This document discusses tumors of the head and neck from a multidisciplinary perspective. It addresses the problems faced by patients with head and neck cancer including diagnosis, comorbidities, pain, procedures, treatments and mortality. It outlines factors related to the patient, the tumor, and treatments. Regarding tumor factors, it discusses biology, site, staging and histopathological characteristics. It provides details on surgical procedures for head and neck cancer. It also briefly discusses radiotherapy and chemotherapy, noting some common side effects of these treatments. The document emphasizes the importance of a multidisciplinary approach and pre-operative nutrition to achieve the best outcomes for patients with head and neck cancer.
This presentation is the first series of the MR imaging of Knee.
In this presentation MRI anatomy has been discussed. As we all know good knowledge of medical imaging three dimensional anatomy is key for good reporting.
Hope we all get benifitted.
Suggestions are most welcome
This presentation is the first series of the MR imaging of Knee.
In this presentation MRI anatomy has been discussed. As we all know good knowledge of medical imaging three dimensional anatomy is key for good reporting.
Hope we all get benifitted.
Suggestions are most welcome
MRI anatomy of ankle radiology ppt pk is nice presentation that covers cross sectional anatomy as well as relevant anatomy from standard radiology book like CT MRI whole body by Hagga . cross section of mri is taken from mrimaster.com. This will help for radiology resident as well radiographers.
MRI anatomy of ankle radiology ppt pk is nice presentation that covers cross sectional anatomy as well as relevant anatomy from standard radiology book like CT MRI whole body by Hagga . cross section of mri is taken from mrimaster.com. This will help for radiology resident as well radiographers.
10th publication - Dr Rahul VC Tiwari - Department of oral and Maxillofacial Surgery, SIBAR Institute of Dental Sciences, Takkellapadu,Guntur, Andhra Pradesh - 522509. IOSR-JDMS
Leiomyoma is a benign tumor that originates from smooth
muscle cell. The most common sites are the uterus, gastrointestinal tract & skin. Leiomyoma is a relatively uncommon smooth muscle tumor rarely found in the head and neck. Enzinger and Weiss (1995), analyzed a total of 7748 leiomyomas, 95% of the tumors occurred in the female genitalia (uterus), 3% in the skin, 0.9% in the gastrointestinal tract and the remainder at various sites including skull base.
paediatric injuries around the elbow
supracondylar elbow injuries
pulled elbow in paediatric age r
radiological signs around elbow in supracondylar fracture humerus
thyroidectomy-surgical seminare, prepared by Dr. Siddharth JINDAL, third year resident in dept. of general surgery at P.D.U. Government Medical College and Civil Hospital, Rajkot, Gujarat.
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
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
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
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
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the 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 lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
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. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
1. Tumores de
Cabeça e Pescoço
Visão Multidisciplinar
Dr. Leonardo G. Rangel
Cirurgião de Cabeça e Pescoço -HUPE-UERJ
Doutorando em Cirurgia
Coordenador de Residência ORL-CCP UERJ
Chefe do Ambulatório de CCP UERJ - HUPE
24. Fatores Tumorais
características Histopatológicas
epithelial membrane antigen and are negative for muscle-
specific actin and vimentin. They may or may not express
cribriform growth patterns reminiscent of adenoid cystic
carcinoma [250]. Basal cell adenocarcinomas show areas
Fig. 3.11: Adenoid cystic carcinoma. a Cribriform growth pattern. Cells with dense angular nuclei and scant clear cytoplasm sur-
round spaces producing a classic Swiss cheese pattern (H&E, 200×). b Perineural invasion (H&E, 200×)
61Pathology of Salivary Gland Disease Chapter 3
30. Caquexia associada a 20% das mortes
Caquexia ≠ Inanição
não reverte com Calorias extras
Anorexia 15-40%
Apetite e Habilidade em comer
principais fatores de Qualidade de Vida
Disfagia≈Desnutrição≈Caquexia
33. should be clearly identified, ligated, and divided to com-
plete the isolation of the internal jugular vein. Other
smaller branches can be cauterized, by means of bipolar
cautery.
