COMPLETE EXAMINATION OF RESPIRATORY SYSTEM IN PEDIATRICS. IT HAS BEEN SUMMARIZED FROM ALL WELL KNOWN 32 BOOKS UNDER GUIDANCE OF ONE OF THE BEST PEDIATRIC DOCTORS AND PROFESSORS .
BY DR. SURAJ R. DHANKIKAR.
COMPLETE EXAMINATION OF RESPIRATORY SYSTEM IN PEDIATRICS. IT HAS BEEN SUMMARIZED FROM ALL WELL KNOWN 32 BOOKS UNDER GUIDANCE OF ONE OF THE BEST PEDIATRIC DOCTORS AND PROFESSORS .
BY DR. SURAJ R. DHANKIKAR.
COMPLETE EXAMINATION OF RESPIRATORY SYSTEM IN PEDIATRICS. IT HAS BEEN SUMMARIZED FROM ALL WELL KNOWN 32 BOOKS UNDER GUIDANCE OF ONE OF THE BEST PEDIATRIC DOCTORS AND PROFESSORS .
BY DR. SURAJ R. DHANKIKAR.
COMPLETE EXAMINATION OF RESPIRATORY SYSTEM IN PEDIATRICS. IT HAS BEEN SUMMARIZED FROM ALL WELL KNOWN 32 BOOKS UNDER GUIDANCE OF ONE OF THE BEST PEDIATRIC DOCTORS AND PROFESSORS .
BY DR. SURAJ R. DHANKIKAR.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
Follow us on: Pinterest
Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
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
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- 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
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
1. Morpho-functional peculiarity of
respiratory system in children
Methods of clinical and paraclinical
investigation
Semiology of diseases
Nursing of sick children
Chief of Department of Propedeutic of Pediatrics N2
Klymenko Viktoria Anatoliivna
Kharkiv National Medical University
2. Content
Morpho-functional peculiarity of
respiratory system
Methods of clinical investigation
Methods of paraclinical investigation
Semiology of diseases
Nursing of sick children
3. The Function of Respiratory System
I. Respiratory -
to deliver the air to organism for gas
exchange, to get the oxygen and to
excrete the carbon dioxide.
II. Nonrespiratory
4. The Nonrespiratory Function of
Respiratory System
Production and regulation of hormone’s and biological active substance’s
activities
production of prostaglandins E, F2-alpha
angiotensin II (arterial blood pressure)
regulation of aldosteron secretion (water and electrolytes metabolism)
inactivation of noradrenalin (sympatric nerves system)
Regulation of blood rheology
Water metabolism
Thermoregulation
Influence the concentration of biologically active substances and drugs
used in medicine in arterial blood
Filter out small blood clots formed in veins
Filter out gas micro-bubbles occurring in the venous blood stream during
diving decompression
Protection for the heart
5. Major elements of the respiratory system
Chest wall
Airways
Alveolar-capillary
units (Lungs)
Pleura
Pulmonary and
bronchial
circulations
Nerves
Lymphatics
8. Lung Embryogenesis
Postnatal development
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f.However,
the final size of the lungs dependences on many other factors such as the subject's level
gestation.
9. Respiratory Distress Syndrome(Pathophysiology)
At birth the pressure needed to expand the lungs requires high
inspiratory pressure.
Normal surfactant - lungs retain 40% of the residual volume
after exhale
Deficiency of surfactant - lungs collapse between breaths, it
makes each inhale as hard as the first breath.
On further - the pulmonary capillary membranes become more
permeable, letting in fibrin, fluid accumulates between the
alveolar spaces - a hyaline membrane is formed - barrier for
gas exchange, caused hypoxemia and carbon dioxide retention
10. Anatomophysiological peculiarities
of respiratory system in children
The nose is relatively small and short
The nasal passage is narrow
In the newborn the lower nasal passage
is absent, it is formed only on the age of
four years.
The nasal mucous is very delicate and
intensively vascularized.
The cavernous portion of the submucosa
of the nasal cavity is under differentiated,
developing only by the age of 8-9 years,
and particularly during puberty.
