The vertebral column, or spine, is composed of 33 vertebrae in early development that fuse together into 26 vertebrae in adulthood. The vertebrae are organized into 7 cervical, 12 thoracic, 5 lumbar, 1 sacrum, and 1 coccyx vertebrae. Each vertebra has a body, vertebral arch, and 7 processes. Between the vertebrae are intervertebral discs that act as shock absorbers and allow movement. The spine has four normal curves that develop during childhood to maintain balance and absorb impacts during walking. The vertebrae permit flexion, extension, lateral flexion, and rotation movements.
Vertebral Column is a complex structure of the Human body. It does not only provides protection for spinal cord but also provide mobility and stability of the trunk and the extremities. To learn structure of Vertebral Column and more Online Medical Resource, Visit at http://gisurgery.info
Vertebral Column is a complex structure of the Human body. It does not only provides protection for spinal cord but also provide mobility and stability of the trunk and the extremities. To learn structure of Vertebral Column and more Online Medical Resource, Visit at http://gisurgery.info
Bones of Trunk (Human Anatomy)
by DR RAI M. AMMAR
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Anattomy of back with Dr. Ameera A. Al-Humidi .pptxAmeera Al-Humidi
this lecture describes the anatomy of bach and details of anatomical variations of vertebrae with related disorders.
the vertebral column consists of seven cervical vertebrae, tweleve thoracic vertebrae, five lumbar vertebrae, sacral vertebrae, and five fused coccygeal vertebrae.
The cervical spine functions to provide mobility and stability to the head while connecting it to the relatively immobile thoracic spine. The movement of nodding the head takes place predominantly through flexion and extension at the joint between the atlas and the occipital bone, the atlanto-occipital joint.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
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.
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.
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.
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
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Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Title: Sense of Taste
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 structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
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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
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
2. The vertebral column, also called the
spine, spinal column or backbone.
Composed of a series of bones called
vertebrae (singular is vertebra).
About 71 cm (28in): adult male.
About 61 cm (24in): adult female.
2
3. Total number of vertebrae during early
development is 33.
As a child grows, several vertebrae in the
sacral and coccygeal regions fuse.
Adults have 26 vertebrae. *Sacrum and
coccyx bones become fused.
5. The cervical, thoracic and lumbar vertebrae
movable
Sacrum and coccyx immovable
Between adjacent vertebrae from the
second cervical vertebra to the sacrum are
intervertebral disc (inter = between).
5
7. General Structure of VertebraeGeneral Structure of Vertebrae
7
1. Cervical vertebrae (C1-C7)
• Formed framework of neck region
• Support skull
• Small in size
• Presense foramen in each transverse process
2. Thoracic vertebrae (T1-T12)
• Formed posterior part of thoracic cage
• Articulates with associated ribs
8. 8
3. Lumbar Vertebrae (L1-L5)
• Formed skeletal support for posterior abdominal wall
• Characterized by large in size
4. Sacrum Vertebrae
• Fusion of 5 sacral bones
• Immovable (synostosis)
• Articulates with L5 at lumbosacral joint
• Articulates laterally with pelvic bone at sacroiliac joint.
• Formed posterior wall of lower abdominal and pelvic cavity
5. Coccyx
• Fusion of 4 coccyx bones
• Immovable (synostosis)
• Formed part of pelvic cavity
9. 1. Supports the head.
2. Help maintain balance in the upright
position.
3. Enclose and protect the spinal cord.
4. Permits movement (move forward,
backward, sideways, and rotate).
5. Absorbs shocks during walking.
6. Serve as a point of attachment for the ribs,
pelvic girdle and muscles of the back and
upper limbs.
9
10. In the fetus, there is a single concave
curve.
At 3 months after birth when infant lifts head
as it begins to crawl the cervical curve
develops.
When child sits up, stands and walks the
lumbar curve develops.
10
11. In adult, it shows four slight bends called
normal curve:
Cervical and lumbar curve are convex
(bulging out)
Thoracic and sacral curve are concave
(cupping in)
14. The thoracic and sacral curves are called
primary curves because they form first
during fetal development.
The cervical and lumbar curves are called
secondary curves because they form later,
several months after birth.
All curve fully developed by age 10.
However, secondary curves may be
progressively lost in old age.
14
15. Newborn Spinal Curvature :
C-shaped curve
Known as Primary Curve
Single curve
Adult Spinal Curvature:
S-shaped vertebral column
Four curve (cervical, thoracic, lumbar amd
sacral curve)
Secondary curvatures develop after birth
15
Differences newborn and adult spinal curvature
17. Consist of four slight
bends (cervical,
thoracic, lumbar,
sacral)
Cervical and lumbar
curve are convex
(bulging out).
