This document discusses pulmonary pathophysiology and signs and symptoms of pulmonary disease. It notes that factors reducing airflow compromise particle clearance and predispose to nosocomial infections. Restricted lung movement from positioning, bandages, CNS depression, or coma can impair ventilation and clearance. Dyspnea is the subjective sensation of uncomfortable breathing and is usually caused by diffuse rather than focal lung disease. Cough is an attempt to clear lower airways and results from inflammation, secretions, or fluid accumulation. Cyanosis occurs when blood contains large amounts of unoxygenated hemoglobin. Clubbing is the enlargement of finger and toe tips associated with decreased oxygenation. Respiratory failure is the inability to oxygenate blood or remove
The human respiratory system involves breathing controlled by the medulla oblongata. Gas exchange occurs in the alveoli of the lungs, with oxygen diffusing into the blood and carbon dioxide diffusing out. Breathing in and out is achieved through contractions and relaxations of the diaphragm and rib cage. Diseases of the respiratory system include bronchitis, emphysema, pneumonia, lung cancer, and asthma.
Pathophysiology of asphyxia & drowningchetan samra
This document discusses pathophysiology of asphyxia. It begins by defining asphyxia and describing the normal levels of oxygen in the blood. It then discusses Gordon's classification of anoxia and the different types. Histotoxic anoxia is subdivided and explained further. The stages of asphyxia and vicious cycle are outlined. Asphyxial triad of cyanosis, congestion/edema and petechiae is defined. Violent asphyxial deaths like hanging, strangulation and drowning are described along with their post-mortem findings. Specific tests for drowning like diatom test are also mentioned.
Changes in Respiratory System with Various Physiological ConditionsAnand Bansal
Topics - High-Altitude Physiology, Deep Sea Diving And Effects Of Increased Barometric Pressure, Changes In Respiratory System During Pregnancy, Physiological Changes Of Repiratory System With Exercise, Physiological Changes Of Respiratory System With Aging
This document discusses the physiological effects of nitrogen and oxygen on deep sea divers. It explains that nitrogen dissolved in tissues can cause nitrogen narcosis or decompression sickness if a diver ascends too quickly. Decompression sickness occurs when nitrogen bubbles form in tissues and block blood vessels, causing pain and other symptoms. The document discusses prevention methods like slow ascension and tank decompression. It also covers saturation diving using helium mixtures and oxygen toxicity risks for deep dives. SCUBA and hyperbaric oxygen therapy techniques are also summarized.
This document discusses various disturbances of respiration, including abnormal respiratory patterns, apnea, dyspnea, periodic breathing, hypoventilation, hyperventilation, and disturbances related to respiratory gases. It provides definitions and descriptions of these conditions, their causes, types, symptoms, and physiological mechanisms. Key topics covered include eupnea, tachypnea, bradypnea, polypnea, voluntary apnea, deglutition apnea, hypoventilation, hyperventilation, Chyne-Stokes breathing, Biot's breathing, hypoxia, cyanosis, and the physiological effects and treatment of oxygen therapy.
This document discusses the physiological effects of exposure to high altitudes and deep sea diving. It explains how the body acclimatizes to decreased oxygen levels at high altitude through increased respiration, red blood cell production, angiogenesis and other adaptations. It describes the risks of acute mountain sickness and pulmonary edema if acclimatization does not occur. For deep sea diving, it outlines the risks of nitrogen narcosis and oxygen toxicity at high pressures.
Edema is the accumulation of excess fluid in body tissues. It can be caused by increased hydrostatic pressure, reduced plasma oncotic pressure, inflammation, lymphatic obstruction, or sodium/water retention. Edema is classified as generalized, localized, pitting or non-pitting depending on location and indentation. Signs include weight gain, swelling, and distended veins. Diagnosis involves medical history, physical exam including edema grading, and tests like serum osmolarity. Treatment focuses on managing the underlying cause, restricting salt, diuretics, antibiotics, oxygen, and nursing care like monitoring for complications.
This document discusses pulmonary pathophysiology and signs and symptoms of pulmonary disease. It notes that factors reducing airflow compromise particle clearance and predispose to nosocomial infections. Restricted lung movement from positioning, bandages, CNS depression, or coma can impair ventilation and clearance. Dyspnea is the subjective sensation of uncomfortable breathing and is usually caused by diffuse rather than focal lung disease. Cough is an attempt to clear lower airways and results from inflammation, secretions, or fluid accumulation. Cyanosis occurs when blood contains large amounts of unoxygenated hemoglobin. Clubbing is the enlargement of finger and toe tips associated with decreased oxygenation. Respiratory failure is the inability to oxygenate blood or remove
The human respiratory system involves breathing controlled by the medulla oblongata. Gas exchange occurs in the alveoli of the lungs, with oxygen diffusing into the blood and carbon dioxide diffusing out. Breathing in and out is achieved through contractions and relaxations of the diaphragm and rib cage. Diseases of the respiratory system include bronchitis, emphysema, pneumonia, lung cancer, and asthma.
Pathophysiology of asphyxia & drowningchetan samra
This document discusses pathophysiology of asphyxia. It begins by defining asphyxia and describing the normal levels of oxygen in the blood. It then discusses Gordon's classification of anoxia and the different types. Histotoxic anoxia is subdivided and explained further. The stages of asphyxia and vicious cycle are outlined. Asphyxial triad of cyanosis, congestion/edema and petechiae is defined. Violent asphyxial deaths like hanging, strangulation and drowning are described along with their post-mortem findings. Specific tests for drowning like diatom test are also mentioned.
Changes in Respiratory System with Various Physiological ConditionsAnand Bansal
Topics - High-Altitude Physiology, Deep Sea Diving And Effects Of Increased Barometric Pressure, Changes In Respiratory System During Pregnancy, Physiological Changes Of Repiratory System With Exercise, Physiological Changes Of Respiratory System With Aging
This document discusses the physiological effects of nitrogen and oxygen on deep sea divers. It explains that nitrogen dissolved in tissues can cause nitrogen narcosis or decompression sickness if a diver ascends too quickly. Decompression sickness occurs when nitrogen bubbles form in tissues and block blood vessels, causing pain and other symptoms. The document discusses prevention methods like slow ascension and tank decompression. It also covers saturation diving using helium mixtures and oxygen toxicity risks for deep dives. SCUBA and hyperbaric oxygen therapy techniques are also summarized.
