RR School Of Nursing

Time 2020-11-19 23:07:29

Web Name: RR School Of Nursing

WebSite: http://www.rrnursingschool.biz

ID:121250

Keywords:

School,RR,Nursing,

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Tue, 17 Nov 2020 21:57:26 |Unity Companies110 comments Indicates ways in which this system affects other systems indicates ways in which other systems affect this one At puberty, androgens stimulate development of body hair and apocrine glands and increased sebaceous secretion estrogens stimulate fat deposition and breast development in females pregnancy may cause pigmentation changes and stretch marks Sensory stimulation of skin important to sexual arousal mammary glands nourish infant Androgens and estrogens stimulate adolescent skeletal growth... There are two common epithelial tissues that are many-layered. Stratified squamous epithelium is many layers of flattened cells. Label and color the basement membrane red, color the cytoplasm blue, and the nuclei purple. There are two major types of stratified squamous epithelium. Keratinized epithelium is found on the skin and is toughened by the protein keratin. Non-keratinized stratified squamous epithelium is found in the oral cavity and vagina and is a mucous Another main type of layered... Tue, 17 Nov 2020 17:20:50 |Newborns9 comments Palmar adduction cortical thumb in a normal infant. The thumbs are freely mobile but are held adducted and flexed across the palms with the fingers tightly clutched over them. Cortical thumbs are a manifestation of hypertonicity when they are present beyond the first 3 to 4 months. Constant palmar adduction or clasped thumb after this age would alert one to the possibility of central nervous system pathology. Clasped thumbs are held in a flexed and adducted position across the palm... Sun, 15 Nov 2020 16:00:08 |Immune Response3 comments The metamorphosis of immunology from a curiosity of medicine associated with vaccination to a modern science focused at the center of basic research in molecular medicine is chronicled here. The people and events that led to this development are no less fascinating than the subject itself. A great number of researchers in diverse areas of medicine and science contributed to building the body of knowledge we now possess. It is possible to name only a few here, but we owe a debt to them all. We... Fri, 06 Nov 2020 21:35:43 |Hearing Loss41 comments This is the most important structure for the clinician diagnostically, because its appearance, and what can be seen through it, are by and large the only anatomic clues to what goes on inside (Figs. 3.3 and 3.4). The most visible landmark beneath the TM is the manubrium, or handle, of the malleus, the lower portion of this first ossicle. The upper portion of the manubrium has a visible prominence, seen near the top of the TM, called the short process. The... Fri, 06 Nov 2020 01:57:41 |Sigmoid Colon1 comment Fig. 14.4 Rectum in a patient after neoadjuvant radiation of a rectal carcinoma. a Angiodysplasias almost completely covering the mucosa. b Point coagulation APC is used to coagulate newly forming vessels. Only a portion of the angiodysplasias should be coagulated to avoid risk of deep ulcerations or stenosis caused by scarring. Fig. 14.4 Rectum in a patient after neoadjuvant radiation of a rectal carcinoma. a Angiodysplasias almost completely covering the mucosa. b Point coagulation APC is... Wed, 04 Nov 2020 14:12:44 |Dendritic Cells2 comments The first direct evidence of DC and IgE interaction was via immunohistochemical and immunoelectron microscope demonstrations of IgE bearing LCs in AD patients 29 . Subsequently, FceRI expression in normal human LCs was also demonstrated simultaneously by two groups 30,31 . Binding of an allergen to the FceRI on APCs from an atopic individual who expresses high levels of this receptor leads to receptor cross-linking and subsequent activation of these cells. In nonatopic individuals this is not... Tue, 27 Oct 2020 23:38:27 |Syndrome Omim27 comments Persistent patency of cranial sutures and fontanels at a time when they are meant to be closed The sutures and fontanels are prominent in the newborn, diminishing in size as ossification of the skull proceeds throughout childhood and early adulthood. The anterior fontanel is wide open at birth and shrinks to fingertip size by the age of 15-18 months. The posterior fontanel is usually closed to palpation by 4 months of life, but occasionally closure is evident at birth. The cranial sutures are... A good night's sleep is vital for your overall health and well-being. A restful and good night's sleep helps body cells rejuvenate and also make it easier for brain cells to process the day's events and store memories acquired that day. With the muscles and tissues well-rested and the brain fresh, you get to wake up feeling re-energized and take on whatever life throws at you. However, the lack of enough and good quality sleep does the exact opposite you wake up feeling tired, stressed, and... Sat, 24 Oct 2020 04:49:17 |Breast Cancer7 comments Analysis of breast calcifications by an experienced mammographer will allow accurate diagnosis of characteristically benign calcifications. The various types are described below. Figure 3-14. Pseudocalcification. Talc powder in moles beneath breast mimics parenchymal calcification. Figure 3-14. Pseudocalcification. Talc powder in moles beneath breast mimics parenchymal calcification. Skin Calcification and Pseudocalcification Skin calcification is commonly related to sebaceous glands and... Sat, 24 Oct 2020 04:49:17 |Unity Companies2 comments Organ systems do not all degenerate at the same rate. For example, from ages 30 to 80, the speed of nerve conduction declines only 10 to 15 , but the number of functional glomeruli in the kidneys declines about 60 . Some physiological functions show only moderate changes at rest but more pronounced differences when tested under exercise conditions. The organ systems also vary widely in the age at which senescence becomes noticeable. There are traces of atherosclerosis, for example, even in... Sat, 24 Oct 2020 04:47:42 |Polycystic Ovary Syndrome1 comment The features of PCOS may be elicited when obtaining the medical history or upon the physical examination. The ovarian morphological and the biochemical and metabolic features of the disorder are discussed in Chapters 16 and 17. The evaluation of patients with androgen excess, including PCOS, is discussed in Chapter 33. 