- Pain is defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage. It can be acute or chronic.
- Acute pain is sharp and short-lived, while chronic pain is intermittent or constant and lasts longer. Chronic pain is more difficult to treat.
- Pain has protective benefits like warning of injury and preventing further damage, but also has negative impacts. The physiology of pain involves receptors, pathways in the peripheral and central nervous systems, and neurotransmitters like glutamate and substance P. The gate control theory proposes mechanisms of pain modulation in the spinal cord and brain.
Physiology of Pain (PPT) Nervous System PhysiologyShaista Jabeen
https://www.youtube.com/channel/UCrrAABI7QDRCJ1yMrQCip_w/videos
https://www.facebook.com/ShaistaJabeeen/
https://www.facebook.com/Human-Physiology-Lectures-100702741804409/
Physiology of Pain (PPT)
Nervous System Physiology
INTRODUCTION
BENEFITS OF PAIN SENSATION
COMPONENTS OF PAIN SENSATION
PATHWAYS OF PAIN SENSATION
FROM SKIN AND DEEPER STRUCTURES
FROM FACE
FROM VISCERA
FROM PELVIC REGION
VISCERAL PAIN
CAUSES OF VISCERAL PAIN
REFERRED PAIN
DEFINITION
EXAMPLES OF REFERRED PAIN
MECHANISM OF REFERRED PAIN
NEUROTRANSMITTERS INVOLVED IN PAIN SENSATION
ANALGESIA SYSTEM
ANALGESIC PATHWAY
GATE CONTROL THEORY
APPLIED PHYSIOLOGY
Short Notes
pdf ppt
Physiology of Pain (PPT) Nervous System PhysiologyShaista Jabeen
https://www.youtube.com/channel/UCrrAABI7QDRCJ1yMrQCip_w/videos
https://www.facebook.com/ShaistaJabeeen/
https://www.facebook.com/Human-Physiology-Lectures-100702741804409/
Physiology of Pain (PPT)
Nervous System Physiology
INTRODUCTION
BENEFITS OF PAIN SENSATION
COMPONENTS OF PAIN SENSATION
PATHWAYS OF PAIN SENSATION
FROM SKIN AND DEEPER STRUCTURES
FROM FACE
FROM VISCERA
FROM PELVIC REGION
VISCERAL PAIN
CAUSES OF VISCERAL PAIN
REFERRED PAIN
DEFINITION
EXAMPLES OF REFERRED PAIN
MECHANISM OF REFERRED PAIN
NEUROTRANSMITTERS INVOLVED IN PAIN SENSATION
ANALGESIA SYSTEM
ANALGESIC PATHWAY
GATE CONTROL THEORY
APPLIED PHYSIOLOGY
Short Notes
pdf ppt
Pain is defined as an “unpleasant emotional experience usually initiated by a noxious stimulus and transmitted over a specialized neural network to the central nervous system where it is interpreted as such”.
Free nerve endings – responsible for carrying noxious stimulus from both superficial as well as deep somatic and visceral pain sensations therefore reffered as nociceptors
According to type of impulses they carry second order neuron can be classified as –
LOW THRESHOLD MECHANOSENSORY( ligth touch, pressure and Proprioception)
NOCIOCEPTIVE SPECIFIC ( Noxious stimulation)
WIDE DYNAMIC RANGE ( wide range of stimulus intensities from nonnoxious to noxious.
SILENT NOCICEPTORS (It is an afferent neuron that appear to remain or silent to any mechanical stimulation .These neuron become active with tissue injury and add to the nociceptive input entering the CNS.
Pain is the common symptom in many chronic conditions such as cancers, neuropathies, and chronic disease. It is also experienced in trauma varying from mild to severe based on the location and degree of trauma. This presentation is a brief outline on types of pain, classification of pain, pain pathways and management of pain
Physiology of Pain, Characteristic of pain, Basic consideration of nervous system, Pain receptor, Mechanism of pain causation, Theories of pain, Pathways of pain, Pain Receptors
Pain pathway gate control theory
Pain management
An unpleasant emotional experience usually initiated by noxious stimulus and transmitted over a specialized neural network to CNS where it is interpreted as such.
1. Exteroceptors: arising from receptors from skin & mucosa. sensed at conscious level
E.g. Merkel corpuscles : Tactile receptors.
Free Nerve ending :Perceive superficial pain.
2. Proprioceptors : From musculoskeletal structures.
The presence , positions & movement of body. below conscious levels.
