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Subscribe to Codify by AAPC and get the code details in a flash. Figure 21D: Right anterior oblique projection of a 3D surface shaded rendering demonstrates fractures of the right lateral ( thick black arrow) and inferior orbital rims ( black arrowheads) and right zygomatic arch ( thin black arrow). ICD-10-CM Code for Fracture of malar, maxillary and zygoma bones S02.4 ICD-10 code S02.4 for Fracture of malar, maxillary and zygoma bones is a medical classification as listed by WHO under the range - Injury, poisoning and certain other consequences of external causes. Orbital floor ( curved arrow) involving the infraorbital nerve canal, and a minimally displaced fracture of the lateral wall of the right maxillary sinus ( wavy arrow). There is a comminuted, inferiorly displaced fracture through the right Facial fractures may be simple, involving a single bone (e.g., nasal bone fracture, zygomatic arch fractures ), or complex, involving more than one bone (e.g. Figure 21C: Coronal reformatted CT image demonstrates an additional fracture of the right superolateral orbital rim ( thick white arrow), just above the frontozygomatic suture. There are also nondisplaced fractures through the anterior and posterolateral walls of the right maxillary sinus ( hatched arrows). Zygomatic bone fractures may either be observed in an isolated zygomatic arch fracture form or in form of complex fractures. Face - Zygomatic arch fracture - OM30 view (Same patient as image above) The zygomatic arch fracture is more easily seen on the OM30 (Occipito-Mental 30). Isolated noncomminuted depressed zygomatic arch fractures are easily treated with the minimally invasive Gillies approach, which most often provides long. In Figure 21B, there is a comminuted fracture of the right zygomatic arch ( white arrowheads), including a more posterior fracture through the base of the zygomatic process of the temporal bone. Zygomatic arch fractures are common injuries, occurring in isolation in 5 of all patients with facial fractures and in 10 of patients with any fracture to the zygomaticomaxillary complex. Figure 21A demonstrates a comminuted fracture ( thin white arrow) through the right lateral orbital wall involving the sphenozygomatic suture, with posterolateral displacement of the lateral orbital rim, and a medially displaced and laterally angulated comminution fragment encroaching on the orbit. If there are any concerns arising from the eye observations, this should be raised with the registrar.Figures 21A and 21B: Axial noncontrast maxillofacial CT images. In terms of what these eye observations comprise: Therefore, the patient should follow strict eye observation protocols in line with your trust protocol. ĜT scan available – axial, coronal and sagittal viewsĭue to the anatomy of the zygomatic-maxillary complex and the process of reduction, there is a risk of blindness (due to retrobulblar haemorrhage) from these operations as well as other eye signs such as enophthalmos, diplopia, traumatic optic neuropathy, superior orbital fissure syndrome. Note antibiotic prescriptions may not always be required and can be controversial therefore check with your senior Ědvise on a soft diet and nose blowing for 4-6 weeks to prevent surgical emphysema.If you have any concerns regarding the patient’s vision/eyes get an ophthalmology consultation.Your initial management of these patients should include: 4 point fixation of a ZMC fracture General ManagementĪs mentioned previously, most fractures you will encounter are not life threatening and often we will wait for the swelling to reduce post-injury to determine the true extent of any functional deficiencies or aesthetic issues. “Look at me, I am the captain now” may be the last universally remembered movie quote from before pop culture became irreparably fragmented. “Captain Phillips” (Streaming November 6) Many of the tropes that made films like “Love Actually” and “About Time” so beloved can be found executed to perfection in “Notting Hill.” The film tells the story of a British bookstore owner (Grant) who finds his life turned upside down when an American movie star (Roberts) enters his store. That’s hardly surprising, considering Richard Curtis’ status as one of the genre’s most prolific writers. And “Notting Hill” is nothing short of a flawless rom-com. Once in a while, we all come down with an itch that can only be scratched by a good romantic comedy. Image