This document discusses various disturbances of respiration, including abnormal respiratory patterns, apnea, dyspnea, periodic breathing, hypoventilation, hyperventilation, and disturbances related to respiratory gases. It provides definitions and descriptions of these conditions, their causes, types, symptoms, and physiological mechanisms. Key topics covered include eupnea, tachypnea, bradypnea, polypnea, voluntary apnea, deglutition apnea, hypoventilation, hyperventilation, Chyne-Stokes breathing, Biot's breathing, hypoxia, cyanosis, and the physiological effects and treatment of oxygen therapy.
This document discusses the physiological effects of exposure to high altitudes and deep sea diving. It explains how the body acclimatizes to decreased oxygen levels at high altitude through increased respiration, red blood cell production, angiogenesis and other adaptations. It describes the risks of acute mountain sickness and pulmonary edema if acclimatization does not occur. For deep sea diving, it outlines the risks of nitrogen narcosis and oxygen toxicity at high pressures.
Edema is the accumulation of excess fluid in body tissues. It can be caused by increased hydrostatic pressure, reduced plasma oncotic pressure, inflammation, lymphatic obstruction, or sodium/water retention. Edema is classified as generalized, localized, pitting or non-pitting depending on location and indentation. Signs include weight gain, swelling, and distended veins. Diagnosis involves medical history, physical exam including edema grading, and tests like serum osmolarity. Treatment focuses on managing the underlying cause, restricting salt, diuretics, antibiotics, oxygen, and nursing care like monitoring for complications.
Deep sea diving and physiological response to high barometric pressure Ranadhi Das
Sea water is approximately 800 times more dense than air. Therefore, it exerts much greater pressure on the body of a diver.
The weight exerted by the atmosphere on an area of 1m2, is approximately 10,000kg at sea level. This value of pressure (10,000 kg m-2) is thus referred to as 1 atmospheric absolute (1 ATA), or 1 atmospheric pressure.
For every 10m(~32feet) below the surface a person dives, he is subjected to an additional pressure of 1ATA. Therefore, at 30m, a diver will experience a pressure of 4 ATA (1 ATA exerted by the atmosphere, & 3 ATA exerted by the 30m of water above him).
It discusses various effects of high altitude on human body in detail, acute mountain sickness, chronic mountain sickness, high altitude pulmonary edema, high altitude cerebral edema, acclimatization
This document provides information on oxygen insufficiency and discusses key points:
- Oxygen is essential for life and is involved in cellular respiration. It makes up 20.94% of air by volume.
- Oxygen insufficiency, or hypoxia, occurs when oxygen delivery to tissues is inadequate to meet metabolic demands. This can be caused by problems with ventilation, gas exchange, oxygen transport, or cellular respiration.
- Symptoms of hypoxia range from shortness of breath to confusion and loss of consciousness. Diagnostic tests for hypoxia include blood gas analysis, pulse oximetry, pulmonary function tests, and imaging studies.
- Nursing management of patients with oxygen insufficiency focuses on
Nursing management of patients with oxygen insufficiencyAparna A
Without adequate oxygen, major organ systems begin to fail within minutes or hours. Oxygen is essential for cellular respiration and is delivered to tissues through a multi-step process involving ventilation, diffusion, transportation, and perfusion. Factors like development, physiology, behavior, lifestyle, and medication can impact oxygenation. It can be measured using tools like pulse oximetry, arterial blood gases, and capnography. Conditions resulting from inadequate oxygen delivery and utilization include hypoxemia, hypoxia, anoxia, respiratory failure, and cyanosis. Prompt treatment focuses on restoring adequate oxygen supply and ventilation.
The document discusses the physiology of high pressure experienced during deep sea diving. It explains that as depth increases, pressure increases linearly and gas volumes in the body decrease. Issues that can arise include nitrogen narcosis, oxygen toxicity, carbon dioxide buildup, and decompression sickness during ascent. Decompression sickness occurs when nitrogen dissolved in tissues comes out of solution rapidly, forming bubbles that block blood vessels. Treatment involves recompression in a hyperbaric chamber to resolve bubbles.
This document discusses the physiology of diving and diving-related injuries and conditions. It covers:
- Gas laws and how gas behaves in the body at different pressures during descent and ascent.
- Common injuries from barotrauma including ear, sinus, and pulmonary barotrauma.
- Decompression sickness (DCS), also known as "the bends", caused by bubbles forming as gases come out of solution during ascent. Symptoms range from joint pain to neurological issues.
- Treatment for DCS and arterial gas embolism involves hyperbaric oxygen therapy to reduce bubble size and accelerate resolution through increased oxygen pressure and nitrogen elimination from tissues.
This document discusses abnormal breathing patterns, defining parameters used to assess breathing such as rate, depth, rhythm, and character. It then describes several specific abnormal patterns including apnea, tachypnea, bradypnea, hyperventilation, Kussmaul breathing, Cheyne-Stokes breathing, and obstructed breathing. For each abnormality, the document provides the defining characteristics and potential underlying causes.
Deep sea diving and effects of increased barometricYogesh Ramasamy
Pressure increases with depth underwater, so divers breathe pressurized gases to equalize pressure in their bodies. Rising too quickly can cause decompression sickness as nitrogen bubbles form in tissues. Symptoms include joint pain and neurological issues. Treatment uses hyperbaric oxygen chambers to slowly reduce pressure and allow bubbles to dissolve harmlessly.
Oxygen insufficeincy and sensory deprivationParbh Jot
The document discusses oxygen insufficiency and sensory deprivation. It defines oxygen insufficiency as a condition where the body or a region is deprived of adequate oxygen supply. Causes include decreased hemoglobin, altitude, tissue oxygen extraction issues, and impaired ventilation. Symptoms include cyanosis, altered breathing, and fatigue. Nursing assessments focus on respiratory status and signs of hypoxia. Oxygen therapy is the primary treatment. Sensory deprivation occurs when a person experiences decreased meaningful stimuli and can affect physical, cognitive, and emotional functioning. At-risk groups include those with sensory impairments or in long-term care. Preventing deprivation involves promoting healthy sensory stimulation.
