The female genital and urinary tracts are anatomically closely related.
The potential for injury to the urinary system must always be considered when operating on the genital system
Bladder injuries are the most frequent urologic injury usually recognized and repaired immediately,
Ureteral injuries(70%) typically are not recognized
immediately & can lead to long term complications
Injury to urinary tract in medical practice was first described on 1030 AD by Avicenna Ibn Sina
in his first medical textbook which called “Al-Kanoun
cardiovascular system
blood vessels
biology
b.pharma
Introduction to Heart
Location & position of heart
Anatomy of heart
Heart wall
Valves of heart
Heart – Interior of front
neuronal organelles
the neuron contains all the regular organelles of the eukaryotic cells. however, rough endoplasmic
reticulum, free ribosomes and polyribosomes of the neurons are collectively referred to as the nissl
(chromophil) bodies (granules).
these organelles are responsible for the intense basophilia of the neuronal perikaryon and are absent in the
axon hillock and in the axon (see diagram 3.).
neurofibrils, neurofilaments, microtubules and microfilaments are widely distributed in the cell body, axon
and dendrites.
golgi complex and lysosomes are restricted to the cell body while mitochondria are widely distributed in all
parts of the neuron but are particularly abundant at the axonal terminals.
inclusion bodies:
the neuron also contains inclusion bodies, which have variable distribution in the nervous system, e.g.:
melanin pigments (neuromelanin) are found in the substantia nigra of the midbrain and locus coeruleus of
the pons in the brainstem
lipofuscin (lipochrome) pigments are found in the spinal cord, medulla oblongata, sensory and
sympathetic ganglia. they are stored in granules derived from lysosomes. lipofuscin appears from the age
of 8 and increases with age. they may appear in other nerve cells but never found in the purkinje cells of
the cerebellum.
other inclusion bodies include:
zinc metal in the hippocampus of the brain
iron metal in the occolomotor nucleus of the midbrain
calcium and magnesium salts (brain sand) in the pineal gland.
synaptic vesicles are membrane-bound sacs of neurotransmitter located at the boutons terminaux of axons.
the axon :( see diagram 3a and 3b)
the characteristic features of the axon are:
a.it arises from the region of the cell body called the axon hillock
b.it is often longer than the dendrites but of uniform diameter.
c.a typical neuron possesses only one axon.
d.its plasmalemma is called the axolemma and its cytoplasm the axoplasm.
e.it contains all neuronal organelles except nissl bodies and golgi complex.
f.may have collateral branches.
g.may be covered by myelin sheath for insulation and rapid conduction of impulses.
h.conducts impulses away from the cell body.
i.its terminal branches are called telodendria, which terminate in dilated terminals (boutons
terminaux) that are involved in formation of contact points called synapses.
j.the initial segment is often involved in inhibitory axo-axonal synapses.
the dendrite (see diagram 3.)
the characteristic features of the dendrite are:
a.it is often shorter than the axon and tapers from the cell body hence the diameter is not
uniform.
b.it has numerous branches.
The female genital and urinary tracts are anatomically closely related.
The potential for injury to the urinary system must always be considered when operating on the genital system
Bladder injuries are the most frequent urologic injury usually recognized and repaired immediately,
Ureteral injuries(70%) typically are not recognized
immediately & can lead to long term complications
Injury to urinary tract in medical practice was first described on 1030 AD by Avicenna Ibn Sina
in his first medical textbook which called “Al-Kanoun
cardiovascular system
blood vessels
biology
b.pharma
Introduction to Heart
Location & position of heart
Anatomy of heart
Heart wall
Valves of heart
Heart – Interior of front
neuronal organelles
the neuron contains all the regular organelles of the eukaryotic cells. however, rough endoplasmic
reticulum, free ribosomes and polyribosomes of the neurons are collectively referred to as the nissl
(chromophil) bodies (granules).
these organelles are responsible for the intense basophilia of the neuronal perikaryon and are absent in the
axon hillock and in the axon (see diagram 3.).
neurofibrils, neurofilaments, microtubules and microfilaments are widely distributed in the cell body, axon
and dendrites.