E.g. 1) Muscle spindles : Skeletal muscle fibers. Mechanoreceptors.
2) Free nerve ending : Perceive deep somatic pain & other sensations.
3. Interoceptors : From viscera of body below conscious level.
E.g. Pacinian corpuscles : perception of touch-pressure.
Free nerve ending : Perceive visceral pain & other sensations.
Mechanism of pain | Analgesic system | Pain PhysiologyFatima Mangrio
This slideshare describes pain transduction which is the mechanism by which nociceptors depolarize to reach threshold, so that a pain signal can be transmitted to the brain. When the signal reaches the brain, the person becomes consciously aware they are in pain - this is called perception.
Pain is defined as an “unpleasant emotional experience usually initiated by a noxious stimulus and transmitted over a specialized neural network to the central nervous system where it is interpreted as such”.
Free nerve endings – responsible for carrying noxious stimulus from both superficial as well as deep somatic and visceral pain sensations therefore reffered as nociceptors
According to type of impulses they carry second order neuron can be classified as –
LOW THRESHOLD MECHANOSENSORY( ligth touch, pressure and Proprioception)
NOCIOCEPTIVE SPECIFIC ( Noxious stimulation)
WIDE DYNAMIC RANGE ( wide range of stimulus intensities from nonnoxious to noxious.
SILENT NOCICEPTORS (It is an afferent neuron that appear to remain or silent to any mechanical stimulation .These neuron become active with tissue injury and add to the nociceptive input entering the CNS.
Pain is the common symptom in many chronic conditions such as cancers, neuropathies, and chronic disease. It is also experienced in trauma varying from mild to severe based on the location and degree of trauma. This presentation is a brief outline on types of pain, classification of pain, pain pathways and management of pain
Physiology of Pain, Characteristic of pain, Basic consideration of nervous system, Pain receptor, Mechanism of pain causation, Theories of pain, Pathways of pain, Pain Receptors
Pain pathway gate control theory
Pain management
An unpleasant emotional experience usually initiated by noxious stimulus and transmitted over a specialized neural network to CNS where it is interpreted as such.
1. Exteroceptors: arising from receptors from skin & mucosa. sensed at conscious level
E.g. Merkel corpuscles : Tactile receptors.
Free Nerve ending :Perceive superficial pain.
2. Proprioceptors : From musculoskeletal structures.
The presence , positions & movement of body. below conscious levels.
E.g. 1) Muscle spindles : Skeletal muscle fibers. Mechanoreceptors.
2) Free nerve ending : Perceive deep somatic pain & other sensations.
3. Interoceptors : From viscera of body below conscious level.
E.g. Pacinian corpuscles : perception of touch-pressure.
Free nerve ending : Perceive visceral pain & other sensations.
Mechanism of pain | Analgesic system | Pain PhysiologyFatima Mangrio
This slideshare describes pain transduction which is the mechanism by which nociceptors depolarize to reach threshold, so that a pain signal can be transmitted to the brain. When the signal reaches the brain, the person becomes consciously aware they are in pain - this is called perception.
Definition n classification •Pathophysiologyof pain. •Physiological Effects of pain. •Pharmacological & non-pharmacological methods of analgesia. •Principles of pain management.METHODS OF CONTROLLING METHODS OF CONTROLLING
Non-pharmacological Preoperative counseling TENS Acupuncture
Pharmacological Opioids •Im •IV infusion •IV PCA Local anaesthetics: •Local Infiltration •Nerve Blocks •Epidural Blocks NSAIDS •IM •IV infusion •IV PCA
NON-PHARMACOLOGICAL METHODS PRE-OP COUNSELLING: Well informed patients about: •Nature of operation •Nature of post operative pain •Methods of analgesia available
Cope better with Post –op Pain
NON-PHARMACOLOGICAL METHODS TENS (Trans Cutaneous electric nerve stimulation)
Stimulates afferent myelinated (A-beta) nerve fibers at 70hz
Inhibitory circuits within sp cord activated
Nerve impulse transmission reduced
Maximum benefit in neurogenic pain
PHARMACOLOGICAL METHODS OPIODS •Activate opiodreceptors within the CNS •Reduce transmission of nerve impulses by modulation in the dorsal horn
PHARMACOLOGICAL METHODS
LOCAL ANAESTHETICS –Blocks the conduction of nerve impulses –Can be given with adrenaline because •Decreases absorption of L.A allowing larger doses •Also acts on alpha 2 receptors which potentiates analgesic effect
PHARMACOLOGICAL METHODS
NASIDS –Blocks synthesis of PG’s –Only suitable for miledto moderate pain
PRINCIPLE OF MANAGEMENT OF PAIN •Pre-emptive analgesia •Balanced or combination analgesia •Analgesia ladder
PHARMACOLOGICAL METHODS