11. Anatomophysiological
peculiarities
of paranasal sinuses
in children
The frontal sinus is absent in babies younger than 1-year, it
appears after 2 yr, attaining its full development by 12-15 yr
The maxillare sinuses are present at birth, but they are very
small, it enlarges gradually to reach its maximum dimensions
about the 21 year (eruption of the upper wisdom tooth)
The ethmoid sinus is present in newborn, but its cells are very
weakly differentiated
The sphenoid sinus occupies the body of the sphenoid bone,
and may be absent or present at birth as a small indentation of
nasal mucosa
12. Anatomophysiological
peculiarities
of upper respiratory tract
in children
The lymphatic ring surrounding the pharynx is not clearly defined
Tonsils are not visible before the end of the first year of life
The lymphatic ring attain its maximum development between 4-10 years
A process of resorption occurs from 14-15 years
Chronic inflammations of the tonsils
and adenoiditis are typical pathology for children
13. Anatomophysiological
peculiarities
of middle respiratory tract in
children
The larynx passage is narrow, its cartilages are soft,
vascularization is intensive larynx stenosis
(croup)
The trachea bifurcates - at the level of the 3rd thoracic
vertebra in the newborn, descending by adolescence to
the level of the 5th .
14. Stridor
is an inspiratory musical wheeze heard
loudest over the trachea during inspiration.
Stridor suggests an obstructed trachea or
larynx.
15. Anatomophysiological peculiarities
of middle respiratory tract in children
(bronchi)
The bronchial passage is narrower than in
adults
The elastic fibres are less defined
The cartilages are soft
The mucous is extensively vascularized
The bronchial lumens become constricted
more easily than in adults
16. Anatomophysiological peculiarities
of lower respiratory tract in children
The lungs are not formed
completely at the moment of
birth, it’s development and
differentiation continues up to
puberty period
The interstitial pulmonary tissue
is better developed and more
vascularized than in adults
Capillaries and lymphatic
sinuses are wider
The lungs of infants are poor in
elastic tissue, particularly in
vicinity of the alveoli
17. The clinical methods of examination
Interrogation
Observation
Palpation
Percussion
Auscultation
18. The common complains:
Cough
Dyspnea
Voice change
Hemoptysis (the coughing with blood)
Chest pain
Wheezing, Stridor, and Snoring - audible
sounds that can be heard without a stethoscope
19. Cough description
Dry or Moist
Onset- acute or slow
Frequency –seldom or often
Regularity –irregular is the most common, regular
(pertussis, chronic diseses)
Pitch/loudness- loud/quiet, high or low pitch
Postural
Quality- hoarse with croup, inspiratory whoop with
pertussis
22. Observation / Inspection of the respiratory system
Physical development
Cyanosis
Position (hands on the knees)
Rate and pattern of breathing
Visible abnormalities of the thoracic cage
Depth and symmetry of lung expansion
Direction of abdominal wall movement
Using of accessory muscles of respiration
Ability to speak
Voice
Digital clubbing
Smell of breath
23. The pattern of breathing
= respiratory rate + rhythm+ depth of breathing+ relative amount
of time spent in inspiration and expiration
Respiratory rate
- Normal
newborn
1-2 years
5-6 years
10 years
adults
40-60 per min
30-35
up to 25
18-20
14-16
- Tachypnea / bradypnea
Tidal volume – 5 ml/kg
Ratio of inspiratory to expiratory time - 2:3
25. Normal chests of children and adults
Movement of the chest wall is minima and symmetrical.
