Reconstruction, Skin Grafts, Other Grafts, Flaps, Soft Tissue Infections, Erysipilas, Cellulitis, Necrotising Fasciitis, Ulcers, Lower Limb Ulcers, Pressure Ulcers

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AN UNEXPECTED CHEST XRAY

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AN UNEXPECTED CHEST XRAY Mrs MacLeod was a rather prudent 54 year old women, that presented with a shortness of breath, a chronic cough and recurrent pneumonia. She had an obstructive lung pattern on pulmonary function tests. She come in for an xray of the chest. The chest XRAY was rather different. There was unequal lung volumes, with the right lung volume being larger than the left. There was also decreased left lung vessels noted. There were no pleural effusions and no pneumothorax present either. The right lung was perfectly normal. Upon further investigation she reported to have had a significant childhood viral infection that resulted in distal airspace obstruction, probably secondary to an adenovirus or and RSV viral infection. A case of Sweyer-James syndrome was diagnosed. She was treated with influenza vaccinations, but in this case no lobectomy was performed as the no specific lung segment was identified.
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The Cardiovascular system, Heart Muscle, The Heart as a pump

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The Cardiovascular System is a  closed system , with a  one way circuit. efficiency Transports Materials throughout the body: Exogenous Endogenous Waste and heat elimination Brain is Oxygen dependent Cannot meed oxygen needs by using the anaerobic pathway 2 ATP + 1 NADH Must use the aerobic pathway - Glycolysis, Citric Acid cycle + Electron Transport System 6H2O+ 30 ATP + 6CO2 Nutrient, Hormone, Immunity transport CO2 and metabolic waste and heat removal How Blood flows: Down a pressure Gradient (dP) from high pressure to a low pressure Pressure, Volume, Flow and Resistance Pressure of a fluid in motion decreases over distance Hydrostatic Pressure: = may also be referred to as the hydraulic pressure - as fluid is in motion In a system that flows, pressure falls over distance as energy is lost to resistance / friction Pressure in Liquid changes without changes in Volume Driving pressure - the pressure of the ventricles on the systemic circulation -   dis
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Lumps in the groin

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Lumps in the groin: Differential diagnosis Inguinal hernia, femoral hernia, enlarged lymph nodes, saphena varix, hydrocele of the cord (or of the canal of Neck in women), vaginal hydrocele, undescended testis, lipoma of the cord, femoral aneurysm, psoas abscess. Determining the diagnosis Hernia A hernia (usually) has a cough impulse (i.e. it expands on coughing) and (usually) reduces with direct pressure or on lying down unless, uncommonly, it is incarcerated (i.e. the contents of the hernia are fixed in the hernia sac by their size and by adhesions).  Movement of the lump is not the same as expansion . Many groin lumps have a transmitted impulse on coughing (i.e. they move) but do not expand on coughing.  Since inguinal and femoral hernias arise from within the abdomen and descend into the groin, it is not possible to get above them. For lumps that arise from within the scrotum, the superior edge can be palpated (i.e. it is possible to get above them). Once a
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