The document discusses tracheoesophageal fistula (TEF), which is an abnormal connection between the trachea and esophagus present from birth. It classifies TEF into 5 types based on the location of the fistula. Signs include excessive drooling and difficulty feeding. Diagnosis involves imaging and inability to pass a feeding tube. Treatment involves surgery to ligate the fistula and reconnect the esophagus. Nursing care focuses on preventing aspiration, supportive care, and parental education on postoperative care and feeding.
A Tracheoesophageal fistula is a congenital disease. It is a acquired communication between the trachea and esophagus. Most of the patient with TEF are diagnosed immediately following after birth.TEF are often associated with life threatening complications.
PYLORIC STENOSIS:
Review the anatomy and physiology of digestive system
Review the incidence of pyloric stenosis
Define pyloric stenosis
Explain the causes and risk factors of pyloric stenosis
Describe the pathophysiology of pyloric stenosis
Enumerate clinical features of pyloric stenosis
Enlist the diagnostic evaluation for pyloric stenosis
Explain the management of pyloric stenosis
Enumerate the complications of pyloric stenosis
A developmental anomaly is a broad term used to define conditions which are present at conception or occur before the end of pregnancy. In the case of cerebral palsy, a small number also occur after birth. this is also a birth defect.
A Tracheoesophageal fistula is a congenital disease. It is a acquired communication between the trachea and esophagus. Most of the patient with TEF are diagnosed immediately following after birth.TEF are often associated with life threatening complications.
PYLORIC STENOSIS:
Review the anatomy and physiology of digestive system
Review the incidence of pyloric stenosis
Define pyloric stenosis
Explain the causes and risk factors of pyloric stenosis
Describe the pathophysiology of pyloric stenosis
Enumerate clinical features of pyloric stenosis
Enlist the diagnostic evaluation for pyloric stenosis
Explain the management of pyloric stenosis
Enumerate the complications of pyloric stenosis
A developmental anomaly is a broad term used to define conditions which are present at conception or occur before the end of pregnancy. In the case of cerebral palsy, a small number also occur after birth. this is also a birth defect.
enuresis involves the inability to awaken from sleep in response to a voiding stimulus (i.e., a full bladder), coupled with excessive nighttime urine production or decreased functional capacity of the bladder
Nosebleeds are very common in young children, affecting most at some time or another. From the outset, it is important to be aware that nosebleeds will often settle down on their own, sometimes requiring medical treatment, but that major underlying causes (blood clotting problems or abnormalities in the nose) are very rare.
Tracheo oesophageal atresia and fistula A-Z for medical students
This powerpoint covers everything you need to know about tracheoesophageal fistula and atresia as a medical student.It is not intended for patients. Covers anatomy, embryology,types ,classification and treatment of tracheo-oesophageal fistula and atresia.
enuresis involves the inability to awaken from sleep in response to a voiding stimulus (i.e., a full bladder), coupled with excessive nighttime urine production or decreased functional capacity of the bladder
Nosebleeds are very common in young children, affecting most at some time or another. From the outset, it is important to be aware that nosebleeds will often settle down on their own, sometimes requiring medical treatment, but that major underlying causes (blood clotting problems or abnormalities in the nose) are very rare.
Tracheo oesophageal atresia and fistula A-Z for medical students
This powerpoint covers everything you need to know about tracheoesophageal fistula and atresia as a medical student.It is not intended for patients. Covers anatomy, embryology,types ,classification and treatment of tracheo-oesophageal fistula and atresia.
Esophageal Atresia (EA) and Tracheo Esophageal Fistula (TEF)puji123456
Esophageal atresia (EA) is the
congenital malformation that
represent the failure of the esophagus
to develop a continuous passage upto
the stomach
Tracheo esophageal fistula (TEF) is
the congenital malformation where the
trachea and esophagus fails to separate
into distinct structures and a passage is
created between the two.
Congenital anomalies of esophagus-Tracheoesophageal fistula, Esophageal atresia, esophageal stenosis, esophageal duplication cyst, esophageal webs or rings,, diverticulum of esophagus and congenital short esophagus
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
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
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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.
