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4/11/2024 0 Comments Hard soft signs neck traumaGunshots (and long knives) may enter multiple zones. What zone is the injury in? And don’t just look at the obvious entry point.The patient should be taken directly to OR after control of the airway, if appropriate. Are there hard signs of injury present? These tell us that a structure that absolutely needs to be fixed has been injured.But we’ve become more selective now with the advent of improved resolution of our CT scans.Ĭurrently, we usually follow a two-step approach to penetrating neck trauma: Yes, there were quite a few negative explorations. In the old days, an injury to this area went straight to the OR regardless of whether there were signs or symptoms of injury. Exposure is simple and the operation is fun. Zone II is everything in-between the mandibular angle and cricoid cartilage. And endovascular / angiographic techniques are now available that may obviate the need for surgery. For this reason, imaging is very desirable and often demonstrates that no significant injury is present. This is challenging and not that desirable, and few surgeons are familiar with the technique. Surgical approach may require dislocation of or fracturing the mandible to get at this area. Injuries to this area may involve the distal carotid and vertebral arteries near the base of the skull, as well as the distal jugular vein. Similarly, the area above the angle of the mandible is Zone III, and is also difficult to expose. Unstable patients must go straight to the OR and the trauma surgeon will determine the surgical approach on the fly. Obviously, this can only be considered in the stable patient. For this reason, diagnostic testing is recommended to assist in determining if an operation is actually needed and what the best surgical exposure would be. The area below the cricoid cartilage is considered Zone I and contains many large vascular and aerodigestive structures that are relatively difficult to approach surgically. The zones are numbered in reverse, from bottom to top, and in Roman numerals. In my next post, I’ll discuss an alternative way to approach it.įirst, lets look at the time-honored zones of the neck. Could it be time? Today, I’ll review some of the basics of classic diagnosis and treatment. The management of penetrating injuries to the neck has changed very little over the years. Shop online for Enkei car wheels and rims at Fitment Industries today and package them with new tires for free mounting, balancing and shipping on us. The Enkei wheel lineup is in stock and ready to ship today, right to your door within 10 days of purchase. Here, you can verify that the wheel you're looking at will fit your setup with no rubbing, scrubbing, or rolling required. Utilizing expertise honed in F1, they offer lightweight and robust designs suitable for all vehicle types. We also invite you to check out our fitment gallery and see how your fellow enthusiasts have built Enkei wheels on their cars. This is RAYSs VOLK RACINGpage.RAYS, a wheel manufacturer, combines race technology and Made-in-Japan precision to create high-performance wheels. You can dial in a perfect fitment with Enkei by your side - the wheels it manufactures are available in diameters ranging from 14 to 20 and widths from 7 to 10. Some of the top Enkei wheels that we offer include the RPF1, Raijin, and Raijin, though you'll find great fitment and better looks with all of Enkei's best options. Whether you need a top set of wheels to handle around tight corners on the track, or a strong, great-looking set to help your car turn heads, Enkei will have an option for you. 17 Inch Mag Wheel - MX1004 Wheels (5x100 PCD) Part Number : MX1004. Retrouvez les jantes alu et accessoires Japan Racing. What Kind of Wheels Does Enkei Make For Cars?Įnkei is famous in the wheel market for building and producing wheels at the top of their class when it comes to design, build quality, and long-lasting performance. Check out what Enkei can do for your car and its needs below. We're enthusiasts just like you, and we know that getting some new wheels set up on your car can be the difference between a setup that you like and one that you can't live without - that's why we're so proud to offer Enkei's lineup of aftermarket car wheels and rims to you.Įnkei has made a name for itself as a leading aftermarket wheel manufacturer, and looking at its lineup, it's easy to see why. When you want to get a new set of car wheels to help your vehicle stand out, we've got you covered. The 5 X 100 Bolt Pattern or Pitch Circle Diameter (PCD) is made up of the stud count (5) and the bolt circle measurement (100), the notional circle determined by the center position of the studs. RAYS, a wheel manufacturer, combines race technology and Made-in-Japan precision to create high-performance wheels. Enkei Aftermarket Car Wheels Available For Sale At Fitment Industries 5 X 100 Bolt Pattern Measurement and Specifications. 4/11/2024 0 Comments Math games for kindergartenTeacher, USA A great game to get to grips with number, offering progression from one mini-game to the next. Start with adding 1 or 2 to a given number and make it hands on and fun. Try the game Reviews My Grade 1 students were engaged even though they were playing the basic subitizing levels They need the practice even if they might not know it. Once kids get good at counting and number identification you can begin to add (count on) and subtract (count backward) with them. Turkey Feather Hunt. Go on a hunt to find colored feathers and then use them to create simple math patterns. Maybe put about 6 numbers on the balloon. Some great outdoor maths games with balloons include: Have a small group of children in a circle (approximately 4 to 6 children). Count as you play hopscotch using this easy to make game.