A Brief Note On Anorexia Nervosa And Bulimia Nervosa

A Brief Note On Anorexia Nervosa And Bulimia Nervosa
Anorexia Nervosa and Bulimia Nervosa Eating disorders are classified as mental disorders and can
lead to life threatening damage. It is important to manage eating disorders to prevent health effects.
There are many different possibilities for patients with disorders. Common treatments for eating
disorders can consists of counselor or therapists. Early detection is important to limit future oral
health effects. A dental hygienist has an advantage to see the inside of the mouth for possible
trauma, erosion, and malnutrition. It is common for patients to be in denial of the situation. A dental
hygienist is trained to communication to the patient about the eating disorder without the patient
feeling attacked. It is important to tell the difference in eating disorders. Most eating disorders all
appear to be anorexia until further signs and symptoms are observed. The two types of eating
disorders being discussed in this paper are anorexia nervosa and bulimia nervosa. On average,
women are more likely to experience an eating disorder. Although, men are not eliminated from
eating disorders. Eating disorders pertain to a patient who is unsatisfied with one's current body
image. Anorexia nervosa and bulimia nervosa are the most common eating disorders. These two
eating disorders are similar in ways that are characterized by low self esteem, body dysmorphia, and
signs of depression. However, anorexia, anorexia nervosa, and bulimia nervosa should not be
confused. Anorexia is the
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Pancreatic Tumors: A Case Study
There is another classification of pancreatic tumor help in decision making of management. This
classification depends on the possibility of surgical removal of the tumor: in this way, tumors are
judged to be "resectable", "borderline resectable" or "unresectable" (American Cancer Society,
2014).
AJCC stages I and II defines the disease without spread to large blood vessels or distant organs such
as the liver or lungs with possibility of surgical resection of the tumor (Bond–Smith et al., 2012).
The AJCC staging system allows distinction between stage III tumors that are judged to be
"borderline resectable" (where surgery is technically feasible because the celiac axis and superior
mesenteric artery are still free) and those that are "unresectable" ... Show more content on
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Badger et al., in 126 surgically resected pancreatic cancer patients, showed that lymphatic vascular
and perineural invasion, together with the grading, are important predictors of outcome and their
presence is associated with a reduced survival (Badger et al ., 2010).
In particular, perineural invasion has a crucial role in the local recurrence of disease after surgery.
Perineural space is known to be an important route of pancreatic cancer invasion. Pancreatic cancer
cells invade the neural plexus distributed in pancreatic parenchyma and spread through perineural
space to reach extra–pancreatic nerves, such as the celiac plexus or the supra–mesenteric artery
plexus. Cancer cell invasion into the neural plexus often results in non–curative resection and,
therefore, retroperitoneal recurrence (Kenmotsu, 1990, Kameda et al., 1990).
(d) CA19–9, CEA: has also importance in the prognosis of cancer pancreas (Blumenthal et al.,
2005). Studies showed that patients who present a significant increase of CA19–9 at the time of
diagnosis or onset of chemotherapy, have a reduced survival compared to those in which the marker
is normal (Maisey et al.,

Median Arcuate Ligament Syndrome
INTRODUCTION
Median Arcuate Ligament Symdrome (MAL) is a very rare condition also knows as celiac axis
compression syndrome (CACS) or Dunbar syndrome. This syndrome has a characteristic triad of
postprandial abdominal pain, abdominal bruit and weight loss. Others symptoms that are commonly
described are nausea and vomiting 1,2 .
As these symptoms are not specific and at the same time overlap with a broad of others conditions,
the diagnosis is often made by exclusion. By the overlap of symptoms and its characteristics, among
the most common diagnoses given to patients with this disease are intestinal ischemia and functional
gastrointestinal disorder (FGID) 1, 3.
The first description of this syndrome was made by Harjola in 1963, but in ... Show more content on
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Other cause that has been proposed for extrinsic compression of the celiac artery is the enlargement
of the celiac ganglionar plexus and low insertion of the ligament by itself 5,8.
Another theory is a sympathetic overstimulation on the celiac artery that can cause a
vasoconstriction of the trunk. A "steeling phenomenon" has been also reported, in which the blood
celiac artery is derived to the superior mesenteric artery, causing an ischemic pain 2,5.
As it was referred before, the prevalence of MAL is calculated to be 10–24%, but the most of the
cases remain asymptomatic. This variation in the presentation can be due to a more extensive
collateral blood supply from the superior or inferior mesenteric arteries 6,7.
The clinical presentation can be vary variable, but the common symptoms are postprandial
abdominal pain (80% of patients) and weight loss of >20 pounds (48% of patients). others
symptoms are nausea, vomiting and diarrhea. At the physical examination an epigastric bruit, can be
found, but it is reported only in 35% of cases. This bruit can change with respiration, been more
intensive in expiration

Pancreatic Cancer Case Study
Informant: Patient and her daughter who appear to be reliable Chief complaint: Persistent nausea
and vomiting with accompying decreased PO intake History of Present Illness: Ms. BH is a 70 year
old female with a history of recently diagnosed pancreatic adenocarcinoma with hepatic lesions,
multifocal PEs s/p IVC filter placement on lovenox, and HTN who presents with persistent nausea
and vomiting. She was diagnosed with pancreatic adenocarcinoma on her last admission to CUMC
in 12/2017 when she presented with epigastric pain, loss of appetite due to nausea and vomiting,
dark, tarry stools, and a reported 20 lb weight loss in the course of a month. An abdominal
ultrasound performed 12/18 showed numerous hepatic lesions and a pancreatic

Colorectal Cancer : Cancer And Cancer
Cancer occurs when abnormal cells in the body uncontrollably replicate forming a malignant tumor
that invades nearby tissues. It has the capability to affect any part of the body and spread to tissues
throughout the body. There are many different types of cancers including rectal cancer, colon cancer,
breast cancer, lung cancer, and skin cancer. Rectal cancer is a disease in which cancer cells develop
and form in the tissues of the rectum. Rectal cancer is typically classified with colon cancer where
they are collectively called colorectal cancer. According to the Centers for Disease Control and
Prevention, colorectal cancer is the second leading cause of cancer–related deaths in the United
States and the third most common cancer in men and in women (CDC, 2014). Colorectal cancer is
the third most commonly cancer diagnosed in men and second in females worldwide (Jemal, 2011).
Certain ethnicities such as blacks have an increased chance of having colorectal cancer compared to
whites and other races. Colorectal cancer also has a higher incidence in men versus in women. It has
been noted that about 90 percent of colorectal cancers are diagnosed in patients who are at the age
of 50 and older. Two–thirds of these patients that were diagnosed were older than 65 years old.
(Haggstrom, 2013). Some of the risk factors of colorectal cancer include environmental factors and
genetic component, high fat, low–fiber diet, diet high in red meats, family history of colorectal
cancer, male