Credit: ©Universal/Courtesy Everett Collection Washington gives one of the most iconic performances of his career and won his second Oscar. David Ayer wrote this landmark police drama about an LAPD rookie (Ethan Hawke) who spends a day with a corrupt narcotics officer who has no problem using his job to make lucrative business deals with the city’s criminal underworld. Image Credit: ©Warner Bros/Courtesy Everett CollectionĪntoine Fuqua is earning some serious early buzz for his upcoming slave escape thriller “Emancipation,” but if the wait for that film is killing you, it’s a great time to revisit the film that launched his career. The film was always excellent, but it definitely hits different after living through a pandemic that limited travel. Clooney stars as a corporate consultant who is paid to travel around the country and fire people but finds that a new romance has the potential to throw a wrench into the solitary lifestyle that he loves so much. Jason Reitman’s ode to business travel gave George Clooney one of the quintessential roles of his later career, proving that this unfairly handsome movie star has only gotten better with age. Image Credit: ©DreamWorks/Courtesy Everett Collection If you find yourself feeling glum because the MLB postseason is winding down, streaming “Moneyball” is the perfect antidote. While a killer script from Aaron Sorkin certainly helped, the film really thrived because of a phenomenal performance by Brad Pitt as Oakland Athletics GM Billy Beane. Turning it into a narrative film was no easy task, but Brad Pitt and director Bennett Miller passed with flying colors. But at its heart, it was still an economics book. Michael Lewis’ “Moneyball” was a groundbreaking look at sabermetrics and the way a few math geniuses revolutionized baseball forever. Image Credit: ©Columbia Pictures/Courtesy Everett Collection However, phenobarbital has a superior success rate compared to lorazepam and other drugs, at least in the elderly. Lorazepam is more effective than diazepam and intravenous phenytoin in the treatment of status epilepticus and has a lower risk of continuing seizures that might require additional medication. Intravenous diazepam or lorazepam are first-line treatments for convulsive status epilepticus. Lorazepam 3mg scored tablets in a blister pack. Withdrawal symptoms, including rebound insomnia and rebound anxiety, may occur after seven days' use of lorazepam. It has a fairly short duration of action. Lorazepam can effectively reduce agitation and induce sleep, and the duration of effects from a single dose makes it an appropriate choice for the short-term treatment of insomnia, especially in the presence of severe anxiety or night terrors. It is fast acting, and useful in treating fast onset panic anxiety. In the US, the FDA advises against use of benzodiazepines such as lorazepam for longer than four weeks. Lorazepam is used in the short-term management of severe anxiety. In 2020, it was the 65th most commonly prescribed medication in the United States, with more than 10 million prescriptions. It is on the World Health Organization's List of Essential Medicines. Lorazepam was initially patented in 1963 and went on sale in the United States in 1977. Due to these concerns, lorazepam use is generally only recommended for up to two to four weeks. In this age group, lorazepam is associated with falls and hip fractures. Older people more often develop adverse effects. If stopped suddenly after long-term use, benzodiazepine withdrawal syndrome may occur. Physical dependence and psychological dependence may also occur. With long-term use, larger doses may be required for the same effect. Among those who are depressed, there may be an increased risk of suicide. When given intravenously, the person should be closely monitored. Ĭommon side effects include weakness, sleepiness, low blood pressure, and a decreased effort to breathe. When given by injection onset of effects is between one and thirty minutes and effects last for up to a day. It can be given by mouth or as an injection into a muscle or vein. It is also used, along with other treatments, for acute coronary syndrome due to cocaine use. It is also used during surgery to interfere with memory formation and to sedate those who are being mechanically ventilated. It is used to treat anxiety disorders, trouble sleeping, severe agitation, active seizures including status epilepticus, alcohol withdrawal, and chemotherapy-induced nausea