Medicogram
Medicogram
in General
Dense white mature cataract
Fatma R. Badr
Fatma R. Badr
in General
What is caput medusae?
What is caput medusae?
It's a consequence of cirrhosis of the liver, and a very sinister sign. Normally the entire venous drainage of the gastrointestinal tract passes to the hepatic portal vein, and thence through the liver before rejoining the general venous return to the heart via the inferior vena cava. It has to do this because many of the compounds absorbed from the gut are toxic, & need to be detoxified by the liver before entering the systemic circulation. Hepatic cirrhosis blocks the entry of blood from the portal vein into liver tissue, causing Portal hypertension. The raised pressure in the portal system causes collateral venous drainage to open up, at 3 sites marking the divide between drainage to the portal & general venous systems. These are the junction between stomach & oesophagus, the anal margin & the umbilicus. Typically patients notice haemorrhoids and veins in the skin radiating outwards from the umbilicus. This is because raised portal pressure reopens the fetal umbilical vein, filling it retrogradely into cutaneous veins. More the point, if these are present, so will large veins be present in the oesophagus. These esophageal varices have a habit of rupturing & bleeding, potentially fatallly unless surgical intervention is promptly available. Even if that doesn’t happen the combination of jaundice & dementia from toxins that have bypassed the liver make death from hepatic failure a singularly degrading & unpleasant way to go. That was the fate of 95% of the alcoholic patients I treated in my career. Several even destroyed transplanted livers just as they had their originals. Early clinicians, lacking technological means of making a diagnosis set great store by observing, collecting, interpreting & teaching symptoms & clinical signs that could be used to deduce the underlying condition. The learning of these skills is still the focus of medical school training today. The appearance of numerous large peri-umbilical veins was soon associated with incipient liver failure. It's doom-laden significance & resemblance to a bunch of snakes reminded those early clinicians of the legend of the deadly gorgons, & Medusa with snakes for hair, so caput Medusae, Latin for “Head of Medusa".
Medicalpedia
Medicalpedia
in General
Severe frostbite in extreme altitude climber (Mt. Everest).
Medicalpedia
Medicalpedia
in General
Case of billateral necrotizing fasciitis post debridement surgery showing muscle exposure.
Case of billateral necrotizing fasciitis post debridement surgery showing muscle exposure.
Necrotizing fasciitis is a rapidly progressive inflammatory infection of the fascia, with secondary necrosis of the subcutaneous tissues. Symptoms may include fever, swelling, and complaint of excessive pain. The initial skin changes are similar to cellulitis or abscess, thus making the diagnosis at early stages difficult. The redness and swelling usually blend into surrounding normal tissues. The overlying skin may appear shiny and tense. Other signs which are more suggestive of necrotizing changes (but present in later stages) are: formation of bullae, bleeding into the skin which is present before skin necrosis (skin turning from red to purple and black due to thrombosis of blood vessels), presence of gas in tissues, and reduced or absent sensation over the skin (due to the necrosis of the underlying nerves). Early diagnosis is difficult, as the disease often looks early on like a simple superficial skin infection. While a number of laboratory and imaging modalities can raise the suspicion for necrotizing fasciitis, none can rule it out. The gold standard for diagnosis is a surgical exploration in a setting of high suspicion. Surgical debridement (cutting away affected tissue) is the mainstay of treatment for necrotizing fasciitis. Aggressive wound debridement should be performed early, usually as soon as the diagnosis of necrotizing soft tissue infection is made. Early medical treatment is often presumptive; thus, antibiotics should be started as soon as this condition is suspected. Tissue cultures (rather than wound swabs) are taken to determine appropriate antibiotic coverage. Besides blood pressure control and hydration, support should be initiated for those with unstable vital signs and low urine output.
Medicogram
Medicogram
in General
Cranial nerve roots
Cranial nerve roots
Great illustration of the cranial nerve roots : Cranial nerves (sometimes also termed cerebral nerves), are nerves that emerge directly from the brain, specifically from the fore-brain and brainstem, in contrast to the spinal nerves, which emerge from various segments of the spinal cord. It is through the cranial nerves that the brain receives information from, and issues controls of functions of various structures, primarily of the head and neck. Since spinal nerves reach only to the level of the first cervical vertebra, thus the cranial nerves fill the same role above this level, as spinal nerves do below the head and neck. Each cranial nerve is paired on the left and right. In humans, there are twelve pairs which are assigned roman numerals according to the order in which they originate from rostral to caudal. An additional pair of cranial nerves, termed cranial nerve zero (CN 0), was first discovered in sharks; its presence in humans remains a matter of debate. Cranial nerves 0, I and II emerge from the cerebrum; the remaining ten pairs emerge from the brainstem. The cranial nerves are components of the peripheral nervous system (PNS), with the exception of cranial nerve II (the optic nerve), which is not a true peripheral nerve but a tract of the diencephalon leading to the retina; both the optic nerve and the retina are hence part of the central nervous system (CNS). The axons of the remaining twelve nerves extend beyond the brain and are therefore considered part of the PNS. The central ganglia of the cranial nerves or cranial nerve nuclei originate in the CNS, preferentially from the brain stem. 📷•Medicogram• #letslearn #cranialnerves #neuroscience #neuro #surgery #medicine #brain #trending #now #medicogram
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