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The patient with acute endocrine problems
Published in Peate Ian, Dutton Helen, Acute Nursing Care, 2020
The thyroid gland is composed of two lobes joined by an isthmus. It is located in the lower part of the neck anterior to the trachea, inferior to the thyroid cartilage (see Figure 11.3) and has an extensive arterial blood supply. When viewed under the microscope, the thyroid gland is composed of closely packed follicles which comprise epithelial cells enclosing a colloid-filled space. These functional units synthesise, store and secrete thyroid hormones. Thyroid cells form the wall of each follicle, and these cells enlarge as their metabolic activity increases. This accounts for the gland becoming visible (goitre) in certain thyroid disorders. In addition to supporting cells, the thyroid also contains C cells which synthesise calcitonin.
Thorax
Published in Bobby Krishnachetty, Abdul Syed, Harriet Scott, Applied Anatomy for the FRCA, 2020
Bobby Krishnachetty, Abdul Syed, Harriet Scott
The right lung is divided into three lobes by the oblique and horizontal fissures whilst the left has two lobes formed by the oblique fissure. Oblique fissure – divides the lower lobe from the upper and middle lobesPosteriorly – starts at T5 vertebral body, then follows the direction of the fifth ribAnteriorly – ends at sixth costochondral junction (T5 → 5th rib → 6th CC junction)Horizontal fissure – delineates the upper and middle lobeAnteriorly – starts at right fourth costochondral junction and runs transversely backwards and meets the oblique fissure in the midaxillary line at the level of the fifth rib (4th CC junction → 5th rib)
Neurology
Published in Roy Palmer, Diana Wetherill, Medicine for Lawyers, 2020
The brain is divided into two halves. The cerebral cortex in each half is responsible for motor and sensory function on the opposite side of the body. It sits astride a central, deeply-placed portion of the brain known as the brain stem which, apart from acting as a conduit for the long nerve fibre tracts that pass to and from the spine, also contains a number of important nuclei (nerve relay stations). The cortex is divided into four lobes (on each side): frontal, parietal, occipital, and temporal. The motor cortex, controlling movement, lies at the back of the frontal lobe and, immediately behind it, in front of the parietal lobe, lies the sensory section of the cortex, which is important in the perception of sensation. The primary visual area is at the back of the brain, in the occipital cortex. Speech is in the left hemisphere in right-handed people and half the left-handed population. The frontal lobe has important functions in behaviour and important cognitive ‘executive’ functions (Figure 14.1). The corollary is that focal damage to the brain often produces easily recognizable clinical syndromes.
An Unguarded Tricuspid Valve Orifice Diagnosed by Autopsy
Published in Fetal and Pediatric Pathology, 2023
Xiaoxue Zhou, Ye Zhang, Yihua He
The family chose termination of the pregnancy. Chromosomal malformation and known congenital heart defect genes were excluded. Exploration of organs such as lungs, liver, gallbladder, and appendix confirmed the normal position and development of internal organs on fetal autopsy. The number of lobes in the lungs were two lobes on the left and three lobes on the right. Marked cardiomegaly was due to the dilated RA on fetal autopsy (Fig. 4). The right ventricle and the left-sided chambers were concordant and of normal size. There was a partial absence of tricuspid septal leaflets and tricuspid septal annulus (Fig. 5). Stenotic pulmonary valve, hypoplasia of the main pulmonary artery and branches were found (Fig. 6). An atrial secundum defect (Fig. 7) with an intact interventricular septum was also present. The final diagnosis on autopsy confirmed UTVO, pulmonary valve stenosis, and secundum atrial septal defect.
Clinical features and high-resolution chest computerized tomography findings of children infected by the B.1.617.2 variant of coronavirus disease 2019
Published in Annals of Medicine, 2022
Chuanjun Xu, Mengya Ma, Yongxiang Yi, Changhua Yi, Hui Dai
The different distribution characteristics are shown in Figure 3. Twenty-one cases showed predominantly peripheral distribution on CT images. Extended bronchial bundle distribution (three cases) and central lung band distribution (one case) were other rare distributions. Four cases showed multiple unilateral lesions, 11 cases showed single unilateral lesions and 12 cases showed multiple bilateral lesions. All five anatomical lung lobes were involved, in descending order of frequency of involvement: right lower lung (19 cases), left lower lung (12 cases), left upper lung (11 cases), right upper lung (8 cases) and right middle lung (8 cases). Ten cases showed predominantly lower lung, and among these, eight cases showed both lower lung and peripheral distribution. A summary organized by CT score groups is shown in Table 5. Among the three CT score groups, a CT score of 0–2 accounted for the highest percentage, and the number in the CT score groups decreased as the CT score increased. The mean CT scores of the early, intermediate and late stages did not show much difference, and a relatively flat trend could be seen. The CT scores in the intermediate stage were slightly higher than those in the early and late stages. Correlation analysis of CT scores with laboratory tests showed that some of the laboratory test subitems had a moderate correlation with CT scores, as shown in Figure 5.
‘Hybrid’ Bronchopulmonary Malformation – Lobar Emphysema and Extra Lobar Sequestration
Published in Fetal and Pediatric Pathology, 2022
Thattaruparambil Prakash Vinayak, Suravi Mohanty, Kanishka Das
ILE affects 1 in 20,000 live births and is a massive overinflation of one or more lobes, multiple segments, or on both sides [9]. It typically involves an upper lobe or the right middle lobe. The symptoms are known to worsen over time, as manifested over the first neonatal week in this child [10]. Likewise, the typical imaging characteristics of lobar emphysema became evident after a few days. BPS is a cystic or solid mass composed of nonfunctional pulmonary tissue that does not usually communicate with the tracheobronchial tree and has an anomalous systemic vascular supply from the thoracic/abdominal aorta. It accounts for up to 6% of all congenital lung malformations [11]. The EL-BPS was situated in the left posterior mediastinum below the left lower lobe. Occasionally a non-BPS lesion can have a systemic arterial supply [12]. Similarly, the described BPS may have had an atypical blood supply rather than from the systemic circulation. The sequestered lobe remained camouflaged by the larger, collapsed lower lobe in the vicinity. If the ILE had not been symptomatic, the EL-BPS might have typically remained quiescent for a variable period. Cardiac anomalies are associated with ILE in 15%, dextrocardia has been documented in BPS [13].