HAIR
TREATING HAEMORRHOIDS
In the procedures shown below, the patient will usually have been given a laxative
so that the lower bowel is clear of faeces. Banding requires no anaesthesia; either
general or epidural anaesthesia is given before a haemorrhoidectomy is performed.
BANDING HAEMORRHOIDS
I
This common, simple,
and effective procedure
is usually painless (causing
no more than a mild ache
afterwards) and no
anaesthesia is required.
The patient lies on one
side, the proctoscope
(instrument for examining
the rectum) is positioned,
and the haemorrhoid is
grasped with forceps.
2
The banding instrument is
inserted and pressed into the
anal wall. Gentle traction is applied
to draw the mass into the drum of
the instrument.
3
The trigger mechanism of
the banding instrument
is fired and the bands are
squeezed on to the neck of
the mass. The proctoscope
is withdrawn, leaving the
haemorrhoid with its base
tightly constricted by the
bands. The haemorrhoid
then withers and drops off
painlessly within a few days
ofthe operation.
HAEMORRHOIDECTOMY
Stages of the procedure
Under general or epidural anaesthesia,
the patient’s rectum is examined with a
proctosigmoidoscope to exclude a diagnosis
of tumour. The patient is then placed in the
lithotomy position. The haemorrhoid is clamped,
placed under traction (as shown above), secured
with a suture, and then removed with a knife.
haemosiderosis
A g e n e r a l i n c r e a s e i n
i r o n
s t o r e s i n t h e
b o d y .
H a e m o s i d e r o s i s
m a y
o c c u r a f t e r
r e p e a t e d
b l o o d
t r a n s f u s i o n s
o r ,
m o r e
r a r e l y , a s a r e s u l t o f e x c e s s i v e i r o n i n t a k e .
haemospermia
T h e
m e d i c a l
t e r m
f o r
b l o o d
i n
t h e
s e m e n ( s e e
s e m e n , b l o o d i n t h e
).
haemostasis
T h e
a r r e s t
o f
b l e e d i n g
.
T h e r e
a r e
t h r e e
m a i n
n a t u r a l
m e c h a n i s m s
b y
w h i c h
b l e e d i n g
i s
s t o p p e d
a f t e r
i n j u r y
F i r s t ,
s m a l l
b l o o d
v e s s e l s
c o n s t r i c t .
S e c o n d ,
s m a l l
b l o o d c e l l s
c a l l e d p l a t e l e t s a g g r e g a t e
a n d p l u g t h e b l e e d i n g p o i n t s . T h i r d , t h e
b l o o d
p l a s m a
c o a g u l a t e s ,
f o r m i n g
f i l a -
m e n t s o f a s u b s t a n c e c a l l e d
f i b r i n
,
w h i c h
h e l p
t o
s e a l t h e
d a m a g e d b l o o d v e s s e l
( s e e
b l o o d c l o t t i n g
).
D e f e c t s i n a n y o f t h e s e
m e c h a n i s m s c a n c a u s e a
b l e e d i n g d i s o r d e r
.
haemostatic drugs
A g r o u p o f d r u g s t o t r e a t b l e e d i n g d i s o r -
d e r s a n d t o c o n t r o l b l e e d i n g . H a e m o s t a t i c
p r e p a r a t i o n s t h a t h e l p b l o o d c l o t t i n g a r e
g i v e n t o p e o p l e w i t h c l o t t i n g f a c t o r d e f i -
c i e n c i e s . F o r e x a m p l e ,
f a c t o r V III
i s u s e d f o r
h a e m o p h i l i a
.
D r u g s t h a t p r e v e n t t h e b r e a k -
d o w n o f f i b r i n i n c l o t s , s u c h a s
t r a n e x a m i c
a c i d
,
c a n a l s o h e l p s t o p b l e e d i n g .
haemothorax
A c o l l e c t i o n o f b l o o d i n t h e p l e u r a l c a v -
i t y
( t h e s p a c e b e t w e e n t h e
c h e s t w a l l
a n d
t h e
l u n g ) .
H a e m o t h o r a x
i s
m o s t
c o m
m o n l y c a u s e d b y c h e s t i n j u r y , b u t i t
m a y a r i s e s p o n t a n e o u s l y i n p e o p l e w i t h
d e f e c t s
o f b l o o d
c o a g u l a t i o n
o r
a s
a
r e s u l t o f c a n c e r .
