...survive without it. In this paper we will consider the role of the diaphragm through its anatomy and physiology. We will then review a congenital birth defect known as Congenital Diaphragmatic Hernia (CDH) and how it changes the anatomy and physiology of the body. We will also look at current research and prognosis of the disease in an effort to gain a better understanding of this often-fatal defect. The diaphragm is located almost centrally in the body. It is a continuous sheet of muscle that spreads across the bottom of the rib cage creating a divide between the thoracic cavity and the abdominal cavity. As detailed in the text Gray’s Anatomy, the convex upper surface of the diaphragm faces the thorax and forms the bottom of the thoracic cavity. The concave inferior surface is pointed towards the abdomen and is mostly covered in peritoneum forming the superior part of the abdominal cavity. The right side of the diaphragm is superior to the right lobe of the liver, the right kidney, and the right adrenal gland. The left side of the diaphragm lays over the left lobe of the liver, the fundus of the stomach, the spleen, the left kidney, and the left adrenal gland (Gray, 2005). The diaphragm has three parts, which are based on the regions of attachment of its outer surfaces. They are known as the sternal, the costal and the lumbar. Again, Gray’s Anatomy goes into great detail but in general, the sternal part is formed at the xiphoid process of the sternum. The costal...
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...intestinal tract, esp. in the colon, causing pain, anorexia, fevers, and, rarely, intestinal perforation, hemorrhage, abscess formation, peritonitis, fistula formation, or death P/t at admission complain of lower left quadrant pain. On initial assessment temperature of 99.6◦F Etiology: Diverticulitis is triggered when fecal matter and bacteria are reserved in the diverticular outpouches, leading to the development of a hardened mass called a fecalith. The fecalith blocks blood supply to the diverticular area, producing inflammation, edema of the tissues, and likely bowel perforation and peritonitis. Globally, most experts suggest that the incidence of the disease most likely parallels that in the U.S., which is 6% to 22% of the population depending on the population series. The lifetime recurrence is 30% after the first episode of diverticulitis and more than 50% after a second episode. P/t had first occurrence 4 month ago....
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...According to Mayo Clinic Staff, "Researchers believed that a number of factors, such as heredity and a malfunctioning immune system, play a role in the development of Crohn's disease." In CD the patient develops inflammation to the wall of the bowel that causes scarring or the inflammation can penetrate through the wall of the bowel and causes a fistula. Some symptoms of CD are persistent diarrhea, abdominal pain and cramps, rectal bleeding, decrease appetite, weight loss and constipation. In order to protect the patient's privacy I will use the initial AJ. I obtained verbal permission from AJ and her mom to interview her. I chose CD because over the past 6 months I have seen the great financial, personal and social impact CD has on AJ and her family. This paper will also address AJ's learning process and educational experience regarding CD. It will also outline the change motivators AJ used and recommend theories of learning and motivation. AJ, a 21 year old nursing student was experiencing frequent bouts of abdominal pain, loose stool and hyperactive bowel sounds in January 2013. After several visits to the doctor AJ stated "I was diagnosed with Irritable bowel syndrome." The physician placed her on Donnatal every six hours around the clock. While taking the prescribed medication she continues to have recurrent abdominal pain and loose stool, her mom who is a nurse requested a Gastrointestinal (GI) consult for her daughter. After 8 months of...
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...a chronic intestinal disorder with ranging symptoms from sharp abdominal pain to altered bowel habits. However, this characterization of the disease is vaguely accurate as IBS is uniquely tailored to each person. The disorder is so individualized that it must be further categorized into IBSD (IBS with diarrhea), IBSC (IBS with constipation), and IBSM (mixed IBS). As a result, the disease is difficult to diagnose...
