Tuesday, February 14, 2017
what causes mesenteric panniculitis
hello everyone! my name is megan, and welcometo another anatomy tutorial. in this tutorial, we will be covering the mesentery which isfound in the abdominal cavity. i'm going to also cover some of the related structuresand organs. before we begin talking about the mesentery,i quickly want to go through a brief overview of the peritoneum. the peritoneum is a doublelayer of serous membrane or mesothelium. it lines the walls of the abdominal cavity andmost of the viscera. throughout the abdominal cavity, there are peritoneal folds that connectorgans together or connect these organs to the abdominal wall. some of these folds alsocontain vessels and nerves that supply the organs. their function is two-fold as theyalso stabilize and help maintain the position
of the organs. the subdivisions of the peritoneum includethe omenta, the mesenteries, and the peritoneal ligaments. in this image, we can see the malepelvis… hi guys, as you can see, this video is a previewwhich is reserved to kenhub premium members. why not become one today? as a premium member,you will get access to this video as well as other videos, quizzes, articles, and ouratlas of human anatomy—everything you need to learn anatomy in the most fun and efficientway. join us and let’s continue learning together! https://www.kenhub.com
Monday, February 13, 2017
Friday, February 10, 2017
small bowel mesentery
hello again and welcome to anotherepisode of cases in radiology. i'm frank gaillard the editor of radiopaedia.organd today we're going to be looking at at a ct of the abdomen in aseventy-year-old female who presented with epigastric pain. her only relevant medical history was that of apast cholecystectomy. as always now is a perfect time to pausethis video and take a minute or two to have a look at the case at your own pace. just follow the link which is eithervisible on your screen or included in the video description.
so here we have coronal and axial stacks through the abdomen. two main findings should have been evident. the first isthat there is a small bowel obstruction as envisaged by these enlarged loops of dilated bowel. these can be traced down into the lowerabdomen to this point where there is an abrupttransition from the distended
proximal lumen to the collapsed more distal lumen which has intussuscepted into the distal loop of bowel. this is also seen on axial imaging at this point where there is almost thecharacteristic donut appearance with mesenteric fat having been pulled into the lumen of the bowel.
going back to the coronal imaging there is the impression off a lead pointmass. the other notable findings are bilateralvery large renal masses, larger on the right. these appear centrally necrotic or cystic. there are numerous lymph nodes scatteredthroughout the mesentery which appear enlarged. but no other solid masses are identified. incidental findings include a largesimple renal cyst on the right.
the first question you should ask yourself is whether or not the bilateraladrenal masses and the small bowel intussusception are related. let's first talk about intussusception. intussusception is when one part of the bowel gets sucked into the more distal bowel and is further advanced by the action of peristalsis. in children this is most oftenidiopathic without an underlying cause identified, or certainly not anunderlying pathological cause; its most often attributed to prominent lymphoid tissue in the submucosa.
in adults however a lead point isusually identified and in most instances it is that of a malignancy. in the large bowel it is that of a colorectal carcinoma which isby far the most common, however small bowel lymphoma and metastases to both large or small bowel particularly from malignant melanoma,breast cancer or lung cancer are identified.
a number of benign neoplasms are alsoencountered. as are some congenital abnormalities although these would beunlikely to first present in a seventy-year-old. inflammatory and trauma has alsobeen reported but is unlikely. let's turn our attention to the adrenalglands. by far the most common cause ofbilateral adrenal masses is that of metastases;
and the primary tumors to considerare those of lung cancer, breast cancer renal cancer which is not evident inthis case, gastrointestinal malignancies, malignant melanoma and lymphoma. it is also worth considering primary tumours although most often these are unilateral. pheochromocytomas for example areencountered bilaterally in up to ten percent ofpatients - whether this represents
metastatic disease to the contralateraladrenal gland or synchronous tumours is debatable. going back to this case we are left withfour options. the first is that the small bowel mass and the bilateral adrenal masses are unrelated and that the adrenal masses were merelyincidentally found due to the presentation of a small bowel obstruction. the second is that they are related and that both represent
metastatic disease. as we saw the primary lesions to beconsidered are breast cancer, lung cancer, and melanoma. the third and fourth possibilities are that one of these lesions represent the primary and that the otherrepresent metastase. for example, the small bowel mass may be a primary adenocarcinoma or carcinoid of the small bowel with adrenal metastases.
or potentially that we have bilateraladrenal malignancies with metastases to the small bowel. review of a chestx-ray and inspection of the breasts remonstrated no obvious lung mass or breast mass. further questioning of the patient didhowever reveal that seven years ago she had had a malignant melanoma excised from herback. the patient went on to have a laparotomy
and had the small bowelintussusception resected and the adrenal glands biopsied. malignant melanoma was the diagnosis inboth instances. so this case is a good example of how systematically working through thedifferential diagnosis for separate lesions enables theunderlying cause to be narrowed down. malignant melanoma is particularly commonin australia because all a population ofimmigrants who have fair skin from northern european countries
now exposed to the harsh sun and the depletedozone layer. it is a sinister tumour insofar that alesion thought to completely have been excised many many years ago can present with metastatic disease and often cando so in unusual ways. it is one of the classic tumours to metastasise to small bowel and should be thought of high on thelist when such presentations are encountered. hope to see you again next time. take care.
