Eustachian Tube: From 2 Different Sources
The passage that runs from the middle ear into the back of the nose, just above the soft palate. The tube acts as a drainage channel from the middle ear and maintains hearing by opening periodically to regulate air pressure. The lower end of the tube opens during swallowing and yawning, allowing air to flow up to the middle ear, equalizing the air pressure on both sides of the eardrum.
When a viral infection such as a cold causes blockage of the eustachian tube, equalization cannot occur, resulting in severe pain and temporary impairment of hearing. A person with a blocked eustachian tube who is subjected to rapid pressure changes may suffer from barotrauma. Glue ear or chronic otitis media may occur if the tube is blocked, preventing adequate drainage from the middle ear. These conditions, which often result in partial hearing loss are more common in children. This is partly because their adenoids are larger and more likely to cause a blockage if they become infected and partly because children’s eustachhian tubes are shorter than those of adults.
the tube that connects the middle *ear to the pharynx. It allows the pressure on the inner side of the eardrum to remain equal to the external pressure. [B. Eustachio (1520–74), Italian anatomist]
A small-bore plastic or rubber tube passed into the stomach through the nose, pharynx and then the oesophagus. It is used either to aspirate gas and liquid from the stomach or to pass food or drugs into it.... nasogastric tube
A fleshy, underground part of a stem or root. Example: potato, Paeonia.... tuber
The term is used in two distinct senses. As a descriptive term in anatomy, a tubercle means a small elevation or roughness upon a BONE, such as the tubercles of the ribs. In the pathological sense, a tubercle is a small mass, barely visible to the naked eye, formed in some organ as the starting-point of TUBERCULOSIS. The name of tubercle bacillus was originally given to the micro-organism that causes this disease, but was subsequently changed to Mycobacterium tuberculosis. The term ‘tubercular’ should strictly be applied to anything connected with or resembling tubercles or nodules, and the term ‘tuberculous’ to anything pertaining to the disease tuberculosis.... tubercle
Tubes, one on each side, lying in the pelvic area of the abdomen, which are attached at one end to the UTERUS, and have the other unattached but lying close to the ovary (see OVARIES). Each is 10–12·5 cm (4–5 inches) long, large at the end next to the ovary, but communicating with the womb by an opening which admits only a bristle. These tubes conduct the ova (see OVUM) from the ovaries to the interior of the womb. Blockage of the Fallopian tubes by a chronic in?ammatory process resulting from infection is a not uncommon cause of infertility in women. (See ECTOPIC PREGNANCY; REPRODUCTIVE SYSTEM.)... fallopian tubes
The structure in the EMBRYO from which the BRAIN and SPINAL CORD develop.... neural tube
Congenital abnormalities resulting from the failure of the NEURAL TUBE to form normally. The resulting conditions include SPINA BIFIDA, MENINGOCELE and defects in the bones of the SKULL.... neural tube defects
See EMBRYO TRANSFER.... test-tube baby
The term given to any skin lesion which is the result of infection with the tubercle bacillus, or Mycobacterium tuberculosis as it is now known.... tuberculide
Tuberculin is the name originally given by Koch in 1890 to a preparation derived from the tubercle bacillus, or Mycobacterium tuberculosis as it is now known, and intended for the diagnosis or treatment of TUBERCULOSIS.... tuberculin
A prominent area on a bone to which tendons are attached.... tuberosity
adj. see tuberous.... tuberose
See AIR PASSAGES; BRONCHUS; LUNGS.... bronchial tubes
The passages, one on each side, leading from the throat to the middle ear. Each is about 38 mm (1••• inches) long and is large at either end, though at its narrowest part it only admits a ?ne probe. The tubes open widely in the act of swallowing or yawning. The opening into the throat is situated just behind the lower part of the nose, so that a catheter can be passed through the corresponding nostril into the tube for in?ation of the middle ear. (See also EAR; NOSE.)... eustachian tubes
See NASOGASTRIC TUBE.... ryle’s tube
been recognised from earliest times. Evidence of the condition has been found in Egyptian mummies; in the fourth century BC Hippocrates, the Greek physician, called it phthisis because of the lung involvement; and in 1882 Koch announced the discovery of the causative organism, the tubercle bacillus or Mycobacterium tuberculosis.
