The document discusses various types of abnormal uterine contractions that can occur during labor, including:
- Excessive contractions like polysystole, hyperstimulation, and tetanic contractions.
- Uterine inertia where contractions are inadequate.
- Tonic uterine contraction and retraction where the whole uterus undergoes spasm.
- Constriction ring where a localized ring of muscle forms around the fetus.
It provides details on symptoms, diagnosis, and management for each abnormality, with conditions like uterine inertia generally treated with oxytocin and procedures like caesarean often needed for severe tonic contractions or constriction rings.
Obstetrics and Gynecological Nursing
The PPT contains detailed information about Abnormal uterine action, its classifications, causes, sign and symptoms and management.
Obstetrics and Gynecological Nursing
The PPT contains detailed information about Abnormal uterine action, its classifications, causes, sign and symptoms and management.
Uterine rupture - All you need to know.Sandeep Das
This presentation gives the detailed information about uterine rupture - definition, epidemiology, classification, signs and symptoms, prevention and management.
Uterine rupture - All you need to know.Sandeep Das
This presentation gives the detailed information about uterine rupture - definition, epidemiology, classification, signs and symptoms, prevention and management.
Malpresentations are all presentations of
fetus other than vertex. Face presentation, brow presentation, shoulder presentation and breech presentation are common malpresentations.
Abnormal uterine action is the one of the factors causing dystocia in which uterine forces are insuffiently strong or inappropriate coordinated to efface and dilate the cervix. Pelvic contraction is often accompanied by uterine dysfunction and the two together constitute the most common cause of dystocia.
Nice presentation For midwifery.
Presented under supervision of Dr. Stella Ass. Lecturer at Muhas
Presenter John Marco
Registration number 2019-04-13514
BSc. Midwifery
Third year student at Muhimbili university of health allied science (MUHAS).
Topic: Abnormal Uterine action.
Pathophysiology of Normal Labor:
A series of events that take place in female genital organs to expel the product of conception that are fetus, placenta, membranes) out of womb through the vagina into the outer world. We further describe pathogenesis and features of different stages of labor
about the process of third stage of labor and management of post Partum Hemorrhage ,which is one of the major causes of blood loss in a pregnant women that needs active management.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
2. BRIEF REVIEW OF NORMAL
UTERINE CONTRACTIONS
POLARITY OF UTERUS: When upper segment
contracts, lower segment relaxes.
PACEMAKERS: Two pacemakers situated at
each cornua of uterus generating the
contraction in co-ordinated manner.
PATTERN OF CONTRACTIONS: uterine
contraction starts at cornua, propagates
towards lower uterine segment with decrease
in the duration and intensity of contraction as it
moves away from pacemaker.
3. PARAMETERS OF UTERINE
CONTRACTION
• BASAL TONE: 5-20mmHg.
• PEAK PRESSURE: around 60 mm Hg
pressure
• FREQUENCY OF CONTRACTION
Adequate uterine contractions are 1 in 3
minutes lasting for 45 seconds.
4. DEFINITION
• Any deviation from normal pattern of
uterine contractions affecting the normal
course of labour is designated as
abnormal uterine contraction.
Over all labour abnormalities occur in
• 25%nulliparous
• 10%multiparous
5. EXCESSIVE UTERINE
CONTRACTION
POLYSYSTOLE :contractions more than once
every 2 minutes.
HYPERSTIMULATION: the above in response
to oxytocin
TETANIC UTERINE CONTRACTION: single
contraction lasting for more than 3 minutes .
HYPERTONIC UTERINE CONTRACTION:
Elevated baseline pressure above 20mm Hg.
6. ETIOLOGY
Cause is obscure but following conditions are
often associated:
Elderly primigravidae
Prolonged pregnancy
Over distended uterus- twins, fibroid
Contracted pelvis
Malpresentation
Obesity
Emotional factor: anxiety and stress
Injudicious administration of sedative,
analgesics, oxytotics
9. UTERINE INERTIA
May appear from the beginning of labour or
may develop subsequently after variable
period of effective contractions.
FEATURES:
• Intensity of contractions- decreases
• Duration –shortens
• Interval – increases
• Good relaxation
• General pattern maintained
10. DIAGNOSIS
Patient feels less pain during contraction
Per abdomen:
-less hardening of uterus
-easily indentable uterine wall
-Fetal parts well palpable
-Fetal heart rate normal
Per vaginal examination
-poor cervical dilatation
-associated contracted pelvis,
malpresentation, malposition, deflexed head
11. MANAGEMENT
GENERAL MEASURES:
Keep up the morale
Avoid supine position
Empty the bladder
Maintain hydration
ACTIVE MEASURES:
Low rupture of membranes followed by
oxytocin drip in escalating doses until
effective uterine contractions set up.
12. ROLE OF CAESAREN SECTION:
-contracted pelvis
-malpresentation
-fetal or maternal distress
13. PRECIPITATE LABOUR
Combined duration of 1st
and 2nd
stage of
labour is < 2 hours.
-common in multipara
-Due to combined effect of hyperactive
uterine contractions and diminished soft
tissue resistance
14. RISK MATERNAL
• Extensive laceration
of cervix, vagina,
perineum.
