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Non-freezing Cold Injury
Non-freezing cold injuries (NFCI) is a class of tissue damage caused by sustained exposure to low temperature without actual freezing. There are several forms of NFCI, and the common names may refer to the circumstances in which they commonly occur or were first described, such as trench foot, which was named after its association with trench warfare. NFCI is caused by microvascular endothelial damage, stasis and vascular occlusion and is characterised by peripheral neuropathy. NFCI generally affects the hands or feet during exposure to temperatures just above freezing, often wet, and is typically found in soldiers. Development may be gradual, and it may be difficult to recognise and treat. Initially the affected area is cold and numb, but this changes to hyperemia (changes to blood flow) within a day or two, along with an intense, painful, burning sensation, blisters, redness, and in some cases ulceration. It may have lifelong effects, including numbness, paraesthesia, and chroni ...
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Freezing
Freezing is a phase transition where a liquid turns into a solid when its temperature is lowered below its freezing point. In accordance with the internationally established definition, freezing means the solidification phase change of a liquid or the liquid content of a substance, usually due to cooling. For most substances, the melting and freezing points are the same temperature; however, certain substances possess differing solid-liquid transition temperatures. For example, agar displays a hysteresis in its melting point and freezing point. It melts at 85 °C (185 °F) and solidifies from 32 °C to 40 °C (89.6 °F to 104 °F). Crystallization Most liquids freeze by crystallization, formation of crystalline solid from the uniform liquid. This is a first-order thermodynamic phase transition, which means that as long as solid and liquid coexist, the temperature of the whole system remains very nearly equal to the melting point due to the slow re ...
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Decompression Sickness
Decompression sickness (abbreviated DCS; also called divers' disease, the bends, aerobullosis, and caisson disease) is a medical condition caused by dissolved gases emerging from solution as bubbles inside the body tissues during decompression. DCS most commonly occurs during or soon after a decompression ascent from underwater diving, but can also result from other causes of depressurisation, such as emerging from a caisson, decompression from saturation, flying in an unpressurised aircraft at high altitude, and extravehicular activity from spacecraft. DCS and arterial gas embolism are collectively referred to as decompression illness. Since bubbles can form in or migrate to any part of the body, DCS can produce many symptoms, and its effects may vary from joint pain and rashes to paralysis and death. DCS often causes air bubbles to settle in major joints like knees or elbows, causing individuals to bend over in excruciating pain, hence its common name, the bends. In ...
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Cyanosis
Cyanosis is the change of body tissue color to a bluish-purple hue as a result of having decreased amounts of oxygen bound to the hemoglobin in the red blood cells of the capillary bed. Body tissues that show cyanosis are usually in locations where the skin is thinner, including the mucous membranes, lips, nail beds, and ear lobes. Some medications containing amiodarone or silver, Mongolian spots, large birth marks, and the consumption of food products with blue or purple dyes can also result in the bluish skin tissue discoloration and may be mistaken for cyanosis. Cyanosis is further classified into central cyanosis vs. peripheral cyanosis. Pathophysiology The mechanism behind cyanosis is different depending on whether it is central or peripheral. Central cyanosis Central cyanosis is caused by a decrease in arterial oxygen saturation (SaO2) and begins to show once the concentration of deoxyhemoglobin in the blood reaches a concentration of ≥ 5.0 g/dL (≥ 3.1 mmol/L ...
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Gait (human)
A gait is a pattern of limb movements made during locomotion. Human gaits are the various ways in which humans can move, either naturally or as a result of specialized training. Human gait is defined as bipedal, biphasic forward propulsion of the center of gravity of the human body, in which there are alternate sinuous movements of different segments of the body with least expenditure of energy. Gait patterns are characterized by differences in limb-movement patterns, overall velocity, forces, kinetic and potential energy cycles, and changes in contact with the ground. Classification Human gaits are classified in various ways. Each gait can be generally categorized as either natural (one that humans use instinctively) or trained (a non-instinctive gait learned via training). Examples of the latter include hand walking and specialized gaits used in martial arts. Gaits can also be categorized according to whether the person remains in continuous contact with the ground. ...
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Proprioception
Proprioception ( ), also referred to as kinaesthesia (or kinesthesia), is the sense of self-movement, force, and body position. It is sometimes described as the "sixth sense". Proprioception is mediated by proprioceptors, mechanosensory neurons located within muscles, tendons, and joints. Most animals possess multiple subtypes of proprioceptors, which detect distinct kinematic parameters, such as joint position, movement, and load. Although all mobile animals possess proprioceptors, the structure of the sensory organs can vary across species. Proprioceptive signals are transmitted to the central nervous system, where they are integrated with information from other sensory systems, such as the visual system and the vestibular system, to create an overall representation of body position, movement, and acceleration. In many animals, sensory feedback from proprioceptors is essential for stabilizing body posture and coordinating body movement. System overview In vertebrates, limb ...
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Perfusion
Perfusion is the passage of fluid through the circulatory system or lymphatic system to an organ or a tissue, usually referring to the delivery of blood to a capillary bed in tissue. Perfusion is measured as the rate at which blood is delivered to tissue, or volume of blood per unit time (blood flow) per unit tissue mass. The SI unit is m3/(s·kg), although for human organs perfusion is typically reported in ml/min/g. The word is derived from the French verb "perfuser" meaning to "pour over or through". All animal tissues require an adequate blood supply for health and life. Poor perfusion (malperfusion), that is, ischemia, causes health problems, as seen in cardiovascular disease, including coronary artery disease, cerebrovascular disease, peripheral artery disease, and many other conditions. Tests verifying that adequate perfusion exists are a part of a patient's assessment process that are performed by medical or emergency personnel. The most common methods include ev ...
