This document discusses the use of various imaging modalities for evaluating neck masses. Ultrasound is useful for differentiating cystic from solid lesions and assessing lymph node size and vascularity. CT provides details of soft tissues and their relationships. MRI is good for lesion detection and involvement of nearby structures but has limitations for nodal assessment. PET/CT is excellent for staging lymphoma and detecting unknown primary cancers. Biopsy is used when malignancy is suspected. The approach depends on whether the mass is in a child or adult, with ultrasound often the initial study. Location provides clues for cystic lesions. Features help characterize solid lesions and lymph nodes. Further tests are guided by ultrasound findings.
This document provides an overview of cerebellopontine angle masses, including their incidence, location, and radiographic features. It discusses the most common masses such as vestibular schwannoma (acoustic neuroma), CPA meningioma, and epidermoid cyst. For each type of mass, it describes their typical appearance on CT and MRI scans, including signal characteristics and enhancement patterns. It also provides differential diagnoses to help distinguish between different pathologies that can present in the CPA region. The goal is to help readers learn as much as possible about CPA masses to aid in successful diagnosis and management.
Role of mdct angio in management of acute chest pain Dr. Muhammad Bin ZulfiqarDr. Muhammad Bin Zulfiqar
In this presentation we will discuss different techniques of MDCT Cardiac imaging to role out different causes of chest pain to help cardiologist in management of the patient.
We shall discuss it case by case.
This document provides information on performing and interpreting CT angiography of the lower limbs. It discusses scanning techniques, protocols, contrast injection, and principles of timing acquisitions. Image post-processing includes MIP, VR, and MPR. Interpretation requires scrutinizing calcifications and stents to avoid overestimating stenosis. Peripheral CTA is useful for evaluating occlusive disease, aneurysms, trauma, infections, embolism, and postoperative surveillance. Examples demonstrate various vascular pathologies.
This document discusses head and neck imaging modalities and anatomy. It provides examples of different pathologies visualized on various imaging modalities like CT, MRI, PET. It describes the paranasal sinuses, skull base, compartments of the neck, and contents of each. Examples of lesions discussed include sinusitis, meningiomas, sarcomas, paragangliomas, cholesteatomas, and lymph nodes. Congenital lesions like thyroglossal duct cysts, branchial cleft cysts, and cystic hygromas are also summarized.
This document provides information about the anatomy and diseases of the pharynx and larynx. It begins with an overview of the anatomy of these structures and then discusses specific diseases including: Thornwaldt cyst, retropharyngeal abscess, juvenile angiofibroma, squamous cell carcinoma of the nasopharynx, vocal cord paralysis, laryngocele, laryngeal trauma, benign laryngeal tumors, laryngeal carcinoma, and the postsurgical larynx. Radiographic features of many of these conditions are illustrated with CT and MRI images.
Management of secondaries neck with occult primarySujay Susikar
This document discusses the management of neck metastases when the primary tumor is unknown or occult. It summarizes that treatment options include surgery such as different types of neck dissection, radiation therapy, or a combination of the two. The type of treatment is based on the histology and may involve treating possible primary sites in addition to the neck.
This document discusses the anatomy and imaging of the paranasal sinuses. It describes the drainage pathways of each sinus and the structures that make up the osteomeatal complex. It also covers anatomical variations that can occur like concha bullosa, Haller cells, and Onodi cells. Imaging modalities for evaluating the sinuses are described, with CT identified as the gold standard due to its ability to depict bone, soft tissues, and air. Scanning techniques for CT include coronal sections performed with the patient in a prone position and their head hyperextended.
Presentation1.pptx, radiological imaging of scrotal diseases.Abdellah Nazeer
This document provides an overview of radiological imaging of scrotal diseases. It begins with the anatomy of the scrotum and its layers. It then discusses congenital diseases like cryptorchidism, which is the absence of one or both testes from the scrotum. Cryptorchidism can occur if the testes fail to descend from the abdomen into the scrotum. The document presents various imaging examples of cryptorchidism showing undescended testes in the inguinal canal or abdomen. It also discusses inflammatory diseases, trauma, testicular torsion, masses, and other pathologies that can be imaged and evaluated radiologically.
This document provides an overview of cerebellopontine angle masses, including their incidence, location, and radiographic features. It discusses the most common masses such as vestibular schwannoma (acoustic neuroma), CPA meningioma, and epidermoid cyst. For each type of mass, it describes their typical appearance on CT and MRI scans, including signal characteristics and enhancement patterns. It also provides differential diagnoses to help distinguish between different pathologies that can present in the CPA region. The goal is to help readers learn as much as possible about CPA masses to aid in successful diagnosis and management.
Role of mdct angio in management of acute chest pain Dr. Muhammad Bin ZulfiqarDr. Muhammad Bin Zulfiqar
In this presentation we will discuss different techniques of MDCT Cardiac imaging to role out different causes of chest pain to help cardiologist in management of the patient.
We shall discuss it case by case.
This document provides information on performing and interpreting CT angiography of the lower limbs. It discusses scanning techniques, protocols, contrast injection, and principles of timing acquisitions. Image post-processing includes MIP, VR, and MPR. Interpretation requires scrutinizing calcifications and stents to avoid overestimating stenosis. Peripheral CTA is useful for evaluating occlusive disease, aneurysms, trauma, infections, embolism, and postoperative surveillance. Examples demonstrate various vascular pathologies.
This document discusses head and neck imaging modalities and anatomy. It provides examples of different pathologies visualized on various imaging modalities like CT, MRI, PET. It describes the paranasal sinuses, skull base, compartments of the neck, and contents of each. Examples of lesions discussed include sinusitis, meningiomas, sarcomas, paragangliomas, cholesteatomas, and lymph nodes. Congenital lesions like thyroglossal duct cysts, branchial cleft cysts, and cystic hygromas are also summarized.
This document provides information about the anatomy and diseases of the pharynx and larynx. It begins with an overview of the anatomy of these structures and then discusses specific diseases including: Thornwaldt cyst, retropharyngeal abscess, juvenile angiofibroma, squamous cell carcinoma of the nasopharynx, vocal cord paralysis, laryngocele, laryngeal trauma, benign laryngeal tumors, laryngeal carcinoma, and the postsurgical larynx. Radiographic features of many of these conditions are illustrated with CT and MRI images.
Management of secondaries neck with occult primarySujay Susikar
This document discusses the management of neck metastases when the primary tumor is unknown or occult. It summarizes that treatment options include surgery such as different types of neck dissection, radiation therapy, or a combination of the two. The type of treatment is based on the histology and may involve treating possible primary sites in addition to the neck.
This document discusses the anatomy and imaging of the paranasal sinuses. It describes the drainage pathways of each sinus and the structures that make up the osteomeatal complex. It also covers anatomical variations that can occur like concha bullosa, Haller cells, and Onodi cells. Imaging modalities for evaluating the sinuses are described, with CT identified as the gold standard due to its ability to depict bone, soft tissues, and air. Scanning techniques for CT include coronal sections performed with the patient in a prone position and their head hyperextended.
Presentation1.pptx, radiological imaging of scrotal diseases.Abdellah Nazeer
This document provides an overview of radiological imaging of scrotal diseases. It begins with the anatomy of the scrotum and its layers. It then discusses congenital diseases like cryptorchidism, which is the absence of one or both testes from the scrotum. Cryptorchidism can occur if the testes fail to descend from the abdomen into the scrotum. The document presents various imaging examples of cryptorchidism showing undescended testes in the inguinal canal or abdomen. It also discusses inflammatory diseases, trauma, testicular torsion, masses, and other pathologies that can be imaged and evaluated radiologically.
Radiological imaging of pleural diseases Pankaj Kaira
The document discusses the anatomy, imaging, and common diseases of the pleura. It begins by describing the normal anatomy of the pleural layers and thickness. Common pleural diseases are then reviewed, including pleural effusions, pneumothorax, hemothorax, and empyema. Imaging findings on chest x-ray, ultrasound, CT, and MRI are provided for diagnosing and characterizing various pleural conditions. Key signs that help differentiate pleural, pulmonary, and extra-pleural masses are also outlined.