2.1. Features Elicitable by Medical History In this section, we will outline important information that the medical history will elicit concerning the features of PCOS, including... Thu, 15 Oct 2020 14:43:04 |Sigmoid Colon30 comments D Instruments left to right for polyp retrieval normal polypectomy snare, grasping forceps, four-pronged grasping forceps, dormia basket. e Polyp trap device. The specimen bag is placed in the trap so that suctioned polyp fragments or small polyps remain hanging in the bag. The bag is cut open with scissors to retrieve the polyp fragments. f Polyp retrieval net. The net is placed over the working channel of the instrument and the polyp or polyp pieces are caught in the net. The polyps are... Varicose veins are tortuous, twisted, or lengthened veins. Unless the enlargement is severe, size alone does not indicate abnormality because size can vary depending on ambient temperature and, in women, hormonal factors. In addition, normal superficial veins in a thin person may appear large, whereas varicose veins in an obese person may be hidden. Varicose veins can be classified as trunk, reticular, or telangiectasia. Telangiectasia are also referred to as spider veins, star bursts, thread... Tue, 13 Oct 2020 10:32:35 |Mental Health1 comment While still a psychiatric resident, Maxie C. Maultsby, Jr., studied briefly with Joseph Wolpe in 1967 and with Ellis for the following 7 years. At the 1975 Chicago National Conference of Rational Emotive and Behavior Therapists, Maultsby described his unique method of psychotherapy called Rational Behavior Therapy, or RBT. Then RBT was and probably still is the only method of psychotherapy that is based on the well-established facts about the mental activities of normal human brains that make... Fri, 09 Oct 2020 14:36:12 |Newborns1 comment Radiograph of the skulls of the same twins as in Figure 2.72 showing the marked lack of mineralization. Figure 2.73. Radiograph of the skulls of the same twins as in Figure 2.72 showing the marked lack of mineralization. Figure 2.74. Short-limbed dwarfism in an infant with the Saldino-Noonan syndrome. This infant demonstrates the marked narrowing of the thorax with a large abdomen. The large abdomen is commonly seen in infants with a narrow thorax because the subcostal space is too... Tue, 06 Oct 2020 07:35:05 |Unity Companies16 comments The body is internally divided into two major body cavities, dorsal and ventral fig. A.7 . The organs within them are called the viscera VISS-er-uh singular, viscus9 . Various membranes line the cavities, cover the viscera, and hold the viscera in place table A.2 . The dorsal body cavity has two subdivisions 1 the cranial CRAY-nee-ul cavity, which is enclosed by the cranium braincase and contains the brain, and 2 the verte bral canal, which is enclosed by the vertebral column backbone and... Sun, 04 Oct 2020 11:17:49 |Sinus Obstruction4 comments Whether venous sinus obstruction in PTS is cause or effect remains unresolved. The experimental and clinical evidence discussed above indicates that there is potential for primary venous sinus pathology to cause PTS and there is also potential for secondary venous sinus obstruction due to raised intracranial pressure. We discuss below the available evidence and also present a unifying theory based on the establishment of a disordered positive feedback cycle. The discussion will centre on the... Sun, 04 Oct 2020 00:53:43 |Spinal Cord6 comments The adenohypophysis produces and secretes many hormones that have diverse target areas. Growth hormone GH is released by the pituitary and causes growth and division of cells throughout the body. Prolactin is more specific in its function. Prolactin stimulates the mammary glands to become functional in milk production. Follicle stimulating hormone FSH and luteinizing hormone LH are gonadotropins that cause the ovaries and testes to release hormones. Thyroid stimulating hormone TSH causes the... Sat, 03 Oct 2020 11:31:37 |Newborns2 comments Frontal view of another infant with arthrogryposis. Extreme intrauterine compression over an extended period of time can produce such severe distortion in multiple joints that supporting ligaments become contracted and opposing tendons stretch. The muscles acting across these joints may atrophy, creating a picture indistinguishable from the intrinsic forms of arthrogryposis multiplex congenita. Figure 5.56. This infant with arthrogryposis demonstrates the severe congenital joint... Thu, 01 Oct 2020 18:57:53 |Syndrome Omim9 comments Exaggerated concavity of the anterior or posterior surface of the vertebral body The anterior and posterior margins of the vertebral body are smoothly concave in normal individuals. An exaggeration of this concavity is referred to as scalloping of the vertebral body Mitchell et al. 1967 . The dorsal side of the vertebral body is also the anterior wall of the spinal canal. Therefore, posterior scalloping typically occurs in conditions associated with increased intradural pressure and dural... Thu, 01 Oct 2020 07:52:41 |Public Health32 comments Defining the target population for a screening program involves describing the settings and the characteristics of the collection of persons who would be eligible for screening Last 1995 . This should be the first step in planning a population-based screening program because screening programs should be tailored to meet