The document summarizes the anatomy of the intercostal muscles and related structures in the thoracic wall. It describes three layers of intercostal muscles - external, internal, and transversus thoracicus. It also details the intercostal nerves, arteries and veins, and their branches. The azygos vein is summarized as connecting the inferior vena cava to the superior vena cava, passing through the thorax on the right side behind structures like the esophagus and lung roots.
rectus sheath, the sheath covering rectus muscle of anterior abdominal wall, formation of the sheath, the muscles involved in ts formation, and the contents the sheath is covering
The thorax is the body cavity, surrounded by the bony rib cage that contains the heart and lungs, the great vessels, the oesophagus and trachea, the thoracic duct and the autonomic innervations of these structures
rectus sheath, the sheath covering rectus muscle of anterior abdominal wall, formation of the sheath, the muscles involved in ts formation, and the contents the sheath is covering
The thorax is the body cavity, surrounded by the bony rib cage that contains the heart and lungs, the great vessels, the oesophagus and trachea, the thoracic duct and the autonomic innervations of these structures
Anatomy notes for the thorax. Describes all aspects of the thorax in detail including anatomy of the heart and lungs . Mentions all the muscles, all the inner actions of the arteries, veins and nerves. Explains osteology of the bones involved for example the ribs the sternum with it’s different dimensions.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
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
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
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
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
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
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
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
2. Boundaries of thoracic cage:
• Ant: Sternum, Costal cartilages and ribs.
• Post: Thoracic vertebrae and ribs.
• Lat: Ribs.
3. Thoracic Inlet (or outlet):
• Ant: Upper border of manubrium
sterni.
• Post: 1st thoracic vertebra.
• On each side: 1st rib & 1st costal
cartilage.
• It is sloping downwards & forward.
• Triangular in shape
• Apex: attached to transverse
process of C7
• Base: Attached to medial border of
the first rib
• Superiorly: Related to subclavian
vessels
• Inferiorly: Apex of lung & cervical
pleura.
4.
5. INTERCOSTAL SPACES
• There are 9 anterior and 11
posterior
• Each space contains:
1- Intercostal muscles:
(External, Internal and transversus thoracicus)
2- An Intercostal nerve.
3- Intercostal vessels:
• a. Intercostal arteries
(Anterior & Posterior)
• b. Intercostal veins
(Anterior & Posterior).
6. EXTERNAL INTERCOSTAL
• Origin: From the lower border of the
rib above
• Insertion: Into outer lip of upper
border of rib below
• Fibers are directed from above
downward and forwards
• Begins from post. end of Intercostal
space close to the tubercle of the rib.
• Ends at the costochondral junction
where it is replaced by external or
anterior Intercostal membrane.
• It elevates the rib during inspiration
7. INTERNAL INTERCOSTAL
• Origin: Floor of costal groove
• Insertion: Inner lip of upper border of
rib below
• Fibers are directed from above
downwards & backward
• Begins from anterior end of space
close to the sternum.
• Ends at the angle of the rib, where it
is replaced by post. Or internal
Intercostal membrane.
• Action: Depresses the rib downwards
during expiration
8. Internal Intercostal
• is partly traversed by the nerve &
vessels, which splits each muscle
into 2 parts:
• Outer: Internal Intercostal (proper)
• Inner: Innermost Intercostal
• (In the middle of the space)
Transversus Thoracicus
• The most inner layer of thoracic
wall
• It is formed of 3 muscles
• 1- Innermost Intercostal.
• 2- Sternocostalis.
• 3- Subcostalis
9.
10. Sternocostalis
• 4 to 5 slips which arise from inner
surface of lower part of body of
sternum and costal cartilages
• Inserted into inner surface of costal
cartilages from 2 to 6.
Subcostalis muscle
• Thin bands of muscle fibers.
• Mainly in lower 6 spaces.
• Only in post. part of spaces.
• Origin: Inner surface & lower border
of rib above.
• Insertion: Upper border of 2nd or 3rd
rib below.
11. Anterior
Intercostal Arteries
• 2 small arteries in each of the 9
spaces.
• The upper 6 from internal mammary
artery
• The lower 3 from musculo-phrenic
artery
• NB. Internal mammary or internal
thoracic artery is a branch from1st part
of subclavian artery
12. Posterior
Intercostal Arteries
• One in each of the 11 spaces
• 1st & 2nd arise from superior
Intercostal artery of costocervical
trunk of 2nd part of subclavian artery
• The lower 9 arteries & subcostal
artery arise from descending thoracic
aorta.
13. In each space the posterior Intercostal
artery and its collateral branch anastomose
with the 2 anterior Intercostal arteries
14. Anterior Intercostal veins
• 2 in each space.
• 9th,8th & 7th join the venae commitantes
of musculo-phrenic artery
• 6th,5th & 4th join venae commitantes of
internal mammary artery
• 3rd,2nd &1st join internal mammary vein
• Internal mammary vein drains into
innominate (Brachiocephalic vein)
17. Intercostal Nerves
• They are the anterior primary rami of
spinal thoracic nerves fromT1 to T11
• T3 toT6 are Typical
• T12 is called Subcostal
• The remaining nerves are called
atypical (non-typical)
• Each nerve runs in the Intercostal
space inferior to the Intercostal
vessels
18. Typical Intercostal nerve
• From T3 to T6
• Leaves the intervertebral foramen to
reach the Intercostal space.
• Runs between pleura & post.
Intercostal membrane
• Pierces Internal Intercostal muscle
splitting it into Internal Intercostal
(proper) and innermost Intercostal.
• Runs between Internal Intercostal
muscle & Pleura.
• Pierces Internal Intercostal muscle,
anterior Intercostal membrane,
pectoralis major, and deep fascia to
become anterior cutaenous nerve
20. 1st Intercostal nerve:
• Joined to Brachial plexus, by a branch that is equivalent to lateral cutaenous
branch.
2nd Intercostal nerve:
• Joined to the medial cutaenous nerve of the arm, by a branch called
Intercostobrachial nerve
• ( corresponds to lateral cutaenous branch)
• In Angina pectoris & myocardial infarction pain referred to medial side of arm
along this nerve.
• So, with previous exception the upper 6 Intercostal nerves supply skin & parietal
pleura and Intercostal muscles in each space
21. Azygos Vein
• Connects IVC with SVC
• Begins in abdomen from back of IVC
at level of L2
• Enters thorax through Aortic opening
of diaphragm on Rt. side of thoracic
duct & aorta.
• In post. Mediastinum it passes behind
Rt. Border of esophagus & root of rt.
Lung
• In sup. Mediastinum (L4) it crosses
above the root of rt. lung
Enters the middle of the back of the
SVC.
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