Radio Frequency Ablation (RFA Treatment ) -Modern Technology for management l...SafeMedTrip
Safemedtrip india's number one company of medical treatment, which provide low cost treatment package for international patient. if you have any problem Please scan and email your medical reports to us at hospitalindia@gmail.com or help@safemedtrip.com or call us at +91-9899993637 and we shall get you a Free, No Obligation Opinion from India's leading Specialist Doctors.
TIRADS is a practical system for stratifying thyroid nodule malignancy risk in clinical practice. A study of 346 nodules found substantial inter-observer agreement for TIRADS categorization. TIRADS categories 5 and 4c had high positive predictive value for malignancy, while reassigning some 4a nodules to category 3 improved specificity. Thus, TIRADS provides a simple method for ultrasound assessment and risk stratification of thyroid nodules.
Brain imaging is important in trauma to identify injuries from primary impact and secondary complications. CT is best for acute trauma to detect fractures and hemorrhages while MRI is more sensitive for diffuse injuries. Common primary injuries seen include fractures, contusions, hematomas, shearing injuries and hemorrhages in various locations. Secondary complications can include swelling, infection and herniations putting pressure on vessels.
This document provides information on various laryngeal pathologies that can be diagnosed using imaging techniques like CT and MRI. It discusses laryngeal cysts, laryngoceles, thyroglossal cysts, laryngotracheitis, epiglottitis, Wegener's granulomatosis, laryngeal stenosis, vascular malformations, vocal cord paralysis, laryngeal trauma, squamous cell carcinoma, supraglottic carcinoma, glottic carcinoma, transglottic carcinoma, subglottic carcinoma, atypical squamous cell carcinomas, hemangiomas and more. Imaging findings that help diagnose and characterize these conditions are also described.
This document provides an overview of the anatomy of the neck spaces and levels of cervical lymph nodes. It describes the cervical fasciae that divide the neck into compartments. The major spaces discussed include the suprahyoid spaces (sublingual, submandibular, buccal, masticator, parotid, pharyngeal mucosal, parapharyngeal), infrahyoid spaces (visceral, anterior cervical, posterior cervical), and spaces extending along the length of the neck (carotid, retropharyngeal, danger, perivertebral). Each space is defined by its boundaries, contents, and relations to surrounding structures. Understanding the neck spaces is important for diagnosing infections and tumors.
This document summarizes important anatomical variations of the paranasal sinuses that are relevant for sinusitis. It describes variations that can occur in structures like the agger nasi cells, uncinate process, middle turbinate, cribriform plate, and maxillary ostia. These variations include pneumatization of cells or bony structures as well as anatomical abnormalities that can obstruct drainage of the sinuses. Understanding these variations is important for evaluating patients with recurrent sinusitis as certain variations may contribute to obstruction and recurrence.
Ultrasound of the abdominal wall herniasSamir Haffar
This document discusses the ultrasound evaluation of anterior abdominal wall hernias. It describes the different types of hernias including epigastric, periumbilical, umbilical, inguinal, femoral and incisional hernias. For each type of hernia, it provides ultrasound images demonstrating the normal abdominal wall anatomy and signs of the hernia. It also discusses some pitfalls in hernia evaluation that can be mistaken for hernias, such as atrophied muscles, lymph nodes, hematomas and subcutaneous masses. In summary, the document provides a comprehensive overview of abdominal wall hernia ultrasound evaluation through descriptions and images of normal findings and various hernia types.
Presentation1.pptx, radiological anatomy of the naso, oro and hypopharynx.Abdellah Nazeer
The document describes the anatomy and structures of the nasopharynx, oropharynx, and hypopharynx. It discusses how the pharynx is divided into three compartments - the nasopharynx extends from the skull base to the soft palate, the oropharynx extends from the soft palate to the hyoid bone, and the hypopharynx extends from the hyoid bone to the cricopharyngeus muscle. It provides details on the muscles, tissues, and spaces associated with each compartment, including the levator veli palatini, tensor veli palatini, lingual tonsils, valleculae, and piriform sinuses.
PNS (Para-nasal-sinuses) anatomy and variantsDr. Mohit Goel
This document describes the anatomy seen on different types of sinus CT scans, including coronal, axial, and sagittal views. It discusses key structures like the frontal sinus, ethmoid air cells, sphenoid sinus, and osteomeatal complex. It also describes common anatomical variations such as septal deviations, agger nasi cells, variations in the uncinate process, and pneumatized middle turbinates (concha bullosa). The goal is to understand normal sinus anatomy and common anatomic variations that can affect sinus drainage and development of disease.
The document discusses primary retroperitoneal neoplasms. It notes that 70-80% of primary retroperitoneal neoplasms are malignant in nature. The retroperitoneum contains mesodermal neoplasms, neurogenic tumors, germ cell and sex cord tumors, and lymphoid neoplasms. The most common primary retroperitoneal sarcomas are liposarcoma, leiomyosarcoma, and malignant fibrous histiocytoma. Neurogenic tumors such as schwannomas and neurofibromas are usually benign and occur in a younger age group. Teratomas are germ cell tumors that may contain fat, calcium, or sebum levels on imaging.
Git and hepatobiliary radiology mocks fcpsdrneelammalik
1. The document lists various radiological findings related to the liver, biliary system, pancreas and gastrointestinal tract. It includes imaging findings for conditions such as cirrhosis, cholangiocarcinoma, hepatocellular carcinoma, pancreatitis and inflammatory bowel disease.
2. Standard MRI liver protocols are outlined involving pre-contrast and post-contrast sequences including T1, T2, diffusion weighted and delayed hepatobiliary phases.
3. The differences between lymphoma and adenocarcinoma of the stomach on imaging are described. Lymphoma is more likely to preserve the stomach lumen and fat planes.
The document describes the different levels and boundaries of the larynx. It defines the supraglottic region as extending from the tip of the epiglottis to the laryngeal ventricle. The glottis extends from the ventricle to 1 cm below the true vocal cords. The subglottic region extends from the true vocal cords to the inferior portion of the cricoid cartilage. It also provides details on the structures within each region such as the false vocal cords in the supraglottis and the true vocal cords in the glottis.
Imaging of kidny i htn by dr.abd alla shady mdFarragBahbah
Renovascular hypertension is a common cause of secondary hypertension that results from renal artery stenosis. It can be diagnosed through imaging tests like Doppler ultrasound, MRI/CT angiography, and renal scintigraphy. These tests identify anatomical narrowing of the renal arteries and assess renal perfusion and function before and after administration of drugs that stimulate the renin-angiotensin system. Percutaneous angioplasty and stenting are endovascular procedures used to treat renovascular hypertension in select patients with refractory or progressive hypertension related to renal artery stenosis. The choice of imaging test depends on factors like renal function and bilateral versus unilateral involvement to identify and characterize renal artery stenosis safely and effectively.
The document discusses imaging for various types of trauma, focusing on craniocerebral trauma, spinal trauma, chest trauma, and pelvic trauma. For head injuries, CT is recommended as the initial investigation to evaluate brain injuries. Plain films are used to evaluate spinal and bone injuries. CT is also recommended for suspected spinal injuries, as it allows viewing the entire cervical spine in axial, sagittal, and coronal reconstructed images. Any neurological deficit indicates major trauma requiring CT and possibly MRI.
T1, T2, and fat suppressed sequences provide different contrasts in MRI neck imaging. Ideally MRI is performed at 1.5T for advanced imaging. MR sialograms compare favorably to digital sialography for visualizing salivary ducts. Carotid body tumors are hypervascular and located at the carotid bifurcation, displaying a "salt and pepper" sign. Nasopharyngeal carcinoma extends into the skull base and cavernous sinus. Neurogenic tumors can extend intraspinally. MRI is better than CT for assessing upper neck, skull base, and pediatric lesions while CT is better for lower neck and bone involvement.