Cyanosis is a bluish discoloration of the skin and mucous membranes due to the presence of large amounts of reduced hemoglobin in the blood. It occurs in conditions that cause hypoxic or stagnant hypoxia, when hemoglobin is altered by poisoning, or when red blood cell count is increased, slowing blood flow. Cyanosis requires at least 5-7g% of reduced hemoglobin and does not occur in anemia, which reduces total hemoglobin. Asphyxia involves hypoxia and hypercapnia from airway obstruction, and leads through stages of increased then depressed breathing to convulsions, loss of consciousness, and death if not resolved. Periodic breathing patterns include Cheyne-Stokes respiration
This document discusses acute dyspnea, defined as an uncomfortable need to breathe. It results from an imbalance between the perceived need and ability to breathe, often due to carbon dioxide buildup or oxygen deprivation. Common causes include pulmonary issues like pneumonia, cardiac issues like pulmonary edema, and metabolic acidosis. Diagnosis involves history, exam, and tests to identify the underlying cause. Treatment focuses on relieving symptoms like with opioids and addressing the specific condition through methods such as antibiotics for pneumonia or oxygen therapy for pulmonary edema.
This document discusses hypoxic and hypercapnic-hypoxic acute respiratory failure (ARF). It defines hypoxic ARF as a PaO2 less than 60 mm Hg and hypercapnic-hypoxic ARF as a PaCO2 greater than 50 mm Hg. The causes, etiologic mechanisms, and clinical manifestations of each condition are described. A focused assessment involving history, physical exam, blood gases, and chest imaging is recommended to evaluate the underlying etiology and guide urgent treatment decisions when hypoxemia is life-threatening.
High altitudes above 10,000 feet can cause hypoxia and physiological responses in the body. There are two responses - acute accommodation responses that occur immediately like hyperventilation and increased heart rate, and longer term acclimatization over days and weeks including increased red blood cell count and lung capacity. Rapid ascents can cause dangerous conditions like high altitude pulmonary edema while more gradual acclimatization reduces risks.
Altitude physiology typically focuses on people above 2500 m; ∼8000 ft. Altitudes above that are sometimes subdivided into very high (3500–5500 m; ∼11,500–18,000 ft) and extreme (>5500 m; >18,000 ft). An estimated 40 million people travel each year to altitudes >2500 m (∼8000 ft),1 and as many or more travel to altitude for leisure and sports, and work in mines, military or border operations, and the like. Altitude medicine considers the clinical disorders associated with acclimatization by the travelers, workers and migrants, and with adaptation by people with lifetimes or populations with millennia of residence (an estimated 83 million people).
With a hurried ascent, many (∼80%) will report a transient headache (high-altitude headache or [HAH]), and some will develop one of three forms of acute high-altitude illness: acute mountain sickness (AMS) and HAH, high-altitude cerebral edema (HACE), and high-altitude pulmonary edema (HAPE). AMS and HAH are annoying and interfere with activity and work, however, HACE and HAPE can be fatal with mortality rates approaching 30%. Among some residents, chronic mountain sickness (CMS) and right ventricular hypertrophy develop over months to years of residence at altitude. Birth weights are generally lower and the rate of small-for-gestational-age babies and congenital heart defects are higher than that in lowland populations.
High altitudes above 9,000 feet can cause physiological effects due to low atmospheric pressure and oxygen levels. The body undergoes adaptations like increased respiration and heart rate, higher red blood cell counts, and fluid shifts. However, too rapid an ascent can cause illnesses like acute mountain sickness (AMS), high altitude pulmonary edema (HAPE), and high altitude cerebral edema (HACE). Treatment involves descending to lower altitudes, supplemental oxygen, medications, and in severe cases hyperbaric chambers. Proper acclimatization over several days is needed to allow the body to adapt when ascending to high altitude locations.
The document summarizes the physiological changes that occur during laparoscopic surgery due to pneumoperitoneum and positioning of the patient. Pneumoperitoneum causes increases in abdominal and thoracic pressure, decreasing cardiac output and lung volume and increasing risk of atelectasis and gas embolism. Positioning such as Trendelenburg can also affect hemodynamics and respiratory function. While healthy patients often tolerate these changes, risks are higher for those with cardiopulmonary or medical issues. Close monitoring is important to detect potential complications involving the cardiovascular, pulmonary, renal and other organ systems.
This document provides an overview and summary of medicine codes in CPT. It discusses several categories of medicine codes including evaluations and management, modifiers, immunizations, psychiatry, end-stage renal disease, cardiology, pulmonary, and more. Codes are organized by specialty and service type, with notes on proper use and billing.
Mohs micrographic surgery is a technique for completely removing skin cancer lesions. It involves the surgeon also acting as the pathologist to examine tissue sections under the microscope between surgical stages. The procedure involves removing tissue in blocks that are each examined microscopically until the edges are clear of cancer cells. Additional blocks are coded separately and any biopsies or repairs performed on the same day are also separately coded.
Breast procedures include incision and drainage of cysts, excision of tumors or biopsies, placement of localization devices, partial or total mastectomy, and stereotactic biopsy using imaging to target microcalcifications. Reconstruction techniques aim to repair the breast and can involve augmentation or mastopexy.
Deep sea diving and physiological response to high barometric pressure Ranadhi Das
Sea water is approximately 800 times more dense than air. Therefore, it exerts much greater pressure on the body of a diver.
The weight exerted by the atmosphere on an area of 1m2, is approximately 10,000kg at sea level. This value of pressure (10,000 kg m-2) is thus referred to as 1 atmospheric absolute (1 ATA), or 1 atmospheric pressure.
For every 10m(~32feet) below the surface a person dives, he is subjected to an additional pressure of 1ATA. Therefore, at 30m, a diver will experience a pressure of 4 ATA (1 ATA exerted by the atmosphere, & 3 ATA exerted by the 30m of water above him).
It discusses various effects of high altitude on human body in detail, acute mountain sickness, chronic mountain sickness, high altitude pulmonary edema, high altitude cerebral edema, acclimatization
This document provides information on oxygen insufficiency and discusses key points:
- Oxygen is essential for life and is involved in cellular respiration. It makes up 20.94% of air by volume.
- Oxygen insufficiency, or hypoxia, occurs when oxygen delivery to tissues is inadequate to meet metabolic demands. This can be caused by problems with ventilation, gas exchange, oxygen transport, or cellular respiration.
