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SGD Gross Anatomy
SGD Gross Anatomy
1. The patient are with pre existing medical conditions, Diabetes Mellitus and
Hypertension. Discuss briefly these two conditions.
Diabetes, often referred to by doctors as diabetes mellitus, describes a group of
metabolic diseases in which the person has high blood glucose (blood sugar), either
because insulin production is inadequate, or because the body's cells do not
respond properly to insulin, or both. Patients with high blood sugar will typically
experience polyuria (frequent urination), they will become increasingly thirsty
(polydipsia) and hungry (polyphagia).
There are three types of diabetes:
Type 1 Diabetes
The body does not produce insulin. Some people may refer to this type as insulindependent diabetes, juvenile diabetes, or early-onset diabetes. People usually
develop type 1 diabetes before their 40th year, often in early adulthood or teenage
years. Patients with type 1 diabetes will need to take insulin injections for the rest of
their life. They must also ensure proper blood-glucose levels by carrying out regular
blood tests and following a special diet.
Type 2 Diabetes
The body does not produce enough insulin for proper function, or the cells in the
body do not react to insulin (insulin resistance). Some people may be able to control
their type 2 diabetes symptoms by losing weight, following a healthy diet, doing
plenty of exercise, and monitoring their blood glucose levels. However, type 2
diabetes is typically a progressive disease - it gradually gets worse - and the patient
will probably end up have to take insulin, usually in tablet form.
Overweight and obese people have a much higher risk of developing type 2
diabetes compared to those with a healthy body weight. People with a lot of visceral
fat, also known as central obesity, belly fat, or abdominal obesity, are especially at
risk. Being overweight/obese causes the body to release chemicals that can
destabilize the body's cardiovascular and metabolic systems.
scientists believe that the impact of sugary soft drinks on diabetes risk may be a
direct one, rather than simply an influence on body weight.
Gestational Diabetes
This type affects females during pregnancy. Some women have very high levels of
glucose in their blood, and their bodies are unable to produce enough insulin to
transport all of the glucose into their cells, resulting in progressively rising levels of
glucose.Diagnosis of gestational diabetes is made during pregnancy. The majority of
gestational diabetes patients can control their diabetes with exercise and diet.
Between 10% to 20% of them will need to take some kind of blood-glucosecontrolling medications. Undiagnosed or uncontrolled gestational diabetes can raise
the risk of complications during childbirth. The baby may be bigger than he/she
should be.
HYPERTENSION
Hypertension, also referred to as high blood pressure, is a condition in which the
arteries have persistently elevated blood pressure. Every time the human heart
beats, it pumps blood to the whole body through the arteries.
Blood pressure is the force of blood pushing up against the blood vessel walls. The
higher the pressure the harder the heart has to pump.
Hypertension can lead to damaged organs, as well as several illnesses, such as
renal failure (kidney failure), aneurysm, heart failure, stroke, or heart attack.
Researchers from UC Davis reported in the Journal of the American Academy of
Neurology that high blood pressure during middle age may raise the risk of
cognitive decline later in life.
According to Medilexicon's medical dictionary, hypertension means "High blood
pressure; transitory or sustained elevation of systemic arterial blood pressure to a
level likely to induce cardiovascular damage or other adverse consequences."
The normal level for blood pressure is below 120/80, where 120 represents the
systolic measurement (peak pressure in the arteries) and 80 represents the diastolic
measurement (minimum pressure in the arteries). Blood pressure between 120/80
and 139/89 is called prehypertension (to denote increased risk of hypertension),
and a blood pressure of 140/90 or above is considered hypertension.
Hypertension may be classified as essential or secondary. Essential hypertension is
the term for high blood pressure with unknown cause. It accounts for about 95% of
cases. Secondary hypertension is the term for high blood pressure with a known
direct cause, such as kidney disease, tumors, or birth control pills.
