The lymphatic system has three functions:
Fluid recovery.
Immunity
Lipid absorption
The lymphatic vessels of the small intestine receive the special designation of lacteals or chyliferous vessels.
The components of the lymphatic system are :-
lymph, the recovered fluid;
Lymphatic vessels, which transport the lymph;
Lymphatic tissue, composed of aggregates of lymphocytes and macrophages that populate many organs of the body; and
Lymphatic organs, in which these cells are especially concentrated and which are set off from surrounding organs by connective tissue capsules.
Thymus gland and spleen by Mohammad MufarrehMMufarreh
A brief overview of the biology of the thymus, T cell development and the immunological and pathological aspects of thymus function.
The spleen is described in a nutshell.
Suitable for teaching undergraduates and reviewing for postgraduates.
Occipital (2-4)
Superior nuchal line between sternocleidomastoid and trapezius
Occipital part of scalp
Superficial cervical lymph nodes
Accessary lymph nodes
Mastoid (1-3)
Superficial to sternocleidomastoid insertion
Posterior parietal scalp
Skin of ear, posterior external acoustic meatus
Superior deep cervical nodes Accessary lymph nodes
Preauricular (2-3)
Anterior to ear over parotid fascia
Drains areas supplied by superficial temporal artery
Anterior parietal scalp
Anterior surface of ear
Superior deep cervical lymph nodes
Parotid (up to 10 or more)
About parotid gland and under parotid fascia
Deep to parotid gland
External acoustic meatus
Skin of frontal and temporal regions
Eyelids, tympanic cavity
Cheek, nose (posterior palate)
Superior deep cervical lymph nodes
Facial
Superficial(up to 12)
Maxillary
Buccal
Mandibular
Distributed along course of facial artery and vein
Skin and mucous membranes of eyelids, nose, cheek
Submandibular nodes
Deep
Distributed along course of maxillary artery lateral to lateral pterygoid muscle
Temporal and infratemporal fossa
Nasal pharynx
Superior deep cervical lymph nodesSuperficial
Anterior jugular vein between superficial cervical fascia and infrahyoid fascia
Skin, muscles, and viscera of infrahyoid region of neck
Superior deep cervical lymph nodes
Deep
Between viscera of neck and investing layer of deep cervical fascia
Adjoining parts of trachea, larynx, thyroid gland
Superior deep cervical lymph nodes
Anterior cervical/Superficial
Submental (2-3)
Submental triangle
Chin
Medial part of lower lip
Lower incisor teeth and gingiva
Tip of tongue
Cheeks
Submandibular lymph node to jugulo-omohyoid lymph node and superior deep cervical lymph nodes
Thymus gland and spleen by Mohammad MufarrehMMufarreh
A brief overview of the biology of the thymus, T cell development and the immunological and pathological aspects of thymus function.
The spleen is described in a nutshell.
Suitable for teaching undergraduates and reviewing for postgraduates.