- Symptoms of hypoxia range from shortness of breath to confusion and loss of consciousness. Diagnostic tests for hypoxia include blood gas analysis, pulse oximetry, pulmonary function tests, and imaging studies.
- Nursing management of patients with oxygen insufficiency focuses on
Nursing management of patients with oxygen insufficiencyAparna A
Without adequate oxygen, major organ systems begin to fail within minutes or hours. Oxygen is essential for cellular respiration and is delivered to tissues through a multi-step process involving ventilation, diffusion, transportation, and perfusion. Factors like development, physiology, behavior, lifestyle, and medication can impact oxygenation. It can be measured using tools like pulse oximetry, arterial blood gases, and capnography. Conditions resulting from inadequate oxygen delivery and utilization include hypoxemia, hypoxia, anoxia, respiratory failure, and cyanosis. Prompt treatment focuses on restoring adequate oxygen supply and ventilation.
The document discusses the physiology of high pressure experienced during deep sea diving. It explains that as depth increases, pressure increases linearly and gas volumes in the body decrease. Issues that can arise include nitrogen narcosis, oxygen toxicity, carbon dioxide buildup, and decompression sickness during ascent. Decompression sickness occurs when nitrogen dissolved in tissues comes out of solution rapidly, forming bubbles that block blood vessels. Treatment involves recompression in a hyperbaric chamber to resolve bubbles.
This document discusses the physiology of diving and diving-related injuries and conditions. It covers:
- Gas laws and how gas behaves in the body at different pressures during descent and ascent.
- Common injuries from barotrauma including ear, sinus, and pulmonary barotrauma.
- Decompression sickness (DCS), also known as "the bends", caused by bubbles forming as gases come out of solution during ascent. Symptoms range from joint pain to neurological issues.
- Treatment for DCS and arterial gas embolism involves hyperbaric oxygen therapy to reduce bubble size and accelerate resolution through increased oxygen pressure and nitrogen elimination from tissues.
This document discusses abnormal breathing patterns, defining parameters used to assess breathing such as rate, depth, rhythm, and character. It then describes several specific abnormal patterns including apnea, tachypnea, bradypnea, hyperventilation, Kussmaul breathing, Cheyne-Stokes breathing, and obstructed breathing. For each abnormality, the document provides the defining characteristics and potential underlying causes.
Deep sea diving and effects of increased barometricYogesh Ramasamy
Pressure increases with depth underwater, so divers breathe pressurized gases to equalize pressure in their bodies. Rising too quickly can cause decompression sickness as nitrogen bubbles form in tissues. Symptoms include joint pain and neurological issues. Treatment uses hyperbaric oxygen chambers to slowly reduce pressure and allow bubbles to dissolve harmlessly.
Oxygen insufficeincy and sensory deprivationParbh Jot
The document discusses oxygen insufficiency and sensory deprivation. It defines oxygen insufficiency as a condition where the body or a region is deprived of adequate oxygen supply. Causes include decreased hemoglobin, altitude, tissue oxygen extraction issues, and impaired ventilation. Symptoms include cyanosis, altered breathing, and fatigue. Nursing assessments focus on respiratory status and signs of hypoxia. Oxygen therapy is the primary treatment. Sensory deprivation occurs when a person experiences decreased meaningful stimuli and can affect physical, cognitive, and emotional functioning. At-risk groups include those with sensory impairments or in long-term care. Preventing deprivation involves promoting healthy sensory stimulation.
Cyanosis is a bluish discoloration of the skin and mucous membranes due to the presence of large amounts of reduced hemoglobin in the blood. It occurs in conditions that cause hypoxic or stagnant hypoxia, when hemoglobin is altered by poisoning, or when red blood cell count is increased, slowing blood flow. Cyanosis requires at least 5-7g% of reduced hemoglobin and does not occur in anemia, which reduces total hemoglobin. Asphyxia involves hypoxia and hypercapnia from airway obstruction, and leads through stages of increased then depressed breathing to convulsions, loss of consciousness, and death if not resolved. Periodic breathing patterns include Cheyne-Stokes respiration
This document discusses acute dyspnea, defined as an uncomfortable need to breathe. It results from an imbalance between the perceived need and ability to breathe, often due to carbon dioxide buildup or oxygen deprivation. Common causes include pulmonary issues like pneumonia, cardiac issues like pulmonary edema, and metabolic acidosis. Diagnosis involves history, exam, and tests to identify the underlying cause. Treatment focuses on relieving symptoms like with opioids and addressing the specific condition through methods such as antibiotics for pneumonia or oxygen therapy for pulmonary edema.
This document discusses hypoxic and hypercapnic-hypoxic acute respiratory failure (ARF). It defines hypoxic ARF as a PaO2 less than 60 mm Hg and hypercapnic-hypoxic ARF as a PaCO2 greater than 50 mm Hg. The causes, etiologic mechanisms, and clinical manifestations of each condition are described. A focused assessment involving history, physical exam, blood gases, and chest imaging is recommended to evaluate the underlying etiology and guide urgent treatment decisions when hypoxemia is life-threatening.
High altitudes above 10,000 feet can cause hypoxia and physiological responses in the body. There are two responses - acute accommodation responses that occur immediately like hyperventilation and increased heart rate, and longer term acclimatization over days and weeks including increased red blood cell count and lung capacity. Rapid ascents can cause dangerous conditions like high altitude pulmonary edema while more gradual acclimatization reduces risks.
Altitude physiology typically focuses on people above 2500 m; ∼8000 ft. Altitudes above that are sometimes subdivided into very high (3500–5500 m; ∼11,500–18,000 ft) and extreme (>5500 m; >18,000 ft). An estimated 40 million people travel each year to altitudes >2500 m (∼8000 ft),1 and as many or more travel to altitude for leisure and sports, and work in mines, military or border operations, and the like. Altitude medicine considers the clinical disorders associated with acclimatization by the travelers, workers and migrants, and with adaptation by people with lifetimes or populations with millennia of residence (an estimated 83 million people).
