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Atrial booster-pump function is the active contribution of atrial contraction to ventricular filling. In the left atrium, contraction late in ventricular diastole helps drive blood through the open mitral valve. It supplements earlier filling associated with atrial conduit function, rather than accounting for all filling during the cardiac cycle.^[ref]

A volumetric descriptor compares the chamber volume just before contraction, $V_{\mathrm{preA}}$, with the subsequent minimum, $V_{\min }$. Their difference is the observed active-phase volume loss; the left atrial active emptying fraction usesFor constructed values 50 and 40 mL, the volume loss is 10 mL and this fraction is $20\%$. Choosing the denominator is part of defining the descriptor.

That loss is not automatically all of the blood flow through the mitral valve during the interval. Integrating the left atrium's balance giveswhere $V_{\mathrm{PV}}$ is signed net pulmonary vein inflow over the same interval. If $V_{\mathrm{PV}}=8$ mL in the constructed example, 18 mL leaves through the mitral valve despite a chamber-volume decrease of only 10 mL.

A primary atrial flow component analysis reconstructed flow from time-resolved computed tomography and computational fluid dynamics, distinguishing modeled passage and residence histories.^[ref] This helps separate a phase-associated volume measurement from the route taken by each parcel. Likewise, an observed contraction-associated volume loss is not itself a controlled measurement of how much less ventricular filling would have occurred without contraction; pressure, timing and continuing inflow can also differ.

Atrial contraction is active shortening of the atrial myocardium that contributes to moving blood from the atria into the ventricles. In the usual coordinated cardiac cycle, it occurs late in ventricular diastole, while the mitral valve and tricuspid valve permit filling. It supplements earlier passive filling; ventricular filling is not restricted to the period of atrial contraction.^[ref]

For the left atrium, this active contribution is called atrial booster-pump function, distinguishable from atrial reservoir function and atrial conduit function. A volume balance separates storage from transport:where $Q_{\mathrm{PV}}$ is summed pulmonary vein inflow and $Q_{\mathrm{mitral}}$ is net outflow through the mitral valve. During atrial contraction, a decrease in chamber volume can accompany outflow larger than the continuing inflow.

In an original example, the left atrium loses 15 mL during a chosen contraction interval while receiving 5 mL through the pulmonary veins. Integrating the balance shows that 20 mL must have left through the mitral valve. The volume decrease alone would undercount that interval's forward transport by 5 mL. Conversely, not all blood entering the left ventricle in that interval was necessarily stored before contraction began.

The distinction matters experimentally: a changing cavity volume, a velocity recorded at a valve and the trajectory of a particular parcel of blood are different observations. A primary flow-component study used time-resolved computed tomography, computational fluid dynamics and modeled particle paths to distinguish atrial transport routes.^[ref] A volume change associated with contraction is informative, but its interpretation requires the concurrent inflows and outflows.

Atrial flow component analysis classifies blood transport through an atrium by the entry, exit and retention histories of represented fluid parcels. It asks a different question from measuring only maximum and minimum left atrium volumes: which blood passed onward, remained within the chamber, or crossed a boundary in another direction?

A primary study used time-resolved computed tomography to reconstruct moving atrial anatomy, computational fluid dynamics to estimate the flow field, and modeled particle trajectories to classify six components. It distinguished atrial conduit flow component, atrial reservoir flow component, atrial delayed-ejection flow component, atrial retained-inflow component, atrial residual-volume component and pulmonary-vein backflow component.^[ref] These are model-derived transport categories, not six separate anatomical chambers.

A typical trajectory calculation followswhere $\mathbf{u}$ is the modeled fluid velocity. Boundary crossings and their timing within a defined cardiac cycle determine the category. For example, the study's conduit definition requires entry and exit within the same ventricular diastolic phase.^[ref] Changing the time window or category definition changes what is counted.

An original weighting example shows why counting markers alone can be misleading. Suppose three modeled markers represent 1, 1 and 8 mL, with the first two assigned to one component. That component contains 2 of 10 mL, or $20\%$, although it contains two-thirds of the markers. The relevant fraction iswith $w_i$ the represented volumes for the chosen analysis. The denominator must be stated; an analysis that includes entering flow is not automatically a partition of one instantaneous chamber volume.

