SHOCK, ELECTRIC
SHOULDER-HAND SYNDROME
S
volume is reduced, blood vessels are
abnormally widened, the heart's action is
weak, blood flow is obstructed, or there
is a combination of these factors. Caus-
es include severe
bleeding
or
burns,
persistent
vomiting
or
diarrhoea, myo-
cardial infarction
,
pulmonary embolism
,
peritonitis
, and some types of
poisoning
.
Symptoms of shock include rapid,
shallow breathing; cold, clammy skin;
rapid, weak pulse; dizziness; weakness;
and fainting. Untreated, shock can lead
to collapse, coma, and death.
Emergency treatment is required. This
involves an
intravenous infusion
of fluid,
a blood transfusion,
oxygen therapy
,
and, if necessary,
morphine
or similar
powerful analgesics. Further treatment
depends on the underlying cause. (See
also
anaphylactic shock; septic shock;
shock, electric; toxic shock syndrome.)
shock, electric The sensation caused by
an electric current passing through the
body, and its effects. A current of suffi-
cient size and duration can cause loss of
consciousness, cardiac arrest, respiratory
arrest, burns, and tissue damage. (See
also
electrical injury.)
shock therapy See
ECT.
shortsightedness See
myopia.
short sight, operations for See
LASIK;
photorefractive keratectomy
;
keratotomy,
radial.
short stature A height significantly be-
low the normal range for a person's age.
Short stature in children is often due to
hereditary factors or slow bone growth.
In most cases, growth eventually speeds
up, resulting in normal adult height. Less
commonly, it is due to a specific disorder
such as bone disease (as in untreated
rickets
or
achondroplasia
) or certain hor-
monal disorders such as
growth hormone
deficiency and
hypothyroidism
.
Emotional
deprivation
, chronic malnutrition and
malabsorption
can also limit growth. Cer-
tain chromosomal disorders cause short
stature; stunting occurs in
Down's syn-
drome
, and the pubertal growth spurt is
absent in
Turner's syndrome.
Other
causes of restricted growth in children
include prolonged use of
corticosteroids
and
anticancer
drugs. Severe untreated
respiratory disease or congenital heart
disease can also cause short stature.
An affected child's growth rate is moni-
tored by regular measurement of height.
X-rays
and
blood tests
may help identify
an underlying cause, which will then be
treated. Growth hormone is given for hor-
mone deficiency, and also to treat short
stature due to disorders such as Turner's
syndrome. (See also
growth, childhood.)
shoulder The area of the body where the
arm attaches to the trunk.Three bones
meet here: the
scapula, clavicle,
and
humerus.
The ball-and-socket joint at the
shoulder has a wide range of movement.
Common injuries include dislocation
(see
shoulder, dislocation of
) and frac-
tures of the clavicle or upper humerus.
The shoulder may be affected by any
joint
disorder, which in severe cases may
lead to
frozen shoulder
. Inflammation of
a tendon or a bursa around a shoulder
joint can cause
painful arc syndrome.
shoulderblade The common name for
the
scapula
.
shoulder, dislocation of Displacement
of the head of the
humerus
out of the
shoulder joint. The main symptom is
pain in the shoulder and upper arm, made
worse by movement. A forward disloca-
tion often produces obvious deformity;
a backward dislocation usually does not.
Diagnosis is by
X-rays.
The head of
the humerus is repositioned in the joint
socket. The shoulder is then immobilized
in a sling for about 3 weeks.
Complications of shoulder dislocation
include damage to nerves, causing tem-
porary weakness and numbness in the
shoulder; damage to an artery in the
upper arm, causing pain and discolor-
ation of the arm and hand; and damage
to muscles that support the shoulder.
shoulder-hand syndrome Pain and
stiffness affecting one shoulder and the
hand on the same side; the hand may
also become hot, sweaty, and swollen.
Arm muscles may waste through lack of
use (see
Sudeck's atrophy).
The cause of
shoulder-hand syndrome is unknown,
but it may occur as a complication of
myocardial infarction
,
stroke
,
herpes
zoster,
or shoulder injury. Recovery usu-
ally occurs in about 2 years. This period
may be shortened by
physiotherapy
and
corticosteroid drugs.
In rare cases, a cer-
vical
sympathectomy
is performed.
508
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