Pulmonary embolism CT scan case Dissertation Example | Topics and Well Written Essays - 2500 words

Pulmonary embolism CT scan case - Dissertation Example Pulmonary embolism Pulmonary embolism is the second most common cause of sudden death. Death occurs within few hours of onset of the condition and in many situations, death occurs much before the diagnosis is made. In those who survive, recurrent embolism and mortality can be prevented by prompt diagnosis and management. However, diagnosis is often missed because of signs and symptoms that are nonspecific. Untreated individuals, who have survived the initial episode, are likely to die due to repeat embolism. Pulmonary embolism can be acute or chronic. Acute embolism occurs when the embolus is situated in the central portion of the vascular lumen or if the embolus occludes the lumen. Chronic embolism occurs when the embolus is eccentric, being contiguous with the wall of the vessel, decreases the diameter of the involved artery by atleast 50 percent and there is evidence of recanalisation or arterial web. Acute embolism distends the the vessel (Ouellette, 2011). Figure 1: Mechanism of pulmonary embolism (medicalook.com) Pulmonary embolism can be peripheral or central based on the branch of the artery located. Main pulmonary artery and its branches, the right and left pulmonary arteries and their subsequent main branches,the anterior trunk, the right and left interlobar arteries, right and left lower lobe arteries, right middle lobe artery and left upper lobe trunk are considered to be central zones. Other branches are peripheral zones (Ouellette, 2011). Pulmonary embolism can be massive or non-massive. Massive embolism occurs when hemodynamic compromise occurs (Ouellette, 2011). The clinical presentation of the condition is highly variable and hence provides scope for missed diagnosis. Classic presentation includes sudden onset of shortness of breath, pleuritic chest pain and hypoxia (Ouellette, 2011). Pulmonary embolism is considered to be a complication of venous thromboembolism like deep vein thrombosis, rather than just a disease. Thus, every individual who is at risk of venous thromboembolism is at risk of developing pulmonary embolism (Ouellette, 2011). In normal individuals, microthrombi, which are nothing but aggregates of platelets, lysed red blood cells and fibrin, are formed and subsequently lysed continuously in the venous system. Through such a mechanism, local hemostasis is possible in response to injury, thus preventing uncontrolled propagation of clot (Ouellette, 2011). In view of nonspecific clinical presentation, every individual with unexplained chest pain, tachypnea or dyspnea must undergo specific diagnostic tests to rule out the disease. Non-specific routine tests ar not helpful in establishing or giving clue for diagnosis. The criterion standard for diagnosis of pulmonary embolism is pulmonary angiography. However, this is rarely performed now and is replaced by computed tomography angiography or CT angiography which is more sensitive and specific (Ouellette, 2011). Famous personality who died of pulmonary embolism O ne of the famous personalities who died of pulmonary embolism is David Bloom, a noted TV journalist (DPSinfo, 2004). Anatomy The key for accurate interpretation of CT angiography is based on the understanding of bronchovascular anatomy (Refer to Figures 2 and 3). It is very important to adopt systematic approach of identifying vessels (Ouellette, 2011). Figure-2: Branches of pulmonary artery (imaios.com) Figure-3: Bronchopulmonary segments (imaios.com). Pathology Both hemodynamic and respiratory consequences arise due to pulmonary

Writing Poetry Essay Example | Topics and Well Written Essays - 1500 words

Writing Poetry - Essay Example Understanding its meaning and rich undertones can be a challenging task for the reader. Several readings and a careful, systematic analysis is called for, in order to fully comprehend its significance. But in the long run the effort is worthwhile as â€Å"The Snow Man† is a remarkable poem and reading it can be an enriching and rewarding experience. The poem begins by introducing the reader to a human, and it is through the eyes of this person that the paradoxical nature of winter, with its cold beauty and innate harshness is revealed. Initially the poet emphasizes the importance of being finely attuned to the nuances of winter at a mental level. Further by dint of prolonged exposure one must be inured to the hardships brought on by the wintry winds. Only then will it be possible for the process of metamorphosis to take place, transforming one into a snowman, which is truly integrated with the magnificent landscape. One evolves into â€Å"†¦the listener, who listens in the snow, / And, nothing himself, beholds/ Nothing that is not there and the nothing that is† (Stevens 9). Speculation as to the events that led to the shaping of the poem may help the reader to better grasp its import. It would appear that Stevens had written this poem, while merely gazing at a wintry landscape and studying its nature. Or, on a more profound note the poem may be his way of giving expression to the realization that the winter of his own life had approached, bringing with it a curious mixture of despondency and hope and the need to shed the unnecessary trappings of civilization, in order to become one with nature, and thereby achieve a purer state of being. This probably explains the sheer intensity of the poem and its theme of learning to let go - giving up everything and thereby acquiring everything which may just turn out to be nothing. From looking at the poem’s antecedents, the reader may divide it into its structural parts for purposes of comprehension. The