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

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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 circulatio...
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Soft Tissue Mass Clinical and Imaging Approach

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An approach to soft tissue masses. Clinical examination and ultrasound review of soft tissue masses may lead to: A specific diagnosis A mass like lesion No sonographic abnormality Specific diagnosis include a foreign body, henia, ganglion cyst, lymph node, Bone and calcifications, epidermal cysts, abscess and hematoma. Mass like lesions may either be superficial and less than 5cm Characteristic of a lipoma ; consider clinical follow up or MRI Not characteristic of a lipoma; consider excision, needle biopsy, or MRI. Mass like lesions may be deep or greater than 5cm in depth.  Please consider an MRI of the extremity in question or a CT of the CHEST and ABDOMEN. In the event of a suspicious  clinical examination, but No sonographic abnormality ; consider MRI or CT. Specific diagnosis  on US:  a foreign body : including wood, glass and metal may be visualised on US. Wood usually has a echogenic focus with abnormal shadowing deep to...
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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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