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
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Trancheosophagial
1. MUHIMBILI UNIVERSITY OF
HEALTH AND ALLIED SCIENCES.
SCHOOL OF NURSING.
DERPARTMENT OF CLINICAL NURSING
PEDIATRIC NURSING( PD300)
PRESENTATION:TOPIC - TRACHEO ESOPHAGEAL FISTULA
PRESENTER:JOHN, Songoma .Reg NO 2009-04-01476
SUPERVISOR :MR. MENTI NDILE
2. INTRODUCTION
• Esophageal atresia (EA) is the congenital malformation that
represent the failure of the esophagus to develop a
continuous passage up to the stomach
• Tracheo esophageal fistula (TEF) is the congenital
malformation where the trachea and esophagus fails to
separate into distinct structures and a passage is created
between the two.
• Tracheoesophageal defect is a serious, congenital condition in
which there is an abnormal connection between the trachea
and the esophagus; the esophagus ends before reaching the
stomach and/or the esophagus develops as a pouch
connected to the trachea by a fistula.
3. Esophagus : tube that connects the mouth to
the stomach
Trachea: "windpipe“
Atresia : absence of a normal opening
Congenital : found at birth.
Fistula : abnormal passage from a body organ to
the body surface or between two internal
body organs.
4.
5. CLASSIFICATION OF TEF
• Classified by American Academy of Pediatrics as
• TYPE A : It consists of blind upper and blind lower esophageal
segment without any tracheo- esophageal fistula (3.7 to 7%).
• TYPE B : It involves fistula from trachea to upper oesophageal
segment (0.8%).
• TYPE C: It type in which proximal esophageal segment
terminates in a blind pouch and the distal esophageal segment
is connected to trachea or primary bronchi by a short fistula at
or near tracheal bifurcation (86%).
• TYPE D : It involves fistula from trachea to both upper and
lower esophageal segments (0.7 to 6%).
• TYPE E : It refers to H type TEF which are having otherwise
normal trachea and oesophagus that are connected by a fistula
(4.4- 7%)
7. INCIDENCE & EPIDEMIOLOGY
• Occurs in 1:3000 to 1:4500 live births. Equal gender
incidence EA associated with prematurity. A history
of maternal polyhydroamnios is present in approx.
50% of infants with the defects. Often present with
VATER/VACTERL syndromes. (VATER/VACTERL is
acronyms that describe the associated anomalies of
vertebral, ano-rectal, cardiovascular, tracheo-
esophageal, and renal and limb abnormalities).
Possible influences Inherent genetic factor ,
teratogens Environment factor Prematurity & low
birth weight.
8. PATHOPHYSIOLOGY
• Upper part of esophagus is developed from
retropharyngeal segment and the lower part from
pregastric segment of the first part of primitive gut.
At 4- 5weeks of gestation the laryngo-tracheal
groove is formed. Two longitudinal furrows develop
and separate the respiratory premordium from
esophagus. Deviation or altered cellular growth of
the septum results in formation of fistula between
esophagus and trachea. Successive stages in the
development of the tracheoesophageal septum
durin g embryologic development.
9. Causes
• Congenital TEF can arise due to failed fusion
of the tracheoesophageal ridges during the
third week of embryological development.TEF
can also occur due to pressure necrosis by a
tracheostomy tube in apposition to a
nasogastric tube (NGT).
10. Environmental (Acquired) Causes
• Although exposure to certain medications and
infections during pregnancy have been
proposed as possible risk factors for
development of esophageal
atresia/tracheoesophageal fistula (EA/TEF), no
external factor has been consistently linked to
the development of EA/TEF
• Exposure to methimazole during pregnancy .
• Maternal diabetes mellitus .