With a hurried ascent, many (∼80%) will report a transient headache (high-altitude headache or [HAH]), and some will develop one of three forms of acute high-altitude illness: acute mountain sickness (AMS) and HAH, high-altitude cerebral edema (HACE), and high-altitude pulmonary edema (HAPE). AMS and HAH are annoying and interfere with activity and work, however, HACE and HAPE can be fatal with mortality rates approaching 30%. Among some residents, chronic mountain sickness (CMS) and right ventricular hypertrophy develop over months to years of residence at altitude. Birth weights are generally lower and the rate of small-for-gestational-age babies and congenital heart defects are higher than that in lowland populations.
High altitudes above 9,000 feet can cause physiological effects due to low atmospheric pressure and oxygen levels. The body undergoes adaptations like increased respiration and heart rate, higher red blood cell counts, and fluid shifts. However, too rapid an ascent can cause illnesses like acute mountain sickness (AMS), high altitude pulmonary edema (HAPE), and high altitude cerebral edema (HACE). Treatment involves descending to lower altitudes, supplemental oxygen, medications, and in severe cases hyperbaric chambers. Proper acclimatization over several days is needed to allow the body to adapt when ascending to high altitude locations.
The document summarizes the physiological changes that occur during laparoscopic surgery due to pneumoperitoneum and positioning of the patient. Pneumoperitoneum causes increases in abdominal and thoracic pressure, decreasing cardiac output and lung volume and increasing risk of atelectasis and gas embolism. Positioning such as Trendelenburg can also affect hemodynamics and respiratory function. While healthy patients often tolerate these changes, risks are higher for those with cardiopulmonary or medical issues. Close monitoring is important to detect potential complications involving the cardiovascular, pulmonary, renal and other organ systems.
This document provides an overview and summary of medicine codes in CPT. It discusses several categories of medicine codes including evaluations and management, modifiers, immunizations, psychiatry, end-stage renal disease, cardiology, pulmonary, and more. Codes are organized by specialty and service type, with notes on proper use and billing.
Mohs micrographic surgery is a technique for completely removing skin cancer lesions. It involves the surgeon also acting as the pathologist to examine tissue sections under the microscope between surgical stages. The procedure involves removing tissue in blocks that are each examined microscopically until the edges are clear of cancer cells. Additional blocks are coded separately and any biopsies or repairs performed on the same day are also separately coded.
Breast procedures include incision and drainage of cysts, excision of tumors or biopsies, placement of localization devices, partial or total mastectomy, and stereotactic biopsy using imaging to target microcalcifications. Reconstruction techniques aim to repair the breast and can involve augmentation or mastopexy.
A hernia occurs when an organ pushes through an opening in the muscle or tissue that holds it in place. There are several types of hernias including inguinal, hiatal, umbilical, and incisional hernias. Common causes are muscle weakness from birth defects, aging, coughing, or surgery. Risk factors include family history, obesity, smoking, and chronic coughing. Hernias may cause pain, weakness, or a feeling of heaviness and can be diagnosed through tests like barium x-rays, endoscopy, or ultrasound. Treatment options include lifestyle changes, medication, or surgery while prevention focuses on not smoking, maintaining a healthy weight, and avoiding heavy lifting or straining.
Modifiers are two-character suffixes added to procedure codes to provide additional information about the service or procedure performed. The document discusses several common modifiers used in medical billing, including:
- Modifier -22 for increased procedure intensity
- Modifier -23 for unusual anesthesia
- Modifier -24 for unrelated E/M services during the postoperative period
- Modifier -25 for significant, separately identifiable E/M services on the same day
- Modifier -50 for bilateral procedures
- Modifier -76 for repeated procedures
- Modifier -80 for assistant surgeon services
The document provides definitions and examples for how and when to use these common billing modifiers to accurately report medical services and ensure proper
This document provides an overview of pathology and laboratory coding. It describes various areas of pathology including anatomical pathology, cytopathology, cytogenetics, microbiology, surgical pathology, and reproductive medicine procedures. For each area, it provides the code ranges and notes on how to report specific tests and procedures. It also provides examples of how to code common pathology cases.
The document provides an overview of the Current Procedural Terminology (CPT) coding system. It describes CPT as a standardized coding system maintained by the American Medical Association to provide uniform descriptions and codes for medical services and procedures. The document outlines the 10 learning objectives of the chapter, including describing the purpose, organization, and use of CPT codes. It also summarizes the different code categories and sections within CPT as well as modifiers used to provide additional information about procedures.
Radiology uses medical imaging techniques like X-rays, ultrasound, CT, MRI and PET to diagnose and treat diseases. Radiography uses X-rays to view internal structures. Ultrasound uses sound waves to detect objects and for medical imaging. CT scans combine many X-ray images from different angles to produce cross-sectional images. MRI uses magnetic fields and radio waves to generate images of organs in the body. Procedures are coded based on the imaging technique used and whether contrast is used. Modifiers identify professional and technical components.
This document provides guidance on using external cause of injury codes, including:
1. External cause codes describe the circumstances surrounding an injury, including how and where it occurred.
2. There are different types of external cause codes that describe how the injury happened, where it happened, what the patient was doing, and whether the intent was intentional or unintentional.
3. External cause codes are used with injury codes in ranges A00-T88 or Z00-Z99. The 7th character must match between the injury and external cause codes.
4. Examples are provided to demonstrate proper use of external cause codes according to the described guidelines.
The document discusses evaluation and management (E/M) coding guidelines. It covers the key components of E/M codes which are history, examination, and medical decision making. E/M codes are used to bill for office visits, hospital visits, consultations, and other services. Assignment of the codes depends on factors like new vs. established patient, type of service, place of service, patient age, and time spent. History, examination, and medical decision making are the three main components used to determine the level of E/M service provided.
Anesthesia induces temporary loss of sensation or awareness through analgesia, paralysis, or amnesia. It can be categorized as general anesthesia, which suppresses the central nervous system, or regional/local anesthesia, which block nerve impulses in a targeted area. The main purposes of anesthesia are hypnosis, analgesia, and muscle relaxation. Anesthesia drugs include intravenous drugs like thiopentone and propofol, inhalational drugs like nitrous oxide and isoflurane, and analgesic drugs like opioids and NSAIDs. Anesthesia is classified and coded based on the type administered and physical status of the patient.