Occipital (2-4)
Superior nuchal line between sternocleidomastoid and trapezius
Occipital part of scalp
Superficial cervical lymph nodes
Accessary lymph nodes
Mastoid (1-3)
Superficial to sternocleidomastoid insertion
Posterior parietal scalp
Skin of ear, posterior external acoustic meatus
Superior deep cervical nodes Accessary lymph nodes
Preauricular (2-3)
Anterior to ear over parotid fascia
Drains areas supplied by superficial temporal artery
Anterior parietal scalp
Anterior surface of ear
Superior deep cervical lymph nodes
Parotid (up to 10 or more)
About parotid gland and under parotid fascia
Deep to parotid gland
External acoustic meatus
Skin of frontal and temporal regions
Eyelids, tympanic cavity
Cheek, nose (posterior palate)
Superior deep cervical lymph nodes
Facial
Superficial(up to 12)
Maxillary
Buccal
Mandibular
Distributed along course of facial artery and vein
Skin and mucous membranes of eyelids, nose, cheek
Submandibular nodes
Deep
Distributed along course of maxillary artery lateral to lateral pterygoid muscle
Temporal and infratemporal fossa
Nasal pharynx
Superior deep cervical lymph nodesSuperficial
Anterior jugular vein between superficial cervical fascia and infrahyoid fascia
Skin, muscles, and viscera of infrahyoid region of neck
Superior deep cervical lymph nodes
Deep
Between viscera of neck and investing layer of deep cervical fascia
Adjoining parts of trachea, larynx, thyroid gland
Superior deep cervical lymph nodes
Anterior cervical/Superficial
Submental (2-3)
Submental triangle
Chin
Medial part of lower lip
Lower incisor teeth and gingiva
Tip of tongue
Cheeks
Submandibular lymph node to jugulo-omohyoid lymph node and superior deep cervical lymph nodes
Unit-III, chapter-2- Lymphatic System,
Functions of Lymphatic System,
Major Parts of Lymphatic System,
Composition of Lymph,
Lymph and Lymphatic Capillaries,
Structure of lymph node,
Mechanisms of Lymph Flow,
Functions of Lymph Node,
Mucosa-Associated Lymphoid Tissue (MALT),
As per PCI syllabus,
B. Pharm. First Year,
Human Anatomy and Physiology-I.
contents of ppt include introduction, embryology, lymphatic organs and tissues, classification of lymph nodes, tnm staging, diseases of lymph nodes, classification of lymph node, inspection and palpation of lymph nodes, composition of lymph, function of lymphatic system and lymph nodes
Definition
General properties
Composition
Function of saliva
Formation of saliva
Method for collecting saliva
Advantages
Limitations
Analysis of saliva done for the diagnosis of systemic disease
Definition:
by Stedmann’s & Lipincott medical dictionary.
A clear, tasteless, odourless, slightly acidic (pH 6.8) viscous fluid, consisting of the secretion from the parotid, sublingual, submandibular salivary glands and the mucous glands of the oral cavity.
General properties
Volume: 1000 to 1500 mL of saliva is secreted per day and, it is approximately about 1 ml/ minute.
Contribution by each major salivary gland is:
i. Parotid glands: 25%
ii. Submandibular glands: 70%
iii. Sublingual glands: 5%.
Reaction: Mixed saliva from all the glands is slightly acidic with pH of 6.35 to 6.85.
Specific gravity: It ranges between 1.002 and 1.012.
Tonicity: Saliva is hypotonSalivary flow
The average person produces approximately 0.5 L – 1.5 L per day
Unstimulated Flow (resting salivary flow―no external stimulus)
Typically 0.2 mL – 0.3 mL per minute
Stimulated Flow (response to a stimulus, usually taste, chewing, or medication [eg, at mealtime])
Typically 1.5 mL – 2 mL per minute
INTRODUCTION
Tongue is a muscular organ
Situated in the floor of the mouth
FUNCTION
Taste
Speech
Mastication
Deglutition
EXTERNAL FEATURES
Tongue has
A Root
A tip
A body
ROOT
Is attached to the mandible and soft palate above and hyoid bone below.
These attachments prevent the swallowing of the tongue.
In between the 2 bones it is related to the geniohyoid and mylohyoid muscles.
TIP
Of the tongue forms the anterior free end which lies behind the upper incisor teeth.
BODY
Has
A curved upper surface or dorsum
An inferior or ventral surface MUSCLES OF THE TONGUE
Middle fibrous septum divides the tongue into right and left halves.
Intrinsic muscles
Superior longitudinal
Inferior longitudinal
Transverse
Vertical
Extrinsic muscles
Genioglossus
Hyoglossus
Styloglossus
Palatoglossus
Central face begins to develop by 4th week, when olfactory placodes appear on both sides of the frontonasal process.
Gradually both placodes develop to form the median and lateral nasal process.
Upper lip is formed by 6th week by fusion of two median nasal processes in midline and the maxilllary process of the 1st branchial arch.
