Project 2

Project A:

1. Pathological Condition : Colon cancer.

Is shown in figure-1.

• a. normal function is to digest and absorb ingested nutrients, and to excrete waste products of digestion. Most nutrients are ingested in a form that is either too complex for absorption or insoluble, and therefore, indigestible or incapable of being digested.
• b. Pathology stage: Most of these tumours are adenocarcinomas (96%), that, in some cases, show a mucinous component.
• c. Reasons: colon cancer begins when healthy cells in the colon develop changes (mutations) in their DNA. A cell's DNA contains a set of instructions that tell a cell what to do. Healthy cells grow and divide in an orderly way to keep your body functioning normally.
• d. Homeostasis change: Altered Ca 2+ homeostasis is a hallmark of cancer cells. Deregulation of cytosolic [Ca 2+] is implicated in metastasis and apoptosis-resistance. Genes involved in cancer influence [Ca 2+] to exert their tumor-related functions.

2. Diagnostic method:

• a. Using a scope to examine the inside of your colon (colonoscopy). Colonoscopy uses a long, flexible and slender tube attached to a video camera and monitor to view your entire colon and rectum. If any suspicious areas are found, your doctor can pass surgical tools through the tube to take tissue samples (biopsies) for analysis and remove polyps. is shown in figure-2.
• b. Data: Recent 20-year follow-up data from this study showed a reduction in colorectal cancer-related mortality of 53% 77, an encouraging result that has been echoed by a more-recent study 80. The quality of colonoscopy is a determining factor in the diagnostic yield of cancer and adenoma, which is the most certain way of avoiding interval cancers (that is, a tumour arising in between screening visits). is shown in figure-3.
• c. Doctor can identify by using Tumor Cell Type

The type of colon tumor describes the cells from which the tumor arises. Adenocarcinoma is the most common type, accounting for 95-98% of colon cancers. An adenocarcinoma arises from the glandular cells that line the inside of the colon. Two subtypes of adenocarcinoma are signet ring and mucinous, which are both named for the way the cells look under the microscope. The other 2-5% of cancers found in the colon are lymphomas, gastrointestinal stromal tumors (GIST), and carcinoid tumors, which are not discussed in this article.

If a polyp was removed, this section will describe the type of polyp. A colon polyp is a benign growth that, over time, can turn into cancer. For that reason, they are removed during a colonoscopy and may be sent to the pathologist to determine what type of polyp it is. There are several types of polyps that can be found in the colon:

1. Tubular adenoma (also called adenomatous polyp): this accounts for 70% of the polyps found in the colon and can progress into cancer, but this happens over many years. If they are found early, they can be removed during a colonoscopy.
2. Villous adenoma: this accounts for 15% of the polyps found in the colon. This type of polyp has the highest risk of turning into cancer. In some cases, these can be removed during colonoscopy, but in other cases, surgery is required.
3. Hyperplastic polyps and Inflammatory (or pseudopolyps): these two types of polyps are not likely to turn into a cancer.

In addition, colon polyps come in two forms, called pedunculated and sessile. Pedunculated polyps grow on a stalk and look like a small mushroom, which can usually be easily removed during a colonoscopy. The sessile type of polyp is flat and grows on the wall of the colon. These are much more difficult to remove and may require surgery to remove the entire polyp.

3. Medication- when tumor is in starting stage,

surgery- when tumor is too large.

1. Polypectomy: A surgeon will remove potentially cancerous polyps from your colon.
2. Local excision: If cancer hasn’t yet spread outside the lining of the colon, your doctor might be able to remove just a small piece of the lining of the colon wall.
3. Colectomy: Once cancer has spread into the tissue surrounding the colon, a doctor will likely have to remove a part of the colon.

4. Surgical solution:

• a. Partial colectomy.
• b. Supine position.
• c.

  Laparoscopic partial colectomy is one of two ways through which a part of the colon is removed. While conventional open colectomy requires a long incision in the abdomen to gain access to the colon, the laparoscopic procedure is less invasive. Also known as minimally invasive colectomy, the surgeon makes small incisions where specialised surgical instruments are inserted. These instruments are used to perform the procedure inside the patient’s body while the surgeon controls them from the outside using a computer monitor as a guide.