the needs of a defined target population. In practice, however, screening programs are developed and implemented in response to the availability of an effective screening test... Mon, 28 Sep 2020 23:28:19 |Mental Health7 comments On Axis III are listed general medical conditions that may be relevant to the disorder s listed on Axes I and II. The presence of Axis III should not be taken to suggest a mind-brain dualism, with Axes I and II representing problems of the mind in the absence of a physiological basis. On the contrary, mental experience is rooted in the function of the brain. Axis III is included in the DSM to encourage a comprehensive evaluation and a consideration of the various ways in which a general medical... Mon, 28 Sep 2020 18:45:56 |Restriction Enzyme7 comments This is the RNA polymerase encoded by bacteriophage T7 is different from its E. coli counterpart. Unlike the a2 2 subunit structure of the E. coli enzyme, T7 RNA polymerase is a single-subunit enzyme that binds to distinct DNA 17 bp promoter sequences 5'-TAATACGACTCACTATA-3' found upstream of the T7 viral gene it activates. E. coli RNA polymerase does not recognize T7 promoter sequences as start sites for transcription. The overall scheme for the production of target proteins using the T7... Sun, 27 Sep 2020 16:13:07 |Unity Companies48 comments Indicates ways in which these systems affect other organ systems indicates ways in which other organ systems affect these systems Lymphatic system drains excess tissue fluid and removes cellular debris and pathogens. Immune system provides defense against pathogens and immune surveillance against cancer. Skin provides mechanical and chemical barriers to pathogens has antigen-presenting cells in epidermis and dermis and is a common site of inflammation Lymphocytes and macrophages arise from bone... Sun, 27 Sep 2020 16:13:07 |Spinal Cord4 comments The oocyte is ovulated from the ovary and moves into the uterine tube. The uterine tube is fringed by small cylindrical structures called fimbriae. The uterus is a small, flask-shaped organ. The uterus has a domed fundus, a main body, a narrowed isthmus, and an inferior cervix. The uterosacral ligament attaches the uterus to the sacrum. Most of the uterine wall is made of the myometrium which is a thick layer of smooth muscle. The vagina is approximately ten centimeters in length and is lined... The cardiovascular system consists of the heart as a pump, blood vessels that take blood away from the heart arteries , and blood vessels that take blood back to the heart veins . Locate the heart on the illustration and color it in purple. Label the common carotid artery and color it in red. Arteries are typically colored in red and veins are colored blue. Label and color in the internal jugular vein too. The internal jugular vein takes blood to the superior vena cava which takes blood to the... Sun, 27 Sep 2020 16:13:07 |Spinal Cord6 comments The lymph system is composed of lymphatics or lymph vessels and glands and is a system with many functions. Fluid that bathes the cells interstitial fluid is returned to the cardiovascular system, in part, by the lymph system. This fluid, called lymph, passes through lymph nodes where impurities and foreign microbes are removed. Other parts of the lymph system include lymph organs such as the spleen. These organs produce cells that protect the body from foreign compounds, and have other immune... Transmural or transenteric endoscopic drainage procedures are performed through several endoscopic approaches through the stomach endoscopic cystogastrostomy or duodenum endoscopic cystoduodenostomy . Several prerequisites need to be fulfilled pursuant to endoscopic transmural drainage Table 1 . Ideally, the pseudocyst must be situated within the pancreatic head or body, and must be firmly adherent to the gastrointestinal tract to cause a visible impression on the gastric or duodenal wall at... Sun, 27 Sep 2020 16:11:14 |Spinal Cord4 comments Cells consist of an enclosing plasma membrane, an inner cytoplasm with numerous organelles, and other cellular structures. The fluid portion of the cell is called the cytosol. Color the cytosol in last after you color the rest of the cellular structures. One of the major structures in the cell is the nucleus. It is the genetic center of the cell and consists of fluid karyoplasm, chromatin containing DNA , and the nucleolus. Color these features and label them on the illustration. The... Sun, 27 Sep 2020 16:11:14 |Sinus Obstruction2 comments The sacrum is normally composed of five modified vertebrae which are fused together. It is a triangular bone mass extending from the inferior vertebral column and containing the sacral and coccygeal nerves. The skin in the sacral region is usually thick, and the subcutaneous tissue varies in thickness according to the habitus of the individual. It tends to be thinner than that found in the adjacent gluteal and lumbar regions. Situated deep below the superficial fascia are two layers of fibrous... Sun, 27 Sep 2020 16:11:14 |Nasolacrimal Ducts2 comments Drainage of tears involves a number of different mechanisms Table 1.3 . Physical factors, such as gravity, respiration, and evaporation, have been suggested. A decisive role is played by capillary attraction, aided by contraction of the lacrimal portion of the orbicularis muscle with blinking, as well as distension of the lacrimal sac by the action of the orbicularis muscle 19 . The mucin diversity of the epithelium of the naso-lacrimal ducts together with TFF peptides that are able to... Sun, 27 Sep 2020 16:11:14 |Spinal Cord13 comments The opening where the spinal cord passes through the vertebra is known as the vertebral foramen. The body of the vertebra is the weight-bearing part of the vertebra and the spinous process is the part that extends posteriorly. This process is an extension from the vertebral arch that curves from the body enclosing the