...The Diaphragm and Congenital Diaphragmatic Hernia The diaphragm is a commonly misunderstood body part. Those who sing appreciate it purely due to their ability to control the diaphragm to enhance their singing. However, its real purpose in the human body is more important than that. The diaphragm plays such a crucial role in everyday life to the extent that one cannot survive without it. In this paper we will consider the role of the diaphragm through its anatomy and physiology. We will then review a congenital birth defect known as Congenital Diaphragmatic Hernia (CDH) and how it changes the anatomy and physiology of the body. We will also look at current research and prognosis of the disease in an effort to gain a better understanding of this often-fatal defect. The diaphragm is located almost centrally in the body. It is a continuous sheet of muscle that spreads across the bottom of the rib cage creating a divide between the thoracic cavity and the abdominal cavity. As detailed in the text Gray’s Anatomy, the convex upper surface of the diaphragm faces the thorax and forms the bottom of the thoracic cavity. The concave inferior surface is pointed towards the abdomen and is mostly covered in peritoneum forming the superior part of the abdominal cavity. The right side of the diaphragm is superior to the right lobe of the liver, the right kidney, and the right adrenal gland. The left side of the diaphragm lays over the left lobe of the liver, the fundus of...
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...Case Study 16: Preventing Neural Tube Defects in Chile Abstract Neural tube defects (NTDs) are the second most common congenital malformation to congenital heart disease and affected 400 babies in Chile annually before a fortification legislation was passed to use fortified flour with folic acid. This fortification reduced spina bifida by 51% and anencephaly by 46% (Levine, 2007). Team One will share answers to questions about this study and research of the problem. The globally astute nurse can provide education and become an advocate to continue to reduce these congenital birth defects through improving the health of women and children and thus all humanity. Case Study Sixteen: Preventing Neural Tube Defects in Chile Despite efforts to reduce neural tube defects, more than 300,000 children are born with neural tube defects annually (CDC, 2012). In Chile, fortification with folate reduced birth defects. Public and private partnerships are necessary for the success of ventures to improve healthcare. Fortification with folate in the diet can be replicated, but must be attune to cultural diet and nutrition habits. Global education is a critical link to success in combating disease and especially with neural tube defects. Once leaders are aware and efforts can focus on problems for education, intervention and evaluation, global health can be improved and the sustainability of our people and planet can continue. Question...
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... Down syndrome (DS) or Trisomy 21 is a complex developmental genetic disorder in which a person has 47 chromosomes instead of 46. Normally, a fertilized egg has 23 pairs of chromosomes. But in most cases, people living with Down syndrome have an extra copy of chromosome 21 also known as Trisomy 21, which is responsible for 95% Down syndrome cases and most common genetic cause of human mental retardation, with an incidence of 1-600/1-1000 live births. It is also responsible for premature pregnancy failure. It is the leading cause of cognitive impairment. Down syndrome occurs because of an abnormality characterized by an extra copy of genetic material on all or part of the 21st chromosome. Every cell in the body contains genes that are grouped along chromosomes in the cell's nucleus or center. There are normally 46 chromosomes in each cell, 23 inherited from your mother and 23 from your father. When some or all of a person's cells have an extra full or partial copy of chromosome 21, the result is Down syndrome. Down syndrome is associated with mild to moderate learning disabilities, developmental delays, characteristic facial features, and low muscle tone in early infancy. Many individuals with Down syndrome also have heart defects, leukemia, early-onset Alzheimer's disease, gastro-intestinal problems, and other health issues. The symptoms of Down syndrome range from mild to severe. Life expectancy for individuals with Down syndrome has dramatically increased over the past...
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...Submitted in Partial Fulfillment for Anatomy and Physiology, Ms. Walter Spring 2013 Things That Can Go Wrong With the Human Body: Hypothyroidism Introduction: Over time, a significant amount of problems with the human body have evolved. These problems have been developed due to both environmental and genetic factors. Dietary changes and urbanization have also played a crucial role in the development of problems that may occur. Our bodies contain a number of functioning systems that are all imperative to our survival. Without these systems, our bodies would not function and in turn, we would cease to exist. The endocrine system serves as one of the body’s ways of sending messages to the brain. It includes a number of vital glands that keep our body’s performance stable and functional. The thyroid gland is one of the most important components in the endocrine system. It is located in the neck, just under the voice box. Its primary function is to release the hormones thyroxin (T4) and triiodothyronine (T3) which control body metabolism, by taking iodine from our food and converting it into these hormones. When the levels of T4 and T3 become too low, the pituitary gland must produce a Thyroid Stimulating Hormone (TSH) which then activates the thyroid gland to generate more hormones. (Norman, 2012). If the thyroid gland does not work properly, these hormones cannot be produced on their own. This condition is known as Hypothyroidism. This paper examines the types and...