sclerosing mesenteritis
let's check out some email today. dear bevvan,i need your help. my husband and i married for better or worse and he is willing to helpme, but i just can't stand it. i wonder if this email is for me. oh here it is. i havem.s. that's multiple sclerosis and i can't get the toilet paper you know where by myselfanymore. do you have any answers. well actually, i think i do. hygiene aftertoileting is something that most adults in america would like to have handled, privately,discreetly, and independently and it is among one of the most challenging activities bothphysically and emotionally for many people with disabilities. people who have normalhand and arm function can only imagine how complicated and difficult handling toiletpaper and getting it to the right perianal
spot can be after toileting. so while thereare several good pieces of adaptive equipment to handle toilet paper, i would like to suggestthat you consider an attachable bidet as a substitute for toilet paper. now an attachable bidet can help a personwith a disability with hygiene after toileting by allowing them to do that activity independentlythrough the touch of a button. if a caregiver is still needed that provides a degree ofseparation that adds to that comfort level between caregiver and person being cared forduring a private activity. bidets are also gaining popularity with seniors who don'thave disabilities for a couple of reasons. there are some normal anal sphincter changesthat may occur with aging and older women
are more susceptible to bladder and vaginalinfections. so the super cleaning power of an attachable bidet is an advantage, becauseit makes cleaning easier and reduces risk of health issues from not totally perfectcleaning. so an attachable bidet has many, many advantages. now i'm still learning aboutbidets, but i have five features that i'd love to share with you. things you can consider.the first is that while in america we consider toilet paper clean, people all over the worldare using bidets quite joyfully and gleefully. some people use them for religious reasons,others are using them because they are friendlier to the environment and others are using thembecause quite frankly they clean better than toilet paper. now, you may or may not wantto run your own personal test on that one,
but i'd like for you to accept that thereis an alternative to toilet paper. tidbit number two, there are several types of bidets.people who have been to europe may be more familiar with the separate stand alone bidet,which can be used for soaking or may have jets. there is an attachable bidet that replacesthe toilet seat on an existing toilet. there is an attachable toilet bidet that fits betweenthe toilet seat and the toilet and then there are portable bidets. now, i'm typically recommendingthe attachable bidet so the toilet seat bidet, because you don't have to have extra roomfor a separate plumbing fixture and because people who have difficulty transferring canjust sit in one place and take care of everything. third thing. you need to consider size andthe functions that you need when you're out
shopping for a bidet. if you have a roundtoilet or an elongated toilet you need a bidet that fits that shape. there are also manyimportant features. the things i think about most are how you control. where are the buttonslocated. are they separate, are they right or left. how big are they? whether you addhot air to dry or not is an important question to ask yourself. i would urge you to do thedrying feature, and the third is how many wands do you have. some of the systems i likebest have two separate water jets. one is for feminine cleansing the other is for analcleansing and then they have air, as well. so you think about all of these differentfeatures you need when you're out there shopping for this device. the fourth thing that youwant to consider is whether or not you need
other adaptive equipment when using the bidet.you can use some of your other assistive equipment like grab bars, whether they're floor to ceilingor mounted on the wall. we've used different types of toilet safety equipment with bidetsand you can use risers with bidets. you can use the type of riser that fits under thetoilet and you can use the type of riser that fits between the toilet and the toilet seat.you can't use the kind of riser that fits on top of the toilet seat with a bidet, butyou can keep things like height and balance supports with a bidet. and the fifth and finalthing that i want to offer is that you should prepare for a bidet. it doesn't take much.it uses the existing water supply from your toilet so that's a no-brainer. when i'm workingwith people that re remodeling their bathroom.
even if they have no trouble at all handlingtoilet paper or getting toilet seated, i suggest they add that outlet down low. that makesit easier to add the bidet in the future. you can add it and plug it in to any outletthat's within a certain distance of the bidet, but if you're using that outlet already forlike curling irons and hair dryers and recharging your toothbrush, you don't want to be tryingto plug the bidet in there as well. so preparing for that while remodeling by just adding aprotected outlet near the toilet will prepare you for the wonderful world of bidets. soshare the news and share the video. there is an alternative to toilet paper.
