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Vascular Access For Chemotherapy
In medicine, vascular access is a means of accessing the bloodstream through the peripheral or central blood vessels in order to obtain blood or deliver medications including chemotherapy. A vascular access procedure involves insertion of a sterile plastic tube called a catheter into a blood vessel. Types of catheters can be either peripherally or centrally located. Peripheral catheters are approximately one inch (25 mm) long and are inserted into the small veins of the forearm. Central catheters are bigger and longer and are inserted into the large veins of the extremities, neck, or chest. Central venous catheters are the primary modality used for delivery of chemotherapeutic agents. The duration of central venous catheterization is dependent on the type of treatment given. Central venous catheters Central venous catheters (CVC) are catheters inserted into the large veins of the arm, neck, chest, or groin. CVC's are used for delivery of medications, nutrients, or blood pro ...
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Venous Access
Venous access is any method used to access the bloodstream through the veins, either to administer intravenous therapy (e.g. medication, fluid), parenteral nutrition, to obtain blood for analysis, or to provide an access point for blood-based treatments such as dialysis or apheresis. Access is most commonly achieved via the Seldinger technique, and guidance tools such as ultrasound and fluoroscopy can also be used to assist with visualizing access placement. Methods Peripheral The most common form of venous access is a peripheral venous cannula which is generally inserted into veins of the hands, forearms, and occasionally feet. Healthcare providers may use a number of different techniques in order to improve the chances of successful access. Some techniques include using a tourniquet, tapping over the vein, warming the area to dilate the vein, or using an ultrasound to directly visualize the target vein. Near-infrared illumination devices can also be used to help identify ...
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Fluoroscopy
Fluoroscopy () is an imaging technique that uses X-rays to obtain real-time moving images of the interior of an object. In its primary application of medical imaging, a fluoroscope () allows a physician to see the internal structure and function of a patient, so that the pumping action of the heart or the motion of swallowing, for example, can be watched. This is useful for both diagnosis and therapy and occurs in general radiology, interventional radiology, and image-guided surgery. In its simplest form, a fluoroscope consists of an X-ray source and a fluorescent screen, between which a patient is placed. However, since the 1950s most fluoroscopes have included X-ray image intensifiers and cameras as well, to improve the image's visibility and make it available on a remote display screen. For many decades, fluoroscopy tended to produce live pictures that were not recorded, but since the 1960s, as technology improved, recording and playback became the norm. Fluoroscopy is s ...
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Jugular Vein
The jugular veins are veins that take deoxygenated blood from the head back to the heart via the superior vena cava. The internal jugular vein descends next to the internal carotid artery and continues posteriorly to the sternocleidomastoid muscle. Structure and Function There are two sets of jugular veins: external and internal. The left and right external jugular veins drain into the subclavian veins. The internal jugular veins join with the subclavian veins more medially to form the brachiocephalic veins. Finally, the left and right brachiocephalic veins join to form the superior vena cava, which delivers deoxygenated blood to the right atrium of the heart. The Jugular veins help carry blood from the heart to and from the brain. An average human brain weighs about 3 pounds, and gets about 15%-20% of the blood that the heart pumps out. It is important for the brain to get enough blood for many reasons. The jugu ...
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Bleeding
Bleeding, hemorrhage, haemorrhage or blood loss, is blood escaping from the circulatory system from damaged blood vessels. Bleeding can occur internally, or externally either through a natural opening such as the mouth, nose, ear, urethra, vagina or anus, or through a puncture in the skin. Hypovolemia is a massive decrease in blood volume, and death by excessive loss of blood is referred to as exsanguination. Typically, a healthy person can endure a loss of 10–15% of the total blood volume without serious medical difficulties (by comparison, blood donation typically takes 8–10% of the donor's blood volume). The stopping or controlling of bleeding is called hemostasis and is an important part of both first aid and surgery. Types * Upper head ** Intracranial hemorrhage – bleeding in the skull. ** Cerebral hemorrhage – a type of intracranial hemorrhage, bleeding within the brain tissue itself. ** Intracerebral hemorrhage – bleeding in the brain caused by the ruptur ...
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Hematoma
A hematoma, also spelled haematoma, or blood suffusion is a localized bleeding outside of blood vessels, due to either disease or trauma including injury or surgery and may involve blood continuing to seep from broken capillary, capillaries. A hematoma is benign and is initially in liquid form spread among the tissues including in sacs between tissues where it may coagulate and solidify before blood is reabsorbed into blood vessels. An ecchymosis is a hematoma of the skin larger than 10 mm. They may occur among and or within many areas such as skin and other organs, connective tissues, bone, joints and muscle. A collection of blood (or even a hemorrhage) may be aggravated by anticoagulant medication (blood thinner). Blood seepage and collection of blood may occur if heparin is given via an Intramuscular injection, intramuscular route; to avoid this, heparin must be given intravenously or subcutaneous injection, subcutaneously. Signs and symptoms Some hematomas are visible ...
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Asepsis
Asepsis is the state of being free from disease-causing micro-organisms (such as pathogenic bacteria, viruses, pathogenic fungi, and parasites). There are two categories of asepsis: medical and surgical. The modern day notion of asepsis is derived from the older antiseptic techniques, a shift initiated by different individuals in the 19th century who introduced practices such as the sterilizing of surgical tools and the wearing of surgical gloves during operations. The goal of asepsis is to eliminate infection, not to achieve sterility. Ideally, a surgical field is sterile, meaning it is free of all biological contaminants (e.g. fungi, bacteria, viruses), not just those that can cause disease, putrefaction, or fermentation. Even in an aseptic state, a condition of sterile inflammation may develop. The term often refers to those practices used to promote or induce asepsis in an operative field of surgery or medicine to prevent infection. History The modern concept of asepsis evol ...
