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Dd wheezy chest in infant for fm
1.
2. Definition
• A wheeze is a high-pitched, musical,
adventitious lung sound produced by airflow
through an abnormally partially narrowed or
compressed lower airway
• A wheeze is synonymous with a high-pitched
or sibilant rhonchus.
3. • Wheezes are heard more commonly during
expiration
• Wheezing during expiration alone = milder
obstruction
• Wheezing during both inspiration and
expiration = more severe airway narrowing.
• Wheezing may be acute or chronic /recurrent
4.
5. Acute
bronchiolitis
Foreign
Cardiac
body
asthma
aspiration
Differential
Diagnosis
Pneumonia GERD
Vascular Bronchial
ring asthma
6.
7. Clinical syndrome
Characterized by pulmonary
hyperinflation and wheezing
Due to
acute, infectious, inflammatory
obstruction of small airways
(bronchioles)*
* With no muscle layer
9. Accumulation
of mucus,
Edema,
Cellular debris
Complete
bronchiolar Atelectasis
Viral invasion of obstruction
small bronchi &
bronchioles Incomplete
Early air trapping
obstruction (Ball
during expiration
valve)
Over inflation
of lung
10.
11. Sex Age Food Season
• Male is • First 2 • Non- • Winter
1.25 years of breastfed and early
times life spring
more • Peak at 2-
frequently 8 months
than
female
12. SYMPTOMS OF PNEUMONIA
Fever, toxic ill, cough, dyspnea and grunting
SIGNS OF ASTHMA
retraction
Hyperinflation, decrease TVF
Diminish airway, Harsh V breathing, Decrease VR, Wheeze
13. Mild Upper Respiratory Tract Infection for 2-3 days
Gradual onset of Respiratory Distress
Paroxysmal Spasmodic Cough
Wheezes
Dyspnea
Irritability
+- Feeding difficulty due to tachypnea
15. Respiration fast & Decrease air entry
shallow. Hyper Harsh vesicular
Labored breathing resonant breathing +
(chest note due to prolonged
indrawing, flaring expiration
alae nasi, IC over Inspiratory +
retraction)
inflated expiratory wheezes
Air hunger
Restlessness
lungs Inspiratory
widespread fine
Cyanosis crackles
16. Differences between bronchiolitis and
bronchial asthma
• 1-Asthma is not common in the first year.
• 2-The following may favors the diagnosis of
asthma which are:
-positive family history, repeated attacks,
markedly prolonged expiration, onset may be
sudden, without preceeding URT infection.,
there will be eosinophilia and favourable
response to bronchodilators.
17. Course of the disease
• -A critical phase in first 48-72 hours by which
the patient is desperately ill and apneic spells
occur in the very young infants and the
followed by rapid improvement.
• - In the outcome of the long term, some
children may develop persistent airway
hyperactivity later in childhood.
18. Complications:
• 1-Bacterial superinfections e.g-
bronchopneumonia.
• 2-Cardiac failure: rare, mainly in patients with
underlying cardiopulmonary disease example
congenital heart disease, cystic fibrosis,
bronchopulmonary dysplasia.
• 3-Death due to severe course with prolonged
apneic spells, severe uncompensated
respiratory acidosis and profound dehydration
due to tachypnea and inability to drink due to
respiratory distress.
•
21. Laboratory studies
. X ray ( or CT chest)
• A CBC is seldom useful since the white blood
cell count is usually within normal limits.
• Arterial blood gases (ABG).
22. Imaging studies
• These are not routinely necessary.
• Hyperinflation and patchy infiltrates may be seen; but
these are non - specific
• Focal atelectasis
• Air trapping
• Flattened diaphragm
• Increased anteroposterior diameter
• Peribronchial cuffing
• Chest radiographs may also reveal evidence of
alternative diagnoses, such as lobar
pneumonia, congestive heart failure, or foreign body
aspiration.
23. • A chest X-ray demonstrating lung hyperinflation with a flattened
diaphragm and bilateral atelectasis in the right apical and left basal
regions in a 16-day-old infant with severe bronchiolitis
24. Other tests
• Antigen tests of nasal washings provide rapid
and accurate detection of RSV.
