Consciousness of Training Body Part(S) by Showing a Picture of Various Exercises in Trunk Muscles*
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A Pocket Manual of Percussion And
r — TC‘ B - •' ■ C T A POCKET MANUAL OF PERCUSSION | AUSCULTATION FOB PHYSICIANS AND STUDENTS. TRANSLATED FROM THE SECOND GERMAN EDITION J. O. HIRSCHFELDER. San Fbancisco: A. L. BANCROFT & COMPANY, PUBLISHEBS, BOOKSELLEBS & STATIONEB3. 1873. Entered according to Act of Congress, in the year 1872, By A. L. BANCROFT & COMPANY, Iii the office of the Librarian of Congress, at Washington. TRAN jLATOR’S PREFACE. However numerou- the works that have been previously published in the Fi 'lish language on the subject of Per- cussion and Auscultation, there has ever existed a lack of a complete yet concise manual, suitable for the pocket. The translation of this work, which is extensively used in the Universities of Germany, is intended to supply this want, and it is hoped will prove a valuable companion to the careful student and practitioner. J. 0. H. San Francisco, November, 1872. PERCUSSION. For the practice of percussion we employ a pleximeter, or a finger, upon which we strike with a hammer, or a finger, producing a sound, the character of which varies according to the condition of the organs lying underneath the spot percussed. In order to determine the extent of the sound produced, we may imagine the following lines to be drawr n upon the chest: (1) the mammary line, which begins at the union of the inner and middle third of the clavicle, and extends downwards through the nipple; (2) the paraster- nal line, which extends midway between the sternum and nipple ; (3) the axillary line, which extends from the centre of the axilla to the end of the 11th rib. -
Supplementary File 1
Supplementary File Table S1 Checklist for Documentation of Google Trends research. a) Initial list of pain locations and factors related to pain Name Matched as topic related to pain (not disease diagnosis) Head & Neck Headache / Head Pain Yes, „Headache” Eye pain Yes „Eye pain” Nose pain No Ear pain Yes, „Ear pain” Toothache Yes, „Toothache” Tongue pain No Lip pain No Sore Throat Yes, „Sore Throat” Neck pain Yes, „Neck pain” Trunk Chest pain / Heart pain Yes, „Chest pain” Breast pain Yes, „Breast pain” Abdominal pain / Stomache Yes, „Abdominal pain” Epigastric pain Yes, „Epigastric pain” Umbilical pain No Flank pain Yes, „Abdominal pain” Hypogastrium pain No Groin pain Yes, „Groin pain” Back pain Yes, „Back pain” Low back pain / Lumbar pain Yes, „Low back pain” Pelvic region Pelvic pain Yes, „Pelvic pain” Penis pain Yes, „Penile pain” Testicular pain / Pain of balls Yes, „Testicular pain” Rectum pain / Anal pain Yes, „Rectum pain” Limbs Shoulder pain Yes, „Shoulder pain” Clavicle pain No Arm pain No Forearm pain No Wrist pain Yes, „Wrist pain” Hand pain / Palm pain No Thigh pain No Buttock pain No Knee pain Yes, „Knee pain” Calf pain / Calf cramps No Podalgia / Feet pain Yes, „Podalgia” Factors Dysmennorhea / Painful Yes, „Dysmenorrhea” mennorhea Dyspareunia / Sex during Yes, „Dyspareunia” intercourse Odynophagia / Pain during Yes, „Odynophagia” swallowing Pain during breathing No Pain during walking No b) Search details Section/Topic Checklist item Search Variables Access Date 22 July 2019 Time Period From January 2004 to date of the -
Review of Sympathetic Blocks Anatomy, Sonoanatomy, Evidence, and Techniques
CHRONIC AND INTERVENTIONAL PAIN REVIEW ARTICLE Review of Sympathetic Blocks Anatomy, Sonoanatomy, Evidence, and Techniques Samir Baig, MD,* Jee Youn Moon, MD, PhD,† and Hariharan Shankar, MBBS*‡ Search Strategy Abstract: The autonomic nervous system is composed of the sympa- thetic and parasympathetic nervous systems. The sympathetic nervous sys- We performed a PubMed and MEDLINE search of all arti- tem is implicated in situations involving emergent action by the body and cles published in English from the years 1916 to 2015 using the “ ”“ ”“ additionally plays a role in mediating pain states and pathologies in the key words ultrasound, ultrasound guided, sympathetic block- ”“ ”“ body. Painful conditions thought to have a sympathetically mediated com- ade, sympathetically mediated pain, stellate ganglion block- ”“ ” “ ” ponent may respond to blockade of the