The pterygopalatine fossa is a small pyramidal space located behind the maxilla and below the orbit. It contains the maxillary nerve, pterygopalatine ganglion, maxillary artery and veins. The fossa communicates with several areas through canals including the orbit, nasal cavity, infratemporal fossa and middle cranial fossa. It is an important distribution center for branches of the maxillary nerve and artery.
Pterygopalatine Fossa
Skeletal Framework of pterygopalatine fossa
Formation of pterygopalatine fossa
Location of pterygopalatine fossa
Contents of pterygopalatine fossa
Boundries of Pterygopalatine Fossa
Pterygopalatine Fossa
Skeletal Framework of pterygopalatine fossa
Formation of pterygopalatine fossa
Location of pterygopalatine fossa
Contents of pterygopalatine fossa
Boundries of Pterygopalatine Fossa
pharynx, wall of pharynx, boundaries of pharynx, parts of pharynx, blood supply lympahtic drainage, nerve supply of pharynx, potential weak ares of pharynx, muscles of pharynx, potential weak ares of pharyngeal wall
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
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
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.
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
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.
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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
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
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.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
- 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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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
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...
Pterygopalatine fossa
1. Pterygopalatine fossa
for 2nd year MBBS, by Dr M Idris Siddiqui
It is a complex small, pyramidal space,
below & behind the apex of orbit,
found deep within the face.
Syn: fossa pterygopalatina [NA], Bichat's fossa,
pterygomaxillary fossa, sphenomaxillary fossa.
5. Location
It is located posterior to the maxilla,
inferior to the apex of the orbit, and
immediately lateral to the lateral wall of
the nose, between the pterygoid process,
the maxilla, and the palatine bone.
6. Boundaries
Anterior: The posterior surface of the maxilla
Posterior: The base of the lateral pterygoid plate
and the opening of the foramen rotundum and
pterygoid canal
Inferior: The junction of the palatine perpendicular
plate and the maxilla
Superior: The greater wing of the sphenoid and
the inferior orbital fissure
Medial: The perpendicular plate of the palatine
bone and the sphenopalatine foramen
Lateral: The pterygomaxillary fissure
7.
8. The pterygopalatine fossa is a small pyramidal space housing the
pterygopalatine ganglion. The fossa is seen through the pterygomaxillary
fissure between the pterygoid process and the maxilla.
9.
10.
11. The fossa has been exposed through the floor of the orbit and maxillary sinus.
The foramen rotundum, pterygoid canal, and pharyngeal canal are openings in the
posterior wall of the pterygopalatine fossa.
12.
13. The pterygopalatine fossa is a major
distributing center for branches of the maxillary
nerve and the pterygopalatine (third) part of
the maxillary artery.
It is located between, and has communications
with, the infratemporal fossa, nasal cavity,
orbit, middle cranial fossa, pharyngeal vault,
maxillary sinus, and oral cavity (palate).
Its contents are
The maxillary nerve (CN V2),
The parasympathetic pterygopalatine ganglion,
The third part of the maxillary artery and
Accompanying veins, and
A surrounding fatty matrix.
14.
15.
16.
17.
18. Contents
The major structures of the fossa are
The maxillary artery,
Accompanying veins
Pterygopalatine ganglion, and
Maxillary nerve.
Fat .
19. Communications
It has a space with multiple entrances and exits.
Through its many complex and small bony passages, important
vessels and nerves communicate with
The oral cavity,
Nasal cavity,
Orbit,
Cranial cavity,
Infratemporal fossa, and
Anterior surface of the face.
In general, the vascular structures of the pterygopalatine
fossa enter it through its lateral wall; the nerves of the
fossa enter it posteriorly.
20. The pterygopalatine fossa communicates
Laterally: with the infratemporal fossa through
the pterygomaxillary fissure.
Medially: with the nasal cavity through the
sphenopalatine foramen.
Anterosuperiorly: with the orbit through the
inferior orbital fissure.
Posterosuperiorly: with the middle cranial fossa
through the foramen rotundum and
pterygoid canal.