Superior Mesenteric Artery Syndrome Analysis
Superior Mesenteric Artery Syndrome
Education is Key
Superior mesenteric artery syndrome is a rare disease that is caused by many different factors, but
the focus of this paper will be how compression from a body cast or spinal injury causes superior
mesenteric artery syndrome. The injuries sustained can lead to a compressed area in the superior
mesenteric artery and the abdominal aorta, which in return will lead to an obstructed duodenum.
Education is key; if the symptoms are recognized early, then early interventions can prevent severe
complications. The safety concern with superior mesenteric artery syndrome is the inability to
absorb nutrients. This can become a life–threatening condition if nutritional needs are not met in a
timely manner ... Show more content on Helpwriting.net ...
Education needs to be directed to not only the patients and their families, but to HCP as well.
According to Dr. A.Run Pal Singh (2015), prevention and prompt treatment of cast syndrome is key
and knowledge of the nursing staff is essential in prevention. Knowing the early signs and
symptoms, as well as diagnostic tests, will not only shorten the disease process, but allow for
immediate treatment to prevent any further complications. Patients compliance to treatment is the
key to their health. This assignment has taught us what superior mesenteric artery syndrome was, as
well as how to provide adequate education to the patients, families, and all HCP.
References
Cheever, K., & Hinkle, J., Brunner & Suddarth's Textbook of Medical– Surgical Nursing pg. 1141–
1146. Wolters Kluwer.
Gebhart, T. (2015). Superior Mesenteric Artery Syndrome [Abstract]. Gastroenterology Nursing,
38(3), 189–193.
Karrer, F. M. (n.d.). Superior Mesenteric Artery Syndrome Follow–up. Retrieved February 18, 2017,
from http://emedicine.medscape.com/article/932220–followup
Ranschaert, E. (n.d.). Superior mesenteric artery syndrome | Radiology Reference Article. Retrieved
February 18, 2017, from https://radiopaedia.org/articles/superior–mesenteric–artery–syndrome.
Singh, D. A., About Dr Arun Pal SinghArun Pal Singh D. P. (2015, December 11).

Aneurysm : A Focal Dilation Of An Infected Arterial Wall
Mycotic aneurysm is a focal dilation of an infected arterial wall. This uncommon disease follows an
aggressive and unpredictable clinical course with significant mortality, and presents unique
diagnostic and therapeutic challenges. This review discusses the pathogenesis, diagnosis, and
therapeutic management of mycotic aneurysms.
Historical Perspective Virchow first described a saccular outpoutching along an arterial wall
corresponding to an embolic source in 1847 [1]. Mycotic aneurysms were initially considered a
physical change secondary to mechanical pressure of emboli against the artery wall [2]. Infectious
etiology was first hypothesized by Goodhart in 1877 [3]. The term 'mycotic' originates from Osler's
Gulstonian Lectures in 1885 [4] in which he associated aortic aneurysms resembling a fungus
growth with a severe or "malignant" form of endocarditis and coined the term "mycotic aneurysms."
The term "mycotic" is a misnomer suggesting fungal infection, though it was originally intended to
refer to all microorganisms [5]. Osler established a clear connection between endocarditis and its
bacterial origin ("micrococci") through histology using bacterial Gram staining, which at the time
was novel in medical practice. He defined the mycotic process in the setting of endocarditis as the
transference of microbes from the growth of the valves to distant parts. In 1887, Langton and
Bowlby corroborated Osler's findings with observations of numerous bacteria derived from the

Alpha-1 Antitrypsin Deficiency (AATD)
Background: Alpha–1 antitrypsin deficiency (AATD) is a genetic disorder that predisposes to
emphysema and liver cirrhosis. We present a unique vascular complication of this syndrome.
Case report: A 47 year–old female with a history of homozygous AATD presented with acute
epigastric pain, near syncope and hypotension. Laboratory tests revealed acute anemia with normal
platelet count and coagulation studies. Abdominal computed tomography angiography detected
hemoperitoneum and hematoma within the gastrohepatic ligament with active extravasation.
Abdominal angiography was suggestive of left gastric aneurysms. Transcatheter arterial
embolization was successfully performed on the proximal left gastric artery to stop the bleeding.
Conclusion: An ... Show more content on Helpwriting.net ...
Although, gastric artery remained a rare site, it is utmost importance to establish early diagnosis in
order to provide urgent intervention; to prevent lethal consequence. Most patients remain
asymptomatic until aneurysm rupture so the majority of patients present to the hospital with acute
abdominal pain with hemorrhagic shock that requires urgent intervention, including ligation or
embolization by surgical or radiological interventional approaches, as in this patient. Transcatheter
embolization is the preferred method in patients with high surgical risk as in our patient and has a
success rate of 85% 10. Anatomically, the splanchnic arteries are defined as celiac, superior
mesenteric and inferior mesenteric arteries, which arise from abdominal aorta. The gastric artery is a
branch of the celiac artery. Common causes of gastric aneurysm formation include periarterial
inflammation, medial degeneration, and arteriosclerosis

Benefits Of Dissecting A Cat
1. Introduction: What is dissection? Dissection is the "process of disassembling and observing
something to determine its internal structure and as an aid to discerning the functions and
relationships of its components" (Dissection). The term is most often used concerning the dissection
of plants and animals, including humans. Comparative anatomy is the investigation of similitudes
and contrasts in the life structures of various species. It is firmly identified with transformative
science and phylogeny. Comparative anatomy has gradually and long been utilized as evidence for
evolution; it indicates that various organisms share a common ancestor. Dissection of cats in an
anatomy class is a common occurrence and believed to be a great learning mechanism for students.
Schools and education systems utilize the availability of a cat because they are vertebrates and
include a great amount of similarity in structures as humans, as students learn the anatomy and
physiology of the human body. Advantages of dissecting a cat include a sensory factor that a visual
study is unable to provide. A fact of being a human is that a great many people recall things they can
touch or work on accomplishing more than they recollect data that they examined. By analyzing a
creature in individual and touching it, the material encounters can give a general, better learning
background that may help them in future classes if science or medical sciences will be examined. I
hold the belief that the

Pancreatic Cancer Research Paper
Pancreatic cancer is one of the deadliest types of cancer. The cancer is normally not found till it's in
the further stages. Pancreatic cancer is when tumors are formed in the pancreas. There are two types
of Pancreatic cancer,endocrine and endocrine tumors.Exocrine is the most common type of
pancreatic cancer. The main type of Exocrine tumor is Pancreatic adenocarcinoma. About 95% of
exocrine tumors are pancreatic adenocarcinoma. This type of cancer usually begins in the ducts of
the pancreas. Endocrine tumors and uncommon and make up less than 4% of pancreatic cancer.
They both occur in people over 40, and a little more common in men. Pancreatic cancer cause is still
unknown, research shows that damage to the DNA can be a cause. It is also ... Show more content
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Abdominal ultrasound is sometimes used for quick and cheap first examinations. If there is
uncertainty about the diagnosis they may do a biopsy by fine needle aspiration. Pancreatic cancer is
usually staged after a ct scan is done. The staging system is four stages,from early to advanced and
based on TNM classification.TNM stands for Tumor size, spread to lymph nodes,and metastasis.
Based on if surgical removal seems possible,the tumors are divided into three broader categories to
help decide treatment. Tumors are resectable, borderline resectable or undetectable. If the disease is
still in an early stage(stage 1 or 2) surgical resection of the tumor can be performed. Stage 3 tumors
can be borderline resectable where surgery can technically still be done or unresectable where its to
locally advanced. Stage 1 cancer is only found in the pancreas. Stage 1 is divided into a and b stages
based on tumor size. Stage 1a is when the tumor is no bigger than 2 cm. Stage 1b is when the tumor
is bigger than 2 cm. The second stage is when the cancer could have spread to nearby tissue and
organs, and may have also spread to the lymph nodes near the

