Симптом наперстка в стоматологии: Причины и условия формирования патологического прикуса. Функция дыхания

Клинические симптомы в стоматологии и челюстно-лицевой хирургии

Симптом (греч. symptoma совпадение, случай, при­знак) — признак патологического состояния или болезни, качественно новый, не свойственный здо­ровому организму феномен, который можно обна­ружить с помощью клинических методов исследова­ния, используемый для диагностики и (или) про­гноза заболевания.

Симптом бабочки — наличие эритемы на спинке носа и на щеках (обычно в области скуловых дуг), по своим очертаниям напоминающей бабочку; ха­рактерен для красной волчанки.

Симптом Бельца — желто-оранжевое окрашива­ние кожи и слизистых оболочек без изменения ок­раски склер; наблюдается при аурантиазе (каротиновой желтухе) кожи.

Симптом Бертона — признак сатурнизма: нежная серая кайма по краю десны у зубов нижней челюс­ти.

Симптом Бехтерева (II) — признак раздражения мозговых оболочек: перкуссия по скуловой дуге вы­зывает боль в голове и сокращение мышц лица.

Симптом Бидермана — возможный признак ак­тивной стадии вторичного сифилиса: темно-красная (обычно розовая) окраска переднего свода глотки.

Симптом Боуга — показание к ортодонтическому лечению: у ребенка 4—7 лет расстояние между по­стоянными молярами не превышает 28 мм.

Симптом Венсана — анестезия или парестезия в области половины нижней губы и подбородка при воспалении, сдавлении или разрыве волокон ниж­него альвеолярного нерва, обусловленных патоло­гическим изменением тканей нижней челюсти.

Симптом Берне (симптом занавески) — признак паралича языкоглоточного нерва: во время рвотного рефлекса мягкое небо не приподнимается, а перетя­гивается на здоровую сторону.

Симптом Вески — врожденный гипертрофичес­кий гингивит.

Симптом Викема (Уикхема) — признак красного плоского лишая: мелкая сетчатость или линии на поверхности папул в результате очагового гранулематоза.

Симптом Виллиса — признак паралича лицевого нерва: гиперемия парализованной половины лица.

Симптом возникающего пузыря — появление на слизистой оболочке рта напряженных пузырей с се­розным или геморрагическим содержимым после их поскабливания шпателем; признак доброкачествен­ной неакантолитической пузырчатки слизистой обо­лочки полости рта.

Симптом волоса — ощущение во рту инородного тела (например, волоса, нитки), вызывающее попыт­ки освободиться от него с помощью движений язы­ка и губ; характерен для отравления тетраэтилсвинцом и некоторыми другими ядами.

Симптом Ганна — признак врожденного птоза, иногда — перенесенного энцефалита: при широком раскрытии рта одновременно широко раскрываются глаза.

Симптом Гареля — признак гайморита: во время просвечивания электрической лампочкой гайморо­вых пазух при их воспалении больной не восприни­мает свет.

Симптом Герена — признак перелома верхней челюсти: при широком раскрытии рта и надавлива­нии указательными пальцами на крючки крыловид­ных отростков основной кости возникают боли, рас­пространяющиеся на всем протяжении поврежден­ной кости.

Симптом Герке — признак медиастинита: при зап­рокидывании головы больного кзади отмечается уси­ление болей в загрудинном пространстве, при воз­вращении головы в прежнее положение боли умень­шаются.

Симптом Гетчинсона (Хатчинсона) (I) — признак позднего врожденного сифилиса: интерстициальный кератит при окрашенной в бледно-розовый цвет ро­говице.

Симптом Гетчинсона (Хатчинсона) (II) — признак позднего врожденного сифилиса: долотообразные верхние первые резцы с полулунной выемкой по ре­жущему краю.

Симптом гидровибрационного колебания — если в результате роста кистозной опухоли произошла ре­зорбция костной стенки, то иногда при перкуссии зубов, корни которых находятся в полости кисты, вибрация и колебания зуба передаются на жидкое содержимое и далее на стенки кисты; эти гидроуда­ры можно ощутить пальцами, если их расположить в области узурированной кости.

Симптом глаз и языка — неспособность больного одновременно удерживать глаза закрытыми, а язык высунутым; проявление гиперкинеза мышц лица и языка, например при малой хорее.

Симптом Говерса (I) — признак поражения лице­вого нерва: при выворачивании нижней губы мыш­цы лица на стороне поражения не сокращаются.

Симптом груши — образование на слизистых обо­лочках и (или) коже пузырей грушевидной формы; признак обыкновенной пузырчатки, обусловленный давлением экссудата на клетки шиловидного слоя эпидермиса, измененные акантолизом.

Симптом Давидсона — признак опухоли гайморо­вой пазухи или гайморита: уменьшение освещенно­сти зрачка, если источник света расположен в поло­сти рта больного.

Симптом двух шпателей — при переломе скуло­вой дуги шпатель не прилегает к телу скуловой кос­ти и расположен по иному в сравнении со здоровой стороной, где он располагается на теле скуловой кости и вдоль наружного отдела орбиты.

Симптом Дюпюитрена — ощущение хруста при надавливании на выбухающую костную стенку аль­веолярного отростка или на челюсть; наблюдается при радикулярной или фоликулярной кисте, а также при некоторых доброкачественных новообразовани­ях челюсти.

Симптом Жильбера-Ано — наличие мелких теле­ангиэктазий звездчатой формы на коже лица и туло­вища при хронических болезнях печени.

Синдром Заблоцкого-Десятовского — признак острого гнойного синусита верхнечелюстной пазу­хи: больной прочищает нос, наклоняет голову впе­ред с поворотом ее в противоположную исследуе­мой гайморовой пазухе сторону; при гайморите в среднем носовом ходе вновь появляется гной.

Симптом занавеса — смещение задней стенки глот­ки в сторону при фонации или надавливании шпателем на язык; признак поражения противоположно­го языкоглоточного нерва или его ядра.

Симптом Кауфмана — признак гнойного гаймо­рита: выпадение слизистой оболочки гайморовой па­зухи, которая при риноскопии может быть ошибоч­но принята за полип среднего носового хода.

Симптом кисета — сужение ротового отверстия с образованием вокруг него глубоких морщин; признак системной склеродермии, обусловленной склерозом и атрофией кожи в области рта.

