This document discusses embryology topics including the bilaminar and trilaminar germ discs, and the pharyngeal apparatus. It describes how the bilaminar germ disc forms from the trophoblast and inner cell mass layers. It then explains how the trilaminar germ disc forms through gastrulation and the establishment of the three germ layers - ectoderm, endoderm, and mesoderm. The document also provides details on the development of the pharyngeal apparatus, including the pharyngeal arches, pouches, grooves, and membranes, and their adult derivatives.
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 parotid gland is a major salivary gland in many animals. In humans, the two parotid glands are present on either side of the mouth and in front of both ears. They are the largest of the salivary glands.
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 parotid gland is a major salivary gland in many animals. In humans, the two parotid glands are present on either side of the mouth and in front of both ears. They are the largest of the salivary glands.
Course in facial development for European Course in Neuroradiology in Tarragona, Spain, originally on 12 octobre 2008. Revised for November, 2010. For questions, e-mail to etchevers at free dot fr. Download for the animations to take place, as some pictures are covered by others.
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The head and neck region of four week human embryo somewhat resemble these regions of a fish embryo of comparable stage
This explains the former use of designation branchial apparatus
Branchial is derived from the Greek word branchia or gill
Embryology is necessary to understand the growth of various anatomical structures pertinent to orthodontics and will help understand the anomalies associated with its maldevelopment.
Development of Oral structures and its applied aspectsDr. Taruni Voora
Explore the fascinating journey of oral structure development and its real-world applications. From early growth stages to its impact on speech, eating, and more, uncover the practical implications in dentistry. Join us for a concise yet insightful exploration of oral structure evolution and its applied aspects!
USMLE GENERAL EMBRYOLOGY 013 Fourth week development B embryo .pdfAHMED ASHOUR
uring the fourth week of embryonic development, significant changes occur as the developing embryo undergoes crucial stages in its formation.
It's important to note that the exact timing of these events can vary among individual embryos, and the descriptions provided are generalizations.
The fourth week represents a critical period in embryonic development, setting the foundation for the formation of various organ systems and body structures.
Craniofacial growth is a complex and a beautiful phenomenon.
It all begins when a sperm cell fuses with an egg cell, a process called fertilization.
Human fertilization is the union of a human egg and sperm, usually occurring in the ampulla of the fallopian tube. The result of this union is the production of a ’Zygote’ cell, or fertilized egg, initiating prenatal development
Prenatal growth can be divided into 3 main stages:
Germinal stage: From ovulation to implantation(0-2 weeks).
Embryonic stage : 3rd week to 8th week.
Fetal stage: 9th week till birth.
Dedicated to my late professor safeer khalil whose guidance lives in our minds.professor late lady reading hospital peshawar and hayatabad medical complex peshawar
Dedicated to our late teacher professor dr umar khitab who taught us with full dedication .his legacy lives in the form of his students through out the world
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
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.
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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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
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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.
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
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
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9. Development Of Trophoblast
1. The trophoblast differentiates into
cytotrophoblast & syncytiotrophoblast.
2.Cells of the cytotrophoblast divide and
migrate externally.
3.They lose their cell membranes to form the
syncytiotrophoblast
10. Inner cell mass differentiates into two layers
1:Epiblast layer
2:Hypoblast layer
11. Clinical correlates
*The syncytiotrophoblast secretes human chorionic
gonadotropin hormone which prevents the
degeneration of the corpus luteum.
By the end of the 2nd week, the amount of
this hormone will be sufficient to be
detected in the maternal blood and urine.
This is the basis of pregnancy test.
12. *occasionally implantation takes place
outside the uterus resulting in ectopic or
extra uterine pregnancy.
*In some cases trophoblast develops and
forms placental membrane although little or
no embryo tissue is present this is known as
hydatiform mole.