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Sepsis
Sepsis, formerly known as septicemia (septicaemia in British English) or blood poisoning, is a life-threatening condition that arises when the body's response to infection causes injury to its own tissues and organs. This initial stage is followed by suppression of the immune system. Common signs and symptoms include fever, tachycardia, increased heart rate, hyperventilation, increased breathing rate, and mental confusion, confusion. There may also be symptoms related to a specific infection, such as a cough with pneumonia, or dysuria, painful urination with a pyelonephritis, kidney infection. The very young, old, and people with a immunodeficiency, weakened immune system may have no symptoms of a specific infection, and the hypothermia, body temperature may be low or normal instead of having a fever. Severe sepsis causes organ dysfunction, poor organ function or blood flow. The presence of Hypotension, low blood pressure, high blood Lactic acid, lactate, or Oliguria, low urine o ...
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Pneumothorax
A pneumothorax is an abnormal collection of air in the pleural space between the lung and the chest wall. Symptoms typically include sudden onset of sharp, one-sided chest pain and shortness of breath. In a minority of cases, a one-way valve is formed by an area of damaged tissue, and the amount of air in the space between chest wall and lungs increases; this is called a tension pneumothorax. This can cause a steadily worsening oxygen shortage and low blood pressure. This leads to a type of shock called obstructive shock, which can be fatal unless reversed. Very rarely, both lungs may be affected by a pneumothorax. It is often called a "collapsed lung", although that term may also refer to atelectasis. A primary spontaneous pneumothorax is one that occurs without an apparent cause and in the absence of significant lung disease. A secondary spontaneous pneumothorax occurs in the presence of existing lung disease. Smoking increases the risk of primary spontaneous pneumothora ...
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Medical Ultrasound
Medical ultrasound includes diagnostic techniques (mainly imaging techniques) using ultrasound, as well as therapeutic applications of ultrasound. In diagnosis, it is used to create an image of internal body structures such as tendons, muscles, joints, blood vessels, and internal organs, to measure some characteristics (e.g. distances and velocities) or to generate an informative audible sound. Its aim is usually to find a source of disease or to exclude pathology. The usage of ultrasound to produce visual images for medicine is called medical ultrasonography or simply sonography. The practice of examining pregnant women using ultrasound is called obstetric ultrasonography, and was an early development of clinical ultrasonography. Ultrasound is composed of sound waves with frequencies which are significantly higher than the range of human hearing (>20,000 Hz). Ultrasonic images, also known as sonograms, are created by sending pulses of ultrasound into tissue using a pr ...
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Blood Vessel
The blood vessels are the components of the circulatory system that transport blood throughout the human body. These vessels transport blood cells, nutrients, and oxygen to the tissues of the body. They also take waste and carbon dioxide away from the tissues. Blood vessels are needed to sustain life, because all of the body's tissues rely on their functionality. There are five types of blood vessels: the arteries, which carry the blood away from the heart; the arterioles; the capillaries, where the exchange of water and chemicals between the blood and the tissues occurs; the venules; and the veins, which carry blood from the capillaries back towards the heart. The word ''vascular'', meaning relating to the blood vessels, is derived from the Latin ''vas'', meaning vessel. Some structures – such as cartilage, the epithelium, and the lens and cornea of the eye – do not contain blood vessels and are labeled ''avascular''. Etymology * artery: late Middle English; from Latin ...
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Brachial Veins
In human anatomy, the brachial veins are venae comitantes of the brachial artery in the arm proper. Because they are deep to muscle, they are considered deep veins. Their course is that of the brachial artery (in reverse): they begin where radial veins and ulnar veins join (corresponding to the bifurcation of the brachial artery). They end at the inferior border of the teres major muscle. At this point, the brachial veins join the basilic vein to form the axillary vein. The brachial veins also have small tributaries that drain the muscles of the upper arm, such as biceps brachii muscle and triceps brachii muscle. Additional Images File:Slide8UUU.JPG, Brachial vein File:Gray576.png, The veins of the right axilla The axilla (also, armpit, underarm or oxter) is the area on the human body directly under the shoulder joint. It includes the axillary space, an anatomical space within the shoulder girdle between the arm and the thoracic cage, bounded superior ..., viewed f ...
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Basilic Vein
The basilic vein is a large superficial vein of the upper limb that helps drain parts of the hand and forearm. It originates on the medial (ulnar) side of the dorsal venous network of the hand and travels up the base of the forearm, where its course is generally visible through the skin as it travels in the subcutaneous fat and fascia lying superficial to the muscles. The basilic vein terminates by uniting with the brachial veins to form the axillary vein. Anatomy Course As it ascends the medial side of the biceps in the arm proper (between the elbow and shoulder), the basilic vein normally perforates the brachial fascia (deep fascia) superior to the medial epicondyle, or even as high as mid-arm. Tributaries and anastomoses Near the region anterior to the cubital fossa (in the bend of the elbow joint), the basilic vein usually communicates with the cephalic vein (the other large superficial vein of the upper extremity) via the median cubital vein. The layout of superfic ...
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