Mark Corson

By L. Saturas. Graceland University. 2018.

Cavity Major Organ(s) in the Cavity Dorsal Cranial Brain Spinal Spinal cord Ventral Thoracic Heart generic 50 gm beloc otc, lungs buy beloc 50gm low price, and associated structures Abdominopelvic Digestive cheap 50gm beloc, excretory, and reproductive organs and structures Table 4-3 Body Quadrants This table lists the quadrants of the body, their corresponding abbreviations, and their major structures. Right Left hypochondriac Epigastric hypochondriac region region region Right upper Left upper quadrant quadrant Right lumbar Umbilical Left lumbar region region region Right lower Left lower quadrant quadrant Right inguinal Hypogastric Left inguinal (iliac) region region (iliac) region Figure 4-4. Table 4-4 Abdominopelvic Regions This table lists the names of the abdominopelvic regions and their location. Region Location Left hypochondriac Upper left region beneath the ribs Epigastric Region above the stomach Right hypochondriac Upper right region beneath the ribs Left lumbar Left middle lateral region Umbilical Region of the navel Right lumbar Right middle lateral region Left inguinal (iliac) Left lower lateral region Hypogastric Lower middle region beneath the navel Right inguinal (iliac) Right lower lateral region It is time to review the planes of the body and quadrants and regions of the abdominopelvic area by completing Learning Activities 4–1 and 4–2. Table 4-5 Directional Terms This table lists directional terms along with their definitions. Term Definition Abduction Movement away from the midsagittal (median) plane of the body or one of its parts Adduction Movement toward the midsagittal (median) plane of the body Directional Terms 47 Table 4-5 Directional Terms—cont’d Term Definition Medial Pertaining to the midline of the body or structure Lateral Pertaining to a side Superior (cephalad) Toward the head or upper portion of a structure Inferior (caudal) Away from the head, or toward the tail or lower part of a structure Proximal Nearer to the center (trunk of the body) or to the point of attachment to the body Distal Further from the center (trunk of the body) or from the point of attachment to the body Anterior (ventral) Front of the body Posterior (dorsal) Back of the body Parietal Pertaining to the outer wall of the body cavity Visceral Pertaining to the viscera, or internal organs, especially the abdominal organs Prone Lying on the abdomen, face down Supine Lying horizontally on the back, face up Inversion Turning inward or inside out Eversion Turning outward Palmar Pertaining to the palm of the hand Plantar Pertaining to the sole of the foot Superficial Toward the surface of the body (external) Deep Away from the surface of the body (internal) It is time to review body cavity, spine, and directional terms by completing Learning Activity 4–3. Medical Word Elements This section introduces combining forms, suffixes, and prefixes related to body structure. Thus, the individual with heterochromia may have one brown iris and one blue iris. Cirrhosis of the liver is usually associated with alcoholism or chronic hepatitis. Pathology 53 Pathology diseases include: • metabolic (such as diabetes) All body cells require oxygen and nutrients for sur- • infectious (such as measles and mumps) vival. They also need a stable internal environment • congenital (such as cleft lip) that provides a narrow range of temperature, water, • hereditary (such as hemophilia) acidity, and salt concentration. This stable internal • environmental (such as burns and trauma) environment is called homeostasis. When home- • neoplastic (such as cancer) ostasis is disrupted and cells, tissues, organs, or sys- tems are unable to function effectively, the condition Establishing the cause and nature of a disease is is called disease. Determining a diagnosis ease is a pathological or morbid condition that helps in the selection of a treatment. A prognosis is presents a group of signs, symptoms, and clinical the prediction of the course of a disease and its findings. A symptom is subjective and is A variety of diagnostic procedures are used to experienced only by the patient. Dizziness, pain, and identify diseases and determine their extent or malaise are examples of symptoms. Diagnostic tests can be simple, such as are the results of radiologic, laboratory, and other listening to chest sounds with a stethoscope, or medical procedures performed on the patient or complex, such as a biopsy. Abbreviations Diagnostic, Symptomatic, and Related Terms This section introduces diagnostic, symptomatic, and related terms and their meanings. Descriptions are provided as well as pro- nunciations and word analyses for selected terms. The endoscope is usually named for the organ, cavity, or canal being exam- ined, such as gastroscope and