Localized intracranial space occupying lesions.
- Tumors usually grow as a spherical mass or diffuse and infiltrate tissue
- occur from the compression and infiltration of tissue
- increased intracranial pressure
- cerebral edema
- seizure activity
- focal neurologic signs
- altered pituitary function
Effects of Neoplasm depend on the region of the brain occupied by the tumor:
Primary tumors: originate from cells and structures within the brain
Secondary (metastatic) tumors: develop from structures outside the brain
- occur in 20-40% of all patients with cancer
- brain tumors rarely metastasize outside the CNS
- metastasis origin
- lower GI tract
Glial and Meningeal tumors: linked to ionizing radiation exposure
- in adults – higher incidence in the fifth, sixth and seventh decades
- higher incidence in men than women
- Adult brain tumors originate most often originate from glial cells (forming the supportive structures of the spinal cord and CNS)
MRI of Brain tumor:
Indications for Orthopedic Surgical interventions
- unstabilized fracture
- joint disease
- necrotic or infarcted tissue
Indications for Joint Replacement
- severe joint pain
- severe disability
- rheumatoid arthritis
- congenital deformity
- femoral neck fractures where blood supply has been disrupted
Joint Implant Types
- Metal and high-density polyethylene components
- implants are usually cemented in place with polymethacrylate (PMMA)
- PMMA is a bone binding agent that has similar properties to bone
- Loosening of prosthesis is the main reason for prosthesis failure
bone ingrowth on right:
2. Press-fit ingrowth prosthesis
- porous-coated and cementless
- bone grows into the implant
Pre-operative considerations: organ functioning
Risk factors for DVT and Pulmonary embolism
- preoperative leg edema
- DVT Hx
- Varicose Veins
- hip prosthesis dislocation
- excessive wound drainage
- heel pressure ulcers
- heterotrophic ossification = bone growth in the periprosthetic space
- avascular osseous necrosis
- loosening of the prosthesis
Martin, Glenn and Porth, Carol, Mattson. 2009. Pathophysiology Concepts of Altered Health States. 8th ed. Lippincott Williams and Wilkins. Philadelphia
A type of nerve damage where both the nerve and the nerve sheath are damaged. Only partial recovery may occur.
Used to stabilize the vertebra after laminectomy or during spinal fusion.
The subcutaneous tissue lies between the skin (epidermis and dermis) and the underlying muscle; it is made up of loose connective tissue and varying amounts of fat. It also contains cutaneous nerves, small lymph vessels and blood vessels.
Subcutaneous treatment can be given when treatment is not suitable to be given orally. Subcutaneous treatment can be given in preference to intramuscular medication.
Subcutaneous treatment can be given in preference to intravenous treatment.
medication may be given several times a day into the same site.
The most frequently used sites include
- Abdomen and chest wall (avoiding the umbilical area)
- Thighs: upper and lateral aspects
- Upper arms: upper and outer aspects
- 1-2mls can be injected as a bolus into a site.
- The abdomen is frequently chosen for infusion of larger volumes. However, many individuals do not like the thought of having needles in their abdomen.
- Erythema and swelling at the site of infusion