The dissection of the carotid sheath has 2 danger points,
one at each end—upper and lower—of the dissection. At
these 2 points the traction exerted to facilitate the dissection
of the fascial envelope produces a folding of the wall of the
internal jugular vein that can be easily sectioned at the touch
of the scalpel blade. The surgeon must be extremely cau-
tious to avoid injuring the vein at these points.
Lower in the neck, the terminal portion of the thoracic
duct on the left side, and the right lymphatic duct—when
present—also are within the boundaries of the dissection
and must be preserved. Once the internal jugular vein is
released from its covering fascia, the dissection continues
medially over the carotid artery. The specimen is now com-
pletely separated from the great vessels and remains at-
tached only to the strap muscles
Dissection of the strap muscles
Although this is described as the last step of the
operation (Figure 10), it may be performed in a different
order according to the needs of the surgery and the
location of the primary tumor. The midline constitutes
the medial border of the dissection for unilateral opera-
tions. Thus, a midline cut is made in the superficial layer
is identified, ligated, and divided at both ends of the
surgical field. The fascia is now dissected from the un-
derlying strap muscles. The dissection starts at the upper
part of the surgical field and continues in a lateral and
inferior direction. The sternohyoid and omohyoid mus-
cles are completely freed from their fascial covering.
The superior thyroid artery can be identified coursing
in an inferomedial direction toward the thyroid gland.
Depending on the resection of the primary tumor, the
Figure 10 The strap muscles are released from their fascial
covering. (1) Strap muscles, (2) thyroid cartilage, (3) thyroid
gland, (4) fascia of the strap muscles, (5) stylohyoid muscle, (6)
digastric muscle, (7) anterior facial vein, and (8) submandibular
gland optionally preserved.
the neck. (1) Carotid artery, (2) internal jugular vein (3) hyoid
bone, (4) suprasternal notch, and (5) thyroid gland
Figure 12 The neck after a right functional neck dissection for
supraglottic cancer of the larynx. (1) Internal jugular vein, (2)
carotid artery, (3) sternocleidomastoid muscle, (4) submandibular
F@lJRE 1. Transection of the strap muscles: Along the superior
border of the thyroid cartilage, the stemohyoid, omohyoid and
tlqrohyoid muscles are cut. The sternothyroid muscle is also
transected. This is performed bilaterally.
FIGURE 3. Disarticulation of the cricothyroid joint: A Freer ele-
vator is placed carefully between the inferior thyroid comu and
the cricoid cartilage so that the recurrent laryngeal nerve is not
damaged. The nerve is not identified during the dissection.
FIGURE 2. Transection of the constrictor muscles: The inferior
pharyngeal constrictor muscles and the thyroid perichondrium
are transected with a No. 15 blade along the posterolateral and
superolateral borders of the thyroid cartilage.
brane, and the periosteum of the inferior hyoid bone is
incised. A Freer elevator is then used to dissect the preepi-
glottic space from the inferior and posterior aspect of the
hyoid bone. The larynx is now entered through a small
transvallecular pharyngotomy, just wide enough to visu-
alize the epiglottis. It is grasped with an Allis clamp and
pulled externally. The surgeon now moves to the head of
the bed, and further tumor cuts can be made under direct
visualization (Fig 5). Using scissors, incisions are made so
that the entire preepiglottic space is resected, but the cuts
are made medial to the main trunk of the internal branch
of the superior laryngeal nerve.
Further tumor cuts are now made on the non-tumor
bearing side. The scissors are advanced anterior to the
previously released pyriform sinus. Precise cuts are made
through the aryepiglottic fold and down to the level of the
false cord. The false cord is transected just anterior to the
arytenoids; the vocal process and true cords are transected
just posterior to the ventricle. It is essential that the aryte-
noid cartilage be preserved on the non-tumor bearing side
of the larynx. In addition, it is important not to enter the
cricoarytenoid joint inadvertently so that postoperative
ankylosis may be avoided. Incisions are now made con-
necting these prearytenoid cuts to the cricothyroidotomy.
The cricothyroid and lateral cricoarytenoid muscles are
transected along the superior border of the cricoid carti-
lage.
Complete visualization of the tumor bearing side is
necessary. The surgeon takes both thyroid ala in her/his
hands and cracks the cartilage down the middle. It is akin
to opening a book. The resection along the tumor bearing
DUANE SEWELL 29
Fatores do Tratamento
Cirurgia