The mediastinum is the central compartment of the thorax located between the two lungs. It is divided into superior, anterior, middle and posterior mediastinum. The mediastinum contains the heart, great vessels, trachea, esophagus and other structures. On a chest x-ray, the subdivisions of the mediastinum are visible with the cardiac shadow marking the middle mediastinum. Conditions like mediastinitis, widening of the mediastinum and mediastinal shift can occur when the mediastinum is affected.
this is Dr.haider's lec, the one we took today , he left it on the desktop and said you can take it =D and btw for the pics he said check any anatomy book even the ones in the library
this is Dr.haider's lec, the one we took today , he left it on the desktop and said you can take it =D and btw for the pics he said check any anatomy book even the ones in the library
The thoracic structure refers to the anatomical components of the thorax, which is the region of the body between the neck and the abdomen, also known as the chest. It includes the thoracic vertebrae, ribs, sternum (breastbone), and associated muscles, ligaments, and organs such as the heart and lungs. The thoracic structure plays a crucial role in protecting vital organs, supporting the upper body, and facilitating respiration.
The thoracic structure encompasses the anatomical elements of the chest region, including the thoracic vertebrae, ribs, sternum, associated muscles, and vital organs such as the heart and lungs. It provides protection, support, and facilitates respiration, highlighting its critical role in overall bodily function and health.The thoracic structure comprises the chest's anatomical components, including vertebrae, ribs, sternum, muscles, and vital organs like the heart and lungs, crucial for protection, support, and respiration..The thoracic structure includes the chest's bones, muscles, and organs, vital for breathing and protecting the heart and lungs.
1. **Thoracic Vertebrae:** The thoracic spine consists of twelve vertebrae (T1-T12) that form the posterior aspect of the thoracic structure. These vertebrae are larger than those in the cervical or lumbar regions and articulate with the ribs, providing stability and support for the upper body.
2. **Ribs:** There are twelve pairs of ribs that attach posteriorly to the thoracic vertebrae and curve anteriorly to meet the sternum. Ribs play a vital role in protecting the internal organs of the thoracic cavity, such as the heart and lungs. The upper seven pairs are true ribs, while the lower five pairs are false ribs (some of which do not directly attach to the sternum) or floating ribs.
3. **Sternum:** The sternum is a flat bone located in the center of the anterior thoracic wall. It consists of three parts: the manubrium, body, and xiphoid process. The sternum serves as an attachment point for the ribs and provides structural support to the chest.
4. **Muscles:** Several muscles surround the thoracic cavity, contributing to breathing and movement of the chest wall. These include the intercostal muscles (external, internal, and innermost), which are located between the ribs and aid in respiration, as well as muscles such as the diaphragm, which separates the thoracic and abdominal cavities and plays a primary role in breathing.
5. **Organs:** The thoracic cavity houses important organs such as the heart and lungs. The heart is situated in the mediastinum, a central compartment of the thoracic cavity, while the lungs occupy the lateral portions. The thoracic structure provides protection and support for these vital organs while allowing for their necessary movements during respiration and circulation.
Understanding the anatomy and function of the thoracic structure is essential for various medical disciplines, including anatomy, physiology, orthopedics, cardiology, and res
Join live classes, download study aids, sell your documents, join or host your own classes online, get tutoring, tutor students, take practices tests and more at Examville.com
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.
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.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
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
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
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
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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.
2. The Mediastinum
• The Mediastinum is a compartment located
between two pleural sacs.
• It is a thick, broad, midline, bulky partition
between two lungs.
• It goes from the sternum anteriorly to
the thoracic vertebrae posteriorly.
• Also it goes from the superior thoracic
aperture to the inferior thoracic aperture.
3.
4. Mediastinum
Anatomically, the mediastinum is divided into two parts by an
imaginary line that runs from the sternal angle anteriorly,
intervertebral disc between T4 and T5 vertebrae posteriorly.
• Superior mediastinum – extends upwards, terminating at the
superior thoracic aperture.
• Inferior mediastinum – extends downwards, terminating at
the diaphragm.
• It is further subdivided into
– Anterior mediastinum.
– Middle mediastinum.
– Posterior mediastinum.
It contains most of the thoracic organs, and acts as a conduit for
structures traversing the thorax on their way into the abdomen.
5. BOUNDARIES OF MEDIASTINUM
• Anterior:
– Sternum.
• Posterior:
– Vertebral column (bodies of thoracic vertebrae and
intervening intervertebral discs).