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...SYPHILIS DEFINITION Syphilis is a highly contagious disease spread primarily by sexual activity, including oral and anal sex. Occasionally, the disease can be passed to another person through prolonged kissing or close bodily contact. Although this disease is spread from sores, the vast majority of those sores go unrecognized. The infected person is often unaware of the disease and unknowingly passes it on to his or her sexual partner. It is caused by a spirochete and is acquired through sexual contact. It may also be congenital in nature. ETIOLOGIC AGENT The infection is caused by a spirochete, Treponema pallidum. * T. pallidum has no other host but man. * From a fresh smear taken from a lesion, T. pallidum appears as a shiny, twirling thread twisting its way in a wave-like corkscrew motion through the debris in the smear. * it is believed that the spirochete can pass through the mucosa even through a crack on its surface may not be visible at the site of entry. 4. The organism is also able to pass through the plancenta and infect the developing fetus within the body of a syphilitic mother. 5. The spirochete does not withstand drying, but withstand considerable temperature variation. 6. Based on studies, the organism has been found alive in a drinking glass a half-hour after the glass has been rinsed with cold water. SOURCES OF INFECTION * Discharges from ovious or concealed lesions of the skin or mucous membranes. * The semen, blood...
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...INTRODUCTION Hypoplastic Left Heart Syndrome (HLHS) is a rare form of pediatric congenital heart defect that affects only 1% of all congenital cardiac disease. HLHS accounts for 23% of all cardiac deaths within the first week of life. HLHS exists under any or all of the following: “hypoplasia of the left ventricle, stenosis/atresia of the aortic valve, stenosis/atresia of the mitral valve, and varying degrees of hypoplasia of the ascending aorta and aortic arch” (Dadlani and Bradley 2011). Without surgical intervention, HLHS is uniformly a fatal condition. Research shows that before the use of these surgical interventions, nearly 90% of all patients diagnosed with HLHS died within the first 30 days of life. Advancements in both pediatric cardiac surgery as well and pediatric cardiology has significantly decreased the fatality rate in HLHS patients over the past decade. When looking at courses of treatment for HLHS there are four main approaches that are commonly used worldwide: The Norwood Palliation,...
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... Introduction to Clinical Applications Objectives In this chapter we will study • various approaches to the study of disease; • the role of the Centers for Disease Control and Prevention; • common causes of disease; • the distinction between signs and symptoms of disease; • terms used to describe the time course of a disease; and • common abbreviations for medical specialists and specialties. Homeostasis and Disease The body’s tendency to maintain internal stability is called homeostasis. Examples include the body’s relatively stable temperature, blood glucose concentration, hormone levels, acid-base balance, and electrolyte balance. When physiological variables deviate too much from their set point, the body activates negative feedback loops that tend to restore stability and maintain health. In some cases, such as the stoppage of bleeding, positive feedback loops are activated to bring about rapid change. If the attempt to regain homeostasis fails, disease results. There is a strong emphasis in medicine today on promoting wellness through prevention. However, this manual focuses on what happens when prevention fails, homeostasis is disrupted, and disease occurs. The Study of Disease Disease (illness) is any deviation from normal that interferes with correct, life-sustaining bodily function. Literally, the word means dis-ease, the opposite of ease (comfort and normal function). Disease may have underlying structural foundations, such as a broken bone, and its effects...
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...Do Bioprosthetic Heart Valves Pose a Greater Risk than Mechanical Heart Valves in the Development of Infective Endocarditis? Prosthetic heart valves are, undoubtedly, one of the most profound innovations to be introduced into the medical community. In 1961 the Starr-Edwards ball and cage mitral valve became the first commercially available mechanical heart valve. In 1969, the Bjork-Shiley tilting disk valve emerged, which was then followed by the St. Jude Medical bi-leaflet valve in 1977. In addition to the creation of mechanical valves, bioprosthetic valves were also being developed; and in1968 the Hancock and Carpentier-Edwards porcine mitral valve became a popular alternative to the mechanical valve (Wheatley and Will, 2005, p.1). Over the...
