The document discusses the anatomy and branches of the maxillary nerve (V2). It begins by outlining the areas innervated and ganglia associated with the nerve. It then describes the individual branches originating from the maxillary nerve in detail, including their course, distribution and innervation. These branches include the middle meningeal nerve, zygomatic nerve, pterygopalatine branches, posterior superior alveolar nerves, and others. It concludes by noting the sphenopalatine ganglion is associated with the maxillary nerve and discusses some clinical implications like trigeminal neuralgias and facial pain.
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
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
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
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
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.
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.
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
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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
3. Second
division- intermediate, in position / size,
between ophthalmic and mandibular.
Originates
from middle of the semilunar ganglion.
leaves the skull -foramen rotundum.
crosses the pterygopalatine fossa ,
enters the orbit through the inferior orbital fissure .
traverses
the infraorbital groove and canal in the floor
of the orbit, and appears upon the face at the infraorbital
foramen.
At
its termination-divides into branches-nose, the
lower eyelid, and the upper lip, joining with
filaments of the facial nerve.
4. Sensory innervation –
Lower eyelid and cheek
Nose
Upper lip
Maxillary teeth,
Nasal mucosa,
Hard palate
Pharynx, tonsil.
Maxillary, ethmoid and
sphenoid sinuses,
meninges.
5. In the cranium
From the
pterygopalatine fossa
•Middle
meningeal.
•
Orbital
(Infraorbital canal )
A)Zygomatic
---zygomaticotemporal
----zygomaticofacial
In the infra
orbital canal
•
Anterior
superior
alveolar .
On the face
•
Inferior
palpebral
•
Superior
labial
•
External
nasal
Inferior orbital fissure
b)Pterygopalatine
branches
•
Nasal (Nasopalatine)
•
Palatine Nerves
(Greater palatine ,
Lesser palatine )
•
Pharyngeal
c) Superior alveolar
nerves (PSA MSA)
6. A. Zygoticaticotemporal
B. Zygomatico facial
C. Post. S. Alveolar
D. Naso palatine
E. Greater Palatine
F. Lesser Palatine
G. Mid & Ant. Alveolar
H. Infraorbital
7. The Middle Meningeal
(Dural branch) -given off at origin from the
semilunar ganglion
supplies the dura mater.
8.
The Zygomatic Nerve - in the pterygopalatine fossa,
enters the orbit by the inferior orbital fissure, divides
into two branches
Zygomatico temporal
Zygomatico facial.
The Zygomatico temporal branch –
Runs in a groove in the zygomatic bone then passing
through a foramen in the zygomatic bone, enters the
temporal fossa.
It ascends between the bone, and Temporalis muscle,
distributed to the skin of the side of the forehead, and
communicates with the facial nerve and with the
aurićulo temporal branch of the mandibular nerve.
.
9.
The Zygomatico facial branchPasses along the orbit, emerges upon the face
through a foramen in the zygomatic bone, and,
perforates the Orbicularis oculi, supplies the
skin on the prominence of the cheek. It joins
with the facial nerve and with the inferior
palpebral branches of the maxillary.
10.
11.
12. Nasal branches –
Enter the posterior part of the nasal cavity by the spheno
palatine foramen
supply the mucous membrane covering the superior and
middle nasal conchæ, posterior ethmoidal cells,
and the posterior part of the septum.
Nasopalatine nerve. It enters the nasal cavity through the
sphenopalatine foramen,
passes across the roof of the nasal cavity below the orifice
of the sphenoid sinus to reach the septum, and then runs
obliquely downward and forward between the periosteum
and mucous membrane of the lower part of the septum. It
descends to the roof of the mouth through the incisive
canal and communicates with the corresponding nerve of
the opposite side and with the anterior palatine nerve. It
furnishes a few filaments to the mucous membrane of the
nasal septum
13. They are three in number: anterior, middle, and
posterior.
anterior
palatine nerve - emerges upon the hard
palate through the greater palatine foramen, and
passes forward in a groove in the hard palate, nearly
as far as the incisor teeth.
It supplies the gums, the mucous membrane and
glands of the hard palate, and communicates in front
with the terminal filaments of the nasopalatine
nerve.
14.
The middle palatine nerve - emerges through one of the minor
palatine canals and distributes branches to the uvula, tonsil,
and soft palate. I
The posterior palatine nerve -it supplies the soft palate, tonsil,
and uvula. The middle and posterior palatine join with the
tonsillar branches of the glossopharyngeal to form a plexus
(circulus tonsillaris) around the tonsil.
17. arise from the trunk of the nerve just before it
enters the infraorbital groove.
descend on the tuberosity of the maxilla and give
off several twigs to the gums and neighboring
parts of the mucous membrane of the cheek.
enter the posterior alveolar canals on the infra
temporal surface of the maxilla, and, passing
from behind forward in the substance of the bone.
communicate with the middle superior alveolar
nerve, and give off branches to the lining
membrane of the maxillary sinus and three twigs
to each molar tooth; these twigs enter the
foramina at the apices of the roots of the teeth.
18.
The Middle Superior Alveolar Branch ,
is given off from the nerve in the posterior part of
the infraorbital canal, and runs downward and
forward in a canal in the lateral wall of the
maxillary sinus to supply the two premolar teeth.
It forms a superior dental plexus with the anterior
and posterior superior alveolar branches.
19.
Given off from the nerve just before its exit from the
infraorbital foramen; it descends in a canal in the
anterior wall of the maxillary sinus, and divides into
branches which supply the incisor and canine teeth. It
communicates with the middle superior alveolar
branch, and gives off a nasal branch, which passes
through a minute canal in the lateral wall of the inferior
meatus, and supplies the mucous membrane of the
anterior part of the inferior meatus and the floor of the
nasal cavity, communicating with the nasal branches
from the sphenopalatine ganglion.
20. Inferior Palpebral Branches –
supply the skin and conjunctiva of the lower eyelid.
External Nasal Branches –
supply the skin of the side of the nose and of the septum.
Superior Labial Branches –
The largest and most numerous,
Distributed to the skin of the upper lip,
The mucous membrane of the mouth, and labial glands.
They are joined, immediately beneath the orbit, by filaments
from the facial nerve, forming with them the infraorbital
plexus.
21. Sphenopalatine Ganglion (ganglion of Meckel) —
The Sphenopalatine ganglion, the largest of the
sympathetic ganglia associated with the branches of
the trigeminal nerve, is deeply placed in the
pterygopalatine fossa, close to the Sphenopalatine
foramen.
It is triangular or heart-shaped, of a reddish-gray color,
and is situated just below the maxillary nerve as it
crosses the fossa.
It receives a sensory, a motor, and a sympathetic root.