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...Amy Taylor BIOL 1101 4/15/2011 Anatomy and Physiology of Crohn’s Disease Crohn’s disease (CD) is a chronic, relapsing inflammatory disease of the intestines with usually peak between 15 and 35. It is one of many Inflammatory bowl disease (IBD), and is sometimes also called Regional enteritis, Morbus Crohn’s, Terminal iletis, or Granulomatous enteritis. It primarily affects the small and large intestine, but can affect the digestive system anywhere between the mouth and the anus. It is named after the physician who examined the disease in a landmark paper written in 1932. Crohn's disease lasts for many years throughout life, and many patients require surgery at some point and even then they can have recurring symptoms. The cause of CD is unknown, although there are two major theories. One theory is that the structural changes in the cells of the bowel are perceived by the immune system as foreign and are attacked, leading to constant inflammation. The second theory is that an unknown type of bacterium persistently attacks the bowel, which also leads to constant inflammation. Patients with CD are usually nutritionally deficient which is mainly due to a decreased intake and malabsorption of nutrients. This tends to happen because certain parts of the abdomen might be inflamed so the patient may not be able to properly absorb the food, which can cause them to be deficient in certain vitamins and other nutrients. Although diet may affect the symptoms in patients...
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...According to Carroll (2007), laboratory evaluation are done in assessing and evaluating acute pancreatitis. She mentioned that initially many biological markers such as amylase and lipase levels, complete blood count with differential metabolic panel, urinalysis and triglyceride levels were being used. However recent studies have found other potential means of concluding the severity and prognosis of pancreatitis. Such promising markers include the use of trypsinogens and pancreatic protease which are used in the auto digestive process of acute pancreatitis. Additional markers that are now being investigated include trypsinogen activation peptide, C-reactive protein, procalcitonin, phosphalipase A2 and the cytokines; interleukin 6 and...
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...appear to be linked to the reduction of fiber in flour due to the development of roller mills that replaced grist mills in the late 1800’s. Roller mills were a more efficient method of refining wheat into flour; however this resulted in the destroying or removal of most of the fiber from the grain. This type of flour absent of fiber became the staple of most flour products from that time forward. Another theory on the advent of these two conditions was a change in consumption to increased refined sugar and meats in western diets during the same time period. SYMPTOMS: The majority of people with diverticulosis will have no symptoms and will not require any treatment. If the condition is symptomatic, cramping and abdominal pain, typically in the lower left abdomen, within the large intestines or colon can occur. When diverticulitis develops due to material in the divertulum, the inflammation or infection may produce inflamed areas which can result in pus or abscesses which can rupture and cause high fever. Other symptoms may be constipation and bowel obstruction. Also, bright red or dark colored blood in stools can occur as a result of diverticular bleeding when a blood vessel inside the diverticulum becomes exposed as a result of tissue degradation, abrasion or internal pressure of constipation, or straining during passing stools. Blood clots may be visible in stools without having symptoms of abdominal pain. If the bleeding is...
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...Patient Education Plan: Crohn’s Disease NUR/427 Health and Chronic Disease Management Patient Education Plan: Crohn’s Disease Patient Case History The patient is a 24-year-old, Caucasian, female who was recently diagnosed with Crohn’s Disease. She is single and currently lives alone in Philadelphia, Pennsylvania. The patient admits to eating a poor/unbalanced diet; she cites her busy schedule as the main factor contributing to her poor nutrition. She is not a smoker. Her father’s sister also has Crohn’s Disease but no one else in the immediate family, at least no one that she knows of, has the disease. She was diagnosed after coming to the emergency room with blood in her stool; she has also experienced bouts of diarrhea off and on for the past several weeks. She takes Advil for headaches daily and complains of constant fatigue, which she attributes to stress. Stress can be attributed to her lifestyle; she is a college graduate who is currently enrolled in a Masters program working toward her MBA. She also works as a teller at a local bank. The field is extremely competitive and between the demand of her job and her schoolwork she has limited time left for a social life. She goes on occasional dates and goes out with girlfriends fewer than two nights a week. Because she is a full-time student she spends a large portion of her time on the computer; she is extremely comfortable using the Internet. The patient has a very busy life and a very full...
