caissons disease
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This document defines and describes decompression sickness (also known as "the bends"), which occurs when nitrogen bubbles form in divers' tissues and blood during rapid decompression. It discusses risk factors like age, obesity, dehydration and rapid ascent. Symptoms range from joint pain and rashes to serious neurological issues. Diagnosis involves imaging and hyperbaric oxygen therapy is the primary treatment. Proper diving procedures and waiting after diving to fly can help prevent decompression sickness. The document also outlines medicolegal importance for investigating diving fatalities and underwater incidents.
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Caisson's disease
Caisson's disease, also known as decompression sickness or the bends, occurs when gas bubbles form in the blood and tissues due to a rapid decrease in surrounding pressure, such as during deep sea diving or flying in a non-pressurized plane. Nitrogen dissolved in the body comes out of solution too quickly, forming bubbles that can damage tissues or block blood flow. Symptoms range from joint pain to paralysis or death. Treatment involves recompression in a hyperbaric chamber to resolve the bubbles. Following diving safety procedures can help prevent decompression sickness.
High altitude illness
High altitude illness occurs when the body has difficulty adjusting to low oxygen levels at high elevations. Mild forms include acute mountain sickness with headaches and fatigue. More severe forms are high altitude cerebral edema, where the brain swells, and high altitude pulmonary edema, where the lungs fill with fluid. To prevent illness, people should ascend gradually to high elevations, stay hydrated, and rest adequately. If symptoms occur, descending to lower elevations provides the best treatment.
Cyanosis ppt by dr girish jain
This document provides an overview of cyanosis, including its definition, mechanisms, types (central, peripheral, differential), etiology, factors affecting detection, and treatment principles. Cyanosis is a bluish discoloration of the skin and mucous membranes that results from low oxygen saturation in the blood. It can be caused by issues in oxygen intake, diffusion, or circulation. The underlying etiology could be pulmonary (hypoventilation, diffusion impairment), cardiac (decreased or increased pulmonary blood flow), or a hemoglobinopathy. Detection is affected by hemoglobin level, fetal hemoglobin, and skin pigmentation. Treatment focuses on addressing the underlying condition rather than cyanosis itself, and may include oxygen therapy, warming, and intravenous
Cough
This document discusses cough, including its definition, phases, types, evaluation, investigations, treatment, and complications. It describes the cough reflex and fibers involved. It outlines acute, subacute and chronic cough causes and characteristics. Investigations discussed include sputum analysis, pulmonary function tests, and imaging. Treatment approaches are described for different cough types and durations. Various antitussive medications and their mechanisms and side effects are explained. Complications of cough are also summarized.
Bronchiectasis.
This document discusses bronchiectasis, including its definition, etiology, clinical features, diagnosis, management, and complications. Some key points:
- Bronchiectasis is irreversible dilation of the airways caused by infection or other insults that damages the airways and impairs mucus clearance.
- It has various etiologies including infection, immunodeficiency, genetic disorders, and aspiration. Recurrent infections lead to a vicious cycle of inflammation and further airway damage.
- Symptoms include chronic productive cough and sputum. Investigations include chest CT, which shows characteristic findings like airway dilation.
- Management focuses on airway clearance, antibiotics for infections, and
Approach to a patient with Haemoptysis
This document provides guidance on evaluating and managing patients presenting with hemoptysis. It defines hemoptysis and outlines its various classifications based on blood loss. Common causes are discussed, including tuberculosis, bronchial carcinoma, bronchiectasis, and lung abscesses. A systematic approach to evaluation is recommended, beginning with history, physical exam, chest imaging, and sputum/blood tests. Bronchoscopy can help localize the bleeding site but is usually best delayed until acute bleeding subsides. The goal is to determine the cause and initiate appropriate treatment while stabilizing patients experiencing massive hemorrhage.
Hemoptysis
Hemoptysis is defined as coughing up blood originating below the vocal cords. It can range from blood-streaked sputum to coughing up pure blood. The document discusses the definition, causes, differential diagnosis, diagnosis and treatment of hemoptysis. The main causes discussed are tracheobronchial diseases like bronchitis and tumors, as well as cardiovascular issues. Diagnosis involves history, examination, labs, chest imaging like CXR, CT, and procedures like bronchoscopy.
