This document discusses the normal anatomy and common congenital anomalies of the superior and inferior vena cavae. It begins with an overview of the embryological development of the vena cavae. It then describes the normal anatomy of the superior and inferior vena cavae and their major tributaries. Common congenital anomalies are then outlined, including double superior vena cavae, left-sided superior vena cava, left inferior vena cava, double inferior vena cava, azygos continuation of the inferior vena cava, and circumcaval anomalies of the left renal vein and ureter. Clinical significance is discussed for some anomalies.
The arterial supply to the upper limb is delivered via five main vessels (proximal to distal):
Subclavian artery
Axillary artery
Brachial artery
Radial artery
Ulnar artery
In this article, we shall look at the anatomy of the arteries of the upper limb – their anatomical course, branches and clinical correlations.
The arterial supply to the upper limb is delivered via five main vessels (proximal to distal):
Subclavian artery
Axillary artery
Brachial artery
Radial artery
Ulnar artery
In this article, we shall look at the anatomy of the arteries of the upper limb – their anatomical course, branches and clinical correlations.
In this presentation the development of Small intestine and Pancreas has been discussed. The viewer would be able to understand the concept of physiological herniation and rotation of the Primary intestinal loop with in the connecting stalk.
venous drainage of the upper limb, median vein of forearm, deep veins, basilic vein, cephalic vein, median cubital vein, superficial vein, dorsal venous arch,
Anatomy of Blood vessels of abdomen pelvic cavities. Portacaval & Cavacaval A...Eneutron
1. The abdominal aorta
a. the parietal branches
b. the visceral branches
2. The common iliac arteries and veins
3. The external iliac artery and veins
4. The internal iliac artery and veins
5. The inferior vena cava
6. The portal vein
7. The cavacacal Anastomoses
8. The portacaval Anastomoses
9. The Fetal Circulation
In this presentation the development of Small intestine and Pancreas has been discussed. The viewer would be able to understand the concept of physiological herniation and rotation of the Primary intestinal loop with in the connecting stalk.
venous drainage of the upper limb, median vein of forearm, deep veins, basilic vein, cephalic vein, median cubital vein, superficial vein, dorsal venous arch,
Anatomy of Blood vessels of abdomen pelvic cavities. Portacaval & Cavacaval A...Eneutron
1. The abdominal aorta
a. the parietal branches
b. the visceral branches
2. The common iliac arteries and veins
3. The external iliac artery and veins
4. The internal iliac artery and veins
5. The inferior vena cava
6. The portal vein
7. The cavacacal Anastomoses
8. The portacaval Anastomoses
9. The Fetal Circulation
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
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
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
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
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.
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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
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
How to Give Better Lectures: Some Tips for Doctors
Normal anatomy and congenital anomalies of vena cavae
1. Normal anatomy and Congenital
anomalies of Vena cavae
Dr. Gobardhan Thapa
Resident, MD Radiodiagnosis
NAMS, Bir hospital,
Kathmandu, Nepal
2. Presentation outline
• Embryology of the vena cavae
• Anatomy of the vena cavae
– Superior vena cava
– Inferior vena cava
• Congenital anomalies of the vena cavae
3. Vena cavae
• Vena cava
– largest veins that return deoxygenated blood into
the heart
• Two vena cavae
– superior vena cava
– Inferior vena cava
5. Embryology of the vena cava
• Veins of the body develop
from three primitive veins
1. Viteline vein-drain from
yolk sac
2. Umblical vein- drain from
the placenta
3. Common cardinal vein-
return poorly oxygenated
blood from the body of
the embryo
6. Development of the superior vena
cava
• First part: right anterior
cardinal vein caudal to
oblique transverse
anastomosis
• Second part: right
common cardinal vein
(right duct of Cuvier)
7. • Initially,
– Vitelline veins: drain the
viscera to the Yolk sac
– Posterior cardinal veins:
drain the body wall
caudal to the heart
• 6-8 weeks:
development of the
infrahepatic IVC
segments from 3 pairs
of primitive veins
• Infrahepatic IVC
– Posterior cardinal veins
– Subcardinal veins
– Supracardinal veins
Development of inferior vena cava
8. Development of inferior vena cava
Normal IVC from 4 segments:
• Hepatic: from the vitelline
vein
• Suprarenal: from the right
subcardinal vein (via
subcardinal-hepatic
anastomosis)
• Renal: right supracardinal
and subcardinal
anastomosis
• Infrarenal: right
supracardinal vein
9. •Azygos and hemiazygos veins develop from the
cranial aspect of the supracardinal veins
• In abdomen, posterior cardinal veins are replaced by
Subcardinal and supracardinal veins
• In pelvis, the posterior cardinal veins persist as