and vomiting. Lorazepam, sold under the brand name Ativan among others, is a benzodiazepine medication. A well trained shooter can shoot two bolts a second. Upon firing the first bolt, the string is caught by two thin metal rods, which are stamped to a metal sheet on the bottom end of the barrel, which is used to pull the string back into position through the racking mechanism, located on the reciever. After around 50 years of trial and error, the Iron Lords came up with the version that is used today. The first models of this weapon were rather janky, due to them using a lever mechanism to re-rack arrows for consecutive shots. Having started its initial production around 150 years ago, the Iron Lord Automatic Repeating Crossbow, or ILARC for short, has become one of the staple weapons for Iron Lord ranged units. The only "Magic" that this weapon has isn't even derived from itself, seeing that a Rogue/Ranger can use this ability with any ranged weapon (Crossbow, bow or any other arrow-shooting weapon). After the first loading, the next loading will only take five seconds. When in Ballista mode, it takes around five seconds to swap crossbow arms, another five seconds to arm the gun and three seconds to load the Ballista arrow. When in its default configuration, the ILARC takes 7.2 seconds to reload. If one takes good care of their weapon and keeps it well maintained, the ILARC can last for up to five years before some noticeable repairs have to be made I highly recommend you to write a concise explanation for what you will put)ĭepending on the arrow type, this weapon can have average to above average penetration, which can be rather useful. (Stats do not determine how powerful your weapon is, this is just to give a general scope of its strengths and limits. When paired with a Rogue/Ranger's main ability, the ILARC glows a fiery orange, charging an explosive ballista arrow that creates a fiery explosion in a 5 (five) meter (16 feet) radius. This can be achieved by pushing a small latch on the weapon's right side, which promptly exposes the barrel. :hotsprings: ஓ๑Capabilities๑ஓ :hotsprings:ĭespite firing its custom, 20centimeter (7 inch long) arrows, the ILARC can also shoot a 550mm "Ballista" arrow (barrel length is 533mm. It also uses wood for the stock and arrows. This weapon is mostly made of steel, with some bronze for the arm ornaments. This weapon has a total length of 1.22 meters, with a maximum weight of around 12.35 kilos. :hotsprings: ஓ๑Length & Weight๑ஓ :hotsprings: This weapon fires at around 40 rounds per minute in its current configuration, seeing that the string needs to be manually racked through a mechanism that runs from the reciever, all the way down to the barrel. :hotsprings: ஓ๑Weapon Type๑ஓ :hotsprings: :hotsprings: ஓ๑Combat Purpose๑ஓ :hotsprings: Due to its arrows being shorter and lighter, they can travel further, being especially useful against lightly armored targets. :hotsprings: ஓ๑Weapon Description๑ஓ :hotsprings:īuilt exclusively by the Iron Lords at the Iron Forge, this crossbow was made to shoot arrows at a fast fire rate while keeping the range and lethality of a regular crossbow. – He was born in Haidian District, Beijing, China. Stage Name: Luhan (루한) Birth Name: Lu Han (鹿晗) Korean Names: Nok Ham (녹함) / Rok Ham (록함) Position: Lead Vocalist, Lead Dancer, Visual, Center Birthday: April 20th, 1990 Zodiac Sign: Taurus Height: 178 cm (5’10”) Weight: 52 kg (114 lbs) Blood Type: O Nationality: Chinese Super Power (Badge): Telekinesis Instagram: Facts: – Xiumin’s Ideal Type: is someone who is hug-able and can give comfort to others. – He enlisted for the military on May 7, 2019. – In 2017 he became a regular cast of the show “It’s Dangerous Beyond The Blankets”. – He acted in the movie “Seondal: The Man Who Sells the River” (2016) – He acted in the web dramas: “Exo Next Door” (2015), “Falling for Challenge” (2015) – He is the neatest, strongest and cleanest member in EXO-M. – He is the oldest member in EXO, though he appears as one of the youngest. – He knows taekwondo, fencing, kendo, and soccer. – He became an SM Entertainment trainee in 2008. – Nicknames: Mini, Lil’ Fattie, Fairytale Xiumin, Bao Zi (Little Bun). – Education: Catholic Kwandong University. – He is from Gyuri, Gyeonggi Province, South Korea. Stage Name: Xiumin (시우민) Birth Name: Kim Min Seok (김민석) Chinese Name: Jin Min Shuo (金珉碩) Position: Sub Rapper, Sub Vocalist Birthday: March 26th, 1990 Zodiac Sign: Aries Height: 173 cm (5’8″) Weight: 53 kg (116 lbs) Blood Type: B Nationality: Korean Super Power (Badge): Frost (Snowflake) Instagram: Facts: – Kris was ranked 75th on TC Candler “The 100 Most Handsome Faces of 2018”. – On May 15, 2014, Kris filed a lawsuit against SM asking for the termination of his contract and left EXO. – He is fluent in English, Cantonese, Mandarin, and Korean. – Due to personal reasons, he changed his birth name from Li Jiaheng to Wu Yifan. – He moved to Vancouver, Canada at age of 10. – He was born in Guangzhou, Guangdong, China. Stage Name: Kris (크리스) Birth Name: Li Jia Heng, but legalized his name to Wu Yi Fan (吴亦凡) English Name: Kris Wu Korean Name: Oh Yeok-beom (오역범) Position: Leader, Main Rapper, Sub Vocalist Birthday: November 6th, 1990 Zodiac Sign: Scorpio Height: 187 cm (6’2″) Weight: 73 kg (160 lbs) Blood Type: O Nationality: Chinese-Canadian Super Power (Badge): Flight (Dragon) Instagram: Facts: EXO-M Fandom Name: EXO-L EXO-M Official Colors: Cosmic Latte Kathryn Janeway made the observation in 2376 that rumors traveled fast on the USS Voyager. ( VOY: " Threshold") Warp 10 had also become a slang term referring to anything extremely fast. Warp 10 was also known as the transwarp threshold. A vessel traveling at warp 10 occupied all points in the universe simultaneously. In 24th century warp theory, warp factor 10 had been redesignated to correspond with infinite velocity. Shuttlecraft Cochrane accelerating to warp 10 USS Enterprise-D accelerated to incredible warp speeds by the Traveler At maximum speed, the ship was traveling at approximately warp 36. In 2270, the Enterprise encountered Karla Five's vessel, that was about to enter the Beta Niobe nova. In 2270, the Enterprise was accelerated to speeds in the excess of warp 22, while being linked to Karla Five's vessel with a tractor beam. Zefram Cochrane also devised modifications to the USS Enterprise that allowed the ship to achieve the speed, though the ship was almost torn apart at that velocity. In the comic book " A Warp in Space" set in the late- 2260s, Starfleet tested the prototype Warp 15 engine on several test ships. At that time the ship could maintain warp 11 without danger. ( TOS: " The Changeling") In 2268, the Kelvans who commandeered the ship made similar modification. Kirk ordered Nomad to reverse the modifications though, as the structure of the Enterprise was not designed to handle the stress of that much power output. When this happened, Montgomery Scott was in disbelief. In 2267, the Nomad probe improved efficiency in the antimatter input valve and energy release controls on the Enterprise, allowing the ship to achieve at least warp 11. ( TOS: " Let That Be Your Last Battlefield") ( TOS: " Journey to Babel") In 2268, Bele, upon commandeering the engine and directional controls of the Enterprise, propelled the starship faster than warp 10 towards Cheron. In 2267, the USS Enterprise engaged an Orion scout ship capable of warp 10, if not higher speeds, since crew safety was of no concern to them, prompting Spock to remark that it was " interesting." The ship was too fast for the Enterprise to hit it with phasers or photon torpedoes. ( TOS: " Journey to Babel") Speeds on the order of warp 15 were called multiwarp speeds. In the 23rd century, warp factors of 10 and higher were known as generally unsafe velocities. They did not clarify whether the same warp factor would have been used for intergalactic travel also. ↑ The Kelvans modified the USS Enterprise to travel at warp eleven through the galactic barrier.↑ Although Tom Paris clearly articulates the distance and time, it is unclear if he was engaging in hyperbole since these parameters indicate that, at warp factor 9.9 as specified, 75,000 light years can be traversed in less than 3.5 years.VOY: " Caretaker" " Death Wish", " Dreadnought"Ģ.5 million light years (to Andromeda Galaxy) Warp factorĥ0 light years (Earth to an area inside the Delphic Expanse)ġ0,000 kilometer intervals as a Klingon D7 approachedĪpproximately 300 billion kilometers (0.032 light years)Ībout 4 billion miles (0.0007 light years) See: Variations in relative speed for more information. Some figures were depicted in charts and others given as statements in dialogue. Average speeds are typically calculated from given values for travel time and distance. The following is a list of warp factor values that have been given a relativistic speed equivalent on screen. |
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