vertebral foramen. This arch is composed of the two pedicles and the two laminae. The superior articular process and the superior articular facet the flat surface on the process... Sun, 27 Sep 2020 16:11:14 |Spinal Cord2 comments The endocrine system is a collection of glands and organs that secrete hormones. This system is grouped according to the function that the individual organs have. Some of these organs have two roles and are called mixed organs. They secrete hormones and also perform other functions such as digestion or secretion. The pancreas is a good example of this. It secretes hormones an endocrine function that regulate blood sugar levels and also secretes enzymes exocrine secretions that break down... Wed, 23 Sep 2020 20:40:35 |Diabetic Foot18 comments This procedure is well suited for older sedentary individuals, and for patients with osteopenia or osteomyelitis of the metatarsal head, where a transpositional osteotomy is not appropriate. Although transfer lesions callus or ulcer have been reported to occur beneath adjacent Fig. 8.15 The Weil lesser metatarsal shortening osteotomy, a The lesser toe is plantarflexed, and the oblique osteotomy cut begins at the distal dorsal edge of the articular cartilage, b Proximal displacement of the... If you have been diagnosed with osteoporosis, you should definitely discuss the diagnosis with your partner. First, your partner should know if you are on any new medications, so he or she can help support you in following the new regimen and watch for reactions. Second, you and your partner should discuss how your lives might be affected by osteoporosis. New medications can present some challenges to your schedule and that of your partner. If you are taking one of the bisphosphonates, you will... The term 'aquaculture' encompasses all cultural (farming) practices producing biomass of aquatic life forms (which for the purposes of this chapter relates to CAB INTERNATIONAL 1998. Fish Diseases and Disorders, Volume 2 Non-infectious Disorders (eds J.F. Leatherland and P.T.K. Woo) 303 fin fish). It does not define the purpose. For example, non-commercial government hatcheries are aquaculture facilities, as are commercial fish farms. If both use similar production methods, they can share the... Thu, 10 Sep 2020 10:49:37 |Syndrome Omim4 comments Shortening of the proximal segments of the extremities humerus, femur By far the most common form of rhizomelic limb shortening is seen in patients with achondroplasia OMIM 100800 , an autosomal dominant disorder with complete penetrance. Although shortening can affect any of the tubular bones, including those in the hands and feet, in patients of all ages, it is most prominent in the proximal segments, especially those of the upper extremities humerus more involved than femur . In infancy,... Sun, 06 Sep 2020 21:46:50 |Anorectal Malformations13 comments Anorectal malformations ARM and cloacal anomalies are rare and complex malformations of the lower gastrointestinal and genitourinary tract. They affect approximately 1 3,500-1 5,000 live births 1 . They may occur in isolation or in association with abnormalities of the urogenital, cardiovascular and skeletal systems as well as with the vertebral, anal, cardiac, tracheoesophageal, renal and limb abnormalities VACTERL association. Treatment has traditionally focussed on achieving urinary and... Fri, 04 Sep 2020 13:39:00 |Spinal Cord1 comment The cornea is the outermost part of the eye and it is responsible for most of the light refraction in the eye the bending of light rays . On the periphery of the cornea is the sclera which helps maintain eye shape. The space behind the cornea is the anterior cavity which is found in front of the lens. It is composed of two smaller chambers, the anterior chamber and the posterior chamber. The anterior chamber is between the cornea and the iris, the part that determines eye color. The posterior... Fri, 04 Sep 2020 13:39:00 |Ischemic Stroke6 comments In addition to the size of the stroke, its location, and the relative involvement of gray versus white matter are key determinants of outcome. For example, small white matter strokes often cause extensive neurologic deficits by interrupting the passage of large axonal bundles such as those within the internal capsule. Blood flow in white matter is lower than in gray matter, and white matter ischemia is typically severe, with rapid cell swelling and tissue edema because there is little... Fri, 04 Sep 2020 13:39:00 |Bone Density1 comment Spinal (or vertebral) fractures are a major concern for men and women with osteoporosis because they can lead to severe pain and disability (see Question 84). These fractures can also lead to kyphosis (see Figure 13 in Question 83). The spine deteriorates and curves due to fractures in individual vertebrae. Most osteoporotic vertebral fractures are traditionally treated with pain medications and a gradual return to normal activities. Although back braces to prevent twisting and support the... Fri, 04 Sep 2020 13:39:00 |Spinal Cord1 comment The testes are enclosed in the scrotal sac which is lined with a smooth muscle layer called the dartos muscle. This muscle contracts when the temperatures drop near the testes, causing them to withdraw closer to the body where it is warmer. Another muscle of the region is the cremaster muscle. It also contracts when it is cold but it is made of skeletal muscle. The epididymis sits on top of the testis like a small cap and is a place where sperm cells mature. The spermatic cord consists of the... Glenner died too young in 1995 due to complications of cardiac amy-loidosis. If he had survived, perhaps he and I would be writing this story together. Instead it will only be my personal recollections of the work we did in 1982-85 that led us to the discovery of the Alzheimer's disease beta protein, Glenner and Wong 1984a now also known as A-beta and beta-A amyloid. My introduction to George