corresponding sympathetic fibers. ade, celiac plexus blockade, , lumbar sympathetic blockade, “ ” “ ” The paravertebral sympathetic chain has been targeted for various painful hypogastric plexus blockade, and ganglion impar blockade. conditions. Although initially injected using landmark-based techniques, In order to capture the breadth of available evidence, because there fluoroscopy and more recently ultrasound imaging have allowed greater were only a few controlled trials, case reports were also included. visualization and facilitated injections of these structures. In addition to There were an insufficient number of reports to perform a system- treating painful conditions, sympathetic blockade has been used to improve atic review. Hence, we elected to perform a narrative review. perfusion, treat angina, and even suppress posttraumatic stress disorder symptoms. This review explores the anatomy, sonoanatomy, and evidence DISCUSSION supporting these injections and focuses on ultrasound-guided/assisted tech- nique for the performance of these blocks. -
Monographie Des Dégenérations Skirrheuses De L'estomac, Fondée
PART II. COMPREHENSIVE ANALYTICAL REVIEW OF MEDICAL LITERATURE. u Tros, tyriusve, nobis nullo discrimine agetur." Monographic des Degenerations Skirrheuses de VEstOmac, Jondee sur un grand nombre d'Observations recueillies tant a la Clinique de VEcole de Medecine de Paris, qvHa / Hopilal Cochin. Par Frederic Chardel, D. M. Medecin de l'Hopital Cochin, &c. 8vo. pp. 216. A Paris. " This excellent Monograph on scirrhous Affections of the Stomach" is the production of Dr. Chardel, a disciple of the celebrated Corvisart, to whom the volume is inscribed. Chardel, on scirrhous Affections of the Stomach. 1Q? a Although publication of no very recent date, we feel persuaded that, in announcing it, we shall introduce to the acquaintance of the general practitioner a work, the contents and even title of which are little known within his sphere of reading and conversation ; and we are in- cited to the labour of its analysis by the hope of confer- ring no mean benefit upon those to whom the original is inaccessible, but who prefer the researches of the dead- house to the abstract and commonly futile speculations of the closet, and regard a correct knowledge of the anato- mical character and varieties of a disease quite as essen- tial to sound nosological arrangement and successful prac- tice, as vigilant observation of the external phaenomena which it presents. To such, then, our analytical sketch is dedicated: and may the ardour displayed by the en- lightened foreigner in the prosecution of his pathological inquiries, exert a benignant influence upon those for whom we write, and arouse them to emulate his example. -
Mvdr. Natália Hvizdošová, Phd. Mudr. Zuzana Kováčová
MVDr. Natália Hvizdošová, PhD. MUDr. Zuzana Kováčová ABDOMEN Borders outer: xiphoid process, costal arch, Th12 iliac crest, anterior superior iliac spine (ASIS), inguinal lig., mons pubis internal: diaphragm (on the right side extends to the 4th intercostal space, on the left side extends to the 5th intercostal space) plane through terminal line Abdominal regions superior - epigastrium (regions: epigastric, hypochondriac left and right) middle - mesogastrium (regions: umbilical, lateral left and right) inferior - hypogastrium (regions: pubic, inguinal left and right) ABDOMINAL WALL Orientation lines xiphisternal line – Th8 subcostal line – L3 bispinal line (transtubercular) – L5 Clinically important lines transpyloric line – L1 (pylorus, duodenal bulb, fundus of gallbladder, superior mesenteric a., cisterna chyli, hilum of kidney, lower border of spinal cord) transumbilical line – L4 Bones Lumbar vertebrae (5): body vertebral arch – lamina of arch, pedicle of arch, superior and inferior vertebral notch – intervertebral foramen vertebral foramen spinous process superior articular process – mammillary process inferior articular process costal process – accessory process Sacrum base of sacrum – promontory, superior articular process lateral part – wing, auricular surface, sacral tuberosity pelvic surface – transverse lines (ridges), anterior sacral foramina dorsal surface – median, intermediate, lateral sacral crest, posterior sacral foramina, sacral horn, sacral canal, sacral hiatus apex of the sacrum Coccyx coccygeal horn Layers of the abdominal wall 1. SKIN 2. SUBCUTANEOUS TISSUE + SUPERFICIAL FASCIAS + SUPRAFASCIAL STRUCTURES Superficial fascias: Camper´s fascia (fatty layer) – downward becomes dartos m. Scarpa´s fascia (membranous layer) – downward becomes superficial perineal fascia of Colles´) dartos m. + Colles´ fascia = tunica dartos Suprafascial structures: Arteries and veins: cutaneous brr. of posterior intercostal a. and v., and musculophrenic a. -