common iliac veins
11. Superior vena cava (SVC)
• formed by the junction of
– the short, vertically oriented right and
– the longer obliquely oriented left brachiocephalic
veins
at the level of T-1
• The third tributary to the SVC is the azygos vein, which
enters the dorsal aspect of the SVC at its midpoint
• SVC contains no valves
• Length: approx 7 cm
• usually less than 2 cm in diameter
12. Superior vena cava: Gross anatomy
Beginning: at the level of first right
costal cartilage
Course: Descend vertically behind the
2nd and 3rd ICS
End: Ends into right atrium at the level
of right 3rd costal cartilage
Lower half is covered by the parietal
pericardium and its wall is partially
composed of visceral pericardium
Tributaries:
• Azygos vein
• Small veins draining pericardium and
other mediastinal structures
13. Relations
• Ventrally: mediastinal fat,
pleura, thymus, and the
adjacent right lung
• Posteriorly: innominate
artery, trachea, right main
bronchus, right main
pulmonary artery, right
superior pulmonary vein
and vagus nerve
• Large number of adjacent
lymph nodes, mostly in its
dorsal aspect
14. Inferior vena cava (IVC)
• formed by the junction of
– right and left common iliac
veins
– at L-5
• ascends on the right of the
abdominal aorta and anterior to
the spine to enter the right
atrium (RA) at about T-8
• The main tributaries of the IVC
are the hepatic (T-10), renal (L-2),
right adrenal and gonadal and
lumbar veins
15. Inferior vena cava: course
Abdominal:
-Retroperitoneal
-run along the side of vertebral
column
-Various other veins drain into
IVC along its course
16. Thoracic
-Pierce the diaphragm at
T-8 level
-Short thoracic course
before draining into right
atrium
• Normal diameter:1.5-
2.5cm
18. Relation of the abdominal part of the
inferior venecava
Anteriorly:
• first part of duodenum
• common bile duct
• portal vein
• head of pancreas
• right gonadal artery
• root of mesentery
• Right common iliac artery
19. Posteriorly:
• The lower three lumbar
vertebral bodies
• Their intervertebral disc
• Right psoas major
• Sympathetic trunk
• Right crus of the
diaphragm
• The medial part of the
suprarenal gland
• Right coeliac ganglion
20. Right:
• The right ureter
• The second part of the
duodenum
• Medial border of right
kidney
• The right lobe of the liver
Left:
• Aorta
• The right crus of the
diaphragm
• The caudate lobe of the
liver
21. Congenital anomalies
Superior vena cava
1) Double SVC
2) Left sided SVC
3) others
Inferior vena cava
1) Left IVC
2) Double IVC
3) Azygos continuation of
the IVC
4) Circumaortic left renal
vein
5) Retroaortic left renal
vein
6) Circumcaval ureter
7) others
23. Double or Bilateral SVC
• Commonest systemic venous
anomaly (present in about 10% of
patients with congenital heart
disease)
• Results from failure of the
embryonic left anterior cardinal
vein to regress
• only about half of these are large
enough – of hemodynamic
significance
24. Double SVC
• Drainage is variable and can be to:
– coronary sinus
– right atrium: via oblique vein of Marshall
– left atrium
• Anastomosis may be present in
between the two cavas
25. Double SVC
Fig. schematic diagrams of double SVC
(SVC – superior vena cava, CS – coronary sinus, RA- right atrium, LA – left atrium)
26. Radiological identification
• Can not be diagnosed
easily in plain chest
radiographs
• Generally recognized in
echocardiograms
• Condition signalled by an
unusually large coronary
sinus entering the right
atrium
• Definitive diagnosis:
angiography of MRI
27. Double SVC
Fig. CT images cranial to caudal depicting the
anomaly.
R SVC = right SVC, LSVC = left SVC, CS = coronary
sinus
28. Left SVC
• Results from failure of the
embryonic left anterior
cardinal vein to regress
associated with the
regression of right
anterior cardinal vein
• Overall incidence: ranges
from 1 per 330 to 1 per
750 normal individuals
and 1 per 25 patients
with congenital heart
disease
29. Left SVC
• Mostly drain to right atrium
(coronary sinus)
• Most commonly associated
with Atrial septal defect
• Other associated cardiac
anomalies are Single atrium,
VSD, PDA, tetalogy of Fallot
• Higher incidence of Left SVC
with partial transposition of
viscera
30. Left SVC
Left Sided Superior Vena Cava
A chest radiograph demonstrates abnormal position of the central venous
catheter (red arrow). Blood gas analysis and contrast injection confirmed
catheter position within a left-sided superior vena cava. Ao, aortic knob
31. Clinical significance
• Not normally of clinical significance
• Surgically important in correct
placement of venous connections in
case of cardiopulmonary bypass
• Positive benefit in some complex
procedures for construction of the
final repair
32. Other anomalies of the right SVC
Rare
• Right SVC draining into
the RA via a low
insertion
• Congenital aneurysm of
SVC (saccular and
Fusiform types)
34. Left IVC
• Results from the regression
of right supracardinal vein
with persistence of left
supracardinal vein
• prevalence: 0.2-0.5%
• Left IVC ends at left renal
vein – then, crosses anterior
to aorta, uniting with right
renal vein – from a normal
right sided prerenal IVC
36. Clinical significance
• Potential for misdiagnosis as left