Glenner was in 1982, when I interviewed for a job in his new laboratory at the University... As is the case with the vast majority of UV-excited fluorescent probes, confocal or epifluorescence microscopy experiments are difficult to perform with LAURDAN. As already mentioned, the extent of LAURDAN photobleaching under epifluorescence and confocal microscopy is severe, making it almost impossible to collect images on LAURDAN-labeled specimens for more than a few seconds Bagatolli and Gratton 2001 . A way to circumvent this problem is by using two-photon-excitation fluorescence... Ischemic stroke compromises blood flow and energy supply to the brain, which triggers at least five fundamental mechanisms that lead to cell death excito-toxicity and ionic imbalance, oxidative nitrative stress, inflammation, apoptosis, and peri-infarct depolarization Fig. 1.1 . These pathophysiological processes evolve in a series of complex spatial and temporal events spread out over hours or even days Major pathways implicated in ischemic cell death excitotoxicity, ionic imbalance, oxidative... Getting lost medially or laterally is fairly common with this approach because there are so many tendons in view. The main way to tell if you are too far to one side or the other is to grasp the tendon gently and pull on it and see what moves. That should give you an idea what structure you are looking at. It is no problem if you are too far one way or another. You simply come back to the midline and find what structure you are looking for. If you see an artery on either the medial or the ulnar... Fri, 28 Aug 2020 16:47:33 |Newborns1 comment Epidermolysis bullosa in which the lesions were present at birth. The feet are one of the most commonly affected sites because babies kick their feet. If the lesions are extensive, the infant is at risk for fluid and electrolyte loss as well as infection. Figure 1.213. Epidermolysis bullosa letalis junctional epidermolysis bullosa, Herlitz's disease in an infant with generalized involvement of the skin. Note the massive involvement of the lower extremities showing the denudation,... Thu, 27 Aug 2020 23:18:01 |Infectious Diseases3 comments The changing pattern of epidemic diseases or diagnostic categories characteristic of the Renaissance is almost as striking as the transformation of art, science, and scholarship. Although leprosy did not entirely disappear, and waves of plague continued to break over Europe, diseases previously rare, absent, or unrecognized such as syphilis, typhus, smallpox, and influenza became major public health threats. Many diseases are worthy of a full biography, but none raises more intriguing questions... Thu, 27 Aug 2020 13:08:58 |Sigmoid Colon10 comments The short segment of the colon between the appendix and the ileocecal valve is the cecum. Cecum. The short segment of the colon between the appendix and the ileocecal valve is the cecum. Fig. 6.30 Cecal pole. One of the tenia leading to the appendiceal orifice from about the 9-o'clock position . Note the distinct vascular pattern of the normal mucosa. Fig. 6.30 Cecal pole. One of the tenia leading to the appendiceal orifice from about the 9-o'clock position . Note the distinct vascular... Wed, 26 Aug 2020 13:28:22 |Lupus Erythematosus4 comments It is essential to have a working clinical diagnosis, but wherever there is doubt the pathologists can provide much more precise information regarding the nature and extent of the lesion. For example, a patch of Bowen's disease intraepidermal carcinoma may resemble sclerosing superficial basal cell carcinoma and a biopsy will usually distinguish them. Similarly, what seems to be a dysplastic pigmented naevus clinically may, on the one hand, prove to be benign or, on the other hand, turn out to... Sat, 22 Aug 2020 02:23:15 |Newborns4 comments Gum hypertrophy in an infant born to a mother treated with phenytoin during pregnancy. Figure 1.91. The components for each individual tooth bud can often be seen on the alveolar ridges of the maxilla and mandible in normal infants. Note the milia on the nose and the demarcation on the lip where the skin meets the mucous membrane. The sucking calluses occur on the mucous membrane part of the lip and are most prominent on the central portion. Figure 1.92. Gum hypertrophy in an... Mon, 17 Aug 2020 15:58:53 |Nasolacrimal Ducts6 comments A careful history must be combined with the external exmination of the lacrimal system that begins with an inspection of the face, external ocular surface, and eyelid structure including the position and contour of the eyelid and eye blink Table 3.4 . Periorbital and facial asymmetry are looked for, as well as the lid malposition, bulges in the medial canthal area, facial nerve palsy, etc. Table 3.4. Watering patients external inspection and palpation Table 3.4. Watering patients external... Fri, 14 Aug 2020 20:41:24 |Newborns8 comments A CT scan of an infant with a grade II PVH-IVH. There is blood within the lateral ventricles without ventricular dilatation. Figure 3.105. A CT scan of an infant with a grade III PVH-IVH. There is blood within the dilated lateral ventricles. Figure 3.106. A CT scan of an infant with a grade IV PVH-IVH. Note the blood within the lateral ventricles and extension into the cerebral parenchyma. Figure 3.107. This term infant presented with marked increase in head size fronto-occipital... Mon, 13 Jul 2020 19:06:24 |Sodium Chloride 7 comments Which one of the following chemicals is NOT suitable as a drug excipient 16. Which of the following chemicals may be included in a drug solution as a chelating agent 17. Which of the following ions may be effectively chelated by EDTA 18. Although most drugs in pharmaceutical dosage forms are expected to decompose following first-order kinetics, an exception are drugs formulated in 19. An early sign of a decomposing epinephrine 20. On exposure to air, aminophylline solutions may develop C a... D, e Acute