A tracheostomy is an opening (made by an incision) through the neck into the trachea (windpipe). A tracheostomy opens the airway and aids breathing.
A tracheostomy may be done in an emergency, at the patient’s bedside or in an operating room. Anesthesia pain relief medication may be used before the procedure. Depending on the person’s condition, the tracheostomy may be temporary or permanent
Includes brief info about epidemiology, etiology, TNM staging, types,symptoms and management of CA larynx/ larynx carcinoma.
glottic ,subglottic and supraglottic carcinoma of larynx is also discussed with the individual management.
RETROPHARYNGEAL ABSCESS
Retropharyngeal abscess ia an infection of the retropharyngeal space
Retropharyngeal space is a potential space posterior to the pharynx and the cervical oesophagus
Often presents late, most times in airway obstruction
It is life threatening,adequate care and management is needed
Mortality and morbidity often follows delayed or missed diagnosis
ENT Review Booklet by Dr. Aryan (Medical Booklet Series by Dr. Aryan Part 12)Dr. Aryan (Anish Dhakal)
This is a part of free booklet series designed by Dr. Aryan for rapid review of basic concepts of medical science. I grant you right to share the booklet for fair use (teaching, scholarship, education and research) anywhere in the world exclusively for non-monetary purposes.
A look at recent literature on the pros and cons of balloon sinuplasty as well as cases where the technology was useful to complete the procedure safely with the best outcome for the patient
Laryngeal cancer constitutes 2,63% of all body cancer in India. It is ten times more common in males than in females. Its incidence is 3.29 new case in males and 0.42 new cases in females per 100,000 population. In this slide, we talk about aetiology, TNM classification and staging, histopathology , diagnosis and treatment
Includes brief info about epidemiology, etiology, TNM staging, types,symptoms and management of CA larynx/ larynx carcinoma.
glottic ,subglottic and supraglottic carcinoma of larynx is also discussed with the individual management.
RETROPHARYNGEAL ABSCESS
Retropharyngeal abscess ia an infection of the retropharyngeal space
Retropharyngeal space is a potential space posterior to the pharynx and the cervical oesophagus
Often presents late, most times in airway obstruction
It is life threatening,adequate care and management is needed
Mortality and morbidity often follows delayed or missed diagnosis
ENT Review Booklet by Dr. Aryan (Medical Booklet Series by Dr. Aryan Part 12)Dr. Aryan (Anish Dhakal)
This is a part of free booklet series designed by Dr. Aryan for rapid review of basic concepts of medical science. I grant you right to share the booklet for fair use (teaching, scholarship, education and research) anywhere in the world exclusively for non-monetary purposes.
A look at recent literature on the pros and cons of balloon sinuplasty as well as cases where the technology was useful to complete the procedure safely with the best outcome for the patient
Laryngeal cancer constitutes 2,63% of all body cancer in India. It is ten times more common in males than in females. Its incidence is 3.29 new case in males and 0.42 new cases in females per 100,000 population. In this slide, we talk about aetiology, TNM classification and staging, histopathology , diagnosis and treatment
detailed information about tracheostomy for the medical students , includes difinition, causes, indications, care provided, management, medical and nursing management of opening , complete care of the patient , patient teaching, family teaching and contained other detailled explanation of tracheostomy
TRACHEOSTOMY is a surgical procedure to maintain a patent airway to the person who is in airway distress or electively in certain surgical procedures like oncological resections to maintain an adequate oxygenation to the patient by creating a stoma on the trachea
Primary vesicoureteral reflux (VUR) is the commonest congenital urological abnormalities in children, which has been associated with an increased risk of urinary tract infection (UTI) and renal scarring, also called reflux nephropathy (RN).
While it is rare, women on dialysis have become pregnant. Of these pregnancies, about 20 percent will end in miscarriage. A full-term pregnancy lasts about 40 weeks; however, about 80 percent of dialysis pregnancies will only go about 32 weeks, resulting in a premature birth
A common viral infection of the nose and throat.
In contrast to the flu, a common cold can be caused by many different types of viruses. The condition is generally harmless and symptoms usually resolve within two weeks.
Symptoms include a runny nose, sneezing and congestion. High fever or severe symptoms are reasons to see a doctor, especially in children.
Most people recover on their own within two weeks. Over-the-counter products and home remedies can help control symptoms.
The major passages and structures of the upper respiratory tract include the nose or nostrils, nasal cavity, mouth, throat (pharynx), and voice box (larynx). The respiratory system is lined with a mucous membrane that secretes mucus. The mucus traps smaller particles like pollen or smoke.
The kidneys filter waste and excess fluid from the blood. As kidneys fail, waste builds up.
Symptoms develop slowly and aren't specific to the disease. Some people have no symptoms at all and are diagnosed by a lab test.
Medication helps manage symptoms. In later stages, filtering the blood with a machine (dialysis) or a transplant may be required.
