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A catheter with a deflated balloon on its tip is passed into the narrowed artery segment anxiety fever purchase phenergan with amex, the balloon inflated anxiety 5 steps phenergan 25 mg mastercard, and the narrow segment widened anxiety 300mg buy generic phenergan 25 mg on line. To to open up arteries to your keep arteries from collapsing anxiety symptoms in 13 year old discount 25 mg phenergan otc, stents (stainless steel heart supports) can be inserted into the artery during angioplasty. This surgery is performed when narrow coronary arteries reduce the flow of oxygen-containing blood to the heart. Coronary bypass surgery An angioplasty procedure to open up arteries in See Angioplasty above either of your legs A diagnostic method in which pulses of sound are transmitted into the neck arteries and the echoes returning from the surfaces of the artery walls are electronically plotted to produce a picture of a small Echo portion of the carotid artery showing the amount of atherosclerosis (hardening of the arteries) that can be seen in the arterial wall. Examples of surgery include valve replacement, ventricular aneurysm resection, aortic stenosis, ventricular stenosis, defect repair, patent ductus closure, pacemaker, implantation of automatic defibrillator, coronary atherectomy. Examples of diagnostic procedures include electrocardiogram, imaging or stress tests involving injection of dye, etc. Appendix F, Page 9 Other diagnostic procedure or surgery related to your heart or blood vessels Terminologнa Mйdico Sнntoma o Diagnуstico Infarto miocбrdico o ataque al corazуn Definiciуn Daсo al mъsculo del corazуn causado por una insuficiencia en el abastecimiento de sangre. Dolor intenso y sensaciуn de opresiуn alrededor del corazуn, generalmente irradiado hacia el hombro izquierdo y hacia abajo por el brazo izquierdo, o en casos excepcionales, del corazуn al abdomen. Globos que se utilizan en los procedimientos de angioplastia Dispositivos intravasculares, tambiйn llamados stents, que se utilizan en los procedimientos de angioplastia Sinуnimos Infarto de miocardio, ataque cardнaco Angina de pecho o dolor de pecho debido a la enfermedad de corazуn Angina, cardiopatнa isquйmica Globo Dispositivo intravascular (soporte de acero inoxidable) o stent por su nombre en inglйs Insuficiencia cardнaca o insuficiencia cardнaca congestiva Fibrilaciуn auricular Trombosis de vena profunda o trombos (coбgulos) en las piernas Accidente cerebrovascular this Section: 3/26/04 Version El corazуn no bombea adecuadamente para proveer de sangre a los уrganos. Nitroglycerin is a vasodilator used for the prevention and treatment of angina pectoris. It is also used to treat hypertensive emergencies and congestive heart failure associated with myocardial infarction. It is available in tablets that are either swallowed or placed under the tongue, a patch, and a paste that is applied to the skin. Beta blockers slow the heart rate, decrease the force of heart contractions, reduce blood pressure, and reduce anxiety. Beta-blockers are used in the treatment of angina, arrhythmias, hypertension, and mitral valve prolapse. Calcium channel blockers (calcium antagonists) are a group of medications that inhibit the influx of extracellular calcium across the myocardial (heart) and vascular (blood vessel) smooth muscle cell membranes. Calcium channel blockers relax blood vessels and increase the supply of blood and oxygen to the heart, while reducing its workload. Antiarrhythmic agents are a group of medications that either suppress the abnormal firing of pacemaker tissue or depress the transmission of impulses in tissues that either conduct too rapidly or participate in reentry Generic names adenosine amiodarone azimilide bretylium disopyramide dofetilide dronedarone flecainide ibutilide lidocaine mexilitine moricizine procainamide propafenone quinidine sotolol tocaininde Trade names Adenocard Amiodaronehc Betapace Betapaceaf Bretylium Bretylium I. Diuretics (commonly called "water pills") constitute a class of many different drug families that have the same action-they remove water from the body. Diuretics