The document discusses the anatomy of the abdomen, including the peritoneal cavity, peritoneum, and inguinal canal. It describes the peritoneal cavity as the potential space between the parietal and visceral peritoneum that contains a thin film of peritoneal fluid. Disorders like ascites and peritonitis that affect the peritoneal cavity are also summarized.
The peritoneum and its functions by Thirumurugan.docxthiru murugan
The peritoneum and its functions:
The peritoneum is a continuous membrane which lines the abdominal cavity and covers the abdominal organs (abdominal viscera).
It acts to support the viscera, and provides pathways for blood vessels and lymph to travel to and from the viscera.
Structure of the Peritoneum:
• The peritoneum consists of two layers that are continuous with each other: the parietal peritoneum and the visceral peritoneum. Both types are made up of simple squamous epithelial cells called mesothelium.
Parts:
1. Parietal peritoneum
2. Visceral peritoneum
3. Peritoneal cavity
Parietal Peritoneum:
The parietal peritoneum lines the internal surface of the abdominopelvic wall. It is derived from somatic mesoderm in the embryo.
It receives the same somatic nerve supply as the region of the abdominal wall that it lines; therefore, pain from the parietal peritoneum is well localized. Parietal peritoneum is sensitive to pressure, pain, laceration and temperature.
Visceral Peritoneum:
The visceral peritoneum invaginates (turned inside out) to cover the majority of the abdominal viscera. It is derived from splanchnic mesoderm in the embryo.
The visceral peritoneum has the same autonomic nerve supply as the viscera it covers. Unlike the parietal peritoneum, pain from the visceral peritoneum is poorly localized and the visceral peritoneum is only sensitive to stretch and chemical irritation.
Peritoneal Cavity: The peritoneal cavity is a potential space between the parietal and visceral peritoneum. It normally contains lubricating fluid
Peritoneal fluid: Peritoneal fluid is a serous fluid made by the peritoneum in the abdominal cavity which lubricates the surface of tissue that lines the abdominal wall and pelvic cavity. It covers most of the organs in the abdomen. An increased volume of peritoneal fluid is called ascites.
Peritoneum location:
• Abdominopelvic cavity is between diaphragm and pelvic floor. It includes abdominal cavity and pelvic cavity.
• The parietal peritoneum lines the walls of this cavity.
• The visceral peritoneum wraps around the abdominal organs, particularly stomach, liver, spleen and parts of small & large intestines.
• Organs inside the visceral peritoneum are called “Intraperitoneal.” The others are “retroperitoneal.”
Intraperitoneal & Retroperitoneal Organs:
The abdominal viscera can be divided anatomically by their relationship to the peritoneum. There are two main groups: Intraperitoneal and retroperitoneal organs.
Intraperitoneal Organs:
• Intraperitoneal organs are enveloped by visceral peritoneum, which covers the organ both anteriorly and posteriorly. Examples include the stomach, liver and spleen.
Retroperitoneal Organs:
Retroperitoneal organs are covered in parietal peritoneum, and that peritoneum only covers their anterior surface.
Mesentery:
• A mesentery is double layer of visceral peritoneum. It connects an Intraperitoneal organ to (usually) the posterior abdom
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
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
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.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
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
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.
3. A potential space between the parietal and visceral
peritoneum.
It contains only a thin film of peritoneal fluid, which consists
of water, electrolytes, leukocytes and antibodies.
The fluid serves two main functions:
It acts as a lubricant, enabling free movement of the
abdominal viscera.
The antibodies fight infection.
PERITONEAL CAVITY
4. The peritoneal cavity can be divided into the greater and
lesser peritoneal sacs.
The greater sac comprises the majority of the peritoneal
cavity.
The lesser sac (also known as the omental bursa) is smaller
and lies posterior to the stomach and lesser omentum.
SUBDIVISIONS OF THE PERITONEAL
CAVITY
5. It is further divided into two compartments by the mesentery
of the transverse colon (known as the transverse mesocolon):
The supracolic compartment lies above the transverse
mesocolon and contains the stomach, liver and spleen.
The infracolic compartment lies below the transverse
mesocolon and contains the small intestine, ascending and
descending colon.