Presentation1.pptx radio;ogical imaging of benign and malignant soft tissue t...Abdellah Nazeer
This document summarizes several benign soft tissue tumors seen on radiological imaging. It describes infantile hemangioma, lymphangioma, angiomatosis, neurofibroma, myofibroma/myofibromatosis, and neurothecoma. For each tumor, it provides definitions, epidemiology including common sites of involvement, clinical findings, and imaging characteristics such as appearance on CT, MRI, and ultrasound. The document contains various images demonstrating the radiological presentation of these soft tissue tumors.
Basic anatomy Views -importance and positioning Interpretation Skull radiographyairwave12
The document provides instructions for various skull and sinus x-ray views including positioning, collimation, and interpretation guidelines. Key views covered include PA, Caldwell, Chamberlain-Townes, lateral, base, Schuller's, Water's, sinus lateral, and basilar views. Proper positioning is emphasized to ensure quality images and evaluation of important anatomical structures like the sinuses, orbits, and temporomandibular joints.
This document provides information about neck masses, including the major structures in the neck, lymph nodes, and the differential diagnosis. It discusses the major structures that can be palpated in the neck, such as the thyroid gland and lymph nodes. The differential diagnosis is divided into congenital, inflammatory, and neoplastic categories. Common congenital masses discussed include thyroglossal duct cysts, cystic hygromas, ectopic thyroid, plunging ranula, branchial cleft cyst, and dermoid cysts. Inflammatory masses are usually self-limiting.
1. Congenital neck masses are abnormal growths present from birth between the clavicles and mandible. The most common congenital neck mass is a thyroglossal cyst, which forms from a persistent thyroglossal duct during development.
2. Other congenital neck masses include branchial cysts, dermoid cysts, cystic hygromas, hamartomas, and teratomas.
3. Evaluation of congenital neck masses involves inspection, imaging like ultrasound or CT to determine if the mass is solid or cystic in nature, and biopsy if needed to arrive at a definitive diagnosis. Surgical excision is usually the treatment for congenital neck masses.
Radiological imaging of pleural diseases Pankaj Kaira
The document discusses the anatomy, imaging, and common diseases of the pleura. It begins by describing the normal anatomy of the pleural layers and thickness. Common pleural diseases are then reviewed, including pleural effusions, pneumothorax, hemothorax, and empyema. Imaging findings on chest x-ray, ultrasound, CT, and MRI are provided for diagnosing and characterizing various pleural conditions. Key signs that help differentiate pleural, pulmonary, and extra-pleural masses are also outlined.
Radio Frequency Ablation (RFA Treatment ) -Modern Technology for management l...SafeMedTrip
Safemedtrip india's number one company of medical treatment, which provide low cost treatment package for international patient. if you have any problem Please scan and email your medical reports to us at hospitalindia@gmail.com or help@safemedtrip.com or call us at +91-9899993637 and we shall get you a Free, No Obligation Opinion from India's leading Specialist Doctors.
TIRADS is a practical system for stratifying thyroid nodule malignancy risk in clinical practice. A study of 346 nodules found substantial inter-observer agreement for TIRADS categorization. TIRADS categories 5 and 4c had high positive predictive value for malignancy, while reassigning some 4a nodules to category 3 improved specificity. Thus, TIRADS provides a simple method for ultrasound assessment and risk stratification of thyroid nodules.
Brain imaging is important in trauma to identify injuries from primary impact and secondary complications. CT is best for acute trauma to detect fractures and hemorrhages while MRI is more sensitive for diffuse injuries. Common primary injuries seen include fractures, contusions, hematomas, shearing injuries and hemorrhages in various locations. Secondary complications can include swelling, infection and herniations putting pressure on vessels.
This document provides information on various laryngeal pathologies that can be diagnosed using imaging techniques like CT and MRI. It discusses laryngeal cysts, laryngoceles, thyroglossal cysts, laryngotracheitis, epiglottitis, Wegener's granulomatosis, laryngeal stenosis, vascular malformations, vocal cord paralysis, laryngeal trauma, squamous cell carcinoma, supraglottic carcinoma, glottic carcinoma, transglottic carcinoma, subglottic carcinoma, atypical squamous cell carcinomas, hemangiomas and more. Imaging findings that help diagnose and characterize these conditions are also described.
This document provides an overview of the anatomy of the neck spaces and levels of cervical lymph nodes. It describes the cervical fasciae that divide the neck into compartments. The major spaces discussed include the suprahyoid spaces (sublingual, submandibular, buccal, masticator, parotid, pharyngeal mucosal, parapharyngeal), infrahyoid spaces (visceral, anterior cervical, posterior cervical), and spaces extending along the length of the neck (carotid, retropharyngeal, danger, perivertebral). Each space is defined by its boundaries, contents, and relations to surrounding structures. Understanding the neck spaces is important for diagnosing infections and tumors.
This document summarizes important anatomical variations of the paranasal sinuses that are relevant for sinusitis. It describes variations that can occur in structures like the agger nasi cells, uncinate process, middle turbinate, cribriform plate, and maxillary ostia. These variations include pneumatization of cells or bony structures as well as anatomical abnormalities that can obstruct drainage of the sinuses. Understanding these variations is important for evaluating patients with recurrent sinusitis as certain variations may contribute to obstruction and recurrence.
Ultrasound of the abdominal wall herniasSamir Haffar
This document discusses the ultrasound evaluation of anterior abdominal wall hernias. It describes the different types of hernias including epigastric, periumbilical, umbilical, inguinal, femoral and incisional hernias. For each type of hernia, it provides ultrasound images demonstrating the normal abdominal wall anatomy and signs of the hernia. It also discusses some pitfalls in hernia evaluation that can be mistaken for hernias, such as atrophied muscles, lymph nodes, hematomas and subcutaneous masses. In summary, the document provides a comprehensive overview of abdominal wall hernia ultrasound evaluation through descriptions and images of normal findings and various hernia types.
Presentation1.pptx, radiological anatomy of the naso, oro and hypopharynx.Abdellah Nazeer
The document describes the anatomy and structures of the nasopharynx, oropharynx, and hypopharynx. It discusses how the pharynx is divided into three compartments - the nasopharynx extends from the skull base to the soft palate, the oropharynx extends from the soft palate to the hyoid bone, and the hypopharynx extends from the hyoid bone to the cricopharyngeus muscle. It provides details on the muscles, tissues, and spaces associated with each compartment, including the levator veli palatini, tensor veli palatini, lingual tonsils, valleculae, and piriform sinuses.
PNS (Para-nasal-sinuses) anatomy and variantsDr. Mohit Goel
This document describes the anatomy seen on different types of sinus CT scans, including coronal, axial, and sagittal views. It discusses key structures like the frontal sinus, ethmoid air cells, sphenoid sinus, and osteomeatal complex. It also describes common anatomical variations such as septal deviations, agger nasi cells, variations in the uncinate process, and pneumatized middle turbinates (concha bullosa). The goal is to understand normal sinus anatomy and common anatomic variations that can affect sinus drainage and development of disease.
The document discusses primary retroperitoneal neoplasms. It notes that 70-80% of primary retroperitoneal neoplasms are malignant in nature. The retroperitoneum contains mesodermal neoplasms, neurogenic tumors, germ cell and sex cord tumors, and lymphoid neoplasms. The most common primary retroperitoneal sarcomas are liposarcoma, leiomyosarcoma, and malignant fibrous histiocytoma. Neurogenic tumors such as schwannomas and neurofibromas are usually benign and occur in a younger age group. Teratomas are germ cell tumors that may contain fat, calcium, or sebum levels on imaging.
Git and hepatobiliary radiology mocks fcpsdrneelammalik
1. The document lists various radiological findings related to the liver, biliary system, pancreas and gastrointestinal tract. It includes imaging findings for conditions such as cirrhosis, cholangiocarcinoma, hepatocellular carcinoma, pancreatitis and inflammatory bowel disease.
2. Standard MRI liver protocols are outlined involving pre-contrast and post-contrast sequences including T1, T2, diffusion weighted and delayed hepatobiliary phases.