Although the most important causes of kidney injury in late pregnancy are preeclampsia and the associated disorders eclampsia and HELLP (hemolysis, elevated liver enzyme levels, low platelet count) syndrome, they will be discussed with the hypertensive disorders of pregnancy.
Hyperoxaluria occurs when you have too much oxalate in your urine. Oxalate is a natural chemical in your body, and it's also found in certain types of food. But too much oxalate in your urine can cause serious problems.
Nephrolithiasis is the term employed for kidney stones, also known as renal calculi, and they are crystal concretions formed typically in the kidney. Calculi typically form in the kidneys and ideally leave the body via the urethra without pain. Larger stones are painful and may need surgical intervention
A tibial shaft fracture occurs along the length of the bone, below the knee and above the ankle. It typically takes a major force to cause this type of broken leg. Motor vehicle collisions, for example, are a common cause of tibial shaft fractures.
A chi-squared test is a statistical hypothesis test that is valid to perform when the test statistic is chi-squared distributed under the null hypothesis, specifically Pearson's chi-squared test and variants
differences between the observed values
Two-way tables are used in statistical analysis to summarize the relationship between two categorical variables. Two-way tables are also known as contingency, cross-tabulation, or crosstab tables.
Data categories are groupings of data with common characteristics or features. They are useful for managing the data because certain data may be treated differently based on their classification. Understanding the relationship and dependency between the different categories can help direct data quality effort
Water management is the control and movement of water resources to minimize damage to life and property and to maximize efficient beneficial use. Good water management of dams and levees reduces the risk of harm due to flooding. Irrigation water management systems make the most efficient use of limited water supplies for agriculture.
Drainage management involves water budgeting and analysis of surface and sub-surface drainage systems. Sometimes water management involves changing practices, such as groundwater withdrawal rates, or allocation of water to different purposes.
A tracheal tube is a catheter that is inserted into the trachea for the primary purpose of establishing and maintaining a patent airway and to ensure the adequate exchange of oxygen and carbon dioxide.
India, country that occupies the greater part of South Asia. With roughly one-sixth of the world’s total population, India is the second most populous country. Types of water resources Surface water Resources Groundwater Resources.
Management of water resources in India has been a challenge whose magnitude has risen manifolds over the past 50 years due to a variety of reasons, notably the rising demands and growing environmental degradation.
Water is used intensively by various sectors such as agriculture, industry, and public. Increasing global water demand and the effects of climate change are leading to overuse of water resources in many regions.
A nasopharyngeal airway, also known as an NPA, nasal trumpet (because of its flared end), or nose hose, is a type of airway adjunct, a tube that is designed to be inserted into the nasal passageway to secure an open airway
An oropharyngeal airway (also known as an oral airway, OPA or Guedel pattern airway) is a medical device called an airway adjunct used in airway management.
BASIC AIRWAY SKILLS AND TECHINC
Head and chin lift,
Jaw thrust (with out neck extension if suspect c-spine injury),
Mouth to mouth ventilation,
Mouth to barrier device,
Bag mask ventilation
Normal childbirth it is process of fetus come out of the vagina, this will start from uterus contraction and delivery fetus out side of female genitalia this full process called has normal delivery
PPH Postpartum hemorrhage, affecter the delivery of fetus vaginal bleeding you can see with in 24 hours this primary PPH, secondary PPH will be up 28 of delivery.
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
The Gram stain is a fundamental technique in microbiology used to classify bacteria based on their cell wall structure. It provides a quick and simple method to distinguish between Gram-positive and Gram-negative bacteria, which have different susceptibilities to antibiotics
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
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.
2. Overviews of the topic:
• Anatomy and Physiology:
• Introduction:
• Anatomic landmarks for tracheostomy:
• Indications:
• Contraindication:
• Technique: (equipment)
• Complication:
3. Anatomy and Physiology:
• The trachea is a structure composed of incomplete cartilaginous rings
(except for the first ring, which is complete) beginning at the
subglottic larynx and terminating at the carina and mainstem bronchi.
• The posterior wall of the trachea is shared with the anterior wall of the
esophagus.
• The first ring which connects the trachea to the larynx is called the
cricoid cartilage, which is a complete ring and also contains the
cricothyroid joint of the larynx.
• The trachea lies deep to the sternohyoid and sternothyroid muscles,
with the thyroid gland typically overlying the second to fourth tracheal
rings in the neck. Immediately lateral to the cervical trachea lie
4. Conti…
• the recurrent laryngeal nerves and some peritracheal lympho-fatty
tissue. These structures are surrounded by the middle (or pretracheal)
layer of the deep cervical fascia.
• Lateral to these structures lies the common carotid arteries, which are
encased in the carotid sheath, a component of the deep layer of the
deep cervical fascia.
• The thymus and anterior mediastinal contents overlie the thoracic
trachea as it courses posterior to the heart.