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...1. Congenital rubella: a) Has an incubation period of 7-10 days. b) May be complicated by polyarthralgia. c) Rarely causes deafness. d) Is an indication for termination if it occurs in the first two months of pregnancy. e) May cause prolonged jaundice. 2. Recognised causes of delayed bone age include: a) Hypopiturtarism b) Primary hypothyroidism c) Congenital adrenal hypoplasia d) Prolonged corticosteroid therapy e) Tuberculosis 3. Kwashiorkor: a) Hypothermia is a recognized complication T b) Edema is mainly due to protein losing enteropathy. T c) Measles is a recognized precipitant F d) The incidence is highest in the first two month of life F e) The birth of a second child to the mother may be a contributory factor F 4. At the age of eight months a baby can be expected to: a) Roll over from front to back T b) Sit up with a straight back T c) Pick a small bead between thumb and finger T d) Say up to five word clearly F e) Feed himself with a spoon F 5. if a child in the ward's develops measles, the following action are appropriate a) Close the wards to all admissions for one week F b) Actively immunized all the other patients against measles T c) Give gamma globulin to all patients who have not been immunized or had measles T d) Forbid visiting by the parents until the rash has gone F e) Give prophylactic antibiotics to all contacts at home T 6. Convulsion in the first week of life is characteristic of a) Hypocalcaemia T b) Post maturity...
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...dehydrationMod dehydrationSevere dehydrationReplacing ongoing losses | MAJOR TEACHING POINTS | NURSING CONSIDERATIONS | Teach parents at well childcare visits in first yearKeep 24 hour supply of ORT in homeBegin with first sign of diarrheaReplace with ½ cup ORT for each diarrheal stoolSeek medical attention prn signs or dehydrationAfter re-hydration resume breast/formula feeding or normal diet in the older childAdvise them never to try to formulate an OR solution themselves.Teach personal hygiene/ hand washingProper preparation and storage of breast milk or formulaCareful food preparationImmunization for RotavirusAvoid unnecessary antibiotic usage | Acute diarrhea is leading cause of illness in children <5 years (10’s of millions cases in US)65% of hospitalizations and 85% of...
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...Congestive Heart Failure FC IV Valvular Heart Disease Secondary to Rheumatic Heart Disease A case Presentation A Presented to: The Faculty College of Nursing Adventist University of the Philippines In Partial fulfillment Of the Course N303 Curative and Rehabilitative Nursing Care 1st Semester By: Tha Hnem Section F Presentation Date: September, 4, 2007 I. Introduction Heart failure, also called congestive heart failure (CHF), is a life-threatening condition in which the heart can no longer pump enough blood to the rest of the body. Heart failure is almost always a chronic, long-term condition, although it can sometimes develop suddenly. Rheumatic fever and Valvular Heart Disease also contributed to Heart Failure. This condition may affect the right side, the left side, or both sides of the heart. Rheumatic heart disease refers to the cardiac manifestations of rheumatic fever, including pancarditis (myocarditis, pericarditis, and endocarditis) during the early acute phase and chronic valvular disease later. Long-term antibiotic therapy can minimize recurrence of rheumatic fever, reducing the risk of permanent cardiac damage and eventual valvular deformity. In valvular heart disease, three types of mechanical disruption can occur; stenosis, or narrowing, of the valve opening: incomplete closure of the valve; or prolepses of the valve. They can result from such disorders as endocarditis (most common), congenital defects, and inflammation, and they...
