SA Medical - General Medicine And Imaging of Disease

Homeostatic Mechanisms Essentially all the organs and tissues of the body perform functions that help to maintain the constituents of the extracellular fluid relatively consistent, homeostasis. Extracellular transport system - Circulatory system  Two stages - around the circulatory system and between the capillaries and the cells. Blood in the capillaries allows exchange between the cells and the interstitial fluid. Origin of Nutrients in the Extracellular Fluid.   The respiratory system provides oxygen and removes carbon dioxide. The gastrointestinal system digests food and absorbs nutrients into the extracellular fluid. The Liver changes the components into usable form, and other tissue (fat cells, kidneys and endocrine glands) help modify the absorbed substances or store them till needed. The musculoskeletal system protection and support. Removal of metabolic End Products Kidneys regulate the extracellular fluid composition by controlling excretion of salts, water an

Sternocleidomastoid Muscle.  It also acts as an accessory muscle of inspiration, along with the  scalene muscles  of the neck Sternocleidomastoid The  triangles of the neck . (Anterior triangles to the left; posterior triangles to the right.) Muscles of the neck. Lateral view. Latin musculus sternocleidomastoideus Gray's subject #111 390 Origin manubrium sterni ,  medial  portion of the  clavicle Insertion mastoid process of the temporal bone ,  superior nuchal line  of the occipital bone Artery occipital artery  and the  superior thyroid artery Nerve motor:  accessory nerve sensory:  cervical plexus  (ventral ramus of the second cranial nerve) Actions Acting alone, tilts head to its own side and rotates it so the face is turned towards the opposite side. Acting together, flexes the neck, raises the sternum and assists in forced inspiration. . The Sternocleidomastoid is crossed by the platysma and the External Jugular Vein. The Sternocleidomastoid covers the great ve

We focus this week on a selection of endocrinology modules from our partners BMJ Learning. The authors of the first module on the diabetic foot, begin with a startling estimate: every 30 seconds a leg is amputated somewhere in the world due to diabetes. Diabetic foot ulcers leave the foot at high risk of amputation so recognising early signs of trouble is critical and saves limbs. In this diagnostic picture test module, the authors outline how to differentiate between neuroischaemic ulcers and neuropathic ulcers and the issues associated with each, while emphasising the vital role for debridement in wound management and the necessity for  multidisciplinary management in patients with diabetes. Although primary and secondary care doctors everywhere have become more proficient in recognising Coeliac disease, the authors of the second module this week point out that many still doubt when to consider the diagnosis and how to manage patients. Indeed, many patients may be symptomatic for yea

General Medical Practitioners are key to the management of heart failure patients: Establishing the diagnosis - you cant treat a patient unless he is diagnosed! GP's need eco-cardiogram and access to BNP lab testing. Management plan : Lifestyle changes Drug treatment for Heart Failure http://saradiology.blogspot.com

The majority of upper respiratory tract infections are due to infection with picornaviruses of the rhinovirus group. However other viruses such as adenoviruses, coronaviruses, coxsachie viruses, echoviruses, influenza viruses, para-influenza viruses and the respiratory syncytial virus (RSV) can cause upper respiratory tract infections. RSV, the influenza viruses, parainfluenza viruses I and II and adenoviruses can also cause acute infection of the larynx, trachea and major bronchi. The common cold is a very common infection caused by rhinoviruses, and also by other respiratory viruses and some enteric viruses. Influenza, Parainfluenza, picorna, respiratory syncytial viruses and adenoviruses have all been implicated. There is usually an acute onset with sneezing, dry sore throat, rhinorrhoea and headache. The condition is generally self-limiting although complications such as otitis media, sinusitis and, very occasionally, pneumonia may occur. coryza  This is discharge from the mucou

Pleural pathology includes: chylothorax haemothorax pneumothorax empyema pleural effusion mesothelioma pleurisy Symptoms and signs of pleural disease include: pleural friction rub pleuritic pain A chylothorax is an uncommon phenomenon characterised by accumulation of lymph in the pleural cavity. It is the most common form of chylous effusion. Chylothorax results from leakage from the thoracic duct or other major channel: most commonly due to trauma or malignancy sometimes, the leakage may be precipitated by penetrating or crushing wounds or may follow surgery. rarely, the chylothorax is due to filariasis or subclavian vein thrombosis, or occurs secondary to chylous ascites Chest radiology reveals an unencapsulated pleural effusion. Aspirates are creamy and opalescent. Once obtained, there is rapid reaccumulation of chyle. Repeated aspiration may cause protein and lymphocyte depletion. Microscopic examination of the aspirate shows a predominance of lymphocytes which is cha

Methods of imaging the respiratory tree, associated structures and regional anatomy include: plain PA chest radiogram and lateral radiogram chest radiography with fluoroscopic screening tomographic radiography computerised axial tomography (CAT) scanning magnetic resonance imaging (NMR) scanning pulmonary angiography or ventilation / perfusion scanning bronchography mediastinoscopy thoracoscopy A chest radiograph should be examined in a systematic way: check the name on the film make an estimate of age and sex of patient if this information is not provided check the projection which should be posterior-anterior - PA the whole of the chest should be visible on the film, check for rotation and that there has been satsifactory penetration check chest expansion and the diaphragm - the right hemidiaphragm is 2 cm higher than the left check for normal lung markings - the horizontal fissure is visible in 60% of normal chest X-rays; it runs from the centre of the right hilum,