• A positive culture or direct fluorescent
antibody test result can confirm the diagnosis
of RSV infection.
• Cultures of RSV are considerably less sensitive
(60%) but are 100% specific.
25. Treatment and medications
• General supportive measures are the mainstay
of treatment for patients with bronchiolitis.
Oxygen
Fluids Nutrition
31. Medications
• Antiviral drugs – only to those have severe
RSV infections or high risk infants (Ribavirin)
• Antibiotics – Of no values
• Corticosteroids – their use is controversial
• Nebulized B2 – agonists – their use are also
controversial
• Aerosolized racemic epinephrine – may have
some benefits as they have a vasoconstrictor
effect
32. Prevention:
• Exclusive breastfeeding for the first 6 months
decrease the risk of acquiring the RSV infection.
• -Avoid exposure to viral URTI during respiratory
illness season.
• -Passive immune-prophylaxis with intravenous
anti-RSV immune globulin or intramuscular anti
RSV monoclonal antibodies, this is given to
selected small infants with underlying cardio-
pulmonary disorders.
• -Vaccination is not yet available and preventive
vaccines are currently being studied.
34. Foreign body aspiration
• very serious, often life-threatening condition
• Ninety percent of deaths occur in patients
who are younger than 5 years, and two thirds
of these deaths occur in infants.
35. Why?
exploration learning to inadequate immature
of their walk and run dentition swallowing
environment coordination
by putting
objects into
their mouths
37. Pathophysiology
Complete airway Partial airway
obstruction obstruction
partially occluded or if
airway at levels above the obstruction occurs
the carina distal to the carina
acute onset of respiratory recurrent pneumonia,
distress in which the persistent cough,
patient is unable to speak hemoptysis, wheezing,
or cough or atelectasis
38. Diagnosis
• History
– Positive history can be obtained
– but often complicated by the fact that the event
may be unwitnessed in 90% of the case, witnessed
by a person not present for history taking, or
witnessed by an older sibling who may have had a
role in the aspiration and chooses not to say
anything.
39. Clinical picture
First phase Second phase Third phase
• immediately following the • asymptomatic period • renewed symptomatic
incident • can last from minutes to period
• choking, gagging, coughing, months following the • Airway inflammation or
wheezing, and/or stridor incident infection occurs
• associated temporary • of cough, wheezing (maybe
cyanotic episode unilateral) , fever, sputum
production, and
occasionally, hemoptysis.
40. • Imaging
– most foreign bodies are not radiopaque
– findings suggestive of the presence of a foreign
body such as
hyperinflation
mediastinal
shift
atelectasis
• Other test:
– Bronchoscopy : diagnostic and therapeutic
41. Expiratory chest radiograph in a 12-month-old boy with a 2-month
history of wheezing demonstrates continued hyperlucency and
hyperexpansion of the right hemithorax. A greater mediastinal shift is
noted toward the left lung field. A corn kernel was removed from the
patient's right mainstem bronchus during bronchoscopy
45. GERD in infant
• Most of the time, reflux in infants is due to a
poorly coordinated gastrointestinal tract.
• Many infants with the condition are otherwise
healthy; however, some infants can have
problems affecting their nerves, brain or muscles.
• Certain factors also may contribute to GERD,
including: obesity, overeating, certain foods,
some beverages, and specific medications.
• There also appears to be an inherited component
to GERD, as it is more common in some families
than in others
47. Signs and symptoms
• Frequent or recurrent vomiting
• Frequent or persistent cough
• Heartburn, gas, abdominal pain, or colicky behavior
(frequent crying and fussiness)
• Regurgitation and re-swallowing
• Colic (frequent crying and fussiness)
• Feeding problems wet burp or frequent hiccups
48. • Recurrent choking or gagging
• poor sleep habits typically with frequent waking
• arching their necks and back during or after eating
• frequent ear infections or sinus congestion
• Poor growth
• Breathing problems
• Recurrent wheezing
54. Scintigraphy
• Caloric liquid or solid meal appropriate to the
patient’s age were used: 200 to 250 mL of
formula or breast milk for small infants was
labeled with isotope
• After the ingestion of the radiolabeled test meal
at lunchtime, the patient was given a small
portion of the unlabeled meal to wash out all
previously ingested radioactivity from the
esophagus
• Images then taken with the gamma camera.