sided paraaortic adenopathy
• Spontaneous rupture of abdominal
aortic aneurysm into left IVC has
been reported
• Transjugular access to the infrarenal
IVC for placement of an IVC Filter
may be difficult
37. Double IVC
• Results from
persistence of both
supracardinal veins
• Prevalence: 0.2-3 %
• Left IVC typically ends
at the left renal vein -
which crosses anterior
to the aorta in the
normal fashion – then
joins the right IVC
39. Double IVC
Duplication of the lnferior Vena Cava
A. lnferior vena cavagram demonstrates the right component of the inferior vena cava(IVC) with a
large inflow from the left renal vein (arrowheads). The left iliac vein did not fill on this injection
B. Contrast injection into the left femoral vein opacifies the left IVC (LIVC), which joins the right IVC
by draining through the left renal vein (LRV arrowheads). RRV (right renal vein)
40. Clinical significance
• Should be suspected in cases of
recurrent pulmonary embolism
following placement of an IVC filter
• Misdiagnosis as lymphadenopathy
41. Azygos continuation of the IVC
• Failure to form the right
subcardinal-hepatic
anastomosis, with resultant
atrophy of the right
subcardinal vein
• Prevalence: 0.6%
• The azygos vein joins the SVC
at the normal location (at the
level of T4 posteriorly)
• Dilatation of azygos vein,
azygos arch and the SVC
• Each gonadal vein drain to the
ipsilateral renal vein
42. Clinical significance
• Avoid misdiagnosis as right paratracheal
mass or retrocrural adenopathy
(enlarged azygos vein at the confluence
with the SVC)
• Preoperative knowledge of the anatomy
important in planning cardiopulmonary
bypass and to avoid difficulties in
catheterizing the heart
43. Circumaortic left renal vein
• Results from the persistence of the
dorsal limb of the embryonic left
renal vein and of the dorsal arch of
the renal collar (intersupracardinal
anastomosis)
• prevalence: 8.7 %
• Two renal veins are present
• The superior renal vein receives
the left adrenal vein and crosses
the aorta anteriorly
• Inferior renal vein receives the left
gonadal vein and crosses
posterior to the aorta
approximately 1-2 cm inferior the
normal anterior vein
44. Circumaortic left renal vein
Fig. Renal vein collar
Selecive injection of upper (anterior) renal vein with retrograde filling
of lower (retroaortic limb)
45. Clinical significance
• Preoperative planning prior to
nephrectomy and in renal vein
catheterization for venous sampling
• Misdiagnosis as retroperitoneal
adenopathy
46. Retro aortic left renal vein
• Persistence of the dorsal
arch of the renal collar
with regression of the
ventral arch – single renal
vein passes posterior to
the aorta
• Prevalence: 2.1%
47. Retro aortic left renal vein
Fig. CT scans show the left renal vein (arrow) descending to cross
posterior to the aorta
48. Clinical significance
• Preoperative recognition of the anomaly
• Posterior nutcracker syndrome
– an unusual cause of unexplained episodes of
microscopic or macroscopic hematouria with or
without flank pain in the absence of glomerular
disease.
– Arises due to compression of a retroaortic left renal
vein between the aorta and the vertebral body,
causing venous hypertension, hematuria, and left
gonadal vein varicocele
49. Circumcaval ureter
• Also termed as a retrocaval
ureter
• Right supracardinal system fails
to develop, whereas the right
posterior cardinal vein persists
• Almost always on the right side
• Proximal ureter courses
posterior to the IVC, then
emerges to the right of aorta,
coming to lie anterior to the
right iliac vessels
• Patient may develop partial
ureteral obstruction or recurrent
urinary tract infections
50. Circumcaval ureter
Fig. CT scans presented from
cranial to caudal show the
anomaly. The right ureter
(arrow) is positioned posterior
to the IVC. The ureter (arrow)
then courses to the left of the
IVC. Finally, the ureter (arrow)
crosses anterior to the
IVC
51. Other anomalies
• Absence of the
infrarenal IVC or the
entire IVC
• Coexistence of more
than one anomaly
Fig. absent infrarenal IVC with collateral
flow from the lower extremities
reaching the azygos system via
paravertebral collateral veins
52.
53. Reference
• Anatomy for diagnostic Imaging, Ryan, 3/e
• Textbook of Radiology and Imaging, Sutton, 7/e
• Fundamentals of diagnostic radiology, Brant and
Helms, 4/e
• Congenital anomalies of the Superior vena cava:
A CT study; Cormier et al, Seminars in
Roentgenology, April 1989
• Spectrum of congenital anomalies of the Inferior
vena cava: Cross sectional imaging findings; Bass
et al, RadioGraphics 2000
Editor's Notes
A rudimentary valve (eustachian valve) is present just prior to its entrance into the RA.
Superior vena caval duplication is the most common form of a left sided SVC, where the normal right sided SVC remains. The right SVC however can be smaller in ~2/3rds of such cases 3.
Nutcracker syndrome is a vascular compression disorder and refers to the compression of the left renal vein between the superior mesenteric artery (SMA) and aorta. This can lead to renal venous hypertension, resulting in rupture of thin-walled veins into the collecting system with resultant haematuria