Cyanosis
Cyanosis
Cyanosis refers to a bluish color of the skin and mucous membranes resulting from an increased quantity of reduced hemoglobin/deoxyhemoglobin or abnormal hemoglobin derivatives, in the small blood vessels of those areas.
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Caisson's disease
Caisson's disease, also known as decompression sickness or the bends, occurs when gas bubbles form in the blood and tissues due to a rapid decrease in surrounding pressure, such as during deep sea diving or flying in a non-pressurized plane. Nitrogen dissolved in the body comes out of solution too quickly, forming bubbles that can damage tissues or block blood flow. Symptoms range from joint pain to paralysis or death. Treatment involves recompression in a hyperbaric chamber to resolve the bubbles. Following diving safety procedures can help prevent decompression sickness.
High altitude illness
High altitude illness occurs when the body has difficulty adjusting to low oxygen levels at high elevations. Mild forms include acute mountain sickness with headaches and fatigue. More severe forms are high altitude cerebral edema, where the brain swells, and high altitude pulmonary edema, where the lungs fill with fluid. To prevent illness, people should ascend gradually to high elevations, stay hydrated, and rest adequately. If symptoms occur, descending to lower elevations provides the best treatment.
Cyanosis ppt by dr girish jain
This document provides an overview of cyanosis, including its definition, mechanisms, types (central, peripheral, differential), etiology, factors affecting detection, and treatment principles. Cyanosis is a bluish discoloration of the skin and mucous membranes that results from low oxygen saturation in the blood. It can be caused by issues in oxygen intake, diffusion, or circulation. The underlying etiology could be pulmonary (hypoventilation, diffusion impairment), cardiac (decreased or increased pulmonary blood flow), or a hemoglobinopathy. Detection is affected by hemoglobin level, fetal hemoglobin, and skin pigmentation. Treatment focuses on addressing the underlying condition rather than cyanosis itself, and may include oxygen therapy, warming, and intravenous
Cough
This document discusses cough, including its definition, phases, types, evaluation, investigations, treatment, and complications. It describes the cough reflex and fibers involved. It outlines acute, subacute and chronic cough causes and characteristics. Investigations discussed include sputum analysis, pulmonary function tests, and imaging. Treatment approaches are described for different cough types and durations. Various antitussive medications and their mechanisms and side effects are explained. Complications of cough are also summarized.
Bronchiectasis.
This document discusses bronchiectasis, including its definition, etiology, clinical features, diagnosis, management, and complications. Some key points:
- Bronchiectasis is irreversible dilation of the airways caused by infection or other insults that damages the airways and impairs mucus clearance.
- It has various etiologies including infection, immunodeficiency, genetic disorders, and aspiration. Recurrent infections lead to a vicious cycle of inflammation and further airway damage.
- Symptoms include chronic productive cough and sputum. Investigations include chest CT, which shows characteristic findings like airway dilation.
- Management focuses on airway clearance, antibiotics for infections, and
Approach to a patient with Haemoptysis
This document provides guidance on evaluating and managing patients presenting with hemoptysis. It defines hemoptysis and outlines its various classifications based on blood loss. Common causes are discussed, including tuberculosis, bronchial carcinoma, bronchiectasis, and lung abscesses. A systematic approach to evaluation is recommended, beginning with history, physical exam, chest imaging, and sputum/blood tests. Bronchoscopy can help localize the bleeding site but is usually best delayed until acute bleeding subsides. The goal is to determine the cause and initiate appropriate treatment while stabilizing patients experiencing massive hemorrhage.
Hemoptysis
Hemoptysis is defined as coughing up blood originating below the vocal cords. It can range from blood-streaked sputum to coughing up pure blood. The document discusses the definition, causes, differential diagnosis, diagnosis and treatment of hemoptysis. The main causes discussed are tracheobronchial diseases like bronchitis and tumors, as well as cardiovascular issues. Diagnosis involves history, examination, labs, chest imaging like CXR, CT, and procedures like bronchoscopy.
Cyanosis
Cyanosis
Cyanosis refers to a bluish color of the skin and mucous membranes resulting from an increased quantity of reduced hemoglobin/deoxyhemoglobin or abnormal hemoglobin derivatives, in the small blood vessels of those areas.
