Normal labor is defined as spontaneous onset at term, with vertex presentation, without undue prolongation, natural termination with minimal aids, and without complications affecting mother or baby. The causes of labor onset are unknown but may include hormonal, mechanical, and neurological factors. Hormonal factors involve increases in estrogen, progesterone withdrawal, and prostaglandins. Mechanical factors include uterine distension and stretch of the lower uterine segment. Neurological factors involve alpha and beta adrenergic receptors in the myometrium. True labor is characterized by regular, progressively intensifying pains and cervical changes like dilation and effacement.
Malpresentations are all presentations of
fetus other than vertex. Face presentation, brow presentation, shoulder presentation and breech presentation are common malpresentations.
Malpresentations are all presentations of
fetus other than vertex. Face presentation, brow presentation, shoulder presentation and breech presentation are common malpresentations.
Prolonged labor is the inability of a woman to proceed with childbirth upon going into labor. Prolonged labor typically lasts over 20 hours for first time mothers, and over 14 hours for women that have already had children.
This ppt is made by Mr. arkab khan pathan under guidance of Mrs. RAKHI GOAR. this ppt contain the detail and all the lecture notes of HEG.
THANK YOU.
Arkab khan
A serious pregnancy complication in which the placenta detaches from the womb (uterus).
Placental abruption occurs when the placenta detaches from the inner wall of the womb before delivery. The condition can deprive the baby of oxygen and nutrients.
Symptoms include vaginal bleeding, stomach pain and back pain in the last 12 weeks of pregnancy.
Depending on the degree of placental separation and how close the baby is to full-term, treatment may include bed rest or a Caesarean (C-section).
Hydatidiform Mole (HM) is a rare mass or growth that forms inside the uterus at the beginning of a pregnancy. It is a type of gestational trophoblastic disease (GTD).
When a normal sperm cell fertilizes one of these oocytes, the resulting embryo has only one set of chromosomes. Because the embryo has no genes from the mother, the pregnancy cannot develop normally, resulting in a hydatidiform mole.
Prolonged labor is the inability of a woman to proceed with childbirth upon going into labor. Prolonged labor typically lasts over 20 hours for first time mothers, and over 14 hours for women that have already had children.
This ppt is made by Mr. arkab khan pathan under guidance of Mrs. RAKHI GOAR. this ppt contain the detail and all the lecture notes of HEG.
THANK YOU.
Arkab khan
A serious pregnancy complication in which the placenta detaches from the womb (uterus).
Placental abruption occurs when the placenta detaches from the inner wall of the womb before delivery. The condition can deprive the baby of oxygen and nutrients.
Symptoms include vaginal bleeding, stomach pain and back pain in the last 12 weeks of pregnancy.
Depending on the degree of placental separation and how close the baby is to full-term, treatment may include bed rest or a Caesarean (C-section).
Hydatidiform Mole (HM) is a rare mass or growth that forms inside the uterus at the beginning of a pregnancy. It is a type of gestational trophoblastic disease (GTD).
When a normal sperm cell fertilizes one of these oocytes, the resulting embryo has only one set of chromosomes. Because the embryo has no genes from the mother, the pregnancy cannot develop normally, resulting in a hydatidiform mole.
NORMAL LABOR.. (EUTOCIA) ABNORMAL LABOR ALSO EXPLAINED. Series of events that take place in the genital organs in an effort to expel the viable products of conception out of the womb through the vagina into the outer world is called LABOR.
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.
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.
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.
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
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.
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 lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
2. LABOR
• DEFINITION :- series of events that takes place in the genital organ in an
effort to expel the viable products of conception ( fetus, placenta and the
membrane ) out of the womb through the vagina into the outer world is
called ‘labor’.
3. NORMAL LABOR
(EUTOCIA)
• DEFINITION:- Labor is called normal if it fulfils the following criteria:
• 1) spontaneous in onset and at term.
• 2) with vertex presentation.
• 3)without undue prolongation
• 4)natural termination with minimal aids
• 5)without having any complication affecting the health of the mother and/or
the baby.
4. CAUSES OF ONSET OF LABOR
It is unknown but the following theories were postulated:
1) Hormonal factors
2) Mechenical factors
3) Neurological factors
5. Hormonal factors
oestrogen:-
Increase release of oxytocin from maternal pituitary.
• Promote synthesis of myometrial receptors for oxytocin by 100-200 folds
,prostaglandin synthesis and increase gap junction in myometrial cells.
• Acc. Lysosomal disintegration in the decidual and amnion cells resulting in increased
prostaglandin (PGF2a) synthesis
• Stimulate the synthesis of myometrial contractile protein –actomyosin through
Camp.
• Increase the excitability of the myometrial cell membranes.
6. Hormonal factors
• Progesterone withdrawl theory
• Before labour , there is a drop in progesterone as the cortisol inhibit the conversion
of foetal pregnenolene to progesterone leading to predominance of the excitability
action of oestrogen.
• Prostaglandin theory:
• Prostaglandin E2 and F2a are powerful stimulators of uterine muscle activity by
increasing gap junction . PGF2a was found to be increased in maternal and foetal
blood as well as the amniotic fluid late in pregnancy and during labor which is
triggered by rise in estrogen level , glucocorticoids , mechanical stretching in late
pregnancy, increase in cytokines (IL-6,TNF) infection, vaginal examination.