golgi complex and lysosomes are restricted to the cell body while mitochondria are widely distributed in all
parts of the neuron but are particularly abundant at the axonal terminals.
inclusion bodies:
the neuron also contains inclusion bodies, which have variable distribution in the nervous system, e.g.:
melanin pigments (neuromelanin) are found in the substantia nigra of the midbrain and locus coeruleus of
the pons in the brainstem
lipofuscin (lipochrome) pigments are found in the spinal cord, medulla oblongata, sensory and
sympathetic ganglia. they are stored in granules derived from lysosomes. lipofuscin appears from the age
of 8 and increases with age. they may appear in other nerve cells but never found in the purkinje cells of
the cerebellum.
other inclusion bodies include:
zinc metal in the hippocampus of the brain
iron metal in the occolomotor nucleus of the midbrain
calcium and magnesium salts (brain sand) in the pineal gland.
synaptic vesicles are membrane-bound sacs of neurotransmitter located at the boutons terminaux of axons.
the axon :( see diagram 3a and 3b)
the characteristic features of the axon are:
a.it arises from the region of the cell body called the axon hillock
b.it is often longer than the dendrites but of uniform diameter.
c.a typical neuron possesses only one axon.
d.its plasmalemma is called the axolemma and its cytoplasm the axoplasm.
e.it contains all neuronal organelles except nissl bodies and golgi complex.
f.may have collateral branches.
g.may be covered by myelin sheath for insulation and rapid conduction of impulses.
h.conducts impulses away from the cell body.
i.its terminal branches are called telodendria, which terminate in dilated terminals (boutons
terminaux) that are involved in formation of contact points called synapses.
j.the initial segment is often involved in inhibitory axo-axonal synapses.
the dendrite (see diagram 3.)
the characteristic features of the dendrite are:
a.it is often shorter than the axon and tapers from the cell body hence the diameter is not
uniform.
b.it has numerous branches.
boundaries of perianal region or perirecatal region, division of perineum, contents of the division, anal region, urogenital region and their contents, perineal body, ischioanal fossa or ischio rectal fossa,boundaries of ischio anal fossa, contents of ischio rectal fossa, dimension of ischio anal fossa, recessess, anterior recesses, posterior recesses, spaces and canals, perianal space, ischioanal spaces, pudendal canal, superficial fascia, deep fascia. cutaneous innervation of urogenital region,
This is a clinically oriented maternal anatomy, prepared by Dr Gebresilassie Andualem
You can get more books from our Telegram channel:
https://t.me/OBGYN_Note_Book
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
Synthetic Fiber Construction in lab .pptxPavel ( NSTU)
Synthetic fiber production is a fascinating and complex field that blends chemistry, engineering, and environmental science. By understanding these aspects, students can gain a comprehensive view of synthetic fiber production, its impact on society and the environment, and the potential for future innovations. Synthetic fibers play a crucial role in modern society, impacting various aspects of daily life, industry, and the environment. ynthetic fibers are integral to modern life, offering a range of benefits from cost-effectiveness and versatility to innovative applications and performance characteristics. While they pose environmental challenges, ongoing research and development aim to create more sustainable and eco-friendly alternatives. Understanding the importance of synthetic fibers helps in appreciating their role in the economy, industry, and daily life, while also emphasizing the need for sustainable practices and innovation.
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...Levi Shapiro
Letter from the Congress of the United States regarding Anti-Semitism sent June 3rd to MIT President Sally Kornbluth, MIT Corp Chair, Mark Gorenberg
Dear Dr. Kornbluth and Mr. Gorenberg,
The US House of Representatives is deeply concerned by ongoing and pervasive acts of antisemitic
harassment and intimidation at the Massachusetts Institute of Technology (MIT). Failing to act decisively to ensure a safe learning environment for all students would be a grave dereliction of your responsibilities as President of MIT and Chair of the MIT Corporation.
This Congress will not stand idly by and allow an environment hostile to Jewish students to persist. The House believes that your institution is in violation of Title VI of the Civil Rights Act, and the inability or
unwillingness to rectify this violation through action requires accountability.
