The male urethra is divided into three parts - prostatic, membranous, and spongy or penile. The prostatic urethra is lined with transitional epithelium and contains the urethral crest and openings of the ejaculatory ducts. The membranous urethra passes through the urogenital diaphragm and is surrounded by the sphincter urethrae muscle. The penile urethra passes through the penis and is lined by pseudostratified columnar epithelium except for the fossa navicularis which has stratified squamous epithelium. Common conditions of the male urethra include urethritis, strictures,
Anatomy of urinary bladder. surfaces, border of urinary bladder its relation , ligament support, peritoneal relation in male and females, pouches, blood supply of bladder, nerve supply of bladder, true and false ligament of urinary bladder,
Anatomy of urinary bladder. surfaces, border of urinary bladder its relation , ligament support, peritoneal relation in male and females, pouches, blood supply of bladder, nerve supply of bladder, true and false ligament of urinary bladder,
location, length, and relation of right an left ureter, raletion of male an female ureter, n physiological site of ureteric constriction, bloo supply an inerve supply of ureter, clinical sinificance of ureter with hysteriectpomy
This is an oblique intermuscular passage in the lower part of the anterior abdominal wall ,
Situated just above the medial half of the inguinal ligament
anatomy of stomach,functions of stomach, location, shape position and parts of stomach,orifices of stomach, curvature of stomach, relations of stomach, blood supply, innervation, lymphatic drainage, clinical relation , GERD, peptic ulcer,
location, length, and relation of right an left ureter, raletion of male an female ureter, n physiological site of ureteric constriction, bloo supply an inerve supply of ureter, clinical sinificance of ureter with hysteriectpomy
This is an oblique intermuscular passage in the lower part of the anterior abdominal wall ,
Situated just above the medial half of the inguinal ligament
anatomy of stomach,functions of stomach, location, shape position and parts of stomach,orifices of stomach, curvature of stomach, relations of stomach, blood supply, innervation, lymphatic drainage, clinical relation , GERD, peptic ulcer,
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Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
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
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.
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
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.
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.
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.
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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.
3. MALE URETHRA IS A
FIBROMUSCULAR CANAL
EXTENDING FROM BLADDER NECK
TO EXTERNAL URINARY MEATUS
ITS LENGTH IS APPROXIMATELY
20 CM
4.
5. IT IS BROADLY DIVIDED INTO THREE PARTS
PROSTATIC
MEMBRANOUS
SPONGY OR PENILE
PROSTATIC AND MEMBRANOUS TOGETHER FORM
POSTERIOR URETHRA
SPONGY PORTION FORMS ANTERIOR URETHRA
6.
7. pars prostatica
3 CM IS LENGTH
LINED BY TRANSITIONAL
EPITHELIUM
IT IS THE WIDEST AND MOST
DILATABLE PART OF MALE
URETHRA
8. COURSE:BEGINS AT THE NECK OF THE
BLADDER ,RUNS DOWNWARDS AND
SLIGHTLY FORWARDS TO END AT THE
POSTERIOR LAYER OF TRIANGULAR
LIGAMENT(UROGENITAL DIAPHRAGM)
9.
10. Upon the posterior wall or floor is a
narrow longitudinal ridge, the urethral
crest (verumontanum), formed by an
elevation of the mucous membrane and
its subjacent tissue.it is 15- 17 mm
in length&3mm in height
11. On either side of the crest is a slightly
depressed fossa, the prostatic sinus, the
floor of which is perforated by numerous
apertures, the orifices of the prostatic
ducts from the lateral lobes of the
prostate; the ducts of the middle lobe open
behind the crest.
12. At the forepart of the urethral
crest, below its summit, is a median
elevation, the colliculus seminalis,
upon or within the margins of which
are the orifices of the prostatic
utricle and the slit-like openings of
the ejaculatory ducts.
13. The prostatic utricle (sinus pocularis )
is also called as the uterus masculinus,
as it is developed from the united lower
ends of the atrophied Müllerian ducts,
and therefore homologous with the
uterus and vagina in the female
14.
15. (pars membranacea)
1.5 – 2 CM IN LENGTH
LINED BY PSEUDO STRATIFIED
COLUMNAR EPITHELIUM
IS THE SHORTEST, LEAST DILATABLE,
AND, WITH THE EXCEPTION OF THE
EXTERNAL ORIFICE, THE NARROWEST
PART OF THE CANAL
16. COURSE:It extends downward and
forward, with a slight anterior
concavity, between the apex of the
prostate and the bulb of the urethra,
perforating the urogenital diaphragm
about 2.5 cm. below and behind the
pubic symphysis.
