CASE OF THE WEEK

Asthmatic child with acute exacerbation. Diagnosis: Right middle lobe and left upper lobe atelectasis
Discussion:

Atelectasis is a common complication of asthma, often due to mucous plugging of bronchi. A child with a known diagnosis of asthma does not require a chest radiograph in order to confirm the diagnosis of asthma, but rather to rule out complications or to exclude other causes for wheezing.
Focal opacities occur frequently on chest radiographs obtained during acute asthma exacerbations. Small linear opacities are frequent and usually represent subsegmental atelectasis. It may be more difficult to distinguish atelectasis from pneumonia if opacities are patchy or irregular.
This case, however, demonstrates typical patterns of lobar atelectasis in the right middle lobe and left upper lobe. The right middle lobe, when collapsed, may have a distinct triangular appearance on both the frontal and lateral radiograph. However, the collapsed middle lobe may be oriented obliquely, which causes it to be poorly defined on the frontal radiograph but sharply defined on the lateral view. The right heart border is usually obscured.
The left upper lobe moves anterosuperiorly when it collapses. This will obscure the upper left mediastinal border, because the thin band of tissue anteriorly (the collapsed left upper lobe) abuts the mediastinum and blurs its margin. The lateral view may demonstrate an opaque soft tissue density anteriorly. The left lower lobe expands to the left apex; therefore aerated lung with lung markings is visible behind the “hazy” collapsed left upper lobe. The clue is the pattern of opacity that results in loss of the left cardiomediastinal border, along with somewhat decreased volume in the left lung.
When atelectasis persists despite therapy, one should consider the possibility of an endobronchial foreign body in the pediatric age group and bronchoscopy may be required.

من طرف **adam** السبت يونيو 19, 2010 6:09 am

جزاك الله خيرااا ................بالجد دايرين مواضيع زى دى وكيسات خاصه للطلبه زيناااا

يديك العافية ومزيد من المعلومات المفيدة

adam
أميرة عثمان خوجلي أسعدني مروركما واليكم المزيد
CASE OF THE WEEK Gr3-midi

Acute cholecystitis: ultrasound. In the upright position, the gallbladder (g) is distended, and pericholecystic fluid is evident (arrowhead). Stone (arrows) does not change location confirming impaction in gallbladder neck.

من طرف ماجدولين صديق الخميس يوليو 08, 2010 5:10 am

كلاااااااااااام جمييييييييل ، يديك العافية يا دكتور

من طرف ماجدولين صديق الخميس يوليو 08, 2010 5:20 am

From
its introduction in 1954 to the mid 1970's, most echocardiographic studies
employed a technique called M-mode, in which the ultrasound beam is aimed
manually at selected cardiac structures to give a graphic recording of their
positions and movements. M-mode recordings permit measurement of cardiac
dimensions and detailed analysis of complex motion patterns depending on
transducer angulation. They also facilitate analysis of time relationships with
other physiological variables such as ECG, heart sounds, and pulse tracings,
which can be recorded simultaneously.

A
more recent development uses electromechanical or electronic techniques to scan
the ultrasound beam rapidly across the heart to produce two-dimensional
tomographic images of selected cardiac sections. This gives more information
than M-mode about the shape of the heart and also shows the spatial
relationships of its structures during the cardiac cycle.

A
comprehensive echocardiographic examination, utilizing both M-mode and two
dimensional recordings, therefore provides a great deal of information about
cardiac anatomy and physiology, the clinical value of which has established
echocardiography as a major diagnostic tool.

This
unit covers the principles of two-dimensional echocardiography in more detail;
it explains the normal two-dimensional recordings in terms of the anatomy of
the cardiac sections scanned by the ultrasound beam. Some supplementary M-mode
recordings are included. Subsequent units will discuss applications of both
M-mode and two-dimensional echocardiography in acquired and congenital disease.

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About Echocardiography