Shaded text wrapped around a corner(Basic)To reproduce the effects on this slide, do the following:On the Home tab, in the Slides group, click Layout, and then click Blank.On the Insert tab, in the Text group, click Text Box, and then on the slide, drag to draw the text box.Enter text in the text box, select the text, and then on the Home tab, in the Font group, select Haettenschweiler from the Font list, and then select 24 from the Font Size list.On the Home tab, in the Paragraph group, click Center to center the text on the slide.Select the text box. Under Drawing Tools, on the Format tab, in the WordArt Styles group, click Text Effects, point to Transform, and then under Warp click Triangle Up (first row, third option from the left). Drag the pink diamond adjustment handle (at the left side of the text box) to adjust the amount of text warp. Select the text. Under Drawing Tools, on the Format tab, in the WordArt Styles group, click the arrow next to Text Fill, point to Gradient, and click More Gradients. In the Format Text Effects dialog box, click Text Fill in the left pane, select Gradient fill in the Text Fill pane, and then do the following:In the Type list, select Linear.Click the button next to Direction, and then click Linear Right (first row, fourth option from the left).In the Angle box, enter 0°.Under Gradient stops, click Add or Remove until five stops appear in the drop-down list.Also under Gradient stops, customize the gradient stops that you added as follows:Select Stop 1 from the list, and then do the following:In the Stop position box, enter 0%. Click the button next to Color, and then under Theme Colors click Blue, Accent 1, Lighter 60% (third row, fifth option from the left).Select Stop 2 from the list, and then do the following:In the Stop position box, enter 17%. Click the button next to Color, and then under Theme Colors click Blue, Accent 1, Lighter 80% (second row, fifth option from the left).Select Stop 3 from the list, and then do the following:In the Stop position box, enter 50%. Click the button next to Color, and then under Theme Colors click White, Background 1 (first row, first option from the left).Select Stop 4 from the list, and then do the following:In the Stop position box, enter 51%. Click the button next to Color, and then under Theme Colors click Blue, Accent 1, Lighter 40% (fourth row, fifth option from the left).Select Stop 5 from the list, and then do the following:In the Stop position box, enter 100%. Click the button next to Color, and then under Theme Colors click Blue, Accent 1, Darker 25% (fifth row, fifth option from the left).Under Drawing Tools, on the Format tab, in the WordArt Styles group, click Text Effects, point to Reflection, and then under Reflection Variations click Tight Reflection, touching (first row, first option from the left).To reproduce the background on this slide, do the following:Right-click the slide background area, and then click Format Background. In the Format Background dialog box, click Fill in the left pane, select Gradient fill in the Fill pane, and then do the following:In the Type list, select Linear.Click the button next to Direction, and then click Linear Down (first row, second option from the left).Under Gradient stops, click Add or Remove until two stops appear in the drop-down list.Also under Gradient stops, customize the gradient stops that you added as follows:Select Stop 1 from the list, and then do the following:In the Stop position box, enter 64%.Click the button next to Color, and then under Theme Colors click Black, Text 1 (first row, second option from the left).Select Stop 2 from the list, and then do the following:In the Stop position box, enter 100%.Click the button next to Color, and then under Theme Colors click Blue, Accent 1, Darker 25% (fifth row, fifth option from the left).
