Tracheostoma
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Tracheostoma
Tracheotomy (, ), or tracheostomy, is a surgical airway management procedure which consists of making an incision on the front of the neck to open a direct airway to the trachea. The resulting stoma (hole) can serve independently as an airway or as a site for a tracheal tube (or tracheostomy tube) to be inserted; this tube allows a person to breathe without the use of the nose or mouth. Etymology and terminology The etymology of the word ''tracheotomy'' comes from two Greek words: the root ''tom-'' (from Greek τομή ''tomḗ'') meaning "to cut", and the word ''trachea'' (from Greek τραχεία ''tracheía''). The word ''tracheostomy'', including the root ''stom-'' (from Greek στόμα ''stóma'') meaning "mouth", refers to the making of a semi-permanent or permanent opening and to the opening itself. Some sources offer different definitions of the above terms. Part of the ambiguity is due to the uncertainty of the intended permanence of the stoma (hole) at the time it ...
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Vocal Folds
In humans, the vocal cords, also known as vocal folds, are folds of throat tissues that are key in creating sounds through Speech, vocalization. The length of the vocal cords affects the pitch of voice, similar to a violin string. Open when breathing and vibrating for speech or singing, the folds are controlled via the recurrent laryngeal nerve, recurrent laryngeal branch of the vagus nerve. They are composed of twin infoldings of mucous membrane stretched horizontally, from back to front, across the larynx. They vibration, vibrate, modulating the flow of air being expelled from the lungs during phonation. The 'true vocal cords' are distinguished from the 'false vocal folds', known as vestibular folds or ''ventricular folds'', which sit slightly superior to the more delicate true folds. These have a minimal role in normal phonation, but can produce deep sonorous tones, screams and growls. The length of the vocal fold at birth is approximately six to eight millimeters and grows t ...
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Branchial Cleft Cyst
A branchial cleft cyst or simply branchial cyst is a cyst as a swelling in the upper part of neck anterior to sternocleidomastoid. It can, but does not necessarily, have an opening to the skin surface, called a fistula. The cause is usually a developmental abnormality arising in the early prenatal period, typically failure of obliteration of the second, third, and fourth pharyngeal groove, branchial cleft, i.e. failure of fusion of the second pharyngeal arch, branchial arches and epicardial ridge in lower part of the neck. Branchial cleft cysts account for almost 20% of neck masses in children. Less commonly, the cysts can develop from the first, third, or fourth clefts, and their location and the location of associated fistulas differs accordingly. Symptoms and signs Most branchial cleft cysts present in late childhood or early adulthood as a solitary, painless mass, which went previously unnoticed, that has now become Infection, infected (typically after an upper respiratory tract ...
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Uvulopalatopharyngoplasty
Uvulopalatopharyngoplasty (abbreviated as UPPP or UP3) is a type of sleep surgery, which are surgical procedures for sleep-related breathing disorders, especially obstructive sleep apnea (OSA). Uvulopalatopharyngoplasty involves removal and/or remodeling of tissues in the throat in order to prevent obstruction of the airway during sleep. Tissues which may typically be removed include the paryngeal tonsils and the adenoid tonsil. Tissues which may typically be remodeled include the uvula (see uvulotomy), the soft palate, and parts of the pharynx. UPPP is the most common surgical procedure performed for OSA. Background OSA is one of the most common types of sleep-related breathing disorder. It involves obstruction of the upper airway during sleep. Loud snoring and apnea (periods of no breathing) followed by gasping and choking are signs of the condition. The main treatment is continuous positive airway pressure and a range of other measures such sleeping on the side and mandibular a ...
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Continuous Positive Airway Pressure
Continuous positive airway pressure (CPAP) is a form of positive airway pressure (PAP) ventilation in which a constant level of pressure greater than atmospheric pressure is continuously applied to the upper respiratory tract of a person. The application of positive pressure may be intended to prevent upper airway collapse, as occurs in obstructive sleep apnea (OSA), or to reduce the work of breathing in conditions such as acute decompensated heart failure. CPAP therapy is highly effective for managing obstructive sleep apnea. Compliance and acceptance of use of CPAP therapy can be a limiting factor, with 8% of people stopping use after the first night and 50% within the first year. Medical uses Moderate to severe obstructive sleep apnea CPAP is the most effective treatment for moderate to severe obstructive sleep apnea, in which the mild pressure from the CPAP prevents the airway from collapsing or becoming blocked. CPAP has been shown to be 100% effective at eliminating ...
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Obstructive Sleep Apnea
Obstructive sleep apnea (OSA) is the most common sleep-related breathing disorder and is characterized by recurrent episodes of complete or partial airway obstruction, obstruction of the respiratory tract#Upper respiratory tract, upper airway leading to reduced or absent breathing during sleep. These episodes are termed "apneas" with complete or near-complete cessation of breathing, or "hypopneas" when the reduction in breathing is partial. In either case, a fall in oxygen saturation (medicine), blood oxygen saturation, a disruption in sleep, or both, may result. A high frequency of apneas or hypopneas during sleep may interfere with the quality of sleep, whichin combination with disturbances in blood oxygenationis thought to contribute to negative consequences to health and quality of life. The terms obstructive sleep apnea syndrome (OSAS) or obstructive sleep apnea–hypopnea syndrome (OSAHS) may be used to refer to OSA when it is associated with symptoms during the daytime (e.g. ...