PRE-NATAL GROWTH AND DEVELOPMENT OF PALATEFormation of primary and secondary palate
Elevation of palatal shelves
Fusion of palatal shelves
Introduction
Epidemiology
Etiology
Manifestations
TNM staging
Squamous cell carcinoma is defined as malignant epithelial neoplasm exhibiting squamous differentiation as characterised by the formation of keratin and/or the presence of intercellular bridges.
( Pindborg et al, 1997).
Is a phenomenon of reflex sequence of muscle contractions that propels the ingested materials and pooled saliva from the mouth to the stomach.
PATTERNS
Infantile (visceral) swallow
Adult/mature swallow
ADULT SWALLOWING
Is composed of 4 stages
Voluntary
Preparatory phase
Oral or buccal
Involuntary: Controlled By Medulla and Lower Pons
Pharyngeal
b. Oesophageal
• Function
• External features
• Papillae of tongue
• Muscles of the tongue
• Arterial supply
• Venous drainage
• Lymphatic drainage
• Nerve supply
• Histology
• Development of tongue -
Intrinsic muscles
Superior longitudinal
Inferior longitudinal
Transverse
Vertical
- Extrinsic muscles
Genioglossus
Hyoglossus
Styloglossus
Palatoglossus
1. Vallate or circumvallate papillae
These are large in size 1-2mm in diameter and are 8-12 in number.
They are situated immediately in front of the sulcus terminalis.
Each papillae are cylindrical projection surrounded by a circular sulcus.
The walls of the papilla are raised above the surface.
2. Fungiform papillae
Are numerous
Near the tip and margins of the tongue, but some of them are scattered over the dorsum.
These are smaller than the vallate papillae but larger than the filliform papillae.
Each papilla consists of a narrow pedicle and a large rounded head.
They are distinguished by their bright red colour.
3. Filliform papillae
Conical papilla
Cover the presulcal area of the dorsum of the tongue and gives it a characteristic velvety appearance.
They are the smallest and most numerous of the lingual papillae.
Each are pointed and covered with keratin
The apex is often split into filamentous processes.
Fifth cranial nerve
Have a large sensory root and a small motor root.
Motor root arises – arises from the lateral aspect of lower pons (cranially) the motor root cross the apex of the petrous temporal bone beneath the superior petrosal sinus, to enter the middle cranial fossa.
Sensory root – arises from the lateral aspect of lower pons (caudally).
RELATIONS
Medially
(a) internal carotid artery
(b) posterior part of cavernous sinus
Laterally - middle meningeal artery
Superiorly - parahippocampal gyrus
Inferiorly
motor root of trigeminal nerve
(b) greater petrosal nerve
(c) apex of the petrous temporal bone
(d) foramen lacerum.OPTHALIMIC DIVISION
Terminal branches of Ophthalmic division of trigeminal nerve, are
1. Frontal
Supratrochlear
Supraorbital
2. Nasociliary
Branch of ciliray ganglion
2-3 long ciliary nerves
Posterior ethmoidal
Infratrochlear
Anterior ethmoidal
3. Lacrimal
Branches
From main trunk
Meningeal branch
Nerve to medial pterygoid
From the anterior trunk
Sensory branch
Buccal nerve
Motor branch
Masseteric
Deep temporal nerve
Nerve to lateral pterygoid
From the posterior trunk
Auriculotemporal
Lingual
Inferior alveolar nerves
COTTON-WOOL APPEARANCE
Active phase showing disorganised bone architecture with numerous, large, multinucleated osteoclasts. The stroma is vascular and fibrous
The late phase features thick trabeculae with a prominent mosaic pattern of prominent, hematoxyphilic, cement lines at the interfaces of episodes of resorption followed by deposition.
Paget disease showing very prominent blue cement lines. The lamellae are arranged haphazardly giving an overall effect of a jigsaw puzzle.
Hume- “caries is essentially a progressive loss by acid dissolution of the apatite component of the enamel then the dentin or of the cementum then dentin.”