The symptoms depend upon the site of the infection. General symptoms such as fever, weight loss and night sweats are common. In the most common form of pulmonary tuberculosis, cough and blood-stained sputum (haemoptysis) are common symptoms.
The route of infection is most often by inhalation, although it can be by ingestion of products such as infected milk. The results of contact depend upon the extent of the exposure and the susceptibility of the individual. Around 30 per cent of those closely exposed to the organism will be infected, but most will contain the infection with no signi?cant clinical illness and only a minority will go on to develop clinical disease. Around 5 per cent of those infected will develop post-primary disease over the next two or three years. The rest are at risk of reactivation of the disease later, particularly if their resistance is reduced by associated disease, poor nutrition or immunosuppression. In developed countries around 5 per cent of those infected will reactivate their healed tuberculosis into a clinical problem.
Immunosuppressed patients such as those infected with HIV are at much greater risk of developing clinical tuberculosis on primary contact or from reactivation. This is a particular problem in many developing countries, where there is a high incidence of both HIV and tuberculosis.
Diagnosis This depends upon identi?cation of mycobacteria on direct staining of sputum or other secretions or tissue, and upon culture of the organism. Culture takes 4–6 weeks but is necessary for di?erentiation from other non-tuberculous mycobacteria and for drug-sensitivity testing. Newer techniques involving DNA ampli?cation by polymerase chain reaction (PCR) can detect small numbers of organisms and help with earlier diagnosis.
Treatment This can be preventative or curative. Important elements of prevention are adequate nutrition and social conditions, BCG vaccination (see IMMUNISATION), an adequate public-health programme for contact tracing, and chemoprophylaxis. Radiological screening with mass miniature radiography is no longer used.
Vaccination with an attenuated organism (BCG – Bacillus Calmette Guerin) is used in the United Kingdom and some other countries at 12–13 years, or earlier in high-risk groups. Some studies show 80 per cent protection against tuberculosis for ten years after vaccination.
Cases of open tuberculosis need to be identi?ed; their close contacts should be reviewed for evidence of disease. Adequate antibiotic chemotherapy removes the infective risk after around two weeks of treatment. Chemoprophylaxis – the use of antituberculous therapy in those without clinical disease – may be used in contacts who develop a strong reaction on tuberculin skin testing or those at high risk because of associated disease.
The major principles of antibiotic chemotherapy for tuberculosis are that a combination of drugs needs to be used, and that treatment needs to be continued for a prolonged period – usually six months. Use of single agents or interrupted courses leads to the development of drug resistance. Serious outbreaks of multiply resistant Mycobacterium tuberculosis have been seen mainly in AIDS units, where patients have greater susceptibility to the disease, but also in developing countries where maintenance of appropriate antibacterial therapy for six months or more can be di?cult.
Streptomycin was the ?rst useful agent identi?ed in 1944. The four drugs used most often now are RIFAMPICIN, ISONIAZID, PYRAZINAMIDE and ETHAMBUTOL. Three to four agents are used for the ?rst two months; then, when sensitivities are known and clinical response observed, two drugs, most often rifampicin and isoniazid, are continued for the rest of the course. Treatment is taken daily, although thrice-weekly, directly observed therapy is used when there is doubt about the patient’s compliance. All the antituberculous agents have a range of adverse effects that need to be monitored during treatment. Provided that the treatment is prescribed and taken appropriately, response to treatment is very good with cure of disease and very low relapse rates.... nature of the disease tuberculosis has
A soft rubber or plastic tube with rounded end, and usually about 75 cm (30 inches) in length, which is used for washing out the stomach when it contains some poisonous material. (See GASTRIC LAVAGE.) A narrower tube, 90 cm (36 inches) in length, is used to obtain a sample of gastric juice for examination. Such a tube can also be allowed to pass out of the stomach into the duodenum so that the contents of the upper part of the small intestine are similarly obtained for analysis.... stomach tube
A tube of thin glass closed at one end, which is used for observing chemical reactions or for bacterial culture.... test-tube
A tube that is passed into the trachea through the nose or mouth that enables delivery of oxygen during artificial ventilation or of anaesthetic gases (see anaesthesia) during surgery. An inflatable cuff around the lower end of the endotracheal tube prevents secretions or stomach contents from entering the lungs.... endotracheal tube
Skin tests used to determine whether or not a person has been exposed to the bacterium that causes tuberculosis. Tuberculin tests are carried out for diagnosis of tuberculosis, and before BCG vaccination. A small amount of tuberculin (purified protein from the bacteria) is injected into the skin. A few days later, the skin reaction, if any, is noted. A reaction indicates previous exposure.... tuberculin tests
a surgical procedure used to treat dysfunction of the *Eustachian tube. A small balloon is inserted from the *nasopharynx into the Eustachian tube in a deflated state under endoscopic control. It is then inflated to widen the Eustachian tube before being deflated and removed.... balloon eustachian tuboplasty
A chronic bone and joint condition due to bovine from of tuberculosis believed to be caused by drinking TB milk and cream. Mostly in children, beginning in fluids surrounding a joint before invading bone tissue. Instead of normal flesh colour a joint has a white appearance. Condition maybe secondary to disease of the lungs or glands. Pain worse at night.