11. Heritable Causes
• Chromosome anomalies have been reported
in approximately 6%-10% of individuals with
EA/TEF . EA/TEF is found in the following
aneuploidy syndromes :
• Trisomy 21 (~0.5%-1.0% of affected
individuals)
• Trisomy 18 (~25% of affected individuals)
• Trisomy 13
• (Mosaic) trisomy X
12. Signs and Symptoms
• Excessive oral secretions
• Constant drooling or Excessive salivation.
• Intolerance of feedings
• Regurgitation of feedings
• Periodic episodes of choking and cyanosis
• When fed, infant swallows but coughs, gags, and
returns feeding through the nose and mouth
• Respiratory distress from aspiration of secretions
• Abdominal distention occurring soon after birth
when air from the trachea enters esophagus and
stomach through the fistula
13. Diagnosis
EA/TEF may be suspected prenatally if
• ultrasound examination reveals polyhydramnios, absence of a
fluid-filled stomach, a small abdomen, lower-than-expected
fetal weight, and a distended esophageal pouch
• Fetal MRI may be used to confirm the presence of EA/TEF
TEF may be detected postnatally by
• X-ray taken with radiopaque catheter placed in esophagus to
check for obstruction; standard chest X- ray shows a dilated air-
filled upper esophageal pouch and can demonstrate
pneumonia
• inability to pass a NG tube into stomach because it meets
resistance; required
• bronchoscopy visualizes fistula between trachea and
esophagus; abdominal ultrasound;
• and an echocardiogram to check for cardiac abnormalities.
14. Treatment of Manifestations
• Initial postnatal intervention, aimed at minimizing
the risk of aspiration pneumonia, typically includes
the elimination of oral feeds, placement of a suction
catheter to allow continuous drainage of secretions,
and elevation of the head of the bed to minimize
reflux .
• Intravenous (IV) glucose and fluids should be
provided; supplemental oxygen should be
administered as needed.
• When intubation cannot be avoided, a possible
complication is the collection of air in the stomach,
which in severe cases can only be removed by
gastrostomy
15. Treatment of Manifestations
• Surgical repair consists of closure of the TEF and anastomosis
of the esophageal segments .
• Surgical repair may need to be delayed in infants with low
birth weight, pneumonia, or other major congenital
anomalies.
• When surgical repair is delayed, infants may be treated with
parenteral nutrition, gastrostomy tube placement, and upper
pouch suctioning until they become surgical candidates.
• The most common complications after surgical repair include
leakage at the site of the anastomosis, recurrent fistula,
structure formation, and gastroesophageal reflux
16. Treatment of Manifestations
Surgery:
• Usually an emergency, is performed as soon as
infant is stable.
• Involves ligation of fistulas and anastamosis of
esophagus to stomach.
• Completed in one procedure if possible or done
as a staged repair. Supportive care until surgery;
IV antibiotics; GT inserted before surgery to
decompress stomach.
17. NURSING MANAGEMENT.
• Assess for symptoms immediately after birth
• Assess patency of esophagus before feeding or
putting to breast
• Evaluate difficulty feeding, respiratory distress, excess
drooling, choking, and coughing
• Assess lung sounds
• Use semi-Fowler’s position to prevent reflux of gastric
contents into trachea and to ease respiratory effort
• Monitor respiratory status closely
• Prevent aspiration
• Maintain fluid and electrolyte balance
18. NURSING MANAGEMENT
• Administer IV fluids to prevent dehydration
• Provide emotional support and reassurance to parents
• Encourage parents to spend as much time with infant as
possible
• Place in warm, humidified environment
• The infant is immediately deprived of oral intake (NPO) Start
IV fluids.
• Removal of secretions from the mouth and upper pouch
requires frequent or continuous suction with Replogle’s
catheter every 5 min gently with pressure of 50 cm of H₂O.
• Broad spectrum antibiotic therapy is often instituted.
19. CLIENT TEACHING FOR SELF-CARE
• Involve parents in care of infant to facilitate
bonding by means of touch and eye contact
• Offer information to parents about the
defect, surgical repair, pre- and postoperative
care and prognosis, and need for possible
further surgery
• Teach parents how to administer
gastrostomy feedings until esophagus heals