  One of these instruments is a cannula or port, a narrow tube that can pass through an incision less than half an inch in size. The surgeon then pumps carbon dioxide through the cannula to inflate the organs and create more space for the procedure to be performed.

  The surgeon then inserts the laparoscope, a thin tube with a tiny video camera attached to one end, which provides a magnified view of the colon on an attached computer monitor.

  For the procedure, the part of the colon that has to be removed is freed from the abdominal wall and other organs. The blood vessels attached to it are then sealed using a special energy device. The part of the colon that has been detached is then extracted through one of the cannula incisions. is shown in figure-5.

• d. procedure: with help of laptower and electro surgical unit, and suction machine, some surgical instruments are essential forPartial colectomy.
• e. https://youtu.be/OPvJmiTMqkc and https://youtu.be/DUQWmpAn_Ik

5.

You’ll spend a few days recovering in the hospital before you’re discharged. It might be two days or up to a week, depending on what kind of operation you had and how you are doing. During this time, you’ll be:

• Monitored for any signs of complications from the procedure.
• Gradually weaned from your pain medication.
• Fed with a liquid diet or soft diet.
• Waiting for your bowels to begin functioning again.

You’ll also receive counseling on how to take care of yourself when you get home. This may include:

• Wound care.
• Ostomy care.
• Dietary advice.

What are the potential risks or complications of colectomy.

Complications are rare, but they're always possible. Complications of colectomy may include:

• Bleeding.
• Infection.
• Injury to nearby organs.
• Anastomotic leak.

How long does it take to recover from a colectomy.

Recovery at home takes up to six weeks. Many people get back to most of their usual routines within two weeks after surgery. Try to be extra gentle with yourself in the first few days after you get home. Getting up to walk around is good for you, but you may feel weak. Don’t try to do too much, too soon.

What can I eat after a colectomy.

You'll likely meet with a dietitian or nutritional counselor after surgery to give you specific advice. They may recommend sticking to a low-fiber diet for up to one month after surgery. Low-fiber foods create less work for your colon while it’s trying to heal. They may also recommend you drink more water.

6.

• a. Laptower- for viewing internal parts during surgery. figure-6
• b. laproscopic instruments- take out the ctted part.figure-7
• c. electrosurgical unit- cutting the part. figure-8
• d. suction machine- for suction of fluids. figure-9

Project b.

1. Pathological Condition : heart attack.

figure-10.

• a. normal function is to circulate blood flow throught the body.
• b. Pathology stage: heart attack is block the blood flow from the heart to entire body.
• c. Reasons: Lifestyle changes , cholestrol or fatty substance of the body.
• d. Homeostasis change: When the heart becomes damaged, such as after a heart attack, it may not be able to maintain adequate flow. This causes blood pressure to fall, initiating homeostatic feedback loops to try to bring blood pressure (and cardiac output) back to normal. One way that the heart can become damaged is through a heart attack.

2. Diagnostic method:

• a.

Electrocardiogram (ECG or EKG). This first test done to diagnose a heart attack records electrical signals as they travel through the heart. Sticky patches (electrodes) are attached to the chest and sometimes the arms and legs. Signals are recorded as waves displayed on a monitor or printed on paper. An ECG can show if you are having or have had a heart attack.

Blood tests. Certain heart proteins slowly leak into the blood after heart damage from a heart attack. Blood tests can be done to check for these proteins (cardiac markers).

Chest X-ray. A chest X-ray shows the condition and size of the heart and lungs.

Echocardiogram. Sound waves (ultrasound) create images of the moving heart. This test can show how blood moves through the heart and heart valves. An echocardiogram can help identify whether an area of your heart has been damaged.

Coronary catheterization (angiogram). A long, thin tube (catheter) is inserted into an artery, usually in the leg, and guided to the heart. Dye flows through the catheter to help the arteries show up more clearly on images made during the test.