21. Direction Passage Connection
Posteriorly foramen rotundum middle cranial fossa
Posteriorly pterygoid canal (Vidian)
middle cranial
fossa, foramen lacerum
Posteriorly
palatovaginal
canal (pharyngeal)
nasal cavity/nasopharynx
Anteriorly inferior orbital fissure orbit
Medially sphenopalatine foramen nasal cavity
Laterally pterygomaxillary fissure infratemporal fossa
Inferiorly
greater palatine
canal (pterygopalatine)
oral cavity, lesser palatine
canals
Passages
The following passages connect the fossa with other parts of the skull:
22.
23.
24.
25. Pterygopalatine Part of the Maxillary Artery
The maxillary artery, a terminal branch of the
external carotid artery, passes anteriorly and
traverses the infratemporal fossa.
It passes over the lateral pterygoid muscle and
enters the pterygopalatine fossa. The
pterygopalatine part of the maxillary artery, its
third part, passes through the pterygomaxillary
fissure and enters the pterygopalatine fossa,
where it lies anterior to the pterygopalatine
ganglion. The artery gives rise to branches that
accompany all nerves in the fossa with the same
names.
26.
27.
28. The maxillary artery
The terminal part of the maxillary artery branches within the nose
to supply
The conchae and nasal septum (by the sphenopalatine artery),
Palate (by the greater and lesser palatine arteries), and
Nasopharynx (by the pharyngeal artery).
The sphenopalatine artery branches off of the maxillary artery
within the confines of the pterygopalatine fossa, then travels
medially through the sphenopalatine foramen to reach the interior
of the nose.
The greater palatine artery departs the maxillary artery within the
fossa as well and descends through the greater palatine canal to
reach the palate.
The lesser palatine arteries, supplying the soft palate, are actually
branches of the greater palatine arteries, supplying the hard
palate.
The small pharyngeal artery leaves the maxillary artery within the
pterygopalatine fossa and enters a small passage, known as the
palatovaginal canal, to emerge into the nasopharynx, which it
supplies with blood.
29. Maxillary Nerve
The maxillary nerve enters the pterygopalatine fossa
through the foramen rotundum and runs anterolaterally
in the posterior part of the fossa. Within the
pterygopalatine fossa, the maxillary nerve gives off the
zygomatic nerve, which divides into zygomaticofacial
and zygomaticotemporal nerves.
These nerves emerge from the zygomatic bone through cranial
foramina of the same name and supply general sensation to the lateral
region of the cheek and temple. The zygomaticotemporal nerve also
gives rise to a communicating branch, which conveys parasympathetic
secretomotor fibers to the lacrimal gland by way of the heretofore
purely sensory lacrimal nerve from CN V1.
While in the pterygopalatine fossa, the maxillary nerve
also gives off the two pterygopalatine nerves that
suspend the parasympathetic pterygopalatine ganglion
in the superior part of the pterygopalatine fossaThe
maxillary nerve leaves the pterygopalatine fossa
through the inferior orbital fissure, after which it is
known as the infraorbital nerve.
30. The pterygopalatine ganglion
The pterygopalatine ganglion is a
parasympathetic ganglion, one of four
found in the head and neck region.
Postganglionic axons from the ganglion
travel through intricate pathways to
innervate the lacrimal gland and, to a
lesser degree, the minor salivary glands of
the soft palate.
31. The nerve of the pterygoid canal
In addition to the maxillary nerve, the
nerve of the pterygoid canal also enters
the pterygopalatine fossa through the
opening of the pterygoid canal in its
posterior wall.
This nerve consists of axons from
(1) the greater petrosal nerve, composed of
preganglionic parasympathetic axons derived from
the facial nerve, and
(2) the deep petrosal nerve, a collection of
postganglionic sympathetic axons derived from the
internal carotid plexus.
32.
33. Transantral Approach to the Pterygopalatine Fossa
Surgical access to the deeply placed
pterygopalatine fossa is gained through the
maxillary sinus. After elevating the upper lip, the
maxillary gingiva and anterior wall of the sinus
are transversed to enter the sinus.
The posterior wall is then chipped away as
needed to open the anterior wall of the
pterygopalatine fossa. In the case of chronic
epistaxis (nosebleed), the third part of the
maxillary artery may be ligated in the fossa to
control the bleeding.