18. Formation of Trilaminar Germ Disc
1. . Gastrulation- most characteristic
feature during 3rd week
2.3 germ layers are established- ectoderm,
endoderm and mesoderm
3.Start with formation of PRIMITIVE
STREAK
19. PRIMITIVE STREAK
1. Midline groove at epiblast
2.Cephalic end-primitive node
3.Cells of epiblast migrate towards primitive
streak
4.This inward movement is known as invagination
5.Invaginated cells displace hypoblast forming
endoderm
20. 6.Some other invaginated cells come to lie
between epiblast and newly formed
endoderm forming mesoderm
7.Remaining cells in epiblast form ectoderm
8.These 3 layers form trilaminar germ disc
21.
22.
23.
24. Clinical Significance
*Teratogenesis
For example large doses of alcohol at this
stage result in holoprosencephally.
*Caudal dysgenesis(Sirenomelia)
Insufficint mesoderm is formed in caudal
most region of embryo.
*Situs inversus
Transposition of viscera in the thorax and
abdomen occurs.
27. Pharangeal apparatus
•The head and neck region of fourThe head and neck region of four
week human embryo somewhatweek human embryo somewhat
resemble these regions of a fishresemble these regions of a fish
embryo of comparable stageembryo of comparable stage
•This explains the former use ofThis explains the former use of
designation branchial apparatusdesignation branchial apparatus
31. •Pharyngeal archesPharyngeal arches
begin to developbegin to develop
early in the fourthearly in the fourth
week as neuralweek as neural
crest cells migratecrest cells migrate
into the head andinto the head and
neck regionneck region
32. Pharyngeal ArchesPharyngeal Arches
• By the end of the fourth week, four pairs ofBy the end of the fourth week, four pairs of
pharyngeal arches are visible externallypharyngeal arches are visible externally
• The fifth and sixth arches are rudimentaryThe fifth and sixth arches are rudimentary
and are not visible on the surface of theand are not visible on the surface of the
embryoembryo
• The pharyngeal arches are separated fromThe pharyngeal arches are separated from
each other by fissures called pharyngealeach other by fissures called pharyngeal
groovesgrooves
33. •Each pharyngeal arch consists of a core ofEach pharyngeal arch consists of a core of
mesenchymemesenchyme
•Is covered externally by ectoderm and internally byIs covered externally by ectoderm and internally by
endodermendoderm
Pharyngeal Arch ComponentsPharyngeal Arch Components
34. Ist Pharangeal Arch Derivatives
Ist pharangeal arch consists of
•Maxillary process
•Mandibular process
Skeletal component
Ist pharangeal arch is known as mandibular arch
37. Mandibular process
Mandibular process give rise to
• Meckle’s cartilage
•Mandible
•Malleus
•Incus
•Anterior ligament of malleus
•Sphenomandibular ligament
38.
39. Musculature of ist arch
Musculature of ist pharangeal arch includes
•Muscles of mastication
•Anterior belly of digastric muscle
•mylohyoid
•Tensor tympani
•Tensor palatini
40. Nerve supply to the ist arch
•Nerve supply to ist arch is provided by
Mandibular branch of trigeminal
nerve
Note
•Ist arch also contribute to dermis
of the face which is innervated by
opthalmic ,maxillary and mandibular
branch of trigeminal nerve.
41.
42. as2nd Pharangeal Arch
skeletal component
2nd
pharangeal arch gives rise to
•Stapes
•Styloid process
•Stylohyoid ligament
•Lesser horn
•Upper portion of the body of hyoid bone
2nd
pharangeal arch is also known a hyoid arch or
rechiert’s cartilage
43.
44. Musculature of 2nd
arch
Musculature of 2nd
arch includes
•Stapedius muscle
•Stylohyoid muscle
•Posterior belly of digastric muscle
•Auricular muscle
•Muscles of facial expression
49. 4th
and 6th
Pharangeal Arch
Skeletal component
Cartilage of 4th
and 6th
arch fuse together to form
•Thyroid
•Cricoid
•Aretenoid
• Corniculate
• And Cuniform cartilage of larynx
50. Musculature of 4th
Arch
It includes
•Cricothyroid
•Levator platini
•Constrictors of pharynx
Nerve supply of 4th
Arch
Innervation is provided by
Superior larangeal branch of vagus
51.
