The document discusses radiological imaging of chronic obstructive pulmonary disease (COPD), specifically chronic bronchitis and emphysema. It describes the different types of emphysema - centrilobular, panlobular, and paraseptal - and how they appear on chest x-rays and CT scans. Centrilobular emphysema is the most common type and presents as focal lucencies in the upper lobes. Panlobular emphysema affects the whole lung lobe and is seen in alpha-1-antitrypsin deficiency. Paraseptal emphysema is adjacent to the pleura. Chronic bronchitis results from excess mucus production and presents with bronchial wall thick
PowerPoint presentation on the topic HRCT Chest. This presentation is divided into 5 different parts. 1)Introduction to HRCT chest 2)Technichal aspects of HRCT 3) Relevant anatomy for HRCT interpretation 4)Pattern of lung disease in HRCT 5)HRCT pattern in various ILD’s
PowerPoint presentation on the topic HRCT Chest. This presentation is divided into 5 different parts. 1)Introduction to HRCT chest 2)Technichal aspects of HRCT 3) Relevant anatomy for HRCT interpretation 4)Pattern of lung disease in HRCT 5)HRCT pattern in various ILD’s
How to Make Awesome SlideShares: Tips & TricksSlideShare
Turbocharge your online presence with SlideShare. We provide the best tips and tricks for succeeding on SlideShare. Get ideas for what to upload, tips for designing your deck and more.
COPD are chronic obstructive airway diseases usually need CT scans for early diagnosis and followup. this ppt will give you a brief idea about imaging in COPD.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
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
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
2. Chronic obstructive pulmonary disease is defined as a
preventable and treatable disease state characterized by
airflow limitation that is not fully reversible. The airflow
limitation is usually progressive and is associated with an
abnormal inflammatory response of the lungs to noxious
particles or gases, primarily caused by cigarette smoking.
Emphysema is one of its components, along with asthma
and chronic bronchitis.
Emphysema is defined pathologically as permanent
enlargement of the airspaces distal to the terminal
bronchioles, accompanied by destruction of their walls
and without obvious fibrosis.
Chronic bronchitis is defined as chronic productive cough
for 3 months in each of 2 successive years in a patient in
whom other causes of chronic cough have been excluded.
3.
4. Clinical presentation
The clinical features of emphysema should be distinguished from the
signs and symptoms of chronic bronchitis. Patients with emphysema
are hypocapnoeic and are often referred to as "pink puffers". This
compares with the hypercapnoea and cyanosis of chronic bronchitis
with patients referred to as "blue bloaters". In practice, features of
these two syndromes coexist as chronic obstructive pulmonary disease.
Patients typically report dyspnea without significant sputum
production.
Signs of emphysema include:
tachypnoea
absence of cyanosis
pursed-lip breathing
chest hyperinflation
reduced breath sounds
hyper-resonant to percussion
Cor pulmonale (late)
5.
6. Radiographic features
Plain film
Except in the case of very advanced disease with bulla formation, chest radiography does
not image emphysema directly, but rather infers the diagnosis due to associated features:
hyperinflation:
flattened hemidiaphragm(s): most reliable sign
increased and usually irregular radiolucency of the lungs
increased retrosternal airspace
increased antero-posterior diameter of chest
widely spaced ribs
sternal bowing
tenting of the diaphragm
saber-sheath trachea
vascular changes:
paucity of blood vessels, often distorted
pulmonary arterial hypertension
pruning of peripheral vessels
increased caliber of central arteries
right ventricular enlargement
It should be remembered, however, that the most common plain film appearance of COPD
is "normal" and the role of chest radiography is to eliminate other causes of lung
symptoms such as infection, bronchiectasis or cancer .
7. CT is currently the modality of choice for detecting emphysema; HRCT is
particularly effective. It should be noted, however, that there is relatively poor
correlation between autopsy-proven emphysema, pulmonary function test
abnormalities and CT with 20% of pathology-proven cases not being evident
on CT and 40% of patients with abnormal CT having normal pulmonary function
tests. CT is able to discriminate between centrilobular, panlobular, and
paraseptal emphysema.
Centrilobular emphysema
Centrilobular is by far the most common type encountered, and is a common
finding in asymptomatic elderly patients. It is predominantly located in the upper
zones of each lobe (i.e. apical and posterior segments of the upper lobes, and
superior segment of the lower lobes) and has a patchy distribution. It appears as
focal lucencies (emphysematous spaces) which measure up to 1 cm in diameter,
located centrally within the secondary pulmonary lobule, often with a central or
peripheral dot representing the central brochovascular bundle
Panlobular emphysema
Panlobular emphysema is predominantly located in the lower lobes, has a
uniform distribution across parts of the secondary pulmonary lobule, which
are homogeneously reduced in attenuation.