Chronic bronchitis
Chronic bronchitis is defined as a persistent cough with mucus production for at least three months in a year for two consecutive years. It is primarily caused by long-term irritation and inflammation of the airways due to cigarette smoke or other inhaled chemicals. Chronic bronchitis can progress to more severe lung diseases like COPD or lung cancer and, if left untreated, may result in heart failure or respiratory infections. The pathology involves damage to the airways, thickening of the mucus membranes, and increased mucus production.
bronchitis - CHRONIC BRONCHITIS
Chronic bronchitis is defined as a productive cough that lasts for three months or more per year for at least two years. Tobacco smoking is the primary cause and leads to chronic obstructive pulmonary disease in most cases. Symptoms include a chronic cough with mucus, wheezing, and shortness of breath. Treatment focuses on quitting smoking, using inhaled bronchodilators and steroids, and addressing exacerbating factors through medications, oxygen therapy, or lung transplantation in severe cases.
Clubbing
Clubbing, also known as Hippocrates fingers, is the bulbous enlargement of the fingertips and nails. It is caused by proliferation of subcutaneous tissues due to chronic hypoxemia from conditions like lung diseases, heart diseases, and liver or gastrointestinal diseases. Examination involves comparing the fingernails to look for reduced or absent diamond-shaped spaces, indicating clubbing. While clubbing itself has no treatment, addressing the underlying condition can potentially reverse it over time.
Pallor
Pallor is a pale skin color caused by reduced oxyhemoglobin levels. It can be caused by anemia, leukemia, heart disease, shock, endocrine disorders, and more. Anemia itself is a reduction in red blood cells, hemoglobin, or red blood cell volume. The most common type is iron deficiency anemia from inadequate iron intake or absorption. Other types include megaloblastic anemia from B12 or folate deficiency, hemolytic anemia from red blood cell membrane issues or immune/non-immune causes, aplastic anemia from bone marrow failure, and anemia of chronic disease seen in infections, inflammation, or cancers.
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This document provides an overview of how to conduct a history and physical examination of the respiratory system. It outlines the components of a respiratory history, including symptoms like cough, sputum production, dyspnea, hemoptysis and chest pain. For each symptom, it describes factors to assess such as duration, severity and aggravating/relieving factors. The document also details the physical exam of the respiratory system, covering vital signs, inspection findings and auscultation of breath sounds. Common causes are provided for abnormal findings on exam.
Pallor
Pallor is caused by decreased blood in the capillary bed, seen as paleness of the skin and mucous membranes. The most common cause is nutritional anemia such as iron deficiency anemia. Conditions causing pallor without anemia include hypopituitarism, hypothyroidism, and shock. Pallor can be graded as mild, moderate, or severe. Examination sites to check for pallor include the lower eyelid conjunctiva, tongue, hard palate, nail beds, and palms. Confirmation of anemia requires blood tests to measure hemoglobin levels, red blood cell count, and hematocrit.
Decompression Sickness
- Henry's law states that the amount of gas dissolved in a liquid is proportional to the partial pressure of that gas in contact with the liquid. During scuba diving, the increased pressure at depth causes more nitrogen to dissolve in tissues. Rapid ascent reduces pressure and causes nitrogen bubbles to form, potentially resulting in decompression sickness (DCS).
- DCS occurs when dissolved nitrogen forms bubbles in tissues during ascent. It can be prevented by following safe ascent procedures and dive tables. Treatment involves recompression in a hyperbaric chamber to resolve the bubbles.
Cyanosis
Cyanosis is a blue discoloration of the skin and mucous membranes caused by low oxygen levels in the blood. There are two main types - peripheral cyanosis, caused by reduced blood flow and seen in the extremities, and central cyanosis, caused by issues with oxygenation in the lungs or mixing of arterial and venous blood with low oxygen saturation systemically. Peripheral cyanosis can be improved by warming the skin, while central cyanosis requires treatments like oxygen therapy, surgery for congenital heart defects, intravenous fluids, or diuretics to manage fluid accumulation. The document discusses the mechanisms, causes, signs, and treatments of both peripheral and central cyanosis in detail.
Pulmonary fibrosis
Pulmonary fibrosis involves the replacement of lung tissue by fibrous tissue, reducing lung volume and altering texture so that ventilation cannot take place. It increases lung recoil pressure and work of breathing. There are three main types: replacement, focal, and interstitial fibrosis. Idiopathic pulmonary fibrosis (IPF) is a disorder of unknown cause characterized by bilateral, progressive interstitial fibrosis with a histological pattern of usual interstitial pneumonia. It typically affects older adults and has a poor prognosis. Symptoms include a dry cough and dyspnea. Investigations show reticulation on chest imaging and restrictive lung function. Treatment is difficult and lung transplantation is the only definitive option.