According to location:
Pit or Fissure caries
Smooth Surface caries
According to rapidity:
Acute
Chronic
Arrested
According to occurrence:
Primary (Virgin) caries
Secondary (Recurrent) caries
According to the site of occurrence:
Enamel caries
Cemental caries.
Acidogenic [ Miller’s Chemico-parasitic] theory.
Proteolytic theory.
Proteolysis- chelation theory.
A Magnified Microscopic Image Is Worth More Than A Thousand Words.
DARK FIELD MICROSCOPE
PHASE CONTRAST MICROSCOPY
POLARIZED LIGHT MICROSCOPY
FLUORESCENT MICROSCOPY
STEREO MICROSCOPE
ELECTRON MICROSCOPY
Maxillary Second Premolar
the maxillary first premolar in function
Less angular ,rounded crown in all aspects.
Single root
Smaller crown cervico occlusally
Root length is as great or greater
BUCCAL ASPECT
Not as long as that of the first premolar
Less pointed
Mesial slope is
shorter than the distal slope
Buccal ridge of the crown may not be so prominent whencompared with the first premolarLINGUAL ASPECT
Lingual cusp is longer making the crown longer on the lingual sideMESIAL ASPECT
Cusps of second premolar are shorter with the buccal and lingual cusps more nearly the same length
Greater distance between cusp tips-that widens the occlusal surface buccolingually
No developmental depression on the mesial surface of the crown as on the first premolar
Crown surface is convex instead
No deep dev. Groove crossing the mesial marginal ridgeOCCLUSAL ASPECT
Outline of the crown is more rounded or oval rather than angular
Central dev. groove is shorter and more irregular
Tendency toward multiple supplementary grooves radiating from the central groove that may extend out to the cusp ridges
Makes for an irregular occlusal surface and gives a very wrinkled appearance
Centered in the maxilla, one on either side of median line, with mesial surface of each in contact with mesial surface of other
Two in number
Larger than the lateral incisor
These teeth supplement each other in function, and they are similar anatomically
Shearing or cutting teeth
Major function is to punch and cut food material during the process of mastication
These teeth have incisal ridges or edges rather than
cusps such as are found on canines & posterior teeth
First evidence of calcification
Crown completion
Eruption
Root completion
3-4 months
4-5 years
7-8 years
10-11 years
PHYSICAL PROPERTIES
CHEMICAL PROPERTIES
STRUCTURE OF ENAMEL
DEVELOPMENT OF ENAMEL
EPITHELIAL ENAMEL ORGAN
AMELOGENESIS
LIFE CYCLE OF AMELOBLASTS
AGE CHANGES IN ENAMEL
DEFECTS OF AMELOGENESIS
CLINICAL IMPLICATIONS
PRENATAL GROWTH OF MANDIBLE
Occurs between the 4th and 7th week of intrauterine life.
4th week of intrauterine life
Formation of the head fold
Following which the developing brain and the pericardium form 2 prominent bulges on the ventral aspect of the embryo.
The 2 bulges are separated from each other by a shallow depression called stomatoedum (corresponding to the primitive mouth).
Floor of the stomatodeum is formed by the Buccopharyngeal membrane, which separates the stomatodeum from the foregut.Soon, mesoderm covering the developing forebrain proliferates, and forms a downward projection that overlaps the upper part of the stomatodeum – this downward projection is called frontonasal process.
Since the formation of various parts of the face involves fusion of diverse components.
Occasionally this fusion can be incomplete give rise to various anomalies
MANDIBULOFACIAL DYSOSTOSIS OR FIRST ARCH SYNDROME
- Entire first arch may remain underdeveloped on one or both sides, affecting
Lower eyelid
Maxilla
Mandible
External ear.