3. The differences between lymphoma and adenocarcinoma of the stomach on imaging are described. Lymphoma is more likely to preserve the stomach lumen and fat planes.
The document describes the different levels and boundaries of the larynx. It defines the supraglottic region as extending from the tip of the epiglottis to the laryngeal ventricle. The glottis extends from the ventricle to 1 cm below the true vocal cords. The subglottic region extends from the true vocal cords to the inferior portion of the cricoid cartilage. It also provides details on the structures within each region such as the false vocal cords in the supraglottis and the true vocal cords in the glottis.
Imaging of kidny i htn by dr.abd alla shady mdFarragBahbah
Renovascular hypertension is a common cause of secondary hypertension that results from renal artery stenosis. It can be diagnosed through imaging tests like Doppler ultrasound, MRI/CT angiography, and renal scintigraphy. These tests identify anatomical narrowing of the renal arteries and assess renal perfusion and function before and after administration of drugs that stimulate the renin-angiotensin system. Percutaneous angioplasty and stenting are endovascular procedures used to treat renovascular hypertension in select patients with refractory or progressive hypertension related to renal artery stenosis. The choice of imaging test depends on factors like renal function and bilateral versus unilateral involvement to identify and characterize renal artery stenosis safely and effectively.
The document discusses imaging for various types of trauma, focusing on craniocerebral trauma, spinal trauma, chest trauma, and pelvic trauma. For head injuries, CT is recommended as the initial investigation to evaluate brain injuries. Plain films are used to evaluate spinal and bone injuries. CT is also recommended for suspected spinal injuries, as it allows viewing the entire cervical spine in axial, sagittal, and coronal reconstructed images. Any neurological deficit indicates major trauma requiring CT and possibly MRI.
T1, T2, and fat suppressed sequences provide different contrasts in MRI neck imaging. Ideally MRI is performed at 1.5T for advanced imaging. MR sialograms compare favorably to digital sialography for visualizing salivary ducts. Carotid body tumors are hypervascular and located at the carotid bifurcation, displaying a "salt and pepper" sign. Nasopharyngeal carcinoma extends into the skull base and cavernous sinus. Neurogenic tumors can extend intraspinally. MRI is better than CT for assessing upper neck, skull base, and pediatric lesions while CT is better for lower neck and bone involvement.
Presentation1.pptx radio;ogical imaging of benign and malignant soft tissue t...Abdellah Nazeer
This document summarizes several benign soft tissue tumors seen on radiological imaging. It describes infantile hemangioma, lymphangioma, angiomatosis, neurofibroma, myofibroma/myofibromatosis, and neurothecoma. For each tumor, it provides definitions, epidemiology including common sites of involvement, clinical findings, and imaging characteristics such as appearance on CT, MRI, and ultrasound. The document contains various images demonstrating the radiological presentation of these soft tissue tumors.
Basic anatomy Views -importance and positioning Interpretation Skull radiographyairwave12
The document provides instructions for various skull and sinus x-ray views including positioning, collimation, and interpretation guidelines. Key views covered include PA, Caldwell, Chamberlain-Townes, lateral, base, Schuller's, Water's, sinus lateral, and basilar views. Proper positioning is emphasized to ensure quality images and evaluation of important anatomical structures like the sinuses, orbits, and temporomandibular joints.
This document provides information about neck masses, including the major structures in the neck, lymph nodes, and the differential diagnosis. It discusses the major structures that can be palpated in the neck, such as the thyroid gland and lymph nodes. The differential diagnosis is divided into congenital, inflammatory, and neoplastic categories. Common congenital masses discussed include thyroglossal duct cysts, cystic hygromas, ectopic thyroid, plunging ranula, branchial cleft cyst, and dermoid cysts. Inflammatory masses are usually self-limiting.
1. Congenital neck masses are abnormal growths present from birth between the clavicles and mandible. The most common congenital neck mass is a thyroglossal cyst, which forms from a persistent thyroglossal duct during development.
2. Other congenital neck masses include branchial cysts, dermoid cysts, cystic hygromas, hamartomas, and teratomas.
3. Evaluation of congenital neck masses involves inspection, imaging like ultrasound or CT to determine if the mass is solid or cystic in nature, and biopsy if needed to arrive at a definitive diagnosis. Surgical excision is usually the treatment for congenital neck masses.
Malignancies of the larynx are most commonly squamous cell carcinomas. They are staged based on tumor size, location within the larynx, and spread to lymph nodes. Treatment depends on the stage and location of the tumor. Early vocal cord lesions are often treated with radiation therapy alone. Moderately advanced tumors may be treated with either radiation or total laryngectomy. Advanced tumors usually require total laryngectomy along with neck dissection and adjuvant treatment. The goal is cure while preserving laryngeal function when possible.
Ultrasonography is a useful tool for examining the thyroid gland and detecting abnormalities. It can help characterize thyroid nodules as benign or malignant based on features such as shape, margins, echogenicity, calcifications, and blood flow patterns. Common benign nodules appear well-marginated, hypoechoic or cystic, and may contain internal debris or a peripheral halo. Diffuse thyroid diseases like multinodular goiter, Graves' disease, and Hashimoto's thyroiditis can also be identified. Ultrasound is also used to guide biopsies and monitor treatment response.
A presentation about an interesting case that came to the Radiology Department of Sebha Medical Center.
A 17 years old male, presented with a painful neck swelling, The swelling was first noticed 10 years ago and was small and painless then. In the last two months, the swelling increased in size and became painful and started to cause slight discomfort on swallowing.
The presentation contains 50 slides, and is divided into the following parts :
1 - The case
2 - Thyroglossal cysts
3 - Imaging Thyroglossal cysts
4 - Differential diagnoses
This presentation was prepared by me and I will present it today in sha Allah in the tutorials of the Radiology Department of Sebha Medical Center.
Congenital neck mass radiology pk final is very good power point presentation for radiologist, radiology resident, student and even ent surgeon or resident doctor.. Every disease of neck lesion is properly describe with multi usg, ct and MRI images. this will help a lot. thanks.
Ultrasound is the first imaging procedure used to evaluate scrotal masses. It can identify masses with nearly 100% sensitivity and determine whether masses are intra- or extra-testicular in most cases. While most solid intra-testicular masses are malignant, most extra-testicular masses are benign. MRI may be useful when ultrasound findings are discrepant with clinical examination or to further evaluate fibrous lesions, lipomas, or hemorrhage. The nature of scrotal masses cannot be determined by imaging alone but localization and structure provide clues about benign or malignant potential.
1. Benign neck diseases are commonly seen in both children and adults. Common etiologies include congenital lesions like lymphangiomas, dermoid cysts, and thyroglossal duct cysts as well as acquired lesions like branchial cysts.
2. Lymphangiomas are benign vascular lesions composed of dilated lymphatic channels or cysts. They can be simple, cavernous, or cystic hygromas. OK-432 is an effective sclerosing agent for treatment.
3. Dermoid cysts contain skin elements and arise from ectodermal differentiation along fusion lines. Complete surgical excision is the treatment of choice.
Presacral tumors are rare lesions located in the retrorectal space. They can be congenital, neurogenic, osseous, or other types. MRI is the best imaging modality to evaluate these tumors. Surgical resection is usually required given the risk of malignancy. The surgical approach depends on the location and extent of the tumor, and may involve the abdomen, perineum, or a combined approach. Complete resection with negative margins while preserving function is the goal.
This document provides information on various neck masses including branchial cysts, branchial fistulas, cystic hygromas, carotid body tumors, and cervical lymphadenopathy. It describes the anatomy, etiology, clinical presentation, diagnosis and management of each condition. Branchial cysts are the most common congenital neck masses and usually present as soft, fluctuant swellings in the neck. Cystic hygromas are lymphangiomas that occur in the neck of newborns. Carotid body tumors develop in the carotid artery bifurcation and may cause cranial nerve palsies or Horner's syndrome. Surgical excision is the main treatment for branchial cysts, cystic hyg
Abstract
Carotid body tumors are rare, slow-growing, hypervascular neuroendocrine tumors. Although these tumors are benign neoplasm, they also have a tendency to malignant transformation. Complete surgical excision is the gold standard therapeutic modality for the treatment of carotid body tumors. Early surgical removal is recommended to prevent the development of larger and more advanced tumors, which are associated with higher morbidity and mortality. In this report, we presented three cases of carotid body tumor which were successfully treated with complete surgical excision, and reviewed the current literature. Furthermore, it was emphasized the necessity of early surgical management regardless of patient age and tumor size.
