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Paradoxical Embolism
An embolus, is described as a free-floating mass, located inside blood vessels that can travel from one site in the blood stream to another. An embolus can be made up of solid (like a blood clot), liquid (like amniotic fluid), or gas (like air). Once these masses get "stuck" in a different blood vessel, it is then known as an "embolism." An embolism can cause ischemia—damage to an organ from lack of oxygen. A paradoxical embolism is a specific type of embolism in which the embolus travels from the right side of the heart (venous circulation) to the left side of the heart (arterial circulation) and lodges itself in a blood vessel known as an artery. It is termed "paradoxical" because venous emboli will usually be lodged in pulmonary artery in an event called pulmonary embolism, instead of systemic circulation. Pathophysiology An embolism may be made from any one of numerous materials that may find itself in a blood vessel, including a piece of a thrombus, known as a thromboembo ...
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Embolus
An embolus (; : emboli; from the Greek ἔμβολος "wedge", "plug") is an unattached mass that travels through the circulatory system, bloodstream and is capable of creating blockages. When an embolus Vascular occlusion, occludes a blood vessel, it is called an embolism or embolic event. There are a number of different types of emboli, including blood clots, cholesterol plaque or crystals, Fat embolism syndrome, fat globules, Air embolism, gas bubbles, and foreign body, foreign bodies, which can result in different types of embolisms. The term is distinct from embolism and thromboembolism, which may be consequences of an embolus, as discussed below. The term was coined in 1848 by Rudolf Virchow as part of his foundational research into Thrombus, blood clots. Nomenclature The term embolus refers generally to any free-floating mass in the bloodstream, or such a mass once lodged at a site of blockage. A related term is embolism, which describes the phenomenon of an embolus lo ...
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Cerebral Arteries
The cerebral arteries describe three main pairs of artery, arteries and their branches, which perfusion, perfuse the cerebrum of the brain. The three main arteries are the: * ''Anterior cerebral artery'' (ACA), which supplies blood to the medial portion of the brain, including the superior parts of the Frontal lobe, frontal and anterior Parietal lobe, parietal lobes * ''Middle cerebral artery'' (MCA), which supplies blood to the majority of the lateral portion of the brain, including the Temporal lobe, temporal and lateral-parietal lobes. It is the largest of the cerebral arteries and is often affected in strokes * ''Posterior cerebral artery'' (PCA), which supplies blood to the posterior portion of the brain, including the occipital lobe, thalamus, and midbrain Both the ACA and MCA originate from the cerebral portion of internal carotid artery, while PCA branches from the intersection of the posterior communicating artery and the anterior portion of the basilar artery. The three p ...
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Vascular Diseases
Vascular disease is a class of diseases of the vessels of the circulatory system in the human body, body, including blood vessels – the arteries and veins, and the lymphatic vessels. Vascular disease is a subgroup of cardiovascular disease. Disorders in this vast network of blood and lymph vessels can cause a range of health problems that can sometimes become severe, and fatal. Coronary heart disease for example, is the leading cause of death for men and women in the United States. Types There are several types of vascular disease, including venous diseases, and arterial diseases, and signs and symptoms vary depending on the disease. Those of the arterial system are associated with blood supply to tissues and its obstruction due to blockages or narrowing. In the venous system disorders are often caused by a slow return of blood due to insufficient valves, or to a thrombus, blood clot. Venous disease Most disorders of the veins involve obstruction such as a thrombus or insuffici ...
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Fluoroscopy
Fluoroscopy (), informally referred to as "fluoro", is an imaging technique that uses X-rays to obtain real-time moving images of the interior of an object. In its primary application of medical imaging, a fluoroscope () allows a surgeon to see the internal anatomy, structure and physiology, function of a patient, so that the pumping action of the heart or the motion of swallowing, for example, can be watched. This is useful for both medical diagnosis, diagnosis and therapy and occurs in general radiology, interventional radiology, and image-guided surgery. In its simplest form, a fluoroscope consists of an X-ray generator, X-ray source and a fluorescence, fluorescent screen, between which a patient is placed. However, since the 1950s most fluoroscopes have included X-ray image intensifiers and cameras as well, to improve the image's visibility and make it available on a remote display screen. For many decades, fluoroscopy tended to produce live pictures that were not recorded, bu ...
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Middle Cerebral Artery
The middle cerebral artery (MCA) is one of the three major paired cerebral artery, cerebral arteries that supply blood to the cerebrum. The MCA arises from the internal carotid artery and continues into the lateral sulcus where it then branches and projects to many parts of the lateral cerebral cortex. It also supplies blood to the anterior temporal lobes and the insular cortex, insular cortices. The left and right MCAs rise from trifurcations of the internal carotid artery, internal carotid arteries and thus are connected to the anterior cerebral artery, anterior cerebral arteries and the posterior communicating artery, posterior communicating arteries, which connect to the posterior cerebral artery, posterior cerebral arteries. The MCAs are not considered a part of the Circle of Willis. Structure The middle cerebral artery divides into four segments, named by the region they supply as opposed to order of branching as the latter can be somewhat variable: *M1: The ''sphenoidal' ...
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Valsalva Maneuver
The Valsalva maneuver is performed by a forceful attempt of exhalation against a closed airway, usually done by closing one's mouth and pinching one's nose shut while expelling air, as if blowing up a balloon. Variations of the maneuver can be used either in medicine, medical examination as a test of cardiac function and autonomic nervous system, autonomic nervous control of the heart (because the maneuver raises the pressure in the lungs), or to clear the ears and paranasal sinuses, sinuses (that is, to equalize pressure between them) when ambient pressure changes, as in scuba diving, hyperbaric oxygen therapy, or air travel. A modified version is done by expiring against a closed glottis. This will elicit the cardiovascular responses described below but will not force air into the Eustachian tubes. History The technique is named after Antonio Maria Valsalva, a 17th-century physician and anatomist from Bologna whose principal scientific interest was the human ear. He descri ...