- Prominence of the cheek is absent
- Ear is displaced ventrally and caudally
Face develops in humans between 4th – 10th week of intrauterine life.
prenatal growth of the maxilla
DEVELOPMENT OF UPPER LIP
Development of lower lip
Development of nose
hare lip
OBLIQUE FACIAL CLEFT
macrostomia
lateral facial cleft
microstomia
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
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
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.
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.
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
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
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.
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.
2. FUNCTIONS OF LYMPHATIC SYSTEM
• The lymphatic system has three functions:
• Fluid recovery.
• Immunity
• Lipid absorption
• The lymphatic vessels of the small intestine receive the special designation of
lacteals or chyliferous vessels.
3. THE MAIN FUNCTIONS OF THE LYMPHATIC SYSTEM ARE AS FOLLOWS
• To collect and transport tissue fluids from the intercellular spaces in all the tissues
tissues of the body, back to the veins in the blood system;
• It plays an important role in returning plasma proteins to the bloodstream;
• Digested fats are absorbed and then transported from the villi in the small
intestine to the bloodstream via the lacteals and lymph vessels.
• New lymphocytes are manufactured in the lymph nodes;
4. • Antibodies and lymphocytes assist the body to build up an effective immunity
to infectious diseases;
• Lymph nodes play an important role in the defence mechanism of the body.
They filter out micro-organisms (such as bacteria) and foreign substances such as
toxins, etc.
• It transports large molecular compounds (such as enzymes and hormones)
from their manufactured sites to the bloodstream.
5. Components of Lymphatic system
The components of the lymphatic system are :-
• lymph, the recovered fluid;
• Lymphatic vessels, which transport the lymph;
• Lymphatic tissue, composed of aggregates of lymphocytes and macrophages
that populate many organs of the body; and
• Lymphatic organs, in which these cells are especially concentrated and which
are set off from surrounding organs by connective tissue capsules.
6. LYMPH
• Lymph is usually a clear, colorless fluid, similar to blood plasma but low in protein. Its
composition varies substantially from place to place.
• Origin of Lymph :-
• Lymph originates in microscopic vessels called lymphatic capillaries. These vessels
penetrate nearly every tissue of the body but are absent from the central nervous
system, cartilage, bone, and bone marrow.
• The gaps between lymphatic endothelial cells are so large that bacteria and other cells
can enter along with the fluid.
7. Lymph
Origin of Lymph :-
• The overlapping edges of the endothelial cells act as valve like flaps that can open and
close.
• When tissue fluid pressure is high, it pushes the flaps inward (open) and fluid flows
into the lymphatic capillary. When pressure is higher in the lymphatic capillary than in
the tissue fluid, the flaps are pressed outward (closed).
8. Lymphatic Capillaries. (a) Relationship of the lymphatic capillaries to a bed of blood
capillaries. (b) Uptake of tissue fluid by a lymphatic capillary.
9. Lymphatic Vessels :-
• They have a tunica interna with an endothelium and
valve, a tunica media with elastic fibers and smooth
muscle, and a thin outer tunica externa.
• Their walls are thinner and their valves are more
numerous than those of the veins.
10. Mechanism of lymphatic flow
• Lymph flows under forces similar to those that govern venous return, except that the
lymphatic system has no pump like the heart.
• Lymph flows at even lower pressure and speed than venous blood; it is moved primarily
by rhythmic contractions of the lymphatic vessels themselves, which contract when
stretched by lymph.
• The lymphatic vessels, like the veins, are also aided by a skeletal muscle pump that
squeezes them and moves the lymph along.
• Also like the medium veins, lymphatic vessels have valves that prevent lymph from
flowing backward.
11. • Since lymphatic vessels are often wrapped with an artery in a common sheath, arterial
pulsation may also rhythmically squeeze the lymphatic vessels and contribute to lymph
flow.
• A thoracic (respiratory) pump aids the flow of lymph from the abdominal to the thoracic
cavity as one inhales, just as it does in venous return.
• Finally, at the point where the collecting ducts join the subclavian veins, the rapidly
flowing bloodstream draws the lymph into it.
