Masthanamma.pptx
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A 47-year-old female patient presented with giddiness, imbalance while walking to the right side, and headaches for 3 months. On examination, she had positive Rhomberg's test and impaired tandem gait to the right side. Motor and sensory examinations were normal. She was diagnosed with a right cerebellopontine angle schwannoma based on her symptoms and examination findings.
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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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- 1. Name- M.Masthanamma Age- 47/F Mrd no- 1321767 Diagnosis – Right CP angle schwannoma
- 2. A 47/F patient who was right handed by nature , - c/o giddiness and reeling sensation since 3 months - c/o swaying while walking to right side. - c/o headache, holocranial type, moderate intensity, partially relieved by medication for 3 months. - No hearing loss or facial deviation - No trauma/fever/vision loss/seizure
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- 4. CRANIAL NERVE EXAMINATION • CN 1: B/L sense of smell normal • CN2: VA right –6/6 and left :- 6/9 fundoscopy –normal disc CN 3,4,6- • EOM normal • No nystagmus • No ptosis • Pupils- B/L 3mm equal and reactive.
- 5. CN 5- intact CN 7- normal CN 8 • B/L AC>BC webers not lateralised CN 9, 10 • Uvula midline • Palatal movements normal ,no asymmetry • Gag reflex intact
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- 7. Sensory system-normal Rhomberg’s – positive FNT, FNFT, DDK- positive on right side. Tandem Gait : impaired Meningeal signs: no
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