This document discusses laryngeal tumours, including benign and malignant types. It focuses on laryngeal squamous cell carcinoma, the most common malignant tumour in the head and neck region. Squamous cell carcinoma can arise in the glottis, supraglottis, or subglottis regions. Risk factors include smoking, alcohol, and asbestos exposure. Presenting symptoms depend on the location of the tumour and may include hoarseness, dyspnea, dysphagia, or cervical lymphadenopathy. Staging involves assessing tumour size, extension, lymph node involvement, and metastases. Treatment options include radiotherapy, chemotherapy, endoscopic resection, laryngectomy, and neck dissection, depending on the stage
Unusual non epithelial tumors of head and neckDrAyush Garg
This document provides information on several unusual non-epithelial tumors of the head and neck region. It discusses glomus tumors, hemangiopericytomas, chordomas, lethal midline granuloma, chloroma, and radiation therapy techniques for treating some of these tumors. Key information includes the classification, epidemiology, pathology, clinical presentation, diagnostic workup, management including surgery and radiation therapy, and radiation therapy techniques for glomus tumors, hemangiopericytomas, chordomas, and lethal midline granuloma.
This document provides tips for using a PowerPoint presentation on lymphangioma and cystic hygroma. It recommends freely editing and modifying the slides. It suggests showing blank slides first to elicit student responses before presenting content. Repeating this process of blank slide then content slide three times promotes active learning. The presentation can also be used for self-study. The final slides provide links to access the full presentation on mobile devices or download the collection.
This document provides tips and instructions for using a PowerPoint presentation (PPT) on nasopharyngeal carcinoma. Some key points:
- Slides can be freely edited and modified. Half the slides are blank for active learning exercises.
- The presentation will go through three revisions: showing blank slides to elicit student responses, then showing content slides.
- It is useful for both self-study and active learning sessions.
- Bibliographic references are provided in the notes section.
- The PPT then provides detailed content on the epidemiology, etiology, clinical features, investigations, management and more of nasopharyngeal carcinoma.
Thyroid malignancies are the most common endocrine malignancies. The annual incidence is 3.7 per 100,000 people with a 3:1 female to male ratio. The main types are papillary carcinoma (60% of cases), follicular carcinoma (17%), anaplastic carcinoma (13%), and medullary carcinoma (6%). Risk factors include a history of radiation exposure, family history, and certain genetic syndromes. Presentation varies from asymptomatic thyroid nodules to symptoms of compression. Treatment depends on the type and stage of cancer, and may include surgery, radioactive iodine therapy, chemotherapy, and external beam radiation. Prognosis ranges from generally good for differentiated cancers to very poor for anap
This document provides information on presacral tumors:
- Presacral tumors can arise from any germ cell layer and have varied etiologies including congenital and neurogenic tumors.
- Imaging such as MRI is important for evaluating the tumor extent and involvement of nearby structures. Biopsy may be needed prior to surgery.
- Complete surgical resection is often challenging due to the tumors' location near the sacrum and involvement of nearby nerves and vessels. A multidisciplinary team is typically involved in the surgical planning and approach.
- Posterior, anterior, and combined approaches can be used depending on the tumor location and extent. Nearby structures like the sacrum or rectum may need resection.
- Long
thyroid thyroid nodules benign and malignant thyroid lesions
difference between benign and malignant nodules
TIRADS
imaging criteria
description of tirads
TIRADS scoring system
A 3-year-old girl has had loose stools for 2 months that often contain undigested food. She is otherwise well and thriving. The most probable diagnosis is chronic non-specific diarrhea (toddler's diarrhea). Management includes decreasing fluid intake, especially of fruit juice, providing high-fat foods to slow gastric emptying, and increasing fiber intake through bulking agents. Pharmacologic intervention is rarely required as symptoms usually resolve spontaneously by age 3-4 years.
The document discusses infant feeding and nutrition. It covers various topics including the types and definitions of breastfeeding, the physiology of lactation, problems associated with breastfeeding, infant growth phases and their energy requirements, and the importance of proper nutrition. The key components of human milk are discussed, including fat, proteins, carbohydrates, oligosaccharides, prebiotics and probiotics. Guidelines around establishing and maintaining breastfeeding are provided. Common breastfeeding and infant feeding problems are also outlined.
Postpartum hemorrhage (PPH) is excessive bleeding after childbirth, defined as blood loss over 500 ml for vaginal births or 1000 ml for C-sections. The main causes of PPH are uterine atony (failure of the uterus to contract), retained placenta, and trauma to the genital tract. Management involves bimanual uterine massage, uterotonic drugs, vaginal packing, balloon tamponade, and in severe cases surgical interventions like B-Lynch sutures or hysterectomy.
This document provides information about fetal cardiotocography (CTG), including:
1. CTG can be performed from 28 weeks of gestation as that is when the fetal autonomic nervous system is mature.
2. Normal CTG findings include a baseline heart rate between 110-160 bpm, variability between 5-25 bpm, and an absence of or early decelerations with at least 2 accelerations in 20 minutes.
3. Abnormal findings include bradycardia (<110 bpm), tachycardia (>160 bpm), decreased variability (<5 bpm), and late or variable decelerations which can indicate fetal hypoxia or distress.
This document discusses the partogram, a tool for recording the progress of labor. It explains that the partogram graphs cervical dilation, fetal descent, and uterine contractions on a chart to allow healthcare providers to monitor labor and identify complications early. The document outlines the components recorded on a partogram, including fetal heart rate, amniotic fluid, maternal vital signs, and medications. It describes how to interpret the alert and action lines plotted on the partogram to determine if labor is progressing normally or requires intervention. The partogram is an important tool that facilitates continuity of care during labor and allows early detection of problems like prolonged or obstructed labor.
Gestational trophoblastic disease (GTD) is a spectrum of tumors caused by abnormal proliferation of placental tissue. It includes hydatidiform moles (complete and partial), which are usually benign, as well as gestational trophoblastic neoplasms like invasive moles, choriocarcinoma, and placental site trophoblastic tumors, which are malignant. GTD is diagnosed using clinical features, ultrasound findings, and elevated human chorionic gonadotropin levels. Treatment may involve D&C for molar pregnancies as well as chemotherapy for malignant or persistent cases. Long term follow up is important to monitor for recurrence or progression to gestational trophoblastic neoplasia due to the
Gametogenesis conversion of germ cells into male and female gametes.pptJwan AlSofi
Gametogenesis refers to the formation of male and female gametes. It begins with primordial germ cells that migrate to the developing gonads. Oogenesis involves the formation of ova through meiotic divisions in females, arresting in prophase I until puberty. Spermatogenesis is the formation of sperm in males through mitotic and meiotic divisions of spermatogonia into spermatids. Spermiogenesis then transforms spermatids into mature spermatozoa through nuclear condensation and tail formation. Abnormal gametes can form with extra nuclei or morphological defects preventing fertilization.
Development of the male& female genital system.pptxJwan AlSofi
The document summarizes the development of the male and female genital systems from an indifferent stage. It describes how in males, the presence of SRY leads testes to develop from indifferent gonads, while in females without SRY ovaries develop. It outlines the development of testes, ovaries, male ducts including epididymis and vas deferens, and female ducts including uterus and vagina from indifferent ducts. External genitalia also develop differently in males under testosterone versus females.
