DEVELOPMENT OF PLACENTA,PLACENTA AT TERM , DECIDUA,PLACENTAL MEMBRANE , PLACENTAL CICULATION,PLACENTAL ENDOCRINE SYNTHESIS,ABNORMAL PLACENTA,FUNCTIONS.
This topic includes menstruation:- its definition, anatomical aspects- follicular growth and atresia, germ cells, premodial follicle; menstrual cycle/ ovarian cycle:- definition, phases- recruitment of groups of follicles (premature phase), selection of dominant follicle and its maturation, ovulation, follicular atresia; Endometrial cycle:- division of endometrium- basal zone, functional zone and its phases- stage of regeneration, stage of proliferation, secretory phase, menstrual phase, mechanism of menstrual bleeding, role of prostaglandins, hormones in relation to ovarian and menstrual cycle, ovulation, luteal-follicular shift, menstrual symptoms, menstrual hygiene, anovular menstruation, artificial postponement; cervical cycle, vaginal cycle and general changes in follicular and luteal phase.
The placenta is formed gradually during the first three months of pregnancy, while, after the fourth month, it grows parallel to the development of the uterus. Once completed, it resembles a spongy disc 20 cm in diameter and 3 cm thick.
This topic includes menstruation:- its definition, anatomical aspects- follicular growth and atresia, germ cells, premodial follicle; menstrual cycle/ ovarian cycle:- definition, phases- recruitment of groups of follicles (premature phase), selection of dominant follicle and its maturation, ovulation, follicular atresia; Endometrial cycle:- division of endometrium- basal zone, functional zone and its phases- stage of regeneration, stage of proliferation, secretory phase, menstrual phase, mechanism of menstrual bleeding, role of prostaglandins, hormones in relation to ovarian and menstrual cycle, ovulation, luteal-follicular shift, menstrual symptoms, menstrual hygiene, anovular menstruation, artificial postponement; cervical cycle, vaginal cycle and general changes in follicular and luteal phase.
The placenta is formed gradually during the first three months of pregnancy, while, after the fourth month, it grows parallel to the development of the uterus. Once completed, it resembles a spongy disc 20 cm in diameter and 3 cm thick.
abruption. This is when the placenta partly or completely peels away from the inner wall of the uterus before delivery. With placental abruption, the developing baby might not get enough oxygen and nutrients. The pregnant person might have back or stomach pain and bleeding from the vagina. Placental abruption can lead to an emergency in which a baby needs to be delivered early.
Placenta previa. This condition happens when the placenta partly or totally covers the cervix. Placenta previa is more common early in pregnancy. It might get better on its own as the uterus grows.
Placenta previa can cause serious vaginal bleeding during pregnancy or delivery. Treatment depends on various factors. They include the amount of bleeding, whether bleeding stops, how far along the pregnancy is and the placenta's position. If placenta previa continues late into the pregnancy, a healthcare professional likely will recommend a C-section.
Placenta accreta. Most often, the placenta separates from the wall of the uterus after childbirth. With placenta accreta, part or all of the placenta stays firmly attached to the uterus. This condition happens when the blood vessels and other parts of the placenta grow into the uterine wall. This can cause serious blood loss during delivery.
Sometimes, the placenta invades well into the muscles of the uterus or grows through the uterine wall. If this happens, a healthcare professional likely will recommend a C-section followed by surgery to remove the uterus. This is called a C-hysterectomy.
The placenta is attached to the wall of the uterus. Most often, it attaches to the top, side, front or back of the uterus. Rarely, it might attach in the lower area of the uterus. When this happens, the placenta may block the passage that connects the uterus to the vagina, called the cervix. If the placenta is near the opening of the cervix, it's known as a low-lying placenta. If it partly or totally covers the opening of the cervix, it causes a condition called placenta previa.
What affects the health of the placenta?
Various factors can affect the health of the placenta, including:
Age of the pregnant person. Some conditions that affect the placenta are more common in older people, especially after age 40.
