This document summarizes cardiac muscle mechanics and the cardiac cycle. It describes how cardiac muscle operates on the ascending limb of the active tension curve, allowing force of contraction to increase with stretching. It then outlines the key components and phases of the cardiac cycle from both mechanical and electrical perspectives. This includes definitions of systole, diastole, and the isovolumic phases. Pressure and volume relationships throughout the cycle are depicted in diagrams. Factors influencing cardiac performance like preload, contractility, and afterload are also defined.
This presentation is about heart, it tells about how Cardiac muscles produce rhythmical beats, how the impulse are generated and conducted. This presentation tries to make Electrocardiogram easy to understand. Thank you
This presentation is about heart, it tells about how Cardiac muscles produce rhythmical beats, how the impulse are generated and conducted. This presentation tries to make Electrocardiogram easy to understand. Thank you
Cardiac cycle refers to a complete heartbeat from its generation to the beginning of the next beat.
Cardiac events that occur from –
beginning of one heart beat to the beginning of the next are called the cardiac cycle.
ECG or electrocardiography is the graphical representation of electrical impulses produced by the heart.
The electrical impulses form due to movement of ions in the myocardial cells representing depolarization and repolarization, denotes the conduction pathway of heart, which coincides with cardiac cycle. Apart from normal electrocardiography common arrhythmias are also discussed during this session.
A PowerPoint Presentation on Basic Electrophysiology of Heart and Angiotensin Converting Enzymes and their Inhibitors suitable for Undergraduate MBBS level Students
Cardiac cycle refers to a complete heartbeat from its generation to the beginning of the next beat.
Cardiac events that occur from –
beginning of one heart beat to the beginning of the next are called the cardiac cycle.
ECG or electrocardiography is the graphical representation of electrical impulses produced by the heart.
The electrical impulses form due to movement of ions in the myocardial cells representing depolarization and repolarization, denotes the conduction pathway of heart, which coincides with cardiac cycle. Apart from normal electrocardiography common arrhythmias are also discussed during this session.
A PowerPoint Presentation on Basic Electrophysiology of Heart and Angiotensin Converting Enzymes and their Inhibitors suitable for Undergraduate MBBS level Students
Useful for medical and biology students who want to study the cardiac cycle in a short time with big benefits !!
CVS physiology - Wigger Diagram - ECG of cardiac cycle - Heart sounds
This presentation describes the normal cardiac cycle referred to pressure-time curves for aorta, the left ventricle and left atrium, the electrocardiogram and the phonocardiogram.
The electrocardiogram (EKG) below the diagram shows the corresponding waves with each phase of the cardiac cycle. The bottom line represents the first and second heart sounds. The cardiac cycle represents the hemodynamic and electric changes that occur in systole and diastole. It has many phases.
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
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
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.
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
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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
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
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
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. CARDIAC MUSCLE MECHANICS
• Cardiac Muscle is unique in several
aspects from both skeletal and smooth
muscle. First of all cardiac muscle
operates on the left hand ascending limb
of the active tension curve so that
stretching cardiac myocyte results in
increased force of contraction (Frank-
Starling law of the heart). Second due to
the low concentration of Ca++ ion muscle
contraction can be enhanced in both
strength and speed by increased Ca++
influx (Contractility or Inotropy).
3. • The Cardiac Cycle
• Defining the components of the cardiac cycle differs according to
whether one looks at the physiologic or the mechanical components of
the cycle. From a mechanical point of view the ventricular cycle can be
divided into systole and diastole; the forceful expulsion of blood and
the process of refilling before the next expulsion respectively. From an
electrical point of view, the myocardium is either depolarizing (phase 0
of the monophasic action potential), repolarizing (phases 1-3 of the
monophasic action potential) or in the resting (phase 4) phase of the
monophasic action potential. If the cell being considered is one
capable of spontaneous depolarization (automaticity) the membrane
potential spontaneously begins to move to the threshold potential to
depolarize in phase 4 of MAP. If the cell being considered does not
posses automaticity, it remains at the resting membrane potential
awaiting for an electrical impulse to depolarize it.
4. Classically, the cardiac cycle consists of ventricular contraction and
ventricular relaxation. Once the electrical signal arrives at the myocyte,
depolarization begins. Ca++is released into the myocyte triggering the actin-
myosin interaction (excitation contraction coupling; see above). As pressure
builds up in the left and right ventricles, the mitral and tricuspid valves are
shut generating the first heart sound S1. S1 consists of M1 and T1; closure
of the mitral and tricuspid valves respectively. Pressure continues to build up
until the aortic and pulmonic valves are forced open. The time between the
closure of the mitral and tricuspid valves and the opening of the aortic and
pulmonic valves is called isovolumic contraction. Contraction is occurring
but blood is not being ejected across the semilunar valves yet. Systole
(Greek for contraction) begins when the
aortic and pulmonic valves open and blood begins to flow across them. The
volume of blood ejected with each cycle is the Stroke Volume which
averages 45+/-13 mL/M2 body surface area.
The rate of ejection is determined by the pressure gradient across the valve.
5. When Ca++ levels in the myocardial cells begin to fall as a result of Ca++
reabsorption, the strength of contraction begins to diminish and intracavitary
pressures begin to decline.
Once the pressure in the aorta and pulmonary artery begin to exceed the
pressures in the left and right ventricular cavities respectively, the aortic and
pulmonic valves will shut.
This generates the second heart sound S2. S2 consists of A2 and P2, the
sequential closure of the aortic and pulmonic valves. The ventricle continues
to relax without further changes in volume until the pressure falls below left
and right atrial pressures. This phase is called the isovolumic relaxation
phase. S2 signals the beginning of diastole.