Parathyroid Glam Research Paper
Overview and Functions of the Parathyroid Glam
Parathyroid glands: Essentials
Parathyroid hormone regulates the body's calcium levels. They are four small glands that are about
the size of a grain of rice and are intended to secrete parathyroid hormone to regulate the level of
calcium in our bodies.
The parathyroid helps the nervous and muscular systems work properly. Calcium is the primary
element that causes the muscles to contract. Calcium levels are vitally important for the normal
conduction of electrical currents along the nerves.
Anatomy of the parathyroid glands
The four parathyroid are usually found in the back of the thyroid but anatomically, they have no
related function. The thyroid gland regulates the body's metabolism and the parathyroid glands
regulate calcium levels and have no effect on metabolism. the four parathyroid travel from the head
area down to the lower neck. A calcium balance will benefit the heart, the kidneys, the nervous
system, and the bones. Low calcium levels can lead to heart, bone, and neural disease. ... Show
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The superior, or top, parathyroid gland is supplied by the inferior thyroid arteries, while the inferior,
or bottom, gland will receive supply from variable sources like the ascending branch of inferior
thyroid artery or the thyroid inferior mesenteric artery. The parathyroid veins drain into a venal
thyroid plexus.
In turn, the parathyroid gland's lymphatic vessels will drain into the deep cervical and paratracheal
lymph nodes. The parathyroid gland is innervated by the thyroid branches of the sympathetic
cervical

Essay on Adam Interactive Lab
6.9
1. Label the following diagram.
A) Parietal brancha of superficial temporal artery
B) Frontal branch of temporal artery
C) Superficial temporal artery
D) External carotid artery
E) Internal carotid
F) Vertebral artery
G) Inferior thyroid artery
H) Subclavian artery
2. What regions of the face are supplied by the external carotid artery? The face.
3. What is the significance of the transverse foramina in cervical vertebrae? They carry blood
vessels and nerves from the body and the brain and vice versa.
4. Through what cranial structure does the carotid artery pass as it enters the brain? The carotid
canal.
6.10
1. Label the following diagram:
A) Anterior cerebral artery
B) anterior communicating artery
C) Middle ... Show more content on Helpwriting.net ...
The gastric artery.
c. What branch supplies blood to the liver? The common hepatic artery.
5. What organs does the superior mesenteric artery supply? The intestine.
6.15
1. Adjust the image to match the diagram below, and then label the diagram.
A) Inferior vena cava
B) Right external iliac vein
C) femoral vein
D) Great saphenous vein
E) deep femoral vein
F) abdominal aorta
G) left common iliac artery
H) left external iliac artery

I) Left internal iliac artery
J) deep femoral artery
K) left femoral artery
2. What two arteries represent the terminal branches of the abdominal aorta? Right and left common
iliac artery.
3. What are the two terminal branches of the common iliac artery? The right and left internal and
external iliac artery.
4. Into what vein does the great saphenous vein drain? The popliteal vein.
5. What large artery, representing the continuation of the external iliac artery, provides the chief
arterial supply to the lower limb? The femoral artery.
6.16
1. Adjust the images in both windows so that they match he diagram below, and then place the
correct names of the labeled letters in the appropriate spaces below the diagrams.
A) Common iliac artery
B) External iliac artery
C) Internal iliac artery
D) Femoral artery
E) Lateral circumflex femoral artery
F) Deep femoral artery
G) descending branch of lateral circumflex femoral artery
H) Descending genicular artery
I) popliteal artery
2. Adjust the image in both

A Tour of the Human Body
Welcome to our Fantastic Voyage! On this journey, we will explore how nutrients are consumed and
passed through the human body before they are finally expelled. This journey will take us through
the digestive, circulatory, and digestive systems. Our journey will begin after we enter our male test
subject's system by inconspicuously entering the digestive system as part of his delicious, all–
American meal consisting of a juicy hamburger, crispy french fries, and an ice–cold root beer. Our
tour will begin as we enter the body through the mouth. As we are thrown about the oral cavity,
please note how mastication allows our delicious meal to be broken down by saliva and the
simultaneous grinding of the food by the test subject's teeth. It is important to note the different
types of teeth that we see. As we move from the center of the mouth towards the back you will
notice that there are two sets of incisors, a set of canines, and a set of premolars, which are followed
by first and second molars (Thibodeau, 1992). The clear substance that is secreted all around us
during this process is called salivary amylase. This mucosal fluid will allow us to travel smoothly to
the esophagus and into the stomach. Right underneath us, at the bottom of the mouth is the tongue
and right above us are the hard and soft palates (Gregory, n.d.). Quickly look at the tear–shaped
tissue hanging from the soft palate before we are violently thrown into the pharynx and down into
the esophagus. That is

Atherosclerosis Formation
Atherosclerosis can be associate with atheromata'formation, which are raised, fibroadipose plaques
that develop within the intimal layer of the artery or within the innermost layers of the tunica media.
Some atheromata undergo calcification or ulceration, and mural thrombi can form over complicated
and uncomplicated atheromata. As a result, can block or diminished the blood flow in the artery,
turning tissue and organs oxygen deprived.
Lesions on the arterial wall can cause them to become weak and get into the high risk area of
dilatation and rupture. Atherosclerotic aneurysm is a disease of elderly persons, rare before age 50.
Its frequency peak is around age of 70 years. It can be seen in different shapes, fusiform, saccular
and cylindrical. The cause is usually atheroma expansion in the ... Show more content on
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The arterial stenosis is frequently mistakenly identified. Acute ischemia can also be caused by the
simultaneous development of portal hypertension or thrombosis of the Superior mesenteric vein.
Identify this disease in the beginning is difficult that's why imaging studies are very important in
these cases. As time passes it was noticed that the aorta has becoming more tortuous, especially in
women and those who are committed with hypertension. Thus, sometimes aorta can be seen
compressing the inferior vena cava. Aorta can suffer alteration in its size, commonly aortic
dilatation. Sometimes involves the full length of the vessel, including the thoracic segment, and is
associated with marked lengthening of the artery, a situation defined as dolichoectasia of the aorta.
The majority of aneurysms are infrarenal. Aneurysms involving both the supra and infrarenal
segments of the aorta have an hourglass appearance due to the local expansion–opposing effects of
the left renal vein. The aneurysm sac is composed of thrombotic formations and atheromata
(abnormal mass of lipids), which reduce the patency of the

Surgical Implications Of Splenic Patients
All the patients who underwent LSPDP at the Li Hui Li Hospital and Li Hui Li Eastern Hospital
between January 2014 and April 2017 were reviewed retrospectively, and were approved by an
institutional review board. Data collected from the medical records were age, sex, preoperative
diabetes mellitus status, preoperative American Society of Anesthesiologists (ASA) grading,
pathological diagnosis, operative time, intraoperative blood loss, length of hospital stay,
postoperative morbidity and mortality. All patients underwent preoperative CT or enhanced MRI
examination to accurately assess the nature of the lesion, location, size and the relationship with the
splenic arteries. The severity of surgical complications was determined according to ... Show more
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The stomach was suspended from the abdominal wall, revealing the pancreas neck, body and tail.
After exploration of the pancreas, pancreatic lesion was identified by using intraoperative
laparoscopic ultrasound. In addition to this, with the help of laparoscopic coagulation shears inferior
margin of the pancreas was divided to separate it from the retroperitoneum. The pancreas was then
pulled superiorly and anteriorly, further revealing the superior mesenteric vein, inferior mesenteric
vein and the splenic vein located within the fusion fascia of Toldt. The longitudinal dissection of the
fusion fascia of Told towards the tail of the pancreas further revealed the splenic vein and was
carefully isolated. Additionally, divulging and isolation of splenic artery was done by gentle traction
of the splenic vein caudally using a vascular sling, where splenic artery lies just above the splenic
vein Figure 2. The dissection then at that point continued from medial to lateral, ligating each
branch of the splenic vessels encountered supplying the pancreas using laparoscopic coagulation
shears or clips. After sufficient surgical margins were attained, the pancreas was transected 2 cm
proximal to the tumor using 45 mm Endo–GIA stapler. Additionally, the Hem–O–lock was clamped
to the distal end of the pancreatic body until the complete resection