are used to lower blood pressure in people with hypertension and to improve heart function in people with congestive heart failure. Diuretics are divided into two general groups: potassium-sparing diuretics and potassium-depleting diuretics. Potassiumdepleting diuretics are further divided into thiazide diuretics and loop diuretics. Digitalis is a general term often used to refer to a group of compounds derived from digitalis purpurea (foxglove) or that have actions similar to that of digitalis. These compounds are used to increase cardiac contractile force, increase cardiac output, reduce edema associated with congestive heart failure, and control certain arrhythmias. They are used to treat hypertension and heart failure and to prolong the survival of participants who have had myocardial infarction. Other vasodilators are antihypertensive medications that relax the muscle in the walls of the blood vessels, allowing the vessels to dilate (widen). Aspirin is an anti-platelet drug that can help to prevent the formation of blood clots, thereby reducing the incidence of cardiovascular and cerebrovascular events. Aspirin given for prevention of these events may be plain or buffered, and may come in tablet, chewable, effervescent, or enteric-coated form. Answer "yes" to this question only if the participant is taking aspiring on a daily basis to lessen his/her risk of above events. Aspirin does not include other over-the-counter analgesics such as acetaminophen (Tylenol) only or ibuprofen (Motrin or Advil).

However anxiety symptoms muscle cramps purchase generic phenergan pills, the mesonephros becomes the functional kidney of adult fish & amphibians anxiety symptoms in toddlers cheap 25 mg phenergan with mastercard. The metanephros originates from two sources: 1] a ureteric bud anxiety symptoms vision order phenergan overnight delivery, which grows out of the mesonephric duct near the cloaca; the bud develops into the ureter anxiety symptoms quality 25mg phenergan, renal pelvis, and numerous collecting ducts; 2] metanephrogenic mass, which is the caudal region of the nephrogenic cord; the mass forms nephrons. The bud induces development of metanephrogenic mesoderm; in turn, the mass induces the cranial end of the ureteric bud to differentiate into renal pelvis and collecting tubules-the tubules induce the metanephrogenic mass cells to form nephrons. Nephrons continue to form and mature postnatally (except in the bovine); thereafter, nephrons cannot be replaced if they are damaged. Urinary Bladder and Urethra A urorectal septum divides the cloaca into: · dorsally, a rectum, anal canal & anal membrane, and · ventrally, a urogenital sinus and urogenital membrane the membranes subsequently degenerate, resulting in an anus and a urogenital orifice, respectively. Cranially, the urogenital sinus connects with the urachus, the intra-embryonic stalk of the allantois. Abnormalities of urinary development include: · Hydronephrosis (cystic/polycystic kidneys) may result from ureteric atresia or from failure of nephrons to communicate with collecting tubules. The adrenal cortex arises from cells of mesonephric tubules that dissociate and migrate to the location of the adrenal gland after the mesonephros degenerates. Adrenal Cortex neural crest cells adrenal cortex adrenal medulla cortex primordium Adrenal Gland 43 Gender genotype is inherited, but gender phenotype is a consequence of hormones released during embryonic development, by the gonad determined by genotype. Genital System Genital development involves transition through an indifferent stage in which gonads, genital ducts and external features are the same in both sexes. Thus, many genital anomalies involve some combination of intersex development and appearance. Indifferent stage: ·the gonad originates from the gonadal ridge, a thickening of intermediate mesoderm plus coelomic mesothelium that develops medial to the mesonephric kidney. Ovary: · gonadal cords undergo reorganization such that individual germ cells become surrounded by a sphere of flat supporting cells, thus primordial follicles are formed · germ cells (oogonia) differentiate into primary oocytes that commence