The results depend on reconstructed boundaries, flow assumptions, numerical tracking and phase definitions. Atrial reservoir function and atrial conduit function can be investigated with these categories, but a volumetric proxy and a parcel-based component need not be identical observations.

The atrial reservoir flow component is blood entering the left atrium during ventricular systole and leaving through the mitral valve in the following ventricular diastole. This parcel-based category in atrial flow component analysis specifies both arrival and departure phases.^[ref]

Its definition explains the storage interpretation of atrial reservoir function. In an idealized closed-outlet interval, the left atrium's volume balance iswhere $Q_{\mathrm{PV}}$ is total net inflow from the pulmonary veins. A stipulated constant 50 mL/s for 0.3 s increases atrial volume by 15 mL. This balance describes storage during that interval. To label all 15 mL as atrial reservoir flow component, a parcel record must additionally show the prescribed subsequent exit.

For example, imagine that the stored 15 mL comprises 12 mL that leaves in the following ventricular diastole and 3 mL that remains beyond it. The volume increase is still 15 mL, but the qualifying atrial reservoir flow component from those arrivals is 12 mL. Conversely, older blood can leave during the same filling phase without having entered during the immediately preceding ventricular systole.

A maximum-minus-minimum atrial volume is therefore not an automatic census of this category. Chamber volume measures how much is inside at a given time; pathlines identify which represented blood is inside and where it goes. The primary study combined moving anatomy from computed tomography, computational fluid dynamics and numerical pathlines rather than directly measuring each parcel's velocity with the anatomical scanner.^[ref] These complementary observations connect a visible chamber motion to a specific transport question.

Atrial reservoir function is the temporary storage of returning blood in an atrium during a phase when its inflow exceeds its outflow. For the left atrium, it is especially relevant while the mitral valve is closed during ventricular systole. It differs from passive onward passage, or atrial conduit function, and from the active late-filling contribution of atrial contraction.^[ref]

A direct volume measure is the excursion $\Delta V=V_{\max }-V_{\min }$ over a specified cardiac cycle. Its denominator matters when it is converted into a ratio. An original example with volumes 70 and 40 mL gives $\Delta V=30$ mL, but $\Delta V/V_{\min }=75\%$ and $\Delta V/V_{\max }\approx 42.9\%$. These ratios describe different normalizations of the same excursion, not contradictory measurements.

The governing storage balance isA constant net inflow of 60 mL/s for 0.4 s stores 24 mL in this idealized interval. Neither the peak inflow rate nor a single chamber volume alone supplies the required integral. Over a repeating cycle with no net accumulation, total inflow and outflow must balance even though storage changes within the cycle.

The volume excursion also does not identify how long each parcel remains in the left atrium. A primary study reconstructed atrial flow using time-resolved computed tomography and computational fluid dynamics, then followed modeled particles to distinguish conduit, reservoir and longer-residence components.^[ref] Two atria can have similar maximum and minimum volumes while differing in which blood passes directly onward or remains through later phases. Storage volume and parcel residence are related questions, but they are different measurements.

Compensation for photons lost along an emission-imaging path. In PET/CT or SPECT/CT, a registered computed tomography attenuation map supplies information for this correction.

Bipes is a taxonomic genus of burrowing amphisbaenians distinguished by retaining external forelimbs despite an elongated body and absence of external hindlimbs. It is an informative comparison with other amphisbaenians, which lack external limbs: external appearance alone does not reveal how much internal anatomy remains.^[ref]

In a 2019 anatomical study, investigators used iodine-enhanced computed tomography to distinguish soft tissues and reconstruct shoulder muscles as well as bones. Bipes retained an almost complete shoulder girdle, while other sampled amphisbaenians had much more reduced bony structures. Nevertheless, all sampled amphisbaenian forms retained the full set of 17 shoulder muscles, sometimes fused or rearranged. Muscle attachment could shift from bone to surrounding soft tissue.^[ref]

The result challenges a tempting shortcut: losing a visible limb does not necessarily delete all its associated muscles at once. Bipes supplies the limbed comparison that helps reveal which internal components have persisted or changed during the evolution of the burrowing body form.