Expansion of chest and abdomen
Use of accessory muscles (intercostal, stenocleidomastoid)
indicates pulmonary impairment
Chest’s observation
26. Digital clubbing -
PAINLESS – FINGERNAILS CURVED AND ENLARGEMENT OF THE CONNECTIVE TISSUES
IN THE TERMINAL PHALANGES OF THE FINGERS >TOES
29. Palpation of Thorax
Feel for pulsations
Areas of induration, bulges, depressions, unusual
movements
Crepitus-crackly or crinkly sensation
Tactile fremitus
30. Tactile fremitus
Condition Tactile
fremitus
Consolidation or atelectasis
(with patent airway)
Increased
Consolidation or atelectasis
(with blocked airway)
Decreased
Asthma Normal
Interstitial lung disease Normal
Emphysema Decreased
Pneumothorax Decreased
Pleural effusion Decreased
33. Boundaries of the lungs
Front
Right lung: the V rib on
the mammilary line.
the IX rib on the axillary
line
Left lung: at the IX rib on
the axillary line
Back
Both lungs:
at the level of the spinous
process of the X – XI thoracic
vertebrae.
34. TOPOGRAPHIC PERCUSSION
DIAPHRAGMATIC EXCURSION
•Patient takes a deep breath
and holds
•Percuss on scapular line until
dullness is heard
• Mark this point
• Allow patient to breath
normally
•Repeat deep breath then
exhale and hold
• Percuss up from the mark until
resonance is heard
• Mark the area
•Diaphragmatic excursion is the
distance between these two
points
NORMAL 3 – 6 CM
35. Comparative Percussion
Compare bilaterally
Use one side as control for the other
Move systematically side to side at intervals
of several centimeters
36. Typical Chest Percussion Sound
in Selected Clinical Conditions
Condition Percussion
Normal Resonant
Consolidation or atelectasis Dull
Asthma Hyperresonant
Interstitial lung disease Resonant
Emphysema Hyperresonant
Pneumothorax Hyperresonant
Pleural effusion Dull
40. Abnormal Breath Sounds
ADVENTITIOUS SOUNDS
To determine:
Loudness, pitch/ and duration (summarized
as fine or coarse)
Number (few to many)
Timing in the respiratory cycle
Location on the chest wall
Persistence of their pattern from breath to
breath
Any change after a cough or a change in the
patient's position
41. Abnormal Breath Sounds
ADVENTITIOUS SOUNDS
Crackles (crepitation) - heard during middle
or end of inspiration, not cleared by cough
Rhonchi - loud, low, coarse, coughing may
clear
Wheeze - musical-louder during inspiration
A more significant finding is heard in expiration
Pleural Friction rub- dry rubbing
42. VOCAL FREMITUS
THE PATIENTS VOICE IS HEARD
THROUGH A STETHOSCOPE PLACED
ON THE PATIENTS CHEST –
NORMALLY THE SOUNDS ARE
INDISTINCT
ABNORMALITIES – SOUND MUCH
LOUDER THAN NORMAL -
BRONCHOPHONY
43. The main methods of paraclinical
examination
examination of secretions
pulmonary function testing
sweat testing
microbiology
blood gas analysis
chest roentgenograms
computer tomography and magnetic resonance imaging
laryngoscopy, bronchoscopy with bronchoalveolar
lavage, thoracoscopy
contrast studies - bronchograms, pulmonary
arteriograms
percutaneous lung tap, lung biopsy
54. Restrictive syndrome
occurs if the lungs are limited in the capability to
broadening
Reasons:
pneumosclerosis
abundant effusion in exudative pleurisy
limited motility due to rib affection (osteomyelitis, fracture
of ribs) or muscle affections (myopathy, paresis and
paralysis of intercostal nerves)
55. Croup syndrome
Voice change
Dry backing cough
Inspiratory dyspnea
It can occur in virus laryngotracheitis,
diphtheritic laryngotracheitis, and measles.
57. PNEUMOTHORAX
INSPECTION – LAG AFFECTED SIDE
PALPATION – ABSENT FREMITUS
PERCUSSION – TYMPANIC
AUSCULTATION – ABSENT BREATH SOUNDS
PNEUMOTHORAX
58. Care for children with respiratory diseases
hygienic regime: temperature regime,
fresh air, cleanliness
accurate nutrition
cleaning of airways
various methods of oxygenation (oxygen
mask, incubator, oxygen supply through
nasal, tracheal tube, AVL)
treatment according to the etiology and
pathogenesis of the disease