įrog Jump Measurement Game. Introduce non-standard measurement to kids with this fun jump and measure game. Balloons are great for physical development, cooperation, and turn taking. Let kids use water squirters to “put out” the correct answer to simple addition or subtraction facts. Go outside and practice counting on a big chalk maze.įire Hose Practice Game. Throw water balloons at sidewalk chalk numbers to practice identification, higher and lower and what comes next when counting. Send kids on a hunt to match the numbers to their corresponding set. A hundred chart can be used for tons of number practice–making it big on contact paper makes it lots of fun. Turn the kids into airplanes as they zoom from one numbered cloud to another. Put those plastic eggs to use by setting up a number identification game.įlight School Number Game. Kids can practice ordering, sorting, and more with Lego bricks.Įgg Counting Game. Hide number sticks in the backyard for the kids to find and order. Make a big board game kids can walk on to practice identifying numbers and number order.īackyard Number Hunt. Match sticky post it notes to numbers during this fun move and learn activity. Search around the house for the correct number of objects on the cards. Help kids recognize numbers and number order with this fun and simple sidewalk chalk game. This week in our Get Ready for K Through PLAY! series I am sharing some fun Kindergarten active math games for kids! Preschoolers and kindergartners love to move! Instead of trying to get them to sit still all the time I am a big fan of letting them move and learn. 4/11/2024 0 Comments Villanova charles barkley daughter
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4/10/2024 0 Comments Us state check off listgoes, while it is the capital of the United States, it is NOT part of any state. Puerto Rico is a US territory, not a state, and although its residents are US citizens, it does not have the same representation in Congress as the 50 states. One common reason for the confusion whether the US counts 50 or 52 states is that people might be including Puerto Rico and Washington, D.C., in the count. People count Puerto Rico and Washington, D.C as US States Let’s have a quick look at these misconceptions and let’s clear things up. However, there are a couple of reasons why some people think that the US indeed counts 52 states instead of 50. If you are looking for a list with 52 US States, then you are, unfortunately, misinformed.Īs a matter of fact, the US only counts 50 states. Together, the 50 states on the US map create a rich geographical tapestry that reflects the country’s diverse environments, regional cultures, and historical narratives. Hawaii, on the other hand, an archipelago in the Pacific Ocean, is famous for its tropical climate, volcanic landscapes, and rich Polynesian culture. (At this point, you might also want to look into what a “ Tri-state area” is).Īlaska, located in the northwest extremity of the continent, is the largest state by land area and is known for its stunning wilderness and remote landscapes. If you are wondering what a contiguous state is, then here’s a definition for you: A contiguous state refers to states that are adjacent to one another and share a common border, forming an unbroken geographical connection.Īs Alaska and Hawaii don’t share a common border and are not adjacent to the other states of the US, these are called non-contiguous states. In addition to the contiguous 48 states, the US map also includes the non-contiguous states of Alaska and Hawaii. The Pacific Coast, with states like California, Oregon, and Washington, features a diverse mix of vibrant cities, rugged coastlines, and lush forests. To the south, bordering Mexico, states like Texas and Arizona showcase a blend of cultural influences and vast desert landscapes.Īs we move towards the West, the majestic Rocky Mountains span across states like Colorado, Wyoming, and Montana, offering breathtaking views and outdoor adventures. The Midwest is characterized by the Great Lakes region, with states such as Michigan, Ohio, and Wisconsin, and the agricultural heartland, featuring states like Iowa (IA), Nebraska (NE), and Kansas (KS). In the east, the Atlantic coast is lined with states like Maine, Florida, and the Carolinas (North Carolina and South Carolina), each with their distinct coastlines and history. If you have a look at a map of North America, you’ll see that the United States is comprised of 50 states that come together to create a beautiful, diverse tapestry.Įach US state has its own individual identity and contributes to the country’s unique character. US States List Largest to Smalls in terms of Land Area If you have have been wondering what US state is the biggest and what US state is the smallest, you will find this info in the list below.Īll 50 US states List Largest to Smallest in Terms of Population We will kick this off with a list of all 50 US states in alphabetical order. Note: You will find FREE downloads (All US States in alphabetical order, US States with capitals, US States on the map & more) towards the end of this post! Enjoy. Let’s keep it simple for today and let us just have a look at what the names of these states are and discuss a few basic facts about these. No matter whether you’re visiting or residing in one of these amazing 50 states, there’s always a novel and thrilling adventure waiting for you.īut what are these 50 states even called to begin with? The US is such a huge and diverse country, with 50 states that span from coast to coast, and from the chilly north to the sunny south.