sigmoidoscope. Rather than being directed into the body, radiation comes from inside the body and is then detected by a specialized camera to produce an image. It is especially useful to visu- -graphy: process of recording alize blood flow through arteries and veins in the brain. A computer analyzes the reflected echoes and converts them into an image on a video monitor. Because this procedure does not use ionizing radiation (x-ray), it is used for visualizing fetuses as well as the neck, abdomen, pelvis, brain, and heart. The evaluation by the pathologist helps determine if and how aggressively the surgeon will treat the patient. Abbreviations This section introduces body structure abbreviations and their meanings. Complete each activity and review your answers to evaluate your understanding of the chapter. Learning Activity 4-1 Identifying Body Planes Label the following illustration using the terms below. Learning Activities 61 Learning Activity 4-2 Identifying Abdominopelvic Divisions Label the quadrants on Figure A and regions on Figure B using the terms below. We recommend you complete the flash-card activity before completing Activities 4–4 and 4–5 below. Learning Activities 63 Learning Activity 4-4 Matching Word Elements Match the following word elements with the definitions in the numbered list. Combining Forms Suffixes Prefixes caud/o kary/o -genesis ad- dist/o leuk/o -gnosis infra- dors/o morph/o -graphy ultra- eti/o poli/o hist/o somat/o idi/o viscer/o jaund/o xer/o 1. Complete the termi- nology and analysis sections for each activity to help you recognize and understand terms related to body structure. Medical Record Activity 4-1 Radiological Consultation Letter: Cervical and Lumbar Spine Terminology Terms listed below come from the Radiological Consultation Letter: Cervical and Lumbar Spine that follows. Use a medical dictionary such as Taber’s Cyclopedic Medical Dictionary, the appendices of this book, or other resources to define each term. Then review the pro- nunciations for each term and practice by reading the medical record aloud. The ver- tebral bodies, however, appear to be well maintained in height; the intervertebral spaces are well main- tained. Impression: Films of the cervical spine demonstrate some reversal of normal cervical curvature and a minimal scoliosis, possibly secondary to muscle spasm, without evidence of recent bony disease or injury.

The aim of this chapter on immunology cheap 50gm beloc with amex, in a compact guide to medical microbiology beloc 50gm overnight delivery, is to present the immune system essentially as a system of defense against in- fections and to identify its strengths and weaknesses to further our under- standing of pathogenesis and prevention of disease cheap beloc 50 gm fast delivery. The Immunological Apparatus & The immune system is comprised of various continuously circulating cells (T and B lymphocytes, and antigen-presenting cells present in various tis- sues). T and B cells develop from a common stem cell type, then mature in the thymus (Tcells) or the bone marrow (B cells), which are called primary (or central) lymphoid organs. The antigen-specific activation of B and/or T cells in- volves their staggered interaction with other cells in a contact-dependent manner and by soluble factors. They secrete antibodies into the blood (soluble antibodies) or onto mucosal surfaces once they have fully matured into plasma cells. Antibodies recognize Kayser, Medical Microbiology © 2005 Thieme All rights reserved. Chemically, B-cell receptors are globulins (“immunoglobulins”) and comprise an astounding variety of specific types. Despite the division of immunoglobulins into classes and subclasses, they all share essentially the same structure. Naive Tcells circulate through the blood, spleen, and other lymphoid tissues, but cannot leave these com- partments to migrate through peripheral nonlymphoid tissues and organs unless they are activated. Self antigens (autoantigens), presented in the thy- mus and lympoid tissues by mobile lymphohematopoietic cells, induce T-cell destruction (so-called negative selection). Antigens that are expressed only in the periphery, that is outside of the thymus and secondary lymphoid or- gans, are ignored by T cells; potentially autoreactive T cells are thus directed against such self antigens. New antigens are first localized within few lym- phoid tissues before they can spread systemically. These must be present in lymphoid tissues for three to five days in order to elicit an immune response. An immune response can be induced against a previously ignored self antigen that does not normally enter lymphoid tissues if its entry is induced by cir- cumstance, for instance, because of cell destruction resulting from chronic peripheral infection. It is important to remember