A Study On The Bony Pelvis
Chapter 1: Introduction
The bony pelvis is consisting of 4 bones which are 2 os coxae or innominate bones, 1 sacrum and 1
coccyx. According to Applegate, E. J. (2010), the term pelvis is used to describe large bony structure
at the base of the spine which the lower limbs and many other vertebrates are attached to it. Thus,
pelvis is applied to the bony that formed by the coccyx, the sacrum and the two hip bones which are
called as the bony pelvis. The term of pelvis also can consider as the cavity surrounded by the bony
pelvis and preferred as the pelvic cavity. Pelvis has strength and power to keep the body upright and
enable it to bend, twist at the waist, to walk and run.
The female pelvis differs from the male pelvis in terms of shape and size. For example, the pelvic
inlet and pelvic outlet of females are wider compared to males. In females the pubic angle is greater
and the ischial spines are shorter than males. Moreover, the widest diameter of female pelvic brim is
transversely oval and further forwards (Medical Art Library, 2015). Meanwhile, the male pelvic
brim is widest towards the back of the pelvis and the outlet is heart–shaped (Figure 1). Table 1 show
the comparison of the male and female pelvis.
2.1 Pelvic Cavity
Dr. C. Dlugos (1999) was mentioned the enclosed chamber located within the abdominal pelvic
cavity is called pelvic cavity. Pelvic cavity is above by the superior aperture and below by the pelvic
diaphragm. It extends backward and downward from

Detection And Management Of A Complex Canal Configuration
Title of the article: Detection And Management Of A Complex Canal Configuration In Mesio
Buccal Root Of Maxillary First Molar Using Three Dimensional Imaging. Abstract: This case report
discusses on the identification and management of complex canal configuration of 3–2–1 in the
mesio buccal (MB) root of maxillary left first molar. Careful attention to details in the pulpal floor,
application of knowledge of laws of orifice location along with deepening the sub pulpal groove
with ultra sonic tips helped in identifying the three MB canals. Manual scouting helped to know the
anatomic configuration and use of three dimensional imaging technique, Spiral computed
tomography (SCT) confirmed the same.SCT images showed bucco lingually wide and bulbous
mesio buccal root with three separate canals at coronal third that merged into two canals in the
middle and exited as a single canal at the apex. This article highlights the role of SCT in three
dimensionally analysing the unseen rarest canal configurations that ultimately enabled the clinician
to thoroughly explore, debride and obturate entire root canal system. Key–words: Canal
configuration, Maxillary first Molar, Mesio buccal canal, Spiral computed tomography,
Introduction: Internal anatomy of the mesio buccal (MB) root of maxillary first molar has been
studied extensively for past three decades as this is the root that exhibited a maximum number of
variations not only in the presence of extra canals but also in their

Fantastic Voyage a&P Ii Essay
Fantastic Voyage
Unit 9 Project
Anatomy and Physiology II
Fantastic Voyage. Once again my mini–sub and I will be miniaturized (8 microns long) and
witnessing another 'Fantastic Voyage' in a human body. This time I will be swallowed by George, a
55 years old man, while he is eating his meal consisting of a hamburger, French fries and a soda. I
will pilot my mini–sub through George's GI (gastrointestinal tract), which is the tube that starts with
the mouth and proceeds to the esophagus, stomach, duodenum, small intestine, large intestine (or
colon), rectum and, finally, the anus (Pansky, 2007). Along this pathway I will describe the digestion
of George's meal and the major structures that I will encounter. Arrived to the distal ... Show more
Instead the pancreatic juice, which is the most important digestive juice, contains mainly water and
enzymes such as: Amylase (breaks down carbohydrates/starch into glucose), Protease (breaks down
proteins into amino acids) and Lipase which breaks down lipids (with the aid of bile) into
triglycerides. It also contains sodium bicarbonate able to neutralize the hydrochloric acid present in
the chyme. Through the lining of the small intestine I can also see numerous "brush border"
enzymes which are further breaking down products of digestion into absorbable particles; these
enzymes constitute the intestinal juice and particularly digest polysaccharides transforming them in
monosaccharaides (Maltase, Sucrase and Lactase), (Patton & Thibodeau, 2008). The chyme
now is entering in the jejunum (the second portion of the small intestine) where digestion continues
and absorption begins. I notice that the jejunum contains numerous villi but less Brunner's glands, it
also presents many large circular folds called plicae circulares (Pansky, 2007). These circular folds
increase the surface area for nutrient absorption; in fact the absorption of the majority of nutrients
takes place here. Now the chyme and I are entering into the ileum which is the final and longest
segment of the small intestine. This tract of the

Anatomy of Digestive, Circulatory, and Urinary Systems
A Fantastic Voyage Anatomy of Digestive, Circulatory & Urinary Systems This is me, Beth Cooper.
I have been shrunk again to the size of 8 microns only. In my mini–sub, I am now entering into the
mouth of a 55 years old man. He just had a lot of junk food including Hamburger, French Fries and
Root beer (which is my carrier as well). It is amazing to see that the digestion process has already
started in the mouth of this man. The food has been broken down in to swallow able portions during
chewing process. Bits of French fries coupled with beer are still present in his mouth and enzymes
are acting on this food. It is the saliva which acts as the first digestive reactor, secreted through
salivary glands. Now that the food has been chewed well, it is now swallowed into esophagus.
Esophagus is a long tube which acts as a path to the main digestive organ: the stomach. However, it
is important to note that it's not just a carrier of the food but also a digestive organ itself. The
enzymes secreted in the esophagus further facilitate the digestion process. The esophagus is a long
muscular tube. I can feel its rhythmic motion while I am moving down the tube along with the food.
This rhythmic motion helps the food to reach the stomach. I can't help noticing the gall bladder
while passing by the liver while entering into stomach (Netter, 2006). I am now entering into
stomach which is a big bag itself. It is a sac like structure which is moving in a churning motion and
is full of

Reflective Essay On Kids Clinical Rotation
This week I started my GI for Kids clinical rotation. I did mostly shadowing on the first couple of
days. While shadowing, I learned Wendy's roles. She sees about average 8–12 patients a day. Her
typical day begins with reviewing her patients' chart to monitor their health status, and then she goes
to see them personally and obtain their progress. Lastly, she consults with doctors (the GI doctor
who she works for and patients' doctor) regarding the appropriate care that those patients need and
order them. I recognized that documentation takes up a huge part of her time. I am familiar with the
hospital setting since I have been working as a RN for the past three years in a hospital. But the
awareness of the different roles I am playing is a ... Show more content on Helpwriting.net ...
And their care is from a more holistic approach. For instance, a patient with necrotic pancreatitis has
been hospitalized for the past three weeks. The mother of the patient has stayed at the beside since
the admission. The mother is a appropriated caregiver and really concerns for her child. Despite the
chronic disease course of the necrotic pancreatitis, Wendy discussed with the mother regarding what
kinds of processes need to be taken place before discharge, such as home health. She believes this
will help to alleviate some stress off from the mother. Wendy did not specify when the patient would
be able to go home, but rather explained what need to be accomplished prior to discharge. I think
this is a appropriate action since it gives the mother an idea of what to expect in ahead. So far, the
GI disorders that I have encountered in this clinical rotation are so different than the ones I saw
during my primary care clinical rotations. Those patients are more complex and acutely ill. I was
unfamiliar with many of these disorders (e.g superior mesenteric artery syndrome) and had to look
them up. Beside the various GI disorders, understand and able to utilize different diagnostic tools
and labs to help to make GI diagnosis is another thing that I hope to accomplish during my clinical
time with Wendy. I am looking forward to next week's clinical

