...Clin Orthop Relat Res (2010) 468:2430–2436 DOI 10.1007/s11999-009-1220-0 CLINICAL RESEARCH Natural Course of Asymptomatic Deep Venous Thrombosis in Hip Surgery without Pharmacologic Thromboprophylaxis in an Asian Population Kosuke Tsuda MD, Tomio Kawasaki MD, Nobuo Nakamura MD, Hideki Yoshikawa MD, Nobuhiko Sugano MD Received: 8 August 2009 / Accepted: 22 December 2009 / Published online: 8 January 2010 Ó The Association of Bone and Joint Surgeons1 2010 Abstract Background The clinical importance of asymptomatic deep venous thrombosis in elective hip surgery is not clearly known. Questions/purposes We determined the preoperative and postoperative incidences of asymptomatic deep venous thrombosis, identified preoperative factors associated with postoperative deep venous thrombosis or pulmonary embolism, and established its natural course in patients who underwent elective hip surgery without receiving pharmacologic thromboprophylaxis. This work was performed at Osaka University Hospital and Kyowakai Hospital. Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. Each author certifies that his or her institution approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research. K. Tsuda, H. Yoshikawa Department...
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...apple and stop just before the ropey neck muscles. You should feel a strong pulse here, indicating the carotid artery, which supplies blood to the brain. Do not apply pressure for a long time, as this could lead to a loss of consciousness. press up. Hand/Feet Wounds On the inside of the wrist, move away from the thumb towards the tip of the forearm. For foot wounds, trace above the front/top of the foot, right where it meets the shin. In both cases, do not forget to feel for a pulse before applying pressure. Upper Arm/Elbow Wounds Access the brachial artery on the inner side of the arm, above the elbow bone, between the large upper arm muscles. This may not be as apparent as the carotid artery. Groin/Thigh Wounds Find the femoral artery in the middle of the bottom crease of the groin, between the groin and the upper thigh. This is also known as the "bikini line." This artery may require substantial pressure, pressing down with the entire heel of your hand, to reduce its circulation. Lower Leg Wounds Press the back of the knee, directly behind the knee cap, to access the popliteal artery. Do not bend or move the leg to put it in a more convenient location. Reach around to the back of the leg...
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...spaces proximal to L5/S1. Some advantages of this approach include less post op pain and decreased manipulation of the aorta and IVC – Various retractors have been designed to enhance access to disc space – Nonetheless, neurologic complications have been reported to be anywhere from 8% to 30%, ranging from paresthesias to femoral nerve palsy. – Despite introduction of retractors, what’s key is the understanding of the relevant anatomy. Previous studies were based on cadavers dissected in the supine position, and concentrated on where nerve exited the psoas mm rather than within a psoas mm. – Purpose of this article: describe lumbar plexus anatomy, relevant to this approach, with emphasis on the L4/5 disk space • Materials and Methods: – 18 cadavers: dissected in lateral decub position, relevant to the recommended surgical technique – 18-ga spinal needles placed under fluoro in mid-coronal planes of disk spaces of L2-L3, L3-L4 and L4-5, because this is where most retractors are placed, and they remained in place until dissection over. – Proceeded with a meticulous dissection to expose the femoral nerve, distance from distance at L4/5 disk space exposed, width measured at the confluence of L2,3 & 4 nerve roots, and then traced back to the spinal foramen. • Results: – Course of L2 and L3 nerve roots after exiting the neural foramina was immediately adjacent to the lateral aspect of pedicle of the vertebral level below...
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...Discussion This experiment was based on data that oxygenated perfusion of NHBD livers will promote cellular recovery from warm ischaemic injury. (Schon, 1994: S159-62) Without perfusion, cold storage exacerbates the injury by subjecting the organ to additional (cold) ischaemia; then, during surgical anastomosis in the recipient, another period of warm ischaemia. These consecutive ischaemic periods facilitate the progression of cellular injury to a state that is not compatible with recovery upon reperfusion. (Endoh, 1996: 110-15) It is therefore essential to restore cellular energy levels between retrieval and reimplantation for NHBD livers. Previous studies have shown that perfusion prior to harvesting of the NHBD liver can restore cellular energy levels before cold storage. Total body reperfusion with cardiopulmonary bypass (CPB) using autologous blood after 30 min without ventilation was shown to revive total adenosine 5' -triphosphate (ATP) content in porcine livers and kidneys", Conditioning the liver with 30 min of normothermic isolated perfusion in vivo, using whole blood, has been shown to increase mitochondrial ATP content after 10 min of circulatory arrest in the porcine model7. CPB for only 10 min after 30 min of arrest, at 37°C, provided functional recovery of the heart, liver and kidney in the canine models. In the porcine transplant model, CPB for systemic perfusion with cold, oxygenated Eurocollins solution restored tissue energy charge after 10 min ofarrest9....