• Considering these mechanisms of lymph flow, it should be apparent that physical exercise
significantly increases the rate of lymphatic return.
12. Lymphatic Cells and Tissues
• T lymphocytes (T cells). These are so-named because they develop for a time in the
thymus and later depend on thymic hormones. There are several subclasses of T cells.
• B lymphocytes (B cells). These are named after an organ in birds (the bursa of Fabricius)
in which they were first discovered. When activated, B cells differentiate into plasma
cells, which produce circulating antibodies, the protective gamma globulins of the body
fluids.
13. Lymphatic Organs
• Primary Lymphatic Organs :-
• Lymphatic (lymphoid) organs contain large numbers of lymphocytes, a type of white
blood cell that plays a pivotal role in immunity.
• The primary lymphatic organs are
• the red bone marrow and
• the thymus gland.
• Lymphocytes originate and/or mature in these organs.
14. Primary Lymphatic Organs
• Red Bone Marrow
• It is the site of stem cells that are ever capable of dividing and producing blood cells.
• Some of these cells become the various types of white blood cells: neutrophils,
eosinophils, basophils, lymphocytes, and monocytes.
• In a child, most of the bones have red bone marrow, but in an adult it is limited to the
sternum, vertebrae, ribs, part of the pelvic girdle, and the proximal heads of the
humerus and femur.
15. Red Bone Marrow
• Red bone marrow is the site of stem cells that are ever capable of dividing and producing
blood cells. Some of these cells become the various types of white blood cells:
• neutrophils, eosinophils, basophils, lymphocytes, and monocytes .
• In a child, most bones have red bone marrow, but in an adult it is limited to the sternum,
vertebrae, ribs, part of the pelvic girdle, and the proximal heads of the humerus and
femur.
16. Red Bone Marrow
• The red bone marrow consists of a network of reticular tissue fibers, which support the
stem cells and their progeny.
• They are packed around thin-walled sinuses filled with venous blood. Differentiated
blood cells enter the bloodstream at these sinuses.
• Lymphocytes differentiate into the B lymphocytes and the T lymphocytes.
• Bone marrow is not only the source of B lymphocytes, but also the place where B
lymphocytes mature.
• T lymphocytes mature in the thymus.
17.
18. Classification
Node Location Afferent Efferent
Superficial Lymph Nodes of the Head
Occipital (2-4) Superior nuchal line
between
sternocleidomastoid and
trapezius
Occipital part of scalp Superficial cervical
lymph nodes
Accessary lymph
Mastoid (1-3) Superficial to
sternocleidomastoid
insertion
Posterior parietal scalp
Skin of ear, posterior external
acoustic meatus
Superior deep cervical
nodes Accessary
nodes
Preauricular (2-3) Anterior to ear over
parotid fascia
Drains areas supplied by
superficial temporal artery
Anterior parietal scalp
Anterior surface of ear
Superior deep cervical
lymph nodes
19.
20. Parotid (up to 10 or more) About parotid gland and
under parotid fascia
Deep to parotid gland
External acoustic meatus
Skin of frontal and
temporal regions
Eyelids, tympanic cavity
Cheek, nose (posterior
palate)
Superior deep cervical
lymph nodes
Facial
Superficial(up to 12)
Maxillary
Buccal
Mandibular
Distributed along course
of facial artery and vein
Skin and mucous
membranes of eyelids,
nose, cheek
Submandibular nodes
Deep Distributed along course
of maxillary artery lateral
to lateral pterygoid
muscle
Temporal and
infratemporal fossa
Nasal pharynx
Superior deep cervical
lymph nodes
21. Cervical Lymph Nodes
Superficial Anterior jugular vein
between superficial
cervical fascia and
infrahyoid fascia
Skin, muscles, and viscera
of infrahyoid region of
neck
Superior deep cervical
lymph nodes
Deep Between viscera of neck
and investing layer of
deep cervical fascia
Adjoining parts of
larynx, thyroid gland
Superior deep cervical
lymph nodes
Anterior cervical/Superficial
Submental (2-3) Submental triangle Chin
Medial part of lower lip
Lower incisor teeth and
gingiva
Tip of tongue
Cheeks
Submandibular lymph
node to jugulo-omohyoid
lymph node and superior
deep cervical lymph
nodes
22.