Laparoscopic Distal Pancreatectomy
Recently, laparoscopic distal pancreatectomy (LDP) has emerged as choice of surgical procedure for
benign or low–grade malignant tumor of the pancreas with an advantage of less postoperative pain
and early recovery after surgery [1, 2]. Traditionally, spleen was removed during LDP because of
surgical difficulty and its close relationship with pancreatic tail. However, splenectomy combined
with resection of other abdominal organs was found to be associated with high postoperative
morbidity like overwhelming post–splenectomy infection (OPSI), subphrenic abscess formation,
hypercoagulability and even increase risk of cancer [3, 17, 18]. Thus, preservation of spleen during
LDP is highly recommended. The Laparoscopic spleen–preserving distal pancreatectomy ... Show
more content on Helpwriting.net ...
The surgeon was accustomed to use superior–anterior approach [10], because the splenic artery is
relatively fixed, and it is easy to control bleeding after the separation and isolation. However, for the
obese patients and the inflamed pancreas, there is risk of splenic artery injury due to obscurity
between spleen artery and celiac trunk, or sometimes during anatomical variations of splenic artery.
Moreover, some surgeons' uses lateral approach [11], where dissection of the pancreas is
commenced from the pancreatic tail and medially toward the pancreatic head. This approach does
not expose the superior mesenteric vein. For the tumor near the tail of the pancreas, the free length
of the splenic vessels is relatively short. However, we routinely carry dissection from medial to
lateral in respect to vascular anatomy, for two reasons: (1) In obese patients, demarcation between
pancreatic tail and splenic hilar is unclear due to excess fat (2) splenic hilar region may have
anatomical variations of splenic vessels and its branches, and thus may easily lead to injury of the
vessels, leading to operation difficulty or further failure to preserve the

Colorectal Anatomy : The Large Intestine
Colorectal anatomy
The large intestine starts at the end of the ileum extending to the anus. It measures around 1.5
meters long. It's differentiated from the small intestine by having a greater caliber with a more fixed
position, and in having certain appendages to its external coat (the appendices epiploicae).
Furthermore, its longitudinal muscular fibers are arranged in three longitudinal bands rather than
forming a continuous layer around the gut. The large intestine is divided into the cecum, colon,
rectum, and anal canal (Henry Gray 2004).
I–The Cecum:
It is connected to the ileum and extends around two and half inches below it. The adult cecum is
usually adherent to the posterior wall of the peritoneal cavity with a serosal cover on its anterior
wall only. The cecum also forms a blind pouch from which the appendix projects (Henry Gray
2004).
It varies in size according to different authors, but on average it reaches around 6.25 cm in length
and 7.5 cm in width. It rests on the iliacus & psoas major muscles, usually in contact with the
anterior abdominal wall. (Henry Gray, 2004).
II–The colon:
The colon functions as a reservoir, moving its contents in the caudal direction towards the anal
canal. It is divided into four parts from proximal to distal; the ascending colon, the transverse colon,
the descending colon, and lastly the sigmoid colon (Fenoglio et al,1999).
 Ascending colon:
It reaches about 6 inches long and extending upwards from the ileo–cecal

My Personal Vision Self-Assessment
On the My Personal Vision Self–Assessment, I answered eight of the ten questions as "mostly true,"
which was above the cutoff score of more than seven "mostly true" answers that indicate that I am
currently in "great shape" when it comes to the development of my personal vision. As the textbook
mentions, coming up with an individual vision or mission is often a difficult challenge, although the
work that goes into the actual achievement of one's vision may be even harder. However, I'm
already ahead of most people on this assignment since I have been continually working on my
personal vision statement since I first started getting into patient advocacy and blogging. Below is
an updated version of the vision that I have for both myself and for

The Anatomy Of Colorectal Anatomy
Colorectal anatomy
The large intestine extends from the end of the ileum to the anus. It is about 1.5 meters long. It
differs from the small intestine in its greater caliber, its more fixed position, its sacculated form, and
in possessing certain appendages to its external coat, the appendices epiploicae. Further, its
longitudinal muscular fibers do not form a continuous layer around the gut, but are arranged in three
longitudinal bands. The large intestine is divided into the cecum, colon, rectum, and anal canal
(Henry Gray 2004).
I–The Cecum:
It is attached to the ileum and extends approximately two and one–half inches below it. The cecum
in an adult usually is adherent to the posterior wall of the peritoneal cavity and has a serosal
covering on its anterior wall only. The cecum forms a blind pouch from which the appendix projects
(Henry Gray 2004).
Its size is variously estimated by different authors, but on an average it may be said to be 6.25 cm in
length and 7.5 cm in width. It rests on the iliacus & psoas major muscles, usually in contact with the
anterior abdominal wall. (Henry Gray , 2004).
II–The colon:
The colon functions as a reservoir moving its contents caudally toward the anal canal. It is divided
into four parts: the ascending colon, the transverse colon, the descending colon, and the sigmoid
colon ( Fenoglio et al,1999).
 Ascending colon:
It is approximately six inches long and extends upward from the ileo–cecal valve to the hepatic

Anatomy Practical Review Essay
1. Name the circulatory system that carries blood from the heart to the lungs and back to the heart.
Correct: pulmonary circulation 2. Name the circulatory system that provides blood to the tissues in
the body.
Correct: systemic circulation
1. Name the structure that is a double fold of peritoneum between the lesser curvature of the
stomach and liver.
Correct: Lesser omentum 2. Name the structure that is a double fold of peritoneum and holds the
colon to the abdominal wall.
Correct: Mesocolon
3. Name the structure that is a double fold of peritoneum and holds the small intestine to the
Correct: Mesentery 4. Name the structure that attaches the liver to the diaphragm.
Correct: Coronary ligament ... Show more content on Helpwriting.net ...
Correct: Splenic Vein & Superior Mesenteric 30. The inferior phrenic arteries supply blood directly
to the____.
Correct: Diaphragm 31. The Splenic Artery supplies blood directly to the ____.
Correct: Spleen 32. The Proper Hepatic Artery supplies blood directly to the ____.
Correct: Liver 33. The Cystic Artery supplies blood directly to the ____.
Correct: Gall Bladder 34. The Superior Mesenteric Artery supplies blood directly to the ____
Small Intestine & Ascending Colon 35. The inferior mesenteric arteries supply blood directly to the
____.
Correct: Descending Colon 36. The Renal Arteries supply blood directly to the ____.
Correct: Kidneys 37. The Gonadal Arteries supply blood directly to the ____.
Correct: Testes/Ovaries 38. Blood in the internal thoracic arteries flows directly into the _____.
Correct: Anterior Intercostal Arteries 39. Blood in the Descending/Thoracic Aorta flows directly
into the _____.
Correct: Posterior Intercostal Arteries 40. Blood in the Azygous Vein flows directly into the _____.
Correct: Superior Vena Cava 41. Blood in the Hemiazygous Vein flows directly into the _____.
Correct: Azygous Vein 42. Blood in the Anterior Intercostal veins flows directly into the _____.
Correct: Internal Thoracic Veins 43. Blood in the Right Posterior Intercostal Veins flows directly
into the _____.
Correct: Azygous Vein 44. Blood flows from the