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...Thrombosed Popliteal Aneurysm (acute obstruction) Presenting Symptom(s): The patient’s chief complaint was left leg pain from the left knee down to the left foot. When asked the patient he was unable to appropriately respond to the question due to confusion. History of present illness: The patient is a male in his mid 70s. The patient presented with new onset left lower extremity ischemia. He was started on an IV heparin drip and transported to ED. He was found to have am occluded left popliteal aneurysm with occlusion of all tibial vessels. The patient was taken to the OR with vascular service for initiation of thrombolysis therapy. He is currently hospitalized for left lower extremity ischemia, angiogram, thrombolysis, bypass femoral popliteal thrombectomy, irrigation and debridement of wound, and a fasciotomy. Then, he was taken back to the OR for debridement of left anterolateral muscular compartment necrosis. This morning, he was noted to be “confused”. The patient was stable and oriented until at least yesterday evening. Per the primary team, he did not appear confused when seen at 6am. He was also noted to have a temperature of 37.4. He did not have any labs checked for 2 days, but this morning his labs were notable for leukocytosis of 13 from 9, hemoglobin on 6.2 from 7.6, and Na of 131 from 136. The patient denies any specific complaints, but does not appear to focus on questions. Pathophysiology: Popliteal aneurysms are defined as localized dilatations of...
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...Gastric Dilatation and Volvulus in Dogs Gastric Dilatation and Volvulus in dogs is also known as gastric torsion or bloat. Some veterinarians will also refer to this as GDV. Dilatation refers to a condition where an organ or structure in the body is stretched beyond the organs normal dimensions (Fossum, 2013). This disease is serious and the mortality rate could potentially be 20%-45% depending on the case of the animal (Fossum, 2013). In the content below, I will be explaining the pathophysiology, clinical signs, diagnosis, treatment, and prevention. Unfortunately, the causes of this disease are still unknown. Veterinarians believe that GDV could happen based on exercising after a dog ingests a large meal or having a large intake of water. Also, feeding your dog a bigger meal once a day, rather than smaller meals twice a day could also have an effect on the stomach (Fossum, 2013). When a dog gets bloat, what happens is the duodenum and pylorus move ventrally and also to the left of the midline. This caused displacement between the esophagus and stomach. The stomach rotates in a clockwise direction from 90 degrees to 360 degrees (Fossum, 2013). Blood vessels connect the spleen to the stomach, so when the stomach rotates, the spleen is taken with it (Elizabeth A. Rozanski, 2007). After this happens, the dog is not able to pass gas due to the stomach being “turned” (Ronald M. Bright, 2007). Having this happen to the canine will show numerous clinical signs. There are certain...
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...These problems can be long term or short term. It can be negative health problems and possibly negative psychological problems. The negative health conditions a person could have are insulin resistance, Type 2 Diabetes, asthma, and hypertension. Also, someone could get high total and LDL cholesterol levels in someone’s blood, sleep apnea, early puberty. A person could get Blount’s disease and slipped capital femoral epiphysis, which are orthopedic problems. Also, non-alcoholic steatohepatitis, fatty inflammation and infiltration of the liver, is also a problem someone could have. The possible negative psychological problems a person could face are behavior and learning problem. Also, someone could face low self-concept, depression symptoms, and a poor body image. The major factor the someone can have is a risk for an eating...
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...The Skeletal System Overview Can you imagine what the human body would be like if it were devoid of bones or some other form of supporting framework? Picture a "blob" utilizing amoeboid movement. Ugh! The skeletal system consists of bones and related connective tissues, which include cartilage, tendons, and ligaments. Bone is a living tissue and is functionally dynamic. It provides a supportive framework for vital body organs, serves as areas for muscle attachment, articulates at joints for stability and movement, and assists in respiratory movements. In addition, it provides areas of storage for substances such as calcium and lipids, and blood cell formation occurs within the cavities containing bone marrow. The skeletal system consists of 206 bones, 80 of which are found in the axial division, and 126 of which make up the appendicular division. Many of the bones of the body, especially those of the appendicular skeleton, provide a system of levers used in movement, and are utilized in numerous ways to control the environment that surrounds you every second of your life. Few people relate the importance of movement as one of the factors necessary for maintaining life, but the body doesn't survive very long without the ability to produce movements. The study and review for this chapter includes microscopic and macroscopic features of bone, bone development and growth, location and identification of bones, joint classification, and the structure of representa tive...