First week of development: Ovulation to Implantation Jwan AlSofi
The document summarizes key aspects of ovulation, fertilization, and early embryonic development. It describes the ovarian and menstrual cycles controlled by hormones like FSH and LH. Ovulation occurs mid-cycle due to an LH surge, releasing an egg. Sperm travel through the reproductive tract while undergoing capacitation. Fertilization typically occurs in the fallopian tubes, involving penetration of the egg's layers and fusion of gametes. This activates the egg and forms pronuclei, leading to cell division and pregnancy if implantation occurs. Otherwise, the corpus luteum regresses and menstruation begins.
Approach to patient with spinal cord lesions & diseases
Localize spinal cord lesions
Determining the Level of the Lesion in Myelopathy
Diseases of spinal cord
Multiple sclerosis is a chronic disease characterized by inflammation, demyelination, and gliosis in the central nervous system. It affects around 5 million people worldwide. The cause is unknown but involves genetic and environmental factors. Symptoms vary widely and can include sensory disturbances, motor symptoms, visual problems, ataxia, and cognitive impairment. Diagnosis involves demonstrating dissemination of lesions in the CNS over time via MRI imaging or evoked potentials testing, and sometimes analysis of cerebrospinal fluid. There are several disease courses including relapsing-remitting MS, primary progressive MS, and secondary progressive MS. Management aims to reduce inflammation and disability progression.
This is a comprehensive approach to a hypertensive patient presenting to the emergency department.
Discussing:-
- Hypertensive emergency
- Hypertensive Urgency
- Hypertensive Crisis
- Hypertensive encephalopathy and retinopathy
- Accelerated Hypertension
- Malignant hypertension
1. Short stature can be caused by familial, constitutional, or pathological factors. Familial short stature runs in families while constitutional short stature involves delayed puberty.
2. Pathological short stature can be disproportionate involving abnormal limb ratios, or proportionate involving prenatal issues like IUGR or postnatal diseases/nutritional disorders.
3. Evaluating a short child involves assessing growth charts, growth velocity, bone age, family history, and screening tests to classify the cause of short stature.
Headache is a common symptom in children and adolescents, with up to 75% experiencing a significant headache by age 15. Headaches can be primary, such as migraines or tension-type headaches, or secondary to other conditions such as viral infections. A thorough history and physical exam are usually sufficient for diagnosis, though imaging may be required if symptoms suggest increased intracranial pressure. Treatment involves acute medication to stop attacks as well as preventive medication and lifestyle modifications if headaches are frequent or disabling.
Neonatal seizures are the most common neurological emergency in newborns. The majority occur within the first day of life, and hypoxic ischemic encephalopathy is the most common cause, especially in term infants. In preterm infants, cerebral vascular events are more often the cause. Neonatal seizures are usually focal and often have identifiable underlying causes, unlike seizures in older children which are often idiophenic. The prognosis depends on the underlying etiology, with hypoxic ischemic encephalopathy carrying the worst prognosis. Phenobarbital remains the first-line treatment, though multiple anticonvulsants may be needed to control seizures.
this is a complete discussion and an approach to a child with febrile seizure / convulsion.
It contains:-
Case scenario
Causes of Seizures in the setting of fever
Definition of Febrile Seizure
Age of Occurrence
Types of Febrile Convulsions
Risks of Recurrent Febrile Seizures
Risk For Developing Epilepsy After Febrile Seizures
Workup for Febrile Seizure
Red Flags in Febrile Seizures
Treatment
Prognosis
Approach to Syncope in Children (Pediatric Syncope).pptxJwan AlSofi
Approach to Syncope in Children (Pediatric Syncope), includes:-
Introduction
Differential diagnosis of syncope
Syncope vs vertigo vs Presyncope vs light-headedness.
Comparison of Clinical Features of Syncope and Seizures
Neurocardiogenic (Vasovagal) syncope
MECHANISMS and Causes of Syncope
Cardiac causes of syncope
Life-threatening causes of syncope
Red Flags in Evaluation of Patients With Syncope
Non-cardiac causes of loss of consciousness.
Noncardiac Causes of Syncope
Differentiating Features for Causes of Syncope
EVALUATION of syncope:- History, Examination,Treatment.
Summary
The infant in choice c presents with signs of moderate encephalopathy after a known perinatal hypoxic event and meets criteria for therapeutic hypothermia based on guidelines. The other infants presented do not meet criteria either due to prematurity, mild encephalopathy findings, or presenting outside the time window.
Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
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
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.
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.
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.
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
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).
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
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.
5. • Plain radiography:
• Conventional films can only be used for a preliminary evaluation especially of the
retropharyngeal space when there is a question of retropharyngeal phlegmon or abscess.
• ULTRASOUND: Ultrasound is useful in
1. differentiating solid from cystic neck lesions,
2. in recording the size of nodes (at least in upper neck)
3. in discriminating high-flow from low-flow vascular malformations
• Computed tomography (CT)
• gives a greatly improved soft tissue detail and air space delineation.
• The vascularity of the lesion as well as its relation to vascular structures can be determined.
• Entire extent of large masses can be assesed.
• CT angiography provides non invasive evaluation of vascular structures of the neck.
• CT/MRI are best indicated for deep or extensive lesions, where para and retropharyngeal spaces are
best suspected to be involved, and when ultrasonography is inconclusive.
• MPT
• MRI is good to excellent in detection of the lesion and extent of involvement of adjoining
structures.
• PET Scan or Combined PET-CT :
1. is excellent for staging and follow up of a malignant Neck mass and in Lymphoma
2. Is the investigation of choice for cases with malignant Lymph node of unknown primary (It
Can Easily detect Hidden Primary in the neck or elsewhere)
3. Differentiate between between benign and malignant masses in a patient with known
Cancer
• US-Guided FNA or Biopsy:
This is commonly used for evaluation of suspicious thyroid nodule , suspicious cervical LYMPH
NODES and for solid neck masses when malignancy is suspected based on CT or MRI.
6.
7. How to approach a Patient
with Neck Mass
radiologically?
(What Radiological Test to
be Ordered and When??)
10. Diagnostic approach
• In a neck lesion in a child, ultrasound can usually determine whether a lesion is
cystic or solid.
Cyst
In cystic lesions the diagnosis can frequently be made based on the location of
the lesion.
Lymph node
If the lesion is solid the next step is to assess whether it is a lymph node or
something else.
Often more than one lymph node is enlarged.
Try to differentiate between reactive nodes, lymphadenitis due to TB or cat-
scratch disease and malignant lymphoma.
Solid - not a lymph node
If a solid lesion is not a lymph node look for a possible site of origin, like the
salivary gland, the thyroid gland or the sternocleidomastoid muscle.
17. • The initial diagnostic test of choice in an adult with a persistent
neck mass is contrast-enhanced CT(CECT) which provides
valuable initial information regarding the size, extent, location,
and content or consistency of the mass.
• Additionally, contrast media may help identify malignant lymph nodes
that are not enlarged and distinguish vessels from lymph nodes.
• Iodine-based contrast media should be avoided in patients with a
history of thyroid disease or when metastatic thyroid cancer is a
concern.
• Although positron emission tomography (PET) with CT can be used
to distinguish between malignant and unaffected tissues, its use in
the preliminary diagnosis is not as effective and should be limited to
definitive management of a malignancy.
• But remember US can still be used as an initial study for adult patient
patient specially if the primary aim is
• to know whether the lesion is cystic or Solid,
• to detect nodal size,
• differentiate high-flow from low-flow vascular lesion.
• Ultrasonography, It may also be preferred to avoid contrast media–
induced nephropathy in patients with underlying renal disease.
18.
19. • Contrast enhanced MRI imaging
• defines soft tissues more clearly than CT ,
• permitting assessment of margins and perineural spread.
• This can aid assessment of operability or radiotherapy
planning of the primary site.
• MRI does not expose patients to ionising radiation, is less
affected by dental amalgam, but can be subject to
movement artefact in the larynx and tongue.
• MRI is a useful adjunct to computed tomography in
detecting and, more importantly, staging the primary tumour.
• Disadvantages MRI : It has NO advantage over US or CT for
assessing nodal disease . Contrast material should be
administered with caution in patients with severe renal
impairment. Claustrophobia, difficulty lying flat, and the long
scan time makes MRI impossible for some patients. The
presence of non-MRI compatible metalwork and pacemakers is
an absolute contraindication.