The thoracic and
sacral curves are
concave (cupping in).
17
19. Increases its strength
Help maintain balance in the upright
position
Absorb shocks during walking
Help protect the vertebrae from fracture
19
20. Scoliosis:
lateral bending of the vertebral column, usually
in the thoracic region.
Kyphosis:
Incerase in the thoracic curve of the vertebral
column.
Lordosis (Hollow back)
Increase in the lumbar and cervical curve of the
vertebral column.
25. Typical vertebrae consists of:
◦ A body
◦ A vertebral arch (pedicles and lamina)
◦ Seven processes: two transverse
processes, one spinous process, four
articular processes
25
26. Largest part of vertebra,
thick.
Disc-shaped anterior
portion
Weight bearing portion –
size increases inferiorly
Its inferior and superior
surfaces are roughened and
give attachment to the
intervertebral disc.
Anterior and lateral
surfaces contain nutrient
foramina – pathway for
blood vessels.
26
27. Extend backwards from the body of the
vertebra.
Consists of a pair of pedicles and a pair of
laminae.
The pedicle project backward from the body to
unite with the laminae.
27
28. Pedicle:
two short, thick processes, which
project backward.
the concavities above and below the
pedicles are named the vertebral
notches –formed IV foramina
Laminae:
two broad & flat plates directed
backward and medialward from the
pedicles.
the laminae end in a single sharp,
slender projection called a spinous
process.
29. 7 processes arise from the vertebral arch:
TWO TRANSVERSE PROCESS
ONE SPINOUS PROCESS
FOUR ARTICULAR
29
30. TRANSVERSE PROCESS:
Extends posterolaterally
for the junction between
pedicle and laminae on
each side (left and right)
ONE SPINOUS PROCESS:
A single spinous process
projects posteriorly from
the junction of the laminae.
These 3 processes serve
as points of attachment for
muscles.
31. ARTICULAR PROCESSES (Zygapophyses):
At the junction between pedicles and lamina meet, also
projecting superior and inferior articular process.
At the end of these processes – concave surface (facet)
IAP of vertebrae above articulates with SAP of vertebrae
below – zygapophysial joints (Facet Joints).
31
32. Between the bodies of the
adjacent vertebrae C2 to
the sacrum.
Each disc forms a
cartilaginous joint to allow
slight movement of the
vertebrae, and acts as a
ligament to hold the
vertebrae together.
32
INTERVERTEBRAL DISCS
33. Each vertebral discs consist of:
an outer fibrous ring consisting of
fibrocartilage called called annulus
fibrosus (annalus = ringlike).
Inner soft, pulpy, highly elastic substance
called the nucleus pulposus (pulposus =
pulplike), which is acts as a shock
absorber, absorbing the impact of the
body's daily activities and keeping the two
vertebrae separated
33
34. Nucleus pulposus hardens and
less elastic with age.
Narrowing of discs and
compression of the vertebrae
results in a decrease in the
height with age.
A tear can occur within the
annulus fibrosus (ring) and cause
the nucleus pulposus may track
into the vertebral canal or
intervertebral foramen to impinge
on neural structures – herniation
IV discs. (prolapsed/slipped disc)
34
35. 1. Binds the vertebrae and
forms a strong joint
2. Permits various
movements of the
vertebral column
3. Absorbs vertical shock
and avoid friction during
intervertebral joints
movements.
35
36. Vertebral foramen
contains : spinal cord
and its roots, spinal
meninges, ASA and
PSA, Venous Plexus, fat
The vertebral foramina
of all vertebrae form the
vertebral (spinal) canal.
37. Spina bifida (congenital)
Two sides of vertebral arch fail to fuse during development, resulting in an
open vertebral canal (cleft)
Absence of spinous process
Ususally in lumbosacral region
Protrusion of spinal meninges (out pouch) and may contain CSF –
meningocele
Protrusion of part of spinal cord and meninges -myelomeningocele
Abnormalities of the Vertebral canalAbnormalities of the Vertebral canal
37
39. Between every pair of vertebrae are two apertures, the
intervertebral foramen (formed by inferior and superior
vertebral notches).
Also called neural foramen.
Passageway for nerve roots.
39
INTERVERTEBRAL FORAMEN
40. C1-C7 (formed framework of the neck)
C1, C2 and C7 – atypical (looks weird!!!)