ulcerative colitis of uncertain genesis presumed cytomegalovirus infection was ruled out. Colon ulcer with adherent clot d . Visible vessel was seen after irrigation and removal of the clot and was closed with a hemoclip Olympus e . f Mild, acute hemorrhagic colitis in left hemicolon. No pathogen isolated. g, h Acute colitis with hemorrhagic erosions g and submucosal hemorrhages h . No pathogen detected. Acute colitis with massive mucosal edema, isolated hemorrhaging, and small,... Mon, 06 Jul 2020 16:14:48 |Newborns1 comment A close-up of the face of the same infant with the typical Potter facies associated with oligohydramnios and renal agenesis. Note the low-set abnormal ears, the flat nose, and micrognathia. Epicanthal folds were also present. Figure 1.26. Radiograph of the lower extremities of the same infant with sirenomelia shows the presence of two separate femora with fusion of soft tissue, two separate tibiae, and a single fibula distally. Skeletal deficiencies may be longitudinal defects... Fri, 12 Jun 2020 13:38:29 |Autoimmune Diseases2 comments Antibodies to nucleosomes have had a comeback in the last few years. This has to do with both the clinical utility of these antibodies in the diagnosis of SLE and drug-induced lupus DIL and new evidence suggesting that nucleosomes may be major candidate autoimmunogens in lupus. Since it is generally accepted that anti-nucleosome antibodies cause the LE cell phenomenon, they were actually among the first autoantibodies discovered. Of note, autoantibodies against individual components of... G Better visualization of this villous adenoma on the cecal pole f using chromoendoscopy. h, i Two villous adenomas with nodular contours, fingerlike processes, and tubular growth. Stained with indigo carmine dye. Cancerous tubulovillous adenoma with deformed surface and ulceration at the polyp base lower left edge of image . Villous adenoma with friable surface, some spontaneous bleeding. Malignant transformation on surface. c Wide tubulovillous adenoma, malignant transformation with surface... Thu, 04 Jun 2020 13:33:35 |Nail Disorders2 comments Robert Baran, Rodney PR Dawber, Eckart Haneke, Antonella Tosti Onycholysis Onychomadesis and shedding Hypertrophic nail and subungual hyperkeratosis Splinter haemorrhages and haematomas Dorsal and ventral pterygium Further reading Onycholysis refers to the detachment of the nail from its bed at its distal and or lateral attachments Figure 4.1 . The pattern of separation of the plate from the nail bed takes many forms. Sometimes it resembles closely the damage from a splinter under the nail, the... The incidence of male genital anomalies is lower than for female genital anomalies. However, an exact level is difficult to define because of limited and contradictory literature. Hoekstra et al. recorded all of the genitourinary anomalies associated with ARM in 150 children 30 . The genital anomalies in boys were relatively uncommon and mainly of little significance, especially when considering sexual function in later life Table 36.3 . In a later series, the incidence of genital anomalies was... Complications of Peripheral Nerve Evaluation PNE Siegel et al. 143 noted 18.2 of adverse effects in 914 test stimulation procedures. The most common adverse events are lead migration from 11.8 143 to 18.6 143 , technical problems 2.6 and pain 2.1 . One surgical intervention 0.1 was required to remove a test lead electrode that became dislodged during lead removal. Local infection and subcutaneous hematoma are rare 143 . Complications of Sacral Nerve Neuromodulation For chronic sacral... Close-up of the head and upper trunk of the same infant as in Figure 1.224. Note die thick, dry, rigid, hardened, cracked skin with deep crevices. The division of the thickened grey- to yellow-colored skin into polygonal, triangular or diamond-shaped plaques by the deep reddish to purple fissures has been said to simulate the traditional costume of a harlequin. The skin has been likened to die bark of a tree, crocodile skin, or Moroccan leather. Figure 1.223. Another example of a... This is another term infant with severe bilateral microphthalmia. The globes are small, and vision is extremely poor. There are several forms of microphthalmia including those associated with congenital infection, chromosomal abnormalities, and the CHARGE syndrome. Figure 2.47. At term birth, the normal ocular sagittal length is 17.5 mm, and the normal corneal diameter is 10 mm. This is a term infant with very severe bilateral microphthalmia. The globes are virtually absent and the... Wed, 20 May 2020 01:35:28 |Anorectal Malformations3 comments Wangensteen and Rice 50 first described the use of inversion radiography in 1930 to indicate the distance between the gas bubble within the terminal colon and the perineal skin. Many authors 6, 8, 11, 13, 19, 22, 29, 39, 48 then subsequently related the distance from the skin to the underlying abnormality, although the measurement of the distance alone does not provide the essential information required, which is the relationship of the blind-ending rectum to the levator ani and sphincter... Early on, there is decreased recruitment and interference, with decreased motor unit action potential amplitudes. In 2-4 weeks, fibrillations will develop, with possible fasciculations. Over time, reinnervation will lead to polyphasic motor units. Nerve conduction velocities and sensory studies are normal. Imaging Inflammation of the anterior spinal cord may be detected with MRI. Post-polio syndrome The diagnosis of PPS is by exclusion of other conditions and demonstration of progressive... Mon, 18 May 2020 14:09:19 |Spinal Cord2 comments The nose consists of the nasal bones, the frontal process of the maxilla at the root of the nose, and a number of cartilages. These nasal cartilages are made of hyaline cartilage. These are the lateral nasal cartilages, the greater alar cartilages, and the lesser alar