• PPH due to
subsequent uterine
hypotonia
• Inversion
• Uterine rupture
• Infection
• Amniotic fluid
embolism
FETUS
• Intracranial stress
and hemorrhage( as
no time for moulding)
• Direct hit on the skull
• Bleeding from Torn
cord
15. TREATMENT
• Patient with prior history should be
hospitalized prior to labour.
• Elective induction of labour by low rupture
of membranes.
• Oxytocin augmentation to be avoided.
• During labour the contractions may be
suppressed with ether or magnesium
sulphate.
• Liberal episiotomy.
• Controlled delivery.
16. TONIC UTERINE CONTRACTION
AND RETRACTION
PATHOLOGICAL ANATOMY OF UTERUS:
Contraction increases in intensity ,duration and
frequency with decreased relaxation in between
Retraction continues
Progressive thinning & elongation of lower uterine
segment
Development of circular groove b/n upper and lower
segment-called BANDL’S RING.
/
17.
18. In primigravidae further retraction ceases in
response to obstruction and labour comes
to a stand still-a state of exhaustion.
In multiparae retraction continues with
progressive dilatation and thinning of lower
uterine segment
Bandl’s ring moves towards the
umblicus
Rupture of lower uterine segment
Fetal jeopardy and death
19. Clinical features
• Patient is anxious looking
• Features of exhaustion and ketoacidosis
• Upper uterine segment is tender and hard
• Lower uterine segment distended and
tender
• Groove is seen between the two.
20. TREATMENT
• Correction of dehydration & ketoacidosis
• Adequate pain relief
• Parenteral antibiotics
EXCLUDE RUPTURE OF UTERUS
Caesarean delivery in majority of cases
22. FEATURES
• Hypertonic uterine state
• Appear in active stage of labour
• New pacemakers appear all over the
uterus
• Irregular and spasmodic contraction of
uterus
• Increased frequency& duration of
contraction with decreased relaxation in
between.
• Rise in the basal tone
23.
24. Clinical features
Patient in agony with unbearable pain
dehydration and ketoacidosis
Bladder is distended with often retention of
uterine
PER ABDOMEN:
Uterine tenderness
Increased uterine contraction with poor
relaxation in between
Palpation of fetal parts is difficult
fetal distress in the form of fetal tachycardia
25. PER VAGINAL EXAMINATION:
• Cervix –poor dilatation
• Poor descent
• Meconium stained liquor may be present
26. TREATMENT
• Correction of dehydration
• Adequate pain relief
• Empty the bladder
• Parenteral antibiotics
27. SPASTIC LOWER SEGMENT
• Fundal dominance is lacking
• Reverse polarity
• Lower segment contractions are stronger
• Inadequate relaxation in b/n the
contractions
• Premature bearing down
• Cervix loose, oedematus, not well applied
to the presenting part
29. CONSTRICTION RING
Also called Schroeder’s ring.
May appear in all stages of labour.
Localized myometrial contraction forms a ring
of circular muscle fibers of the uterus
Situated at the junction of upper and lower
segment
Usually around constricted part of the fetus.
32. FEATURES
• Maternal condition not affected
• Fetal distress may occur
• Ring is not palpable during per abdomen
• Felt in
o first stage during –caesarean section
o Second stage –forceps application
o Third stage –manual removal of placenta
33. Delivery is usually by caesarean section
Ring usually passes of by deepening plane of
anaesthesia.
In case of difficulties ring is cut vertically to
deliver the baby.
34. CONSTRICTION RING
Localised
incoordinate uterine
contraction
Undue irritability of
uterus
Usually at the junction
of upper and lower
uterine segment
Upper segment
contracts and retracts
with relaxation in
between
Lower uterine
segment thick and
loose
RETRACTION RING
• End result of tonic uterine
contraction and retraction
• Following obstructed
labour
• Always at the junction of
upper and lower uterine
segment
• Tonically contracted
upper uterine segment
• Lower uterine segment
thinned out
35. CONSTRICTION RING
• MATERNAL
condition Always
unaffected unless
labour is prolonged
• Ring is not felt on
per abdomen
• Round ligament not
felt
On per vaginal
examination ring
can be felt usually
above head
RETRACTION RING
• Maternal exhaustion
and sepsis appear
early
• Ring is felt as a
groove
Round ligament taut
and tender
Can not be felt on per
vaginal examination
37. TYPES OF CERVICAL
DYSTOCIA
PRIMARY
I. First birth when
ext os fails to
dilate
II.Rigid cervix
III.Insufficient
uterine
contraction
IV.Malpresentation
and malposition
SECONDARY
I. Excessive
scarring or rigidity
of cervix from
previous
operation or
disease
II.Post delivery
III.Cervical cancer
38. MANAGEMENT:
If only thin rim of cervix left behind- it is
pushed up manually during contraction
If cervix is thinned out but only half dilated –
Duhrssens’s incision is given at 2’oclock
and 10 o’clock position followed by
forceps or ventouse extraction
39. GENERALISED TONIC
CONTRACTION
Also called uterine tetany
No physiological differentiation between
active upper segment and passive lower
segment.
Pronounced retraction occurs involving whole
of the uterus up to the level of internal os.
Whole uterus undergoes a tonic muscular
spasm holding the fetus inside
42. FEATURES
PER ABDOMINAL EXAMINATION
• Uterus is smaller in size, tense, tender
• Fetal parts are not palpable
• Fetal heart sounds not audible
PER VAGINAL EXAMINATION
• Dry and oedematus vagina
• Jammed head with a big caput