Traumatology in any case of Fracture.Symptoms and Complications of a fracture

Fractures usually due to trauma which may be :
-direct trauma which is inflected to the bone itself for exemple in case of car accident.
-indirect trauma: trauma is not inflicted to the bone which is broken indirectly.

Less commonly is Pathological Fracture : the bone weakened by disease (osteomyelitis,metastasis) that leads at minor trauma.

Classification of Fracture:
1.According to the presence of skin wound:
-Simple (close) fracture :Overlying skin is intact.
-Compound  (open) fracture: associated with overlying skin wound.

2.According to displacement and deformity:
-displaced (angulation,over-riding,rotation,anterior or posterior,lateral).
-undisplaced fracture.

3.According to the shape of the fracture:
-transverse fracture
-longitudinal fracture
-oblique fracture
-comminuted fracture
-spiral fracture
-impacted fracture.

4.Stable or unstable
5.Complete or Incomplete Fisure Fracture
6.Complicated or uncomplicated fracture.

Complications of Fractures:
1.General Complications: (only in fracture femur,pelvis or spine).
-Shock : neurogenic due to severe pain and haemorrhage
-Paralytic ileus and acute gastric dilatation
-Fat embolism
-Complications of prolonged bed rest especially in old people.
-Traumatic anuria in crushing injury
-Urinary calculi
-Tetanus.

Local Complications:
-injury of the skin leading to compound fracture and infection.
-injury of vessels leading to haemorrhage,spasm.
-injury of nerves: may be immediate injury or delayed injury
injury of muscles: loss of muvement,deformity
-injury of joints:ligament injuries,effusion,dislocation.

Symptoms of a fracture:
-Inability to move the part and loss of function
-Pain and tenderness
-Deformity
-Swelling
-abnormal mobility

For investigation is necessary plain X-ray.

Whipworm-Parasite of unwashed hands,unwashed vegetables and unsanitary water

Trichocephalus Trichiurus known by common name as Whipworm is more prevalent in poor sanitary areas and is more common in children.

Man is the only definitive host.The adult worms live in the caecum and appendix with the thin and anterior portion embedded in the mucosa parallel to the digestive tract.In heavy infection,it may extend into the colon and even the rectum.Each female deposits 3000-6000 eggs a day.

Under favourable conditions like warm regions,shaded,moist soil,the eggs develops a rhabditiform larva within 3 to 4 weeks.

Man parasites infection by ingestion of mature egg with contaminated food (green raw vegetables)unsanitary water and unwashed hands.In the lawer part of the small intestine,the larva hatches through one of the poles of the egg,passes directly to the caecum,moults 4 times and becomes sexually mature.
Egga appears in faeces 3 months after infection.

In light infection no symptoms,presence of the parasite is discovered only on stool examination.
The heavy infection results in:
-extensive inflammation and irritation of the mucous membrane at the points of attachement with hemorrhage that leads to submucosal absesses and ulcers.Appears abdominal pain,most commonly in the lower right quadrant of the abdomen,nausea,vomiting and diarrhoea with streaks of blood.
-appendicitis
-anaemia
-dysentery.

Whipworm can be detected by faeces laboratory.

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Hydatid Worm-The parasite infection from dog to man

The hydatid worm have a size of 3-6 mm,adult worms live in the small intestine of dogs and other canines,but never man.
Eggs discharged in faeces are swallowed by intermediate host as sheep,cattle and occasionaly man.
Man ingests the egg along food or water contaminated with faeces of dog or by handling dogs whose hairs are usually contaminated with eggs.


In the intestine the hatches,penetrates the mucosa,to reach different organs where it develops into hydatid cyst.The liver is the common affected organ followed by the lung,then the brain,bone,spleen,kidney,muscles,heart and eyes.

When the cyst is ingested by dog and other canines,the animals develop the adult worms.Since cysts in the viscera of man are not available for dog,the life cycle of the parasite comes to a blind end.

Symptomatology:
Local effects: depend on the size and site of the cyst:
cough,pain,symptoms of increased intracranial tension,epilepsy,bone erosion,fracture.

Diagnosis:
Radiological: X-ray,ulrasonography,C.T scans.
Puncture and aspiration to demonstrate hydatid sand.

Treatment:
-Surgical removal
-Sterilization.

Control and Prevention:

For the dog:
-periodic examination and treatment of pet
-elimination of stray ones
-infected organs in slaughter houses should be destroyed to prevent infection of dogs

For the man:
-avoid food and drink contaminated with faeces of dogs (avoid contact with faeces r the dog presence in food places)
-avoid contact with possible contaminated dogs
-wash the hands after you play with the dog.

Reaction of the body during exposure to heat

When external temperature is 32°C or above the non-evaporative,heat loss stops,even the body gain heat from the atmosphere.Now,the only way of heat loss is evaporation.
The reaction of the body: The body tries to decrease the heat gain by non-evapotrative mech,when the temperature is above 32°C,in addition to decrease heat gain,sweat secretion starts.