cartilages. The septal cartilage also forms part of these cartilages. The openings of the nose nostrils are the external nares external naris singular . The nasal cavity has a wall that runs down the middle of it called the nasal... Thickened, hyperkeratotic, irregular ragged cuticles Figure 5.12 are most commonly seen in dermatomyositis Figure 5.13 . Perionychial tissues are constantly subjected to trauma. In nail biters and 'pickers' the cuticles and nail folds may show considerable damage, erosions, haemorrhage and crusting. The ulnar side of the nail fold and cuticle is most vulnerable and there may be small trian-gular tags of skin hangnail, Figure 5.14 and separated spicules of nail, still attached proxi-mally.... Sat, 16 May 2020 00:32:34 |Nail Disorders1 comment Antonella Tosti, Robert Baran, Rodney PR Dawber, Eckart Haneke Candida onychomycosis Further reading Fungi may invade the nails in four different ways, leading to four separate types of onychomycosis with specific clinical features, prognosis and response to treatment. The type of nail invasion depends on the fungus responsible and the host susceptibility. Invasion occurs 1 Via the distal subungual area and the lateral nail groove, leading to distal lateral subungual onychomycosis Figure 8.1 .... Fri, 15 May 2020 19:51:00 |Anorectal Malformations2 comments Table 8.9 Wingspread Conference classification Table 8.9 Wingspread Conference classification 2. Anal agenesis without fistula 3. Anal agenesis without fistula 1. Anocutaneous perineal fistula 1. Anovestibular perineal fistula, 2. Anocutaneous perineal fistula Persistent cloacal anomaly Rare malformations complex, it allowed ARM to be viewed in a structured fashion. Intermediate was later added to this classification to describe those lesions where the rectum ends below the PC line. In 1964... Wed, 13 May 2020 14:57:56 |Polycystic Ovary Syndrome2 comments We calculated the health care-related economic burden in PCOS based on the above prevalences of disease (64). We restricted the calculation to the United States only, although we recognize that PCOS is an international disorder. However, we should note that our estimation is highly conservative because we did not include a number of costs for which we did not have accurate and present-day prevalence and monetary estimates (Table 1). We did include the costs of the initial evaluation, detailed... We outline here the basics of the medical history and physical exam in the patient suspected of suffering from androgen excess. The timing and pace of pubertal development and its relation to complaints of unwanted hair growth, hair loss, acne, and or obesity should be established. The onset and progression of these complaints should also be established. Drug or medication use and exposure or use of skin irritants should be elicited. A detailed menstrual history should be obtained, with an... Wed, 13 May 2020 02:40:26 |Newborns1 comment Radiograph of an infant with metatropic dysplasia. This is another form of dwarfism associated with a narrow thorax, thoracic kyphoscoliosis and metaphyseal flaring giving the typical dumb-bell appearance . The proportion of the length of the trunk to the extremities reverses during childhood. At first the trunk is too long and the extremities too short. With increasing kyphoscoliosis the trunk becomes short. Figure 2.61. Radiograph of an infant with metatropic dysplasia. This is... Hakelius 13 and Hakelius et al. 14-16 originally described the procedure in which a graft of muscle usually the palmaris longus, less commonly the sartorius, or extensor digitorum brevis is first de-nervated 2 weeks before transplantation and is then transplanted as a U-shaped sling around the rectum, in close contact with the puborectalis, and anchored to the pubic bone Figs. 31.6 and 31.7 . Denervation allows muscle survival as it initiates a lower level of energy consumption. The graft... Mon, 11 May 2020 07:03:16 |Unity Companies1 comment The conversion of light energy into action potentials occurs in the retina. We begin our exploration of this process with the cellular layout of the retina fig. 16.32 . From there we go to the pigments that absorb light and then to what happens when light is absorbed. The most posterior layer of the retina is the pigment epithelium, a layer of darkly pigmented cuboidal cells whose basal processes interdigitate with receptor cells of the retina. The pigment here is not involved in nerve... Figure 4.6 Representation of the primary dopamine-containing tracts in the human brain. The nigrostriatal tract is primarily involved in motor control, but also in reward- and goal-directed behavior. Blockade of D2 receptors here produces some of the antipsychotic effects of antipsychotics, but high levels of blockade gt 80 produce parkinsonian side-effects. Blockade of D2 receptors in the tuberoinfundibular pathway increases plasma prolactin. It is thought that it is the blockade of D2 and... The body must react to the external environment and the internal environment and communicate information between regions of the body. This job is primarily the task of the nervous system. Proper response to the external environment is critical for thermal regulation, response to threats, taking advantage of opportunities such as food availability, and a host of other stimuli. Response to the internal environment is important for sensing muscle tension, digestive processes, maintenance of blood... Thu, 07 May 2020 12:56:58 |Abdominal Wall2 comments The external abdominal oblique muscle Figs. 1.6,1.7 is the most superficial abdominal muscle that originates from the external surfaces of the lower seven or eight ribs and interdigitates with the serratus anterior and la-tissimus dorsi muscles. Most of the muscle fibers run downward and medially, forming an aponeurosis near the lateral border of the rectus abdominis. The muscle fibers from the lower two ribs descend vertically