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...In the Vet Clinic Question 1 a) Name and describe three (3) ways an animal may show you that they are stressed. A great many people who live with canines perceive a percentage of the "greater" pieces of information that a canine's on edge, 1. Uncomfortable, or out and out frightened -groveling, 2. whimpering, and a tucked tail, to name only three.more unobtrusive signs. They for the most part don't reflect all out frenzy, however they let you know that all's not exactly right 3. On the off chance that we can interpret our pooches' 4. Leashing the skin behind while walking non-verbal communication, we can ransom delicate puppies before they get overpowered. Furthermore even boneheaded, giddy sorts may discover a few circumstances excessively for them. Come to consider it, viewing them nearly may uncover that they're not such blockheads truth be told. When we perceive our canines' anxiety flags and make a move to bail them out, we're taking consideration both of the puppy and of ourselves. I regularly recollect a maturing puppy named Jack whose people recognized that he generally withdrew from their little child's methodology. They don't thought anything of it, so Jack's rehashed nonaggressive flags that he despised kiddy-style taking care of didn't traverse. b) Name and describe three (3) ways an animal may show you that they are comfortable. Some solace practices show up over a few taxa (e.g. autogrooming), while others may be...
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...A kid with Hepatitis A can return to school 1 week within the onset of jaundice. 2. After a patient has dialysis they may have a slight fever...this is normal due to the fact that the dialysis solution is warmed by the machine. 3. Hyperkalemia presents on an EKG as tall peaked T-waves 4. The antidote for Mag Sulfate toxicity is ---Calcium Gluconate 5. Impetigo is a CONTAGEOUS skin disorder and the person needs to wash ALL linens and dishes seperate from the family. They also need to wash their hands frequently and avoid contact. positive sweat test. indicative of cystic fibrosis 1. Herbs: Black Cohosh is used to treat menopausal symptoms. When taken with an antihypertensive, it may cause hypotension. Licorice can increase potassium loss and may cause dig toxicity. 2. With acute appendicitis, expect to see pain first then nausea and vomiting. With gastroenitis, you will see nausea and vomiting first then pain. 3. If a patient is allergic to latex, they should avoid apricots, cherries, grapes, kiwi, passion fruit, bananas, avocados, chestnuts, tomatoes and peaches. 4. Do not elevate the stump after an AKA after the first 24 hours, as this may cause flexion contracture. 5. Beta Blockers and ACEI are less effective in African Americans than Caucasians. 1. for the myelogram postop positions. water based dye (lighter) bed elevated. oil based dye heavier bed flat. 2.autonomic dysreflexia- elevated bed first....then check foley...
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...is a potentially lethal disease that is increasing in incidence. Its mortality has improved as a result of a better understanding of the natural history of the disease and improvement of critical care. Approximately 210,000 patients are admitted to hospitals each year with acute pancreatitis with approximately 20% meeting criteria for severe pancreatitis alone in the US. Alcoholic pancreatitis is seen more frequently in men. Manifestation Acute pancreatitis is an important cause of acute upper abdominal pain. Because its manifestations are similar to a number of other acute illnesses, it is difficult to base a diagnosis only on symptoms and signs. The two most common causes of acute pancreatitis in adults are gallstones and alcoholism. Treatment The main goal of initial treatment is to prevent complications of severe pancreatitis by reducing pancreatic secretory stimuli. Initially, the patient should be hydrated and kept NPO with bowel rest when nausea, vomiting, and abdominal pain are an issue. The majority of patients will improve within 3 to 7 days. Patients with poor prognosis should be admitted to the ICU. Complications The most likely complication from pancreatitis is acute renal failure. Prognosis Early evaluation for patients with acute pancreatitis is important. Usually,...
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...than an oropharyngeal cause of dysphagia? Chest pain during meals. 5. What does the pathophysiology of chronic gastritis include? Atrophy of the gastric mucosa with decreased secretions. 6. Acute right lower quadrant pain associated with rebound tenderness and systemic signs of inflammation are indicative of: Appendicitis. 7. How may a fistula form with Crohn’s disease? Recurrent inflammation, necrosis, and fibrosis forming a connection between intestinal loops. 8. A 60-year-old male presents with GI bleeding and abdominal pain. He reports that he takes NSAIDs daily to prevent heart attack. Tests reveal that he has a peptic ulcer. The most likely cause of this disease is: Inhibiting mucosal prostaglandin synthesis. 9. Prolonged or severe stress predisposes to peptic ulcer disease because: Of reduced blood flow to the gastric wall and mucous glands. 10. A 50-year-old male complains of frequently recurring abdominal pain, diarrhea, and bloody stools. A possible diagnosis would be: Ulcerative Colitis. 11. What is a common cause of gastroenteritis due to Salmonella? Raw or undercooked poultry or eggs. 12. T-cell lymphoma was diagnosed in a 55-year-old man who had a lengthy history of intestinal disease. Which of the following diseases most likely preceded this malignancy? Celiac Disease. 13. Difficulty swallowing is known as Dysphagia. 14. The most common disorder associated with upper GI...
