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Portal hypertension is an increase in the blood pressure within a system of veins called the portal venous system. Veins coming from the stomach, intestine, spleen, and pancreas merge into the portal vein, which then branches into smaller vessels and travels through the liver.
Four-Step Guide to ABG Analysis Is the pH normal, acidotic or alkalotic? Are the pCO2 or HCO3 abnormal? Which one appears to influence the pH? If both the pCO2 and HCO3 are abnormal, the one which deviates most from the norm is most likely causing an abnormal pH. Check the pO2. Is the patient hypoxic?
Dacryocystorhinostomy (DCR) is a procedure performed for the treatment of tearing (epiphora) due to blockage of the nasolacrimal duct. Tears originate in the lacrimal gland, located at the upper outer margin of the eye. As tears cross the eye with each blink, they are directed into small openings in the eyelids called puncta. From this point, tears travel through a pathway known as the canalicular system into the lacrimal sac. The lacrimal sac is located between the eye and the nose, and funnels tears into the nasal cavity through the nasolacrimal duct (Figure 1). As this is quite a long path for tears to travel, there can be many causes of excessive tearing. Blockage of the nasolacrimal duct is one common cause, and can be treated by creating a direct opening from the lacrimal sac into the nasal cavity in a procedure known as DCR. The evaluation and management of tearing may involve both an ophthalmologist and an otolaryngologist.
Ovarian teratoma is a type of germ cell tumour. Germ cell tumours are cancers that begin in egg cells in women or sperm cells in men. There are 2 main types of ovarian teratoma. Mature teratoma, which is benign. Immature teratoma, which is cancerous.
Transposition of the great arteries is a serious but rare heart defect present at birth (congenital), in which the two main arteries leaving the heart are reversed (transposed). Transposition of the great arteries changes the way blood circulates through the body, leaving a shortage of oxygen in blood flowing from the heart to the rest of the body. Without an adequate supply of oxygen-rich blood, the body can't function properly and your child faces serious complications or death without treatment.
Wilms tumor, also known as nephroblastoma, is a cancer of the kidneys that typically occurs in children, rarely in adults. It is named after Dr. Max Wilms, the German surgeon (1867–1918) who first described it. Approximately 500 cases are diagnosed in the U.S. annually.
The examination consists of three portions: Inspection, Palpation, and Synthesis of data from these techniques In addition to palpating for size, also note the gland texture, mobility, tenderness and the presence of nodules. Inspection Inspection: Anterior Approach The patient should be seated or standing in a comfortable position with the neck in a neutral or slightly extended position. Cross-lighting increases shadows, improving the detection of masses. To enhance visualization of the thyroid, you can: Extending the neck, which stretches overlying tissues Have the patient swallow a sip of water, watching for the upward movement of the thyroid gland. quicktime video 251KB video demo from Return to the Bedside Inspection: Lateral Approach After completing anterior inspection of the thyroid, observe the neck from the side. Estimate the smooth, straight contour from the cricoid cartilage to the suprasternal notch. Measure any prominence beyond this imagined contour, using a ruler placed in the area of prominence. Palpation Note: There is no data comparing palpation using the anterior approach to the posterior approach so examiners should use the approach that they find most comfortable. Palpation: Anterior Approach placement of hands for palpatation of thyroid in anterior approach The patient is examined in the seated or standing position. Attempt to locate the thyroid isthmus by palpating between the cricoid cartilage and the suprasternal notch. Use one hand to slightly retract the sternocleidomastoid muscle while using the other to palpate the thyroid. Have the patient swallow a sip of water as you palpate, feeling for the upward movement of the thyroid gland. quicktime video 454KB video demo from Return to the Bedside. Palpation: Posterior Approach placement of hands for palpatation of thyroid in posterior approach The patient is examined in the seated or standing position. Standing behind the patient, attempt to locate the thyroid isthmus by palpating between the cricoid cartilage and the suprasternal notch. Move your hands laterally to try to feel under the sternocleidomstoids for the fullness of the thyroid. Have the patient swallow a sip of water as you palpate, feeling for the upward movement of the thyroid gland.
The heart itself is made up of 4 chambers, 2 atria and 2 ventricles. De-oxygenated blood returns to the right side of the heart via the venous circulation. It is pumped into the right ventricle and then to the lungs where carbon dioxide is released and oxygen is absorbed. The oxygenated blood then travels back to the left side of the heart into the left atria, then into the left ventricle from where it is pumped into the aorta and arterial circulation.