A Study of Penetrating Thoracic and Abdominal Injuries
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 14, Issue 8 Ver. II (Aug. 2015), PP 64-95 www.iosrjournals.org A Study of Penetrating Thoracic and Abdominal Injuries Dr. Hardik Dodia, Dr. Keval Sansiya 1(General Surgery department, B.J. Medical College/ Gujarat University,India) 21(General Surgery department, B.J. Medical College/ Gujarat University,India) Abstract :In view of increasing number of penetrating thoracic or abdominal or combined injuries, this study has been chosen with reference to the patients presenting at Civil Hospitals Ahmedabad, affiliated with B.J. Medical college.This is a study of 25 cases. Age/Sex Incidence, Common viscera involved depending on site involved, operative procedures to be carried out according to viscera involved, Complications related to procedure and injuries, common cause of death have been highlighted in this study. Keywords: Penetrating injuries to thorax, penetrating abdominal injuries, common cause of death in penetrating trauma, Complications related to penetrating trauma. 1. INTRODUCTION Trauma remains the most common cause of death for all individuals between the ages of 1 and 44 years and is the third most common cause of death regardless of age. Penetrating thoracic or abdominal or combined injuries are one of the common injuries caused by assault. These injuries are associated with high risk of life threatening intra abdominal or intra thoracic organ injury. Due to the inadequate treatment of the injuries, many of the cases are fatal. The knowledge in the management of Penetrating trauma is progressively increasing due to the in-patient data gathered from different parts of the world. -
Abdomen Abdomen
Abdomen Abdomen The abdomen is the part of the trunk between the thorax and the pelvis. It is a flexible, dynamic container, housing most of the organs of the alimentary system and part of the urogenital system. The abdomen consists of: • abdominal walls • abdominal cavity • abdominal viscera ABDOMINAL WALL Boundaries: • Superior : - xiphoid proc. - costal arch - XII rib • Inferior : - pubic symphysis - inguinal groove - iliac crest • Lateral: - posterior axillary line ABDOMINAL WALL The regional system divides the abdomen based on: • the subcostal plane – linea bicostalis: between Х-th ribs • the transtubercular plane – linea bispinalis: between ASIS. Epigastrium Mesogastrium Hypogastrium ABDOMINAL WALL The right and left midclavicular lines subdivide it into: Epigastrium: • Epigastric region • Right hypochondric region • Left hypochondric region Mesogastrium: • Umbilical region • Regio lateralis dex. • Regio lateralis sin. Hypogastrium: • Pubic region • Right inguinal region • Left inguinal region Organization of the layers Skin Subcutaneous tissue superficial fatty layer - Camper's fascia deep membranous layer - Scarpa's fascia Muscles Transversalis fascia Extraperitoneal fat Parietal peritoneum Organization of the layers Skin Subcutaneous tissue superficial fatty layer - Camper's fascia deep membranous layer - Scarpa's fascia Muscles Transversalis fascia Extraperitoneal fat Parietal peritoneum Superficial structures Arteries: • Superficial epigastric a. • Superficial circumflex iliac a. • External pudendal a. Superficial structures Veins: In the upper abdomen: - Thoracoepigastric v. In the lower abdomen: - Superficial epigastric v. - Superficial circumflex iliac v. - External pudendal v. Around the umbilicus: - Parumbilical veins • Deep veins: - Intercostal vv. - Superior epigastric v. - Inferior epigastric v. Superficial structures Veins: In the upper abdomen: - Thoracoepigastric v. In the lower abdomen: - Superficial epigastric v. - Superficial circumflex iliac v. - External pudendal v. -
Ultrasound Guided Percutaneous Catheter Drainage of An
