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Examination of the abdominal system
Published in Tracy Lapworth, Deborah Cook, Clinical Assessment, 2022
Note The abdomen is defined as the region lying between the thorax above (separated by the diaphragm) and the pelvic cavity below. The abdomen can be divided either into nine portions or simply four quadrants and three regions.
Cranial nerves
Published in Ian Mann, Alastair Noyce, The Finalist’s Guide to Passing the OSCE, 2021
When one examines the field of each individual eye, it is necessary to assess all four quadrants. To do this, instruct the patient to cover one eye, and stare with their other eye into your corresponding eye (i.e. if the patient is covering their left eye, they should stare with their right eye directly into your left eye). Always start with your fingers at the extremes of the visual field, and move your finger in towards the centre. The patient should inform you as soon as they see the finger moving. Compare the patient’s visual field to your own. Central, colour visual fields can also be tested using a red hat pin. Finally, the blind spot may be demonstrated by slowly bringing the hat pin in from a lateral position until the patient loses sight of it. This happens at about 30° from the midline, and it subsequently reappears medially. Blind spot mapping, if done, should also be performed in the vertical plane. Compare the blind spot to your own and note if it appears enlarged.
The immune and lymphatic systems, infection and sepsis
Published in Peate Ian, Dutton Helen, Acute Nursing Care, 2020
Michelle Treacy, Caroline Smales, Helen Dutton
The spleen is located just under the diaphragm in the upper left quadrant of the abdominal cavity, curving around the anterior aspect of the stomach; it is supplied by the splenic artery which enters at the hilus. The main functions of the largest lymphoid organ are: Surveillance for infection;Lymphocyte propagation;Filtering and cleaning of the blood from blood-borne pathogens and toxins;Storage of platelets and removal of ageing, faulty platelets and red blood cells and the extraction and storage of iron for the production of haemoglobin.
Umbilical cord diameter in the prediction of foetal growth restriction: a cross sectional study
Published in Journal of Obstetrics and Gynaecology, 2022
Mariam L. Mohamed, Magda M. Elbeily, Maisara M. Shalaby, Yara H. Khattab, Omima T. Taha
Each patient had ultrasound examination performed by a senior radiologist for the following:The umbilical cord diameter in the 28th, 32nd, 36th, and the 40th week. The measurement was taken from a free floating loop of the UC, midway between the placental and foetal side. Three measurements were taken and the largest measurement was considered in the analysis.Other parameters of the umbilical cord including the pulsatility index, the resistive index, and the systolic/diastolic ratio were obtained. UA waveforms were obtained from free loops of the umbilical cord, midway between the placental and foetal insertions, in the absence of foetal breathing. The average PI, RI, and S/D ratio were calculated (Lewkowitz et al. 2019).Foetal middle cerebral artery Doppler was measured using the artery nearer to the probe. PI and RI were measured in auto mood over three cardiac cycles. We used the measure that was repeated twice consecutively (Srikumar et al. 2017).Amniotic fluid index (AFI) was measured as described by Phelan et al. The maternal abdomen was divided into four quadrants. The amniotic fluid was measured followed by summing the deepest pocket in each quadrant without foetal parts or presence of umbilical cord (Phelan et al. 1987).
Anterior scleral thickness dimensions by swept-source optical coherence tomography
Published in Clinical and Experimental Optometry, 2022
José Ignacio Fernández-Vigo, Hang Shi, Bárbara Burgos-Blasco, Susana Fernández-Aragón, Lucía De-Pablo-Gómez-de-Liaño, Bachar Kudsieh, Ana Macarro-Merino, José Ángel Fernández-Vigo
Our study has several limitations. Participants in this study were recruited in an outpatient eye clinic setting, and selection bias cannot be ruled out. Also, only Caucasian subjects were included. In addition, we only assessed the horizontal quadrants and not the vertical quadrants to avoid the need for eyelid manipulation. A compensation for tissue refractive index distortion was not performed. Moreover, measurements on structures that are not perpendicular to the OCT optical axis could be affected by optical distortion and Laplace correction has not been applied.35–37 Finally, as the exploration was performed with a lateral gaze, measurements of parameters such as the anterior chamber angle or iris thickness could be affected. However, the anterior segment lens for anterior segment examination is already calibrated to provide proper values, but a slight error could not be ruled out.
Orbital Metastasis Secondary to Breast Cancer: A Rare Cause of Unilateral External Ophthalmoplegia
Published in Neuro-Ophthalmology, 2021
Omer Karti, Ozlem Ozdemir, Dilek Top Karti, Mehmet Ozgur Zengin, Sertac Tatli, Tuncay Kusbeci, Nese Celebisoy
Orbital metastases usually present with unilateral involvement and are usually observed in patients with advanced cancer with widespread metastases. The lateral and superior anatomical quadrants of the orbits are most commonly affected.1,4,12 The time interval between the diagnosis of the primary cancer and orbital metastasis may be quite long and vary from 4.5 to 6.5 years for breast cancer.12 Furthermore, an orbital metastasis may be the first presentation of malignancy in almost one-third of cases.10 Although MRI and computed tomography are useful tools for the diagnosis, a definitive diagnosis is made by fine-needle aspiration biopsy of the lesion with potential risks of bleeding, vision loss, diplopia, dissemination of tumour cells, and globe injury. Therefore, the pros and cons should be considered before undergoing the biopsy.4,13–16 The diagnosis can also be made radiologically or clinically in a patient with widespread metastases and/or a history of cancer.4