20.
21.
22. After a neck mass is observed , the 1st thing we have
to know is whether the lesion is benign or malignant ,
if the lesion is cyst then it is very unlikely to be
malignant ,
while if the lesion is solid then it is mostly malignant is
adult specially those above above 40yr of age, while
most of the solid neck masses in children are still
benign .
As stated previously , US is very useful for making the
diagnosis of cystic vs. Solid masses.
After a lesion is proved cystic , then the differential
diagnosis would be according to the location.
23. Location of cysticlesions
• Once you have decided that the lesion is cystic its location will
often point to its nature .
Midline lesions
o Midline lesions are either thyroglossal duct cysts, dermoid
cysts or ranulas.
o Older children can be asked to protrude their tongue.
A thyroglossal duct cyst will move upward with the hyoid
bone.
Ranulas have a typical location in the floor of the mouth.
Off-midline lesions
o Off-midline lesions can be branchial cleft cysts or
lymphangiomas.
o Branchial cleft cysts often contain debris.
o Anteriorly located lymphangiomas are often multicystic.
o In the posterior neck they are often single.
24.
25. Location US appearance
Thyroglossal
duct cyst
Midline of neck - hypo-echoic and may
contain internal echoes
- In fornt of the trachea
Branchial cyst - Anterior to SCM
- Superficial to bifurcation
of ICA
- Anechoic / sometimes
internal echoes
- Post acoustic enhancement
Dermoid cyst Suprasternal notch oval lesion With
homogeneous hyper-echoic
contents
Post acoustic enhancement
Ranula • Floor of the mouth
• It can also extend through
or over mylohyoid muscle
and is then called
"plunging ranula" and
present as a submental
submandibular mass
- Anechoic
- Post acoustic enhancement
- continuous with the
sublingual salivary
26. Lymphanagioma
• Remember that Lymphnagioma could be multicompartmental and
multispaceous ,then US will not be able to determine the exact
extension of the lesion specially to the chest which is an important
consideration for surgical resection, then CT or MRI would be of help to
know the extension of a large lesion.
• Below is an eg. of a child with a large neck mass, US features suggested
Lymphangioma but the extent was not possible to be assumed on US,
MRI was helpful to delineate the extent.
Look how MRI
proved the
mediastinal and
intrathoracic
extension of the
Cystic Hygroma
and its relation
to the vessels .
27. Thyroglossal duct cyst
• Thyroglossal duct cysts are common lesions in children.
• The thyroglossal duct runs from the base of tongue at the foramen
caecum to the thyroid gland.
• The embryonic thyroid gland travels through the duct to reach its final
normal position.
• Normally, the thyroglossal duct then involutes, but when the duct
persists, a thyroglossal duct cyst can develop anywhere along this tract .
• Thyroglossal duct cysts move upward if the tongue is protruded or
during swallowing
• Ultrasound is usually sufficient to make the diagnosis.
• Always look for the presence of a normal thyroid gland and make
an image of it.
28.
29. • Thyroglossal duct cysts can be anechoic orhypo-
echoic with internal echoes, due to infection,
hemorrhage, or proteinaceouscontent.
• The majority of thyroglossal duct cysts is located
within 2 cm of the midline.
• Here a tranverse image of a hypoechoicthyroglossal duct
cyst with some internal echoes located in the midline.
30. Here a tranverse image of an anechoic
thyroglossal duct cyst just left of the midline.
31.
32.
33. Dermoid cyst
• Dermoid cysts are inclusion cysts, that contain
epithelium and skin adnexa like hair follicles, sebaceous
glands and sweatglands.
• 7% of dermoid cysts occur in the head and neck region,
especially around the orbit and in the midline of the neck
with a predilection for the suprasternal notch.
• The content of
Thyroglossal duct cysts is usually hypo-echoic and
may contain internal echoes,
while dermoid cysts generally have a more
homogeneous hyper-echoic content.
34.
35. • Here a typical homogeneous hyper-echoic ovallesion,
representing a dermoid cyst, which was located in its
favorite location, the suprasternalnotch.
36. Branchial cleft cyst
• Most branchial cysts are remnants of the second brancial cleft.
• Cysts at the level of the thyroid gland can be remnants of the third
or fourth branchial cleft.
• Incomplete obliteration results in either a cyst (75%), a sinus or a
fistula (25%).
• Cysts present as painless masses, sometimes appearing suddenly after
internal hemorrhage.
• They are located along the anterior border of the
sternocleidomastoid muscle, lateral to the common carotid
artery, and if more cranially between the internal and external
carotid artery.
• Sometimes a beak sign may be seen as a curved rim of the lesion
pointing medially between the internal and external carotid.
37.
38.
39. On ultrasound
• they often contains internal echoes caused by debris,
which consists of cholesterol crystals.
• The cyst is usually compressible, which results in
movement of the content. This may not be the case
in a cyst with a fresh internal hemorrhage.
• They can inflame and present with an empyema.
42. Ranula
• A ranula is a fluid filled
cyst originating from the
sublingualsalivary
• It can extend into the
floor of the mouth and be
visible on inspection of
the oral cavity.
• It can also extend through
or over mylohyoid
muscle and is then called
"plunging ranula" and
present as asubmental
submandibular mass.
• Here an image of a sixteen-
year-old with a firm
swelling under the tongue
the left side.
• Ultrasound showed an
anechoic continuous with
the sublingual salivary
43.
44. Solid Neck Masses
Once a neck mass is turned to be not cystic
(i.e SOLID) , then the next step is to know
whether this SOLID MASS is LYMPH NODES or
NOT
if it is LYMPH NODES whether it is BENIGN or
MALIGNANT.
US is again very helpful to decide whether such
solid lesion is lymph nodes or not and whether it
has benign or malignant features.
46. This image shows a commonly used
classification for the location of lymph
nodes.
1.Level 1
Submental and submandibular
nodes
2.Level 2
Nodes along the internal jugular
vein, above the level of the hyoid
bone
3.Level 3
Nodes along the internal jugular
vein, between the hyoid bone and
cricoid cartilage
4.Level 4
Nodes along the internal jugular
vein, below the cricoid cartilage
5.Level 5
Posterior to the sternocleidomastoid
muscle, above the clavicles
6.Level 6
Anterior to the thyroid gland
47. LN appearance on US:-
Normal lymph nodes are always visible
with ultrasound in children.
A normal lymph node:
1. Is sharply delineated
2. Is oval
3. Has an echogenic center
4. Has a short axis < 10 mm.
The normal jugulodigastric node which is
located below the mandibular angle can
have a short axis of 15 mm.
48.
49.
50. • Enlarged lymph nodes in the neck are very common in children.
• In most cases these are reactive nodes as a reaction to a nearby infection.
• Less commonly it is due to a primary infection of the lymph nodes itself, which is
called lymphadenitis.
• Usually the terms reactive lymphadenopathy and lymphadenitis are used
synonymously.
• Although ultrasound cannot always reliably distinguish lymphadenitis from a
malignant lymphoma, the following table can be helpful to decide whether an
excision biopsy should be done or that a "wait and scan" policy can be adopted.
• Supraclavicular lymph nodes should always be considered to be malignant
until proven otherwise.
51. • Vascular Pattern:
Normal and reactive lymph
nodes tend to have central
hilar vascular pattern.
club- or Y-shaped and extended
from the extra-nodal area into
deep portion of the node.
May be appear as apparently a-
vascular lesion.
Metastatic and lympho-
matous nodes usually show
peripheral or mixed vascularity.
The presence of peripheral
vascularity strongly suggesting
of a pathologic process.
52.
53.
54. • After a solid neck mass turned to be lymph
nodes with suspicious malignant features, the next
step is to confirm its malignant nature by either US or
sometimes CT guided FNA/Biopsy.