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Electrocardiography
Electrocardiography is the process of producing an electrocardiogram (ECG or EKG), a recording of the heart's electrical activity through repeated cardiac cycles. It is an electrogram of the heart which is a graph of voltage versus time of the electrical activity of the heart using electrodes placed on the skin. These electrodes detect the small electrical changes that are a consequence of cardiac muscle depolarization followed by repolarization during each cardiac cycle (heartbeat). Changes in the normal ECG pattern occur in numerous cardiac abnormalities, including: * Cardiac rhythmicity, Cardiac rhythm disturbances, such as atrial fibrillation and ventricular tachycardia; * Inadequate coronary artery blood flow, such as myocardial ischemia and myocardial infarction; * and electrolyte disturbances, such as hypokalemia. Traditionally, "ECG" usually means a 12-lead ECG taken while lying down as discussed below. However, other devices can record the electrical activity of ...
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Platelet
Platelets or thrombocytes () are a part of blood whose function (along with the coagulation#Coagulation factors, coagulation factors) is to react to bleeding from blood vessel injury by clumping to form a thrombus, blood clot. Platelets have no cell nucleus; they are fragments of cytoplasm from megakaryocytes which reside in bone marrow or Lung, lung tissue, and then enter the circulation. Platelets are found only in mammals, whereas in other vertebrates (e.g. birds, amphibians), thrombocytes circulate as intact agranulocyte, mononuclear cells. One major function of platelets is to contribute to hemostasis: the process of stopping bleeding at the site where the lining of vessels (endothelium) has been interrupted. Platelets gather at the site and, unless the interruption is physically too large, they plug the hole. First, platelets attach to substances outside the interrupted endothelium: ''adhesion (medicine), adhesion''. Second, they change shape, turn on receptors and secret ...
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Nail Clubbing
Nail clubbing, also known as digital clubbing or clubbing, is a deformity of the finger or toe Nail (anatomy), nails associated with a number of diseases, anomalies and defects, some congenital, mostly of the heart disease, heart and lung disease, lungs.Freedberg, et al. (2003). ''Fitzpatrick's Dermatology in General Medicine''. (6th ed.). McGraw-Hill. . When it occurs together with joint effusions, joint pains, and abnormal skin and bone growth it is known as hypertrophic osteoarthropathy. Clubbing is associated with lung cancer, lung infections, interstitial lung disease, cystic fibrosis, or cardiovascular disease. Clubbing may also run in families, and occur unassociated with other medical problems. Clubbing has been recognized as a sign of disease since the time of Hippocrates. Causes Clubbing is associated with * Lung disease: ** Lung cancer ** Interstitial lung disease most commonly idiopathic pulmonary fibrosis ** Complicated tuberculosis ** Suppurative lung disease: ...
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Coronary Arteries
The coronary arteries are the arteries, arterial blood vessels of coronary circulation, which transport oxygenated blood to the Cardiac muscle, heart muscle. The heart requires a continuous supply of oxygen to function and survive, much like any other tissue or organ of the body. The coronary arteries wrap around the entire heart. The two main branches are the left coronary artery and right coronary artery. The arteries can additionally be categorized based on the area of the heart for which they provide circulation. These categories are called ''epicardial'' (above the epicardium, or the outermost tissue of the heart) and ''microvascular'' (close to the endocardium, or the innermost tissue of the heart). Reduced function of the coronary arteries can lead to decreased flow of oxygen and nutrients to the heart. Not only does this affect supply to the heart muscle itself, but it also can affect the ability of the heart to pump blood throughout the body. Therefore, any disorder or d ...
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Myocardial Infarction
A myocardial infarction (MI), commonly known as a heart attack, occurs when Ischemia, blood flow decreases or stops in one of the coronary arteries of the heart, causing infarction (tissue death) to the heart muscle. The most common symptom is retrosternal Angina, chest pain or discomfort that classically radiates to the left shoulder, arm, or jaw. The pain may occasionally feel like heartburn. This is the dangerous type of acute coronary syndrome. Other symptoms may include shortness of breath, nausea, presyncope, feeling faint, a diaphoresis, cold sweat, Fatigue, feeling tired, and decreased level of consciousness. About 30% of people have atypical symptoms. Women more often present without chest pain and instead have neck pain, arm pain or feel tired. Among those over 75 years old, about 5% have had an MI with little or no history of symptoms. An MI may cause heart failure, an Cardiac arrhythmia, irregular heartbeat, cardiogenic shock or cardiac arrest. Most MIs occur d ...
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Ischemia
Ischemia or ischaemia is a restriction in blood supply to any tissue, muscle group, or organ of the body, causing a shortage of oxygen that is needed for cellular metabolism (to keep tissue alive). Ischemia is generally caused by problems with blood vessels, with resultant damage to or dysfunction of tissue, i.e., hypoxia and microvascular dysfunction. It also implies local hypoxia in a part of a body resulting from constriction (such as vasoconstriction, thrombosis, or embolism). Ischemia causes not only insufficiency of oxygen but also reduced availability of nutrients and inadequate removal of metabolic wastes. Ischemia can be partial (poor perfusion) or total blockage. The inadequate delivery of oxygenated blood to the organs must be resolved either by treating the cause of the inadequate delivery or reducing the oxygen demand of the system that needs it. For example, patients with myocardial ischemia have a decreased blood flow to the heart and are prescribe ...
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