Local chest examination
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Cough
Cough is a protective reflex that clears the lungs of secretions and foreign materials. It can be acute (<3 weeks), subacute (3-8 weeks), or chronic (>8 weeks). Coughs are classified based on duration and characterized by timing, associated symptoms, sputum production, and presence of blood. Causes include infections, lung diseases like COPD, and conditions like GERD or postnasal drip. Treatment depends on the underlying cause but may include over-the-counter medications, antibiotics, inhalers, or acid blockers.
Clinical Examination of RS
Brief Presentation on clinical examination of Respiratory System with Report of Normal case
references:
macleod's clinical examination 13th edition
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R Alagappan - Manual of Practical Medicine, 4th Edition
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The document discusses pulmonary eosinophilias, which are a heterogeneous group of disorders characterized by varying degrees of pulmonary or blood eosinophilia. It classifies the main types as Loeffler's syndrome, drug and toxin induced eosinophilic pneumonia, tropical pulmonary eosinophilia, and allergic bronchopulmonary aspergillosis. Loeffler's syndrome is characterized by transient pulmonary infiltrates associated with eosinophilia caused by parasites. Tropical pulmonary eosinophilia is caused by a hypersensitivity reaction to filarial parasites. Allergic bronchopulmonary aspergillosis involves a hypersensitivity response to inhaled fungal antigens like Aspergillus.
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Clubbing
Clubbing refers to focal swelling of the fingers and toes caused by proliferation of connective tissue between the nail matrix and distal phalanx. It is characterized by increased transverse and anteroposterior diameter of the nails. Clubbing can be examined by measuring angles like the Lovibond angle and hyponychial angle. The degree of clubbing is classified from 10 to 40 based on features present. Common causes of clubbing include cyanotic heart disease, lung diseases like bronchiectasis and cystic fibrosis, gastrointestinal conditions like inflammatory bowel disease, and infections like endocarditis. Clubbing is a nonspecific physical finding that may indicate underlying chronic diseases or conditions.
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The document discusses primary hyperparathyroidism, which is caused by adenomas, hyperplasia, or carcinoma of the parathyroid glands. It causes increased calcium absorption and bone resorption while promoting calcium and phosphate excretion in the kidneys. Symptoms include kidney stones, bone loss, fatigue, and abdominal pain. Diagnosis involves blood tests showing elevated calcium and PTH levels. Treatment is parathyroidectomy for severe cases.
Clubbing
Clubbing refers to enlargement of the fingers and toes, particularly on the dorsal surface at the nail bed. It is graded based on changes to the nail bed and angle of the finger. Clubbing is associated with lung, heart, gastrointestinal and endocrine diseases. Some common causes that can be remembered with the acronym CLUBBING include congenital heart diseases, lung diseases, and cancers of the lungs, liver or bowels. Current evidence suggests clubbing may be caused by platelets that normally break down in the lungs but in lung diseases reach the extremities, releasing growth factors that stimulate connective tissue proliferation and clubbing. Clinical tests to assess clubbing include checking for nail bed fluctuation, loss of the Lovib
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This document summarizes common diving injuries and their classification, prevention, and treatment. It discusses conditions like barotrauma of the ears, sinuses, lungs and other tissues that can occur from pressure changes during dives. It also covers decompression sickness and the formation of gas bubbles in tissues or blood from rising too quickly to the surface. Treatment focuses on rehydration, oxygen therapy, and hyperbaric oxygen chambers to remedy tissue bubble issues.
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Chronic bronchitis is defined as a persistent cough with mucus production for at least three months in a year for two consecutive years. It is primarily caused by long-term irritation and inflammation of the airways due to cigarette smoke or other inhaled chemicals. Chronic bronchitis can progress to more severe lung diseases like COPD or lung cancer and, if left untreated, may result in heart failure or respiratory infections. The pathology involves damage to the airways, thickening of the mucus membranes, and increased mucus production.
bronchitis - CHRONIC BRONCHITIS
Chronic bronchitis is defined as a productive cough that lasts for three months or more per year for at least two years. Tobacco smoking is the primary cause and leads to chronic obstructive pulmonary disease in most cases. Symptoms include a chronic cough with mucus, wheezing, and shortness of breath. Treatment focuses on quitting smoking, using inhaled bronchodilators and steroids, and addressing exacerbating factors through medications, oxygen therapy, or lung transplantation in severe cases.