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...Homo erectus. Be sure to 1) identify at least one important distinctive feature each of the head, chest and femur of H.erectus and discuss the way in which each of these structures is different from that found in modern humans; 2) discuss what the anatomy of H.erectus tells us about this species: a) diet and b) locomotor capabilities. * Head: H.erectus had a significant increase in brain size with a skull vault of about 1000 cc. This size is bigger than all the previous members of the genus Homo and similar to that of humans. * Chest: H.erectus had narrow rib cages similar to modern humans’, which indicates that H.erectus did not have complex guts like Lucy’s and was probably meat eaters. * Femur: H.erectus had extremely long femoral necks which were ever longer than humans’ which indicated that they might be even more adapted in bipedalism. * Diet and Locomotion: The anatomy of H.erectus indicates that their diet probably contained mainly meat and they are probably no longer foliovores. Like modern humans they relied on high protein, meat concentrated diet. Their means of locomotion was a kind of bipedalism probably even more efficient than modern humans’. 2. Identify what it means to be a) altricial, b) precocial and c) secondarily altricial. Then discuss the evidence that leads researchers to believe that H. erectus was secondarily altricial. * Altricial: Born helpless, the babies need time in a nest/den with mothers. For example kittens or puppies. ...
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...loss. In addition, individuals older than 60 years often have a decrease in weight for height and BMI. • Name two abnormal physical examination findings associated with obesity and their possible causes. Physical examination findings in obesity include changes in anthropometrics measurements, vital signs, skin, eyes, throat, neck, chest, abdomen, reproductive system problems, and musculoskeletal difficulties. Anthropometrics measurements changes involves high BMI percentile and short stature, due to overweight, obesity, or an underlying endocrine or genetic condition. Another example of physical changes in obesity are related to musculoskeletal difficulties, such as abnormal gait and limited range of motion, due to slipped capital femoral epiphysis, bowing of tibia, due to Blount disease (growth disorder of the tibia), and small hands and feet, or polydactyly (extra finger of the hand or toes), due to some genetic syndromes. • Describe a typical bulimic patient A typical bulimic patient usually presents binge-eating episodes biweekly, purging of high-calorie or high-carbohydrate foods, symptoms of bloating, fullness, lethargy, abdominal pain, heartburn, and sore throat. A bulimic patient could exhibits normal body weight, underweight, or overweight. In addition, a bulimic patient could presents knuckle calluses, dental enamel erosion, and salivary gland enlargement, metabolic alkalosis from vomiting, hypokalemia from laxative or diuretic use, and elevated salivary amylase. A proper...
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...INTRODUCTION I. SYLLABUS & COURSE POLICIES II. BODY ORGANIZATION A. Chemical Level: atoms and molecules B. Cellular Level: Cell: basic structural and functional unit of life C. Tissue Level: Tissue: similar cells that perform a common function D. Organ Level: Organ: 2 or more kinds of tissues integrated to perform specific functions E. Organ System Level: Organ system: organs having related functions F. Organismal Level: Organism: has several organ systems which work together to maintain life III. PLANES OF REFERENCE & DESCRIPTIVE TERMINOLOGY A. Anatomical Position: upright, feet parallel, eyes & palms forward B. Planes of Reference: Imaginary lines or actual dissecting cuts (sections) which may be used to "section" the body or an organ. 1. Sagittal: divides the body or organ into unequal right and left portions. a. Midsagittal: divides the body or organ into equal HALVES 2. Coronal (= Frontal) Plane: divides the body or organ into anterior (front) and posterior (back) portions 3. Transverse (= Horizontal, Cross-sectional) Plane: Divides the body or organ into superior (top) and inferior (bottom) C. Directional Terms for the Body: Terms are in table 1.2 on p. 12, (and fig 1.7 on p. 13) - LEARN THEM!! Ex: Medial: closer to midline Lateral: away from the midline IV. BODY REGIONS A. Cephalic Region or Head 1. Facial Region a. Orbital – eye ...
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...Instructor’s Manual for the Laboratory Manual to Accompany Hole’s Essentials of Human Anatomy and Physiology Eighth Edition Terry R. Martin Kishwaukee College [pic] [pic] Instructor’s Manual for the Laboratory Manual to Accompany Hole’s essentials of human anatomy and physiology, eighth edition David shier, jackie butler, and ricki lewis Published by McGraw-Hill Higher Education, an imprint of The McGraw-Hill Companies, Inc., 1221 Avenue of the Americas, New York, NY 10020. Copyright © The McGraw-Hill Companies, Inc, 2003, 2000, 1998. All rights reserved. The contents, or parts thereof, may be reproduced in print form solely for classroom use with Hole’s essentials of human anatomy and physiology, eighth edition, provided such reproductions bear copyright notice, but may not be reproduced in any other form or for any other purpose without the prior written consent of The McGraw-Hill Companies, Inc., including, but not limited to, in any network or other electronic storage or transmission, or broadcast for distance learning. www.mhhe.com Contents PREFACE V An Overview vi Instructional Approaches viii Correlation of Textbook Chapters and Laboratory Exercises ix Suggested Time Schedule xi Fundamentals of Human Anatomy and Physiology Exercise 1 Scientific Method and Measurements 1 Exercise 2 Body Organization...
