Category: Neuroanatomy.
When one half of the pons is injured involving the corticospinal tract (above the decussation of the pyramids), the facial nerve (CN VII) nucleus and/or facial nerve fibers, and the nucleus of CN VI (abducens) or the nearby paramedian pontine reticular formation (PPRF) fibers to CN VI, the resulting constellation of signs/symptoms includes: contralateral spastic weakness/paralysis (weakness, hypertonia, hyperreflexia and Babinski's sign), ipsilateral upper and lower facial weakness and loss of volitional abduction of the ipsilateral eye (horizontal gaze paresis).
From: http://en.wikipedia.org/wiki/Foville's_syndrome
Foville's syndrome is caused by the blockage of the perforating branches of the basilar artery in the region of the brainstem known as the pons.[1]
Structures affected by the infarct are the PPRF, nuclei of cranial nerves VI and VII, corticospinal tract, medial lemniscus, and the medial longitudinal fasciculus.
The syndrome is reported in http://www.nzma.org.nz/journal/119-1232/1928/ in which the case mentioned the syndrome on a suspected Wernicke’s encephalopathy.
There is another recorded case: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1143046/
Friday, February 26, 2010
Sunday, January 17, 2010
Happy New Year 2010
I just realized I made this blog idle for quite some time (My bad). Therefore I would like to just write an entry wishing all a wondeful new year of 2010. Hope everyone will have a good time this year, ya?
Wednesday, November 25, 2009
Sucking Chest Wound
http://www.brooksidepress.org/Products/OperationalMedicine/DATA/operationalmed/Procedures/TreataSuckingChestWound.htm
I was looking at a statement talking about sucking chest wound.
The statement as shows: First aid for sucking chest wound is with occlusive dressing that allows air out (taped on three sides) but not in.
I didn't quite get it. Just imagine one day, you are walking in an American street and you witnessed a gun fight. Someone got shot on the chest. In such scenario, let's just test how much knowledge you know for this scenario ya? By the way, the above statement was from Kaplan Surgery CK 2008-2009. For the pictures, just go and visit the html at the top of the post.
A sucking chest wound is identified by the sucking or hissing sound made during breathing by the casualty.
With this type of wound, the chest cavity is no longer sealed, allowing air to rush through the wound and into the chest during inhalation. This causes the lung to collapse. This is a life-threatening condition and requires immediate treatment.
Start by uncovering the wound. If the clothing is stuck to the wound or in a chemical environment, then clothing should not be removed. Don't attempt to clean the wound. That will be done later.
Use the casualty's hand to cover the wound while you quickly prepare an occlusive patch. The plastic wrapper of a battle dressing works very well, although any air-tight material can be substituted, such as:
Cellophane
Aluminum foil
Duct Tape
Vaseline Gauze
The patch should be large enough to extend 2 inches beyond the edge of the wound. Smaller patches tend to get pulled back into the wound.
Secure the patch to the wound with adhesive tape. Three sides should be taped, while the 4th side is left untaped. Whenever the casualty breaths out (exhales), air is expelled from the chest cavity and escapes from underneath the open edge of the patch. Whenever the casualty breaths in (inhales), the patch sticks to the skin and keeps air from returning into the chest cavity. This helps to re-inflate the collapsed lung.
Place a small battle dressing over the patch, but don't make it so tight that the casualty can't breath.
Sometimes, you won't have any adhesive tape, or the tape won't stick (blood, water, mud, or perspiration may keep it from sticking). In that case, it is still very helpful to use the patch, held in place by a battle dressing or triangular bandage.
Finally, roll the patient onto the injured side while awaiting transportation.
Some medical bags include pre-packaged chest seals. These are easy to use and fast.
· Use the enclosed gauze pad to wipe the skin dry around the wound.
· Peel off the paper backing and place the sticky side of the seal over the wound and surrounding skin
· The one-way flutter valve will allow air to be expelled from the chest, but will keep the outside air from returning.
I was looking at a statement talking about sucking chest wound.
The statement as shows: First aid for sucking chest wound is with occlusive dressing that allows air out (taped on three sides) but not in.
I didn't quite get it. Just imagine one day, you are walking in an American street and you witnessed a gun fight. Someone got shot on the chest. In such scenario, let's just test how much knowledge you know for this scenario ya? By the way, the above statement was from Kaplan Surgery CK 2008-2009. For the pictures, just go and visit the html at the top of the post.
A sucking chest wound is identified by the sucking or hissing sound made during breathing by the casualty.
With this type of wound, the chest cavity is no longer sealed, allowing air to rush through the wound and into the chest during inhalation. This causes the lung to collapse. This is a life-threatening condition and requires immediate treatment.
Start by uncovering the wound. If the clothing is stuck to the wound or in a chemical environment, then clothing should not be removed. Don't attempt to clean the wound. That will be done later.
Use the casualty's hand to cover the wound while you quickly prepare an occlusive patch. The plastic wrapper of a battle dressing works very well, although any air-tight material can be substituted, such as:
Cellophane
Aluminum foil
Duct Tape
Vaseline Gauze
The patch should be large enough to extend 2 inches beyond the edge of the wound. Smaller patches tend to get pulled back into the wound.