Imaging that combines computed tomography with intravascular contrast to display blood vessels. It produces an anatomical view of contrast-filled vessels; image timing and spatial resolution affect which abnormalities can be seen.

Coronary angiography images the coronary arteries using a contrast medium and X-rays. In conventional invasive coronary angiography, a catheter delivers contrast to the coronary circulation while the imaging system records the contrast-filled vessel paths. The contrast improves visibility of the blood-filled lumen against surrounding tissue.^[ref]

The apparatus connects fluid delivery to imaging geometry. An X-ray source and detector record the contrast signal during its passage through the vessels; changing viewing angle changes how overlapping arterial segments project into the image. The result is primarily a description of the contrast-filled lumen. It is not a direct measurement of every feature of the arterial wall or of how much oxygen reaches the myocardium.

An original geometric example shows why one apparent width can be incomplete evidence. Suppose a local lumen has an elliptical area with diameters $3.0$ and $1.5\mathrm{mm}$. Its area ishalf that of a circular $3.0\mathrm{mm}$ lumen. One viewing direction can nevertheless show the same $3.0\mathrm{mm}$ projected width as that circle, while an orthogonal view shows $1.5\mathrm{mm}$. A projected width does not uniquely determine lumen area without a shape and viewing model. These chosen dimensions are not a diagnostic threshold.

Timing and motion matter too: a moving vessel and changing contrast concentration can alter the recorded signal. A geometric narrowing, a pressure difference and downstream blood delivery are related observations but are not interchangeable. A physiological assessment needs evidence beyond one static projection.

Coronary CT angiography uses a different acquisition geometry: many X-ray views are reconstructed into a volume, commonly after contrast administration through a peripheral vein. The NHLBI account distinguishes cardiac computed tomography from the catheter-based angiographic description.^[ref] Naming the method makes clear whether a claim concerns a projection sequence or a reconstructed three-dimensional image.

A dimensionless relative attenuation value calibrated so that water is zero and air is approximately $-1000$. It depends on the computed tomography spectrum and material composition. It is not directly a linear attenuation coefficient at the $511\mathrm{keV}$ energy used in positron emission tomography.

A dentinal tubule is a microscopic channel in dentine, within the mineralized material formed by odontoblasts. The tubule network records the paths of odontoblast processes as dentine is deposited. A tubule is a structural channel; whether a prepared specimen contains fluid, a cellular process or an empty space depends on the tissue and its preparation.^[ref]

Elephant ivory provides a useful structural example. In a2017 study, observations of different cut planes and computed tomography using synchrotron radiation connected visible tubule profiles with their three-dimensional trajectories. A tube cut across, along or obliquely does not present the same two-dimensional profile. Consequently, a collection of oval profiles in a section need not consist of isolated oval cavities.^[ref]

A deliberately simplified transport example makes the channel size matter. For steady laminar flow through a straight circular tube, the Hagen-Poiseuille equation gives $Q=\pi r^4\Delta p/(8\mu L)$, where $r$ is tube radius, $L$ length and $\mu$ fluid dynamic viscosity. Doubling $r$ would multiply $Q$ by16 at fixed pressure difference and length. Real dentinal tubules branch, vary in width and may be obstructed, so this ideal calculation illustrates sensitivity to geometry rather than predicting a whole tooth's permeability.

Interventional radiology uses medical imaging to guide instruments into the body for diagnosis or treatment. A biopsy can obtain material for diagnosis; a catheter can provide access for a therapeutic procedure. Guidance may use fluoroscopy, ultrasound, computed tomography or magnetic resonance imaging, depending on the instrument, target and procedure.^[ref]

The central measurement problem is localization. In an image-guided biopsy, seeing a suspicious region and seeing a needle separately is insufficient: the operator needs evidence that the sampling part of the needle reaches the intended region. A single X-ray projection collapses depth, so two objects can overlap on the image while remaining separated in the body. Choosing imaging views and following instrument motion addresses that geometric uncertainty. This explains why image guidance is more than taking a picture before an intervention.