The Problem Of Pancreas Adenocarcinoma With Complete...
Problem
Pancreas adenocarcinoma with complete encasement of the superior mesenteric artery and vein.
AJCC stage III, T4 Nx M0.
Definition
Fourth most common cancer mortality cause in USA.1
Contributes to 3% estimated new cancer each year in USA, contributing to 44, 030 new diagnosis
and 37, 660 expected deaths in 2013.1
Most aggressive cancer with less than 2% 5 years survival.1
Clinical staging o Stage I or II – surgically resectable.2 o Stage III – localy advanced, unresectable.2
o Stage IV – metastatic.2
Sign and symptoms
Abdominal pain.2
Weight loss.2
Asthenia.2
Anorexia.2
Jaundice.2
Diagnostics
Best initial diagnostic test using tri–phasic pancreatic–protocol CT.3
Endoscopic ultrasound.2, 3
MRI.3
Monitor tumour markers carcinoembryonic antigen (CEA) and carbohydrate antigen 19–9 (CA19–
9). Both has no specificity or sensitivity to be used in screening but can be useful for monitoring
patient with known pancreatic cancer.2
Risk factors
Genetic/family history.2, 3
Smoking.2, 3
Long–standing diabetes mellitus.2, 3
Nonhereditary or hereditary chronic pancreatitis.2
Obesity.2, 3
Non–O blood group.2
Occupational exposures.3
High fat diet.3
Complication
Poor survival rate upon diagnosis. 90% patient pass away within 1 year being diagnosed.4
Physiological impact, may cause depression,4 anxiety5.

Affect quality of life (QOL).4
Metastasis and invasion to another parts of the body.2
Options
Pharmaceutical regimen
FOLFIRINOX
o

A Brief Summary Of Degenated Blood
The first main vessel that leaves the heart is the pulmonary artery and is the only artery that carries
de–oxygenated blood and traveling through the lungs is then oxygenated and returned to the heart
by the pulmonary vein and that is the only vein in the body to carry oxygenated blood. The now
oxygenated blood leaves from the heart by the aorta and the splits to the carotid artery also known
as the subclavian artery to the arms and the thoracic artery. The carotid artery leads to smaller
arteries, arterioles and continuous capillaries around the arms and head and lead back to the heart
first through the fenestrated capillaries, venule and medium sized veins and back to the largest vein
that is called the jugular vein that is also known as

A Short Note On Systemic Sclerosis ( Ss ) Based On The...
Discussion
We report a case of male, 47 years old diagnosed with systemic sclerosis (ss) based on the joint
committee of the ACR and the EULAR new classification criteria for ss with a score 11. "Hoogen,
2013" table1
Gastrointestinal involvement is frequent in scleroderma. It represents 10–75 % of cases. "
marie,2008" " Gyger,2011". Severe complications affects only 8 %, but the mortality is high as
gastroparesis results in difficulty in swallowing with subsequent malnutrition and cachexia,
gastroesophageal reflux disease, moreover gastric bleeding out of gastric antral vascular ectasia
(GAVE) "Marie,2008 "
GAVE was initially reported by Ryder et al in 1953 and described as erosive gastritis with numerous
capillaries. " monteroa,2012 " In 1984, Jabbari et al named it 's classic endoscopic appearance as
water melon stomach.
GAVE is a rare cause of upper GI blood loss. It represents 4 % of non variceal upper GI
hemorrhage. " Jinga,2013 " It 's commonly associated with other diseases such as portal
hypertension, chronic kidney disease and collagen vascular autoimmune diseases especially
scleroderma, hypothyroidism and primary biliary cirrhosis. " Lata, 2012 " It 's frequency has been
increased among patients diagnosed with ss. " Pisharam,2014 " " Hung,2013"
The common presentation of GAVE is an elderly woman with median age 70 years old. " Parrado,
2010" GAVE is usually diagnosed in patients with already established ss within 3 years from onset
of ss. It may be the the 1st

Early Embryology Simple Summary
Embryology
Week 1
Ovarian cycle:
GnRH from hypothalamus FSH and LH from pituitary cyclic changes in the ovary.
Follicular phase: * 15–20 preantral follicles start to grow due to FSH * 1 reaches full maturity
released * Others undrgo atresia * Estrogens are released which; 1. Proliferate endometrium 2. Thin
the cervical mucus 3. Stimulate pituitary to release LH * The LH; 1. Elevate concentrations of
maturation promoting factor (oocytes complete meiosis one and begin meiosis II, stopped at
metaphase) 2. Stimulate progesterone production by follicular stromal cells (luteinisation) 3. Cause
follicular rupture
Ovulation
* High concentration of LH makes the collagenase ... Show more content on Helpwriting.net ...
Week 4 * Folded disc * Neural plate closing to become neural groove * Neuropores are open *
Heart bulge * Big paraxial mesoderm * Beginning of Guts * Pharyngeal arches start to emerge
Week 5 * Forebrain * pharyngeal arches (each one has all 3 germ layers) * upper limb bud * liver
bulge * placodes present * Late in the week = lower limb bud, bigger first pharyngeal arch. * Begin
to see stomach
Week 6 * Cranial flexure * Cervical flexure * Vertebral discs forming from somites * Dermis is
spreading out * 3rd and fouther arch are buried under the skin with the Otic placode * Upper limb
bud has fan structure
Week 7 * Arches are merging * Mesonephric swelling * Ossification occurs
Week 8 * Elbow and shoulders are evident * Later can see wrist and knee * Vascular plexus on skull
* All of inner ear structures are formed
Week 9
Mesenchyme around membranous labyrinth chondrifies
Week 12 – 16
Capsule adjacent to membranous labyrinth undergoes vacuolisation to form cavity around
membranous labyrinth and fills with perilymph
Week 16–24
Centres of ossification appear in remaining cartilage of otic capsule petrous part of temporal bone.
Face and Neck * Each arch consists of the 3 germ layers + neural crest cells that will form the
skeletal components. * Mesoderm muscles of the face and neck

Portal Vein Thrombosis On Patients With Liver
ISSN 2320–5407 International Journal of Advanced Research (2015), Volume 3, Issue 12, 1539 –
1548
1539
Journal homepage: http://www.journalijar.com INTERNATIONAL JOURNAL OF ADVANCED
RESEARCH RESEARCH ARTICLE
Portal vein thrombosis in patients with liver cirrhosis Insights to risk factors, clinical presentation
and outcome
Afifi F. Afifi 1
, Usama M. Basha 1
, Fady M. Wadea 1
, Abdelaziz E. Samack 2
, Raghda A. Elsherbini 3
1– GIT and hepatology unit, internal medicine department, faculty of medicine, zagazig university.
2– radiology department, faculty of medicine, zagazig university.
3– clinical pathology department, faculty of medicine, zagazig university. EGYPT
Manuscript Info Abstract
Manuscript History:
Received: xxxxxxx
Final Accepted: xxxxxxxxxxxxxx
Published Online: xxxxxxxxxxxx
Key words:
Portal vein, Thrombosis, risk factors, cirrhosis.
*Corresponding Author
Pawan Kumar Thakur
Background and objectives: Portal vein thrombosis (PVT) is an increasingly recognized
complication of liver cirrhosis. It is associated with worsening liver function, ascites and the
occurrence of gastroesophageal variceal bleeding. The aim of this work was to clarify the risk
factors, clinical presentation and complications of portal vein thrombosis in patients with liver
cirrhosis and to study the outcome with or without treatment after
6 months follow up.
Methods: Hospitalized cirrhotic patients (N = 80) were segregated into the
PVT and non–PVT groups. PVT was detected by

