N-Trivia

Types of Cast and Indications
Classifications of Anemia
Intrauterine Reproductive Development

Types of Cast and Indications

Posted: 20 Oct 2010 05:43 PM PDT

Cast

Is a temporary immobilization.
Types:
1. Plaster
2. Fiber glass

Function

To promote healing and early weight bearing.
To support, maintain and protect realigned bone.
To prevent or correct deformity
To immobilize

Cast Application

Apply the stockinette.
Apply the wadding sheet.
Fiber glass or the plaster cast

Contraindications

Pregnancy
Skin disease
Swelling
Open wound
Infection

Nursing Interventions

Handle wet cast with palms of hands, not fingers.
Cast should be allowed to air dry.
Elevate the cast on one or two pillows during drying.
Observe "hot spot" and musty odor, which is signs and symptoms of infection.
Maintain skin integrity – "petalling"
Do neurovascular checks such as skin color, skin temperature, sensation, mobility and pulse.
Assess for vascular occlusion.
Adhesive tape petals reduce irritation at cast edges.
Prevent complication of mobility.

Types Of Cast, Molds And Indications

Airplane cast – for humerus and shoulder joint with compound fracture.
Basket cast – for severe leg trauma with open wound or inflammation.
Body cast – for lower dorso-lumbar spine affectation.
Boot leg cast – for hip and femoral fracture.
Cast brace – for fracture of femur (distal curve) with flexion and extension.
Collar cast – for cervical affectation.
Cylindrical leg cast – for fractured patella.
Delbit cast – for fracture of tibia or fibula.
Double hip spica cast – for fracture of hip and femur.
Double hip spica mold – cervical affectation with callus formation.
Frog cast – for congenital hip dislocation.
Functional cast – for fractured humerus with abduction and adduction.
Hanging cast – for fractured shaft of the humerus.
Internal rotator splint – for post hip operation.
Long arm circular cast – for fractured radius or ulna
Long arm posterior mold – for fractured radius or ulna with compound affectation.
Long leg circular cast – for fractured tibia-fibula.
Long leg posterior mold – for fracture tibia-fibula with compound affectation.
Minerva cast – for upper dorsal or cervical affectation.
Munster cast – for fractured radius or ulna with callus formation.
Night splint – for post polio.
Pantalon cast – for pelvic bone fracture
Patella tendon bearing cast – for fractured tibia-fibula with callus formation.
Quadrilateral (ischial weight bearing) cast – for shaft of femur with callus formation.
Rizzer's jacket – for scoliosis
Short arm circular cast – for wrist and fingers.
Short arm posterior mold – for wrist and fingers with compound affectation.
Short leg circular cast – for ankle and foot fracture.
Short leg posterior mold – for ankle and foot with compound affectation.
Shoulder spica – for humerus and shoulder joint.
Single hip spica – for hip and 1 femur.
Single hip spica mold – for pelvic fracture with callus formation.
1 and ½ hip spica – for hip and femur.
1 and ½ spica mold – for hip and femur with compound affectation.

Classifications of Anemia

Posted: 20 Oct 2010 05:04 PM PDT

Overview

The main function of a red blood cell or erythrocyte is to carry and transport oxygen to the different parts of the body. The normal RBC count is 4-6 million/mm3. Hemoglobin (Hgb), an iron-bearing protein, is found inside an erythrocyte. Molecules of this iron containing protein are responsible for transporting the bulk of oxygen that is carried in the blood.

The more hemoglobin molecules the RBC contain, a higher amount of oxygen will they be able to carry. If the hemoglobin is defective, the erythrocyte will also malfunction. A red blood cell is just a vessel; the one that performs the oxygen transportation is the hemoglobin. Normal hemoglobin is 13-18 grams/dl in males and 12-16 grams/dl in females. A decrease in the RBC or hemoglobin or the oxygen-carrying ability of a blood is termed as anemia.

Erythrocyte Formation

RBC's are produced by the bone marrow a process known as erythropoiesis. Before a red blood cell is formed, the hematopoietic stem cell first produces an uncommitted stem cell to be formed to committed progenitor cell. Progenitor cells are not only the precursor of RBC, but also of lymphocytes and megakaryocytes (antecedent of platelets). Before an erythrocyte is formed the progenitor cells develop an erythroblast, then a reticulocyte, and finally erythrocyte (RBC). A hormone, erythropoietin, which is secreted by the kidney, also controls RBC production by stimulating the bone marrow.