DKA may occur with insulin deficiency, under the following circumstances:
during an infection or illness (e.g., urinary tract infection or pneumonia)
Dilative - The heart can become enlarged due to dilation of the myocardium. An
example is Dilated Cardiomyopathy (DCM), which is the most common form of nonischemic cardiomyopathy. In DCM, the heart becomes weakened and enlarged, and
congestive heart failure (CHF) quickly follows. Signs and symptoms are those of left
and/ or right heart failure, and signs on autopsy would include central hemorrhagic
necrosis in the liver.
Hypertrophic - Just as our skeletal muscles hypertrophy (grow in size) in response to
increased demand, cardiac muscle undergoes hypertrophy when placed under a
high workload for a prolonged period of time. Some cardiac hypertrophy is normal
and reversible, such as that seen in athletes and pregnant women. Pathologic
hypertrophy is the result of diseases that place increased demand on the heart,
such as chronic hypertension, myocardial infarction, and valvular damage.
Left ventricular hypertrophy (LVH) is the most common type of hypertrophic heart
disease. A common cause of LVH is chronic hypertension, which increases the
afterload on the left ventricle. This means the left ventricle has to increase
contractility and/ or preload to maintain the same stroke volume. Over time the
added stress on the left ventricular myocardium results in muscle hypertrophy and
remodeling of the left ventricle to a less efficient size and shape. This leads to a
diminishing ejection fraction, meaning the heart must work even harder to maintain
cardiac output. The larger heart also demands more blood flow, and so becomes
more susceptible to ischemic injury.
2.The timing of the heart sound (i.e. early diastolic, pan systolic, etc.)
3.The grade or intensity of the heart sound (i.e.1-6 (see table below))
4.The quality and shape of the heart sound (i.e. musical crescendo, harsh snap,
etc.)
4. Discuss the course of the anterior tibial artery until it becomes the dorsalis pedis
artery
The anterior tibial artery commences at the bifurcation of the popliteal, at the lower
border of the Popliteus, passes forward between the two heads of the Tibialis
posterior, and through the aperture above the upper border of the interosseous
membrane, to the deep part of the front of the leg: it here lies close to the medial
side of the neck of the fibula. It then descends on the anterior surface of the
interosseous membrane, gradually approaching the tibia; at the lower part of the
leg it lies on this bone, and then on the front of the ankle-joint, where it is more
superficial, and becomes the dorsalis pedis.
Length varies from 12.5 to 15 cm. and its weight from 60 to 100 gm.
Parts of Pancreas
Head of pancreas lies within the C-shaped concavity of the duodenum;
Uncinate process emerges from the lower part of head, and lies deep to superior
mesenteric vessels.
Neck of pancreas is the constricted part between the head and the body.
It is anterior to the superior mesenteric vessels, and, posterior to the neck of the
pancreas, the superior mesenteric and the splenic veins join to form the portal vein
Tail of pancreas ends as it passes between layers of the splenorenal ligament.
Head of Pancreas
Head of the pancreas is the expanded part of the gland in the C-shaped curve of the
duodenum.
It firmly attaches to the medial aspect of the descending and horizontal parts of
the duodenum.
Uncinate process is a projection from the inferior part of the pancreatic head,
It extends medially to the left, posterior to the superior mesentery artery.
Head of the pancreas rests posteriorly on the IVC, right renal artery and vein, and
the left renal vein. On its way to opening into the descending part of the duodenum,
the bile
duct lies in a groove on the posterosuperior surface of the head or is embedded in
its substance.
Neck of the pancreas is short and overlies the superior mesenteric vessels, which
form a groove in its posterior aspect.
The anterior surface of the neck, covered with peritoneum, is adjacent to the
pylorus of the stomach.
Body of pancreas continues from the neck and lies to the left of the superior
mesenteric vessels, passing over the aorta and L2 vertebra, posterior to the
omental bursa.
The anterior surface of the body of the pancreas is covered with peritoneum and lies
in the floor of the omental bursa and forms part of the stomach bed.