Abdomen Anatomy Mcq
9. The spleen is situated in the:
A. Right Upper Hypocondrium
B. Left Upper Hypochondrium, protected by ribs IX–XI C.
D.
E.
18. The pancreatic duct of the pancreas
A. Joins the common hepatic duct
B. Begins in the tail of the pancreas
C. Empties to the duodenum at minor duodenal papilla
D. Can be closed by sphincter of Oddi
E. After entering the pancreatic head turns superiorly
42. The common hepatic duct:
A. Drains the bile and pancreatic secretion
B. Is formed by fusion of hepatic and cystic duct ( =common bile duct)
C. Runs with the portal vein the lesser omentum
D. Is formed by fusion of right and left bile duct
E. None of above
(is formed by the fusion of right and left hepatic duct, joins the cystic duct and forms the common ...
Show more content on Helpwriting.net ...
Lateral and Middle ––– to the left
E. None
63. Which sentence related to the medullary substance of the kidneys is wrong
A. Is situated at the outer part of the kidney
B. Contains the "corpuscular renis"
C. Is made up of renal pyramids
D. Is a part of each renal lobe
E. Is situated at the inner part of the kidney
2 The posterior layer of the rectus sheath
A. Consist of the fused posterior lamina of the internal oblique and the transverse abdominal
aponeurosis

B. Consist of the fused anterior lamina of the internal oblique and the internal oblique aponeurosis
C. The inferior one–third of it is deficient
D. Its deficient superior to the costal margin
E. None of above
49. The anterior layer of the rectus sheath:
A. Consists of the fused posterior lamina of the internal oblique and the transverse abdominal
aponeurosis.
B. Consists of the fused anterior lamina of the internal oblique and the external oblique aponeurosis
C. the inferior one third of it is deficient
D. its deficient superior to the costal margin
E. none of the above
7 The pyloric orifice is usually located just to the
A. Left of the midline on the level of lower border L1
B. Right of the midline on the level of lower border L1
C. Right to the midline in the transpyloric plane
D. Right of the midline on the level of lower border L2
E. Right of the midline on the level of upper border Th12
13 Kidneys are positioned
A. Intraperitoneally
B. Primary retroperitoneally
C.

Anatomy and Physiology 2 Study Guide
The following are examples of frequently missed questions from the unit exams. The questions are
similar in theme to the ones missed however were taken from blackboard and are not exactly
worded like the exam questions. They are meant to act as a study guide only. Please do not have the
misconception that these questions will be the exact questions on the final. What you should do is to
use these questions as a guide and to research not only why the answer is correct but also why the
other answers are not correct. Once you have an understanding of the concept you will be able to
answer any question on the topic. | |The adrenal cortex secretes angiotensin II. ... Show more content
| |A |Platelets | |b. |Antibodies | |c. |Erythrocytes | |d. |Neutrophils | |e. |Monocytes | | |Erythropoiesis is
stimulated by a hormone that is secreted by | |a. |the pituitary gland. | |b. |the bone marrow. | |C |the
kidneys. | |d. |the thymus. | |e. |the spleen. | | |The amount of blood (mL) coming from one ventricle
in one heartbeat is called | |a. |the ejection fraction. | |b. |the preload. | |c. |the afterload. | |D |the
stroke volume. | |e. |the cardiac output. | | |The cardiac center, which modifies the

Compare/Contrast Medi A Case Study
The contrast media used to do a mapping of the liver arteries was omnipaque 350. The generic name
of this product is Iohexol. This product contains iodine and belongs to a class of drugs known as
contrast media or dyes. This contrast media is use before X–ray imaging test such as CT,
fluoroscopy to mention some. It works by adding contrast to the body parts to be seen in the image
by the radiologist. Furthermore, the nurse in combination with the radiologist use different kinds of
medications to ............. First, lidocaine is a local anesthetic which produces loss of feeling or
sensation confined to one part of the body. Second, versed(Midazolam) is used before surgery or a
procedure. It helps to cause drowsiness, decrease anxiety, and to decrease your memory of the
surgery or ... Show more content on Helpwriting.net ...
Third, Fentanyl is medication used to help relieve severe ongoing pain (such as due to cancer).
Fentanyl belongs to a class of drugs known as opioid (narcotic) analgesics. It works in the brain to
change how your body feels and responds to pain. Fourth, verapamil is a calcium–channel blocker.
It affects the amount of calcium found in your heart and muscle cells. This relaxes your blood
vessels, which can reduce the amount of work the heart has to do. Fifth, heparin is a drug that works
as an anticoagulant, which means that it prevents blood clots from forming and prevents existing
blood clots from expanding. It was originally extracted from the liver, but now it is mostly
manufactured synthetically. Heparin, however does not actually dissolve existing blood clots; it only
prevents them from forming or expanding. Sixth, nitroglycerin is used for relax and dilate the blood
vessels (vasodilator), improving blood flow. Eight, Y–90 is a radioactive form of rare earth metal
yttrium used in radiation therapy and immunotherapy. In addition, a TR Band was used as
compression device designed to assist homeostasis of the radial artery after a trans radial

Cancer Medical History: A Case Study
Cancer Medical History– Patient M.W.
In August 2009 M.W. a 56 year old female, was diagnosed with a stage II–B adenocarcinoma of the
pancreatic head, ductal type, with perinueral invasion, with two of nine lymph nodes involved by
direct extension and positive margin. Shortly after diagnosis, she received the Whipple procedure
followed by treatment with gemcitabine and 5FU chemoradiation. She was diagnosed later with a
regional cancer recurrence in the retro portal space nestled between the portal vein, the inferior vena
cava, the superior mesenteric artery, and the left renal vein. It is possible this recurrence was nodal
in origin rather than in the autonomic neural sheath surrounding the artery which is the typical
region of recurrence. Subsequently, she was treated with six cycles of Folifirinox with 5FU adjuvant
followed by an additional four cycles ending in May of 2012. Following this treatment, a CT scan
showed improvement of her disease. A few months later she received a partial cycle of Abraxane
with Gemcitabine. In the first few months of 2014, she was enrolled in a ... Show more content on
Helpwriting.net ...
's radiotherapy and Capecitabine treatment he presented a troubling set of symptoms. He was tired,
lacked appetite, and felt an overall depression in his mood and health. His physicians expected his
symptoms to originate from metastatic disease or tumor progression but no signs of either were
found. A CT scan was ordered and revealed thickening of the second portion of the duodenum,
which may have been the first sign of liver disease caused by PVT. By the beginning of 2014 there
were still no tumor recurrence or metastatic disease in the chest, abdomen, or pelvis, but he
exhibited worsening cachexia. The patient took a series of two liver function tests within two
months. The first showed mild elevation of liver enzymes. The next month, repeat liver function
tests revealed the worsening condition of his disease (Table 2) accompanied by declining

Cholangiocarcinoma Case Study
Introduction (Incidence, risk factors, classification, histological subtypes)
Cholangiocarcinoma is a rare malignancy that originates from the epithelial lining of the biliary
ductal system. It constitutes around 3% of all gastrointestinal malignancies. There is a high
variability in the estimated incidence of cholangiocarcinoma across the world, with the highest age
standardized incidence rate in the northeast provinces of Thailand (113 per 100,00 person–year) as
compared to the western hemisphere (0.5–1.5 per 100,00 person–year). Cholangiocarcinomas are
resistant to chemotherapy and radiotherapy and surgical resection constitutes the definitive form of
therapy. Poor prognosis and low 5 year survival is almost universal to theses tumors, ... Show more
It has been created to standardize the staging system for hilar cholangiocarcinomas in order to
provide information regarding the resectability, liver transplantation and prognosis of the tumor. It
includes information from the previous staging systems including: the extent of the tumor in the
biliary system (B), tumor size (T), tumor form (F), involvement of the portal vein (PV),
involvement of the hepatic artery (HA), liver volume remnant (V), the presence of underlying liver
disease (D), the status of lymph nodes (N) and the presence of metastatic disease (M) (Figure