that induction of a small number of T cells will not suffice to provide immune protection against a pathogen. This can be better understood by examining how the individual com- ponents of the immune response function. The human immunological system can be conceived as a widely dis- tributed organ comprising approximately 1012 individual cells, mainly lym- phocytes, with a total weight of approximately 1kg. Leukocytes arise from pluripotent stem cells in the bone marrow, then differentiate further as two distinct lineages. The myeloid lineage constitutes granulocytes and mono- cytes, which perform important basic defense functions as phagocytes (“scavenger cells”). The lymphoid lineage gives rise to the effector cells of the specific immune response, T and B lymphocytes. These cells are con- stantly being renewed (about 106 new lymphocytes are produced in every minute) and destroyed in large numbers (see Fig. T and B lym- phocytes, while morphologically similar, undergo distinct maturation pro- Kayser, Medical Microbiology © 2005 Thieme All rights reserved. The antigen-independent phase of lymphocyte differentiation takes place in the so-called primary lymphoid organs: T lymphocytes mature in the thymus and B lymphocytes in the bursa fabricI (in birds). Although mammals have no bursa, the term B lymphocytes (or B cells) has been retained to distinguish these cells, with their clearly distinct 2 functions and maturation in the bone marrow, from T lymphocytes, which mature in the thymus (Table 2. In addition to their divergent differentia- Maturation of B and T cells Primary (central) lymphoid organs Secondary (peripheral) lymphoid organs Antigen-independent Antigen-dependent Progenitor Precursor B Immature Mature Activated Blast Plasma cell B (pro-B) cell (pre-B) cell B cell IgM B cell B cell IgD B cell µ µ B cells µ λ5/V B λ or κ IgM IgM pre 1,2 IgD IgM Bone marrow αβ αβ Effector T Stem cell ρTα Mature T cells β β (Te) cells T cells αβ Activation in secondary Immature T cells ± selection lymphoid organs (via contact and/ Thymic cortex Thymic medulla or interleukins) Fig. Stem cells that remain in the bone marrow develop into mature B cells via several anti- gen-independent stages; including the k5Vpre-B cell stage, and pre-B cells with a special k5 precursor chain. Antigen contact within secondary lymphoid or- gans can then activate these cells, finally causing them to differentiate into anti- body-secreting plasma cells. From here, these single positive T cells can emigrate to peripheral secondary lymphoid organs, where they may become activated by a combination of antigen contacts, secondary signals, and cytokines. They manifest contrasting response patterns to cyto- kines, and display a marked preference to occupy different compartments of lymphoid organs. The antigen-dependent differentiation processes which leads to T and B cell specialization, takes place within the secondary lym- phoid organs where lymphocytes come into contact with antigens. As a general rule the secondary lymphoid organs contain only mature T and B cells, and comprise encapsulated organs such as the lymph nodes and spleen, or non-encapsulated structures which contain lymphocytes and are associated with the skin, mucosa, gut, or bronchus (i. Together, the primary and secondary lymphoid organs ac- count for approximately 1–2% of body weight. The B-Cell System & B lymphocytes produce antibodies in two forms; a membrane-bound form and a secreted form. Following antigen stimulation, B lymphocytes differentiate into plasma cells, which secrete antibodies exhibiting the same antigen specifi- city as the B-cell receptor. This system is characterized as humoral immu- nity, due to this release of receptors into the “humoral” system which constitutes vascular contents and mucous environments. Usage subject to terms and conditions of license 50 2 Basic Principles of Immunology system also contains non-specific defense mechanisms, including the com- plement system (see “Immune response and effector mechanisms,” p. These immunoglobulins comprise a number of classes and subclasses, as well as numerous different specificities, but share a common structure 2 (Fig. The five corresponding im- munoglobulin classes are designated as IgM, IgD, IgG, IgA, or IgE, depending on which type of heavy chain they use (Fig. A special characteristic of the immunoglobulin classes IgA and IgM is that these comprise a basic monomeric structure that can be doubled or quintupled (i. The upper half of the figure shows the intact monomer consisting of two L and two H chains. Follow- ing pepsin digestion (right), the Fc portion is fragmented, but the Fab fragments remain held together by disulfide bonds. These consist of the variable domains of the H and L chains, joined covalently by a synthetic linker peptide.