Postsecondary education is a unique opportunity for students to learn and have their ideas and beliefs challenged. However, universities receiving hundreds of millions of federal funds annually have denied
students that opportunity and have been hijacked to become venues for the promotion of terrorism, antisemitic harassment and intimidation, unlawful encampments, and in some cases, assaults and riots.
The House of Representatives will not countenance the use of federal funds to indoctrinate students into hateful, antisemitic, anti-American supporters of terrorism. Investigations into campus antisemitism by the Committee on Education and the Workforce and the Committee on Ways and Means have been expanded into a Congress-wide probe across all relevant jurisdictions to address this national crisis. The undersigned Committees will conduct oversight into the use of federal funds at MIT and its learning environment under authorities granted to each Committee.
• The Committee on Education and the Workforce has been investigating your institution since December 7, 2023. The Committee has broad jurisdiction over postsecondary education, including its compliance with Title VI of the Civil Rights Act, campus safety concerns over disruptions to the learning environment, and the awarding of federal student aid under the Higher Education Act.
• The Committee on Oversight and Accountability is investigating the sources of funding and other support flowing to groups espousing pro-Hamas propaganda and engaged in antisemitic harassment and intimidation of students. The Committee on Oversight and Accountability is the principal oversight committee of the US House of Representatives and has broad authority to investigate “any matter” at “any time” under House Rule X.
• The Committee on Ways and Means has been investigating several universities since November 15, 2023, when the Committee held a hearing entitled From Ivory Towers to Dark Corners: Investigating the Nexus Between Antisemitism, Tax-Exempt Universities, and Terror Financing. The Committee followed the hearing with letters to those institutions on January 10, 202
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
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Introduction to AI for Nonprofits with Tapp NetworkTechSoup
Dive into the world of AI! Experts Jon Hill and Tareq Monaur will guide you through AI's role in enhancing nonprofit websites and basic marketing strategies, making it easy to understand and apply.
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
2. Basic movements
• Stationary circle
• Thumb walk, thumb circle
• Pump, pump-chase
• Scoop
• “J” strokes, “Jay walk”
• Flat hand push: only stretches the
lymphatics in one direction
• Figure 8
3. Stationary circle
• Working phase: Straight stretch-
oval-shaped stretching of the skin;
slight compression at the beginning
of the movement, stretch of the
tissues at the end of the movement
• Zero phase
4. Thumb walk, thumb circle
• Applied with the palmer surface of
the thumb
• Primarily on the hand and foot, face,
bony protuberance
5. Pump
• on the extremities, gently compress
the tissues and scoop or stretch the
skin toward the appropriate lymph
node
• Working phase: the hand is placed on
the skin with ulnar deviation and
wrist flexion, finger extended, thumb
in opposition to the fingers, transit
to radial deviation and wrist
extension
6. Scoop
• Applied on distal extremities, spiral
shaped movement
• Working phase: hand in ulnar
deviation and pronation (perpendicular
to the pathway of lymph collectors),
web space between the index finger
and thumb is in contact with the skin,
gliding over the skin in a spiral like
movement
7. Rotary, “J” strokes, “Jay walk”
• on the back of the torso, thigh
• Hand in an elevated position and
parallel to the pathway of lymph
collectors, wrist in flexion, all finger
tips in contact with the skin
• Palm placed on the skin in an elliptical
movement (over the ulnar side)
8. Fibrosis technique
• Kneading: the fibrotic tissue is lifted
softly from the underlying tissue in
an S-shape
• Fibrotic tissue fold is lifted and the
other hand pressing down on it
• Contraindicated in the area of
radiation fibrosis
9. Sequence
• Begin on the well side first: massage
lymph node and trunk quadrant
opposite to the edematous side
• Clearing across the watersheds
• Clearance of deep truncal areas
• Massage the lymph nodes and trunk
quadrant closest to the edematous
limb
• Massage the proximal area of the
edematous limb
• Massage the distal area of the
edematous limb
• Lymph node
10. Truncal decongestion
for unilateral secondary U/E lymphedema
• Terminus
• Lateral neck lymph node (20 circles, 6-10 cirs/
s)
• Anterior thorax on the contralateral side
– Axillary lymph node
– Thoracic breathing
• Activation and utilization of the AAA/PAA/AI
anastomosis
• Inguinal lymph nodes on the ipsilateral,
affected side
• Intercostal and parasternal techniques on the
affected trunk quadrant to utilize deep
drainage pathway
15. The intercostal lymph nodes occupy
the posterior parts of the
intercostal spaces, in relation to the
intercostal vessels.