• Superior:
– Superior thoracic aperture.
• Inferior:
– Diaphragm.
• On every side:
– Mediastinal pleura.
8. DIVISIONS
• The mediastinum is divided into 2 parts:
• 1. Superior mediastinum
• Lies above “transverse thoracic plane” that runs from
the sternal angle anteriorly, fourth thoracic
vertebra/intervertebral disc between T4 and T5
vertebrae posteriorly.
• 2. The inferior mediastinum is further subdivided into
3 parts by the pericardium (enclosing heart).
– The part in front of the pericardium is referred to as anterior
mediastinum.
– The part supporting the pericardium is referred to as
posterior mediastinum.
– The pericardium and its contents (heart and roots of its great
vessels) constitute the middle mediastinum.
9.
10. CONTENTS
• The major contents of mediastinum are:
– Thymus.
– Heart enclosed in the pericardial sac.
– Major arteries and veins like thoracic aorta, pulmonary
trunk, etc.
– Trachea.
– Esophagus.
– Thoracic duct.
– Neural structures, like sympathetic trunks, vagus
nerves, phrenic nerve, etc.
– Lymph nodes.
11.
12. Superior Mediastinum
• Borders
• The superior mediastinum is bordered by the
following thoracic structures:
– Superior: – Thoracic inlet.
– Inferior :– Continuous with the inferior mediastinum at
the level of the sternal angle.
– Anterior :– Manubrium of the sternum.
– Posterior :– Vertebral bodies of T1-4.
– Lateral :– Pleurae of the lungs.
16. Contents(detail)
• Great Vessels
– Arch of Aorta with three major branches are within the
superior mediastinum:
• Brachiocephalic artery – supplying the right side of the head & neck
and the right upper limb.
• Left Common carotid artery – to the left side of the head & neck.
• Left Subclavian artery – to the left upper limb.
– Superior Vena Cava with its tributaries are located within
the superior mediastinum:
• Brachiocephalic veins – draining blood from the upper body.
– Left superior intercostal vein – collects blood from the left 2nd and 3rd intercostal
vein. It drains into the left brachiocephalic vein.
– Supreme intercostal vein – drains the vein from first intercostal space directly into
the brachiocephalic veins.
• Azygos vein – receiving blood from the right posterior intercostal veins.
The left intercostal veins drain first into the hemiazygos and accessory
hemiazygos veins before joining the azygos vein around T7-T9.
• Nerves:
cont
17. Nerves
• Right vagus nerve – runs parallel to the trachea and passes
posteriorly to the superior vena cava and the right primary
bronchus.
• Left vagus nerve – enters the superior mediastinum between
the left common carotid and the left subclavian arteries.
• The left recurrent laryngeal nerve arises from the left
vagus nerve as it passes the aortic arch.
• Phrenic Nerve From the anterior surface of the anterior
scalene muscle, the phrenic nerves (roots C3, C4 and C5) enter
the superior mediastinum lateral to the great vessels.
• Other Nerves
– Cardiac nerves – originate from the superior, middle and inferior
cardiac ganglion and form the superficial and deep cardiac
plexuses in the superior mediastinum.
• Sympathetic trunk – runs bilaterally to the vertebral bodies
along the entire length of the vertebral column.
18. Other Structures in the Superior Mediastinum
• Thymus :The thymus gland is the most anterior structure within the
superior mediastinum. It sits flush against the posterior surface of the
sternum and extends into the anterior mediastinum and can often
reach into the neck.
• Trachea: The trachea bifurcates into the primary bronchi posterior to
the ascending aorta at the level of the sternal angle.
• Esophagus :The esophagus ascends towards the pharynx, which it joins
at the level of C6.
• Thoracic duct :the superior mediastinum, the thoracic duct passes to
the left of the esophagus on its path to the junction of the left internal
jugular and subclavian veins.
• Muscles: The sternohyoid and sternothyroid muscles originate from the
posterior surface of the manubrium. They are part of the infrahyoid
muscle group of the neck.
• The inferior aspect of the longus colli muscle also originates within the
superior mediastinum
19.
20.
21.
22.
23. The anterior mediastinum
Borders
• Lateral borders:
– Mediastinal pleura (part of the parietal pleural membrane).
• Anterior border:
– Body of the sternum and the transversus thoracis muscles.
• Posterior border:
– Pericardium.
• Roof:
– Continuous with the superior mediastinum at the level of the
sternal angle.
• Floor:
– Diaphragm.