The infracolic compartment is further divided into left and
right infracolic spaces by the mesentery of the small
intestine.
THE GREATER SAC
6. It lies posterior to the stomach
and lesser omentum. It allows the
stomach to move freely against
the structures posterior and
inferior to it.
The omental bursa is connected
with the greater sac through an
opening in the omental bursa, the
epiploic foramen.
OMENTAL BURSA
7. Ascites refers to an accumulation of excess fluid in the
peritoneal cavity. It can occur in conjunction with infection
and peritonitis, however it is more commonly caused by portal
hypertension secondary to cirrhosis of the liver.
Other causes include; malignancies of the GI tract,
malnutrition, heart failure, and mechanical injuries which
result in internal bleeding. Patients present with a distended
abdomen, discomfort, nausea, and dyspnoea.
CLINICAL RELEVANCE: DISORDERS OF
THE PERITONEAL CAVITY
ASCITES
8. Peritonitis refers to infection and inflammation of the
peritoneum. It can occur as a result of bacterial contamination
during a laparotomy (open surgical incision of the peritoneum) or
it can occur secondary to an infection elsewhere in the GI tract,
for example a burst appendix, acute pancreatitis or a gastric
ulcer eroding through the wall of the stomach. Exudation of fluid
into the peritoneal cavity occurs.
The patient experiences pain and tenderness of the overlying
skin and the anterolateral abdominal muscles contract to protect
the viscera (known as guarding). Other symptoms include; fever,
nausea, vomiting, and constipation. Patients may lie with their
knees flexed in an effort to relax the anterolateral abdominal
wall muscles. Generalised peritonitis (when peritonitis is
widespread in the abdominal cavity) can result in sepsis and thus
must be treated as an emergency or it can be fatal.
PERITONITIS
10. The peritoneum is a continuous transparent membrane which
lines the abdominal cavity and covers the abdominal organs
(or viscera).
It acts to support the viscera, and provides a pathway for
blood vessels and lymph.
11. The peritoneum consists of two layers which are continuous
with each other; the parietal peritoneum and the visceral
peritoneum.
They both consist of a layer of simple squamous epithelial
cells, called mesothelium.
STRUCTURE OF THE PERITONEUM
12. The parietal peritoneum lines the internal surface of the
abdominopelvic wall.
It receives the same somatic nerve supply as the region of the
abdominal wall that it lines, therefore pain from the parietal
peritoneum is well localised and it is sensitive to pressure,
pain, laceration and temperature.
PARIETAL PERITONEUM
13. The visceral peritoneum invaginates to cover the majority of
the abdominal viscera.
The visceral peritoneum has the same nerve supply as the
viscera it invests. Unlike the parietal peritoneum, pain from
the visceral peritoneum is poorly localised and is only
sensitive to stretch and chemical irritation
VISCERAL PERITONEUM
14.
15. The peritoneal cavity is a potential space between the parietal
and visceral peritoneum. It contains a small amount of
lubricating fluid.
PERITONEAL CAVITY
16. The abdominal viscera can be divided anatomically by their
relationship with the peritoneum. There are two main groups,
intraperitoneal and retroperitoneal organs.
INTRAPERITONEAL & RETROPERITONEAL
ORGANS
17. Intraperitoneal organs are completely covered in visceral
peritoneum, anteriorly and posteriorly. Examples include the
stomach, liver and spleen.
INTRAPERITONEAL ORGANS
18. These organs are only covered in peritoneum on their anterior
surface. They can be subdivided into two groups:
Primarily retroperitoneal organs develop and remain outside
of the parietal peritoneum. The oesophagus, rectum and
kidneys are all primarily retroperitoneal
Secondarily retroperitoneal organs: peritoneum only covers
the anterior surface. Examples of secondarily retroperitoneal
organs include is the ascending and descending colon.
RETROPERITONEAL ORGANS
19. A useful mnemonic to help in recalling which abdominal
viscera are retroperitoneal is SAD PUCKER:
S = Suprarenal (adrenal) Glands
A = Aorta/IVC
D =Duodenum (except the duodenal cap- first 2cm)
P = Pancreas (except the tail)
U = Ureters
C = Colon (ascending and descending parts)
K = Kidneys
E = (O)esophagus
R = Rectum
20.