This document provides an overview of the cardiovascular system, including the heart, blood vessels, circulation, and common medical procedures. It describes the heart's location, layers, chambers, and functions. It explains the roles of arteries, veins, and blood vessels in oxygenated and deoxygenated blood transport. It also summarizes pacemaker systems, implantable defibrillators, coronary artery bypass grafting procedures, and common cardiac issues like tachycardia and bradycardia.
The document discusses evaluation and management (E/M) coding guidelines. It covers the key components of E/M codes which are history, examination, and medical decision making. E/M codes are used to bill for office visits, hospital visits, consultations, and other services. Assignment of the codes depends on factors like new vs. established patient, type of service, place of service, patient age, and time spent. History, examination, and medical decision making are the three main components used to determine the level of E/M service provided.
This document provides information about Dr. Santosh Kumar Guptha's medical coding training program through his company Medesun Healthcare Solutions. It outlines his qualifications and certifications in medical coding, as well as details of the Comprehensive Medical Coding and Billing Training program including modules covered, fees, enrollment process, and benefits of the training such as preparing students for the CPC certification exam. The training is offered both online and in-classroom formats.
The male and female reproductive systems work together to produce offspring. The male reproductive system consists of internal and external sex organs that produce sperm and semen. The testes produce testosterone and sperm, while the penis allows for sperm delivery during intercourse. Similarly, the female reproductive system includes ovaries, fallopian tubes, uterus, and vagina. The ovaries produce eggs and hormones, the fallopian tubes aid fertilization, and the uterus nourishes the developing fetus. Fertilization occurs when sperm meets egg, initiating pregnancy and embryonic development over three trimesters until birth.
This document discusses several congenital malformations of the respiratory system. It describes choanal atresia where the nasal passage is blocked, as well as laryngeal webs that block the larynx. It also mentions laryngoceles, which are air sacs connecting to the larynx that protrude in the neck. Congenital cystic lung diseases and agenesis of the lung, where it is partially or completely absent, can also occur. Various conditions like these that affect the nose, larynx, trachea, bronchi and lungs are classified in the ICD-10 coding system.
This document presents information on cor pulmonale delivered by Mr. Om Verma. It begins with objectives of reviewing anatomy and physiology of the respiratory and cardiovascular systems and defining cor pulmonale. It then reviews anatomy of the respiratory and cardiovascular systems, defines cor pulmonale as enlargement of the right ventricle due to lung disease, and discusses etiology including COPD, blood clots, cystic fibrosis. It also covers pathogenesis, clinical manifestations, diagnosis involving tests like echocardiogram, management including oxygen therapy and drugs, and nursing care for patients.
The document discusses various lower respiratory disorders including:
1. Atelectasis, which is the collapse or closure of the lung resulting in reduced gas exchange. Pneumonia, an inflammation of the lung parenchyma caused by a microbial agent, is discussed along with types such as bacterial, viral, fungal and aspiration pneumonia.
2. Pulmonary tuberculosis, an infectious lung disease caused by the bacterium Mycobacterium tuberculosis, is usually spread through the air. Lung abscess, defined as necrosis of lung tissue and cavity formation caused by microbial infection, is also covered.
3. Other conditions mentioned include pleural conditions, pulmonary edema, acute respiratory failure, pulmonary embolism
abnormal breathing patterns in respiratory systemMahrukhMunawar1
This document summarizes different breathing patterns and their physiology. It describes the normal breathing rate and process of gas exchange. Factors like age, body size and exercise influence breathing. Parameters to assess breathing include rate, depth, rhythm and character. Abnormal breathing patterns discussed include apnea, tachypnea, bradypnea, hyperventilation, Kussmaul breathing, Cheyne-Stokes breathing, Biot's breathing, sighing breathing and obstructed breathing. Causes and characteristics of each abnormal pattern are provided.
Oxygen insufficiency refers to a lack of adequate oxygen in the body. It has been linked to major illnesses like heart disease and cancer. Some key causes include hypoxia, respiratory diseases, drug overdoses, and carbon monoxide poisoning. Symptoms range from mild issues like headaches to life-threatening problems like seizures and loss of consciousness. Treatment focuses on restoring oxygen levels through supplemental oxygen, ventilation support, blood transfusions, and addressing any underlying medical conditions. Nurses play an important role in monitoring patients, providing oxygen therapy safely and effectively, and educating on prevention.
This document discusses breathing patterns, including normal breathing and several abnormal patterns. It begins by covering the physiology of breathing and influencing factors. It then examines parameters for assessing breathing and various abnormal patterns such as apnea, tachypnea, bradypnea, hyperventilation, Kussmaul breathing, Cheyne-Stokes breathing, Biot's breathing, sighing breathing, and obstructed breathing. Each abnormal pattern is defined and examples of potential causes are provided.
1. The document discusses paediatric lung disease and anatomy. It describes the normal anatomy of the lungs and histology of the bronchioles, alveolar walls and septa.
2. Specific paediatric lung diseases discussed include congenital anomalies, cysts, bronchopulmonary sequestration, bronchopulmonary dysplasia, atelectasis, collapse and respiratory distress syndrome.
3. Neonatal respiratory distress syndrome, also known as hyaline membrane disease, is caused by surfactant deficiency in premature infants and results in the deposition of hyaline membranes in the alveoli.
This document discusses acid-base disorders. It begins by outlining the aims of examining pH, determining the primary disorder, calculating the anion gap, assessing compensation, and defining the disorder and treatment. It then provides introductions to pH, the Henderson-Hasselbalch equation, arterial blood gas analyses, and the anion gap. The document proceeds to discuss types of acid-base disorders including metabolic acidosis, respiratory acidosis, metabolic alkalosis, and respiratory alkalosis. It covers causes, symptoms, and treatments for each. An example case is presented of a patient with respiratory alkalosis.
An approach to respiratory distrss and managementdishitri1096
Respiratory distress in infants is characterized by increased work of breathing seen as grunting, chest retractions, and cyanosis. It is a common cause of infant mortality and morbidity. When an infant presents with respiratory distress, the clinician should evaluate for respiratory and non-respiratory causes through a physical exam, pulse oximetry, blood gas analysis, and investigations. Based on the severity of symptoms and underlying etiology, management may involve oxygen therapy, antibiotics, ventilation, or admission to the intensive care unit for close monitoring. The goal is to identify the specific cause and provide appropriate treatment to stabilize the infant's respiratory status.
