anatomy of large intestine, its section, ceacum, ascending colon, transverse colon, descending colon, sigmoid colon, functions of large intestine , relations of each components of large intestine, carddinal siggns of large intestine, iliocecal junstion, difference between large and small intestine. abdominal angina, superior mesenteric and inferior mesenteric artery, lymphatic drainage, colonoscophy,
This is not a substitute for Books. Let it just help you understand some concepts in liver anatomy.
Continuation of this work will depend on your feedback. Stay Blessed.
anatomy of large intestine, its section, ceacum, ascending colon, transverse colon, descending colon, sigmoid colon, functions of large intestine , relations of each components of large intestine, carddinal siggns of large intestine, iliocecal junstion, difference between large and small intestine. abdominal angina, superior mesenteric and inferior mesenteric artery, lymphatic drainage, colonoscophy,
This is not a substitute for Books. Let it just help you understand some concepts in liver anatomy.
Continuation of this work will depend on your feedback. Stay Blessed.
It includes structure of stomach, stomach bed, function and internal structure.
Give your like & share with other nursing students.
The stomach is an important organ and the most dilated portion of the digestive system. The esophagus precedes it, and the small intestine follows. It is a large, muscular, and hollow organ allowing for a capacity to hold food. It is comprised of 4 main regions, the cardia, fundus, body, and pylorus.
It includes structure of stomach, stomach bed, function and internal structure.
Give your like & share with other nursing students.
The stomach is an important organ and the most dilated portion of the digestive system. The esophagus precedes it, and the small intestine follows. It is a large, muscular, and hollow organ allowing for a capacity to hold food. It is comprised of 4 main regions, the cardia, fundus, body, and pylorus.
*Features*
•The liver is a large and solid gland situated in the right upper quadrant of the abdominal cavity. In the living subject, the liver is reddish brown in colour, soft in consistency, and very friable. It weighs about 1600 g in males and about 1300 g in females.
*Location*
The liver occupies the whole of the right hypo chondrium, the greater part of the epigastrium, and extends into the left hypochondrium reaching up to the left lateral line. From the above, it will be obvious that most of the liver is covered by ribs and costal cartilages, except in the upper part of the epigastrium where it is in contact with the anterior abdominal wall.
The liver is the largest gland in the body. It secretes.
bile and performs various other metabolic functions. The liver is also called the 'hepar' from which we have the adjective 'hepatic' applied to many structures connected with the organ.
*External Features*
The liver is wedge-shaped. It resembles a four-sided pyramid laid on one side.
*Surfaces*
It has five surfaces. These are:
1 Anterior, 2 Posterior,3 Superior,4 Inferior, and 5 Right.
Out of these, the inferior surface is well defined because it is demarcated, anteriorly, by a sharp inferior border. The other surfaces are more or less continuous with each other and are imperfectly separated from one another by ill-defined, rounded borders.
*Prominent Border*
The inferior border is sharp anteriorly where it separates the anterior surface from the inferior surface. It is somewhat rounded laterally where it separates the right surface from the inferior surface. The sharp anterior part is marked by:
a. An interlobar notch or the notch for the ligamentum teres. b. A cystic notch for the fundus of the gallbladder In the epigastrium, the inferior border extends from the left 8th costal cartilage to the right 9th costal cartilage.
*Lobes*
The liver is divided into right and left lobes by the attachment of the falciform ligament anteriorly and superiorly; by the fissure for the ligamentum teres inferiorly; and by the fissure for the ligamentum venosum posteriorly.
The right lobe is much larger than the left lobe, and forms five-sixths of the liver. It contributes to all the five surfaces of the liver, and presents the caudate and quadrate lobes.
The caudate lobe is situated on the posterior surface. It is bounded on the right by the groove for the inferior vena cava, on the left by the fissure for the ligamentum yenosum, and inferiorly by the porta hepatis. Above, it is continuous with the superior surface. Below and to the right, just behind the porta hepatis, it is connected to the right lobe of the liver by the caudate process .Below and to the left, it presents a small rounded elevation called the papillary process.
The quadrate lobe is situated on the inferior surface, and is rectangular in shape. It is bounded anteriorly by the inferior border, posteriorly by the porta hepatis, on the right by the fossa for the hepatic ducts.
Liver is the largest internal organ of the body weighing about 1500g in adults. It occupies the right hypochondrium and extends into the epigastrium and left hypochondrium .
Anatomy, components parts, and blood supply of eyeball.
Hello friends..you can use these notes for your convenience as they are taken from many other standard books.. Thank you.
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.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
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
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
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
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
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
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.
2. Introduction
(Greek hepar : liver)
It is the largest gland of the body.
occupying much of the right upper
part of the abdominal cavity.
It consists of both exocrine and
endocrine parts.
The liver performs a wide range of
metabolic activities necessary for
homeostasis, nutrition, and
immune response.
3. Main functions are
It secretes bile and stores glycogen.
It synthesizes the serum proteins and lipids.