Donut with text inside(Intermediate)To reproduce the donut shape on this slide, do the following:On the Home tab, in the Slides group, click Layout, and then click Blank.On the Home tab, in the Drawing group, click Shapes, and then under Basic Shapes click Donut (third row, second option from the left). On the slide, drag to draw a donut. Drag the yellow diamond adjustment handle to the left to decrease the width of the donut. Select the donut. Under Drawing Tools, on the Format tab, in the Size group, do the following:In the Shape Height box, enter 5.92”.In the Shape Width box, enter 5.92”.Under Drawing Tools, on the Format tab, in the Shape Styles group, click the arrow next to Shape Outline, and then click No Outline. Also under Drawing Tools, on the Format tab, in the Shape Styles group, click the arrow next to Shape Fill, and then under Theme Colors click Olive Green, Accent 3, Darker 25% (fifth row, seventh option from the left). Also under Drawing Tools, on the Format tab, in the Shape Styles group, click Shape Effects, and then do the following:Point to Bevel, and then under Bevel click Soft Round (second row, second option from the left). Point to Shadow, and then under Outer click Offset Diagonal Bottom Right (first row, first option from the left).To reproduce the text on this slide, do the following:On the Insert tab, in the Text group, click Text Box, and then on the slide, drag to draw the text box.Enter text in the text box, select the text, and then on the Home tab, in the Font group, select Consolas from the Font list, enter 27 in the Font Size box, click the button next to Font Color, and then under Theme Colors click White, Background 1 (first row, first option from the left). Tip: To enter the two bullets with the text, on the Insert tab, in the Text group, click Symbol. In the Symbol dialog box, do the following:In the Font list, select (normal text).In the Character Code box, enter 0095 to select BULLET, and then click Insert.On the Home tab, in the Paragraph group, click Align Text Left to align the text left in the text box. Select the text box. Under Drawing Tools, on the Format tab, in the WordArt Styles group, click Text Effects, and then do the following:Point to Shadow, and then under Outer click Offset Diagonal Bottom Right (first row, first option from the left). Point to Transform, and then under Follow Path click Circle (third option from the left). Under Drawing Tools, on the Format tab, in the Size group, do the following:In the Shape Height box, enter 4.78”.In the Shape Width box, enter 4.78”.Drag the text box onto the donut shape so that the text wraps around the donut. If the text does not wrap completely and evenly around the donut shape, select the text box and then do the following:If the text does not wrap completely around the donut shape, on the Home tab, in the Font group, in the FontSize box, enter larger font sizes in 1-pt increments until the text is evenly spaced within the donut shape. If the entire line of text does not fit evenly within the donut shape, on the Home tab, in the Font group, in the FontSize box, enter smaller font sizes in 1-pt increments until the text is evenly spaced within the donut shape.If the text does not wrap completely around or does not fit evenly within the donut shape, also try editing the CharacterSpacing. On the Home tab, in the Font group, click CharacterSpacing, and then do the following:To expand the text, in the CharacterSpacing list, select Loose or VeryLoose. To contract the text, in the CharacterSpacing list, select Tight or VeryTight.For more precise character spacing, click More Spacing. In the Font dialog box, on the Character Spacing tab, in the Spacing list, select Expanded or Condensed. In the By box, adjust the size by 0.1-pt increments until the text is spaced evenly.Press and hold SHIFT, and then select the text box and the donut shape. On the Home tab, in the Drawing group, click Arrange, and then click Group. Select the group. On the Home tab, in the Drawing group, click Arrange, point to Align, and then do the following:Click Align to Slide.Click Align Center.Click Align Middle. To reproduce the background on this slide, do the following:Right-click the slide background area, and then click Format Background. In the Format Background dialog box, click Fill in the left pane, select Gradient fill in the Fill pane, and then do the following:In the Type list, select Radial.Click the button next to Direction, and then click From Center (third option from the left).Under Gradient stops, click Add or Remove until three stops appear in the drop-down list.Also under Gradient stops, customize the gradient stops that you added as follows:Select Stop 1 from the list, and then do the following:In the Stop position box, enter 0%.Click the button next to Color, and then under Theme Colors click Aqua, Accent 5, Darker 25% (fifth row, ninth option from the left).Select Stop 2 from the list, and then do the following: In the Stop position box, enter 54%.Click the button next to Color, and then under Theme Colors click Aqua, Accent 5, Darker 50% (sixth row, ninth option from the left). Select Stop 3 from the list, and then do the following: In the Stop position box, enter 100%.Click the button next to Color, and then under Theme Colors click Black, Text 1 (first row, second option from the left).