Симптом Крисовского — признак раннего врож­денного сифилиса: радиарные рубцы после заживле­ния глубоких трещин вокруг рта и в месте соедине­ния фиброзной ткани твердого неба и задней стенки глотки.

Симптом Купермана — признак эритремии (бо­лезнь Вакеза): резкий контраст между цианотичным мягким небом и бледной окраской твердого неба.

Симптом Либермейстера — ранний признак воз­душной эмболии: чувство онемения языка, бледное пятно на языке.

Симптом Малевича («Разбитого горшка») — при­знак перелома скуловой кости, верхней челюсти; при перкуссии зубов слышен глухой, дребезжащий, на­поминающий издаваемый имеющим трещину гли­няным горшком, по которому наносят легкие уда­ры, звук.

Симптом Мальча — неспособность больного вы­сунуть язык, наблюдаемая при сыпном тифе и обус­ловленная поражением ядер подъязычного нерва.

Симптом Марфана — яркая гиперемия слизистой оболочки кончика языка в форме треугольника, на­блюдаемая при брюшном тифе.

Симптом «Маски клоуна» — отсутствие покрас­нения парализованной стороны лица при плаче; на­блюдается при неврите лицевого нерва.

Симптом Миршана — усиленное болезненное вы­деление слюны после смазывания языка слабым ра­створом уксуса у больных эпидемическим паротитом.

Симптом Мондрада—Крона — невозможность произвольных мимических движений при сохранности непроизвольной мимики, обусловленной эмоциями; на­блюдается при центральном параличе лицевого нерва.

Симптом Моргана — признак старения: появле­ние мелких телеангиэктазий на лице, а позже и на других частях тела.

Симптом нагрузки — возникновение боли в ли­нии перелома нижней челюсти при медленном сбли­жении большого и указательного пальцев, установ­ленных на левый и правый углы челюсти, — при­знак перелома подбородочного отдела или тела че­люсти; возникновение боли при надавливании ука­зательным пальцем на подбородок в направлении спереди назад и снизу вверх — признак перелома угла челюсти или ее ветви; признак перелома нижней че­люсти.

Симптом наполнения — характерен для каверноз­ной гемангиомы: при наклоне головы вниз происхо­дит увеличение объема опухоли, а при изменении положения головы она вновь приобретает свои прежние размеры.

Симптом «пергаментный хруст» — истончение стенки челюстей вследствие роста кистозных опухо­лей. При надавливании пальцем истонченная кость прогибается и при этом ощущается характерный хруст (треск), который сравнивают с хрустом пергамента.

Симптом Попова (I) — патология прикуса: сме­щение (выдвигание) зуба в направлении отсутству­ющих антагонистов.

Симптом «разбитого горшка» — признак закры­тых переломов тела верхней челюсти при условии нарушения целости ячеистого отростка, передней и наружной стенки верхнечелюстной (гайморовой) пазухи. Заключается в том, что при ударе инструмен­том по коронке верхних зубов можно услышать вме­сто обычного «чистого» звука глухой, дребезжащий — наподобие звука, издаваемого треснутым глиняным горшком. Этот симптом часто наблюдается при огнестрельных переломах верхней челюсти.

Симптом Робертсона — признак симуляции: при надавливании на болезненную точку зрачок обычно расширяется, в случае же симуляции боли диаметр зрачка при этом не изменяется.

Симптом Робинсона-Фурнье — рубцы кожи вок­руг рта на месте диффузных папулезных инфильтра­тов при раннем врожденном сифилисе.

Симптом Розенберга-Винокурова-Лендорфа — появление энантемы в виде нескольких багрово-крас­ных точечных пятнышек на слизистой оболочке мяг­кого неба, языка и передних дужек у больных сып­ным тифом на 3-й день болезни.

Симптом сжатия — характерен для гемангиом: при механическом надавливании на опухоль она спадает и бледнеет, после устранения раздражителя она при­обретает прежние размеры и цвет.

Симптом Телемана — функциональная перегрузка передних зубов с одной стороны в связи с блокадой движений от взаимного перемещения верхнего и нижнего моляров одноименной стороны.

Симптом Трела — признак туберкулезного поражения полости рта: желтые пятна вокруг язв.

Симптом Тресильяна — признак эпидемического паротита: красная кайма вокруг отверстия протока околоушной железы.

Симптом Филатова — признак начальной стадии кори: появление в продромальном периоде бледных пятен (мелких белых точек на красном фоне) на слизистой оболочке полости рта.

Симптом Форххаймера — признак краснухи: высыпание красных пятен на мягком небе.

Симптом Франке — признак инфлюэнцы (гриппа): красные полосы около края десен.

Симптом Фурнье (I) — возможный признак активной стадии вторичного сифилиса: резкое отграничение кожных высыпаний.

Симптом Фурнье (III) — признак раннего врожденного сифилиса: радиарные рубцы вокруг углов рта после заживления глубоких трещин.

Симптом Хвостека — сокращение мышц лица в ответ на удар молоточком в области прохождения лицевого нерва; признак повышения нервно-мышечной возбудимости, например при гипокальциемии, алкалозе, гипомагниемии.

Симптом Херинга — признак гнойного синусита верхнечелюстной пазухи: при освещении полости рта электрической лампочкой на стороне поражения определяется затемнение.

Симптом Хетчкока — признак эпидемического паротита: болезненность угла нижней челюсти.

Симптом хоботка — тоническое сокращение мышц вокруг рта, при котором губы постоянно вытянуты вперед; признак кататонии.

Симптом Шарко (II) — более высокое стояние брови на стороне периферического пареза мимических мышц и более низкое ее стояние при их контрактуре; наблюдается при периферическом поражении лицевого нерва.

Симптом Шелли — признак инфлюэнцы (гриппа): сагоподобная сыпь на губах и небе.

Симптом Шмрекера — признак наличия околокорневой гранулемы или кисты при условии, если они узурировали (разрушили) переднюю стенку челюсти. Заключается в том, что если положить палец на область верхушки корня и слегка ударять инструментом по коронке зуба, то палец ощущает сотрясение (зыбление).