Balanced Analgesia –NASID are used in conjunction with opioids. –Reduces amount of opioids –Reduces side affect of opioids,ASSESMENT OF PAIN •Observe the behaviour of the patient •Monitor analgesic requirement of the patient –Visual Analogue Score( VAS )
–Verbal Rating Score ( VRS ) •None •Mild •Moderate •severe
this is a material that simplifies the pathophysiology of pain and discusses the spinothalamic pathways and receptors involved in pain perception. this would be helpful for nursing students taking medical-surgical nursing. this was curated by RN anointing julius
Nutrition in New born and Kids
Calorie requirement of newborn and growing kids
Protein energy malnutrition
Vitamin deficiency disorders in kids
Ricketts
Scurvy
Kwashiorkor
Marasmus
The limbic system, also known as the paleomammalian cortex, is a set of brain structures located on both sides of the thalamus, immediately beneath the medial temporal lobe of the cerebrum primarily in the forebrain.[1]
It supports a variety of functions including emotion, behavior, motivation, long-term memory, and olfaction.[2] Emotional life is largely housed in the limbic system, and it critically aids the formation of memories.
With a primordial structure, the limbic system is involved in lower order emotional processing of input from sensory systems
This PPT describes neurological gait deviations.
It describes Hemiplegic/circumductory gait, Spastic Diplegic gait, Parkinson gait, Myopathic & Ataxic gait in detail along with its causes and management in with Physiotherapy treatment. detail
This PPT is made to explain basic techniques of therapeutic massage in detail.
It includes : Stroking, Pressure Manipulation, Tapotement & Vibration
Physiological effects, Therapeutic uses, Caution & Contraindications.
Description : Osteogenesis Imperfecta/
Brittle bone disease :
It is disorder of type I collagen synthesis that affects all connective tissue in the body.
Musculoskeletal involvement is diffuse and includes osteoporosis with excessive fracture even at birth, bowing of long bone, spinal deformities, muscle weakness and ligamentous laxity.
Key words :
Osteogenesis Imperfecta, Brittle bone disease, Genetic disorder, Pathophysiology, Types of OI, Denetinogenesis Imperfecta, Bluish sclera, Frequent fractures, fractures, Hearing loss, Management, orthopedic, Rehabilitation
Physiotherapy, pediatrics, physiotherapist, pediatric orthopedic surgery.
Arthrogryposis multiplex congenita is a disorder that affects the early development of body joints in a fetus, most commonly the large joints in the arms and legs. An infant who is born with the condition typically has limited mobility and obvious physical deformities in one or more joints.
1. Scar Tissue
2.What makes a scar
3. Characteristics of Scar
4. Scar & Adhesion
5. Classification as External and Internal scars
6 Detriments/Disadvantages
7. How scar tissue forms in muscle
8. Phases of scar healing
9.Phases of wound healing
10. Release of scar and adhesion
11. Massage
12. Massage techniques
13. Conditions : Burns & Skin grafting
14. Cautions
15. Procedure
16. When to start massage after surgery
17. How to massage scar tissue
18. Effleurage, Kneading, Skin rolling and Friction
19. Caution
20. Keloid
21. Warning.
What is oedema?
types of oedema
1. soft and mobile
2. consolidated/endurated
Conditions in which oedema is treated with massage
a) Radical mastectomy
b) Venous ulcer
c) gravitational/paralytic oedema
Technique of massage to reduce oedema
Kneading
Effleurage
Picking Up &
Friction
Instructions to patient
Position of Patient
Aim
Procedure &
Steps of Massage Application
Diabetes Mellitus
Introduction
Pathophysiology
Types of Diabetes Mellitus
Type 1, 2 and
gestational diabetes
rescent research in Type 1 diabetes
Risk factors and causes
Complications short term and long term of diabetes
Management
Treatment with Insulin
Diabetic drugs
Healthy Diet
Exercises prescription
aerobic exercises,
resistance exercises and
flexibility
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.
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
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.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
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.
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
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
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
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.
2. DEFINITION
“A sensory unpleasant and emotional experience associated
with or without actual potential tissue damage or describe in
term of such damage”
Pain sensation is described in many ways like sharp,
pricking, electrical, dull ache, shooting, cutting,
stabbing, etc.