If a thought appears buy cheap beloc 50 gm on line, the moment you recognize it cheap beloc 50 gm on-line, just say discount beloc 50 gm, “thinking” to yourself. Close your eyes, notice your sensations and as you do, name them as “thinking,” H “ feeling,” or “body sensation. This exercise is a way of cultivating your awareness but at the same time distancing yourself from the meaning that you would Mindfulness: A Technique to Deal with Stress • 45 normally attach to your thoughts and feelings. Just acknowledge this by saying, “thinking” and return to monitoring and labeling your experiences. What normally happens is that when an emotion such as anger, sadness, suffering, or joy arises, there is no awareness about what’s happening. You identify so strongly with the emotion that you become the emotional state itself, instead of recognizing that it’s just a state of mind that has arisen. For example, if you’re angry, this could actually reflect an underlying fear that you have, which is, in turn, based on previous experiences. This time, when a thought, feeling or physical sensation pops up, I want you to go a bit further with your labeling and actually try to name the experience. You’re trying to become more specific about each experience, rather than just generically noting the labels: “thinking,” “ feeling,” and “body sensation. Close your eyes, notice your sensations and label them specifically, H and then return to the text. Your mind was too busy noticing itself and your body to be engaged in the, often artificial, manufacture of stressful thoughts. Short Circuiting Judgments and Encouraging Acceptance With mindfulness, the goal is to take note of an experience for what it is without any further judgment and without the need to change what’s happening. Ideally there’s no layering over the experience with further, personal, biased perspectives. These biased perspectives lead to either a desire for, or a rejection of, what you’re currently experiencing. Remember that your normal response to an experience is to have an initial judgment of the event. Rather than just accepting this reaction, you tend to amplify it and judge yourself even further. When Mika’s on a diet and has some ice cream, she feels bad that she gave in to her cravings. Next, she makes the judgment that she’s always making these mistakes, and her pattern of thoughts leads right into her habitual story about how she’s hopeless and so fat that no one could ever love her. Ideally there would just be the awareness that she has eaten ice cream without the subsequent judgments. She would then accept that she chose to eat ice cream without any denial, guilt, or resistance. This may not have been the best decision that she could have made given her diet, but she doesn’t have to torment herself over it. She can accept and learn from what she has done and act accordingly in the future. However, as you now know, it is the nature of the mind to compare every event to a personal belief system. If Mika could bring mindfulness to her situation, she would be aware of the mental, emotional, and physical responses and just accept the judgment and anger without needing to deny it or to be totally swept away by it. Mindfulness: A Technique to Deal with Stress • 47 It requires a lot of mental energy to either suppress an event or actively seek after it. In fact, when you actively try to suppress a mental state, it usually gives it more energy to return and persevere. Mindfulness can help you to simply be aware, that is to stay present, to the anger, frustration, or hopelessness that may arise as a consequence of a decision, without encouraging these emotions any further. When you’re present in the moment to what you’re experiencing, you’re calm and accepting. You may not like what you’re experiencing, but how can you change what has already happened? The action of eating ice cream may not have been Mika’s best choice under the circumstances, but this doesn’t make her unlovable! The action may not have been the best decision, but it doesn’t make her a bad person either. The practice of mindfulness stops habitual thought patterns in their tracks whenever you choose to apply it. You’ll practice just accepting whatever arises, whether it’s the initial event, or the automatic judgments that sneak in before you can refocus your awareness again on the present. Non-Attachment and Non-Identifcation: Letting Go of the Velcro Mind When you say to yourself, “I am angry,” or “I am hurt,” or “I am sad,” you’re personalizing your experience. If you can 48 • Mindfulness Medication learn to describe your emotions with the phrases “now anger,” “now pain,” “now sadness,” you’re distancing yourself by just labeling a generic mental state, an emotion, or a physical sensation. In a way, you’re gaining some much-needed perspective, so that you can stand back a bit. Recall that thoughts pop up and vanish just as quickly, but when you latch on to them and stick them into a pattern of storytelling, emotions are triggered. The mind likes to attach new experiences to memories of previous ones and to personally identify with what’s occurring. If you can start to take the “I” out of things, you will be practicing what mindfulness describes as non-identification and non-attachment. Think of an emotion that you experience as not ‘your’ emotion per se but just as ‘an emotion’, a mental state that has developed and can just as easily go away. The experience just becomes a little less sticky and your Velcro Mind, which likes to grab and hold onto things, can let go a bit.