Симптом Штрауса — значительное уменьшение потоотделения на парализованной стороне лица при инъекции пилокарпина больному с поражением лицевого нерва; признак, позволяющий дифференцировать периферическое поражение лицевого нерва от центрального.

Симптом Шультце — сокращение лицевых мышц, возникающее при легком ударе по щеке; признак тетании.

Симптом «щелкающего» сустава — признак начальной стадии хронических артритов, артрозоартритов височно-нижнечелюстного сустава.

Симптом эректильности  — при надавливании на измененные участки кожи или слизистой оболочки полости рта мягкие ткани бледнеют и легко уменьшаются в объеме, после устранения давления — вновь приобретают прежние окраску и объем; наблюдается при гемангиомах.

 

 Современная стоматология. — 2005. — №1, 3.

90000 dentistry | Definition, History, & Fields 90001 90002 Early dentistry 90003 90004 Dentistry, in some form, has been practiced since ancient times. For example, Egyptian skulls dating from 2900 to 2750 bce contain evidence of small holes in the jaw in the vicinity of a tooth’s roots. Such holes are believed to have been drilled to drain abscesses. In addition, accounts of dental treatment appear in Egyptian scrolls dating from 1500 bce. It is thought that the Egyptians practiced oral surgery perhaps as early as 2500 bce, although evidence for this is minimal.An early attempt at tooth replacement dates to Phoenicia (modern Lebanon) around 600 bce, where missing teeth were replaced with animal teeth and were bound into place with cord. 90005 90004 True restorative dentistry began with the Etruscans, who lived in the area of ​​what is today central and northern Italy. Numerous dental bridges and partial dentures of gold have been found in Etruscan tombs, which date to about 500 bce. The Romans, who conquered the Etruscans, adopted Etruscan culture, and dentistry became a regular part of Roman medical practice.The Greeks also practiced some form of oral medicine, including tooth extractions, from the time of Hippocrates, around 400 bce. 90005 90004 In the Eastern world, dentistry had a totally different history. There is evidence that the early Chinese practiced some restorative dentistry as early as the year 200 bce, using silver amalgam as fillings. Oral medicine was part of the regular medical practice in other early Asian civilizations, such as those in India and Japan. 90005 Get exclusive access to content from our тисяча сімсот шістьдесят вісім First Edition with your subscription.Subscribe today 90004 Because of the proscription in the Qur’an, the sacred scripture of Islam, against mutilating the body, surgery was not practiced in Islamic countries. Instead, reliance was placed upon healing through the use of herbs and medicines; preventive dentistry through strict adherence to oral hygiene became paramount. The writings of early Arabic physicians, such as Avicenna and Abū al-Qāsim, show that scaling and cleaning of teeth were practiced. Extractions were rare and were performed only when a tooth had been loosened.90005 90002 Development of dentistry in Europe 90003 90004 With the demise of the western Roman Empire about the year 475 ce, medicine in Europe declined into a torpor that would last for almost a thousand years. About the only places where medicine or surgery was practiced were monasteries, and monks were aided in their surgical ministrations by the local barbers, who went to the monasteries to cut the monks ‘hair and shave the monks’ beards. In 1163 a church council at Tours, France, ordered that henceforth no monks or priests were to practice any surgery, since it was felt that the shedding of blood was incompatible with the holy office of the clergy.Thus, the only people who had any rudimentary knowledge of surgery were the barbers, and they stepped into the breach, calling themselves barber-surgeons. They practiced simple dentistry, including extractions and cleaning of teeth. In the 1600s a number of barber-surgeons began restricting their activity to surgery and dropped the word «barber,» simply calling themselves surgeons. In England, Henry VIII granted a charter to a combined group of barbers and surgeons, which ultimately evolved into the Royal College of Surgeons.90005 90004 In 1530 the first book devoted entirely to dentistry was published in Germany and was written in German instead of Latin. It addressed barber-surgeons and surgeons, who treated the mouth, rather than university-trained physicians, who ignored all diseases of the teeth. Subsequent to this publication, other surgeons published texts incorporating aspects of dental treatment. 90005 90004 By the 1700s in France, a number of surgeons were restricting their practice to dentistry, and in тисячу сімсот двадцять вісім a leading Parisian surgeon, Pierre Fauchard, gathered together all that was then known about dentistry in a monumental book, 90019 The Surgeon Dentist 90020, or 90019 Treatise on the Teeth 90020.In it he discussed and described all facets of diagnosis and treatment of dental diseases, including orthodontics, prosthetics, periodontal diseases, and oral surgery. Fauchard effectively separated dentistry from the larger field of surgery and thus established dentistry as its own profession. Fauchard is known today as the father of modern dentistry. Other surgeons in Germany and France, who made notable contributions to the field of dentistry, readily followed his lead. 90005 90004 English dentistry did not advance as far as French dentistry in the 18th century.The guild that had united the barbers and surgeons was dissolved in 1745, with the surgeons going their own way. Some barbers continued their dental ministrations and were designated «tooth drawers.» A second group, as a result of the French influence, referred to themselves as «dentists,» while those who did all manner of dentistry were called «operators for the teeth.» The first English book on dentistry, 90019 The Operator for the Teeth 90020, by Englishman Charles Allen, was published in 1685; however, no other works on English dentistry were published until Thomas Berdmore, dentist to King George III, published his treatise on dental disorders and deformities, in 1768.In 1771 English surgeon John Hunter, famed as the father of modern surgery, published 90019 The Natural History of the Human Teeth 90020, an outstanding text on dental anatomy. Hunter also pioneered the transplantation of teeth from one individual to another, and, because of his tremendous reputation, this practice was widely adopted. Although tooth transplantation between individuals did not prove successful, it was nevertheless the first attempt to transplant human tissue from one person to another.In 1806 English dentist Joseph Fox, who served on the staff of Guy’s Hospital in London, offered the first observations on what is today recognized as the «rejection phenomenon» of transplants. 