8. Paraseptal emphysema
Paraseptal emphysema is located adjacent to the pleura and
septal lines with a peripheral distribution within the secondary
pulmonary lobule. The affected lobules are almost always
subpleural, and demonstrate small focal lucencies up to 10 mm
in size.
Any lucency larger than 10 mm should be referred to as
subpleural blebs or subpleural bullae (synonymous).
In all three subtypes, the emphysematous spaces are not
bounded by any visible wall.
MRI
MRI is in the research phases for evaluation of lung parenchymal
abnormalities like emphysema. Dynamic breathing MRI may
have a future role in assessing pulmonary emphysema
9. Emphysema
Emphysema typically presents as areas of low attenuation without visible walls as
a result of parenchymal destruction.
Centrilobular emphysema
Most common type
Irreversible destruction of alveolar walls in the centrilobular portion of the
lobule
Upper lobe predominance and uneven distribution
Strongly associated with smoking.
Panlobular emphysema
Affects the whole secondary lobule
Lower lobe predominance
In alpha-1-antitrypsin deficiency, but also seen in smokers with advanced
emphysema
Paraseptal emphysema
Adjacent to the pleura and interlobar fissures
Can be isolated phenomenon in young adults, or in older patients with
centrilobular emphysema
In young adults often associated with spontaneous pneumothorax
10. Types of emphysema: line diagram shows the parts of secondary pulmonary lobule that are
affected in different types of emphysema. Respiratory bronchioles are primarily affected by
centrilobular emphysema; peripheral alveolar ducts, sacs, and alveoli in paraseptal
emphysema (PLE); all the components (i.e., respiratory bronchioles, alveolar ducts, alveolar
sacs, and alveoli) in panlobular emphysema (PLE), and any part in irregular or
paracicatricial emphysema.
11.
12.
13. Centrilobular emphysema (CLE) and edema: A, Chest radiographs, postero-
anterior and lateral views, show hyperinflation of the lungs (flattened
diaphragm), increased translucency in the upper lungs with vascular attenuation
and loss of arborization. B, Emphysematous spaces outlined by edema fluid filling
the surrounding airspaces give an appearance of reticulation in this patient with
lung edema superimposed on confluent, upper-lung predominant CLE.
14. Centrilobular Emphysema in a Cigarette Smoker. Axial CT image through the upper lungs
shows numerous well-defined lucencies, many of which are traversed by a central vessel.
15. Centrilobular emphysema due to smoking. The periphery of the lung is spared (blue
arrows). Centrilobular artery (yellow arrows) is seen in the center of the hypodense area.
17. Centrilobular emphysema:
A, Transverse computed
tomography images shows
centrilobular
hypoattenuation with upper
lung predominance. Note
the resemblance of the
macroscopic pathologic
image in Figure 4A. B,
Coronal minimum intensity
projection image brings out
the distribution and extent
of emphysema.
18. Centrilobular emphysema: Transverse computed tomography images in the first
row and minimum intensity projection images in the second row show confluent
centrilobular hypoattenuation with posterior lung predominance (arrows), Also
note para-septal emphysema in the left upper lobe (arrow heads).
19.
20. Panlobular emphysema (PLE) from a-1–antitrypsin deficiency: chest radiographs
in postero-anterior and lateral projections show hyperinflation and increased
translucency in the lower lungs with vascular attenuation, indicating PLE.
21. Panlobular emphysema (PLE) from a-1–antitrypsin deficiency: computed tomography
images (first row) show confluent lower-lung predominant panlobular
hypoattenuation, indicating PLE. The confluence, panlobular distribution, lower-lung
predominance, and vascular attenuation are better shown by the coronal minimum
intensity projection and maximum intensity projection images (second row).
22. A- Chest tomography in axial cut showing areas of panlobular emphysema in predominately
lower lobes. Note cylindroids bronchiectasis and thickening of bronchial walls, most evidence
in right. B- coronal reformatted showing hyper-inflation areas in lower lobes.
23. Ritalin lung with panlobular emphysema: chest radiographs, postero-anterior projection,
and computed tomography (coronal reformatted image) show basal-predominant
panlobular hypoattenuation similar to that found in a-1–antitrypsin deficiency.
24. Panlobular Emphysema in a Patient with Alpha-1 Antitrypsin Deficiency. Axial image through
the lower lungs shows homogenous decrease in lung attenuation in both lower
lobes. Some of the interlobular septa in the right lower lobe are accentuated by the emphysema.
27. Paraseptal emphysema: computed tomography shows rectangular cysts sharing
walls in subpleural upper lobes and the superior segment of the left lower lobe.
Centrilobular emphysema is also evident in the upper lobes (arrows).