21. A mesentery is double layer of visceral peritoneum. It
connects an intraperitoneal organ to the (usually) posterior
abdominal wall. It provides a pathway for nerves, blood
vessels and lymphatics from the body wall to the viscera.
The mesentery of the small intestine is simply called ‘the
mesentery’. Mesentery related to other parts of the
gastrointestinal system is named according to the viscera it
connects to, for example the transverse and sigmoid
mesocolons, the mesoappendix.
MESENTERY
22. The omentum is a double layer of peritoneum that extends
from the stomach and proximal part of the duodenum to other
abdominal organs
OMENTUM
23. The greater omentum consists of four layers of peritoneum. It
descends from the greater curvature of the stomach and
proximal part of the duodenum, then folds back up and
attaches to the anterior surface of the transverse colon.
It has a role in immunity and is sometimes referred to as the
‘abdominal policeman’ because it can migrate to infected
viscera
GREATER OMENTUM
24. The lesser omentum is considerably smaller and attaches
from the lesser curvature of the stomach and the proximal
part of the duodenum to the liver.
It consists of two parts: the hepatogastric ligament and the
hepatoduodenal ligament.
LESSER OMENTUM
25. A peritoneal ligament is a double fold of peritoneum that
connects viscera together or connects viscera to the
abdominal wall, for example the hepatogastric ligament which
connects the liver to the stomach.
PERITONEAL LIGAMENTS
26. Referred Pain
Pain from the viscera is poorly localised. As described earlier, it is referred to areas
of skin (dermatomes) which are supplied by the same sensory ganglia and spinal
cord segments as the nerve fibres innervating the viscera.
Pain is referred according to the embryological origin of the organ; thus pain from
foregut structures are referred to the epigastric region, midgut structures are to the
umbilical region and hindgut structures to the pubic region of the abdomen.
The foregut includes the oesophagus, stomach, pancreas, liver, gallbladder and the
duodenum (proximal to the entrance of the common bile duct).
The midgut extends from the duodenum (distal to the entrance of the common bile
duct) to the junction of the proximal two thirds of the transverse colon with the
distal third.
The hindgut extends from the distal one third of the transverse colon to the upper
part of the anal canal.
Pain in retroperitoneal organs (e.g. kidney, pancreas) may present as back pain.
Irritation of the diaphragm (e.g. as a result of inflammation of the liver, gallbladder
or duodenum) may result in shoulder tip pain.
CLINICAL RELEVANCE
27. Referred Pain in Appendicitis
Initially pain from the appendix (midgut structure) and
visceral peritoneum is referred to the umbilical region. As the
appendix becomes inflamed and irritates the parietal
peritoneum the pain becomes localised to the right lower
quadrant.
CLINICAL RELEVANCE
28. It is a short passage that extends inferiorly and medially,
through the inferior part of the abdominal wall. It is superior
and parallel to the inguinal ligament.
It acts as a pathway by which structures can pass from the
abdominal wall to the external genitalia.
The inguinal canal also has clinical importance. It is a
potential weakness in the abdominal wall, and therefore a
common site of herniation.
INGUINAL CANAL
29.
30. The inguinal canal is made up of:
Anterior and posterior walls
Superficial and deep rings (openings)
Roof and floor (or superior and inferior walls)
The anterior wall is formed by the aponeurosis of the external
oblique, and reinforced by the internal oblique muscle laterally.
The posterior wall is formed by the transversalis fascia.
The roof is formed by the transversalis fascia, internal oblique
and transversus abdominis.
The floor is formed by the inguinal ligament (a ‘rolled up’ portion
of the external oblique aponeurosis) and thickened medially by
the lacunar ligament.
BOUNDARIES
31. In men, the spermatic cord passes through the inguinal canal,
to supply and drain the testes. In women, the round ligament
of uterus traverses through the canal.
The walls of the inguinal canal are usually collapsed around
their contents, preventing other structures from potentially
entering the canal and becoming stuck.
CONTENTS