meiosis, but remain stuck in prophase of Meiosis I (meiosis is not continued until ovulation occurs, as an adult) · follicle and germ cell proliferation is completed in utero, the lifetime allotment of primary oocytes is already present in the neonatal ovary. Genital Ducts Accessory Glands Ligaments Indifferent stage: Transverse Section through · both sexes have male (mesonephric) and female Urogenital Ridge (paramesonephric) genital ducts and a urogenital sinus · the mesonephric (Wolffian) duct persists after the mesonephric mesopnephros disintegrates tubules · a paramesonephric (Mullerian) duct develops along the ventrolateral coelomic surface of the mesonephros (it begins as a groove, then becomes a core of cells, and subsequently it canalizes and elongates) · testicular hormones determine which duct system gonad paramesonephric develops: coelomic duct mesonephric mesothelium male duct development requires testosterone, duct produced by interstitial cells; female duct development is suppressed by an inhibitory hormone released by sustentacular cells. Vaginal Development lumen of fused pramesonephric ducts ovary uterus broad ligament (urogenital fold) (lateral view) uterine body urethra cervix · further caudally, bilateral paramesonephric ducts shift medially and fuse into a single tube that ends blindly in contact with the urogenital sinus. The fused ducts become: uterine body, uterine cervix, and the cranial third of the vagina. In contrast, rodents and the rabbit have a double uterus (two cervices enter a single vagina). Males: · paramesonephric ducts regress due to an inhibitory hormone produced by sustentacular cells of the testis (duct remnants are often evident in the adult · several mesonephric tubules become efferent ductules (they already communicate with the male horse as a uterus masculinus). Prostate and bulbourethral glands develop in typical gland fashion by outgrowths of urogenital sinus endoderm. In females, the ovary remains intra-abdominal and the extent of caudal shift is species dependent. Males: · growth at the base of the genital tubercle generates an elongate phallus with the original genital tubercle becoming glans at the tip of the phallus · the urogenital orifice and urogenital folds elongate ventrally along with the attached phallus; the folds form a urogenital groove and the penile urethra is created when the groove closes by medial merger of urogenital folds in proximal to distal sequence. The scrotum initially overlies the gubernaculum and vaginal process in the inguinal region, and then it generally shifts cranially (except that it remains caudal in the cat and pig). Females: · urogenital orifice becomes the vulval cleft, which opens into the vestibule (urogenital sinus) · the genital tubercle becomes the clitoris · urogenital folds elongate, overgrow the genital tubercle, and become labia of the vulva · genital swellings disappear in female domestic mammals (but become major labia in primates). Mammary Glands In both genders, a mammary ridge (line) of thickened ectoderm forms bilaterally from the axillary region to the inguinal region. Mammary buds develop periodically along the ridge; elsewhere, mammary ridge ectoderm regresses. Buds determine the number and locations of mammary glands, since each bud develops into a mammary gland (2, sheep, goat, mare; 4 cow; 8, queen; 10, bitch; 14; sow). At each mammary bud, ectoderm induces proliferation of underlying mesoderm and mesoderm induces epithelial cell proliferation (teat formation). Epithelial cell solid cords invade underlying mesoderm and eventually canalize to form epithelial lined lactiferous ducts. The number of cell cord invasions and subsequent lactiferous duct systems per teat is species dependent (approximately: 1, sheep, goat, cow; 2 mare sow; 6, queen; 12, bitch). In some cases, multiple lactiferous ducts open into a pit (inverted nipple) that becomes a nipple following proliferation of underlaying mesoderm. It is common for extra buds develop and degenerate, failure to degenerate results in supernumerary teats. Because the face develops separately, and it can undergo wide variation in shape & size, as seen in dogs.

