2014-01-12 | best for all medical and surgical blog

EXPLAINING OF ASCENDING CHOLANGITIS

EXPLAINING OF ASCENDING CHOLANGITIS

Definition

Acute cholangnitis: is an ascending bacterial infection of common bile duct in association with partial or complete obstruction of the bile ducts or acute inflammation of common bile duct

When associated with kidney (renal) failure, heart (cardiac) impairment, liver (hepatic) abscesses, and malignancies the morbidity and morality rates may be high

is one of the two main complications of common bile duct (choledochal) stones, the other gallstone pancreatitis

. Hepatic bile is sterile, and bile in the bile ducts is kept sterile by continuous bile flow and by the presence of antibacterial substances in bile such as immunoglobulin

DIAGNOSIS OF BILIARY TRACT OR GALL BLADDER DISEASES

DIAGNOSIS OF BILIARY TRACT OR GALL BLADDER DISEASES

There are many diagnostic studies which can evaluated the state of biliary tract and gall bladder diseases which facilitated to reach proper diagnosis these diagnostic measures can be classified as follow

Laboratory diagnostic study

When patients with suspected diseases of the gallbladder or the extrahepatic biliary tree are evaluated by

EXPLAINING GALL BLADDER ANATOMY

EXPLAINING GALL BLADDER ANATOMY

GALL BLADDER ANATOMY

The gallbladder is a pear-shaped sac, about 7 to 10 cm long with an average capacity of 30 -50 mL containing bile

When obstructed, the gallbladder can distend markedly and contain up to 300 mL
The gallbladder is located in a fossa on the inferior surface of the liver that is in line with the anatomic division of the liver into right and left liver lobes

GALL BLADDER

The gallbladder is divided into four anatomic areas

The fundus
The corpus (body
The infundibulum
The neck

EXPLAINING OF ACALCULAR CHOLECYSTITIS

EXPLAINING OF ACALCULAR CHOLECYSTITIS

Acalcular or non calcular cholecystitis

Definition
It is mean acute or chronic inflammation of the gall bladder due to other causes rather than gall stones

Acalculous cholecystitis typically develops in critically ill patient in the intensive care unit

gall bladder anatomy

Risk factors are

Patients on parenteral nutrition with severe burns
sepsis
major operations
multiple trauma
prolonged illness with multiple organ system failure

EXPLAINING OF GALL BLADDER STONES

EXPLAINING OF GALL BLADDER STONE

Introduction

Gallstone disease is one of the most common problems affecting the digestive tract The prevalence of gallstones is related to many factors, including age, gender, and ethnic background

Women are three times more likely to develop gallstones than men, and first-degree relatives of patients with gallstones have a twofold greater prevalence In order to understanding the gall bladder stone formation and its types it should be first known the anatomy of the gall bladder as follow

EXPLAINING OF GALL BLADDER STONES

GALL BLADDER STONES

Anatomy of the Gallbladder

The gallbladder is a pear-shaped sac, about 7 to 10 cm long with an average capacity of 30 -50 mL containing bile

ACUTE CHOLECYSTITIS CAUSES AND TREATMENT

ACUTE CHOLECYSTITIS CAUSES AND TREATMENT

ACUTE CHOLECYSTITIS

Definition

That is mean acute or sudden inflammation or infection of the gall bladder which may due to stones in the gall bladder or other causes rather than stones

Types

There are two types either

Acute calcular (stone ) cholecystitis about 95% also called

acute obstructive cholecystitis

Acute non calcular( no stones) cholecystitis about 5% also called acute non obstructive cholecystits

CHRONIC CHOLECYSTITIS CAUSES AND TREATMENT

CHRONIC CHOLECYSTITIS CAUSES AND TREATMENT

Definition

Chronic cholecystitis means chronic inflammation of the gall bladder

Types

Chronic calcular cholecysitits due to stones in gall bladder most common form
Chronic non calcular cholecysitis due to other causes than stone in gall bladder less common

HOW FRACTURED BONE HEALED AND UNION

HOW FRACTURED BONE HEALED AND UNION

When the bone become fractured there are many mechanism or pathophysiology process which start after the bone become fractured to allow it to become healed as follow

When a bone break there is disruption of periosteum, cortical bone trabecular bone and the blood vessels which run in the periosteum and the medulla

There is haemorrhage and immediate release of cytokines this signals to cells locally that damage has occurred

EXPLAINING EXTERNAL FIXATION OF BONE FRACTURED

EXPLAINING EXTERNAL FIXATION OF BONE FRACTURED

There are two types of bone fixation

Internal fixation and external fixation

Internal fixation see here

External fixation

Are those where the mechanical strength of the construct is outside the skin or fixation of fracture outside the skin