International Surgery Journal Das DK et al. Int Surg J. 2019 Jun;6(6):2219-2221 http://www.ijsurgery.com pISSN 2349-3305 | eISSN 2349-2902 DOI: http://dx.doi.org/10.18203/2349-2902.isj20192399 Case Report Ultrasound guided percutaneous catheter drainage of an appendicular perforation with large intraperitoneal abscess formation: an effective modality of management in selected cases Deepak Kumar Das*, Rajat Kumar Patra, Subhrajit Mishra, Sudhir Kumar Panigrahi Department of Surgery, Kalinga Institute of medical Sciences, Bhubaneswar, Odisha, India Received: 20 March 2019 Accepted: 17 May 2019 *Correspondence: Dr. Deepak Kumar Das, E-mail: [email protected] Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Appendicular pathology is a very common entity and appendicular perforation can present in various forms ranging from right lower abdominal pain, fever and anorexia to frank peritonitis with endotoxaemic shock. We present a 18 year female with fever, anorexia and a large upper and mid abdominal swelling of 2 weeks duration which after admission was treated with intravenous fluids, antibiotics, analgesics and antiemetics. Her CECT abdomen and pelvis revealed a huge fluid containing cystic lesion with a perforated appendix tip and intraluminal faecolith and calculi. She underwent USG guided 10F pigtail catheter drainage of the walled off peritoneal collection on 3rd day of admission. About 700 ml of serous fluid with minimal flecks was drained within 2 hours and another 860 ml over next 3 days. -
1 Anatomy of the Abdominal Wall 1
Chapter 1 Anatomy of the Abdominal Wall 1 Orhan E. Arslan 1.1 Introduction The abdominal wall encompasses an area of the body boundedsuperiorlybythexiphoidprocessandcostal arch, and inferiorly by the inguinal ligament, pubic bones and the iliac crest. Epigastrium Visualization, palpation, percussion, and ausculta- Right Left tion of the anterolateral abdominal wall may reveal ab- hypochondriac hypochondriac normalities associated with abdominal organs, such as Transpyloric T12 Plane the liver, spleen, stomach, abdominal aorta, pancreas L1 and appendix, as well as thoracic and pelvic organs. L2 Right L3 Left Visible or palpable deformities such as swelling and Subcostal Lumbar (Lateral) Lumbar (Lateral) scars, pain and tenderness may reflect disease process- Plane L4 L5 es in the abdominal cavity or elsewhere. Pleural irrita- Intertuber- Left tion as a result of pleurisy or dislocation of the ribs may cular Iliac (inguinal) Plane result in pain that radiates to the anterior abdomen. Hypogastrium Pain from a diseased abdominal organ may refer to the Right Umbilical Iliac (inguinal) Region anterolateral abdomen and other parts of the body, e.g., cholecystitis produces pain in the shoulder area as well as the right hypochondriac region. The abdominal wall Fig. 1.1. Various regions of the anterior abdominal wall should be suspected as the source of the pain in indi- viduals who exhibit chronic and unremitting pain with minimal or no relationship to gastrointestinal func- the lower border of the first lumbar vertebra. The sub- tion, but which shows variation with changes of pos- costal plane that passes across the costal margins and ture [1]. This is also true when the anterior abdominal the upper border of the third lumbar vertebra may be wall tenderness is unchanged or exacerbated upon con- used instead of the transpyloric plane. -
Acute Abdomen
Acute Abdomen Andreas M Kluftinger MD FRCSC Kelowna General Hospital Disclosure • Heeadsoyaernia Advisory Panel – Ethicon, Johnson & Johnson • Funding – nil, zilch, zippo, nada, zero Objectives • Understand the Pathophysiology and Etiology of the acute abdomen • Approch to acute abdomen in rural practice • Case presentations Stedman' s Medical Dictionary 27th Edition “any serious acute intra-abdominal condition attended by pain, tenderness, and muscular rigidity, and for which emergency surgery must be considered." Acute Abdominal Pain • 5-10 % of ER visits • Complex “black box” • De lays in diagnos is can increase mor bidity • Excessive consultations (+/- transport) and imaging can be costly and tax resources. • Primaryygy assessment and triage are key History & Physical • Onset, nature, duration, location, radiation • Aggravating