The preferred route of access for temporary transvenous pacing is the internal jugular vein followed by subclavian and femoral veins. However, all the major venous access sites (internal and external jugular, subclavian, brachial, femoral) have been used and each is associated with particular problems.

ICDs are useful in preventing sudden death in patients with known, sustained ventricular tachycardia or fibrillation. Studies have shown ICDs to have a role in preventing cardiac arrest in high-risk patients who haven't had, but are at risk for, life-threatening ventricular arrhythmias. View an animation of an ICD. Newer-generation ICDs may have a dual function which includes the ability to serve as a pacemaker. The pacemaker feature would stimulate the heart to beat if the heart rate is detected to be too slow. What is an Implantable Cardioverter Defibrillator (ICD)? An ICD is a battery-powered device placed under the skin that keeps track of your heart rate. Thin wires connect the ICD to your heart. If an abnormal heart rhythm is detected the device will deliver an electric shock to restore a normal heartbeat if your heart is beating chaotically and much too fast. ICDs have been very useful in preventing sudden death in patients with known, sustained ventricular tachycardia or fibrillation. Studies have shown that they may have a role in preventing cardiac arrest in high-risk patients who haven't had, but are at risk for, life-threatening ventricular arrhythmias.

A pacemaker is a small device that's placed in the chest or abdomen to help control abnormal heart rhythms. This device uses electrical pulses to prompt the heart to beat at a normal rate. Pacemakers are used to treat arrhythmias (ah-RITH-me-ahs). Arrhythmias are problems with the rate or rhythm of the heartbeat.Feb 28, 2012

Near the end of diastole, the ventricles nearly fill with blood, and then the atria contract, adding even more volume to the ventricles. The volume of blood in the ventricles at the end of diastole is referred to as the end-diastolic volume. The other phase of the cardiac cycle is called systole.

Heart sounds are the noises generated by the beating heart and the resultant flow of blood through it. Specifically, the sounds reflect the turbulence created when the heart valves snap shut. In cardiac auscultation, an examiner may use a stethoscope to listen for these unique and distinct sounds that provide important auditory data regarding the condition of the heart. In healthy adults, there are two normal heart sounds often described as a lub and a dub (or dup), that occur in sequence with each heartbeat. These are the first heart sound (S1) and second heart sound (S2), produced by the closing of the atrioventricular valves and semilunar valves, respectively. In addition to these normal sounds, a variety of other sounds may be present including heart murmurs, adventitious sounds, and gallop rhythms S3 and S4.

Breath sounds can be either normal or abnormal. These sounds come from the lungs when you breathe in or out. These sounds can be heard using a stethoscope or simply when breathing. Abnormal breath sounds can indicate a lung problem, such as: an obstruction inflammation an infection fluid in the lungs asthma Listening to breath sounds is an important part of diagnosing many different medical conditions.

Lung Sounds - Rales, Rhonchi, Wheezes

Physiological & pathological breath sounds

This video: Multiple myeloma is a cancer that forms in a type of white blood cell called a plasma cell. Plasma cells help you fight infections by making antibodies that recognize and attack germs. Multiple myeloma causes cancer cells to accumulate in the bone marrow, where they crowd out healthy blood cells. Rather than produce helpful antibodies, the cancer cells produce abnormal proteins that can cause kidney problems. Treatment for multiple myeloma isn't always necessary. If you're not experiencing signs and symptoms, you may not require treatment. If signs and symptoms develop, a number of treatments can help control your multiple myeloma.

Hodgkin lymphoma has characteristics that distinguish it from other diseases classified as lymphoma, including the presence of Reed-Sternberg cells. These are large, cancerous cells found in Hodgkin lymphoma tissues, named for the scientists who first identified them. Hodgkin lymphoma is one of the most curable forms of cancer. NHL represents a diverse group of diseases distinguished by the characteristics of the cancer cells associated with each disease type. Most people with NHL have a B-cell type of NHL (about 85 percent). The others have a T-cell type or an NK-cell type of lymphoma. Some patients with fast-growing NHL can be cured. For patients with slow-growing NHL, treatment may keep the disease in check for many years.

Bone marrow is the soft, sponge-like material found inside bones. It contains immature cells known as hematopoietic or blood-forming stem cells. (Hematopoietic stem cells are different from embryonic stem cells. Embryonic stem cells can develop into every type of cell in the body.) Hematopoietic stem cells divide to form more blood-forming stem cells, or they mature into one of three types of blood cells: white blood cells, which fight infection; red blood cells, which carry oxygen; and platelets, which help the blood to clot. Most hematopoietic stem cells are found in the bone marrow, but some cells, called peripheral blood stem cells (PBSCs), are found in the bloodstream. Blood in the umbilical cord also contains hematopoietic stem cells. Cells from any of these sources can be used in transplants.

In an autologous transplant, a patient's own blood-forming stem cells are collected. He or she is then treated with high doses of chemotherapy, or a combination of chemotherapy and radiation. The high-dose treatment kills cancer cells, but also eliminates the blood-producing cells that are left in the bone marrow.

Bone marrow biopsy and bone marrow aspiration are procedures to collect and examine bone marrow — the spongy tissue inside some of your larger bones. Bone marrow biopsy and aspiration can show whether your bone marrow is healthy and making normal amounts of blood cells. Doctors use these procedures to diagnose and monitor blood and marrow diseases, including some cancers, as well as fevers of unknown origin. Bone marrow has a fluid portion and a more solid portion. In bone marrow biopsy, your doctor uses a needle to withdraw a sample of the solid portion. In bone marrow aspiration, a needle is used to withdraw a sample of the fluid portion.

Examination of the Hands

MENTAL STATUS EXAMINATION

NEUROLOGICAL EXAMINATION

Shaking violently in a hospital crib, two tiny legs twitch and shudder uncontrollably. Wailing, muscle clenching and gasping for breath accompany the disturbing fit-like seizure. But, what makes the image all the more heartbreaking, is the newborn baby's diagnosis. Despite being just weeks old, the tiny baby is suffering the effects of drug withdrawal, having been born addicted to opioids. Every 19 minutes a child in the US is born with an opioid addiction - a devastating affliction inherited from their drug-addict mothers. While for most newborns the first precious weeks of life are full of love, care and adoration, for babies born addicted to drugs their first weeks are long, agonizing and distressing as they battle neonatal abstinence syndrome.

Screening is looking for cancer before a person has any symptoms. This can help find cancer at an early stage when it may be easier to treat. Lung cancer may have spread by the time a person has symptoms. One reason lung cancer is so serious is because it usually is not found until it has spread and is more difficult to treat. Screening may provide new hope for early detection and treatment of lung cancer. Scientists study screening tests to find those with the fewest risks and most benefits. They look at results over time to see if finding the cancer early decreases a person's chance of dying from the disease.

Signs and symptoms of chronic kidney disease develop over time if kidney damage progresses slowly. Signs and symptoms of kidney disease may include: Nausea Vomiting Loss of appetite Fatigue and weakness Sleep problems Changes in how much you urinate Decreased mental sharpness Muscle twitches and cramps Swelling of feet and ankles Persistent itching Chest pain, if fluid builds up around the lining of the heart Shortness of breath, if fluid builds up in the lungs High blood pressure (hypertension) that's difficult to control Signs and symptoms of kidney disease are often nonspecific, meaning they can also be caused by other illnesses. Because your kidneys are highly adaptable and able to compensate for lost function, signs and symptoms may not appear until irreversible damage has occurred.

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