90005.90000 Cavities, Cost, Dentistry, Benefits, Risks & More 90001 90002 Laser dentistry is the use of lasers to treat a number of different dental conditions. It became commercially used in clinical dental practice for procedures involving tooth tissue in 1989. 90003 90002 Laser dentistry potentially offers a more comfortable treatment option for a number of dental procedures involving hard or soft tissue compared to drills and other non-laser tools. 90003 90002 LASER stands for «light amplification by the stimulated emission of radiation.»The instrument creates light energy in a very narrow and focused beam. This laser light produces a reaction when it hits tissue, allowing it to remove or shape the tissue. 90003 90002 Laser dentistry is used in a variety of procedures, including: 90003 90002 Lasers can make dental treatments more efficient, cost effective, and comfortable. The Food and Drug Administration (FDA) has approved laser dentistry as a treatment option for several dental conditions. 90003 90002 It’s worth noting that the American Dental Association (ADA) currently has yet to do so, though they are hopeful about the potential of the field.90003 90002 The two main types of procedures used for laser dentistry are hard tissue and soft tissue procedures. Hard tissue refers to the teeth, and soft tissue refers to the gums. 90003 90002 Common hard tissue procedures include: 90003 90018 90019 90020 Cavity detection. 90021 Lasers can detect cavities early by finding evidence of tooth decay. 90022 90019 90020 Tooth preparations and dental fillings. 90021 Local anesthesia and traditional drills are often not needed with laser treatments.Lasers can kill bacteria in a cavity, which can aid in the long-term health of a tooth. 90022 90019 90020 Treating tooth sensitivity. 90021 Teeth that have sensitivity to hot and cold can be treated with dental lasers that seal tubules on the tooth’s root. 90022 90031 90002 Common soft tissue procedures include: 90003 90018 90019 90020 Treating a «gummy smile.» 90021 Lasers are used to reshape gum tissue associated with «gummy smile,» in which the gums ‘length covers much of the tooth. 90022 90019 90020 Crown lengthening 90021 90020.90021 This procedure reshapes both gum tissue and bone for healthier tooth structure, which helps with placing restorations on the teeth. 90022 90019 90020 Treating tongue frenulum attachment. 90021 Those with a thick or tight frenulum (the fold of skin under the front part of tongue that anchors to the mouth floor) may benefit from a laser frenectomy. This treatment helps children whose restricted frenulum causes them to be tongue-tied, have difficulty breastfeeding, or have a speech impediment.90022 90019 90020 Removing soft tissue folds. 90021 Lasers can remove soft tissue folds from ill-fitting dentures without pain or sutures. 90022 90031 90002 Other laser procedures include: 90003 90018 90019 90020 Viewing tissues. 90021 Optical coherence tomography allows a doctor to safely see inside a tooth or gum tissue. 90022 90019 90020 Removing benign tumors. 90021 Lasers can remove tumors from the palate, gums, and sides of the lips and cheeks through a pain- and suture-free method.90022 90019 90020 Treating obstructive sleep apnea. 90021 Lasers can reshape the throat and relieve associated breathing problems when sleep apnea is caused by tissue overgrowth in the throat. 90022 90019 90020 TMJ (temporomandibular joint) treatment. 90021 Lasers can help reduce pain and inflammation in the joint. 90022 90019 90020 Nerve regeneration. 90021 Lasers can help regenerate damaged blood vessels, nerves, and scars. 90022 90019 90020 Treating cold sores. 90021 Lasers can minimize healing time and reduce pain from cold sores.90022 90019 90020 Teeth whitening. 90021 Lasers speed up the bleaching process during teeth-whitening sessions. 90022 90031 90002 Laser treatments such as these can vary in price, depending on the procedure being done and the laser equipment used. Compared to non-laser treatment, they may be less expensive because the laser treatment is usually completed in fewer sessions. Additionally, dental insurance usually determines reimbursement costs based on the treatment itself and not on what method is used.90003 90002 Therefore, your compensation is likely to be the same as it would with drilling and other procedures. However, it’s always important to ask about your specific policy beforehand to get the most accurate information. 90003 90002 Dental professionals use either hard tissue or soft tissue lasers, depending on the treatment. Some will use both types if the treatment allows. 90003 90002 Hard tissue lasers can cut through tooth structure. Their wavelengths are absorbed through the combination of water and a specific mineral found in teeth.These lasers are most often used to prep or shape teeth for composite bonding, to repair dental fillings that have worn down, and to remove some tooth structure. 90003 90094 Benefits of using laser dentistry over other methods 90095 90018 90019 There is potentially a decreased need for sutures with soft tissue lasers. 90022 90019 Bleeding is minimized in treated soft tissues, as the laser promotes blood clotting. 90022 90019 With some procedures, anesthesia is unnecessary. 90022 90019 The chance for bacterial infections is lower because the laser sterilizes the area.90022 90019 Wounds can heal faster, and it’s possible for tissue to regenerate. 90022 90019 The procedures may involve less damage to the surrounding tissues. 90022 90031 90002 Soft tissue lasers can be absorbed through water and hemoglobin. Hemoglobin is a protein found in red blood cells. 90003 90002 These lasers are used to treat periodontitis, including killing bacteria and activating tissue regrowth. 90003 90002 Soft tissue lasers seal nerve endings and blood vessels while they penetrate the tissue.For this reason, many experience almost no pain after laser treatment. The lasers also promote faster healing of the tissue. 90003 90094 Disadvantages of laser dentistry 90095 90018 90019 Lasers can not be used on teeth that already have certain types of filling, such as metal amalgam. 90022 90019 Hard lasers can sometimes injure tooth pulp. 90022 90019 Some laser procedures still require anesthesia. 90022 90019 Drills are still sometimes needed to complete fillings, including shaping, adjusting the bite, and polishing the filling.90022 90019 Certain procedures can not be done with laser treatment, depending on the preexisting surrounding tissue or components involving the tooth or gums. 90022 90019 There is a risk of gum injury. 90022 90031 90002 The risks of laser dentistry are relatively small. It’s important to find a qualified dental professional, as using the wrong wavelength or power level could damage tissue. Additionally, some providers worry that advertisers are pushing the use of laser treatment beyond what people actually need.90003 90002 Your dentist will have you use special glasses to protect your eyes from the laser. 