During ventricular systole, when the mitral and tricuspid valves are closed,
the atria (left and right) are filling up with blood and their pressures are
rising. When the left and right atrial pressures exceed the left and right
ventricular pressure, the mitral and tricuspid valves open and the first (or
early) rapid filling phase begins. The early rapid filling phase accounts for
most (80%) of diastolic ventricular filling and may generate a heart sound
known as S3
6. . Atrial systole represents the second rapid filling phase of diastole
accounting for 15% of diastolic filling and completes filling of the right and
left ventricles before ventricular systole commences. The interval between
these two rapid filling phases is called diastasis (Greek for separating apart).
Five percent of diastolic ventricular filling occurs during this phase.
Intra atrial pressure recordings reveal two peaks and two descents. The a
wave is the atrial pressure generated during atrial systole immediately
preceding ventricular systole.
The peak atrial pressure recorded during ventricular systole before the
tricuspid and mitral valves open is the v wave.
7. The following graph shows (The Cardiac Cycle. Definition of Systole and
Diastole. (Opening and Closure of the Aortic and Mitral Valves ).
8.
9. Superimposed are the left atrial pressure tracing (green), the left ventricular
pressure tracing (blue) and the aortic pressure tracing. S1 occurs when the
mitral and tricuspid valves close at the onset of systole. When pressure in
the LV cavity falls below aortic pressure at the end of systole, the aortic
pulmonic valves close and generate S2. The mitral valve opens when LA
pressure exceeds left ventricular pressure. S3 can normally be heard in
individuals without heart disease up to the age of 40 and occurs when blood
rushes into the left ventricle (first rapid filling phase) after the mitral valve
opens in
diastole. An S4 is usually an abnormal finding and occurs at the time of the
second rapid filling phase of the left ventricle. It remains debatable if a
“normal” S4 occurs in the elderly particularly after exercise.
10.
11. The Isovolumic Phases of the Cardiac Cycle. Left ventricular contraction
begins when the mitral valve shuts (S1) however it is only when the LV
cavity pressure exceeds aortic pressure that the actual ejection of blood
occurs. The period in between is the isovolumic
contraction. The isovolumic relaxation time is the time between the closure
of the aortic valve (S2) and the opening of the mitral valve at the onset of the
first rapid filling phase.
12. Important to remember……
Preload refers to the degree the ventricle is distended (extent of
myofibrillar stretch) before systole occurs. The Frank-Starling law states
that within limits stroke volume is greater the more distended the ventricle
is (the greater the degree of stretch) at the end of diastole. Hence, the
greater end-diastolic volume is the greater stroke volume is. Patients who
are dehydrated or have suffered significant hemorrhage have lower
cardiac outputs despite having a normal ventricle because they have
lower preload. This is rectified by increasing their preload with the
administration of fluid or blood.
The left ventricular ejection fraction (LVEF) is an indicator of left
ventricular systolic function.
• LVEF = Stroke volume / End diastolic volume
• LVEDP = LA pressure = PCWP = PA diastolic pressure*
• Cardiac output is heart rate (HR) X stroke volume (SV).
13. Stroke volume =End-diastolic volume(EDV) – End-systolic volume (ESV).
The determinants of cardiac output are Preload, Contractility and
Afterload.
Afterload is represented by the aortic systolic pressure.
Afterload is the force against which the heart has to pump. Ventricular
wall stress best represents afterload and is formally defined by Laplace’s
law.
The relationship between cardiac output and afterload is inverse; the
greater the afterload, the lower the cardiac output.
14. The following graph plots the pressures in the ventricle against the volume
of that ventricle (Pressure-Volume loop).
15. Ventricular Volumes
End-diastolic volume (EDV): volume of blood in the ventricle at the end of
diastole.
End-systolic volume (ESV): volume of blood in the ventricle at the end of
systole .
Stroke volume (SV): volume of blood ejected by the ventricle per beat
SV = EDV - ESV
Ejection Fraction (EF): EF = S V /ED V
(should be greater than 55% in a normal heart).
16. consequences of a loss in preload, e.g., hemorrhage, venodilators
(nitroglycerin)
• Performance decreases because of a loss in preload.
• The loss of venous return and preload reduces cardiac output and blood
pressure, and via the carotid sinus, reflex sympathetic stimulation to
theheart increases.
• The increased contractility partially compensates for the loss of preload.
• When there is a loss of either preload or contractility that compromises
performance, the other factor usually increases to return performance
toward normal. However, the compensatory mechanism is usually
incomplete.
17. consequences of a loss in contractility, e.g., congestive heart failure
• Performance decreases because of a loss in contractility.
• A decrease in contractility decreases ejection fraction, which increases
preload.
• The increased preload partially compensates for the loss of contractility.
• An acute decrease in afterload, e.g., peripheral vasodilation, produces the
same change.
The reason for preload rising as inotropy declines acutely is that the
increased end-systolic volume is added to the normal venous return filling
the ventricle For example, if end-systolic volume is normally 50 ml of blood
and it is increased to 80 ml in failure, this extra residual volume is added to
the incoming venous return leading to an increase in end-diastolic volume
and pressure.
18. consequences of an acute increase in contractility
• Performance increases.
• The increased contractility increases ejection fraction.
• The increased ejection fraction decreases preload.
• An acute decrease is afterload, e.g., peripheral vasodilation, produces the
same changes
. consequences of an acute increase in preload e.g., volume loading in
the individual going from the upright to the supine position.
• Increased venous return increases preload, which increases performance
and cardiac output.
Increasing cardiac output raises blood pressure, and via the carotid sinus
reflex, sympathetic stimulation to the heart decreases.
• The decreased sympathetic stimulation reduces contractility.