An early therapeutic motivation was to use the access already provided by arterial catheters to treat obstructed vessels. Charles T. Dotter and Melvin P. Judkins's 1965 report described a percutaneous transluminal approach to arterial obstruction. Its developmental discussion connected contrast examinations and observed catheter pathways with the possibility of opening a passage through an obstructed region.^[ref]

The example connects anatomical imaging to mechanical action: identifying a narrowed path and changing that path are different tasks, but the same image-guided access can support both. The historical report motivates the method; it is not a procedure-selection rule for an individual patient.

Methods that infer internal biological structure or function from measured signals. Computed tomography, positron emission tomography and single-photon emission computed tomography use different signal-generation and reconstruction physics.

A researcher in quantitative medical imaging whose 2012 study tested computed tomography-based attenuation correction for positron emission tomography of bone. The study compared CT-derived linear attenuation coefficients with measurements made at the 511 keV energy of PET photons. Bone segments provided a controlled test object, while patient data tested the effect on reconstructed tracer uptake. The work shows why an anatomical image cannot simply be reused as an attenuation map without accounting for photon energy and tissue composition.^[ref]

Natascha Westphal coauthored a 2019 study of shoulder muscles in amphisbaenians, asking whether reductions of limbs and supporting bones are accompanied by equivalent losses of muscles. The researchers used iodine-enhanced computed tomography to visualize soft tissues in three dimensions and compare them with the skeleton.^[ref]

All investigated amphisbaenian taxa retained the full set of seventeen shoulder muscles, although some muscles were fused or reorganized. Bipes retained forelimbs and a nearly complete shoulder girdle, while other sampled lineages showed greater skeletal reduction. In severely reduced forms, muscle attachments could shift to skin, connective tissue or other muscles. The result supports a decoupling of muscle and bone evolution: losing a skeletal element does not by itself establish that the associated musculature has vanished.^[ref]

In ideal computed tomography, the unknown is an absorption coefficient $a(x)$. Along a straight ray the transmitted intensity satisfies $dI/d\tau =-aI$, soThus calibrated transmission measurements supply the Radon transform of the slice. The inversion above reconstructs the coefficient by filtered backprojection: filter each projection in its transverse variable and then accumulate it over the rays through each image point. This turns a collection of line-integral measurements into a spatial map, which is the key usefulness of the result.

The ideal derivation assumes known ray geometry, sufficiently complete angular sampling and a straight-ray attenuation model. The ramp Fourier multiplier grows at high frequency, so measurement noise is amplified. Practical reconstruction therefore uses discretization and regularization of an inverse problem, for example a window on the ramp filter. Limited angles or missing detector positions cannot be treated as if they were complete noiseless Radon transform data.

In single-photon emission computed tomography, the unknown is an emitting source, rather than the absorption coefficient reconstructed by transmission computed tomography. Photons emitted at different points on the same ray are weighted by their probability of surviving the path to the detector. If the known attenuation is $a$ and the detector is at the positive end of the ray, the data are an attenuated Radon transformThe directional transport equation is $\mathbf{d}\cdot \nabla u+au=f$ with zero incoming intensity. An integrating factor derives this attenuation weight. The same complexification, boundary-value and jump strategy gives spectral reconstruction of an attenuated Radon transform when attenuation is known. The unattenuated inverse from part (d) applies directly only when $a=0$; for nonzero attenuation the weighted jump and inverse must be used. This distinction allows emission imaging of the source without confusing it with reconstruction of the absorbing medium.

Neither the smell of alcohol nor a drunken appearance excludes concussion or a more serious head injury. The useful distinction comes from the history, a complete examination and repeated assessment; alcohol intoxication and head injury may occur together.

First establish the order of events. Witnesses may describe drinking followed by progressive slurring, unsteadiness and drowsiness, or a blow or fall followed immediately by altered consciousness, confusion or a gap in human memory. Ask about the amount and timing of the drink, the mechanism of injury and any interval of apparent recovery. A person may have fallen because of alcohol intoxication, and subsequently have suffered a head injury. Conversely, an injured person may be mistakenly described as drunk because of slurred speech and an unsteady gait.

