This document discusses the anatomy of the sellar region. It describes the structures below and above the sella turcica such as the nasal cavity, sphenoid bone, pituitary fossa, and suprasellar region. It details the pituitary gland, diaphragma sellae, intercavernous connections, and the ventricular and arterial relationships above the sella. The sphenoid sinus, carotid prominences, and lateral wall are also examined. Neurovascular structures like the optic chiasm, oculomotor nerve, arteries, and veins are mapped in relation to the sellar region.
This presentation provides a comprehensive review of major sulci of brain which help in defining the different lobes of brain.Very useful for first year residents.
Cisterns of brain and its contents along with its classification and approach...Rajeev Bhandari
This presentation tell us about the basic of cistern , according to its classification both supra tentorial and infratentorial along with ventral and dorsal cistern. basically the cistern contains are well explained on this slide nerve , artery and vein. I hope it will help to rembember well about the contains of cistern and different location of cisterns.
Before embarking on an approach, the surgeon should be familiar with both the ventricular anatomy and the options for optimally Accessing lesions in third ventricle is a surgical challenge because of its difficult corridor as well as deeper location, need of neural incision, preservation of vascular, thalamus and hypothalamus and likely risk of fornix injury.
Foramen magnum meningiomas are challenging tumors, requiring special considerations because of the vicinity of the medulla oblongata, the lower cranial nerves, and the vertebral artery. It accounts for 1-3% of all intracranial Meningioma.
This presentation provides a comprehensive review of major sulci of brain which help in defining the different lobes of brain.Very useful for first year residents.
Cisterns of brain and its contents along with its classification and approach...Rajeev Bhandari
This presentation tell us about the basic of cistern , according to its classification both supra tentorial and infratentorial along with ventral and dorsal cistern. basically the cistern contains are well explained on this slide nerve , artery and vein. I hope it will help to rembember well about the contains of cistern and different location of cisterns.
Before embarking on an approach, the surgeon should be familiar with both the ventricular anatomy and the options for optimally Accessing lesions in third ventricle is a surgical challenge because of its difficult corridor as well as deeper location, need of neural incision, preservation of vascular, thalamus and hypothalamus and likely risk of fornix injury.
Foramen magnum meningiomas are challenging tumors, requiring special considerations because of the vicinity of the medulla oblongata, the lower cranial nerves, and the vertebral artery. It accounts for 1-3% of all intracranial Meningioma.
This presentation deals with the inside of the skull (cranial cavity) and description of some separate bones. There is another presentation “Skull - the normas” that describes norma verticalis, occipitalis, lateralis, frontalis and basalis and is necessary to complete the objectives.
Objectives
Identify the features of the major bones forming the cranial cavity according to normas and separate bones.
Describe the major sutures.
Describe the structure of the flat bones forming the skull and their blood supply.
Discuss ossification of the skull and the changes that occur during postnatal development.
Locate important bony surface landmarks.
surgical anatomy of nose is a humble attempt to make the anatomy of nose simpler and easy for medical students and fellow physicians. at the end of the presentation the students will be able to identify all the structures.
Referred from different sources , here i present a very concise presentation on CRANIAL CAVITY . This presentation will give you complete knowledge of the topic cranial cavity with well elaborated and intellectual diagrams hand picked from F. Netter. ......... Do like and share , Leave your comments so as to get more stuff like this in future.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
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
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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2. To Understand The Anatomy of
Sellar Region
Below Sella Above
Nasal Cavity
Sphenoid Bone
Pituitary Fossa
Pituitary Gland
Suprasellar &
Ventricular Relations
Sphenoid Sinus Diaphragma
Inter Cav. Conn.
4. Nasal Septum is formed by
Anteriorly And Superiorly : perpendicular plate of the ethmoid.
Inferiorly And Posteriorly : vomer.
Posterior Nasal Aperture is boardered by
Above : anterior aspect of the sphenoid body,
Below : posterior margin of the hard palate.
Medially : nasal septum formed by the vomer.
Laterally : medial pterygoid plate.
Nasal Cavity
10. Sphenoid Sinus
It is present as minute cavities at birth, but its main development takes place after puberty.
There are three types :
Conchal
Presellar
Sellar
12. Sphenoid Sinus Septae
Vary greatly in size, shape, thickness, location, and relation to sellar floor.
The cavities within the sinus are seldom symmetrical from side to side.
Role of imaging : CT Paranasal Sinuses + MRI
13. Carotid Prominence
The carotid prominences are seen lateral to the anterior wall of the sella
3 parts
Retrosellar segment posterolateral part of the sinus. ( Sellar Type )
Infrasellar segment below the sellar floor.
Presellar segment anterolateral to the anterior sellar wall.
The bone separating the artery and the sphenoid sinus is thinner over the anterior than the
posterior parts
The shortest distance between both carotid bulges into the sphenoid sinus is usually located at
the level of the tuberculum sellae .
14.
15.
16.
17.
18. • Superolateral portion of the sinus optic canal protrusion
• Midlateral wall below the optic canal superior orbital fissure prominence
• Inferolateral part maxillary nerve protrudes
NOTE
Lateral Wall Of The Sphenoid Sinus
21. Opticocarotid Recess
A pneumatized diverticulum of the sinus extends laterally into the optic strut.