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Rheumatic fever affects children (ages 5­15 years) anxiety symptoms feeling hot purchase discount phenergan on line, and there is a decreasing incidence in the United States anxiety symptoms definition buy discount phenergan 25mg line. The myocardium can develop myocarditis anxiety level test order phenergan 25mg overnight delivery, whose most distinctive feature is the Aschoff body anxiety symptoms breathlessness order phenergan in india, in which fibrinoid necrosis is surrounded by macrophages (Anitschkow cells), lymphocytes, and plasma cells. Endocarditis may be a prominent feature that typically involves mitral and aortic valves (forming fibrin vegetations along the lines of closure) and may also cause left atrial endocardial thickening (MacCallum plaques). Complications can include mitral stenosis and/or regurgitation, aortic stenosis and/or regurgitation, congestive heart failure, and infective endocarditis. Risk factors include rheumatic heart disease, mitral valve prolapse, bicuspid aortic valve, degenerative calcific aortic stenosis, congenital heart disease, artificial valves, indwelling catheters, dental procedures, immunosuppression, and intravenous drug use. Acute endocarditis produces large destructive vegetations (fibrin, platelets, bacteria, and neutrophils). Bridge to Microbiology Viridans streptococci · Alpha-hemolytic · Bile-resistant · Optochin-resistant · Subacute endocarditis is typically due to a low virulence organism, such as Streptococcus group viridans, which usually colonizes a previously damaged valve. Clinically, endocarditis presents with fever, chills, weight loss, and cardiac murmur. Embolic phenomena may occur, and may affect systemic organs; retina (Roth spots); and distal extremities (Osler nodes [painful, red subcutaneous nodules on the fingers and toes], Janeway lesions [painless, red lesions on the palms and soles], and splinter fingernail hemorrhages). Complications include septic emboli, valve damage resulting in insufficiency and congestive heart failure, myocardial abscess, and dehiscence of an artificial heart valve. Clinically, the patient may be asymptomatic or may suffer from acute heart failure or even dilated cardiomyopathy. It presents in infancy with congestive heart failure that is accompanied by weak pulses and cyanosis in the lower extremities; the prognosis is poor without surgical correction. It can present in a child or an adult with hypertension in the upper extremities, and hypotension and weak pulses in the lower extremities. Some collateral circulation may be supplied via the internal mammary and intercostal arteries; the effects of this collateral circulation may be visible on chest x-ray with notching of the ribs due to bone remodeling as a consequence of increased blood flow through the intercostal arteries. Complications can include congestive heart failure (the heart is trying too hard), intracerebral hemorrhage (the blood pressure in the carotid arteries is too high), and dissecting aortic aneurysm (the blood pressure in the aortic route is too high). The classic tetrad includes right ventricular outflow obstruction/stenosis; right ventricular hypertrophy; ventricular septal defect; and overriding aorta. Clinical findings include cyanosis, shortness of breath, digital clubbing, and polycythemia. Progressive pulmonary outflow stenosis and cyanosis develop over time; treatment is surgical correction. Tetralogy of Fallot is the most common cause of congenital cyanotic heart dis- Figure 13-3. Common Forms of Cyanotic Congenital Heart Disease 100 Chapter 13 · Cardiac Pathology Transposition of the great vessels is an abnormal development of the truncoconal septum whereby the aorta arises from the right ventricle, and the pulmonary artery arises from the left ventricle. Common Forms of Acyanotic Congenital Heart Disease Truncus arteriosus is a failure to develop a dividing septum between the aorta and pulmonary artery, resulting in a common trunk. Truncus arteriosus causes early cyanosis and congestive heart failure, with a poor prognosis without surgery. Clinical findings include machinery murmur, late cyanosis, and congestive heart failure. The cause is genetic in 20­50% of cases, but some cases are related to alcohol, medications (Adriamycin [doxorubicin]), cocaine, viral myocarditis (Coxsackievirus B and enteroviruses), parasitic infections (Chagas disease), iron overload or pregnancy. In cases of all types, the underlying etiology leads to destruction of myocardial contractility, which affects systolic function. Complications include mural thrombi and cardiac arrhythmias; prognosis is poor with 5-year survival of 25%. There is myocyte hypertrophy with interstitial fibrosis on microscopy, and eccentric hypertrophy seen on gross examination. The condition is an asymmetrical hypertrophy of cardiac muscle that causes decreased compliance affecting diastolic function.