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...I. Identifying information A.Gender: Female B.Age: 36 years old C.Place of Interview: New York Downtown Hospital D.Source of information: patient, patients chart E.Statement of reliability: Patient was coherent and reliable II. Chief Concern Patient was admitted to the labor and delivery department because of vaginal bleeding and lower abdominal pain. III. History of Present Illness The Patient is a 36 year old female, G2P1001, that is 28 3/7 weeks pregnant who presented to the emergency room with bloody mucus discharge, active vaginal bleeding, abdominal pain and occasional lower back cramps. A McDonald cerclage was placed on 10/13 due to thinned cervix and fear of miscarriage. Upon speculum examination, her cervix was closed and the cerclage was correctly in place. She was given two doses of betamethasone (12/3,12/4). She denies headache, dizziness and vision problems. She had a normal vaginal delivery in 1998 with no complications. IV. Past Medical History Medications: 1.Prenatal vitamins- 1tab/day, PO Past Medical Diagnoses: Patient denies any previous medical conditions. She stated that is has always been in good health and no previous diagnoses. Allergies: No known allergies Immunizations/vaccines: All of the patient’s immunizations were “up to date” Blood Transfusions/Surgical History: No transfusions, only surgery was the current cerclage placement and an appendectomy in 1982. V. Social History The patient denies...
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...Draft of Intern’s Project Penetrating Abdominal Injuries at Georgetown Public Hospital Corporation (GPHC). Investigator: Hemraj Ramcharran Supervisors: Dr Shilendra Rajkumar Dr Madan Rambaran Abstract Many cases of penetrating abdominal injuries present to the Georgetown Public Hospital all of which are managed by the department of Surgery. No audit has been conducted on the management of these injuries and their success rates. Hence this prospective study “Penetrating abdominal Injuries at Georgetown Public Hospital (GPHC)” seeks to shed some light in these areas in terms of percentage of abdominal injuries managed surgically or conservatively and diagnostic adjuncts used in the management of these patients. Studies done in other countries clearly show that there is a steady and progressive movement away from surgical management of penetrating abdominal wounds towards conservative management. The study is a prospective one that will extend over the period (April 01 – Sept 31). The study population will consist of persons over 12 years old and admitted for penetrating abdominal injury. Data will be collected by means of a form shown in appendix 2. This form has three parts which are biodata, immediate management and subsequent management. These forms will be in the accident and emergency room and the surgical wards. On admission of the patient, the on call surgical GMO or Intern will fill out the...
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...against Dr. Hilbun, a general surgeon who performed surgery on Terry Hall. She was complaining about abdominal pain. He consulted and operated on her for a small bowel obstruction, which she consented to. After he observed her in the recovery room, he left for the night. Throughout the night, she started having more and more pain and her vital signs were abnormal, but Dr. Hilbun was never notified of such pain. He was notified about another patient of his and failed to check up on Mrs. Hall and she later died of respiratory failure in the morning. The nurses at the hospital were never ordered to call him if things changed with Mrs. Hall. An autopsy was done and it showed that a sponge had been left in her abdominal cavity but it did not cause her death. Mrs. Hall's husband filed a malpractice/wrongful death case against Dr. Hilbun stating that he failed to follow-up after the operation and give post-operation instructions to the nursing staff. At the trial, Hall's husband called Dr. Hoerr as a witness but was disqualified because he was not familiar with the local standard of care, only the national one. After reading about this case, I believe that Dr. Hilbun was at fault for the four D's of negligence. The first D is duty, which there was a patient and physician relationship. He did perform an exploratory laparotomy on her for a bowel obstruction after she came in for abdominal pain. The second would be derelict, which means the patient would have to prove the physician failed...
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