Cardiac CT or MRI. These tests create images of the heart and chest. Cardiac CT scans use X-rays. Cardiac MRI uses a magnetic field and radio waves to create images of your heart. For both tests, you usually lie on a table that slides inside a long tubelike machine. Each test can be used to diagnose heart problems. They can help show the severity of heart damage.

• b. figure-11.

Echocardiogram.

diagnosis is by using the figure-11.

Heart echo can reveal how someone’s heart has been affected by a heart attack. This can be diagnosed when one part of the heart doesn’t work as well as the other segments, called “regional wall motion abnormality“. Echo is widely used to Identify the cause of heart failure.

• c.

1. Anesthesia is given if the test is transoesophageal echocardiogram.
2. Electrodes are fixed on the chest.
3. Transducer is used to take ultrasound images for which a gel is applied for smooth movement.
4. Follow instruction regarding position change and breathing pattern.

parameters he considered.

1. Normal results are inferred when the images produced do not show any complications.
2. Abnormal results are signified when images show defects in heart size, shape, muscles or valves.

• d. Medication when minimum blocage, angioplasty when the blocage is more.

3.

• a. medication- tablets.
• b. surgery- angioplasty and cardiac bypass surgery.

4. surgical solution.

figure-12.

figure-13.

• a. Name of surgery- angioplasty.
• b. Supine position.
• c. figure-14.

This description will be about a coronary angioplasty, but providers perform angioplasty in a similar way on other parts of your body. However, they may put the catheter in through a different artery than they would for the heart.

1. Your provider puts a catheter or tube through your skin and into a blood vessel in your wrist or groin. They use medicine to keep you from feeling the tube go into your body.
2. With X-rays to help find the way, a cardiologist, or heart expert, moves the catheter (tube) through your blood vessels to get to your blocked or narrowed coronary artery. You might feel warm briefly when they release a dye through the catheter to make it easier to see your blood vessels.
3. When they get to the problem area, your provider will put in a wire and another catheter (a balloon catheter) that has a very small balloon at the end of it.
4. Once they inflate the balloon, it moves the plaque out of the way and off to the side of the artery wall. This clears the way for blood to get through. Your narrow coronary artery is like a crowded subway car with people blocking the aisle. In order for people to get through the aisle, others need to move closer to the walls. The catheter balloon is like a football team that would force everyone to the side of the subway car so they could get through the aisle. Your provider will usually then put in a stent, a small hollow scaffold made of metal. Stronger than a balloon, the stent keeps the artery open after balloon removal.

The stent, which your provider expands and locks into position after it’s put in your artery, stays inside your artery long after the angioplasty is done. Many stents have a drug coating that helps prevent your artery from getting too narrow again.

If you have peripheral artery disease, your provider may use a balloon that transfers its medicine coating to the artery wall. The drug stays behind after the balloon is taken out.

You may feel some discomfort when your provider inflates the balloon, but that goes away when they deflate it. Your healthcare provider deflates the balloon after it has done its job. The balloon can be inflated a couple of times in the same spot or in another blocked artery in your body.

Using an angiogram (X-ray images of your blood vessels), your provider can compare how well your blood flowed before and after your angioplasty to see how well it worked.during angioplasty procedure.

• d. CATHLAB x-ray system, guide wire, stunt, IABP machine, anasthesia machine.
• e. https://youtu.be/F2bJFDvDVxg and https://youtu.be/sfemrawMfT4

5.

1. Monitor patient’s vital signs especially the cardiac rate and rhythm using a cardiac monitor every 15 to 30 minutes for two hours.
2. Apply a sandbag on the site for 6-8 hours or as ordered by the physician.
3. Monitor for bleeding. Inspect the pressure dressing if soak. ...
4. Instruct the patient to keep the extremity straight for 4-6 hours or as indicated by the physician.

6.

Ultrasound- image acquisition. figure-15.

CATH LAB( FLEUROSCOPY X-ray system)- accising the site. figure-16.

IABP machine- increase the artery size. figure-17.