The document discusses various vascular anomalies of the chest that can occur due to abnormalities in the development of the aortic arch system and pulmonary veins in embryos. It describes conditions like double aortic arch where both arches encircle the trachea and esophagus, coarctation of the aorta where there is narrowing of the descending aorta, and total anomalous pulmonary venous return where the pulmonary veins drain into structures other than the left atrium. It also provides diagrams and links to further explain these different vascular anomalies.
An overview of the normal embryological process of development of the Aortic arch and the clinically relevant anomalies of the aortic arch development. Ideal for Cardiology Fellows.
An overview of the normal embryological process of development of the Aortic arch and the clinically relevant anomalies of the aortic arch development. Ideal for Cardiology Fellows.
Anomalous coronary arteries are a rare but recognized cause of myocardial ischemia and sudden death. Identification currently requires x-ray angiography, which may have difficulty defining the three-dimensional course of the anomalous vessel. Magnetic resonance coronary angiography (MRCA) has been shown to image coronary artery anatomy noninvasively
The conotruncus comprises collectively two myocardial subsegments, the conus and the truncus.
Conus is the myocardial segment between ventricle and semi lunar valves which gives rise to sub arterial coni.
Truncus is the fibrous segment between semi lunar valves and aortic sac which gives rise to great arteries.
Anomalous coronary arteries are a rare but recognized cause of myocardial ischemia and sudden death. Identification currently requires x-ray angiography, which may have difficulty defining the three-dimensional course of the anomalous vessel. Magnetic resonance coronary angiography (MRCA) has been shown to image coronary artery anatomy noninvasively
The conotruncus comprises collectively two myocardial subsegments, the conus and the truncus.
Conus is the myocardial segment between ventricle and semi lunar valves which gives rise to sub arterial coni.
Truncus is the fibrous segment between semi lunar valves and aortic sac which gives rise to great arteries.
Tetralogy of Fallot
Tetralogy of Fallot with Pulmonary
Stenosis
TETRALOGY OF FALLOT WITH CONGENITAL PULMONARY ATRESIA
Tetralogy of Fallot with Absent Pulmonary Valve
USMLE CVS 006 007 Development of the heart anatomy .pdfAHMED ASHOUR
The development of the heart is a complex and highly regulated process that begins early in embryonic life.
Understanding the stages of heart development is crucial for recognizing
and addressing congenital heart defects that may occur during this intricate process.
USMLE CVS 001 Mediastinum anatomy medical chest .pdfAHMED ASHOUR
The mediastinum is the central compartment of the thoracic cavity, located between the lungs.
It is a three-dimensional space that houses various structures within the chest.
The mediastinum extends from the sternum (front of the chest) to the vertebral column (back of the chest) and from the superior thoracic aperture (top of the chest) to the diaphragm (bottom of the chest).
Understanding the anatomy of the mediastinum is crucial for healthcare professionals to interpret diagnostic findings and manage conditions affecting this central compartment of the thoracic cavity.
Embracing GenAI - A Strategic ImperativePeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
Honest Reviews of Tim Han LMA Course Program.pptxtimhan337
Personal development courses are widely available today, with each one promising life-changing outcomes. Tim Han’s Life Mastery Achievers (LMA) Course has drawn a lot of interest. In addition to offering my frank assessment of Success Insider’s LMA Course, this piece examines the course’s effects via a variety of Tim Han LMA course reviews and Success Insider comments.
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
2. Aortic Arches
• The aortic arches are a series of
paired arterial channels encircling
the embryonic pharynx
Develop in the 4th week
Supply the developing
pharyngeal arches
Arise from the aortic sac
Run dorsally, embedded in the
mesenchyme of the pharyngeal
arches and
Terminate in the right and left
dorsal aortae
3.
4.
5. Arch of Aorta
Derived as:
• Proximal segment
from aortic sac
• Middle segment from
the left 4th aortic arch
• Distal segment from
the left dorsal aorta
6. Subclavian Artery
• The right subclavian
artery formed from the:
Right 4th aortic arch
Right dorsal aorta
Right 7 th
intersegmental
artery
• The left subclavian
artery formed from the
left 7th intersegmental
artery
7. Changes in the original aortic arch system
• Obliteration of:
• Most of the 1st & 2nd arches
• 5th arches completely
• Distal part of the right sixth
arch
• The segment of both aorta
lying between the 3rd & 4th
arches
• The segment of right aorta
lying between the 7th
intersegmental artery & the
fused dorsal aorta
8. Aortic Arch Anomalies
• Due to many changes involved in transformation
of the embryonic pharyngeal arch system of
arteries into the adult arterial pattern
• Most irregularities result from the persistence of
parts of aortic arches that usually disappear, or
from disappearance of parts that normally
persists
9.
10. Vascular Rings
• malformation of the aortic arch that results in
vascular branches or major blood vessels
encircling the trachea and esophagus.
• True rings: Double aortic arch (most
common), double aortic arch with atretic left
segment, right sided arch with abberant left
subclavian
• In a double aortic arch, the two arches
encircle the trachea and esophagus.
11. Other non-true ring arch
abnormalities
• left arch with abberant right subclavian
(most common arch abnormality), Mirror
image right arch, aortic coarctation,
common origin of brachiocephalic and left
common carotid artery (bovine
configuration.), brachiocephalic artery
compression.
14. Double Arch of Aorta
• Characterized by a vascular
ring encircling the trachea
and esophagus, usually
causing compression of both
structures.