sclerosing mesenteritis diagnosis
let's check out some email today. dear bevvan,i need your help. my husband and i married for better or worse and he is willing to helpme, but i just can't stand it. i wonder if this email is for me. oh here it is. i havem.s. that's multiple sclerosis and i can't get the toilet paper you know where by myselfanymore. do you have any answers. well actually, i think i do. hygiene aftertoileting is something that most adults in america would like to have handled, privately,discreetly, and independently and it is among one of the most challenging activities bothphysically and emotionally for many people with disabilities. people who have normalhand and arm function can only imagine how complicated and difficult handling toiletpaper and getting it to the right perianal
spot can be after toileting. so while thereare several good pieces of adaptive equipment to handle toilet paper, i would like to suggestthat you consider an attachable bidet as a substitute for toilet paper. now an attachable bidet can help a personwith a disability with hygiene after toileting by allowing them to do that activity independentlythrough the touch of a button. if a caregiver is still needed that provides a degree ofseparation that adds to that comfort level between caregiver and person being cared forduring a private activity. bidets are also gaining popularity with seniors who don'thave disabilities for a couple of reasons. there are some normal anal sphincter changesthat may occur with aging and older women
are more susceptible to bladder and vaginalinfections. so the super cleaning power of an attachable bidet is an advantage, becauseit makes cleaning easier and reduces risk of health issues from not totally perfectcleaning. so an attachable bidet has many, many advantages. now i'm still learning aboutbidets, but i have five features that i'd love to share with you. things you can consider.the first is that while in america we consider toilet paper clean, people all over the worldare using bidets quite joyfully and gleefully. some people use them for religious reasons,others are using them because they are friendlier to the environment and others are using thembecause quite frankly they clean better than toilet paper. now, you may or may not wantto run your own personal test on that one,
but i'd like for you to accept that thereis an alternative to toilet paper. tidbit number two, there are several types of bidets.people who have been to europe may be more familiar with the separate stand alone bidet,which can be used for soaking or may have jets. there is an attachable bidet that replacesthe toilet seat on an existing toilet. there is an attachable toilet bidet that fits betweenthe toilet seat and the toilet and then there are portable bidets. now, i'm typically recommendingthe attachable bidet so the toilet seat bidet, because you don't have to have extra roomfor a separate plumbing fixture and because people who have difficulty transferring canjust sit in one place and take care of everything. third thing. you need to consider size andthe functions that you need when you're out
shopping for a bidet. if you have a roundtoilet or an elongated toilet you need a bidet that fits that shape. there are also manyimportant features. the things i think about most are how you control. where are the buttonslocated. are they separate, are they right or left. how big are they? whether you addhot air to dry or not is an important question to ask yourself. i would urge you to do thedrying feature, and the third is how many wands do you have. some of the systems i likebest have two separate water jets. one is for feminine cleansing the other is for analcleansing and then they have air, as well. so you think about all of these differentfeatures you need when you're out there shopping for this device. the fourth thing that youwant to consider is whether or not you need
other adaptive equipment when using the bidet.you can use some of your other assistive equipment like grab bars, whether they're floor to ceilingor mounted on the wall. we've used different types of toilet safety equipment with bidetsand you can use risers with bidets. you can use the type of riser that fits under thetoilet and you can use the type of riser that fits between the toilet and the toilet seat.you can't use the kind of riser that fits on top of the toilet seat with a bidet, butyou can keep things like height and balance supports with a bidet. and the fifth and finalthing that i want to offer is that you should prepare for a bidet. it doesn't take much.it uses the existing water supply from your toilet so that's a no-brainer. when i'm workingwith people that re remodeling their bathroom.
even if they have no trouble at all handlingtoilet paper or getting toilet seated, i suggest they add that outlet down low. that makesit easier to add the bidet in the future. you can add it and plug it in to any outletthat's within a certain distance of the bidet, but if you're using that outlet already forlike curling irons and hair dryers and recharging your toothbrush, you don't want to be tryingto plug the bidet in there as well. so preparing for that while remodeling by just adding aprotected outlet near the toilet will prepare you for the wonderful world of bidets. soshare the news and share the video. there is an alternative to toilet paper.
sarcoidosis emedicine
hola. me llamo linda cooke y soy un paciente con epoc he querido hacer este videoblog en "lovexair" para ayudar a otras personas afectadas por la epoc. tengo una condiciã³n genã©tica llamada alfa-1 antitripsina puede que a algunos os suene. es una condiciã³n progresiva crã³nica... empecã© a sentirme mal a los treinta y tantos... ...sin saber quã© tenãa. a los 40 me diagnosticaron un enfisema,
estaba aterrorizada. mã¡s tarde me diagnosticaron sarcoidosis, fibrosis pulmonar y broquioestasis. asã que a los 50 estaba bastante enferma, necesitaba oxãgeno y tuve que prejubilarme. la vida se tornã³ un poco pesada. en abril de este aã±o 2009, me incluyeron en la lista para un doble transplante de pulmã³n. increiblemente, 9 dãas mã¡s tarde recibã dos pulmones nuevos. las palabras no pueden expresar mi gratitud por estos dos nuevos pulmones. ha sido una etapa increãble. en mis prã³ximos blogs, me gustarãa hablar mã¡s sobre este camino hacia el transplante
y cã³mo ha afectado a mi vida, a mi familia y a mis amistades. hasta que hablemos de nuevo, cuãdense mucho. â¡hasta luego!
Subscribe to:
Posts (Atom)