7. Oxytocin theory
• Although oxytocin is a powerful stimulator of uterine contraction , its natural
role in onset of labor is doubtful. The secretion of oxytocinase enzyme from
the placenta is decreased near term due to placental ischemia leading to
predominance of oxytocin action .
• Large no. of oxytocin receptors present in the fundus than cervix.
• Receptor no. and sensitivity increasing during labor.
• Stimulate prostaglandin (E2 and F2a) synthesis and release
8. Foetal cortisol theory
Cascade of events activate fetal hypothalamic-pituitary-
adrenal axis prior to onset of labor ->increased CRH-> increased release
of ACTH -> fetal adrenals -> increased cortisol secretion -> accelerated
production of estrogen and prostaglandins from placenta.
9.
10. Mechenical factors
• Uterine distension theory
• Like any hollow organ in the body , when the uterus is distended to a certain
limit, it starts to contract to evacuate its contents. This explains the preterm
labor in case of multiple pregnancy and polyhydramnios.
• Stretch of the lower uterine segment:
• By the presenting part near term.
11. Neurological factors
• Both alfa and beta adrenergic receptors are present in myometrium; estrogen
causing the alfa receptors and progesterone the beta receptor to function
predominantly.
• The contractile response is initiated through the alfa receptors of post
ganglionic nerve fibers in and around the cervix, and the lower part of
uterus .
12. Contractile system of myometrium
• The basic elements involved are
• A) actin
• B) myosin
• C) ATP
• D) enzyme myosin light chain kinase (MLCK)
• E) calcium
13. Clinical picture of labor
• Prodormal (prelabor) stage – premonitoring stage- may begin 2-3 weeks before the
onset of true labor in primigravidae and a few days before in multigravidae.
• The features are inconsistent and may consist of the following;-
• Lightening
It is the relief of upper abdominal pressure symptoms as dyspnea , dyspepsia and
palpitation due to :
>descent in the fundal level after engagement of the head and
>shelfing of the uterus.
14. • Cevical changes:- few days prior to onset of labor, cervix become ripe.
• A ripe cervix is soft , admit one finger easily , cervical canal is dilatable.
15. Onset of labour
• It is characterised by :
• True labor pain
• A)
• >it is expelled cervical mucus plug tinged with blood from ruptured small
vessels tinged with blood from ruptured small vessels as a result of
separation of the membranes from the lower uterine segment. Labour is
usually starts several hours to few days after show.
16. • True labor pain False labor pain
1)Regular 1) Irregular
2)Increase progressively in frequency 2) Do not
duration and intensity
3)Pain is felt in abdomen and radiating to 3) pain is mainly felt in the abdomen.
the back.
4)Progressive dilation and effacement of 4)no effect on cervix.
cervix.
17. •True labor pain False labor pain
5)Membrane are bulging during 5) No bulging of the membranes
contraction
6) Not relieved by antispasmodics or 6) Can be relieved by antispasmodic
sedatives. and sedatives.
18. B) SHOW:- expulsion of cervical mucus plug mixed with blood is called ‘show’.
Oozing of blood is due to rupture of capillary vessels of cervix and from the
raw decidual surface caused by separation of membrane due to stretching of
lower uterine segment.
C) Dilation of the cervix:
• > a closed cervix is a reliable sign that labor has not begun . In multigravidae
the cervix may admit the tip of the finger before onset of labor
D) formation of the bag of fore – water :
• >it bulges through the cervix and becomes tense during uterine contraction.
20. Physiological effects of labor
• On mother
• Temperature : slight >37.5
• Pulse increases upto 100/min
• Blood pressure : systolic blood pressure may rise slightly due to pain , anxiety and stress.
• Oedema and congestion of the conjunctiva .
• Minor injuries : to the birth canal and perineum may occur particularly in primary gravidas
• blood loss from the placental site is 100-200 ml and from laceration or episiotomy is 100ml
so the total average blood loss in normal is 250ml.
21. Physiological effects of labor on foetus
• Moulding:
• The physiological gradual overlapping of the vault bones as the skull is
compressing during its passage in the birth canal .
• One parietal bone overlaps the other and both overlap the occipital and
frontal bones so fontanelles are no more detectable . It is of a good value in
reducing the skull diameters but severe and /or rapid moulding is dangerous
as it may cause intracranial haemorrhage
22. Degree of moulding
• + suture lines closed but not overlap.
• ++ overlap of bone but reducible.
• +++ overlap of the bones but irreducible.
23. • Caput succedaneum:
• A) it is a soft swelling of the most dependent part of the foetal head occurs in
prolonged labor before full cervical dilation and after rupture of the membranes
with poorly defined margins in contrast to cephalhaematoma which is
hemorrhage of blood b/w the skull and periosteum of any age , its boundaries are
limited by individual bones.
• B) it is due to obstruction of the venous return from the lower part of the scalp by
the cervical ring.
• Presence of caput indicates
-Foetus was live during the labor
-Labor was prolonged and difficult
-The attitude of foetal head during labor can be expected as caput is present in the
most dependent part of it.