The Heart and Circulation of Blood
The Heart and Circulation of Blood
In this research paper, I will be analyzing the process of blood circulation within the human body. I
will be focusing on the pulmonary circuit and the systemic circuit, as well as the relationship with
the hepatic portal system. The combination of these systems allows the body to function properly
and maintain unconscious homeostasis. I will also be talking about the effects that fitness and diet
have on these processes.
The pulmonary circuit passes already–used, deoxygenated and carbon dioxide–rich blood from the
heart to the lungs in order for that the blood to become oxygenized. Once oxygenized, the blood is
distributed throughout the body via the systemic circuit, being transported in ... Show more content
In addition to the systemic circuit, there is a path that the blood can take through the mesenteric
artery that allows it to pass through the hepatic portal system. The mesenteric artery runs the blood
to the gastrointestinal tract and spleen and then to the liver. The blood's oxygen is exchanged with
carbon dioxide in the capillaries of the gastrointestinal tract, but some of the blood does not take
part in this exchange, and instead travels through the hepatic portal vein to the liver. The liver is
particularly special, as it receives both oxygenated and deoxygenated blood. The liver then cleanses
the blood of bacteria and any other harmful substance that may be in it (King, 2010). From here, the
blood flows to the hepatic vein, which is then joined into the inferior vena cava, and ultimately back
to the heart.
It is vital that these processes are carried out without fault. They are all important to maintaining
homeostasis, and one of the ways to keep the blood flowing healthily is with exercise and a
balanced diet. Proper eating and exercise are important for allowing our bodies to fight problems
such as pulmonary hypertension, which an individual can get due to high blood pressure, and causes
the victim to have a shortness of breath (Fagard, 1999). In addition, studies have shown that
exercise

The Longitudinal Layer
The longitudinal layer is 2.5 mm thick and the thickness decreases with age. Cranially the layer is
predominantly muscular while fibro–elastic caudally. The fibro–elastic tissue of the longitudinal
layer is continuous with the fibro–elastic network outside the sphincter to the perianal skin to form
the corrugator cutis ani, thereby forming an intra–sphincteric fibro–elastic network passing through
the external sphincter(Stoker, 2009).
External anal sphincter The external sphincter is a cylindrical striated muscle under voluntary
control and comprises predominantly slow–twitch muscle fibres, capable of prolonged contraction.
With age there is a shift towards more type II (rapid) fibres (Cni, 1993). The external sphincter has a
nerve supply by the inferior rectal branch of the pudendal nerve (S2, S3) and the perineal branch of
the fourth sacral nerve (S4). Primary function is closure of the anal canal to postpone evacuation,
regulation is partly reflex (e.g., sudden increase in abdominal pressure) and partly voluntary through
the visceral and somatic afferent and somatic efferent nerves. The external sphincter also contributes
to some extent to the anal resting tone. The external sphincter constitutes the inferior outer aspect of
the anal sphincter and envelops the inter–sphincteric space . The external sphincter is approximately
2.7 cm high, but is anteriorly shorter in women (approximately 1.5 cm) (Rociu et al., 2000). The
lateral part of the external sphincter is

The fantastic voyage of the digestive system Essay
Once again we have been miniaturized in the submarine to continue the fantastic voyage of the
digestive system. We will be touring a 55–year–old male. The host will be having a hamburger,
French fries, and a root beer. We will be tracing lunch through the digestion process. Digestion is
the process of turning the food that is ate into energy needed to survive and involves creating waste
to be eliminated. (Mohan, 2010). The digestive tract is a long twisting tube that starts at the mouth
and ends at the anus, called the alimentary canal. The wall of this tube is fashioned of four layers of
tissue. The layers are listed from the inside coat to the outside coat: mucosa or mucus membrane,
submucosa, muscularis, and serosa. The hollow space ... Show more content on Helpwriting.net ...
As you can see, it is a tubelike structure made of muscle and lined with mucous membrane. The
pharynx functions as part of the respiratory and digestive system because it is located behind the
nasal cavities and the mouth. It is the structure that we refer to as the throat. It is about twelve and a
half centimeters long and consists of three parts; the nasopharynx, oropharynx and the
laryngopharynx. (Anatomy.tv, n.d.) The esophagus branches off of the pharynx which carries food
to the stomach. Swallowing takes place in the pharynx partly as a reflex and partly under voluntary
control. The tongue and soft palate pushes food into the pharynx, which closes off the trachea. The
food then enters the esophagus. The esophagus is a muscular tube extending from the pharynx to the
stomach. . (Mohan, 2010). It is about 25 centimeters long. The production of mucus by glands in the
mucosal lining as you can see lubricates the tube to permit easier passage of food moving toward
the stomach. (Thibodeau & Patton, 2008). Food is pushed through the esophagus and into the
stomach by a series of contractions called peristalsis. The lower esophageal sphincter is just before
the opening to the stomach. It opens to let food pass into the stomach and closes to keep it there.
(Mohan, 2010).
The stomach is a sac–like organ with strong muscular walls that lies in the upper abdominal cavity
just under the diaphragm. The stomach looks small after it is emptied, but it expands

Cardiovascular System Essays
The cardiovascular system, which consists of the heart and blood vessels, is the circulatory systems
in our body. The major function of the system is transportation; the heart is the system pump and the
blood vessels are the delivery routes. The heart transport respiratory gases, nutrients, wastes, and
other substances vital to the body's homeostasis to and from the cells by using the blood as a
medium.
The heart is a cone–shaped organ approximately the size of a fist with an apex and a base. It is
located within the mediastinum or medial cavity of the thorax. The heart is enclosed within a double
walled pericardium, a fibroserous sac. The pericardium has a superficial fibrous pericardium and
deep two–layer serous pericardium. The ... Show more content on Helpwriting.net ...
Left ventricle pumps the blood into the aorta, where the blood is supplied to the body tissues by the
systemic arteries.
Heart valves ensure one way blood flow through heart. The atrioventricular (AV) valves lie between
the atria and the ventricles prevents the back flow of blood in to the atria while the ventricles
contract. Chordae tendinae anchor AV values to papillary muscles. The left AV valve, the mitral or
bicuspid valve consists of two cusps of endocardium. The right atrioventricular valve, the tricuspid
valve, has three cusps. The second sets of valve are the semilunar valves. The pulmonary semilunar
valves lie between the right ventricle and pulmonary trunk. Aortic semilunar valves lie between
ventricle and the aorta. Semilunar valves prevent the backflow of blood into the ventricle.
The hearts function as a double pump that serves two circulations. The pulmonary pump in the right
side of heart is provided for the gas exchange in the body, and the systemic circulation in the left
side provides the functional blood supply to all body tissues. The functional blood to the heart is
provided by the coronary arteries. Right coronary artery supplies the heart through the posterior
interventricular and marginal artery branches; and the left coronary artery supplies the heart via
anterior interventricular artery and the circumflex artery. The myocardium is drained by great,
small, and middle cardiac veins which

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