Clubbing
Clubbing, also known as Hippocrates fingers, is the bulbous enlargement of the fingertips and nails. It is caused by proliferation of subcutaneous tissues due to chronic hypoxemia from conditions like lung diseases, heart diseases, and liver or gastrointestinal diseases. Examination involves comparing the fingernails to look for reduced or absent diamond-shaped spaces, indicating clubbing. While clubbing itself has no treatment, addressing the underlying condition can potentially reverse it over time.
Pallor
Pallor is a pale skin color caused by reduced oxyhemoglobin levels. It can be caused by anemia, leukemia, heart disease, shock, endocrine disorders, and more. Anemia itself is a reduction in red blood cells, hemoglobin, or red blood cell volume. The most common type is iron deficiency anemia from inadequate iron intake or absorption. Other types include megaloblastic anemia from B12 or folate deficiency, hemolytic anemia from red blood cell membrane issues or immune/non-immune causes, aplastic anemia from bone marrow failure, and anemia of chronic disease seen in infections, inflammation, or cancers.
History taking and general examination of respiratory system
This document provides an overview of how to conduct a history and physical examination of the respiratory system. It outlines the components of a respiratory history, including symptoms like cough, sputum production, dyspnea, hemoptysis and chest pain. For each symptom, it describes factors to assess such as duration, severity and aggravating/relieving factors. The document also details the physical exam of the respiratory system, covering vital signs, inspection findings and auscultation of breath sounds. Common causes are provided for abnormal findings on exam.
Pallor
Pallor is caused by decreased blood in the capillary bed, seen as paleness of the skin and mucous membranes. The most common cause is nutritional anemia such as iron deficiency anemia. Conditions causing pallor without anemia include hypopituitarism, hypothyroidism, and shock. Pallor can be graded as mild, moderate, or severe. Examination sites to check for pallor include the lower eyelid conjunctiva, tongue, hard palate, nail beds, and palms. Confirmation of anemia requires blood tests to measure hemoglobin levels, red blood cell count, and hematocrit.
Decompression Sickness
- Henry's law states that the amount of gas dissolved in a liquid is proportional to the partial pressure of that gas in contact with the liquid. During scuba diving, the increased pressure at depth causes more nitrogen to dissolve in tissues. Rapid ascent reduces pressure and causes nitrogen bubbles to form, potentially resulting in decompression sickness (DCS).
- DCS occurs when dissolved nitrogen forms bubbles in tissues during ascent. It can be prevented by following safe ascent procedures and dive tables. Treatment involves recompression in a hyperbaric chamber to resolve the bubbles.
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Cyanosis is a blue discoloration of the skin and mucous membranes caused by low oxygen levels in the blood. There are two main types - peripheral cyanosis, caused by reduced blood flow and seen in the extremities, and central cyanosis, caused by issues with oxygenation in the lungs or mixing of arterial and venous blood with low oxygen saturation systemically. Peripheral cyanosis can be improved by warming the skin, while central cyanosis requires treatments like oxygen therapy, surgery for congenital heart defects, intravenous fluids, or diuretics to manage fluid accumulation. The document discusses the mechanisms, causes, signs, and treatments of both peripheral and central cyanosis in detail.
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Pulmonary fibrosis involves the replacement of lung tissue by fibrous tissue, reducing lung volume and altering texture so that ventilation cannot take place. It increases lung recoil pressure and work of breathing. There are three main types: replacement, focal, and interstitial fibrosis. Idiopathic pulmonary fibrosis (IPF) is a disorder of unknown cause characterized by bilateral, progressive interstitial fibrosis with a histological pattern of usual interstitial pneumonia. It typically affects older adults and has a poor prognosis. Symptoms include a dry cough and dyspnea. Investigations show reticulation on chest imaging and restrictive lung function. Treatment is difficult and lung transplantation is the only definitive option.
Local chest examination
This document provides information on performing a local examination of the chest. It describes the key components of inspection, palpation, percussion, and auscultation. Inspection involves examining the shape of the chest and spine for any deformities. Palpation is used to confirm respiratory movements and feel for pulsations, adventitious sounds, and tracheal position. Percussion determines the lung borders and areas of dullness or resonance. Auscultation identifies breath sounds and adventitious sounds such as rhonchi or pleural rubs. Performing a thorough local chest exam provides important clinical information.