3. Pain may be acute or chronic.
Acute pain is a sharp pain of short duration with easily
identified cause.
Often it is localized in a small area before spreading to
neighboring areas. Usually it is treated by medications.
Chronic pain is the intermittent or constant pain with
different intensities. It lasts for longer periods.
It is somewhat difficult to treat chronic pain and it needs
professional expert care.
TYPEs OF PAIN
4. Benefits of Pain Sensation
Pain is an important sensory symptom. Though it is an unpleasant
sensation, it has protective or survival benefits such as:
Pain gives warning signal about the existence of a problem or
threat. It also creates awareness of injury.
Pain prevents further damage by causing reflex withdrawal of the
body from the source of injury
Pain forces the person to rest or to minimize the activities thus
enabling rapid healing of injured part
Pain urges the person to take required treatment to prevent
major damage.
5. Fast pain is the first sensation whenever a pain stimulus is applied.
It is experienced as a bright, sharp and localized pain sensation.
Fast pain is followed by the slow pain, which is experienced as a
dull, diffused and unpleasant pain.
Receptors for both the components of pain are same, i.e. the free
nerve endings.
But, afferent nerve fibers are different.
Components OF PAIN Sensation
6. Components OF PAIN Sensation
Fast pain or First pain
Carried by Aδ fibers
e.g. during injury
Slow pain or Second pain
Carried by C fibers
e.g. after injury
7. Pathways Of Pain Sensation
Pain Sensation
Receptor : Free nerve ending
1st order neurons :
Posterior nerve root ganglion
Fast pain – A δ-fibers
Slow pain – C fibers
8. Pathways Of Pain Sensation
2nd order neurons :
Fast pain – marginal nucleus in spinal cord
Slow pain – substantia gelatinosa of Rolando
Fibers form lateral spinothalamic tract
3rd order neurons :
Ventral posterolateral
nucleus of thalamus,
reticular formation and midbrain
Center : Sensory cortex
9.
10. Pathways Of Pain Sensation
Pain sensation from various parts of body is carried to brain
by different pathways which are:
Pathway from skin and deeper structures
Pathway from face
Pathway from viscera
Pathway from pelvic region.
11. From Skin and Deeper Structures
Receptors
First order neurons : Fast and slow pain fibers
Second order neurons
Third order neurons
Center for pain sensation
12. Pathway from Skin & Deeper
Structures
1st order neurons
These are the cells in the
posterior nerve root
ganglia, receive impulses
from pain receptors
through dendrites • These
impulses are transmitted
through the axons to
cord • Impulses are
transmitted by Aδ fibre or
2nd order neurons
The neurons of marginal
nucleus & substantia
gelatinosa form the II
neurons • Fibres from
these neurons ascend in
the form of the lateral
spinothalamic tract
• Fibres of fast pain arise
from neurons of the
marginal nucleus • The
fibres of slow pain arise
3rd order neurons
The neurons of pain
pathway are the neurons
Thalamic nucleus, reticular
formation, tectum, gray
matter around the
aqueduct of sylvius
• Axons from these
neurons reach the sensory
area of cerebral cortex or
hypothalamus
13.
14.
15.
16.
17.
18. Trigeminal pain pathway:
Pain sensation from face and mouth is carried by three peripheral
nerve branches (V1, V2 and V3) of trigeminal nerve whose cell
bodies sit in trigeminal ganglion (TG) and project centrally to
synapse with the second order neurons in the trigeminal spinal
nucleus caudalis (VC).
The second order neurons then ascend to terminate in thalamus.
From thalamus, nociceptive information is projected to primary
somatosensory cortex (SI) where pain processing occurs.
Pathway from Face
19. The spinal trigeminal
nucleus represents pain-
temperature sensation fr
om the face.
Pathway from Face
20. Pathway from Viscera
Pain sensation from thoracic and abdominal viscera is transmitted
by sympathetic (thoracolumbar) nerves.
Pain from esophagus, trachea and pharynx is carried by vagus
and glossopharyngeal nerves.
24. CAUSES OF VISCERAL PAIN
Ischemia
Substances released during ischemic reactions such as bradykinin and
proteolytic enzymes stimulate the pain receptors of viscera.
Chemical Stimuli
Chemical substances like acidic gastric juice, leak from ruptured ulcers
into peritoneal cavity and produce pain.
Spasm and Over distention of Hollow Organs
Spastic contraction of smooth muscles in gastrointestinal tract and
other hollow organs of viscera cause pain by stimulating the free nerve
endings. Over distention of hollow organs also causes pain.