Water breaking before labor. During pregnancy, the developing baby is surrounded and cushioned by a fluid-filled layer of tissue called the amniotic sac. If the sac leaks or breaks before labor starts, it's known as the water breaking. This raises the risk of problems with the placenta.
High blood pressure. This condition can cause less blood to reach the placenta.
Being pregnant with twins or other multiples. Being pregnant with more than one baby might raise the risk of some conditions related to the placenta.
Blood-clotting conditions. Typically, blood hardens into a clump to help control bleeding from cuts. This process is called clotting. Sometimes, blood clots form inside the body and lead to medical problems. Conditions that ca
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
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.
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
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.
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.
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.
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
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
Maxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptx
PLACENTA
1. 1
PLACENTA
• This is a fetomaternal organ.
• It has two components:
– Fetal part – develops from the chorionic sac ( chorion
frondosum )
– Maternal part – derived from the endometrium ( functional
layer – decidua basalis )
• The placenta and the umbilical cord are a transport system for
substances between the mother and the fetus.( vessels in umbilical
cord )
• Function Of The Placenta:
1. Protection
2. Nutrition
3. Respiration
4. Excretion
5. Hormone production
3. Further Development of Chorionic
Villi
Early in the 3rd
week,
mesenchyme growth into the
primary villi forming a core of
mesenchymal tissue. Thus the
Secondary Chorionic Villi are
formed over the entire surface of
the chorionic sac.
Some mesenchymal cells in the
secondary villi differentiate into
capillaries and blood cells
forming the Tertiary Chorionic
Villi.
The capillaries in the villi fuse to
form arteriocapillary networks.
4. The previous formed
arteriocapillary networks
become connected with the
embryonic heart through
vessels which are formed in the
mesenchyme of the chorion and
connecting stalk.
By the end of the 3rd
week,
embryonic blood begins to flow
through the capillaries in the
chorionic villi.
Oxygen & nutrients in the
maternal blood in the intervillous
space diffuse through the walls
of the villi and enter the
embryo’s blood.
Carbon dioxide & waste
products diffuse from blood in
the fetal capillaries through the
wall of the chorionic villi into the
5.
6. 6
DECIDUA
• This is the endometrium
of the gravid (pregnant)
uterus.
• It has four parts:
– Decidua basalis: it
forms the maternal
part of the placenta
– Decidua capsularis:
it covers the
conceptus
– Decidua parietalis:
the rest of the
endometrium
– Decidua reflexa:
– Junction between
capsularis &
parietalis.
7. 7
DEVELOPMENT OF PLACENTA
• Until the beginning of the 8th
week, the entire chorionic
sac is covered with villi.
• After that, as the sac grows,
only the part that is
associated with Decidua
basalis retain its villi.
• Villi of Decidua capsularis
compressed by the
developing sac.
• Thus, two types of chorion
are formed:
– Chorion frondosum
(villous chorion)
– Chorion laeve – bare
(smooth) chorion
– About 18 weeks old, it
covers 15-30% of the
decidua and weights
about 1 6 of fetus
8. 8
DEVELOPMENT OF
PLACENTA
• The villous
chorion ( increase
in number, enlarge
and branch ) will
form the fetal part
of the placenta.
• The decidua
basalis will form
the maternal part
of the placenta.
• The placenta will
grow rapidly.
• By the end of the
4th
month, the
decidua basalis is
almost entirely
replaced by the
fetal part of the
placenta.
9. 9
FULL-TERM
PLACENTA
• Cotyledons –about 15 to 20
slightly bulging villous areas.
Their surface is covered by
shreds of decidua basalis
from the uterine wall.
• After birth, the placenta is
always inspeced for missing
cotyledons. Cotyledons
remaining attached to the
uterine wall after birth may
cause severe bleeding.
• Grooves – formerly occupied
by placental septa
• The fetal part of placenta;
fetal membranes called
developmental adnexa
• Placenta;fetal membranes
which are expelled are called
afterbirth or secundina
Maternal side
10. 10
FULL-TERM PLACENTA
( Discoid shape -500- 600 gm- Diameter 15-20 cm
– Thickness of 2-3 cm)
• Fetal surface:
• This side is smooth
and shiny. It is
covered by amnion.