Stacked, 3-D text with center perspective(Intermediate)To reproduce the text effects on this slide, do the following:On the Home tab, in the Slides group, click Layout, and then click Blank.On the Insert tab, in the Text group, click Text Box, and then on the slide, drag to draw the text box.Enter text in the text box, select the text, and then on the Home tab, in the Font group, select Impact from the Font list, and then change the font size of each line so that the text is approximately the same width. For example, if you entered FIRST on the first line, SECOND on the second line, and THIRD on the third line (as shown on the slide), do the following:Select the first line of text, and then on the Home tab, in the Font group, enter 92 in the Font Size box. Select the second line of text, and then on the Home tab, in the Font group, enter 65 in the Font Size box. Select the third line of text, and then on the Home tab, in the Font group, enter 92 in the Font Size box. Select all of the text. On the Home tab, in the Font group, click Character Spacing, and then click More Spacing. In the Font dialog box, on the Character Spacing tab, in the Spacing list, select Expanded. In the By box, enter 2.On the Home tab, in the Paragraph group, click Center to center the text in the text box.Under Drawing Tools, on the Format tab, in the bottom right corner of the WordArt Styles group, click the Format Text Effects dialog box launcher. In the Format Text Effects dialog box, click Text Fill in the left pane. Select Solid fill in the Text Fill pane, click the button next to Color, and then under Theme Colors click Black, Text 1, Lighter 15% (fifth row, second option from the left). Also in the Format Text Effects dialog box, click 3-D Rotation in the left pane, click the button next to Presets in the 3-D Rotation pane, and then under Perspective click Perspective Front (first row, first option from the left). Also in the Format Text Effects dialog box, click 3-D Format in the left pane, and then do the following in the 3-D Format pane:Under Depth, click the button next to Color, and then under Theme Colors click White, Background 1 (first row, first option from the left). In the Depth box, enter 300 pt. Under Surface, click the button next to Material, and then under Standard click Matte (first row, first option from the left). Click the button next to Lighting, and then under Neutral click Balance (first row, second option from the left). To reproduce the lines behind the text, do the following:On the Home tab, in the Drawing group, click Shapes, and then under Rectangles, click Rectangle (first option from the left). On the slide, drag to draw a rectangle.On the Home tab, in the Drawing group, click the arrow next to Shape Fill, and then click No Fill.On the Home tab, in the Drawing group, click the arrow next to Shape Outline, and then under Theme Colors click White, Background 1 (first row, first option from the left). On the Home tab, in the Drawing group, click the arrow next to Shape Outline, point to Weight, and then click More Lines.In the Format Shape dialog box, click Line Style in the left pane. In the Line Style pane, in the Width box, enter 2 pt.On the Home tab, in the Drawing group, click Arrange, and then click Send to Back.To reproduce the background on this slide, do the following:Right-click the slide background area, and then click Format Background. In the Format Background dialog box, click Fill in the left pane, select Gradient fill in the Fill pane, and then do the following:In the Type list, select Radial.Click the button next to Direction, and then click From Center (third option from the left).Under Gradient stops, click Add or Remove until two stops appear in the drop-down list.Also under Gradient stops, customize the gradient stops that you added as follows:Select Stop 1 from the list, and then do the following:In the Stop position box, enter 10%.Click the button next to Color, and then under Theme Colors click White, Background 1 (first row, first option from the left).Select Stop 2 from the list, and then do the following:In the Stop position box, enter 100%.Click the button next to Color, and then under Theme Colors click Black, Text 1 (first row, second option from the left).