Secure the patch to the wound with adhesive tape. Three sides should be taped, while the 4th side is left untaped. Whenever the casualty breaths out (exhales), air is expelled from the chest cavity and escapes from underneath the open edge of the patch. Whenever the casualty breaths in (inhales), the patch sticks to the skin and keeps air from returning into the chest cavity. This helps to re-inflate the collapsed lung.
Place a small battle dressing over the patch, but don't make it so tight that the casualty can't breath.
Sometimes, you won't have any adhesive tape, or the tape won't stick (blood, water, mud, or perspiration may keep it from sticking). In that case, it is still very helpful to use the patch, held in place by a battle dressing or triangular bandage.
Finally, roll the patient onto the injured side while awaiting transportation.
Some medical bags include pre-packaged chest seals. These are easy to use and fast.
· Use the enclosed gauze pad to wipe the skin dry around the wound.
· Peel off the paper backing and place the sticky side of the seal over the wound and surrounding skin
· The one-way flutter valve will allow air to be expelled from the chest, but will keep the outside air from returning.
Sunday, October 18, 2009
Catheter ablation & Heart Surgery
http://www.revolutionhealth.com/articles/catheter-ablation-for-atrial-fibrillation/hw159948
http://www.texasheartinstitute.org/hic/topics/proced/
http://www.texasheartinstitute.org/hic/topics/proced/mazes.cfm
Basically this is an extension on the previous topic. Related but is a different thing altogether. It's about atrial fibrillation. Basically these procedures are done when conventional medical treatment fails to treat the condition.
Catheter Ablation
Indication: Refractory atrial fibrillation (not responding to medication)
Method: Thin, flexible wires are inserted into a vein in the groin and threaded up through the vein and into the heart. There is an electrode at the tip of the wires. The electrode sends out radio waves that create heat. This heat destroys the heart tissue that causes atrial fibrillation or the heart tissue that keeps it happening.
1) Focal ablation
2) Circumferential ablation
3) Pulmonary vein ablation
4) Nodal ablation (attempt to control symptoms)
http://www.revolutionhealth.com/articles/av-node-ablation/zm6205
Of note of this procedure is that a permanent pacemaker would be inserted (note that this procedure actually destroys an AVN. So definitely you need to reimburse something right?)
Maze Surgery
Indication: Chronic Atrial Fibrillation
Method: Refer to Day of Surgery
http://www.texasheartinstitute.org/hic/topics/proced/
http://www.texasheartinstitute.org/hic/topics/proced/mazes.cfm
Basically this is an extension on the previous topic. Related but is a different thing altogether. It's about atrial fibrillation. Basically these procedures are done when conventional medical treatment fails to treat the condition.
Catheter Ablation
Indication: Refractory atrial fibrillation (not responding to medication)
Method: Thin, flexible wires are inserted into a vein in the groin and threaded up through the vein and into the heart. There is an electrode at the tip of the wires. The electrode sends out radio waves that create heat. This heat destroys the heart tissue that causes atrial fibrillation or the heart tissue that keeps it happening.
1) Focal ablation
2) Circumferential ablation
3) Pulmonary vein ablation
4) Nodal ablation (attempt to control symptoms)
http://www.revolutionhealth.com/articles/av-node-ablation/zm6205
Of note of this procedure is that a permanent pacemaker would be inserted (note that this procedure actually destroys an AVN. So definitely you need to reimburse something right?)
Maze Surgery
Indication: Chronic Atrial Fibrillation
Method: Refer to Day of Surgery
Check out this website
http://www.hrsonline.org/Education/SelfStudy/
Okay, so I come across this website. I was looking on a trial--AFFIRM trial just to take a look on the efficacy of antiarrhythmic drugs. For further information about the trial, http://www.hrsonline.org/Education/SelfStudy/ClinicalTrials/AF/AFFIRM.cfm, check out the website I put out.
One word about the AFFIRM study. It's basically comparing the efficacy of using rate-limiting method and rhythm-limiting method to control atrial fibrillation. Result is that no statistical difference observed in both treatment. Rhythm-limiting method is referred usage of sodium channel blockers whilst rate-limiting method is referred to usage of beta-blockers, ccb etc. methods to control atrial fib.
Currently I can't think of any good subject to write on. But what I can do is just look out for good websites where they can provide a certain good information that we could appreciate as a medical student who hungers for nothing but knowledge.
Okay, so I come across this website. I was looking on a trial--AFFIRM trial just to take a look on the efficacy of antiarrhythmic drugs. For further information about the trial, http://www.hrsonline.org/Education/SelfStudy/ClinicalTrials/AF/AFFIRM.cfm, check out the website I put out.
One word about the AFFIRM study. It's basically comparing the efficacy of using rate-limiting method and rhythm-limiting method to control atrial fibrillation. Result is that no statistical difference observed in both treatment. Rhythm-limiting method is referred usage of sodium channel blockers whilst rate-limiting method is referred to usage of beta-blockers, ccb etc. methods to control atrial fib.
Currently I can't think of any good subject to write on. But what I can do is just look out for good websites where they can provide a certain good information that we could appreciate as a medical student who hungers for nothing but knowledge.
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