Asking residents about adverse events in a computer dialogue: how accurate are they? Utilizing information technology on patient care rounds to enhance pharmacist effectiveness order 50gm beloc overnight delivery. Diffusion of pharmacist interventions within the framework of clinical pharmacy activity in the clinical ward buy 50gm beloc amex. Drug supply chain safety in hospitals: current data and experience of the Grenoble university hospital order 50gm beloc. A computerized system for identifying and informing physicians about problematic drug use in nursing homes. Individualised aminoglycoside dosage based on pharmacokinetic analysis is superior to dosage based on physician intuition at achieving target plasma drug concentrations. Use of hospital prescribing data to monitor the implementation of clinical guidelines. A conceptual framework for evaluating outpatient electronic prescribing systems based on their functional capabilities. Management of patients with diabetes through information technology: tools for monitoring and control of the patients’ metabolic behavior. Reducing medication errors and increasing patient safety: case studies in clinical pharmacology. A computerised prescribing decision support system to improve patient adherence with prescribing. Computerised reminders and feedback in medication management: a systematic review of randomised controlled trials. Evaluation of the quality of drug therapy among elderly patients in nursing homes. Evaluation of a newly implemented once-daily aminoglycoside dosing and monitoring program. Use of antibiotics at hospitals in Stockholm: A benchmarking project using internet. A novel point-of-care information system reduces anaesthesiologists’ errors while managing case scenarios. Economical impact of an automated dispensing system in the emergency ward of a general hospital. Opinion survey about the correct use of an automated dispensing machine in the emergency ward of a general hospital. Analysis of failures detected during the medication-dispensing process and their contributing factors. Implementation of an integrated instrument control and data management system for point of care blood gas testing. Data quality in the outpatient setting: impact on clinical decision support systems. Journal of Pharmaceutical Finance, Economics and Policy 2007;15(3): Database: Embase Sept 22-09. Use of telepharmacy technology offers potential for improved financial management. What do patients want to know: An empirical approach to explanation generation and validation. Prevention of adverse drug reactions in intensive care patients by personal intervention based on an electronic clinical decision support system. Cognitive analysis of physicians and nurses cooperation in the medication ordering and administration process. Drug-related problems and adverse drug events: negligence, litigation and prevention. Physicians’ resistance toward healthcare information technology: A theoretical model and empirical test. Establishing user requirements for a patient held electronic record system in the United Kingdom. The impact of the electronic health record on patient safety: an Alberta perspective. Conversion of conventional human insulin vials to analog insulin pens in a community hospital. Proceedings - the Annual Symposium on Computer Applications in Medical Care 1995;17-21. Patient safety in emergency situations: A Web-based pediatric arrest medication calculator. Journal for Healthcare Quality: Promoting Excellence in Healthcare 2006;28(2):27-31. Implementation and evaluation of a pharmacy- based computer-assisted antimicrobial surveillance service. The anesthesia information management system for electronic documentation: What are we waiting for? Measuring international normalized ratios in long-term care: a comparison of commercial laboratory and point-of-care device results. Viewpoint: Controversies surrounding use of order sets for clinical decision support in computerized provider order entry. The feasibility of implementing an electronic prescribing decision support system: a case study of an Australian public hospital. The effect of home monitoring and telemanagement on blood pressure control among African Americans. Frequency of and intervention against errors in documentation and dispensing of drugs.