90003 90002 To find a qualified dentist for laser treatment, look for a professional who has taken educational courses and received the appropriate training. Popular sources of education are through dental schools and dental associations, as well as through the Academy of Laser Dentistry (ALD). 90003 90002 You can also ask your insurance provider for recommendations and ask friends and family who have had positive experiences with laser dentistry.Websites with rating systems can also be useful, though it’s important to determine whether the raters are giving unbiased opinions. 90003.90000 Intestinal Obstruction: Causes, Symptoms, and Diagnosis 90001 90002 Digested food particles must travel through 25 feet or more of intestines as part of normal digestion. These digested wastes are constantly in motion. However, intestinal obstruction can put a stop to this. An intestinal obstruction occurs when your small or large intestine is blocked. The blockage can be partial or total, and it prevents passage of fluids and digested food. 90003 90002 If intestinal obstruction happens, food, fluids, gastric acids, and gas build up behind the site of the blockage.If enough pressure builds up, your intestine can rupture, leaking harmful intestinal contents and bacteria into your abdominal cavity. This is a life-threatening complication. 90003 90002 There are many potential causes of intestinal obstruction. Often, this condition can not be prevented. Early diagnosis and treatment are crucial. An untreated intestinal obstruction can be fatal. 90003 90002 Intestinal obstruction causes a wide range of uncomfortable symptoms, including: 90003 90002 Some of the symptoms may depend on the location and length of time of the obstruction.For example, vomiting is an early sign of small intestine obstruction. This may also occur with an obstruction of your large intestine, if it’s ongoing. A partial obstruction can result in diarrhea, while a complete obstruction can result in an inability to pass gas or stool. 90003 90002 Intestinal obstruction may also cause serious infection and inflammation of your abdominal cavity, known as peritonitis. This occurs when a portion of your intestine has ruptured. It leads to fever and increasing abdominal pain.This condition is a life-threatening emergency requiring surgery. 90003 90002 An obstruction can be partial, which may resolve without surgery. A complete blockage is more likely to need intestinal surgery. 90003 90016 Mechanical obstructions 90017 90002 Mechanical obstructions are when something physically blocks your intestine. In the small intestine, this can be due to: 90003 90020 90021 adhesions, which consist of fibrous tissue that can develop after any abdominal or pelvic surgery or after severe inflammation 90022 90021 volvulus, or twisting of the intestines 90022 90021 intussusception, a «telescoping , «or pushing, of one segment of intestine into the next section 90022 90021 malformations of the intestine, often in newborns, but can also occur in children and teens 90022 90021 tumors within your small intestine 90022 90021 gallstones, although they rarely cause obstructions 90022 90021 swallowed objects, especially in children 90022 90021 hernias, which involve a portion of your intestine protruding outside of your body or into another part of your body 90022 90021 inflammatory bowel disease, such as Crohn’s disease 90022 90039 90002 Although less common, mechanical obstructions can also block your colon, or large intestine.This can be due to: 90003 90020 90021 impacted stool 90022 90021 adhesions from pelvic infections or surgeries 90022 90021 ovarian cancer 90022 90021 colon cancer 90022 90021 meconium plug in newborns (meconium being the stool babies first pass) 90022 90021 volvulus and intussusception 90022 90021 diverticulitis , the inflammation or infection of bulging pouches of intestine 90022 90021 stricture, a narrowing in the colon caused by scarring or inflammation 90022 90039 90016 Nonmechanical obstruction 90017 90002 Your small and large intestines normally work in a coordinated system of movement.If something interrupts these coordinated contractions, it can cause a functional intestinal obstruction. This is generally known as a nonmechanical obstruction. If it’s a temporary condition, it’s referred to as an ileus. It’s called a pseudo-obstruction if it becomes chronic, or long term. 90003 90002 Causes for ileus include: 90003 90002 Intestinal pseudo-obstruction can be caused by: 90003 90002 Intestinal obstruction in infants typically arises from infections, organ diseases, and decreased blood flow to the intestines (strangulation).Some children experience the condition after having a stomach flu. This can cause inflammation in their intestines. 90003 90002 Intussusception is most common in children 2 years old and younger. This occurs when one part of their bowel collapses or slides into another part. As a result, their intestine becomes blocked. 90003 90002 Any type of intestinal obstruction is difficult to diagnose in infants because they can not describe their symptoms. Instead, parents must observe their children for changes and symptoms that could indicate a blockage.Examples include: 90003 90020 90021 abdominal swelling 90022 90021 drawing knees up to their chest 90022 90021 appearing excessively drowsy 90022 90021 having a fever 90022 90021 grunting in pain 90022 90021 passing stools that appear to have blood in them, known as a currant jelly stool 90022 90021 very loud crying 90022 90021 vomiting, particularly bile-like vomiting that is yellow-green 90022 90021 displaying signs of weakness 90022 90039 90002 If you notice these symptoms or other changes in your child, seek immediate medical attention.90003 90002 Seek medical care if you have symptoms of an intestinal obstruction, especially if you’ve recently undergone abdominal surgery. If you experience abdominal bloating, severe constipation, and a loss of appetite, seek immediate medical attention. 90003 90002 First, a doctor may push on your abdomen to examine it. They then listen with a stethoscope to any sounds being made. The presence of a hard lump or particular kinds of sounds, especially in a child, may help determine whether an obstruction exists.90003 90002 Other tests include: 90003 90020 90021 blood tests for blood counts, liver and kidney function, and levels of electrolytes 90022 90021 X-rays 90022 90021 CT scan 90022 90021 colonoscopy, a flexible lighted tube that your doctor uses to look at your large intestine 90022 90021 enema with contrast 90022 90039 90002 Treatment is essential to reduce complications such as: 90003 90002 If the obstruction is preventing blood from getting to a segment of intestine, this can lead to: 90003 90020 90021 infection 90022 90021 tissue death 90022 90021 intestinal perforation 90022 90021 sepsis, a life-threatening blood infection 90022 90021 multiple organ failure 90022 90021 death 90022 90039 90002 For some people with a chronic obstruction due to a stricture or narrowing of their intestine, a doctor may place a metal stent that expands inside the intestine using a long tube called an endoscope.The stent, a wire mesh, holds open the intestine. The procedure may not require cutting into the abdomen, and it’s usually used if a person is not a candidate for traditional surgery. 