Different suffixes may change the word from a noun (naming people anxiety brain purchase phenergan uk, places anxiety symptoms throat closing buy cheap phenergan 25 mg, or things) to an adjective (descriptor) (Figure 1­2) anxiety workbook for teens phenergan 25mg without prescription. Examples of this include the following terms: Cyanosis is a noun meaning condition of blue discoloration anxiety level quiz purchase phenergan toronto, whereas cyanotic is an adjective meaning pertaining to blue discoloration. Anemia is a noun meaning a blood condition of deficient red blood cells and/or hemoglobin, whereas anemic is an adjective meaning pertaining to a blood condition of deficient red blood cells and/or hemoglobin. Mucus is a noun meaning a slimelike substance that is composed of glandular secretion, salts, cells, and leukocytes, whereas mucous is an adjective meaning pertaining to mucus. Ilium is a noun meaning a part of the hip, whereas iliac is an adjective meaning pertaining to the hip. Condyle is a noun meaning a rounded projection on a bone, whereas condylar is an adjective meaning pertaining to a rounded projection on a bone. Carpus is a noun meaning the joint between the radius and ulna and metacarpal bones, whereas carpal is an adjective meaning pertaining to the joint between the radius and ulna and metacarpal bones. Analyzing Medical Terms Medical terminology can be more easily understood when the following objectives are adhered to when a medical term is examined for the first time: Dissect: Analyze the word structurally by dividing it into its basic components. Begin at the end: After dividing the word into its basic parts, define the suffix first, the prefix second, and then the root. Anatomical order: Where body systems are involved, the words usually are built in the order in which the organs occur in the body. For example, gastroenteritis is the proper term for inflammation of the stomach and small intestine. Because food passes from the stomach into the small intestine, the medical term for stomach appears before the medical term for small intestine. The order of word parts in a medical term may also represent the order of blood flow through organs. The exception to this involves some diagnostic procedures in which tools or substances are passed retrograde, or in the opposite direction of anatomical order. In these cases, the words are built in the order in which the equipment passes the body part. Defining from back to front, the suffix -ectomy is surgical removal, one combining form ovari/o means ovary, and the other combining form hysteri/o means uterus. Together the term ovariohysterectomy means surgical removal of the ovaries and uterus. This term is based on the order in which the ovaries and uterus are found in the body. Noun cyanosis anemia mucus ilium condyle carpus Suffix -osis -ia -us -um -e -us Adjective cyanotic anemic mucous iliac condylar carpal Suffix -tic -ic -ous -ac -ar -al Figure 1­2 Suffix variation depending on usage Proper pronunciation of medical terms takes time and practice. Listening to how medical professionals pronounce words, using medical dictionaries and textbooks, and listening to prepared audio are the best ways to learn pronunciation. There are individual variations based on geographic location and personal preference. Medical dictionaries also vary in how they present pronunciation of medical terms. Some sources mark the syllable receiving the greatest emphasis with a primary accent () and the syllable receiving the second most emphasis with a secondary accent (). Other sources boldface and capitalize the syllable receiving the most emphasis, Copyright 2009 Cengage Learning, Inc. Table 1­3 Vowel Pronunciation Guide Sound ah ah eh oy u ay aw Example idea aerobic bronchi oestrogen (old English form) sarcoid euthanasia Einstein air auditory General Pronunciation Guidelines Vowels can be short or long (Table 1­3). The urethra takes urine from the urinary bladder to the outside of the body, whereas ureters collect urine from the kidney and transport it to the urinary bladder. Medical terms may be pronounced the same but have different meanings, so spelling is important. However, ileum is the distal part of the small intestine (e = enter/o or e = eating), whereas ilium is part of the pelvic bone (pelvic has an i in it). For example, the combining form myel/o represents the spinal cord and bone marrow. For example, when used as a noun, mucus (the slimy stuff secreted from mucous membranes) is spelled differently than when it is used as an adjective (as in mucous membrane).