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Intensive Care Unit
An intensive care unit (ICU), also known as an intensive therapy unit or intensive treatment unit (ITU) or critical care unit (CCU), is a special department of a hospital or health care facility that provides intensive care medicine. An intensive care unit (ICU) was defined by the task force of the World Federation of Societies of Intensive and Critical Care Medicine as "an organized system for the provision of care to critically ill patients that provides intensive and specialized medical and nursing care, an enhanced capacity for monitoring, and multiple modalities of physiologic organ support to sustain life during a period of life-threatening organ system insufficiency." Patients may be referred directly from an emergency department or from a ward if they rapidly deteriorate, or immediately after surgery if the surgery is very invasive and the patient is at high risk of complications. History In 1854, Florence Nightingale left for the Crimean War, where triage was used ...
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Antihypotensive Agent
An antihypotensive, also known as a vasopressor, is an agent that raises blood pressure by constricting blood vessels, thereby increasing systemic vascular resistance. This is different from inotropes which increase the force of cardiac contraction. Some substances do both (e.g. dopamine, dobutamine). If low blood pressure is due to blood loss, then preparations increasing volume of blood circulation—plasma-substituting solutions such as colloid and crystalloid solutions (salt solutions)—will raise the blood pressure without any direct vasopressor activity. Packed red blood cells, plasma or whole blood should not be used solely for volume expansion or to increase oncotic pressure of circulating blood. Blood products should only be used if reduced oxygen carrying capacity or coagulopathy is present. Other causes of either absolute (dehydration, loss of plasma via wound/burns) or relative ( third space losses) vascular volume depletion also respond, although blood products a ...
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Sedative
A sedative or tranquilliser is a substance that induces sedation by reducing irritability or Psychomotor agitation, excitement. They are central nervous system (CNS) Depressant, depressants and interact with brain activity, causing its deceleration. Various kinds of sedatives can be distinguished, but the majority of them affect the neurotransmitter Gamma-Aminobutyric acid, gamma-aminobutyric acid (GABA). Most sedatives produce relaxing effects by increasing GABA activity. This group is related to hypnotics. The term ''sedative'' describes drugs that serve to calm or Anxiolytic, relieve anxiety, whereas the term ''hypnotic'' describes drugs whose main purpose is to initiate, sustain, or lengthen sleep. Because these two functions frequently overlap, and because drugs in this class generally produce dose-dependent effects (ranging from anxiolysis to loss of consciousness), they are often referred to collectively as ''sedative–hypnotic'' drugs. Terminology There is some overlap ...
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Coma
A coma is a deep state of prolonged unconsciousness in which a person cannot be awakened, fails to Nociception, respond normally to Pain, painful stimuli, light, or sound, lacks a normal Circadian rhythm, sleep-wake cycle and does not initiate voluntary actions. The person may experience respiratory and circulatory problems due to the body's inability to maintain normal bodily functions. People in a coma often require extensive medical care to maintain their health and prevent complications such as pneumonia or blood clots. Coma patients exhibit a complete absence of wakefulness and are unable to consciously feel, speak or move. Comas can be the result of natural causes, or can be Induced coma, medically induced, for example, during General anaesthesia, general anesthesia. Clinically, a coma can be defined as the consistent inability to follow a one-step command. For a patient to maintain consciousness, the components of ''wakefulness'' and ''awareness'' must be maintained. Wak ...
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Pulmonary Toilet
Pulmonary hygiene, also referred to as pulmonary toilet, is a set of methods used to clear mucus and secretions from the airways. The word ''pulmonary'' refers to the lungs. The word ''toilet'', related to the French ''toilette'', refers to body care and hygiene; this root is used in words such as ''toiletry'' that also relate to cleansing. Respiratory health (pulmonary hygiene) depends on consistent clearance of airway secretions. Normal airway clearance is accomplished by two important mechanisms: the mucociliary clearance system and the ability to cough. Impaired mucociliary clearance is linked to poor lung function in a broad range of diseases and disabilities. Pulmonary hygiene prevents atelectasis (the collapse of the alveoli of the lungs) and rids the respiratory system of secretions, which could cause respiratory infections. It can also decrease pulmonary shunting, increase the functional reserve capacity of the lungs, and prevent respiratory infection after chest trau ...
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VIP Bird2
A very important person (VIP or V.I.P.) or personage is a person who is accorded special privileges due to their high social rank, status, influence, or importance. The term was not common until sometime after World War II when it was popularised by Royal Air Force pilots. Examples include celebrities, heads of state or government, other high-ranking politicians, or any other socially notable person who receives special treatment for any reason. The special treatment usually involves separation from common people, and a higher level of comfort or service. Commerce In some cases, such as with tickets, VIP may be used as a title in a similar way to ''premium'' or ''exclusive.'' Usually in airports, VIP tickets can be purchased by anyone, but still meaning separation from other customers, own security checks etc. VIP airport terminals may be used by foreign ministers, ambassadors or high-ranking government personalities, provided that they are officially invited by the receivi ...
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Cricothyrotomy
A cricothyrotomy (also called cricothyroidotomy or laryngotomy) is a medical procedure where an opening is created through the cricothyroid membrane to establish a patent airway during emergency airway management. Cricothyrotomy is primarily performed as the last step in airway management algorithms in cases where an airway cannot be established by other means of nasal or oral tracheal intubation. These situations, often referred to as "cannot intubate, cannot ventilate" (CICV) or "cannot intubate, cannot oxygenate" (CICO), are commonly seen as a result of airway obstruction, angioedema, trauma, burns, or abnormal anatomy. Multiple types of cricothyrotomy may be considered for emergency surgical airway management, including surgical cricothyrotomy and needle cricothyrotomy. Surgical cricothyrotomy is performed by inserting a large-bore tube through an opening in the cricothyroid membrane created via incision or using the Seldinger technique. Needle cricothyrotomy is performed by ...
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