and relieving factors • Assoc ia te d GI or GU sympt oms • Past history (Surg and Med) • Review of Systems • Full physical exam Stereotypes of Pain Onset and Associated Pathology •SddSudden onset •RidRapid onset •GdGradual onset (full pain in seconds) (initial sensation to (hours) full pain over minutes or hours) •Perforated ulcer •Strangulated hernia •Appendicitis •Mesenteric infarction •Volvulus •Strangulated hernia •Ruptured abdominal •Intussusception •Chronic pancreatitis aortic aneurysm •Acute pancreatitis •Peptic ulcer disease •Ruptured ectopic •Biliary colic •Inflammatory bowel disease pregnancy •Diver ticu litis •MtilhditiMesenteric lymphadenitis •Ovarian torsion or •Ureteral and renal •Cystitis and -
Case Report a Rare Case of Torsion of Wandering Spleen in a Multiparous Woman S
DOI: 10.14260/jemds/2015/299 CASE REPORT A RARE CASE OF TORSION OF WANDERING SPLEEN IN A MULTIPAROUS WOMAN S. Venkateshwar Rao1, Shirish Paul Ganta2, N. Kiran Raju3, V. N. Narvekar4, V. Sivaleela5 HOW TO CITE THIS ARTICLE: S. Venkateshwar Rao, Shirish Paul Ganta, N. Kiran Raju, V. N. Narvekar, V. Sivaleela. “A Rare Case of Torsion of Wandering Spleen in a Multiparous Woman”. Journal of Evolution of Medical and Dental Sciences 2015; Vol. 4, Issue 12, February 09; Page: 2082-2086, DOI: 10.14260/jemds/2015/299 ABSTRACT: Wandering spleen is a rare clinical entity characterized by splenic hypermobility resulting from laxity or maldevelopment of supporting splenic ligaments1. Its major complication is splenic torsion, which is a potentially fatal surgical emergency2. We present a rare case of wandering spleen with torsion and splenic infarction in a multiparous patient. KEYWORDS: Wandering spleen, hypogastrium, pelvis, ultrasound, computed tomography, MRI. CASE REPORT: A 52- year old female presented with abdominal pain for 10 days. On clinical examination the patient was afebrile, moderately built and fully conscious. There was no jaundice, cyanosis or lymphadenopathy. Abdominal examination revealed that the abdomen was soft with no organomegaly. Splenic fossa was empty. There was an approximately 17x7 cm sized mass palpable in the hypogastrium, extending into the pelvis, which was firm and sharp in consistency and slightly tender and non-mobile in nature. The inferior margin of this mass could not be appreciated and was dull on percussion. Per-vaginal examination showed that there were no adnexal mass lesions. Examinations of the cardiovascular and central nervous systems were unremarkable. -
Operative Surgery & Topographical Anatomy of the Abdomen. Surgical
Operative surgery & topographical anatomy of the abdomen. Surgical anatomy of the inguinal canal and spermatic cord. Surgical anatomy of the inguinal canal and spermatic cord. Topographical peculiarities of the inguinal hernias.The descendense of the testicle, formation of scrotal layers. Boundaries: Superior boundary is formed by the margins of the costal arches (arcus costae) and xyphoid process Inferior boundary is formed by the inguinal folds, which are coincide with inguinal ligaments and pubic symphysis The lateral boundaries are the middle axillary (Lesgaft’s) lines. By two horizontal lines the anterior wall is divided into 3 regions: 1. Epigastrium 2. Mesogastrium 3. Hypogastrium The first horizontal line is between the lower points of the 10th pair of ribs and is called bicostal line (linea bicostarum) The second horizontal line is between spinae iliacae anteriores superiores and is called bispinal line (linea bispinarum) By two vertical lines which pass from the lower points of the 10th pair of ribs to the pubic tubercles the mesogastrium and hypogastrium are divided into three regions . The mesogastrium – into umbilical, right and left abdominal lateral regions, the hypogastrium – into pubic, right and left inguinal regions. So there are formed seven regions. If there will be drawn two vertical lines which coincide with the midclavicular lines to the pubic tubercles the epigastrium also can divided into three regions – the epigastric, right and left hypochondric regions. So nine regions are formed. Layers of anterior abdominal wall: 1. Skin is thin, elastic, moveable, except umbilical region, is covered by hair only in the pubic and inguinal parts, with sebaceous and sweat glands.