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Immersion Foot
Immersion foot syndromes are a class of foot injury caused by water absorption in the outer layer of skin. There are different subclass names for this condition based on the temperature of the water to which the foot is exposed. These include trench foot, tropical immersion foot, and warm water immersion foot. In one 3-day military study, it was found that submersion in water allowing for a higher skin temperature resulted in worse skin maceration and pain. Causes Trench foot ''Trench foot '' is a medical condition caused by prolonged exposure of the feet to damp, unsanitary, and cold conditions. The use of the word ''trench'' in the name of this condition is a reference to trench warfare, mainly associated with World War I. Affected feet may become numb, affected by erythrosis (turning red) or cyanosis (turning blue) as a result of poor vascular supply, and feet may begin to have a decaying odour due to the possibility of the early stages of necrosis setting in. As the condi ...
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Trench Foot
Trench foot is a type of foot damage due to moisture. Initial symptoms often include tingling or itching which can progress to numbness. The feet may become red or bluish in color. As the condition worsens the feet can start to swell and smell of decay. Complications may include skin breakdown or infection. Trench foot occurs due to prolonged exposure of the feet to cold, damp, and often unsanitary conditions. Unlike frostbite, trench foot usually occurs at temperatures above freezing, and can be classed as a form of non-freezing cold injury. Onset can be as rapid as 10 hours. Risk factors include overly tight boots and not moving. The underlying mechanism is believed to involve constriction of blood vessels resulting in insufficient blood flow to the feet. Diagnosis is based on symptoms and examination. Prevention involves keeping the feet warm, dry, and clean. After the condition has occurred, pain medications may be required during the gradual rewarming process. Pain ...
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Frostbite
Frostbite is a skin injury that occurs when exposed to extreme low temperatures, causing the freezing of the skin or other tissues, commonly affecting the fingers, toes, nose, ears, cheeks and chin areas. Most often, frostbite occurs in the hands and feet. The initial symptoms are typically a feeling of cold and tingling or numbing. This may be followed by clumsiness with a white or bluish color to the skin. Swelling or blistering may occur following treatment. Complications may include hypothermia or compartment syndrome. People who are exposed to low temperatures for prolonged periods, such as winter sports enthusiasts, military personnel, and homeless individuals, are at greatest risk. Other risk factors include drinking alcohol, smoking, mental health problems, certain medications, and prior injuries due to cold. The underlying mechanism involves injury from ice crystals and blood clots in small blood vessels following thawing. Diagnosis is based on symptoms. Severity ma ...
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Hypothermia
Hypothermia is defined as a body core temperature below in humans. Symptoms depend on the temperature. In mild hypothermia, there is shivering and mental confusion. In moderate hypothermia, shivering stops and confusion increases. In severe hypothermia, there may be hallucinations and #Paradoxical undressing, paradoxical undressing, in which a person removes their clothing, as well as an increased risk of the cardiac arrest, heart stopping. Hypothermia has two main types of causes. It classically occurs from exposure to cold weather and cold water immersion. It may also occur from any condition that decreases heat production or increases heat loss. Commonly, this includes alcohol intoxication but may also include hypoglycemia, low blood sugar, anorexia nervosa, anorexia and advanced age. Human body temperature, Body temperature is usually maintained near a constant level of through thermoregulation. Efforts to increase body temperature involve shivering, increased voluntary ...
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Systemic Disease
A systemic disease is one that affects a number of organs and tissues, or affects the body as a whole. Examples * Mastocytosis, including mast cell activation syndrome and eosinophilic esophagitis * Chronic fatigue syndrome * Systemic vasculitis e.g. SLE, PAN * Sarcoidosis – a disease that mainly affects the lungs, brain, joints and eyes, found most often in young African-American women. * Hypothyroidism – where the thyroid gland produces too little thyroid hormones. * Diabetes mellitus – an imbalance in blood glucose (sugar) levels. * Fibromyalgia * Adrenal insufficiency – where the adrenal glands don't produce enough steroid hormones * Coeliac disease – an autoimmune disease triggered by gluten consumption, which may involve several organs and cause a variety of symptoms, or be completely asymptomatic. * Ulcerative colitis – an inflammatory bowel disease * Crohn's disease – an inflammatory bowel disease * Hypertension (high blood pressure) * Metab ...
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Localized Disease
A localized disease is an infectious or neoplastic process that originates in and is confined to one organ system or general area in the body,Dorland's Illustrated Medical Dictionary,28th edition. W.B.Saunders, Harcourt Brace & Company such as a sprained ankle, a boil on the hand, an abscess of finger. A localized cancer that has not extended beyond the margins of the organ involved can also be described as localized disease, while cancers that extend into other tissues are described as invasive. Tumors that are non-hematologic in origin but extend into the bloodstream or lymphatic system are known as metastatic. Localized diseases are contrasted with disseminated diseases and systemic diseases. Some diseases are capable of changing from local to disseminated diseases. Pneumonia, for example, is generally confined to one or both lungs but can become disseminated through sepsis, in which the microorganism responsible for the pneumonia "seeds" the bloodstream or lymphatic syste ...
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