90003 90002 Treatment depends on the location and severity of the obstruction. Do not attempt to treat the problem at home. The appropriate treatment depends on the type of intestinal obstruction. 90003 90002 For partial obstructions or an ileus, it may be possible to treat by simply resting the bowels and giving intravenous (IV) fluids.Bowel rest means you’ll be given nothing to eat, or clear liquids only, during that time. If the cause of the obstruction is known, your doctor treats that as well. 90003 90002 Treating dehydration is important. A doctor may give you IV fluids to correct electrolyte imbalance. A catheter may be inserted into your bladder to drain urine. 90003 90002 A tube may need to be passed through your nose and down into your throat, stomach, and intestines to relieve: 90003 90002 If your problem is due to the use of narcotic pain medications, your doctor can prescribe medication that reduces the effect of the narcotics on your bowels.90003 90002 Surgery will be required if these measures fail or if your symptoms become worse. Treatment in this case typically requires a hospital stay. You’ll be given IV fluids, because in addition to relieving dehydration, they help prevent shock during surgery. 90003 90002 A severe complication of a bowel obstruction can be permanent damage to your intestine. If this occurs, a surgeon will perform an operation to remove the section of dead tissue and rejoin the two healthy ends of your intestine.90003 90002 While prescription medications can not treat the obstruction itself, they can help reduce your nausea until further interventions are performed. Examples of medications your doctor may prescribe include: 90003 90020 90021 antibiotics to reduce infection 90022 90021 antinausea medicines to keep you from vomiting 90022 90021 pain relievers 90022 90039 90002 You should not ignore the symptoms of an intestinal obstruction or attempt to treat an intestinal obstruction at home. 90003 90002 When left untreated, intestinal obstruction can cause the tissue in the affected part of your intestine to die.It can also lead to a hole, or perforation, in the wall of your intestine, severe infection, and shock. 90003 90002 Overall, the outlook of your condition depends on its cause. Most cases of intestinal obstruction are treatable. However, other causes, such as cancer, require long-term treatment and monitoring. 90003.90000 13 Signs and Symptoms of Lyme Disease 90001 90002 Lyme disease is an underreported, under-researched, and often debilitating disease transmitted by spirochete bacteria. The spiral-shaped bacteria, 90003 Borrelia burgdorferi 90004, are transmitted by blacklegged deer ticks. Lyme’s wide range of symptoms mimic those of many other ailments, making it difficult to diagnose (1, 2). 90005 90002 The blacklegged ticks can also transmit other disease-causing bacteria, viruses, and parasites. These are known as coinfections (1).These ticks that transmit Lyme are increasing their geographical spread. As of 2016, they were found in about half the counties in 43 of 50 states in the United States (3). 90005 90002 Lyme is the fifth most reported of notifiable diseases in the United States, with an estimated 329,000 new cases found annually (4). But in some states, estimates suggest that Lyme disease is profoundly underreported (4). Some studies estimate that there are as many as 1 million cases of Lyme in the United States every year (5).90005 90002 Most people with Lyme who are treated right away with three weeks of antibiotics have a good prognosis. 90005 90002 But if you’re not treated for weeks, months, or even years after infection, Lyme becomes more difficult to treat. Within days of the bite, the bacteria can move to your central nervous system, muscles and joints, eyes, and heart (6, 7). 90005 90002 Lyme is sometimes divided into three categories: acute, early disseminated, and late disseminated. But the progression of the disease can vary by individual, and not all people go through each stage (8).90005 90002 Every individual reacts to the Lyme bacteria differently. You may have some or all of these symptoms. Your symptoms may also vary in severity. Lyme is a multi-system disease. 90005 90002 Here is a list of 13 common signs and symptoms of Lyme disease. 90005 90002 The signature rash of a Lyme tick bite looks like a solid red oval or a bull’s-eye. It can appear anywhere on your body. The bull’s-eye has a central red spot, surrounded by a clear circle with a wide red circle on the outside.90005 90002 The rash is flat and usually does not itch. The rash is a sign that the infection is spreading within your skin tissues. The rash expands and then resolves over time, even if you’re not treated. 90005 90002 Thirty percent or more of people with Lyme disease do not remember having the rash (9). 90005 90002 Even fewer people remember a tick attachment. Estimates range from 20 to 50 percent (10). The ticks in the nymph stage are the size of poppy seeds, and their bites are easy to miss.90005 90002 The initial red rash usually appears at the site of the bite within 3 to 30 days (11). Similar but smaller rashes can appear three to five weeks later, as the bacteria spread through tissues (12). Sometimes the rash is just a red blotch (1, 13). The rash can also take other forms, including a raised rash or blisters (14). 90005 90002 If you do have a rash, it’s important to photograph it and see your doctor to get treated promptly. 90005 90032 90033 Summary: 90034 If you see a flat rash shaped like an oval or bull’s-eye anywhere on your body, it could be Lyme.See your doctor. 90035 90002 Whether or not you see the tick bite or the classic Lyme rash, your early symptoms are likely to be flu-like. Symptoms are often cyclical, waxing and waning every few weeks (12). 90005 90002 Tiredness, exhaustion, and lack of energy are the most frequent symptoms. The Lyme fatigue can seem different from regular tiredness, where you can point to activity as a cause. This fatigue seems to take over your body and can be severe. 90005 90002 You may find yourself needing a nap during the day, or needing to sleep one or more hours longer than usual.90005 90002 In one study, about 84 percent of children with Lyme reported fatigue (8). In a 2013 study of adults with Lyme, 76 percent reported fatigue (15). 90005 90002 Sometimes Lyme-related fatigue is misdiagnosed as chronic fatigue syndrome, fibromyalgia, or depression (8). 90005 90002 In some Lyme cases, fatigue can be disabling (16). 90005 90032 90033 Summary: 90034 Extreme fatigue is a frequent symptom of Lyme. 90035 90002 Joint pain and stiffness, often intermittent, are early Lyme symptoms.Your joints may be inflamed, warm to the touch, painful, and swollen. You may have stiffness and limited range of motion in some joints (1). 