24. • The anterior mediastinum contains no major
structures. It accommodates loose connective tissue
(including the sternopericardial ligaments), fat, some
lymphatic vessels, lymph nodes and branches of the
internal thoracic vessels.
• In infants and children, the thymus extends inferiorly
into the anterior mediastinum.
– However the thymus recedes during puberty and is mostly
replaced by adipose tissue in the adult
Contents
25.
26. The middle mediastinum
Borders
• Anterior:
– Anterior margin of the pericardium.
• Posterior:
– Posterior border of the pericardium.
• Laterally:
– pleura of the lungs.
• Superiorly:
– Line extending between the sternal angle (the angle formed
by the junction of the sternal body and manubrium) and the
T4 vertebrae.
• Inferiorly:
– Superior surface of the diaphragm.
27.
28.
29. Contents
The middle mediastinum contains:
• Organs:
– The heart,
– The pericardium.
– The tracheal bifurcation and the left and right main bronchi.
• Vessels: The middle mediastinum is associated with the
origins of the great vessels that run to and from the heart:
– Ascending aorta – the first part of the aorta. It moves upwards,
exiting the fibrous pericardium and entering the superior
mediastinum
– Pulmonary trunk – gives rise to the left and right pulmonary
arteries.
– Superior vena cava – returns deoxygenated blood from the
upper half of the body.
• It is formed by the right and left brachiocephalic veins.
30. Nerves
• The cardiac plexus and the phrenic nerves are both located
within the middle mediastinum.
• Cardiac plexus – a network of nerves located at the base of
the heart, containing sympathetic and parasympathetic
fibres. The sympathetic nerves are derived from the T1-T4
segments of the spinal cord, and the parasympathetic
innervation is supplied by the vagus nerve. The plexus can
be subdivided into superficial and deep components.
• Phrenic nerves (left and right) – mixed nerves
that provides motor innervation to the diaphragm. They
arise in the neck, and descend through the middle
mediastinum to reach the diaphragm.
31. Lymphatics
• The tracheobronchial lymph nodes are located
within the middle mediastinum.
• They are a group of nodes associated with the
trachea and bronchi of the respiratory tract.
• They form from the gathering of bronchial nodes
within the hila of the lungs.
• Individual groups of nodes are connected via fine
lymphatic channels.
36. Thoracic Aorta
• The thoracic (descending) aorta is a continuation of the arch of the
aorta. It descends through the posterior mediastinum to the left of
the vertebrae. At the inferior border of T12, the thoracic aorta
becomes the abdominal aorta, and passes through the aortic
hiatus of the diaphragm.
• A number of branches arise from the thoracic aorta in the posterior
mediastinum.
– Unpaired branches to viscera extend anteriorly,
– Paired branches to viscera extend laterally, and
– Paired segmental parietal branches extend mostly posterolaterally.
• The major branches are:
– Posterior intercostal arteries
– Bronchial arteries
– Esophageal arteries
– Superior phrenic arteries
37. Thoracic Duct
• The thoracic duct is the largest lymphatic vessel in the
body, allowing return of lymph from most of the body
(all but the right superior quadrant) into the venous
system.
• The duct originates from the cisterna chyli in the
abdomen, and enters the mediastinum through
the aortic hiatus.
• It ascends to lie directly anterior to the T6-T12
vertebrae, before deviating left as it ascends into the
superior mediastinum.
• While located in the posterior mediastinum, the
thoracic duct receives lymphatic drainage from the
intercostal spaces.
38. Azygos System of Veins
• This venous network drains blood from the body walls
and mediastinal viscera, and empties into the superior
vena cava. It consists of three major veins:
• Azygos vein – Formed by the union of the right lumbar
vein and the right subcostal vein. It enters the
mediastinum via the aortic hiatus and drains into the
superior vena cava.
• Hemiazygos vein – Formed by the union of the left
lumbar vein and left subcostal vein. It enters the
mediastinum through the left crus of the diaphragm,
ascending on the left side.
• Accessory hemiazygos vein – Formed by the union of
the fourth to eighth intercostal veins. It drains into the
azygos vein at T7.
39. Esophagus
• It passes into the posterior mediastinum from the
superior mediastinum, descending posteriorly to
the arch of the aorta and the heart.
• Whilst initially positioned to the right, the oesophagus
deviates to the left as it moves downwards.
• It leaves the mediastinum via the esophageal hiatus of
the diaphragm.
• The esophageal plexus is a network of nerves
surrounding the oesophagus as it descends, comprising
of branches from the left and right vagus nerves.