They receive the deep lymphatics from
the postero-lateral aspect of the chest
The efferents of the glands in the lower
four or five spaces unite to form a trunk,
which descends and opens either into the
cisterna chyli or into the commencement
of the thoracic duct.
The efferents of the glands in the upper
spaces of the left side end in the
thoracic duct; those of the corresponding
right spaces, in the right lymphatic duct
Intercostal technique
Stationary circle with 3
or 4 finger pads, with
pressure working deep
(perforation precollector)
16. Truncal decongestion
for bilateral secondary U/E lymphedema
Supine
• Lateral neck lymph node
• Abdominal treatment/diaphragmatic breathing
• Inguinal lymph nodes on both sides
• Activation and utilization of the AI
anastomosis on both sides (rotary technique
and stationary circle)
• Intercostal and parasternal techniques on the
both affected trunk quadrants to utilize deep
drainage pathway
17. Abdominal treatment
• Superficial abdominal treatment:
Increase lymph transport within the
thoracic duct and larger lymphatic
trunks
• Deep abdominal treatment:Caudal
part of the thoracic duct, the
cisterna chyli, the pelvic and lumbar
lymph node are stimulated
18. Lumbar area
• Area outlined by the lower
horizontal watershed, horizontal
gluteal fold, and the sagittal
watershed
• Effleurage, starting at the
posterior sagittal watershed
toward the inguinal LN
• PII
• Paravertebral lymph node
Stationary circle paravertebrally
with the finger pads (working deep)
Paravertebral
lympn node
19. Truncal decongestion
for unilateral secondary L/E lymphedema
• Lateral neck lymph node
• Axillary lymph nodes on the ipsilateral,
affected side
• Activation and utilization of the IA
anastomosis on the affected side (rotary
technique and stationary circle)
• Inguinal lymph nodes on the contralateral
side
• Activation and utilization of the AII/PII
anastomosis
• Abdominal treatment/diaphragmatic
breathing
• Paravertebral technique
20. Truncal decongestion
for bilateral secondary L/E lymphedema
Supine
• Lateral neck lymph node
• Abdominal treatment/diaphragmatic
breathing
• axillary lymph nodes on both sides
• Activation and utilization of the IA
anastomosis on both sides (rotary
technique and stationary circle)
22. Collectors on the L/E
• inguinal node/ pelvic lymph node/ lumbar
lymph node/ lumbar trunk / cisterna chyli/
thoracic duct
• Collectors from the dorsum of the foot/
ventromedial territory/ skin of the lower leg,
except an area in the middle of the calf/
follow the great saphenous vein/ pass behind
the medial condyle of the femur/ superficial
inguinal LN
• Dorsolateral territory/ drain skin in the middle
of the calf/ follow the small saphenous vein/
superficial popliteal LN/ deep popliteal LN/
deep inguinal LN
23. Lower quadrant
• Terminus
• Deep abdomen- lumbar node chain
• Inguinal nodes
• IT band (upper/middle/lower)
• Rectus femoris (upper/middle/lower)
• Gracilis (lower half of the medial thigh)
• Flush knee: thumb scroop
• Lower leg
24. Lower quadrant
• Ankle, metatarsal, lateral malleolus: thumb
scroop;
• center of sacrum, off each side
stretch laterally over waist
• Popliteal lymph nodes
• Gluteal region to knee
• Knee to ankle
• stationary circle between the malleoli and
Achilles tendon tendon
• Dorsum and sole of the feet
• Inguinal node
25. Genital
lymphedema
O Usually irreversible without treatment, tends to
become more fibrotic and increases in size
O Malignant/primary/secondary
O Combined penile and scrotal swelling
O Genital swelling should precede the sequence for
leg lymphedema
O Complications including lymphatic cysts, fistula,
lymphorrhea, bacteria and mycotic infection