Examine the level of consciousness, orientation, speech, human memory and ability to follow commands. In alcohol intoxication, disinhibition, slurred speech, incoordination, vomiting and increasing drowsiness can occur; severe poisoning can progress to coma and impaired breathing. After concussion, confusion, amnesia, headache, dizziness, nausea and vomiting may occur, with or without an observed loss of consciousness. Thus vomiting or drowsiness alone does not decide the diagnosis.^[ref][ref]

Look for a scalp wound, swelling or other evidence of impact, and examine the pupils, their reaction to light, limb movements and any focal neurological deficit. Unequal pupils, one-sided weakness, a worsening level of consciousness or a seizure should prompt concern for significant traumatic brain injury, rather than be dismissed as ordinary drunkenness or uncomplicated concussion. The absence of an external wound does not exclude an internal injury. Nor are a flushed face, a particular pulse or the smell of drink sufficiently specific to settle the question.

The defensible diagnostic conclusion may initially be uncertainty requiring observation and investigation. Current guidance specifically requires important traumatic brain injury to be excluded before depressed consciousness is attributed to intoxication. Modern computed tomography and measurement of blood glucose can resolve problems that an 1864 bedside examination could not; these are later diagnostic aids, not equipment to attribute to the examination's period.^[ref]

Suspected strangulation means threatened or impaired blood supply to herniated tissue; it is more serious than irreducibility alone and can occur without complete intestinal obstruction. The diagnostic assessment must combine the local swelling, abdominal symptoms, general condition and time course.

Ask about a previous hernia, whether it was reducible, a new painful swelling, abrupt failure of reduction, the onset of pain and vomiting, bowel function and prior attempts at manipulation. Examine the relevant sites, including both groins and the femoral regions, rather than attributing unexplained vomiting and abdominal pain solely to a gastric illness. A previously familiar painless lump can become dangerous after years of intermittent reduction. A small femoral hernia may be less conspicuous than its systemic consequences suggest.

Locally, new tenderness, tension, irreducibility and loss of a usual cough impulse raise concern. Erythematous or discoloured overlying skin is more alarming, but can be absent early. Abdominal distension, persistent vomiting and failure to pass stool or flatus support intestinal obstruction. Increasing pain, tachycardia, fever, dehydration, peritonitis or shock suggest advancing compromise. Do not wait for every late sign: prolonged delay can lead to intestinal ischaemia, necrosis and sepsis.^[ref]

Several negative observations are unsafe reassurances. Passage of stool may merely empty bowel below the obstruction. If only part of the bowel wall is trapped, as in a Richter hernia, complete obstruction may never occur. A very ill person may describe less pain late in the course. Disappearance of the external swelling after a forceful manipulation does not prove safe restoration of viable bowel: persistence of pain or obstruction demands reassessment, including possible reduction en masse.^[ref]

An 1866 surgeon relied heavily on these bedside features and on the distinction from an inflamed lymph node, hydrocele, another groin mass or non-strangulated hernia. Contemporary reports describe sequences of attempted reduction, baths, enemata and chloroform before operation. They document period practice; they must not be transferred into a rule that strangulation begins only when repeated reduction has failed.^[ref]

Modern correction: suspected strangulation needs immediate surgical assessment and timely operative treatment. Selected blood tests and imaging, commonly contrast-enhanced computed tomography when useful and feasible, support assessment but should not delay action in a convincing emergency. Normal early laboratory results do not exclude local ischaemia. Current guidance distinguishes an acutely irreducible hernia without evidence of bowel compromise, where supervised reduction may be considered, from suspected strangulation, where emergency surgery is indicated. Ongoing symptoms after apparent reduction also require observation and reassessment.^[ref] The diagnostic goal is not merely to name the lump, but to recognize endangered tissue before irreversible injury.

Single-photon emission computed tomography detects individual gamma rays from a tracer. Mechanically collimated gamma cameras acquire projections from multiple angles for tomography. The collimator discards most emitted photons, creating a strong sensitivity–spatial resolution trade-off.

Positron emission tomography uses a Positron-emitting tracer. The emitted Positron travels a short distance before electron-positron annihilation produces an approximately back-to-back photon pair. Coincident detection in a detector ring defines a line of response, giving electronic collimation and greater detection efficiency; time-of-flight PET further constrains position along that line. The positron range, non-collinearity, detector size, scatter and accidental coincidences limit spatial resolution and quantification. In both hybrids, computed tomography supplies anatomy and an attenuation correction map, with attention to registration and respiratory motion.^[ref]