Cough
Cough is a protective reflex that clears the lungs of secretions and foreign materials. It can be acute (<3 weeks), subacute (3-8 weeks), or chronic (>8 weeks). Coughs are classified based on duration and characterized by timing, associated symptoms, sputum production, and presence of blood. Causes include infections, lung diseases like COPD, and conditions like GERD or postnasal drip. Treatment depends on the underlying cause but may include over-the-counter medications, antibiotics, inhalers, or acid blockers.
Clinical Examination of RS
Brief Presentation on clinical examination of Respiratory System with Report of Normal case
references:
macleod's clinical examination 13th edition
hutchinson clinical methods
R Alagappan - Manual of Practical Medicine, 4th Edition
Pneumothorax PPT
Pneumothorax refers to the presence of air in the pleural space and can occur spontaneously due to ruptured blebs or as a result of trauma or medical procedures. It presents clinically as reduced breath sounds, hyperresonance to percussion, and mediastinal shift. Chest x-ray or CT scan are used for diagnosis and show hypertranslucency. Treatment involves supplemental oxygen, aspiration, or chest tube placement. Physiotherapy focuses on improving ventilation and exercise tolerance. Recurrence can be prevented through procedures like pleurodesis or thoracotomy along with smoking cessation.
PULMONARY EOSINOPHILIAS
The document discusses pulmonary eosinophilias, which are a heterogeneous group of disorders characterized by varying degrees of pulmonary or blood eosinophilia. It classifies the main types as Loeffler's syndrome, drug and toxin induced eosinophilic pneumonia, tropical pulmonary eosinophilia, and allergic bronchopulmonary aspergillosis. Loeffler's syndrome is characterized by transient pulmonary infiltrates associated with eosinophilia caused by parasites. Tropical pulmonary eosinophilia is caused by a hypersensitivity reaction to filarial parasites. Allergic bronchopulmonary aspergillosis involves a hypersensitivity response to inhaled fungal antigens like Aspergillus.
Lung consolidation
This document discusses a case of lung consolidation seen in a patient. It provides definitions and causes of lung consolidation, including pneumonia, malignancy, and infarction. Differential diagnoses for consolidation are discussed. The document also contains sections on carcinoma of the lung, bronchial carcinoma, clinical features, investigations, management, and classifications of pneumonia by pathogen, anatomy, presentation, duration, and environment.
Hospital acquired pneumonia
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Lecture By:
Dr .Mohammed Munir Khan
Consultant pulmonologist
MB, DTCD, DCard, DGM, MRCP,
FRCP (London), FRCP (Ire.)
Clubbing
Clubbing refers to focal swelling of the fingers and toes caused by proliferation of connective tissue between the nail matrix and distal phalanx. It is characterized by increased transverse and anteroposterior diameter of the nails. Clubbing can be examined by measuring angles like the Lovibond angle and hyponychial angle. The degree of clubbing is classified from 10 to 40 based on features present. Common causes of clubbing include cyanotic heart disease, lung diseases like bronchiectasis and cystic fibrosis, gastrointestinal conditions like inflammatory bowel disease, and infections like endocarditis. Clubbing is a nonspecific physical finding that may indicate underlying chronic diseases or conditions.
Hyperparathyroidism
The document discusses primary hyperparathyroidism, which is caused by adenomas, hyperplasia, or carcinoma of the parathyroid glands. It causes increased calcium absorption and bone resorption while promoting calcium and phosphate excretion in the kidneys. Symptoms include kidney stones, bone loss, fatigue, and abdominal pain. Diagnosis involves blood tests showing elevated calcium and PTH levels. Treatment is parathyroidectomy for severe cases.