90005 90002 Pain may move around. Sometimes your knees may hurt, whereas other times it’s your neck or your heels. You may also have bursitis (16). Bursae are the thin cushions between bone and surrounding tissue. 90005 90002 The pain may be severe, and it may be transitory. More than one joint may be affected. Most often the large joints are involved (12).90005 90002 People often attribute joint problems to age, genetics, or sports. Lyme should be added to that list, as these statistics indicate: 90005 90060 90061 One study estimates that 80 percent of people with untreated Lyme have muscle and joint symptoms (17). 90062 90061 Fifty percent of people with untreated Lyme have intermittent episodes of arthritis (17). 90062 90061 Two-thirds of people have their first episode of joint pain within six months of the infection (18). 90062 90061 Use of anti-inflammatory drugs may mask the actual number of people with joint swelling (19).90062 90069 90032 90033 Summary: 90034 Joint pain that comes and goes, or moves from joint to joint, could be a sign of Lyme. 90035 90002 Other common flu-like symptoms are headaches, dizziness, fever, muscle pain, and malaise. 90005 90002 About 50 percent of people with Lyme disease have flu-like symptoms within a week of their infection (18). 90005 90002 Your symptoms may be low-level, and you may not think of Lyme as a cause. For example, when fever occurs, it’s usually low-grade (18).90005 90002 In fact, it can be difficult to distinguish Lyme flu symptoms from a common flu or viral infection. But, unlike a viral flu, for some people the Lyme flu-like symptoms come and go. 90005 90002 Here are a few statistics from different studies of Lyme patients: 90005 90060 90061 Seventy-eight percent of children in one study reported headaches (8). 90062 90061 Forty-eight percent of adults with Lyme in one study reported headaches (20). 90062 90061 Fifty-one percent of children with Lyme reported dizziness (8).90062 90061 In a 2013 study of adults with Lyme, 30 percent experienced dizziness (15). 90062 90061 Thirty-nine percent of children with Lyme reported fevers or sweats (8). 90062 90061 Among adults with Lyme, 60 percent reported fever in a 2013 study (15). 90062 90061 Forty-three percent of children with Lyme reported neck pain (8). 90062 90061 A smaller number of children with Lyme reported sore throats (8). 90062 90069 90032 90033 Summary: 90034 Low-level flu symptoms that periodically return could be a sign of Lyme.90035 90002 Sleep disturbances in Lyme are common. 90005 90002 Joint pain may wake you up at night. Your body temperature may fluctuate, and night sweats or chills can wake you. 90005 90002 Your face and head may feel flushed. 90005 90002 Here are some of the statistics from studies: 90005 90060 90061 In a 2013 study, 60 percent of adults with early Lyme reported sweats and chills (15). 90062 90061 The same study reported that 41 percent experienced sleep disturbances (15). 90062 90061 Twenty-five percent of children with Lyme reported disturbed sleep (8).90062 90069 90032 90033 Summary: 90034 Sleep disturbances are common with Lyme, including night sweats and chills. 90035 90002 There are many kinds and degrees of cognitive disturbances, and they can be scary. 90005 90002 You may notice that you have difficulty concentrating in school or at work. 90005 90002 Your memory may have lapses that were not there before. You may have to reach to remember a familiar name. 90005 90002 You may feel as though you’re processing information more slowly.90005 90002 Sometimes when driving or taking public transportation to a familiar place, you may forget how to get there. Or you may be confused about where you are or why you’re there. 90005 90002 You might get to a store to shop, but entirely forget what it was that you were supposed to look for. 90005 90002 You might at first attribute this to stress or age, but the decline in capabilities may worry you. 90005 90002 Here are some statistics: 90005 90060 90061 Seventy-four percent of children with untreated Lyme reported cognitive problems (8).90062 90061 Twenty-four percent of adults with early Lyme reported difficulty concentrating (15). 90062 90061 In later Lyme, 81 percent of adults reported memory loss (21). 90062 90069 90032 90033 Summary: 90034 Lyme bacteria can affect your brain and mental processes. 90035 90002 Bright indoor light may feel uncomfortable or even blinding. 90005 90002 Light sensitivity is bad enough for some people to need sunglasses indoors, in addition to wearing sunglasses outdoors in normal light. 90005 90002 Light sensitivity was found in 16 percent of adults with early Lyme (15).90005 90002 In the same study, 13 percent reported blurry vision. 90005 90032 90033 Summary: 90034 Light sensitivity, including to indoor light, is a symptom of Lyme. 90035 90002 Neurological symptoms can be subtle and sometimes specific. 90005 90002 In general, you may feel unsure of your balance or less coordinated in your movements. 90005 90002 Walking down a slight incline on your driveway might take an effort that it never did before. 90005 90002 You might trip and fall more than once, although this never happened to you before.90005 90002 Some Lyme effects are very specific. 90005 90002 For example, the Lyme bacteria may affect one or more of your cranial nerves. These are the 12 pairs of nerves that come from your brain to your head and neck area. 90005 90002 If the bacteria invade the facial nerve (the seventh cranial nerve), you can develop muscle weakness or paralysis on one or both sides of your face. This palsy is sometimes mistakenly called Bell’s palsy. Lyme disease is one of the few illnesses that cause palsies on both sides of the face.Or you may have numbness and tingling on your face. 90005 90002 Other affected cranial nerves can cause loss of taste and smell. 90005 90002 A Centers for Disease Control and Prevention (CDC) study of 248,074 reported Lyme disease cases nationwide from тисячу дев’ятсот дев’яносто два to 2006 found that 12 percent of Lyme patients had cranial nerve symptoms (9). 90005 90002 As the Lyme bacteria spread through the nervous system, they can inflame the tissues where the brain and spinal cord meet (the meninges). 90005 90002 Some of the common symptoms of Lyme meningitis are neck pain or stiffness, headache, and light sensitivity.Encephalopathy, which alters your mental state, is less common. 90005 90002 These neurological symptoms occur in about 10 percent of adult individuals with untreated Lyme disease (18). 90005 90032 90033 Summary: 90034 Neurological problems, ranging from balance issues, to stiff neck, to facial palsy, could be symptoms of Lyme. 90035 90002 Skin symptoms appear early in Lyme (21). 90005 90002 You may have unexplained skin rashes or large bruises without usual cause. 90005 90002 Skin outbreaks may be itchy or unsightly.They could also be more serious, such as B cell lymphoma (21). 