• The innominate artery crosses over the trachea as it arises from the
aorta.
5. Introduction:
• Tracheostomy is an operative procedure that creates a surgical
airway in the cervical trachea.
• It is most often performed in patients who have had difficulty
weaning off a ventilator, followed by those who have suffered trauma
or a catastrophic neurologic insult.
• Infectious and neoplastic processes are less common in diseases
that require a surgical airway.
• Tracheostomy is a utilitarian surgical procedure of access; therefore,
it should be discussed in light of the problem it addresses: access to
the tracheobronchial tree.
• The trachea is a conduit between the upper airway and the lungs
that delivers moist warm air and expels carbon dioxide and sputum.
6. Anatomic landmarks for tracheostomy:
• Thyroid notch - a palpable landmark to identify the superior aspect of
the larynx in the midline.
• Cricothyroid membrane - a palpable depression between cricoid and
thyroid cartilages. This is the location for an emergent cricothyrotomy.
• Cricoid cartilage - a palpable landmark to identify the junction of the
larynx and trachea. The skin incision is typically placed 1-2cm inferior
to the cricoid.
• Sternal notch - a palpable landmark to identify the thoracic inlet. It is
important to palpate here to the possibility of a high-riding innominate
artery that may be encountered during tracheostomy.
7.
8. Indications:
• Acute upper airway obstruction with failed endotracheal intubation (foreign body,
angioedema, infection, anaphylaxis, etc.)
• Post-cricothyrotomy (if a cricothyrotomy has been placed it should be immediately
formalized into a tracheostomy once an airway has been secured)
• Penetrating laryngeal trauma
• LeFort III fracture
• Obstruction of the mouth or throat
• Breathing difficulty caused by edema (swelling), injury or pulmonary (lung) conditions
• Airway reconstruction following tracheal or laryngeal surgery
• Airway protection from secretions or food because of swallowing problems
• Airway protection after head and neck surgery
• Long-term need for ventilator (breathing machine) support
9. Indications for elective tracheostomy include:
• Prolonged ventilator dependence
• Prophylactic tracheostomy prior to head and neck cancer treatment
• Obstructive sleep apnoea refractory to other treatments
• Chronic aspiration
• Neuromuscular disease
• Subglottic stenosis
10.
11.
12. Technique:
• Open Tracheostomy
• Anatomic landmarks such as the thyroid notch, cricoid cartilage, and sternal notch
are palpated and marked.
• The surgeon should pay close attention to palpation in the sternal notch to detect a
high-riding innominate artery.
• A skin incision is then marked in the midline anterior neck 1 to 2 cm inferior to the
carotid cartilage. A horizontal or vertical incision may be utilized.
• The incision is extended through the platysma muscle to expose the strap muscles
(sternohyoid and sternothyroid), identifying the median raphe.
• The strap muscles are then retracted laterally, exposing the cricoid cartilage and
thyroid gland.
• The thyroid isthmus is identified and ligated, if necessary, depending on its
location along the trachea.
13.
14. • Hemostats can be utilized to cross-clamp the isthmus, subsequently
oversewing each stump with a silk suture to ensure hemostasis of thyroid
tissue.
• A cricoid hook is then placed under the cricoid cartilage to elevate the
larynx and trachea into the operative field.
• The second and third tracheal rings are identified.
• Stay ligatures may be placed laterally to facilitate traction on the trachea for
tube placement, as well as tube security in the postoperative period.
• An incision is made between the second and third rings, and tracheostomy
tube placed.
• Various modifications have been proposed including removal of an anterior
window of cartilage (often removing a segment of 1 to 2 rings), the use of a
vertical anterior incision across 1-2 rings (used in pediatric tracheostomy),
or the creation of a Bjork flap,
15. Technique:
• in which an inferiorly-based cartilage flap is created and secured to the
subcutaneous tissues.
• The first ring is avoided to decrease the risk of subsequent stenosis.
• With the tube in place, it is connected to the anesthesia circuit, and
end-tidal CO2 confirmed.
• Only then is the cricoid hook released.
• The tracheostomy tube is secured with a soft trans-cervical tie as well
as sutured to the anterior neck skin until the first tracheostomy tube
change on postoperative day five.
16.
17. Percutaneous Tracheostomy:
• This method uses a dilatational process via a modified Seldinger technique under
bronchoscopy guidance.
• There have been numerous studies comparing the outcomes of the two techniques,
suggesting several potential advantages of each technique over the other.
• The percutaneous technique is more amenable to bedside performance, avoiding
the transport of potentially critically ill patients to the operating room.
• The percutaneous technique has also been associated with less blood loss and
lower infection rates than the open technique.
• The percutaneous technique has been associated with several significant
devastating complications such as tracheal laceration, aortic injury, and esophageal
perforation, which are extremely unusual after the open procedure.