Pneumonia is an inflammation of the lungs caused by bacteria or viruses. It causes the air sacs in the lungs to fill with fluid or pus, making breathing difficult. There are several types of pneumonia defined by their causes, including bacterial, viral, aspiration, and hospital-acquired pneumonia. Symptoms include cough, fever, chills, and difficulty breathing. Pneumonia is diagnosed through physical exam, chest x-ray, and sputum/blood tests and treated with antibiotics, oxygen, cough medication, and breathing exercises. Complications can include pleural effusion, abscesses, or spread of infection to the blood or brain.
This document discusses oxygen insufficiency, including factors that can affect oxygenation, the definition and causes of oxygen insufficiency, signs and symptoms, diagnostic evaluations, complications, and management. It outlines environmental, physiological, developmental, and lifestyle risk factors that can decrease oxygen levels. The signs of oxygen insufficiency include cyanosis, syncope, and hypoventilation. Diagnostic tests include arterial blood gases, spirometry, chest x-rays, and pulse oximetry. Management involves positioning, breathing exercises, chest physiotherapy, suctioning, oxygen therapy, and nursing care focused on airway clearance and maintenance.
This document discusses respiratory and metabolic acidosis and alkalosis. It covers:
- The definitions and mechanisms of respiratory acidosis, respiratory alkalosis, metabolic acidosis, and metabolic alkalosis.
- The causes, signs and symptoms, and compensation mechanisms for each condition.
- Specific types like acute vs chronic respiratory acidosis, and chloride responsive vs chloride resistant metabolic alkalosis.
- How the kidneys, lungs, and buffering systems work to regulate pH and compensate for acid-base imbalances.
1. Metabolic acidosis and alkalosis occur due to issues with acid-base homeostasis and pH regulation in the body. Metabolic acidosis occurs when the body produces excessive acid or the kidneys cannot remove enough acid, while metabolic alkalosis is caused by decreased hydrogen ion concentration and increased bicarbonate.
2. The document discusses the causes, signs and symptoms, and compensation mechanisms for respiratory and metabolic acidosis and alkalosis. For metabolic conditions, compensation involves buffering, intracellular mechanisms, respiration, and the kidneys. Respiratory compensation aims to alter blood pH by varying breathing rate to expel or retain carbon dioxide.
3. The types and mechanisms of acute vs chronic respiratory
This document discusses several common respiratory diseases that can affect newborns, including respiratory distress syndrome (RDS), transient tachypnea of the newborn (TTN), meconium aspiration syndrome (MAS), primary pulmonary hypertension of the newborn (PPHN), and apnea of prematurity. It provides details on the causes, clinical presentations, diagnoses and management of each condition. The document is intended to educate medical professionals such as pediatricians on recognizing and treating respiratory issues in newborns.
Lung abscess is a pus-filled cavity formed by the necrosis of lung tissue, usually caused by aspiration or infection by bacteria or fungi. Common symptoms include cough, sputum, fever, and chest pain. Diagnosis involves imaging like CT scans and chest X-rays along with sputum and blood cultures. Treatment primarily consists of prolonged antibiotic therapy for 2-4 months, with drainage or surgery occasionally needed for large abscesses. Complications can include chronic abscesses, empyema, bleeding, or broncho-pleural fistulas if not properly treated.
This document discusses respiratory depression, the effects of alcohol on the respiratory system, blood gas analysis, rib fractures, and pneumothorax. It defines respiratory depression and lists several potential causes. It describes how alcohol can lead to pneumonia, acute respiratory distress syndrome, and other long-term respiratory issues over time. The document explains blood gas analysis and the effects of abnormal pH, PCO2, and HCO3 values. It also discusses rib fractures, pneumothorax, and their potential complications like respiratory failure. Treatment options are provided for rib fractures, pneumothorax, and the management of associated conditions.
Meconium aspiration syndrome is a common cause of respiratory failure in term and post-term infants caused by inhalation of meconium-stained amniotic fluid before, during, or after birth. It can range from mild respiratory issues to severe forms that can lead to death. Risk factors include fetal distress, umbilical cord compression, post-term birth, and breech presentation. Clinically, affected infants may experience tachypnea, retractions, grunting, and decreased breath sounds. Chest x-rays can show infiltrates, atelectasis, and pneumothorax. Management involves respiratory support, antibiotics, surfactant therapy, and measures to maintain temperature and oxygen levels.
Bronchiolitis and pneumonia in children are common respiratory illnesses worldwide, especially in developing countries. Bronchiolitis most often affects infants under 1 year of age and is usually caused by viruses like RSV. Pneumonia has many causes including viruses, bacteria, mycoplasma, and chlamydia. Management involves supportive care with oxygen and fluids. Antibiotics are used to treat suspected bacterial pneumonia but the specific antibiotic chosen depends on the age of the child, severity of illness, and underlying risk factors. Both conditions are generally self-limiting but complications can occur.
Similar to Respiratory and cardiovascular disorders of perinatal period (20)
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Dysphasia is a partial or complete impairment of communication abilities caused by brain injury, while aphasia is an inability to understand or form language due to damage to specific brain regions, typically from a stroke or head trauma. Agnosia is the inability to process sensory information like recognizing objects or sounds despite intact senses, while apraxia is difficulty performing motor tasks like movements when asked despite understanding instructions. Acalculia and agraphia involve impaired mathematical and writing abilities, respectively, from acquired neurological disorders.
This document discusses various symptoms and signs involving cognition, perception, emotional state, and behavior. It introduces somnolence, stupor, coma and other conditions like catatonia. The Glasgow Coma Scale is discussed as a standardized scale for assessing levels of consciousness from deep unconsciousness to full alertness. Other conditions mentioned include delirium, amnesia, vertigo, anosmia, and parosmia. The document concludes by listing relevant ICD-10 codes covering symptoms related to cognitive functions, awareness, dizziness, smell and taste disturbances, general sensations, emotional state, and appearance/behavior.
This document provides general symptoms and signs for various medical conditions organized by ICD-10-CM guidelines. It lists common symptoms like fever, headache, malaise, fatigue, convulsions, and shock. It also describes conditions such as leukemia, neutropenia, anorexia nervosa, polydipsia, polyphagia, cachexia, and nail clubbing. The document instructs medical coders on classifying these symptoms and signs using ICD-10-CM codes ranging from fever of unknown origin to generalized hyperhidrosis to unspecified illness.