Clubbing
Clubbing refers to enlargement of the fingers and toes, particularly on the dorsal surface at the nail bed. It is graded based on changes to the nail bed and angle of the finger. Clubbing is associated with lung, heart, gastrointestinal and endocrine diseases. Some common causes that can be remembered with the acronym CLUBBING include congenital heart diseases, lung diseases, and cancers of the lungs, liver or bowels. Current evidence suggests clubbing may be caused by platelets that normally break down in the lungs but in lung diseases reach the extremities, releasing growth factors that stimulate connective tissue proliferation and clubbing. Clinical tests to assess clubbing include checking for nail bed fluctuation, loss of the Lovib
Splenomegaly : causes , clinical approach and examination
Splenomegaly : Spleen weight of 400-500gm
750 – 1000gm : prominent below costal margin
>1000gm : massive splenomegaly
stepwise approach
History
Physical examination
Laboratory tests
Imaging
Specialised tests
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History taking and general examination of respiratory system
History taking and general examination of respiratory system
Splenomegaly : causes , clinical approach and examination
Splenomegaly : causes , clinical approach and examination
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Presentation on dysponea
Dyspnea derives from Greek for “ “ shortness of breath hard breathing ”. It is often also described as ”. This is a subjective sensation of breathing, from mild discomfort to feelings of suffocation. It is a sign of a variety of disorders and is primarily an indication of ventilation or of inadequate insufficient amounts of oxygen in the circulating blood .
Dyspnea happens when a “mismatch” occurs between afferent and efferent signaling. As the brain receives afferent ventilation information, it is able to compare it to the current level of respiration by the efferent signals. If the level of respiration is inappropriate for the body’s status and need, then dyspnea might occur
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The respiratory system
The document outlines plans for the week of respiratory system notes and labs, including a respiratory notes worksheet on Monday, a lung capacity lab on Tuesday, circulatory notes and worksheets on Wednesday, and pulse labs on Thursday and Friday. Students are instructed to bring a notebook and writing utensils. The remainder of the document details the structures and functions of the respiratory system, gas exchange process, common respiratory illnesses, and career options in respiratory therapy.
6-180410171042.pptx ppt okhhgvnjggghjhgyuggg
Dyspnea, also known as shortness of breath, is a subjective sensation that results from a mismatch between the brain's perception of how much ventilation is needed and the amount of ventilation that is occurring. Three main components contribute to dyspnea: afferent signals from receptors in the lungs and airways, efferent signals from the brain to respiratory muscles, and central processing in the brain. A variety of cardiac, pulmonary, and other medical disorders can cause dyspnea through different mechanisms that impact ventilation. Management of dyspnea involves treating its underlying cause, reducing ventilatory demand, improving respiratory muscle function, and techniques to decrease the sense of respiratory effort.
Polytrauma part 2 (ards)
Acute respiratory distress syndrome (ARDS) is a Sudden failure of the respiratory system. It Can occur in anyone over the age of one who is critically ill. It is a Life- threatening because normal gas exchange does not take place due to severe fluid buildup in both lungs.
Prevention can be achieved by Limiting Blood Loss so decreasing transfusion requirements, Early Stabilization Of unstable Fractures and Early prophylactic mechanical Ventilation.
Established cases with ARDS is treated in the Intensive Care Unit By Mechanical ventilation and Oxygen therapy through a ventilator, Fluids through an IV line to improve blood flow and provide nutrition and medicine to prevent and treat infections and to relieve pain.
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caissons disease
- 2. Over view Definition Risk factors Pathogenesis Signs and symptoms Diagnosis Treatment Prevention Medicolegal importance
- 3. Definition Acute decompression syndrome (Caisson’s disease) is an acute neurological emergency in divers. Also known as divers disease, bends,staggers,aeroembolic. Decompression sickness is a disorder in which nitrogen dissolved in the blood and tissues by high pressure forms bubbles . It occurs most frequently during deep sea diving or flying in a non pressurized aircraft or underwater construction worker.
- 5. Risk Factors Alcohol excess Cardiac defects-patent foramen ovale,ASD Cold water Dehydration Exertion Flying after diving Fatigue Hypoxia Increased pressure Length of time spent in pressurized environment Medications like-antihistamines,narcotics Obesity Older age Rapid ascent
- 6. Effects of high partial pressure: At 100 feet –increased pressure is 4 times greater than surface. At 120 feet-mild narcosis will appears- lose his or her self care At 150-200 feet-drowsy At 200-250-strength decreasing significantly and divers feel clumsy to perform the work Beyond 250 feet-divers almost useless as a result of nitrogen narcosis
- 7. Henry's law is one of the gas laws states that: at a constant temperature, the amount of a given gas that dissolves in a given type and volume of liquid is directly proportional to the partial pressure of that gas in equilibrium with that liquid. P=KH C P-PARTIAL PRESSURE OF THE GAS IN THE ATOMP PRESSURE. C-CONC OF DISSSOLVED GASES
- 8. Pathogenesis It is a particular form of gas embolism which occurs when indiviuals are exposed to sudden lowering of pressure . When air is breathed under high pressure- increased amount of gas become dissolved in the blood If the divers ascents suddenly ,bubbles of nitrogen gets formed. It causes – Bends-joints and skeletal pain Chokes-breathing problem Staggers-neurological problems
- 9. Symptoms – 1-6 hours Dizziness Double vision Headache Trouble to speak Pain in legs-joint pain Itching and rashes Serious And Life-threatening Symptoms: affecting the brain, spinal cord, inner ear, and/or lung Mild Symptoms: Arthralgia, Skin Marbling, Small Patchy Hemorrhages, And Lymphatic Obstruction.