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...Acquisitions Editor: Crystal Taylor Product Managers: Kelley A. Squazzo & Catherine A. Noonan Designer: Doug Smock Compositor: SPi Technologies First Edition © 2011 Lippincott Williams & Wilkins, a Wolters Kluwer business. 351 West Camden Street Baltimore, MD 21201 Printed in China All rights reserved. This book is protected by copyright. No part of this book may be reproduced or transmitted in any form or by any means, including as photocopies or scanned-in or other electronic copies, or utilized by any information storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews. Materials appearing in this book prepared by individuals as part of their official duties as U.S. government employees are not covered by the abovementioned copyright. To request permission, please contact Lippincott Williams & Wilkins at Two Commerce Square, 2001 Market street, Philadelphia, PA 19103 USA, via email at permissions@lww.com, or via website at lww.com (products and services). Library of Congress Cataloging-in-Publication Data Lambert, Harold Wayne, 1972– Lippincott’s illustrated Q&A review of anatomy and embryology / H. Wayne Lambert, Lawrence E. Wineski ; with special contributions from Jeffery P. Hogg, Pat Abramson, Bruce Palmer. — 1st ed. p. ; cm. Includes index. ISBN 978-1-60547-315-4 1. Human anatomy—Examinations, questions, etc. I. Wineski, Lawrence E. II. Title. [DNLM: 1. Anatomy—Examination Questions...
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...UNDERSTANDING THE HUMAN BODY NOTES Anatomical Position - Posterior = Back Anterior = Front Dorsal = Back Ventral = Front Medial = Middle Lateral = Side Superior = Above Inferior = Below Proximal = Near point of attachment / Beginning Distal = Away from point of attachment / end Cephalic = Head Caudal = Tail Anatomical Guides – Using a known anatomical structure or region identifying an underlying or adjacent structure. Linear Guide – Drawing a real or imaginary line to locate an anatomical structure. Anatomical Limits – Proximal and distal aspects of an Anatomical structure. Planes - imaginary divisions of the human body. Sagittal – Cut the body in half from Left Right Midsagittal – Equal part left right Parasagittal – Non-equal left right parts. Coronal – Dividing body from front back Transverse – Divides the body into superior and inferior Body Cavities - The human body consists of the following body cavities: Dorsal body cavity Cranial cavity- enclosed by the Skull and contains the brain, eyes, and ears. Spinal canal - enclosed by the spine and contains the spinal cord. Ventral body cavity Thoracic cavity enclosed by the ribcage and contains the lungs and heart. Abdominopelvic cavity Abdominal cavity, enclosed by the ribcage and pelvis and contains the Kidneys, ureters, stomach, intestines, liver, gallbladder, and pancreas Pelvic cavity, enclosed by the pelvis and contains bladder, anus and reproductive system. Pelvic...
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...4 Answers to Activities in the Study Guide Chapter 1 THE HUMAN BODY A. COMPLETION 1. ANATOMY, PHYSIOLOGY 2. directions, planes, cavities, structural 3. superior, inferior 4. ventral 5. posterior 6. cephalad or cranial 7. proximal 8. distal 9. sagittal 10. transverse 11. coronal 12. viscera 13. cranial, spinal 14. mediastinum 15. parietal peritoneum 16. cells 17. protoplasm 18. pathology 19. epithelial, connective, muscle, nervous 20. cardiac 21. dermis, epidermis 22. homeostasis 23. sweat 24. system 25. skeletal, smooth, cardiac B. Matching 26. C 27. f 28. i 29. b 30. g 31. l 32. a 33. n 34. k 35. d 36. o 37. e 38. h 39. m 40. j C. Key Terms ANSWERS MAY VARY. 41. Second subdivision of ventral cavity 42. Heart and vessels pump and distribute blood to and from all cells of the body 43. Toward the head 44. Binds together and supports other tissue and organs 45. Divides front and back of body 46. Farthest from origin 47. Back or posterior 48. Produces hormones that chemically regulate body’s functions temperature and pressure 49. Lowermost or below/lower part of body 50. Protects, insulates, regulates water and termperature...
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