This document provides guidelines for coding signs and symptoms as well as abnormal laboratory findings. It explains that R codes should be used when a definitive diagnosis has not been provided. The guidelines indicate that signs and symptoms codes should not be used if they are part of the disease process for a confirmed diagnosis. Coma scale codes and their proper sequencing is also outlined. Functional quadriplegia and coding considerations for HIV are briefly discussed.
This document discusses congenital malformations, deformations, and chromosomal abnormalities that are present at birth. It outlines various types of congenital anomalies based on the ICD-10-CM classification system, including those involving the nervous system, eye/ear/face, circulatory system, respiratory system, digestive system, genital organs, urinary system, musculoskeletal system, and chromosomal abnormalities. The guidelines specify that acquired diseases are excluded and there is no age restriction on patients.
This document discusses several congenital malformations of the nervous system, including anencephaly, acephaly, microcephaly, congenital hydrocephalus, agyria, lissencephaly, and spina bifida. Anencephaly is the absence of a major portion of the brain, skull, and scalp that occurs during embryonic development. Microcephaly is a condition where the brain does not develop properly, resulting in a smaller than normal head. Congenital hydrocephalus is a condition where there is abnormal accumulation of cerebrospinal fluid within the brain, typically causing increased pressure inside the skull. Spina bifida is a birth defect where there is incomplete closing of the backbone and membranes
This document discusses various problems that can affect newborns, including acidemia, acidosis, anoxia, asphyxia, hypercapnia, hypoxemia, and hypoxia. It defines each condition and provides details on their symptoms and causes. Acidemia refers to an increased acidity in the blood, while acidosis is a more general term for increased acidity throughout the body. Anoxia means a total lack of oxygen, and asphyxia is a deficient oxygen supply caused by abnormal breathing. Hypercapnia is an elevated level of carbon dioxide in the blood. Hypoxemia and hypoxia both refer to low oxygen levels, with hypoxemia specifically affecting arterial blood. The document concludes
This document discusses various problems that can affect newborns, including acidemia, acidosis, anoxia, asphyxia, hypercapnia, hypoxemia, and hypoxia. It defines each condition and provides details on their symptoms and causes. Acidemia refers to an increased acidity in the blood, while acidosis is a more general term for increased acidity throughout the body. Anoxia means a total lack of oxygen, and asphyxia is a deficient oxygen supply caused by abnormal breathing. Hypercapnia is an elevated level of carbon dioxide in the blood. Hypoxemia is low oxygen in the arterial blood, while hypoxia refers more broadly to insufficient oxygen supply at the tissue level
Omphalitis, or inflammation of the umbilical cord stump, is a common bacterial infection in newborns that typically occurs within 3-45 days after birth. The bacteria infects the small remaining portion of the umbilical cord after birth. This can lead to redness, swelling, and in severe cases a spread of the infection through the umbilical vessels to the rest of the body. Other infections specific to the perinatal period discussed include neonatal mastitis, which is breast inflammation usually due to infection, and neonatal pyoderma, which refers to pus-forming skin infections like impetigo that affect newborns. The document also provides ICD-10 codes for coding various infections
This document discusses several digestive disorders that can affect newborns. Meconium plug syndrome refers to a functional colonic obstruction caused by a meconium plug, usually in the left colon. Meconium peritonitis occurs when the bowel ruptures before birth, releasing meconium into the abdominal cavity and causing inflammation. Twenty percent of infants with meconium peritonitis will have vomiting, dilated bowels visible on x-rays, and require surgery. It can sometimes be diagnosed prenatally via ultrasound showing calcifications in the abdominal cavity. The document also lists ICD-10 codes for various newborn digestive disorders including necrotizing enterocolitis which is classified into stages of severity.
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it describes the bony anatomy including the femoral head , acetabulum, labrum . also discusses the capsule , ligaments . muscle that act on the hip joint and the range of motion are outlined. factors affecting hip joint stability and weight transmission through the joint are summarized.
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2. INTRODUCTION
• Metabolic acidosis is a condition that occurs when the body
produces excessive quantities of acid or when the kidneys are
not removing enough acid from the body. If unchecked,
metabolic acidosis leads to acidemia, i.e., blood pH is low (less
than 7.35) due to increased production of hydrogen ions by
the body or the inability of the body to
form bicarbonate (HCO3
−) in the kidney.
3. • Acidosis refers to a process that causes a low pH in blood and
tissues.
• Acidemia refers specifically to a low pH in the blood.
• acidosis occurs Free hydrogen ions then diffuse into the
blood, lowering the pH. Arterial blood gas analysis detects
acidemia (pH lower than 7.35). When acidemia is present,
acidosis is presumed.
5. RESPIRATORY DISTRESS
• Respiratory distress is difficulty in breathing, and the
psychological experience associated with such difficulty, even
if there is no physiological basis for experiencing such distress.
• The physical presentation of respiratory distress is generally
referred to as labored breathing, while the sensation of
respiratory distress is called shortness of breath or dyspnea.
6. CONGENITAL PNUEMONIA
• Pneumonia is an inflammatory condition of the lung affecting
primarily the microscopic air sacs known as alveoli. Typical
signs and symptoms include a varying severity and
combination of productive or dry cough, chest pain, fever,
and trouble breathing, depending on the underlying cause.
• If it occurs during the birth is known as congenital pneumonia
7. NEONATAL ASPIRATION
• Meconium aspiration syndrome (MAS) also known
as neonatal aspiration of meconium is a medical condition
affecting newborn infants. It occurs when meconium is
present in their lungs during or before delivery.
8. • Meconium is the first stool of an infant, composed of
materials ingested during the time the infant spends in
the uterus.
9. ICD-10-CM GUIDELINES
• Metabolic acidemia in newborn- P19
• Respiratory distress of newborn- P22
• Congenital pneumonia-P23
• Neonatal aspiration-P24
• Interstitial emphysema and related conditions originating in
the perinatal period- P25
• Pulmonary hemorrhage originating in the perinatal period-
P26
10. • Chronic respiratory disease originating in the perinatal period-
P27
• Other respiratory conditions originating in the perinatal
period-P28
• Cardiovascular disorders originating in the perinatal period-
P29
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