52. Musculature of 6th
arch
•It includes intrinsic muscles of larynx
Nerve supply
•Innervation is by recurrent larangeal
branch of vagus
53.
54. Pharangeal pouches
•The pharyngeal pouches are balloon like
diverticula that formed on the endodermal
side between the pharyngeal archespharyngeal arches
•The pairs of pouches develop in a
craniocaudal sequence between the arches
55.
56. • There are four well defined pairs of pharyngeal
pouches
•The fifth pair is absent or rudimentary
• The first pair of pouches lies between the first
and second pharyngeal arches
57. • The first pharyngeal pouch forms stalk like
diverticulum called tubotympanic recess
•The distal portion of diverticulum widens
into sac like structure primitive tympanic Or
middle ear cavity
•The lining of tympanic cavity later aids in
the formation of tympanic membrane or ear
drum
Derivatives of Ist Pharangeal Pouch
59. •The second pharyngeal pouch is largely
obliterated ( disappear ) as the palatine tonsils
develop
• Part of the cavity of this pouch remains as the
tonsillar sinus or fossa
Derivatives of Second Pharyngeal Pouch
61. Derivatives of Third Pharyngeal Pouch
Epithelium of dorsal region of 3rd
pouch
differntiates into inferior thyroid gland
While ventral region differntiates into thymus.
62. The primordia of
thymus and inferior
parathyroid glands
lose their connections
with the pharynx and
migrate into the neck
Later the inferior
parathyroid glands
separate from the
thymus and lie on the
dorsal surface of the
thyroid gland
63. Derivatives of Fourth Pharyngeal PouchDerivatives of Fourth Pharyngeal Pouch
Each dorsal part develops into a superiorEach dorsal part develops into a superior
parathyroid glandparathyroid gland
It lies on the dorsal surface of the thyroid glandIt lies on the dorsal surface of the thyroid gland
Ventral region of 4th
pouch forms ultimobranchial
body
64. Ultimobranchial body is later on incorporated
into thyroid gland.
Cells of Ultimobranchial body give rise to
parafollicular cells Or C cells of thyroid gland
which secretes calcitonin.
65. Derivatives of Fifth Pharyngeal PouchDerivatives of Fifth Pharyngeal Pouch
When this develops, this rudimentary pouchWhen this develops, this rudimentary pouch
becomes part of the fourth pharyngeal pouchbecomes part of the fourth pharyngeal pouch
and helps to form the ultimopharyngeal bodyand helps to form the ultimopharyngeal body
66. Pharyngeal GroovesPharyngeal Grooves
During the fourth and fifth weeks, head andDuring the fourth and fifth weeks, head and
neck region of the human embryo exhibit fourneck region of the human embryo exhibit four
pharyngeal grooves or clefts on each sidepharyngeal grooves or clefts on each side
These grooves separate the pharyngeal archesThese grooves separate the pharyngeal arches
externallyexternally
Only first pair persists as the external acousticOnly first pair persists as the external acoustic
meatusmeatus
67. The other grooves normally obliterated withThe other grooves normally obliterated with
the cervical sinus as the neck developsthe cervical sinus as the neck develops
68. Pharyngeal MembranesPharyngeal Membranes
• The connection between the endoderm of
the pharyngeal pouchespharyngeal pouches and the ectoderm of
the pharyngeal groovespharyngeal grooves form a double layered
membrane called the pharyngeal membrane
These membranes form where the epithelia ofThese membranes form where the epithelia of
the grooves and pouches approach each otherthe grooves and pouches approach each other
69. The endoderm of the pouches and ectoderm of theThe endoderm of the pouches and ectoderm of the
grooves are soon separated by mesenchymegrooves are soon separated by mesenchyme
Only first pharyngeal membrane becomes theOnly first pharyngeal membrane becomes the
tympanic membrane, others obliteratetympanic membrane, others obliterate