17. the membranous urethra is completely
surrounded by the fibers of the
Sphincter urethrae. In front of it the
deep dorsal vein of the penis enters the
pelvis between the transverse ligament
of the pelvis and the arcuate pubic
ligament
The glands of cowper ( bulbo urethral
glands) lie on either side of its posterior
surface
18. PARS CAVERNOSA; PENILE
URETHRA
15 CM IN LENGTH
LINED BY PSEUDO STRATIFIED
COLUMNAR EPITHELIUM EXCEPT
FOR TERMINAL 12MM , THE FOSSA
NAVICULARIS , WHICH IS LINED
BY STRATIFIED SQUAMOUS
EPITHELIUM
19. COURSE:extends from the termination of
the membranous portion to the external
urethral orifice. Commencing below the
inferior fascia of the urogenital diaphragm it
passes forward and upward to the front of
the symphysis pubis; and then, in the flaccid
condition of the penis, it bends downward
and forward.
20. it is dilated behind, within the bulb,
and again anteriorly within the glans
penis, where it forms the fossa
navicularis urethræ.
The external urethral orifice
(orificium urethræ externum; meatus
urinarius) is the most contracted part
of the urethra; it is a vertical slit,
about 6 mm. long.
21. The lining membrane of the urethra,
especially on the floor of the
cavernous portion, presents the
orifices of numerous mucous glands
and follicles situated in the submucous
tissue, and named the urethral glands
(Littré). Besides these there are a
number of small pit-like recesses, or
lacunæ, of varying sizes.
22. One of these lacunæ, larger than the
rest, is situated on the upper surface
of the fossa navicularis; it is called
the lacuna magna or sinus of guerin
The bulbo-urethral glands open into
the cavernous portion about 2.5 cm.
in front of the inferior fascia of the
urogenital diaphragm.
23.
24. INTERNAL URETHRAL SPCHINTER:
Also known as sphincter vesicae
Involuntary in nature
Supplied by sympathetic nerves from
lower thoracic and upper lumbar
segments
It controls the neck of bladder and
prostatic urethra above openings of
ejaculatory ducts
25. EXTERNAL URETHRAL SPHINCTER:
Also known as SPHINCTER URETHRAE
Voluntary in nature
Supplied by perineal branch of pudendal
nerve(S2 S3 S4)
It controls membranous urethra and is
responsible for the voluntary holding of urine
26.
27. The prostatic urethra is supplied by the
inferior vesical artery.
The bulbourethral artery supplies the
membranous and bulbar urethra
penile urethra is supplied by the deep
penile artery, a branch of the internal
pudendal artery.
In general, venous drainage mirrors the
arterial supply
28. Lymphatics from prostatic and membranous
parts pass mostly to the internal iliac nodes
and partly to the external iliac nodes
Lymphatics from spongy part pass mostly to
deep inguinal nodes but some may end in
superficial inguinal and external iliac
29. Wall of urethra composed of mucous ,
submucous and muscular layers
Mucuous membrane consists of lining
epithelium that rests on connective
tissue
Mucosa shows invaginations into which
mucus glands open
30. The sub mucosa consists of loose connective
tissue.
the muscle coat consists of inner
longitudinal and outer circular layer of
smooth muscle.it is well defined only in
prostatic and membranous urethra,the
penile part is surrounded by ocassional
fibres only
31. The part of urethra extending from
urinary bladder upto the openings of
ejaculatory ducts, is derived from
caudal part of vesico urethral
canal(endoderm).the posterior wall of
this part is derived from the absorbed
mesonephric ducts(mesoderm)
32. The rest of prostatic urethra and the
membranous urethra,are derived from the
pelvic part of definitive urogenital sinus
The penile part of urethra except the
terminal part is derived from the epithelium
of the phallic part of the definitive
urogenital sinus
The terminal part that lies in the glans is
derived from ectoderm
33. RUPTURE OF URETHRA:the urethra
is commonly ruptured beneath the
pubis by a fall astride a sharp
object.this causes extravasation of
urine
HYPOSPADIAS:common anamoly in
which urethra opens on the
undersurface of penis
34. EPISPADIAS: rare condition in which
urethra opens on the dorsum of
penis.this condition is associated with
ectopia vesicae
35. URETHRITIS:inflammation of urethra
Presents with
Discharge
Discomfort during micturition and burning
micturition
Confirmatory test is finding of increased
number of polymorphonuclear leucocytes in
the urethral smear or in sediment of first
vioded urine
38. STICTURE OF URETHRA: urethral stricture
is a narrowing of the urethra caused by
injury or disease such as
urinary tract infections
can occur as complication of gonococcal and
non gonococcal urethritis
39. soft strictures occur following non
gonococcal urethritis
hard strictures occur following
gonococcal
other causes:
Trauma is more common cause,it can
be physical(eg catheterization ,
urethroscopy)
Chemical (burns from podophyllin ,tca
or diathermy