downward to attach to the iliac crest. Muscle fibers are rarely... Wed, 06 May 2020 04:15:23 |Spinal Cord3 comments The eye is located in the orbit of the skull and has several external features. Above the eye is the eyebrow. The corners of the eye have either a lateral commissure or a medial commissure. Next to the medial commissure is the caruncle, a small thickened tissue in the medial corner of the eye. The outer surface of the eye is protected by the upper and lower eyelids. The blink reflex rapidly closes the eyelids to keep dust from hitting the outer surface of the eye. Label and color the sclera the... Mon, 04 May 2020 15:19:28 |Diabetic Foot13 comments Neuro-Ischemic Ulcer with Osteomyelitis Neuro-Ischemic Ulcer on the Hallux with Osteomyelitis A 68-year-old obese male patient with type 2 diabetes diagnosed at the age of 46 years visited the outpatient diabetic foot clinic because of two chronic ulcers on his right hallux. He was treated with a combination of sulfonylurea during the day and a mixture of 20 rapid acting-80 intermediate acting insulin before dinner he also had dislipidemia which was being treated with simvastatin. On... Mon, 04 May 2020 09:54:14 |Diabetic Foot2 comments A 65-year-old male patient with longstanding type 2 diabetes attended the outpatient diabetic foot clinic for callus removal and treatment of ulcers on the tip of his second and fifth right toes Figure 3.27 . On examination, he had bounding pedal pulses, and severe peripheral neuropathy. Metatarsal heads were prominent, and claw toes were present. Claw toe deformities may cause prominence of metatarsal heads with subsequent Figure 3.27 Prominent metatarsal heads and claw toes callus formation... Birth trauma refers to those injuries sustained during labor and delivery. Despite skilled and competent obstetric care, some may be unavoidable. Factors predisposing infants to injury include macrosomia, prematurity, cephalopelvic disproportion, dystocia, prolonged labor, and abnormal presentation. In 1988, birth injuries ranked eight as major causes of neonatal mortality and caused 4.6 deaths per 100,000 live births. The clinician who cares for newborn infants must be familiar with the... Sat, 02 May 2020 23:39:01 | Spinal Cord1 comment Two main cartilages of the larynx can be seen from an anterior view. The thyroid cartilage is superior to the cricoid cartilage. Below the larynx is the trachea which divides into the right and left primary bronchi. The right primary bronchus leads to the right lung and the left primary bronchus leads to the left lung. Label the parts of the respiratory system illustrated. Color the two visible cartilages of the larynx different colors and the trachea another color. Color the bronchi in first... The apex of the heart is inferior and the base is superior. Label each chamber of the heart and color them each a different color. Locate the coronary arteries and their branches and color them in red. The right coronary artery leads to the right marginal artery. The left coronary artery takes blood to the anterior interventricular branch and the circumflex branch. The cardiac veins can also be seen on the anterior side. The great cardiac vein runs in the interventricular sulcus on the anterior... Right hand of the same infant with amyotonia congenita. Note the lack of finger creases and the abnormal appearance of the hand due to lack of intrauterine fetal movement. Finger creases normally develop at 11 to 12 weeks gesta-tional age. Figure 3.117. In this male infant with myotonic dystrophy, note the marked hypotonia, cryptorchidism, and clubfoot. Figure 3.118. The face of the same infant as shown in Figure 3.117 shows the typical lack of expression and the bilateral ptosis... Wed, 29 Apr 2020 09:29:36 |Newborns1 comment In this infant with a f9 lipomeningocele with a tethered cord, note the associated skin discoloration with a small skin tag. Figure 3.82. A lipomeningocele with an associated sinus tract is present in this infant. Figure 3.83. Infant with a large dermal sinus tract associated with cord tethering and spinal dysraphism. On MRI there was a tethered cord and spina bifida both above and below the lesion. Figure 3.84. Small finger-like dermal tag extending from the mid-line of the back... Wed, 29 Apr 2020 03:50:19 |Nail Disorders1 comment Repeated microtrauma of the nail apparatus The painful nail Further reading This chapter looks at three distinct aspects of trauma, under the headings 1 Major trauma involving any digit . This section considers major trauma, single overwhelming injury, necessitating only minor 'office' surgery. Complex laceration and most of the traumatic abnormalities are beyond the intended scope of this book. Damage from acute trauma may have immediate and or delayed effects. Acute subungual haematoma is... Wed, 29 Apr 2020 00:41:31 |Mental Health11 comments On Axis II are listed Personality Disorders and Mental Retardation. These disorders, by definition, are present for a substantial period of time (i.e., years). Although Axis I disorders may also be present for similar lengths of time, enduring symptoms are fundamentally part of these Axis II disorders. Also listed on Axis II are other traits or prominent features of a person's personality that a clinician deems maladaptive (e.g., frequent use of denial, excessive impulsivity). In addition to... Sun, 26 Apr 2020 13:23:30 |Newborns1 comment Retinal hemorrhages occur frequently in the neonate, especially following vaginal delivery. In some studies, the incidence of small retinal hemorrhages is as high as 25 irrespective of whether the delivery was spontaneous or required the application of forceps. These retinal hemorrhages resolve spontaneously without any consequences. In contrast, hemorrhages into the vitreous gel may prevent light from getting through to the retina for several days or even weeks and will cause a...

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