23. Submandibula
r (3-6)
Submandibular
triangle adjacent
to
gland
Facial nodes
Chin
Lateral upper and
lips
Submental nodes
Cheeks and nose,
anterior nasal cavity
Maxillary and
mandibular teeth and
gingiva
Oral palate
Lateral parts of
2/3 of tongue
Superior deep
cervical lymph
nodes and
jugulo-omohyoid
lymph nodes
Superficial
cervical (1-2)
Along external
jugular vein
superficial to
sternocleidomast
oid muscle
Lower part of ear and
parotid region
Superior deep
cervical lymph
nodes
24.
25.
26. Deep Cervical Lymph Nodes
Superior deep
cervical
Surrounding
internal jugular
vein deep to
sternocleidomastoi
d and superior to
omohyoid muscle
Occipital nodes
Mastoid nodes
Preauricular nodes
Parotid nodes
Submandibular
nodes
Superficial cervical
nodes
Retropharyngeal
nodes
Inferior deep
cervical nodes or
separate channel
to jugulo-
subclavian
junction
Jugulodigastric Junction of internal
jugular vein and
posterior digastric
muscle
Palatine and lingual
tonsils
Posterior palate
Lateral portions of
the anterior 2/3 of
tongue
Inferior deep
cervical lymph
nodes
27.
28. Jugulo-
omohyoid
Above junction of
internal jugular
vein and
muscle
Posterior 1/3 of
tongue
Submandibular
nodes
Submental nodes
Inferior deep
cervical lymph
nodes
Inferior deep
cervical
Along internal
jugular vein below
omohyoid muscle
deep to the
sternocleidomastoi
d muscle
Transverse cervical
nodes
Anterior cervical
nodes
Superior deep
cervical nodes
Jugular trunk
Retropharynge
al (1-3)
Retropharyngeal
space
Posterior nasal
cavity
Paranasal sinuses
Hard and soft
palate
Nasopharynx,
oropharynx
Anditory tube
Superior deep
cervical nodes
29.
30. Accessory (2-6) Along accessory
nerve in posterior
triangle
Occipital nodes
Mastoid nodes
Lateral neck and
shoulder
Transverse cervical
nodes
Transverse
cervical (1-10)
Along transverse
cervical blood
vessels at level of
clavicle
Accessory nodes
Apical axillary
nodes
Lateral neck
Anterior thoracic
wall
Jugular trunk or
directly into
thoracic duct or
right lymphatic
duct or
independently
junction of
jugular vein and
subclavian vein
1. Fluid recovery Each day, they lose an excess of 2 to 4 L of water and one-quarter to one-half of the plasma protein. The lymphatic system absorbs this excess fluid and returns it to the bloodstream by way of the lymphatic vessels.
2. Immunity. As the lymphatic system recovers excess tissue fluid, it also picks up foreign cells and chemicals from the tissues. On its way back to the bloodstream, the fluid passes through lymph nodes, where immune cells stand guard against foreign matter. When they detect it, they activate a protective immune response.
3. Lipid absorption. In the small intestine, special lymphatic vessels called lacteals absorb dietary lipids that are not absorbed by the blood capillaries
A lymphatic capillary consists of a sac of thin endothelial cells that loosely overlap each other like the shingles of a roof. The cells are tethered to surrounding tissue by protein filaments that prevent the sac from collapsing. Unlike the endothelial cells of blood capillaries, lymphatic endothelial cells are not joined by tight junctions. The gaps between them are so large that bacteria and other cells can enter along with the fluid.
Lymphatic vessels form in the embryo by budding from the veins, so it is not surprising that the larger ones have a similar histology.