Stacked, 3-D text with center perspective(Intermediate)To reproduce the text effects on this slide, do the following:On the Home tab, in the Slides group, click Layout, and then click Blank.On the Insert tab, in the Text group, click Text Box, and then on the slide, drag to draw the text box.Enter text in the text box, select the text, and then on the Home tab, in the Font group, select Impact from the Font list, and then change the font size of each line so that the text is approximately the same width. For example, if you entered FIRST on the first line, SECOND on the second line, and THIRD on the third line (as shown on the slide), do the following:Select the first line of text, and then on the Home tab, in the Font group, enter 92 in the Font Size box. Select the second line of text, and then on the Home tab, in the Font group, enter 65 in the Font Size box. Select the third line of text, and then on the Home tab, in the Font group, enter 92 in the Font Size box. Select all of the text. On the Home tab, in the Font group, click Character Spacing, and then click More Spacing. In the Font dialog box, on the Character Spacing tab, in the Spacing list, select Expanded. In the By box, enter 2.On the Home tab, in the Paragraph group, click Center to center the text in the text box.Under Drawing Tools, on the Format tab, in the bottom right corner of the WordArt Styles group, click the Format Text Effects dialog box launcher. In the Format Text Effects dialog box, click Text Fill in the left pane. Select Solid fill in the Text Fill pane, click the button next to Color, and then under Theme Colors click Black, Text 1, Lighter 15% (fifth row, second option from the left). Also in the Format Text Effects dialog box, click 3-D Rotation in the left pane, click the button next to Presets in the 3-D Rotation pane, and then under Perspective click Perspective Front (first row, first option from the left). Also in the Format Text Effects dialog box, click 3-D Format in the left pane, and then do the following in the 3-D Format pane:Under Depth, click the button next to Color, and then under Theme Colors click White, Background 1 (first row, first option from the left). In the Depth box, enter 300 pt. Under Surface, click the button next to Material, and then under Standard click Matte (first row, first option from the left). Click the button next to Lighting, and then under Neutral click Balance (first row, second option from the left). To reproduce the lines behind the text, do the following:On the Home tab, in the Drawing group, click Shapes, and then under Rectangles, click Rectangle (first option from the left). On the slide, drag to draw a rectangle.On the Home tab, in the Drawing group, click the arrow next to Shape Fill, and then click No Fill.On the Home tab, in the Drawing group, click the arrow next to Shape Outline, and then under Theme Colors click White, Background 1 (first row, first option from the left). On the Home tab, in the Drawing group, click the arrow next to Shape Outline, point to Weight, and then click More Lines.In the Format Shape dialog box, click Line Style in the left pane. In the Line Style pane, in the Width box, enter 2 pt.On the Home tab, in the Drawing group, click Arrange, and then click Send to Back.To reproduce the background on this slide, do the following:Right-click the slide background area, and then click Format Background. In the Format Background dialog box, click Fill in the left pane, select Gradient fill in the Fill pane, and then do the following:In the Type list, select Radial.Click the button next to Direction, and then click From Center (third option from the left).Under Gradient stops, click Add or Remove until two stops appear in the drop-down list.Also under Gradient stops, customize the gradient stops that you added as follows:Select Stop 1 from the list, and then do the following:In the Stop position box, enter 10%.Click the button next to Color, and then under Theme Colors click White, Background 1 (first row, first option from the left).Select Stop 2 from the list, and then do the following:In the Stop position box, enter 100%.Click the button next to Color, and then under Theme Colors click Black, Text 1 (first row, second option from the left).
Stacked, 3-D text with center perspective(Intermediate)To reproduce the text effects on this slide, do the following:On the Home tab, in the Slides group, click Layout, and then click Blank.On the Insert tab, in the Text group, click Text Box, and then on the slide, drag to draw the text box.Enter text in the text box, select the text, and then on the Home tab, in the Font group, select Impact from the Font list, and then change the font size of each line so that the text is approximately the same width. For example, if you entered FIRST on the first line, SECOND on the second line, and THIRD on the third line (as shown on the slide), do the following:Select the first line of text, and then on the Home tab, in the Font group, enter 92 in the Font Size box. Select the second line of text, and then on the Home tab, in the Font group, enter 65 in the Font Size box. Select the third line of text, and then on the Home tab, in the Font group, enter 92 in the Font Size box. Select all of the text. On the Home tab, in the Font group, click Character Spacing, and then click More Spacing. In the Font dialog box, on the Character Spacing tab, in the Spacing list, select Expanded. In the By box, enter 2.On the Home tab, in the Paragraph group, click Center to center the text in the text box.Under Drawing Tools, on the Format tab, in the bottom right corner of the WordArt Styles group, click the Format Text Effects dialog box launcher. In the Format Text Effects dialog box, click Text Fill in the left pane. Select Solid fill in the Text Fill pane, click the button next to Color, and then under Theme Colors click Black, Text 1, Lighter 15% (fifth row, second option from the left). Also in the Format Text Effects dialog box, click 3-D Rotation in the left pane, click the button next to Presets in the 3-D Rotation pane, and then under Perspective click Perspective Front (first row, first option from the left). Also in the Format Text Effects dialog box, click 3-D Format in the left pane, and then do the following in the 3-D Format pane:Under Depth, click the button next to Color, and then under Theme Colors click