Is an alternative way to holding a fracture is to insert pins and wires into the bone on each side of the fracture, and to attach these to an external frame that provides the structural integrity

Fixators can be as simple as a set of pins incorporated into a plaster through single- and double-bar fixators or as complex as ring fixators holding the bone through tension wires

ALL YOU NEED ABOUT INTERNAL FIXATION OF FRACTURED BONE

ALL YOU NEED ABOUT INTERNAL FIXATION OF FRACTURED BONE

Types of fixation

Fixation can be divided into external and internal fixations

Internal fixation

Are implants that are fitted directly on to or put down the inside of the bone and are then covered with soft tissues and skin

,Internal fixation can allow accurate reduction of fractures, and allows strong and stable fixation, so that the patient can rapidly return to everyday activities, with the minimum of inconvenience

Internal fixation is best performed under a tourniquet, if possible in order to obtain a blood-free view

EXPLAINING CEREBRAL ANEURYSM

EXPLAINING CEREBRAL ANEURYSM

Definition

An aneurysm is focal dilatation of the vessel wall

, Is most often a balloon-like outpouching, but may also be fusiform

Aneurysms usually occur at branch points of major vessels e.g, internal carotid artery (lCA) bifurcation, or at the origin of smaller vessels e.g., posterior communicating artery or ophthalmic artery

Approximately 85% of aneurysms arise from the anterior circulation (carotid) and 15% from the posterior circulation

vertebrobasilar

EXPLAINING OF PITUITARY GLAND TUMOURS

EXPLAINING OF PITUITARY GLAND TUMOURS

Introduction

In order to understanding the pituitary gland tumours it should be first known the important anatomy of the pitiuitary

The pituitary gland or hypophysis cerebri is the master gland in the body

It is an endocrine gland which secreted many hormones in the blood It very small in size a pea sized

It is intracranial structures which present in the middle cranial fossa It is lies in bony cavity like structure called sella trucica

It is composite structure consists of three parts the anterior intermediate and posterior lobe

Hormones secreted by anterior pituitary by its cells

Acidophilic cells secreted somatotropic or growth hormone and prolactin

Basophilic cells secreted adrenocorticotropic hormone (ACTH) , thyroid stimulating hormone (TSH) follicular and luteinzing hormones (FSH and LH

EXPLAINING COMMON MALIGNANT BONE TUMOURS

EXPLAINING COMMON MALIGNANT BONE TUMOURS

Common primary malignant bone tumours

Are osteosarcoma , chondrosarcoma , Ewing,s sarcoma , adamantinoma , malignant fibrous histocytoma , lymphoma , myeloma

Osteosarcoma: second commonest primary malignant bone tumour, aggressive and metastasising, affecting the young

Chondrosarcoma: third commonest primary malignant bone tumour

Ewing's sarcoma: second commonest primary bone tumour in children

EXPLAINING OF MALIGNANT BONE TUMOURS

EXPLAINING OF MALIGNANT BONE TUMOURS

Introduction

The malignant tumours of the bones are divided into primary malignant bones tumours which arise from the bones and these are rare tumours and secondary bones tumous which arise due to metastasis from other organs and these are commoner than primary bones tumours

ALL YOU NEED ABOUT OSTEOARTHRITIS AO

ALL YOU NEED ABOUT OSTEOARTHRITIS AO

Definition of osteoarthritis

Is a non inflammatory disorder of movable joints which affected any synovial joints and affected both bone and cartilage and characterized by deterioration of articular cartilage and formation of new bone at the joint surfaces and margins this disorder is also known as degenerative joint disease

Causes of osteoarthritis AO

There are two types of osteoarthritis primary and secondary osteoarthritis

EXPLAINING OF SYMPTOMS SIGNS AND TREATMENT OF OSTEOARTHRITIS

EXPLAINING OF SYMPTOMS SIGNS AND TREATMENT OF OSTEOARTHRITIS AO

Symptoms and signs of osteoarthritis

Symptoms of osteoarthritis AO

Pain of osteoarthritis: is characterized by dull aching pain poorly localized up till severe pain may awake patient during sleep the pain increase with activity as with joint movement and using and the pain relieved by rest the pain increase at the end of the day the pain may occur with minimal motion and even at rest the pain may become sharp due to muscle spasm around the joint the pain worse by exercise
Joint stiffness: limited stiffness on awakening in the morning and after a periods of inactivity during the day is common as the joint is limbered up the patient feel better
If the patient sits down for any length of time pain may develop after the commencement of activity
patients may complains from locking episodes and joint loosen as in loose bodies or meniscal tear
Limitation of motion or movement :often involving loss of extension and flexion
In the hip joint :patient usually maintain 90 degree of flexion but lose most abduction and internal and external rotation