It detoxifies blood from endogenous and exogenous substances (e.g.,
toxins, drugs, alcohol, etc.) that enter the circulation.
It produces hemopoietic cells of all types during fetal life.
4. LOCATION
The liver almost fully occupies:
The right hypochondrium.
Upper part of the epigastrium.
And part of the left hypochondrium up to the
left lateral (midclavicular) line.
It extends upward under the rib cage as far as
the 5th rib anteriorly on the right side (below
the right nipple) and left 5th intercostal space
The sharp inferior border crosses the midline
at the level of trans pyloric plane (at the level
of L1 vertebra.
5. SHAPE, SIZE, AND COLOUR
Shape
The liver is wedge shaped and
resembles a four-sided pyramid
laid on one side with its base
directed towards the right and
apex directed towards the left.
Colour
It is red-brown in colour.
Weight
In males: 1.4 to 1.8kg.
In females: 1.2 to 1.4kg.
In newborn: 1/18th of the body
weight.
At birth: 150 g.
Proportional weight: In adult
1/40th of the body weight.
6. EXTERNAL FEATURES
The wedge-shaped liver
presents:
Two well-defined
surfaces: diaphragmatic
and visceral.
One well-defined border:
inferior border.
7. Diaphragmatic Surface
The dome-shaped diaphragmatic surface includes
smooth peritoneal areas which face superiorly,
anteriorly and to the right.
And a rough bare area (devoid of the peritoneum)
which faces posteriorly.
The inferior vena cava (IVC) is embedded in the
deep sulcus in the left part of the bare area.
In most cases, this sulcus is roofed by the fibrous
tissue termed ligament of IVC which may contain
hepatic tissue converting the sulcus into the
tunnel.
The peritoneal ligaments are coronary, left and
right triangular and falciform ligaments.
8. Visceral Surface (Inferior Surface):
Relatively flat or concave.
It is directed downward, backward, and to the
left.
It is separated in front from the diaphragmatic
surface by the sharp inferior border and behind
from the diaphragm by the posterior layer of
coronary ligament.
The notable features on the visceral surface are:
1. Fossa for the gallbladder.
2. Fissure for the ligamentum teres hepatis.
3. Porta hepatis.
The visceral surface is covered by the peritoneum
except at the fossa for gallbladder and the porta
hepatis.
9.
10. Inferior Border
The features of the inferior border are as follows:
It separates the diaphragmatic surface from the visceral surface.
It is rounded laterally where it separates the right lateral surface
from the inferior surface.
It is thin and sharp medially where it separates the anterior surface
from the inferior surface.
It presents two notches:
(a) Notch for ligamentum teres or interlobar notch: It is located just
to the right of the median plane.
(b) Cystic notch: It is located about 5 cm to the right of the median
plane and often corresponds to the fundus of the gallbladder.
11. LOBES OF THE LIVER
Anatomical Lobes:
On the diaphragmatic surface: the
liver is divided into two lobes, right
and left, by the attachment of the
falciform ligament.
The right lobe which forms the base of
the wedge-shaped liver is
approximately six times larger than
the left lobe.
12. On the visceral surface: the liver is
divided into four lobes:
1. Right lobe: to right of the fossa for
gallbladder.
2. Left lobe: to the left of the fissures for
ligamentum teres and ligamentum
venosum.
3. Quadrate lobe: between the fossa for
gallbladder and the fissure for
ligamentum teres below the porta
hepatis.
4. Caudate lobe: between the groove for IVC
and the fissure for ligamentum venosum.
13. Physiological Lobes/Functional Lobes/True
Lobes
The division of the liver into lobes is based on the intrahepatic
distribution of branches of the bile ducts, hepatic artery, and portal vein.
The liver is divided into right and left physiological lobes by an imaginary
sagittal plane/line (Cantlie’s plane/line).
On the posteroinferior surface: this plane passes through the fossa for
gallbladder, to the groove for IVC.
(Note: Caudate lobe is equally shared between the right and left lobes.)
The anterosuperior surface: this plane passes from the IVC to the cystic
notch present a little to the right of the falciform ligament.
The physiological right and left lobes are approximately equal in size.
14.
15. HEPATIC SEGMENTS (SEGMENTS OF THE
LIVER)
There are eight hepatic segments. They
are deduced as follows
The right physiological lobe is divided
into anterior and
posterior parts, and the left physiological
lobe into medial and lateral parts.
Each of these parts is further divided into
upper and lower parts and form eight
surgically resectable hepatic segments.
The veins draining the hepatic segments
are intersegmental, i.e., they drain more
than one segments.
16. Couinaud’s segments: According to
nomenclature of Couinaud, the hepatic segments
are numbered I to VIII.
I to IV in the left hemi liver and V to VIII in the
right hemi liver.
According to this nomenclature, the segment I
corresponds to the caudate lobe and segment IV
corresponds to the quadrate lobe.
Segment I to IV of the left lobe are supplied by
the left branch of hepatic artery, left branch of
portal vein and drained by left hepatic duct.