Decreased heat gain:
1.Vasodilatation of skin vessels (maximum dilatation at 32°C):
-by decreasing the symptom impulses,the blood flow to the skin increases.
-the temperature of skin rises and the non-evaporative heat loss may increase if the external temperature is below the skin temperature.
-the temperature of skin rises and the evaporative heat loss may increase if the xternal temperature is below the skin temperature.
2.Decreased heat production: The heat production is decreased to the basal level (apathy and anorexia).

Increased heat loss: This starts when the external temperature is above 32 °C.

Read More:
The Quantity and Role of Water in the body

Importance of IRON in Diet.Formation of Red Blood Cells

Iron:
Iron is important for the formation of hemoglobin,myoglobin and other substances such as cytocromes,cytocromes oxydase,peroxidase and catalase enzyme.


Iron Requirements:
In a normal adult very little iron is lost from the body,man lose 0.6 mg per day,wemen lose double this amount becouse of the additional iron losr during menstruation.The amount of iron absorbed is equal to the amount lost,if it wear any greated iron overload would develop.

Iron Absorption:
Iron is absorbed from all parts of the small intestine.Iron is more readily absorbed in the ferrous state but most of the dietary iron is in the ferric form.Only a trace of iron is absorbed in the stomach,but gastric secretions especially hydrochloric acid,dissolve the iron and to permit it to form soluble complexes with ascorbic acid that helps its reduction to the ferrous form.

The importance of this function is indicated by the fact that iron defeciency anemia is a frequent complication of partial gastrectomy.Iron absorption occurs through secretion of protein,apotransferrin by the liver which passes to the small intestine through ble.

When iron is absorbed from the small intestine,it imediatly combines with apotransferrin to form transferrin.This is a lose combination and iron can be released at any point in the body.
Excess iron in the blood can be deposited in all cells of the body.
When the bady has become saturated with iron so that all of the apoferitin in the iron storage areas is already combined with iron,the rate absorption decreases.

Source of Iron in Foods:
Boild Organs
-liver,fish,kidney,heart,goose,shrimps,tongue
Vegetal:
-thyme,curry powder,cinnamon,wheat bran,paprika,bran flakes,cereals,soya,hazelnuts,almonds

CANCER PREVENTION!Formation of Red Blood Cells.Importance of Diet in formation of Red Blood Cells

Red blood Cells production occurs in the bone marrow,starting with the stem cell and progressing through various intermediates.Normal development takes about 7-10 days.

Red Blood Cells are produced in the liver and spleen of the fetus.After birth the bone marrow is the site of formation of Red Blood Cells.Until adolescence the bone marrow of all bones produces Red Blood Cells.
By the age of 20,the marrow is in the cavities of long bones exept the upper humerous and femur becomes infiltrated with fat and produces more red cells.After the age of 20 the marrow of the flat bones is the only site of formation of Red Blood Cells.

Factors affecting the Formation of Red Blood Cells:

-Healthy bone marrow
-Healthy liver
-Hormones
-Diet :Proteins,Iron,Vitamins
-Tissue oxygenation.

1.Healthy Bone Marrow:
A healthy bone marrow is essential for the production of red cells.Bone marrow is destroyd by X-ray,atomic radiation,drugs as CHLORAMPHENICOL and by malignant tumours.

2.Healthy liver:
The liver is important for the formation of red blood cells because:
-it acts as a store of Vitamin B12
-it acts as a store of iron
-it is the site of formation of globin part of hemoglobin molecule.

3.Hormones:
Hormones regulate the metabolic processes in various tissues including the bone marrow.Thus,thyroid hormones,androgens and gluccorticoids stimulate formation of red cells.

4.Diet:
Because of the continuing need to replenish red blood cells,the cells of the bone marrow are among the most rapidly growing and reproducing cells of the entire body.Therefore,as would be expected,their maturation and rate of production is affected greatly by a person's nutritional status.
-Proteins: Proteins of high biological value are needed in the diet to build globin of hemoglobin.Defeciency of proteins in the diet leads to failure of formation of red blood cells.
-Iron: Iron is important for the formation of hemoglobin,myoglobin and other substances such as cytocromes,cytocromes oxydase,peroxidase and catalase enzyme.
-Vitamin B12: All vitamins are needed for formation of red blod cells,but vitamin B12 and folic acid are especcilay important for final maturation of the red cells.
Vitamin B12 contains COBALT and is important for DNA formation.

5.Tissue Oxygenation:
Any condition that cause the amont of oxygen transported to the tissue to decrease will increase the rateof red blood cells production.This can occur in the fallowing conditions:
-at high altitudes where the oxygen pressure is the atmospheric air is decreased thus decreasing oxygen supply to the tissue.
-various diseases as prolonged heart failure and lung diseases.
-increased demand for oxygen as in athletes and hard workers.

READ ALSO:
Importance of Iron in Diet in Formation of Red Blood Cells