90005 90002 Other skin ailments associated with Lyme are: 90005 90060 90061 morphea, or discolored patches of skin (21) 90062 90061 lichen sclerosus, or white patches of thin skin (21) 90062 90061 parapsoriasis, a precursor to skin lymphoma 90062 90069 90002 In Europe, some of the skin diseases that result from Lyme transmitted by a different Borrelia species are: 90005 90060 90061 borrelial lymphocytoma, which is common in Europe as an early Lyme marker (22) 90062 90061 acrodermatitis chronica atrophicans (21) 90062 90069 90032 90033 Summary: 90034 In addition to the classic Lyme rash, other unexplained rashes can be Lyme symptoms.90035 90002 Lyme bacteria can invade your heart tissue, a condition called Lyme carditis. 90005 90002 Carditis can range from mild to severe. 90005 90002 The bacterial interference in your heart can cause chest pains, light-headedness, shortness of breath, or heart palpitations (23). 90005 90002 The inflammation caused by the infection blocks the transmission of electrical signals from one chamber of the heart to the other, so the heart beats irregularly. This is known as heart block. 90005 90002 Lyme can also affect the heart muscle itself.90005 90002 How common is Lyme carditis? Here are some statistics: 90005 90060 90061 The CDC reports that only 1 percent of reported Lyme cases involve carditis (23). 90062 90061 Other studies report that 4 to 10 percent of Lyme patients (or more) have carditis (24, 25). However, these figures may include a broader definition of carditis. 90062 90061 Children can also have Lyme carditis (24). 90062 90069 90002 With treatment, most people will recover from an episode of Lyme carditis. However, it has caused occasional deaths.The CDC reported three sudden Lyme carditis deaths from 2012-2013 (26). 90005 90032 90033 Summary: 90034 Lyme bacteria can affect your heart, producing a range of symptoms. 90035 90002 Lyme can affect your moods. 90005 90002 You may be more irritable, anxious, or depressed. 90005 90002 Twenty-one percent of early Lyme patients reported irritability as a symptom. Ten percent of Lyme patients in the same study reported anxiety (15). 90005 90032 90033 Summary: 90034 Mood swings can be a symptom of Lyme.90035 90002 Some people with Lyme may have sharp rib and chest pains that send them to the emergency room, suspecting a heart problem (27). 90005 90002 When no problem is found, after the usual testing, the ER diagnosis is noted as an unidentified «musculoskeletal» cause. 90005 90002 You can also have strange sensations like skin tingling or crawling, or numbness or itchiness (27). 90005 90002 Other symptoms have to do with cranial nerves. 90005 90060 90061 Ear-ringing (tinnitus). Tinnitus can be a nuisance, especially at bedtime when it seems to get louder as you’re trying to fall asleep.About 10 percent of people with Lyme experience this (15). 90062 90061 Hearing loss. One study reported that 15 percent of Lyme patients experienced loss of hearing (28). 90062 90061 Jaw pain or toothaches that are not related to actual tooth decay or infection. 90062 90069 90032 90033 Summary: 90034 Lyme can be the cause of unexplained sensations or pain. 90035 90002 Children are the largest population of Lyme patients. 90005 90002 The CDC study of reported Lyme cases from 1992-2006 found that the incidence of new cases was highest among 5 to 14-year-olds (9).About one quarter of reported Lyme cases in the United States involve children under 14 years old (29). 90005 90002 Children can have all the signs and symptoms of Lyme that adults have, but they may have trouble telling you exactly what they feel or where it hurts. 90005 90002 You may notice a decline in school performance, or your child’s mood swings may become problematic. 90005 90002 Your child’s social and speech skills or motor coordination may regress. Or your child may lose their appetite.90005 90002 Children are more likely than adults to have arthritis as an initial symptom (25). 90005 90002 In a 2012 Nova Scotian study of children with Lyme, 65 percent developed Lyme arthritis (30). The knee was the most commonly affected joint. 90005 90032 90033 Summary: 90034 Children have the same Lyme symptoms as adults, but are more likely to have arthritis. 90035 90002 If you have some of the signs and symptoms of Lyme, see a doctor — preferably one familiar with treating Lyme disease! 90005 90002 The International Lyme and Associated Diseases Society (ILADS) can provide a list of Lyme-aware doctors in your area (31).90005 90032 90033 Summary: 90034 Find a doctor familiar with treating Lyme disease. 90035 90304 What about tests? 90305 90002 The commonly used ELISA test is not a reliable indicator for many Lyme patients (32). 90005 90002 The Western blot test tends to be more sensitive, but it still misses 20 percent or more of Lyme cases (32). 90005 90002 If you do not have the initial Lyme rash, diagnosis is usually based on your symptoms and your potential exposure to blacklegged ticks. The doctor will rule out other possible diseases that may cause the same symptoms.90005 90032 90033 Summary: 90034 Lyme diagnosis is usually based on your symptoms. 90035 90304 What to do if you have a blacklegged tick bite 90305 90002 Remove the tick by pulling it directly out with fine-tipped tweezers. Lift upward with slow and even pressure. Do not twist when removing it. Do not crush it or put soap or other substances on it. Do not apply heat to it. 90005 90002 Place the tick in a resealable container. See if you can identify what kind of a tick it is. 90005 90002 Immediately after removing the tick, wash your skin well with soap and water or with rubbing alcohol.90005 90002 Not all ticks carry Lyme. The Lyme bacteria is transmitted only by blacklegged ticks in their nymph or adult stage. 90005 90002 Save the tick to show your doctor. The doctor will want to determine if it’s a blacklegged tick and if there’s evidence of feeding. Ticks enlarge as they feed. Your risk of getting Lyme from an infected tick increases with the length of time that the tick fed on your blood. 90005 90032 90033 Summary: 90034 Pull the tick out with tweezers and save it in a resealable container for identification.90035 90304 Antibiotics work 90305 90002 If you have the classic Lyme rash or other symptoms of early Lyme, you’ll need at least three weeks of oral antibiotics. Shorter courses of treatment have resulted in a 40 percent relapse rate (33). 90005 90002 Even with three weeks of antibiotics, you may need one or more courses of antibiotics if your symptoms return. 90005 90002 Lyme is tricky and affects different people in different ways. The longer you’ve had symptoms, the more difficult it is to treat.90005 90032 90033 Summary: 90034 At least three weeks of oral antibiotics are recommended when you have symptoms of early Lyme. 90035 90002 Lyme is a serious tick-borne disease with a wide range of symptoms. 90005 90002 If you get treated as soon as possible with an adequate course of antibiotics, you’ll have a better outcome. 90005 90002 Finding a Lyme-aware doctor is important. 90005.