- 10. Frequency & onset Symptoms Frequency Local Joint Pain 89% Arm Symptoms 70% Leg Symptoms 30% Dizziness 5.3% Paralysis 2.3% Shortness Of Breath 1.6% Extreme Fatigue 1.3% Collapse /unconscious 0.5% Time to onset % of cases Within 1 hour 42% Within 3 hours 60% Within 8 hours 83% Within 24 hours 98% Within 48 hours 100%
- 11. Diagnosis 1)X-ray and CT scan of whole body 2)Suspected venous embolism: a)Abdomen opened first b)Opening of the chest c)PM demonstration of venous embolism d)Source of air - Air in SVC(stab wounds of neck) e)Composition of air - >95% nitrogen- nitrogen narcosis
- 14. Treatment 100% Hyperbaric oxygen therapy followed by Recompression in a hyperbaric chamber. Platelet inhibitors Anti-inflammatory drugs are also useful.
- 15. Prevention To prevent the excess formation of bubbles leading to decompression sickness, divers limit their ascent rate Dive and rise slowly in the water, and don't stay at your deepest depth longer than recommended. Do not fly within 24 hours after diving. Don't drink alcohol before diving. Avoid hot tubs or hot baths after diving. Make sure you are well hydrated, well rested and prepared before you scuba dive.
- 16. Region Autopsy findings External examination cyanosis, cherry red coloration,marbling ,facial edema,froth in mouth and nose,mottled pallor of tongue ,abrasions ,contusions .. Head and neck #,gas bubbles in cerebral arteries,vessels, SDH,SAH,focal hge,cerebral edema Eyes and ears Rupture of tympanic membrane,gas in retinal vessels Chest ,tracheobronchial tree,and lungs Foam,aspirated vomit,pneumothorax,pulmonary edema,petechial hemorrhage,nitrogen bubbles in pericapillary pulmonary arteries,fat emboli. Blood from heart Air embolism,alcohol intoxication,CO . Heart Air embolism ,IHD Other organs Fatty change liver,infarction in many organs Spinal cord Nitrogen bubbles in spinal arteries Bones and joints Dysbaric osteonecrosis
- 18. PM DEMONSTRATION 1) Air in right ventricle Sternum removed Vessels clamped Pericardium opened Beaded appearance Coronaries incised 2)Minus plunger 3)Pyrogallol test AIR EMBOLISM
- 19. Pyrogallol Test RAPID AUTOPSY TEST Principle 1)putrifactive gases will not contain any o2 2)Alkaline solution turns purple Procedure 1)4ml freshly prepared 2%pyrogallol solution-2 syringes 2)1st syringe-add 4 drops of 0.5M NaOH – RV – aspirate – seal - shake – turns purple 3)2nd syringe – as control - turn brown in all cases
- 20. MEDICOLEGAL IMPORTANCE: Underwater Crime Scuba Deaths Underwater Disasters Underwater photograpny Recreational Diving Fatalities Forensic Biology Education Archives Cave Divers Unlock Mysteries Suicidal Inhalation
- 21. References Anil agarwal text book of forensic medicine Knights –forensic pathology Narayana reddy textbook of forensic medicine Dikishit textbook of forensic medicine Gautam Biswas-Review of forensic medicine and toxicology International Journal of Advanced Research (2016), Volume 4, Issue 2, 25-30/6https:// Journals.sagepub.com/doi/10.1177/0025817217734481 July 2013 Journal of Forensic Sciences 58(5) DOI: 10.1111/15564029.12239 Source PubMed