– The fibres of the plexus converge to form the anterior vagal
trunk and posterior vagal trunk, which travel along the
surface of the oesophagus as it exits the thorax
40. Sympathetic Trunks
• The sympathetic trunks are paired bundles of
nerves that extend from the base of the skull to the
coccyx.
• In the thoracic region, these nerve bundles are
known as the thoracic sympathetic trunks. As they
descend through the thorax, they lie within the
posterior mediastinum.
• Arising from these trunks are the lower
thoracic splanchnic nerves – they continue
inferiorly to supply the viscera of the abdomen.
41. VISUALIZATION OF SUBDIVISIONS OF MEDIASTINUM
IN CHEST RADIOGRAPH
• The subdivisions of mediastinum are well-appreciated
in lateral view of X-ray chest. The shadow above the
sternal plane represents superior mediastinum.
• The subdivisions of inferior mediastinum are
demarcated as under:
• 1. Cardiac shadow above the anterior part of
diaphragm represents the middle mediastinum.
• 2. Retrosternal space/space in the front of cardiac
shadow represents the anterior mediastinum.
• 3. Retrocardiac space/space between the cardiac
shadow and shadow of vertebral column represents
the posterior mediastinum.
42. X-Ray chest PA(A) include SVC (1), ascending aorta (2), RA (3), IVC (4), aortic arch (5), pulmonary
trunk (6), LA appendage (7), and LV (8).
Lateral film (B) include: superior (S), anterior (A), middle (M) and posterior (P) compartments.
43. MEDIASTINITIS
• It is the inflammation of the loose connective
tissue of the mediastinum.
• The fascial spaces of the neck (example:
pretracheal and retropharyngeal spaces)
extend below into the mediastinum inside the
thoracic cavity.
• Deep infections of the neck may readily
spread into the thoracic cavity causing
mediastinitis.
44. SUBCUTANEOUS EMPHYSEMA IN THE ROOT OF NECK
• The structures that make up mediastinum are
embedded in the loose connective tissue that is
continuous with the loose connective tissue of
the root of the neck.
• For that reason, in esophageal perforations caused
by penetrating wounds, air escapes into the
connective tissue spaces of mediastinum and could
ascend below the fascia to the root of the neck
producing subcutaneous emphysema.
45. MEDIASTINAL SYNDROME
• The compression of mediastinal structures by any growth like
tumor or cyst gives rise to a group of signs and symptoms.
syndrome.
• The common causes of mediastinal syndrome are
bronchiogenic carcinoma, aneurysm of aorta, enlargement of
mediastinal lymph nodes in Hodgkin disease.
• The clinical features of mediastinal syndrome are:
– Engorgement of veins in the upper half of the body: because of
obstruction of SVC,
– Dyspnea (difficulty in breathing): because of compression of
trachea,
– Dysphagia (difficulty in swallowing): because of compression of
esophagus,
– Dyspnea (hoarseness of voice): because of compression of left
recurrent laryngeal nerve, and
– Erosion of bodies of thoracic vertebrae: because of pressure on
the vertebral column
46. WIDENING OF THE MEDIASTINUM
• The widening of mediastinum is frequently
observed in chest radiographs. It can happen
because of a number of reasons, like
• (a) hemorrhage into the mediastinum from
lacerated great vessels (aorta, SVC) following
trauma, example: head on collision,
• (b) Massive enlargement of mediastinal lymph
nodes because of cancer of lymphoid tissue, viz.
malignant lymphoma,
• ( c) Enlargement (hypertrophy) of heart because of
congestive heart failure (CHF).
47. MEDIASTINAL SHIFT
• The mediastinal shift is common in lung and pleural
pathology.
• The mediastinum shifts to the affected (diseased) side
because of appreciable reduction in lung volume and
decrease in intrapleural pressure- as in collapse of lung
and atelectasis.
• The mediastinum shifts to the healthy side when the
intrapleural pressure is appreciably high on the
affected side – as in pneumothorax and hydrothorax.
– Mediastinal shift indicates lung pathology. The mediastinal
shift can be discovered by palpating the trachea in
the suprasternal notch.
48. EXTENSION OF PUS INTO THE POSTERIOR
MEDIASTINUM FROM NECK
• The posterior mediastinum is continuous
via superior mediastinum with spaces in
the neck between pretracheal and
prevertebral layers of deep cervical
fascia like retropharyngeal space, etc.
• For That Reason, pus from neck can
extend into the posterior mediastinum.