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...A toddler with Down syndrome Jeffrey was 14 months when I met him. He was born with Down syndrome and a congenital heart defect and had an open heart surgery when he was 6 months old. Jeffrey often got ear infections and had recently had a set of pressure equalizing (pe) ear tubes placed. Jeffrey was not walking and was not yet crawling. Children with Down syndrome do learn to crawl and walk and talk; it takes longer. Recent research and clinical experience suggests that, with regard to talking, these children benefit from early oral stimulation, oral motor awareness and multiple experiences with oral sensory stimulation. As soon as I met Jeffery, we began working on ` mouth wakeup` activities , stimulating his teeth, lips, gums , hard and soft palate, inside cheeks, and outside jaw muscles with a variety of toys and tools, including vibrators. We taught his parents to do the same at home. Another part of getting ready to talk is stimulating receptive language (language comprehension). In speech therapy visits we begin using short descriptive sentences to describe toys Jeffrey picked up (he was in a high chair initially). We dropped direct questions during these periods of indirect language stimulation and encouraged the parents to do the same. After two to three weeks, Jeffrey’s mother became adept at these techniques and began describing his activities as he did them so that he could hear them and associate the object he had with the words he heard. Her continuing work in this...
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...(Stretchy Skin Disease) Ehlers-Danlos Syndrome, also known as Stretchy Skin Disease is a connective tissue disorder that is inherited. There are several types of Ehlers-Danlos syndrome ranging from mild to life threatening (Ehlers-Danlos syndrome, 2006). According to NCBI, this disease is characterized by hyperextensibility of the skin, joint hypermobility, weakness of tissue, and rupture in arteries. People with this disease have a deficiency in collagen causing the skin, muscles and joints to not hold firm. Signs & Symptoms * Double-Jointedness, joint popping, joint dislocation, congenital hip dislocation * Easily damaged, bruised or stretchy skin, poor wound healing * Chronic joint pain * Very soft and velvety skin, very stretchy skin, fragile * Vision problems, deformed surface of the eye, crossed eyes * Weak internal organs Most Ehlers-Danlos syndrome types affect the joint tissue and skin; a couple other types affect the same, including fragile blood vessels that affecting the internal organs. Complications * Premature rupture of membranes, rupture of intestines, uterus or eyeballs * Periodontitis * Mitral valve prolapse * Failure of surgical wounds properly healing * Early-onset arthritis Treatment/Maintenance Currently there is no cure for Ehlers-Danlos syndrome, only management. It is important that each person establish a network of clinical physicians who are very familiar with the disease and know how to...
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...Preventing Heart Failure Readmissions Henry D. Santos Purdue University Calumet I. Introduction High morbidity, mortality, and healthcare spending have been connected with heart failure management. As per Gheorghiade et al., every year, there are almost a million cases of hospitalization for heart failure, responsible for 6.5 million hospital days, and estimated expenditures of $37.2 billion here in the United States alone (2013). The incident of heart failure readmissions has increased over the last decades, distinctly related to the aging population and surpassed recovery after a myocardial infarction. Based on the Centers for Medicare and Medicaid Services (CMS) 2005 data, heart failure is the most frequent diagnosis among Medicare beneficiaries and the third highest reimbursement for hospitals (AHRQ, 2013). In 2009, CMS started the public reporting of readmission rates after being discharge for heart failure, and, the year after, the Patient Protection and Affordable Act inaugurated financial penalties for healthcare establishments with most rates of readmission within the 30 days after discharge. The elevated concern relating the want to decrease readmissions has been the biggest focused of national researchers and hospitals with the efforts of identifying and predicting which patients with heart failure are likely to be readmitted. Formulated designs and preventive strategies have been established, in order to avoid unnecessary readmissions. Heart failures risk...
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...The Tuskegee study was a human study program to evaluate the progression of syphilis. The purpose was to study and record of the sexually transmitted disease. 600 African American men where held without their agreement to be studied.399 Syphilis cases and 201 syphilis free cases. The researchers convinced these men that they were being treated for “bad blood”. This stood for a number of things such as fatigue, anemia, and syphilis. In exchange for the men’s’ cooperation they received medical exams, free meals, and burial insurance. This project originally was supposed to last for only six months and that six months turned into 40 years. The first press story about the study in 1972, caused the public to have an all-out cry for help for those men. They were being denied their rights by not being told in detail what was going on and they were not being treated for their disease correctly. The assistant secretary for Health and Scientific Affairs appointed an Ad Hoc Advisory panel to review the study. The members where from medicine, law, religion, labor, education, health administration, and public affairs fields. Their job was to evaluate what should be done next. Forty years of human study and nothing knew was acquired or done. This is what caused them to get involved in the first place. The final report of the panel showed the violations that where found throughout the study. This included not treating the patients and not thoroughly explaining the situation. They also...
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