This pneumatization may extend into the anterior clinoid process
This explains CSF can leak into the sinus after an anterior clinoidectomy with resulting rhinorrhea.
24. Anterior Lobe + Posterior Lobe + Stalk
The anterior lobe wraps around the lower part of the pituitary stalk to form the pars tuberalis
Pituitary Gland
25.
26. Roof of the sella
Covers the pituitary gland, except for A small central opening in its center (stalk)
Rectangular
Convex/concave
A deficiency of the diaphragm sellae is assumed to be A precondition to empty sella
Central opening in diaphragm > diameter of stalk
Outpouching of the arachnoid through the central opening >> CSF LEAK
Diaphragma Sellae
27.
28. The distance separating the medial margin of the carotid artery and the lateral surface of the pituitary
gland is an important consideration in trans sphenoidal surgery
The proximity of the carotid arteries to the midline is extremely important in pituitary surgery
Arterial bleeding during transsphenoidal surgery has been reported as due to
o Carotid artery injury,
o Tear in inferior hypophyseal artery
o Avulsion of a small capsular artery from the carotid artery
Pituitary Gland and Carotid Arteries
29. Six sagittal sections of the sellar region
showing variations in the intercavernous
connections within the dura.
The variations shown include combinations of
anterior, posterior, and inferior intercavernous
connections and the frequent presence of a
basilar sinus posterior to the dorsum.
Intercavernous Venous Connections
31. SUPRASELLAR & 3RD VENTRICULAR REGION
Ventricular &
Cisternal
Relationships
Cranial
Nerves
Arterial
Relationships
Venous
Relationships
Anterior
Incisural
Space
Optic Chiasm
Occulomotor N
ICA
P. CoA
Ant. Choroidal A
ACA
Basilar Bif.
Small Tributaries
Basal Vein
Internal Cer. V
Great Vein
32. Anterior Incisural Space = Suprasellar Area
Superior Part of Anterior Incisural Space above chiasm
- Superiorly rostrum of the corpus callosum
- Posteriorly lamina terminalis
- laterally medial surfaces of the frontal lobes
Laterally, the anterior incisural space opens into the part of the sylvian fissure
Posterior Part of The Anterior Incisural Space Interpeduncular Cistern
Between cerebral peduncles and the dorsum sellae
Separated from the chiasmatic cistern by liliquest membrane.
Chiasmatic Cistern communicates with Cisterna Laminae Terminalis.
Ventricular & Cisternal Relationships
33. The optic chiasm is situated at the junction of the
anterior wall and floor of the third ventricle
ABOVE
ACA, A-CoA
Lamina terminalis
3rd Ventricle
BEHIND
Tuber cinereum
Infundibulum
LATERALLY
The internal carotid arteries
BELOW
Diaphragma sellae
Pituitary gland
OPTIC CHIASM
NEURAL RELATIONSHIPS
35. The relationship of the chiasm to the sella
The normal chiasm overlies the diaphragm
The prefixed chiasm overlies the tuberculum.
The postfixed chiasm overlies the dorsum.
36. NOTE
If the chiasm is prefixed and the tumor is seen through a thin, stretched
arterial wall of the third ventricle, the lamina terminalis may be opened to
expose the tumor, but this exposure is infrequently used for pituitary
adenomas, and they more commonly form craniopharyngiomas and
gliomas involving the third ventricle.
If the space between the carotid artery and the optic nerve has been
enlarged, by a lateral or parasellar extension of tumor, the tumor may be
removed through this space
37. Arises in the interpeduncular cistern from the midbrain on the medial side of the cerebral peduncle
and courses between the posterior cerebral and superior cerebellar arteries .
Courses in the lateral wall of the interpeduncular cistern and forms the pillars to which Liliquist’s
membrane attaches.
Liliquist’s membrane arises from the arachnoid membrane covering the dorsum sellae and separates
the chiasmatic and interpeduncular cisterns.
The uncus of the temporal lobe is situated lateral to the oculomotor nerve.
The oculomotor nerve pierces the roof of the cavernous sinus and slopes downward in the
superolateral corner of the cavernous sinus.
OCULOMOTOR NERVE
NEURAL RELATIONSHIPS
40. Superiorview of the Suprasellar Region
The carotid arteries course along the lateral margin of
the chiasmatic cistern.
The basilar bifurcation is located above and behind the
sella.
The posterior communicating arteries travel backward
across the dorsum to join the posterior cerebral
arteries.
The posterior communicating arteries usually course
above and medial to the oculomotor nerves.
44. REFRENCES
Rhoton, Albert L., Jr. 2002. “The Sellar Region.” Neurosurgery 51 (4 Suppl): S335–74
Hiremath, Shivaprakash B., Amol A. Gautam, Keerthy Sheeja, and Geena Benjamin. 2018. “Assessment
of Variations in Sphenoid Sinus Pneumatization in Indian Population: A Multidetector Computed
Tomography Study.” The Indian Journal of Radiology & Imaging 28 (3): 273–79.