Medicaltalks
Medicaltalks
in General
Here is an incredible shot that demonstrates how small a developing pair of fetal lungs can be! Regardless whether they call the land, the sky, or the water their home, all reptiles, birds and mammals rely on their lungs for gas exchange. To fulfill the task of gas exchange, the lung possesses a huge inner surface and a tree-like system of conducting airways ventilating the gas exchange area. During lung development, the conducting airways are formed first, followed by the formation and enlargement of the gas exchange area. The development of the respiratory system begins at about week 4 of gestation. By week 28, enough alveoli have matured that a baby born prematurely at this time can usually breathe on its own. The respiratory system, however, is not fully developed until early childhood, when a full complement of mature alveoli is present. During weeks 4-7, an olfactory pit is one of a pair of structures that will enlarge to become the nasal cavity. The lung bud will bulge from the foregut and develop. The laryngotracheal bud will develop into the trachea and bronchial bud, which eventually become the bronchi and all other lower respiratory structures. By week 16, respiratory bronchioles form. The fetus now has all major lung structures involved in the airway. Once the respiratory bronchioles form, further development includes extensive vascularization, or the development of the blood vessels, as well as the formation of alveolar ducts and alveolar precursors. At about week 19, the respiratory bronchioles have formed. Major growth and maturation of the respiratory system occurs from week 24 until term. More alveolar precursors develop, and larger amounts of pulmonary surfactant are produced. The respiratory system continues to expand, and the surfaces that will form the respiratory membrane develop further. At this point, pulmonary capillaries have formed and continue to expand, creating a large surface area for gas exchange. The major milestone of respiratory development occurs at around week 28, when sufficient alveolar precursors have matured so that a baby born prematurely at this time can usually breathe on its own. Photo by @mrs_angemi
Medicaltalks
Medicaltalks
in General
⚠️Femur fracture⚠️
⚠️Femur fracture⚠️
This case involved a femur fracture and ankle fracture! (both fractures on the same leg). Femoral shaft fractures can result from high or low energy mechanisms and are often associated with other serious injuries. The most common causes include automobile accidents, falls from heights, ground-level falls in individuals with osteoporosis, and gunshots. A trauma is typically involving a direct hit to the thigh or an indirect force transmitted through the knee. Operative fixation with intramedullary nailing is the best option to ensure union of the less severe fracture. External fixation is used in more extensive cases. In severe open femur fracture cases patients might need a surgery called open reduction and internal fixation (ORIF) in order to bring the bones back into place and help them heal. Screws, plates, sutures, or rods are used to hold the broken bone together to ensure the bone stays aligned while healing. “Open reduction” means surgery is needed to realign the bone fracture into the normal position. “Internal fixation” refers to the steel rods, screws, or plates used to keep the bone fracture stable in order to heal the right way and to help prevent infection. Under general anesthesia, an incision is made at the site of the break or injury, and the fracture is carefully re-aligned or the joint replaced. The hardware is installed, and the incision is closed with staples or stitches. The steel rods, screws, or plates can be permanent, or temporary and removed when healing takes place. Once the open reduction internal fixation is performed, a cast is usually applied. In the prehospital setting, what do you think would work best to stabilize the position of the injured leg? Photo by @savageparamedics
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