26. Genital lymphedema treatment
• If fistula is present, wearing sterile gloves
for treatment
• Lateral neck lymph node
• axillary lymph nodes on both sides
• Activation and utilization of the IA
anastomosis on both sides
• Inguinal lymph nodes on both sides
• Abdominal treatment/diaphragmatic
breathing
• Treatment of the scrotum
27. Face and neck
• Indication:
• Local injury (bruising and swelling), dental
surgery or cosmetic surgery
• Low energy resulted of stress, overwork,
or depression can depress the immune
system
• Tense facial muscles- MLD not only move
lymph, it is deeply relaxing
• Unhealthy skin-MLD remove toxins
28. Face and neck
• Contraindication:
• open wounds, incisions, scratches and
abrasions should allow to heal
• Local swelling due to allergies,
hormones, steroids, fatigue,
infection, excess salt in the diet
29. neck
• Performed on both sides of the neck and
face
• Supraclavicular nodes: 20 stationary circles
over the sternal and clavicular attachments
of the SCM muscle, 7s /circle, 3 mins
• 20 stationary circles on the area between
the ear and the mastoid process, posterior
and inferior to the ear (parotid and
retroauricular lymph node)
30. neck
• Drain the nodes along the region of
the SCM muscle, stationary circles 7
times,7s/circle, total 3-4 mins
(lateral cervical lymph node)
• 8-10 mins to drain the cervical lymph
nodes
31. Direction
• Face and neck
• Lymph nodes in the neck: lymph from
the superficial lymphatics of the
head
• Occipital nodes: lymph from the top
of the head, back of the head, then
drain toward the cervical nodes
(along the SCM)
• Pre-auricular and mandibular nodes:
lymph from the fascial lymphatics,
then drain into the cervical nodes
32. neck
• Place the flat fingers of both hands under
the neck, 7 7s stationary circles over the
cervical vertebrae, on the sides of the
neck, 7 7s stationary circles
• Two flat fingers inside the triangle formed
by the SCM, the clavicle, and the scalene
muscle, 7 7s stationary circles
• Under the chin, under the jaw line (midway
between the chin and the angle of the jaw),
under the ear (submandibular LN)
34. Posterior neck and
occipital area
• Deep lateral cervical lymph node
• Occipital and parietal region,
retroauricular lymph node and
parotid LN
• Upper trapezius m (in the direction
of the supraclavicular fossa)
• Paravertebral lymph node
35. face
• Pretreatment: lateral neck
• In the direction of the angle of the jaw
• On the chin (below the bottom lip), 7 7s
stationary circle (submental, submendibular
LN)
• Deep lateral cervical LN
• Above the jaw line, over the molar
• Lower and upper jaw
• Bridge of the nose and cheek
• Upper lip/ Corners of mouth
36. face
• 2nd and 3rd fingers: tip/bridge/root of the nose,
lower eyelids, toward the cheeks, to
supraclavicular fossa
• Medial corner of the eyes, upper eyelid and
eyebrow, to preauricular LN
• Corner of the mouth
• Chin (below the bottom lip)
• Over the region of the molar teeth
• Masseter
• On the region of the TMJ
• Eye sockets (below the eyebrows)
• Forehead toward preauricular LN
37. face
• Temple (temporalis)
• Two fingers in front, two fingers behind
the ear
• Scalp
• TMJ
• Masseter
• Between the ear and mastoid process
• sternal and clavicular attachment of the
SCM
44. Watersheds between
the trunk and the extremities
n Inguinal watershed:
separating the lower
extremity from the trunk;
starts at the pubic symphysis
and follows the iliac crest to
the apex of the sacrum
n Axillary watershed:
separating the arm from the
trunk; starts at the coracoid
process traveling along the
axillary fold, continuing
posterior to the midpoint of
the spine of the scapula