S y m p t o m s
o f h a e m o t h o r a x
i n c l u d e
p a i n i n t h e
a f f e c t e d s i d e
o f t h e
c h e s t
a n d
u p p e r
a b d o m e n ,
a n d
b r e a t h l e s s -
n e s s . I f e x t e n s i v e , t h e r e m a y b e p a r t i a l
l u n g c o l l a p s e . B l o o d i n t h e p l e u r a l c a v -
i t y i s w i t h d r a w n t h r o u g h a n e e d l e .
Hailey-Hailey disease
A l s o k n o w n a s b e n i g n f a m i l i a l
p e m p h -
i g u s
,
a f o r m o f p e m p h i g u s ( a b l i s t e r i n g
s k i n
d i s e a s e )
t h a t
m a i n l y
a f f e c t s
t h e
n e c k , a r m p i t s , a n d g r o i n . H a i l e y - H a i l e y
d i s e a s e t e n d s t o r u n i n f a m i l i e s .
hair
A t h r e a d l i k e s t r u c t u r e c o m p o s e d o f d e a d
c e l l s c o n t a i n i n g
k e r a t i n ,
a f i b r o u s p r o t e i n .
STRUCTURE AND FUNCTION
T h e r o o t o f e a c h h a i r i s e m b e d d e d i n a
t i n y p i t i n t h e d e r m i s
( i n n e r )
l a y e r o f
t h e
s k i n
c a l l e d a h a i r
f o l l i c l e
.
E a c h s h a f t
o f h a i r c o n s i s t s o f a s p o n g y s e m i h o l l o w
c o r e ( t h e m e d u l l a ) , a s u r r o u n d i n g l a y e r
o f l o n g , t h i n f i b r e s ( t h e c o r t e x ) , a n d , o n
t h e o u t s i d e , s e v e r a l l a y e r s o f o v e r l a p p i n g
c e l l s ( t h e c u t i c l e ) .
W
h i l e a h a i r i s g r o w i n g , t h e r o o t i s
e n c l o s e d b y t i s s u e c a l l e d a b u l b , w h i c h
s u p p l i e s t h e h a i r w i t h k e r a t i n . T h e b u l b
i s t h e p a l e s w e l l i n g t h a t s o m e t i m e s c a n
b e s e e n w h e n a h a i r i s p u l l e d o u t . T h e
u p g r o w t h
o f
d e a d
c e l l s
a n d
k e r a t i n
f r o m t h e r o o t f o r m s t h e h a i r . O n c e t h e
h a i r
h a s
s t o p p e d
g r o w i n g ,
t h e
b u l b
r e t r a c t s f r o m t h e r o o t a n d t h e h a i r e v e n -
t u a l l y f a l l s o u t .
H a i r i s i n v o l v e d i n t h e r e g u l a t i o n o f
b o d y t e m p e r a t u r e
( k n o w n a s t h e r m
o -
r e g u l a t i o n ) .
I f t h e
b o d y
i s
t o o
c o l d ,
e r e c t o r p i l i m u s c l e s i n t h e s k i n c o n t r a c t ,
p u l l i n g t h e h a i r s u p r i g h t t o f o r m g o o s e
p i m p l e s .
E r e c t h a i r s t r a p
a n i n s u l a t i n g
l a y e r o f a i r n e x t t o t h e s k i n .
TYPES
T h e r e
a r e
t h r e e
t y p e s
o f h u m a n
h a i r .
F r o m t h e f o u r t h m
o n t h o f g e s t a t i o n , t h e
f e t u s i s c o v e r e d w i t h d o w n y h a i r c a l l e d
l a n u g o , w h i c h i s s h e d d u r i n g t h e n i n t h
m o n t h .
A f t e r
b i r t h
a n d
u n t i l
p u b e r t y ,
v e l l u s
h a i r ,
w h i c h
i s
f i n e ,
s h o r t ,
a n d
c o l o u r l e s s , c o v e r s m o s t o f t h e b o d y T h e
t h i r d t y p e , t e r m i n a l h a i r , i s t h i c k e r , l o n g -
e r , a n d o f t e n p i g m e n t e d ; i t g r o w s o n t h e
s c a l p , t h e e y e b r o w s , a n d t h e e y e l a s h e s . A t
H
357
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