White, Background 1 (first row, first option from the left). In the Depth box, enter 300 pt. Under Surface, click the button next to Material, and then under Standard click Matte (first row, first option from the left). Click the button next to Lighting, and then under Neutral click Balance (first row, second option from the left). To reproduce the lines behind the text, do the following:On the Home tab, in the Drawing group, click Shapes, and then under Rectangles, click Rectangle (first option from the left). On the slide, drag to draw a rectangle.On the Home tab, in the Drawing group, click the arrow next to Shape Fill, and then click No Fill.On the Home tab, in the Drawing group, click the arrow next to Shape Outline, and then under Theme Colors click White, Background 1 (first row, first option from the left). On the Home tab, in the Drawing group, click the arrow next to Shape Outline, point to Weight, and then click More Lines.In the Format Shape dialog box, click Line Style in the left pane. In the Line Style pane, in the Width box, enter 2 pt.On the Home tab, in the Drawing group, click Arrange, and then click Send to Back.To reproduce the background on this slide, do the following:Right-click the slide background area, and then click Format Background. In the Format Background dialog box, click Fill in the left pane, select Gradient fill in the Fill pane, and then do the following:In the Type list, select Radial.Click the button next to Direction, and then click From Center (third option from the left).Under Gradient stops, click Add or Remove until two stops appear in the drop-down list.Also under Gradient stops, customize the gradient stops that you added as follows:Select Stop 1 from the list, and then do the following:In the Stop position box, enter 10%.Click the button next to Color, and then under Theme Colors click White, Background 1 (first row, first option from the left).Select Stop 2 from the list, and then do the following:In the Stop position box, enter 100%.Click the button next to Color, and then under Theme Colors click Black, Text 1 (first row, second option from the left).
Stacked, 3-D text with center perspective(Intermediate)To reproduce the text effects on this slide, do the following:On the Home tab, in the Slides group, click Layout, and then click Blank.On the Insert tab, in the Text group, click Text Box, and then on the slide, drag to draw the text box.Enter text in the text box, select the text, and then on the Home tab, in the Font group, select Impact from the Font list, and then change the font size of each line so that the text is approximately the same width. For example, if you entered FIRST on the first line, SECOND on the second line, and THIRD on the third line (as shown on the slide), do the following:Select the first line of text, and then on the Home tab, in the Font group, enter 92 in the Font Size box. Select the second line of text, and then on the Home tab, in the Font group, enter 65 in the Font Size box. Select the third line of text, and then on the Home tab, in the Font group, enter 92 in the Font Size box. Select all of the text. On the Home tab, in the Font group, click Character Spacing, and then click More Spacing. In the Font dialog box, on the Character Spacing tab, in the Spacing list, select Expanded. In the By box, enter 2.On the Home tab, in the Paragraph group, click Center to center the text in the text box.Under Drawing Tools, on the Format tab, in the bottom right corner of the WordArt Styles group, click the Format Text Effects dialog box launcher. In the Format Text Effects dialog box, click Text Fill in the left pane. Select Solid fill in the Text Fill pane, click the button next to Color, and then under Theme Colors click Black, Text 1, Lighter 15% (fifth row, second option from the left). Also in the Format Text Effects dialog box, click 3-D Rotation in the left pane, click the button next to Presets in the 3-D Rotation pane, and then under Perspective click Perspective Front (first row, first option from the left). Also in the Format Text Effects dialog box, click 3-D Format in the left pane, and then do the following in the 3-D Format pane:Under Depth, click the button next to Color, and then under Theme Colors click White, Background 1 (first row, first option from the left). In the Depth box, enter 300 pt. Under Surface, click the button next to Material, and then under Standard click Matte (first row, first option from the left). Click the button next to Lighting, and then under Neutral click Balance (first row, second option from the left). To reproduce the lines behind the text, do the following:On the Home tab, in the Drawing group, click Shapes, and then under Rectangles, click Rectangle (first option from the left). On the slide, drag to draw a rectangle.On the Home tab, in the Drawing group, click the arrow next to Shape Fill, and then click No Fill.On the Home tab, in the Drawing group, click the arrow next to Shape Outline, and then under Theme Colors click White, Background 1 (first row, first option from the left). On the Home tab, in the Drawing group, click the arrow next to Shape Outline, point to Weight, and then click More Lines.In the Format Shape dialog box, click Line Style in the left pane. In the Line Style pane, in the Width box, enter 2 pt.On the Home tab, in the Drawing group, click Arrange, and then click Send to Back.To reproduce the background on this slide, do the following:Right-click the slide background area, and then click Format Background. In the Format Background dialog box, click Fill in the left pane, select Gradient fill in the Fill pane, and then do the following:In the Type list, select Radial.Click the button next to Direction, and then click From Center (third option from the left).Under Gradient stops, click Add or Remove until two stops appear in the drop-down list.Also under Gradient stops, customize the gradient stops that you added as follows:Select Stop 1 from the list, and then do the following:In the Stop position box, enter 10%.Click the button next to Color, and then under Theme Colors click White, Background 1 (first row, first option from the left).Select Stop 2 from the list, and then do the following:In the Stop position box, enter 100%.Click the button next to Color, and then under Theme Colors click Black, Text 1 (first row, second option from the left).