• The degree of compression
varies
• Usually the right arch is RCC LCC
larger and passes posterior
to the esophagus RSA LSA
• The right common carotid
and subclavian arteries arise
separately from right arch
20. Pulmonary Artery
• Sling
Pulmonary sling occurs because of failure of
formation of Left 6th aortic arch so there is absence of
Left pulmonary artery
• The blood to the Left lung comes from an aberrant
Left pulmonary artery which arises from Right
pulmonary artery and crosses between esophagus
and trachea
• Bronchial cyst may produce same finding on
esophagus/trachea
• http://radiopaedia.org/articles/pulmonary-sling
24. Coarctation of Aorta
• Abnormality of the 4th and 6th arch
• An infantile coarctation is characterised by diffuse hypoplasia or narrowing of the aorta from
proximal to the ductus arteriosus, associated with cyanosis of lower extremities due to left to
right shunting through the PDA
• An adult coarctation in contrast is characterised by a short segment abrupt stenosis of the
post-ductal aorta. It is due to thickening of the aortic media and typically occurs just distal
ligamentum arteriosum (remnant of the ductus arteriosus), non-cyanotic, p/w lower extremity
hyPOtension
• Complications: Bacterial endocarditis common in 1st 5 decades, Aortic rupture 2~3rd decade
subarachnoid hemorrhage(congenital Berry aneurysm)
28. Transposition of the Great
Arteries
• Transposition of the great arteries, the most common cyanotic congenital heart
lesion found in neonates, accounts for 5%–7% of congenital cardiac
malformations.
• It is most common in infants of diabetic mothers. It is isolated in 90% of those
affected and rarely is associated with a syndrome or an extracardiac
malformation.
• in transposition of the great arteries, the pulmonary artery is situated to the
right of its normal location and is obscured by the aorta on frontal chest
radiographs. This malposition, in association with stress-induced thymic atrophy
and hyperinflated lungs, results in the apparent narrowing of the superior
mediastinum on radiographs, the most consistent sign of transposition of the
great arteries.
29.
30.
31. Total anomalous pulmonary
venous return
• The pulmonary veins fail to drain into the left atrium and instead form an aberrant connection
with some other cardiovascular structure.
• Four types of TAPVR thus may be defined.In type I, the most common of the four (55% of
cases), the anomalous pulmonary veins terminate at the supracardiac level. Typically, four
anomalous pulmonary veins (two from each lung) converge directly behind the left atrium and
form a common vein, known as the vertical vein, that passes anterior to the left pulmonary
artery and the left main bronchus to join the innominate vein.
• Less commonly, anomalous drainage to the left brachiocephalic vein, the right superior vena
cava, or the azygos vein occurs.
32. Total anomalous pulmonary
venous return
• Type II TAPVR (30% of cases) involves a pulmonary venous connection at the cardiac level. The
pulmonary veins join either the coronary sinus or the right atrium.
• Type III TAPVR (13% of cases) involves a connection at the infracardiac or infradiaphragmatic
level. The pulmonary veins join behind the left atrium to form a common vertical descending
vein, which courses anterior to the esophagus and passes through the diaphragm at the
esophageal hiatus. This vertical vein usually joins the portal venous system but occasionally
connects directly to the ductus venosus, the hepatic veins, or the inferior vena cava. Type III
TAPVR is virtually always accompanied by some degree of obstructed venous return.
• Type IV TAPVR involves anomalous venous connections at two or more levels. In the most
common pattern, the vertical vein drains into the left innominate vein, and the anomalous vein
or veins from the right lung drain into either the right atrium or the coronary sinus. This
pattern generally is associated with other major cardiac lesions.
33.
34.
35. Partial anomalous pulmonary
venous return
• anomalous pulmonary vein that drains any or all of the
lobes of the right lung. The so-called scimitar vein usually
empties into the inferior vena cava but also may drain into
the portal vein, hepatic vein, or right atrium
41. Links to cases
• http://radiopaedia.org/articles/aortic-arch-
variants
• http://radiopaedia.org/articles/pulmonary-
sling
42. Sources
1. Aortic Arches. Zaidi, Zeenat.
http://www.docstoc.com/docs/125362680/12-Aortic-Arches
2. Berdon WE. Rings, slings, other things: vascular compression of the infant trachea
updated from the midcentury to the millennium – the legacy of Robert E. Gross, MD,
and Edward B. D. Neuhauser, MD. Radiology 2000;216:624–32
3. http://www.radiologyassistant.nl/en/p4718c7f2eb7cc/vascular-anomalies-of-aorta-pulmonary-and-s
4. http://www.hawaii.edu/medicine/pediatrics/pemxray/v6c19.html
5. Classic imaging signs of congenital cardiovascular abnormalities.
http://radiographics.rsna.org/content/27/5/1323.full
Figure 8. Tubular hypoplasia (preductal or infantile-type aortic coarctation). Drawing shows a focal constriction of the aorta (1) above the level of the ductus arteriosus (2) and a lengthy narrowed segment of the aortic arch (3) after the origin of the innominate artery (4). 5 = left common carotid artery, 6 = left subclavian artery, 7 = right heart structures, 8 = left heart structures, 9 = pulmonary artery.
Figure 7. Localized (postductal or adult-type) aortic coarctation. Drawing shows a focal constriction of the aorta (1) just beyond the origin of the left subclavian artery (2) and the ligamentum arteriosum (3). The contour of the aorta is deformed by both pre- and poststenotic dilatation, and the left subclavian artery is dilated. 4 = left common carotid artery, 5 = innominate artery, 6 = right heart structures, 7 = left heart structures, 8 = pulmonary artery.
the characteristic ventricular septal defect (1), infundibular pulmonary stenosis (2), overriding aorta (3), and right ventricular hypertrophy
Downward displacement of the tricuspid valves in Ebsteins’s anomaly