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A detailed description of the Arterial Pulse including its waveform and pathological subtypes. Also discussed are the abnormal rates (tachycardia and bradycardia) and their causes, abnormal rhythm (including regularly regular and irregularly irregular pulses) and abnormal character (including pulses bisferiens, pulses parvus et tarsus, pulsus alternans, pulses paradoxus and others.) Description of pulse in various pathological states including Aortic stenosis and aortic regurgitation is also included. Finally there is also a description of the peripheral signs of aortic regurgitation.
Two types of clinically distinct necrotizing fasciitis have been described. The most common form (type II) usually occurs in individuals with no concurrent medical illness. Many patients report a history of laceration, blunt trauma, or a surgical procedure as a predisposing factor. It is typically caused by group A Streptococcus (Streptococcus pyogenes). In contrast, type I is usually seen in patients with underlying diabetes and peripheral vascular disease. It is generally a polymicrobial infection; some commonly isolated organisms include Staphylococcus aureus, Bacteroides tragi/is, Escherichia coli, group A Streptococcus, and Pre vote/fa species. Crepitus is more common if anaerobic organisms, such as Clostridium perfringens or 8 tragi/is, are involved.
Mitral Valve Prolapse and Mitral Regurgitation. Review of mitral valve anatomy and function, including papillary muscle structure and function, with severe mitral valve prolapse and mitral regurgitation due to a flail segment caused by ruptured papillary muscle and chorda tendinae attachment.
Your sleeping pose can have a major impact on your slumber—as well as your overall health. Poor p.m. posture could potentially cause back and neck pain, fatigue, sleep apnea, muscle cramping, impaired circulation, headaches, heartburn, tummy troubles, and even premature wrinkles
Nosebleeds are common. Most often they are a nuisance and not a true medical problem. But they can be both. Nosebleed care Sit upright and lean forward. By remaining upright, you reduce blood pressure in the veins of your nose. This discourages further bleeding. Sitting forward will help you avoid swallowing blood, which can irritate your stomach. Pinch your nose. Use your thumb and index finger to pinch your nostrils shut. Breathe through your mouth. Continue to pinch for five to 10 minutes. Pinching sends pressure to the bleeding point on the nasal septum and often stops the flow of blood. To prevent re-bleeding, don't pick or blow your nose and don't bend down for several hours after the bleeding episode. During this time remember to keep your head higher than the level of your heart. If re-bleeding occurs, blow out forcefully to clear your nose of blood clots and spray both sides of your nose with a decongestant nasal spray containing oxymetazoline (Afrin, Mucinex Moisture Smart, others). Pinch your nose again as described above and call your doctor. When to seek emergency care The bleeding lasts for more than 20 minutes The nosebleed follows an accident, a fall or an injury to your head, including a punch in the face that may have broken your nose