Types of anemia

Hypoproliferative Anemias

This type of anemia covers all condition where the bone marrow incapable of producing enough cells to develop to erythrocyte. Lack of erythropoietin may also be a contributing factor of the abnormality. The following types of anemia are under this classification:

Aplastic anemia –In this condition, the precursor cells (stem or progenital cells, which is responsible in forming components of blood) are extremely deficient, thereby, production of all formed elements (including RBC, lymphocyte, megakaryocytes) are reduced. Because of the depressed bone marrow function, it is replaced by fat cells leading to anemia, excessive bleeding (thrombocytopenia) and infections (depressed WBC count). This type of anemia is also a common example of a pancytopenic disorder.
Iron-deficiency anemia – It is also called microcytic, hypochromic anemia. This is type of anemia is the most common form among all ages, and is characterized by a low iron concentration in the body.
Megaloblastic anemia – A macrocytic, normochromic anemia results as the essential factors (vitamin B12 and folic acid) for normal DNA synthesis are missing causing suppression of mitosis in the bone marrow and allowing the RNA or protein synthesis to take place for the progression of cell growth without cell division. The resulting cells remain enlarged (because mitosis is absent).

1. Vitamin B12 deficiency – Vitamin B12 or cobalamin is required for normal DNA synthesis. It is not synthesized in the tissues of but solely depends on the dietary intake of meat, liver, dairy products and sea foods.
2. Folic Acid Deficiency – folic acid is also important for the DNA synthesis of cells. The dietary sources of folate are meats, eggs, leafy vegetables which are easily available.

Hemolytic Anemias

This type of anemia refers to the state where hemolysis (erythrocyte destruction) causes symptoms of anemia. Classification of this condition is further narrowed into intrinsic (inherited) or extrinsic (damage in erythrocyte is caused by environmental factors).

Intrinsic Hemolytic Anemia

Sickle Cell anemia – an inherited disorder on the beta chain of the hemoglobin resulting to abnormally shaped red blood cells. In this condition an abnormal hemoglobin S (HbS) is contained in the RBC's causing distortions or sickling of the red blood cells.
Thalassemia – group of genetic disorders that involve a defective hemoglobin- chain synthesis. Thalassemia major is threatening disease characterized by severe anemia, hemolysis and ineffective erythropoiesis. Thalassemia minor is a mild form of anemia. The affected individual has only one defective gene and is asymptomatic.

Extrinsic Hemolytic Anemia

Immune hemolytic anemia – a person's own antibodies destroy his own red blood cells (hemolysis).
Mechanical hemolytic anemia – hemolysis is caused by trauma or physical injuries that disrupt red blood cells altering and tearing them through the small vessels.

Intrauterine Reproductive Development

Posted: 20 Oct 2010 05:01 PM PDT

Physiology of Intrauterine Reproductive Development

The genetic sex of an individual is determined at conception. The sperm contains either an X or Y chromosome while the ovum always carries an X chromosome. Fertilization is the process where the union of egg and sperm cell occur. If a sperm containing an X chromosome fertilizes the ovum (X), the resulting zygote will become a chromosomal female (XX). But if the inherited chromosome from the father is Y combined with X from the mother the result will be a genetic male (XY). Thus, it is the father that determines the sex of the baby.

Gonads are body organs that produce sex cells in an individual. It is ovaries in females and testes in males. Several processes take place in the utero before gonads are formed and fetal external genitalia are differentiated to male and female.

Primitive gonadal tissue is the first component of gonads formed at about 5 weeks of intrauterine life. During this time male and female reproductive system still looks similar or sexually undifferentiated.
In both sexes, still at 5 weeks I.U. life, two indistinguishable ducts are formed and present. The first is called a mesonephric and the other is paramesonephric duct.
Mesonephric or also called a Wolffian duct is a pair of organ found during intrauterine period that connects the primitive kidney to cloaca (opening of reproductive tracts) and will develop into male reproductive organ.
Paramesonephric or mullerian ducts are paired ducts present during the prenatal period that develops into female reproductive organs.
At about 7-8 weeks, internal reproductive structures starts to develop. Primitive testes begin to differentiate in genetic males. Testes (testis is the singular form) are responsible for producing testosterone. In response to the presence of testosterone, the mesonephric or Wolffian duct starts to develop into the male reproductive organs. Paramesonephric or mullerian duct on the other hand, undergoes degeneration. To easily remember because mesonephric duct starts with letter "M," it is the structure that develops into male reproductive organs.
The external genitals continue to look similar until the ninth week.
Around 10 weeks, if no testosterone would cause the differentiation of mesonephric duct, the primitive gonadal tissues will develop into ovaries. The paramesonephric or mullerian duct then progresses to become the female reproductive organs. It is during this time that all oocytes (immature female reproductive cells) are formed inside the ovaries.
Differentiation of external genitalia in both sexes is complete at approximately 12 weeks.
The noticeable difference is noted because the influence of testosterone in male causes the penile tissue to elongate and the urogenital fold situated at the ventral portion of the penis closes to form the urethra.
If no testosterone is detected in the system, the urogenital folds remains wide and apart (open) which forms the labia minora in females. The scrotal tissue in males is the one that develops as labia majora in females.
Though the external reproductive organs are already different at 12 weeks, to avoid false interpretation during ultrasonography, it is recommended to undergo the test in determining the sex of the fetus at the midpoint of pregnancy where further external sexual development takes place. However, some are assessing the gender of the baby at about 18-22 weeks age of gestation. More inaccurate results are reported with an ultrasound done before 18 weeks.