Expanded text with bevel and shadow(Basic)To reproduce the text effects on this slide, do the following:On the Home tab, in the Slides group, click Layout, and then click Blank.On the Insert tab, in the Text group, click Text Box, and then on the slide, drag to draw the text box.Enter text in the text box, select the text, and then on the Home tab, in the Font group, select Calisto MT from the Font list and then select 60 from the Font Size list.On the Home tab, in the Paragraph group, click Center to center the text in the text box.On the Home tab, in the Font group, click Character Spacing, and then click More Spacing. In the Font dialog box, on the Character Spacing tab, in the Spacing list, select Expanded. In the By box, enter 22.Under Drawing Tools, on the Format tab, in the WordArt Styles group, click the arrow next to Text Fill, and then under Theme Colors click Tan, Background 2, Darker 50% (fourth row, third option from the left). Under Drawing Tools, on the Format tab, in the bottom right corner of the WordArt Styles group, click the Format Text Effects dialog box launcher. In the Format Text Effects dialog box, click 3-D Format in the left pane, and then do the following in the 3-D Format pane:Under Bevel, click the button next to Top, and then under Bevel click Soft Round (second row, second option from the left). Next to Top, in the Width box, enter 4 pt, and in the Height box,enter 6 pt. Under Depth, click the button next to Color, and then under Theme Colors click Tan, Background 2, Darker 50% (fourth row, third option from the left). In the Depth box, enter 6 pt. Under Contour, click the button next to Color, and then under Theme Colors click White, Background 1 (first row, first option from the left). In the Size box, enter 0 pt. Under Surface, click the button next to Material, and then under Translucent click Powder. Click the button next to Lighting, and then under Warm click Morning. Also in the Format Text Effects dialog box, click Shadow in the left pane, and then do the following in the Shadow pane:Click the button next to Presets, and under Perspective, click Perspective Diagonal Upper Left (first row, first option from the left). In the Transparency box, enter 85%. To reproduce the background on this slide, do the following:Right-click the slide background area, then click Format Background. In the Format Background dialog box, click Fill in the left pane, select Gradient fill in the Fill pane, and then do the following:In the Type list, select Radial.Click the button next to Direction, and then click From Corner (first option from the left).Under Gradient stops, click Add or Remove until three stops appear in the drop-down list.Also under Gradient stops, customize the gradient stops that you added as follows:Select Stop 1 from the list, and then do the following:In the Stop position box, enter 45%.Click the button next to Color, and then under Theme Colors click White, Background 1 (first row, first option from the left).Select Stop 2 from the list, and then do the following:In the Stop position box, enter 80%.Click the button next to Color, click More Colors, and then in the Colors dialog box, on the Custom tab, enter values for Red: 223, Green: 219, Blue: 211.Select Stop 3 from the list, and then do the following:In the Stop position box, enter 100%.Click the button next to Color, click More Colors, and then in the Colors dialog box, on the Custom tab, enter values for Red: 213, Green: 208, Blue: 197.