• The umbilical cord is
attached close to the
center of the placenta.
• The umbilical vessels
radiate from the
umbilical cord.
• They branch on the
fetal surface to form
chorionic vessels.
• They enter the
chorionic villi to form
arteriocapillary-
venous system.
Fetal side
14. 14
PLACENTAL MEMBRANE
knot –syncytiotrophoblast
–Toward end of pregnancy –
phagocytic cells
• This is a composite structure
that consists of the extrafetal
tissues separating the fetal
blood from the maternal
blood.
• It has four layers:
– Syncytiotrophoblast
– Cytotrophoblast
– Connective tissue of
villus
– Endothelium of fetal
capillaries
• After the 20th
week, the
cytotrophoblastic cells
disappear and the placental
membrane consists only of
three layers.
21. When villi persist on the entire
surface of the chorionic sac ,a
thin layer of placenta attaches to
a large area of the uterus …… it
is a membranous placenta.
30. PLACENTAL FUNCTION
• Transfer of nutrients and waste products bn
the mother & fetus.
RESPIRATORY
EXCRETORY
NUTRITIVE
• Produces or metabolizes the hormones &
enzymes necessary to maintain the
pregnancy.
32. Transfer function
• Transport is facilitated by the close
approximation of maternal and fetal
vascular systems within the placenta.
• It is important to recognize that there
normally is no mixing of fetal and maternal
blood within the placenta.
33. • Respiratory function—Intake of o2 &
output of co2 takes place by simple
diffusion.o2 supply to fetus rate of
5ml/kg/min & this achieved with cord flow
of 165-330ml/min.
• Excretory function—waste products urea,
uric acid,creatinine are excreted to maternal
blood by simple diffusion.
34.
35. NUTRITIVE FUNCTION
• Glucose is the major energy substrate
provided to the placenta and fetus. It is
transported across the placenta by facilitated
diffusion via hexose transporters
• Although the fetus receives large amounts of
intact glucose, a large amount is oxidized
within the placenta to lactate, which is used
for fetal energy production.
36. • Amino acid concentrations in fetal blood
are higher than in maternal blood.
Amino acids are therefore transported
to the fetus by active transport .
• LIPIDS—TG`s & FA directly
transported from mother to fetus in early
pregnancy but synthesized in fetus later
in pregnancy. Thus, fetal fat has got
dual origin.
37. • Water & electrolytes—Na,K+,Cl- by
simple diffusion.Ca,Ph,iron by active
transport.
• BARRIER FUNCTION:-Protective
barrier to the fetus against noxious
agents circulating in maternal blood.
(High MW >500daltons.
38. IMMUNOLOGICAL
FUNCTION
• Fetus & placenta contain paternally determined
antigens,foreign to the mother . Inspite of this
,no evidence of graft rejection. Probably:
1. Fibrinoid & sialomucin coating of trophoblast
may suppress the troblastic antigen.
2. Placental hormones ,steroids, HCG have got
weak immunosuppressive effect, may be
responsible for producing sialomucin.
39. 3.Nitabuch`s layer which intervenes bn
decidua basalis &cytotrophoblast probably
inactivates the antigenic property of tissue.
4.There is little HLA & blood group antigens on
trophoblast surface. so antigenic stimulus is
poor.
5. Production of block antibodies by mother
,protects fetus from rejection.
40. • ENDOCRINE—hormones secreted
internally.
• HORMONE--Any organic chemical that is
secreted by a gland into the circulatory
system and is transported to some target
organ. The target may be either peripheral
tissue (such as muscle or other gland) or
brain.
41. Fetal, placental & maternal compartments
form an integrated hormonal unit
The feto-placental-maternal (FPM) unit
creates the
Endocrine Environment
that maintains and drives the processes of
pregnancy and pre-natal development.