C3-C6 – have similarities – typical
◦ Smaller bodies, short
◦ Larger vertebral arch – hence larger vertebral foramen (cervical
enlargement)
◦ Transverse process consist transverse foramina @ foramen
transversarium (vertebral artery)
◦ Spinous process short and bifid
Cervical VertebraeCervical Vertebrae
40
41. C1 – Atlas
Ring shaped
Lack of body (fused with body of
C2)
Composed by lateral masses
interconnected by an anterior and
posterior arch
Each lateral masses consist
SAFacet which artculates with
occipital condyle – AOJ
Also consist IAF which articulates
with SAF of C2 – AAJ (C1/C2)
anterior arch of C1 articulates with
dens of C2 – support via
transverse ligament
41
42. C2 (Axis)
Structure similar with typical cervical vertebrae but
Have peg like processes called dens or odontoid
process
Dens projecting upwards from body of C2 toward
vertebral foramen of C1 which articulates with anterior
arch of C1 (AAJ).
42
43. Typical thoracic vertebrae
◦ Fairly large size of body
◦ Long spinous process and
pointed and angled
downward
◦ Vertebral foramen generally
circular
◦ Transverse process
projecting posterolaterally.
◦ Have 3 pairs of facets –
attachment for the ribs (2
pairs of demifacets at the
body and 1 pair of facet at
the transverse process.
Thoracic Vertebrae (T1-T12)Thoracic Vertebrae (T1-T12)
43
44. T1 has a superior facet and inferior demifacets for head of ribs.
T2-T8 have superior and inferior demifacets for head of ribs.
T9 has a superior demifacets
T10-T12 have superior facet.
Movements of the thoracic vertebrae are limited by thin intervetebral disc
and by attachment of the ribs to the sternum (sternocostal jnt).
44
45. The largest and strongest – weight
bearing
Thickest body
Spinous process is thickest and
broad and project posteriorly –
attachment for the large back
muscles
Superior articular process facing
medially, inferior articular process
facing laterally.
Lumbar Vertebrae (L1-L5)Lumbar Vertebrae (L1-L5)
45
47. Inverted triangular in-shaped
Fusion of 5 sacral vertebrae – fusion started 16-18 y’old and completed at
30.
Sacrum serve strong foundation for the pelvic girdle attachment (sacroiliac
joint)
Formed posterior wall of the lower abd cavity and pelvic cavity.
At the superior (base), consist SAP which articulates with IAP of L5 – LSJ
(L5/S1)
Sacrum (S1-S5)Sacrum (S1-S5)
47
48. anterior surface, consist transverse
ridge, mark the joining of bodies
Lateral surface – smooth surface
called ala
Anterior ridge of sacral body which
projecting forward – promontory
Consist 4 pairs of anterior sacral
foramina – routes for anterior rami
of sacral spinal nerve
48
49. At the posterior surface consist
posterior sacral foramina – routes
for posterior rami of sacaral spinal
nerves.
Sacral canal- continuation of
vertebral canal from L5 (routes for
roots of sacral and coccygeal spinal
nerves), and terminates as a
opening called sacral hiatus (routes
for S5 and co1 spinal nerve).
On either side of the sacral hiatus,
consist sacral cornua.
Median sacral crest – fusion of
spinous process
Lateral sacral crest – fusion of
transverse process
49
51. Inverted Triangular in shaped
Fusion of 4 coccyx vertebrae
Dorsal surface, 2 projection called coccygeal cornua –
attachment for sacrococcygeal ligament and also
attachment for pelvic floor muscles (levator ani)
Coccyx vertebrae (co1-co4)Coccyx vertebrae (co1-co4)
51
52. Flexion (to bend)
Extension (to stretch out)
Hyperextension
Lateral flexion
Rotation – right and left rotate
52
53.
54. Flexion: C1 (atlas): allows for forward and
backward motion of the head.
Extension: Straightening the joint, moving the
spine back
Lateral Flexion (Abduction): moving the spine to
the side (left or right); the neck moves toward the
shoulder.
Rotation: C2 (axis) for rotation making a "no"
motion. Turning the spine to the side (right or left);
the neck turns toward the shoulder.
54
56. Flexion: moving the spine forward, the thorax
moves toward the pelvis.
Extension / Hyperextension: Straightening the
joint by moving the spine back, the thorax moves
away from the pelvis.
Lateral Flexion (Abduction): moving the spine to
the side (left or right), the thorax moves to the side
toward the pelvis.
Rotation: turning the spine to the side (right or
left); the thorax rotates to one side.
56