28. Paraseptal Emphysema in a Cigarette Smoker. Axial image through the upper
lungs shows multiple well-demarcated subpleural air-containing spaces.
31. Paracicatricial emphysema (PCE) from progressive massive fibrosis caused by silicosis:
computed tomography images in lung window show conglomerate masses in the
posterior upper lobes with surrounding low attenuation (arrows) indicating PCE.
Hyperinflation of the anterior upper lungs is from traction by the conglomerate masses.
32. Coronal reformat demonstrating heterogeneous opacity in the right upper lobe
and areas of centrilobular emphysema and para-septal. Tuberculosis in COPD.
33. Bullous emphysema: postero-anterior radiograph and coronal computed tomography
multiplanar reformation and maximum intensity projection images show a large bulla
in the right upper lobe with atelectasis of the adjacent lung (arrows).
34. Apical bleb: computed tomography through the lung apex and multiplanar
reformation show a left apical bleb floating in small pneumothorax
(arrows). Also note unruptured blebs in the right lung apex.
35.
36.
37.
38.
39. Quantification of Emphysema and Air Trapping in 66 year old Individual with GOLD Stage 3 COPD (FEV1 43% predicted)
(a) Inspiratory CT: coronal image depicts voxels with CT attenuation less than -950HU indicating emphysema (14% in
this case). Color coding: Indicates lobes. (b) Inspiratory CT: coronal image depicts distribution of sizes of
emphysematous clusters, with color coding depending on cluster size. (c) Expiratory CT: coronal image depicts voxels
with CT attenuation less than -856HU indicating air trapping (38% in this case). (d) Image map derived from co-
registered inspiratory and expiratory images depicts change in voxel attenuation from inspiration to expiration.
Color coding: Red indicates voxels that were less than -950 HU on inspiration and less than -856 HU on expiration
(emphysema). Yellow indicates voxels that were greater than -950 HU on inspiration, but less than -856 HU on expiration
(air trapping). Green indicates voxels that were less than -950 HU on inspiration and less than -856 on expiration
(normal). White indicates voxels that were greater than -950 HU on inspiration but less than -856 on expiration.
Progress in Imaging COPD, 2004-2014
40. Follow up CT Analysis in Same Subject as Shown in Figure 6. Color coding: Same as in Figure 6. (a) %
LAA-950 has increased from 14% to 23%. (b) Cluster sizes have also increased. (c)Air trapping appears
to have increased from 38% to 45%. (d) Inspiratory-expiratory registration shows that only the amount
of emphysema increased, while the amount of gas trapping remained constant. (e) Longitudinal
registration of baseline and follow up inspiratory scans with micro mapping shows areas of stable
emphysema in red, new areas of emphysema in yellow, and stable normal lung in green.
42. Chronic bronchitis (CB) is often defined as the presence of
productive cough for 3 months in two successive years in a
patient in whom other causes of chronic cough, such as
tuberculosis, lung cancer and heart failure, have been
excluded. It can be an important pathological component
of chronic obstructive pulmonary disease. (often
considered as a distinct phenotype of COPD)
Pathology
Chronic bronchitis most often results from overproduction
and hypersecretion of mucus by goblet cells. This can in
turn lead to worsening airflow obstruction by luminal
obstruction of small airways, epithelial remodeling, and
alteration of airway surface tension predisposing to
collapse.
43. Diagnosis:
A physical examination will often reveal decreased intensity of
breath sounds, wheezing, rhonchi, and prolonged expiration. Most
physicians rely on the presence of a persistent dry or wet cough as
evidence of bronchitis.
A variety of tests may be performed in patients presenting with
cough and shortness of breath:
A chest X-ray is useful to exclude pneumonia which is more common
in those with a fever, fast heart rate, fast respiratory rate, or who
are old.
A sputum sample showing neutrophil granulocytes (inflammatory
white blood cells) and culture showing that has pathogenic
microorganisms such as Streptococcus species.
A blood test would indicate inflammation (as indicated by a raised
white blood cell count and elevated C-reactive protein).
44. Chronic bronchitis with bronchial wall thickening with increased brochovascular
markings, enlarged vessels and cardiomeagly (abnormal enlargement of the heart).
45. Chronic bronchitis: postero-anterior radiograph (A) and computed tomography
(B) show bilateral bronchial wall thickening, the so-called, ‘‘dirty lung.’’
46. Computed tomography (CT) scan in an elderly patient with known chronic
bronchitis. The scans demonstrate thickening of the bronchial walls (purple
arrows) and bronchi filled with mucus or phlegm (blue arrows).
47. Computed tomography (CT) scan in patient with chronic bronchitis showing thickening
of the bronchial walls (red arrows) and mucous within the bronchi (yellow arrows).