43. To understand the FPM one should know:
1. The major hormones involved:
hCGn
Progesterone
Estrogen
Human Chorionic Somatomammotropin (hCS)
(placental lactogen)
2. How the FPM compartments work together
to produce the steroid hormones
3. The transfer of hormones between
the FPM compartments.
44.
45. Human Chorionic Gonadotropin (hCG)
• PREGNANCY HORMONE---
glycoprotein
• Half life –24hrsof hCG
• Levels peak at 60-70 days then remain at a low
plateau for the rest of pregnancy.
• Placental GnRH have control of hCG.
• FUNCTIONS:
1. RESCUE &MAINTENANCE of function of
corpus luteum.
46. • Prevents degeneration of corpus luteum
• Stimulates corpus luteum to secrete E + P which,
in turn, stimulate continual growth of
endometrium.
2.hCG stimulates leydig cells of male fetus to
produce testosterone in conjunction with fetal
pituitary gonadotrophins.Thus indirectly involed
in development of external genitalia.
3. Suppresses maternal immune function
& reduces possibility of fetus immunorejection
47. Human Chorionic Somammotropin (hCS)
or Placental Lactogen
• Structure similar to growth hormone
• Produced by the placenta
• Levels throughout pregnancy
• Large amounts in maternal blood but
DO NOT reach the fetus
48. Human Chorionic Somammotropin (hCS)
or Placental Lactogen
• Biological effects are reverse of those of insulin:
utilization of lipids;
• make glucose more readily available to fetus,
and for milk production.
• hCS levels proportionate to placental size
• hCS levels placental
insuffiency
49. Estrogen (E)
• FORMS-estriol,estradiol &estrone .
• Estriol most important .
• Levels increase throughout pregnancy
• 90% produced by placenta.
(syncytiotrophoblast)
• Placental production is transferred to both
maternal and fetal compartments
50.
51. • Two of the principle effects of placental
estrogens are:
• Stimulate growth of the myometrium and
antagonize the myometrial-suppressing activity of
progesterone. In many species, the high levels of
estrogen in late gestation induces myometrial
oxytocin receptors, thereby preparing the uterus
for parturition.
• Stimulate mammary gland development.
Estrogens are one in a battery of hormones
necessary for both ductal and alveolar growth in
the mammary gland.
52. Progesterone (P)
• Levels increase throughout pregnancy
• 80-90% is produced by placenta and
secreted to both fetus and mother
53. • Progestins, including progesterone, have two
major roles during pregnancy:
• Support of the endometrium to provide an
environment conducive to fetal survival. If the
endometrium is deprived of progestins, the
pregnancy will inevitably be terminated.
• Suppression of contractility in uterine smooth
muscle, which, if unchecked, would clearly be a
disaster. This is often called the "progesterone
block" on the myometrium. Toward the end of
gestation, this myometrial-quieting effect is
antagonized by rising levels of estrogens, thereby
facilitating parturition.
54. • Progesterone and other progestins also
potently inhibit secretion of the pituitary
gonadotropins luteinizing hormone and
follicle stimulating hormone. This effect
almost always prevents ovulation from
occuring during pregnancy
57. Adrenal Gland Development
• Adrenal Cortex
– Vital to organism survival
– Begins to develop at 4th
week of embryonic life
– Functional around 10th
to 12th
week of embryonic life
– Enzymes necessary for biosynthesis of adrenocortical
hormones do not develop simultaneously
– hCG may have a role in stimulating Adrenocortical
development
• Adrenal Medulla
– Originates from nervous system
– Ganglia of Autonomic Nervous System
58. Fetal Adrenal Cortex Function
– Adrenal Cortex
• Zona Glomerulosa
– Has enzymes to convert Pregnenalone to:
» Progesterone
» Deoxycorticosterone
» Corticosterone
» Aldosterone
• Zona Fasciculata
– Converts Pregnenalone and Progesterone to 17OH-Pre
and 17OH-Pro
– 17OH-Pro is converted to cortisol (major glucocorticoid)
• Zona Reticularis
– Converts 17OH-Pre into DHEA and Androstenedione
(androgens)