The segments V to VIII of right lobe are supplied
by right hepatic artery, right branch of portal
vein and drained by right hepatic duct.
17. PERITONEAL RELATIONS
Most of the liver is covered by the peritoneum.
The areas which are not covered by the peritoneum are:
Bare area of the liver: It is a triangular area on the posterior aspect of
the right lobe.
Fossa for gallbladder, on the inferior surface of the liver between
right and quadrate lobes.
Groove for IVC, on the posterior surface of the right lobe of the liver.
Groove for ligamentum venosum.
Porta hepatis.
18. LIGAMENTS
False Ligaments: are actually peritoneal
folds and include:
1. Falciform ligament.
2. Coronary ligament.
3. Right triangular ligament.
4. Left triangular ligament.
5. Lesser omentum.
True Ligaments: are actually the
remnants of fetal structures and include:
1. Ligamentum teres hepatis.
2. Ligamentum venosum.
19. RELATIONS
Diaphragmatic Surface:
Superior Surface:-
The convex right and left parts of this surface fit into the corresponding domes of
the diaphragm, which separate them from the corresponding lung and pleura.
The central depressed area of this surface is related to the central tendon of the
diaphragm, which separates it from the pericardium of the heart. Hence, this area is
often termed cardiac impression.
Anterior Surface:-
Xiphoid process and anterior abdominal wall in the median plane and diaphragm
on each side. The falciform ligament is attached to this surface a little to the right of
the median plane.
Right Lateral Surface:-
Diaphragm opposite 7th to 11th ribs in the midaxillary line.
20. Posterior Surface:-
This surface presents: bare area of the liver, groove for IVC, caudate lobe,
fissure for ligamentum venosum, and posterior surface of the left lobe.
The bare area of the liver is a triangular area to the right of groove for the IVC
between the two layers of coronary and right triangular ligaments.
It is in direct contact with the diaphragm.
The right suprarenal gland is related to the inferomedial part of this area, i.e.,
near the groove for IVC.
The groove for IVC as the name indicates lodges the IVC.
The caudate lobe is related to the superior recess of the lesser sac.
Esophagus, just to the left of the upper part of fissure for ligamentum venosum
and causes esophageal impression.
The fundus of the stomach is related just to the left of the esophageal
impression.
21. Visceral Surface (Inferior Surface):-
The inferior surface of the left lobe is related to the stomach, which produces a
gastric impression.
Near the left side of the fissure for ligamentum venosum, this surface presents a
slight elevation that comes in contact with the lesser omentum. Hence, it is called
tuber omentale/ omental tuberosity.
The quadrate lobe is related to the pyloric end of the stomach and the first part of
the duodenum.
The fossa for gallbladder, occupied by the gallbladder with its cystic duct.
The right colic flexure is related to the inferior surface to the right of the
gallbladder colic impression.
The junction of first and second parts of the duodenum is related to the right upper
part of the fossa for gallbladder produces the duodenal impression.
The right kidney is related to the inferior surface posterior to the colic impression
and to the right of the duodenal impression and causes renal impression.
24. BLOOD SUPPLY
The liver is a highly vascular organ.
It receives blood from two sources. The arterial blood
(oxygenated) is supplied by the hepatic artery and venous
blood (rich in nutrients) is supplied by the portal vein.
Through the liver. About 80% of this is delivered through
the portal vein and 20% is delivered through the hepatic
artery.
25. VENOUS DRAINAGE
Most of the venous blood from liver is drained by three large hepatic
veins:
(a) left hepatic vein between medial and lateral segments of the left
true lobe,
(b) middle hepatic vein between true right and left true lobes,
(c) right hepatic vein between anterior and posterior segments of the
right true lobe.
26. NERVE SUPPLY
The liver is supplied by both sympathetic and parasympathetic
fibres.
The sympathetic fibres are derived from the coeliac plexus.
The parasympathetic fibres are derived from the hepatic branch of
the anterior vagal trunk.
27. FACTORS KEEPING THE LIVER IN
POSITION
Hepatic veins connecting the liver to the IVC.
Intra-abdominal pressure maintained by the tone of abdominal
muscles.
Peritoneal ligaments connecting the liver to the abdominal walls.
28. Clinical correlation
Cirrhosis of the liver: The hepatocytes sometimes may undergo necross
following their injury and death caused by infection, toxins, alcohol, and
poisons.
The dead hepatocytes are replaced by fibrous tissue by the proliferation of
the perilobular connective tissue.
The resultant hepatic fibrosis is clinically termed cirrhosis of the liver.
The patient develops jaundice due to obstruction of bile flow.
29. Needle biopsy of the liver:
In needle biopsy of the liver, the needle is
inserted in the midaxillary line through
9th or 10th intercostal space.
The needle passes through the chest
wall,costodiaphragmatic recess of the
pleura, diaphragm, and right anterior
intraperitoneal space to enter the liver.
Needle inserted above the 8th intercostal
space will injure the lung.