25. Referred Pain
Referred pain is the pain
that is perceived at a site
adjacent to or away from
the site of origin.
Deep pain and some
visceral pain are referred
to other areas. But,
superficial pain is not
referred.
26. EXAMPLES OF REFERRED PAIN
Cardiac pain is felt at inner part of left
arm and left shoulder
Pain in ovary is referred to umbilicus
Pain from testis is felt in abdomen
Pain in diaphragm is referred to shoulder
Pain in gallbladder is referred to
epigastric region
Renal pain is referred to loin.
27. MECHANISM OF REFERRED PAIN
According to dermatomal rule, pain is
referred to a structure, which is developed
from the same dermatome from which the
pain producing structure is developed.
A dermatome includes all the structures or
parts of the body, which are innervated by
afferent nerve fibers of one dorsal root.
For example, the heart and inner aspect of
left arm originate from the same
dermatome.
So, the pain in heart is referred to left arm.
29. NEUROTRANSMITTERS INVOLVED
IN PAIN SENSATION
Glutamate and substance P are the neurotransmitters
secreted by pain nerve endings.
Aδ afferent fibers, which transmit impulses of fast pain
secrete glutamate.
The C type fibers, which transmit impulses of slow pain
secrete substance P.
30. ANALGESIA SYSTEM
Analgesia system means the pain control system.
Body has its own analgesia system in brain, which provides
a short term relief from pain.
It is also called endogenous analgesic system.
Analgesia system has got its own pathway through which
it blocks the synaptic transmission of pain sensation in
spinal cord and thus attenuates the experience of pain.
In fact analgesic drugs such as opioids act through this
system and provide a controlled pain relief.
31. Analgesic Pathway
Analgesic pathway that interferes with pain
transmission is often considered as descending pain
pathway, the ascending pain pathway being the
afferent fibers that transmit pain sensation to the
brain.
33. Neurotransmitters of Analgesic
Pathway
Neurotransmitters released by the fibers of analgesic
pathway are
serotonin and
opiate receptor substances namely enkephalin,
dynorphin and endorphin.
34. GATE CONTROL THEORY
Psychologist Ronald Melzack and the anatomist Patrick
Wall proposed the gate control theory for pain in 1965 to
explain the pain suppression.
According to them, the pain stimuli transmitted by afferent
pain fibers are blocked by gate mechanism located at the
posterior gray horn of spinal cord.
If the gate is opened, pain is felt. If the gate is closed, pain
is suppressed.
35. Mechanism of Gate Control at Spinal
Level
When pain stimulus is applied on any part of body, besides pain
receptors, the receptors of other sensations such as touch are also
stimulated
When all these impulses reach the spinal cord through posterior
nerve root, the fibers of touch sensation (posterior column fibers)
send collaterals to the neurons of pain pathway, i.e. cells of marginal
nucleus and substantia gelatinosa
Impulses of touch sensation passing through these collaterals inhibit
the release of glutamate and substance P from the pain fibers
This closes the gate and the pain transmission is blocked
36. Role of Brain in Gate Control
Mechanism
According to Melzack and Wall, brain also plays some
important role in the gate control system of the spinal cord
as follows:
1. If the gates in spinal cord are not closed, pain signals
reach thalamus through lateral spinothalamic tract
2. These signals are processed in thalamus and sent to
sensory cortex
3. Perception of pain occurs in cortical level in context of the
person’s emotional status and previous experiences
37. Role of Brain in Gate Control
Mechanism
4. The person responds to the pain based on the
integration of all these information in the brain. Thus, the
brain determines the severity and extent of pain.
5. To minimize the severity and extent of pain, brain sends
message back to spinal cord to close the gate by releasing
pain relievers such as opiate peptides
6. Now the pain stimulus is blocked and the person feels
less pain.
39. Significance of Gate Control
Thus, gating of pain at spinal level is similar to presynaptic
inhibition. It forms the basis for relief of pain through
rubbing, massage techniques, application of ice packs,
acupuncture and electrical analgesia.
All these techniques relieve pain by stimulating the release
of endogenous pain relievers (opioid peptides), which
close the gate and block the pain signals.
40. APPLIED PHYSIOLOGY
1. Analgesia
Analgesia means loss of pain sensation.
2. Hyperalgesia
Hyperalgesia is defined as the increased sensitivity to pain
sensation.
3. Paralgesia
Abnormal pain sensation is called paralgesia.