• If the malignant nature of the lymph nodes is
confirmed by Histopathology , the next step will be :
1. If the Lymph nodes turned to be lymphoma, then staging has to
be done with either CT scan or PET scan (PET is preferred over CT
both for staging and follow up, once it is available and the pt can
pay for it), US has limited role for staging and follow up .
2. If the lymph nodes turned to be cancerous (Metastatic ) , the next
step is to know its primary source by either CT scan, MRI or PET
scan. Most of the malignant cervical lymph nodes has a hidden
primary in the pharynx , but supraclavicular lymph nodes can be
from primary of Breast, Intra-abdominal (mainly pancreas and
stomach) and Chest (bronchogenic and esophagus ) .
55. Below is a case with malignant neck
lymph node, after investigation it
revealed to has a primary from
Tonsil .
56. - In many cases the imaging findings in a solid lesion will be non-specific
and a diagnosis can only be made through biopsy or excision.
- the solid neck is not lymph nodes , then it should be further
characterized for :
- possible site of origin (is it arising from vessels, nerve course ,muscles, bone ,
salivary glands... etc.) ,
- content (fat, hemorrhage, calcium, necrosis..etc ) ,
- vascularity ,
- extension ,
- invasion to any nearby structures ,
- mass effect on vital structure and compression on air way and food passage
as well as for complication .
- According to the analysis of the above features , a possible diagnosis
(provisional diagnosis ) or a narrow list of differential diagnosis can be
achieved .
- These questions could usually be answered by Contrast Enhanced CT
Scan +/- CT Angiography or by Contrast Enhanced MRI .
- If still the result was not conclusive , the next step would be FNA/Biopsy
of the lesion under US or CT guidance after excluding the vascular
nature of the lesion based on Imaging features .
58. Thyroid nodules
• Thyroid nodules are common.
• They can be single or multiple.
• Some are purely cystic but most are solid.
• On ultrasound they are isoechoic with the normal
gland.
• In a goiter a multitude of solid nodules are seen.
• If there is concern about a possible malignancy fine
needle aspiration can bedone.
59.
60. • This is an
ultrasound
image of a
six-year-old
girl with a
small cyst
with a septum
in the right
thyroid lobe.
It remained
unchanged
over a year.
61. Thyroiditis
• The most common forms of thyroiditis are Hashimoto's thyroiditis and
Graves disease.
• Both Hashimoto's thyreoiditis and Graves disease can present as an enlarged
and hyperemic thyroid.
• Hashimoto's thyroiditis or chronic lymphocytic thyroiditis:
is an auto-immune disease.
It presents with hypothyroidism.
Although primarily a disease of the middle-aged it can present in
children.
On ultrasound the gland is diffusely enlarged and inhomogeneous.
In a later stage the gland shrinks.
On color doppler the blood flow is often normal but can be increased
like in Graves' disease.
62. • In Graves disease the thyroid gland is also enlarged and
shows an increased perfusion.
• On color Doppler it has been described as an inferno in red
and blue.
• Here an image of a 16-year-old girl with hyperthreoidism.
A diffusely enlarged thyroid gland is seen with hyperemia.
The final diagnosis was Graves disease.
She was treated with I-131.
63. Venous malformation
Venous malformation
• A six-month-old boy presented
with a swelling in the left neck at
birth.
• Several ultrasound examinations
could not differentiate between a
hemangioma or a venous
malformation.
At six months of age, the
ultrasound showed a lesion,
which was mostly composed of
vessels which increased in size
on straining.
• On color Doppler the lesion
showed increased flow while
crying.
The final diagnosis on imaging
and on clinical examination was
a venous malformation.
64. Salivary glands
Enlargement of the salivary
glands can be diffuse or focal.
Diffuse swelling mostly affects
the parotid glands.
If it is bilateral it can be caused
by autoimmune diseases (like
Sjögren's disease) or infections(
HIV).
On ultrasound many small
hypoechoic lesions are present.
Unilateral swelling can be
caused by a bacterial parotitis.
Hemangioma is the most
common parotid gland tumor of
childhood, which involute inthe
course of a fewmonths.
Salivary glands
• Enlargement of the salivary
glands can be diffuse or focal.
• Diffuse swelling mostly affects
the parotid glands.
• If it is bilateral it can be caused
by autoimmune diseases (like
Sjögren's disease) or
infections (HIV).
• On ultrasound many small
hypoechoic lesions are present.
• Unilateral swelling can be
caused by a bacterial parotitis.
• Hemangioma is the most
common parotid gland tumor
of childhood, which involute in
the course of a few months.
65.
66.
67.
68. • 90% OF ADULT NECK MASSESARE MALIGNANT.
• 90% OF PEDIATRIC NECK MASSES ARE
INFECTIOUS IN NATURE.
Some Pearls
69. Spaces of the infrahyoid neck
1.Visceral space
• Central compartment containing several viscera like the larynx,
thyroid, hypopharynx and cervical esophagus
2.Carotid space
• Paired space just lateral to the visceral compartment which contains the
internal carotid artery, internal jugular vein and several neural structures.
3.Retropharyngeal space
• A small virtual space containing only fat continuous with the suprahyoid
space and the middle mediastinum.
4.Posterior Cervical Space
• Paired space posterolateral to the carotid
space. It contains fat, lymph nodes and
neural elements.
5.Perivertebral space
• This large space completely encircles the vertebral body including the
pre- and paravertebral muscles.
73. • A 5 year old boy presents with a 2cm size oval shape mobile lump at the
midline of his neck above the level of the hyoid bone . Which initial
imaging modality is best to make the diagnosis ?
1. Plain Xray of Neck AP and Lateral
2. Ultrasound (US) of neck
3. Contrast Enhanced CT Neck
4. MRI NECK
• Contrast Enhanced CT scan is the primary investigation of Choices for
differentiating cystic from Solid Neck mass .
• True False
• Group 3 or Level 3 lymph nodes of the neck is the lymph nodes located
at:
1. Submandibular region
2. Submental region
3. Between Hyoid and Cricoid posterior to Sternocleidomastoid muscle
4. Between Hyoid and cricoid along the sternocleidomastoid muscle and
Internal Jugular vein(IJV)
Editor's Notes
As noticed from the figure above ,
most of the neck masses in pediatric age group is either congenital (usually cystic ) or inflammatory ,
majority of the neck masses in adult above the age of 4o year is neoplastic ,
therefore; the first goal in adult is to determine if the mass is malignant or benign;
malignancies are more common in adult smokers older than 40 years.
Masseteric space
To say a lesion is a cyst rather than a solid mass, we need to have 2 things:
Anechoic
Posterior acoustic enhancement
Sometimes the cyst contains thick substances, so the anechoic feature is lost. So how we know if the lesion is a cyst ( with thick substances) or a solid mass since both may appear iso/hypoechoic ? if post. Enhancement present : it is a cyst //// if no post. Enhancement : solid mass.
Cystic Hygroma also called cystic lymphangioma
The term hygroma means moist tumour
If the Branchial cleft cyst was at the level of Carotid artery 2nd
If the Branchial cleft cyst was at the level of thyroid or below 3rd or 4th
Ranula is a clinical variant of mucocele and presents as a swelling in the floor of the mouth.
The process is similar in nature to mucocele formation, but ranula involves obstruction of a major (rather than minor) salivary gland.
The predominant location is the sublingual gland.
No hilum most likely malignant
Reactive nodes usually show un- sharp borders. Un-sharp borders due to edema & inflammation of surrounding soft tissue.
Most reliable sign for lymphadenitis Tenderness. (Dr.Ayad)
Most likely malignant bczz no hilum
Pulsating mass bw external and internal CA carotid body tumor
- On the left a CT image of a patient with massive subcutaneous emphysema after a motor vehicle accident.Air has dissected along the layers of the cervical fascia.Notice that you are able to find all five spaces - they are now outlined by air.
US can easily differentiate between cystic and solid masses, no radiation hazard, available and cheap
US is the primary investigation of Choice for differentiating cystic versus Solid neck mass
Between Hyoid and cricoid along the sternocleidomastoid muscle and Internal Jugular vein(IJV)