi
Acoustic radiation force impulse (ARFI) is a sonographic technique that uses acoustic beams to mechanically excite tissue and monitor the displacement response to assess tissue stiffness without external compression. It provides qualitative images (Virtual Touch Tissue Imaging) and quantitative stiffness measurements (Virtual Touch Tissue Quantification) by tracking tissue displacement over time. Stiffer tissues like malignancies display as darker on images and have higher shear wave velocities measured in m/s. ARFI can help characterize and differentiate liver masses, breast and thyroid nodules, prostate cancer, and more.
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Physiology of Chemical Sensation of smell.pdf
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
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The Electrocardiogram - Physiologic Principles
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
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Physiology of Special Chemical Sensation of Taste
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
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Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
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Genitourinary signs
- 1. Genitourinary Dr Dalia El Said, MD General organization for teaching Hospitals and Institutes.
- 3. Onion ring appearance Testicular epidermoid
- 4. Koala bear sign Pelvic inflammatory disease Uterus UB
- 5. Koala bear sign Pelvic inflammatory disease ( tubo-ovarian abscesses) Uterus
- 6. Kissing ovaries Pelvic endometriosis (The sign caused by pelvic adhesions)
- 7. Deep pelvic endometriosis Torus uterinus. (site of attachment of uterosacral ligaments to the uterus). Uterosacral ligaments. Dome of the bladder.
- 8. Peritoneal inclusion cyst / pseudocyst. Multi- loculated fluid collection conforming to the peritoneal space and enclosing the ipsilateral normal ovary (Arrow).
- 10. Prostatic cysts
- 11. Prostatic cysts Utricle cyst - Midline. - Communicate with the urethra. Müllerian duct cyst. - Extend above the prostate •- M.B lateral to the midline. •- They do not communicate with the urethra