Elecampane (Inula) has a direct effect on TB bacilli, controlling night sweats and localising the disease. Agents yielding salicylates (mild analgesics) Meadowsweet, White Willow, etc are of value. Echinacea increases phagocytic power of the leucocytes and may normalise percentage count of neutraphiles. To meet individual needs, it will be necessary to vary treatment many times during the course of the disease.
Alternatives. Echinacea, Elecampane, Balm of Gilead buds (Hyde), Gotu Kola, Comfrey root, Iceland Moss. Rupturewort promotes elasticity of lung tissue.
Decoction. Equal parts: Iceland Moss, Comfrey root, Elecampane root, Liquorice. Mix. 1oz to 1 pint water gently simmered 20 minutes in a covered vessel. Dose: Half a cup thrice daily.
Alternative formulae:– Powders. White Willow 2; Comfrey 1; Echinacea 1; Ginger quarter. Mix. Dose: 750mg (three 00 capsules or half a teaspoon) thrice daily.
Tinctures. White Willow 2; Echinacea 1; Blue Cohosh half; White Poplar half; Tincture Capsicum quarter. Mix. 1 teaspoon thrice daily before meals.
Tincture Krameria (Rhatany root), Dose: 30-60 drops in water thrice daily.
Fenugreek seed tea.
Comfrey. Potential benefit of Comfrey root outweighs risk.
Topical. Compresses: Mullein leaves, Lobelia, Comfrey root or Fenugreek. Evening Primrose oil. No massage to affected joints.
Diet. Low carbohydrate. Oily fish.
Supplements. Vitamins A, B6, B12, D, Niacin, Calcium, Iron, Phosphorus.
General. Tuberculosis is a notifiable disease for which specific medical treatment is available. Failure to comply may expose a practitioner to a charge of negligence. ... arthritis – tuberculous
(FTR) an *interventional radiology technique to open up blocked Fallopian tubes as a treatment for infertility. This usually follows a *hysterosalphingogram.... fallopian tube recanalization
acute generalized *tuberculosis characterized by lesions in affected organs, which resemble millet seeds.... miliary tuberculosis
an electronic device that magnifies the light emitted from a *scintillator by accelerating electrons in a high-voltage field. The resulting signal can be used to display the scintillations on a TV screen. Such devices are commonly used in *gamma cameras.... photomultiplier tube
see tuberculosis.... pulmonary tuberculosis
fine-calibre tubes for insertion into subcutaneous tissue to drain excess fluid. They are rarely used in practice today. [R. Southey (1835–99), British physician]... southey’s tubes
n. (in anatomy) a long hollow cylindrical structure, e.g. a *Fallopian tube.... tube
adj. having small rounded swellings or nodules, not necessarily caused by tuberculosis.... tubercular
n. a mass of cheeselike material resembling a tumour, seen in some cases of *tuberculosis. Tuberculomas are found in a variety of sites, including the lung or brain, and a single mass may be the only clinical evidence of disease. Treatment is by surgical excision, together with antituberculous drugs.... tuberculoma
(tuberose) adj. knobbed; having nodules or rounded swellings.... tuberous