Įach state has its own mix of beautiful scenery, fascinating history, and unique traditions that make it a great place to visit or call home. Mario Forever’s general appearance does not stray far from the original game but new features have been added to enhance the gaming experience. Whether real or not, both can be defeated by jumping over them and reaching for the axe at the end of the bridge. This is important to know because he has put false Bowsers in each world. The 8th and final world is where King Bowser and Princess Peach are located. You must use all of Mario's abilities to get through the game’s eight worlds. Once you’ve acquired it, you can send fireballs towards your enemies. This is a rare skill that comes out of the floating boxes. Another strategy you can use is to apply the Fire Flower ability. It will retract into its shell and can be pushed to hit other enemies. An efficient way to get multiple enemies at once is to jump on a Koopa Troopa. This means you can jump over your enemies or hit the brick they’re sitting on so they fall over. Once ingested, Mario will double in size and give you the advantage of moving across the platform with ease.Īs Mario, you must defeat Goombas and Koopa Troopas that surround you. These are important in extending Mario’s life and skill. The special abilities come in the form of a Super Mushroom. Along the way, you must collect coins, shatter bricks, and gather special abilities. The objective of Mario Forever is the same as Super Mario Bros: you must race through the Mushroom Kingdom, survive the attacks of Bowser’s henchmen, and rescue Princess Peach. As Mario, you must traverse across the 8 worlds to save the princess and free the kingdom from evil. The gang has also kidnapped Princess Peach to use as leverage against Mario. The Mushroom Kingdom has been invaded by Bowser and the Koopa Troopas, turning many of its citizens into inanimate objects. It does, however, maintain the original story. This fangame was developed by Softendo to allow players to play the original Super Mario Brothers game with improved graphics and new features. 3: Mario Forever is a fan translation of the original Super Mario Bros game included in the Super Mario All-Stars set. 4/10/2024 0 Comments Decibel meter scaleThe SPL app also displays a maximum decibel level of 57.8 dB. In this first test, I set it to “A.” Then I set the response time to “slow” and set the range lower (about “40”).Īs you can see, the average A-weighted decibel level shown on the SPL Meter (41.2 dB) is closer to the reading on the handheld device (40.6 dB). Like the NIOSH app, SPL Meter also has the option of using A or C-weighted decibels. The SPL Meter app also has a range setting (from 40 to 120), and a toggle switch for slow or fast response time. In this case, I measured some passing traffic outside the window. I n this third example, I’ve used the SPL Meter app to compare it to the handheld device. LCpeak is the peak of the C-weighted sound level, which in this case was 78.2 dB - higher than the Lmax. Lmax indicates the maximum A-weighted sound level, which was 54.3 dB. LAeq is the A-weighted sound level (in this case, 27.2 dB) So what does this mean? Let’s check this handy acoustic glossary from Gracey & Associates in the U.K. Here you can see that the instantaneous level was 31.1 dBC, the LAeq was 27.7 dB, the Lmax was 54.3 dB, and the LCpeak was 78.2 dB. The NIOSH app also lets you run an analysis over time and generate a report, so I clicked the “run” icon on the lower left to gather more data. The reading varied a lot, and this app still showed a lower decibel level than the BASX meter, which registered at 38.2 dBA. In the second example, I’ve switched the NIOSH app to use C-weighted decibels with a “fast” response time. A few tweaks to the default calibration or threshold settings might change the results. Normal room noise in my home is typically around 35 decibels, so the 23.5 dBA reading in the NIOSH app seems rather low. In this example, my NIOSH app was set to “slow.”Ĭuriously, I think the hand-held meter in this photo might be more accurate than the NIOSH app on the smartphone. This is a complex app with a number of settings that enable you to calibrate it manually, set a threshold level (in this case, the threshold was set to “80”), use a frequency weighting of A, C, or Z, and choose a slow or fast time weighting. In this first example, I placed the handheld BASX meter next to a smartphone running the free NIOSH Sound Level Meter. But it’s an easy, entry-level way to get a quick dBA reading at the press of a button. This model doesn’t offer a lot of settings or features and it doesn’t offer C-weighted measurements. Price-wise, it’s on the low end of the spectrum (~ $20 USD). For example, the BAFX 3370 decibel reader in the images below measures A-weighted decibels (dBA) in a range from 30-130 dBA. Whether you use a decibel app on your smartphone or a hand-held device, the settings can also produce different results. Readily available apps such as the NIOSH Sound Level Meter, Decibel Meter, and SPL Meter give you the ability to choose between A and C-weighted decibels. When you use C-weighted decibels, they include the lower frequencies that get cut off by A-weighted measurements. You can also measure C-weighted decibels (dBC). The good news: A-weighted decibels are not your only option. These low frequencies might not get measured accurately if they focus on A-weighted decibels alone. This includes rumbling that might be caused by a toddler thumping across uncarpeted hardwood floors, or by construction equipment, motorcycles, leaf blowers, jackhammers, and garbage trucks, to name a few. Erica Walker explained in an interview with Soundproofist, it’s often the low frequencies that really bother people and cause stress. In many applications, this is perfectly fine. An A-weighted measurement cuts off the extreme high and low frequencies, measuring the typical frequencies that humans can hear. Typically, noise-measuring tools use A-weighted decibels, or dBA. Your results might depend on your tools and settings. If you try to measure the decibel level of a noise and get unexpected results, you’re not alone. Why a noise might seem louder than its decibel reading |
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