The sciatic nerve is the longest and largest nerve in the human body. It runs from the lower back through the back of the leg, and down to the toes. Any type of pain and/or neurological symptoms that are felt along the sciatic nerve is referred to as sciatica.
Lower Limb Human Anatomy ( Muscles )
by DR RAI M. AMMAR
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Lower Limb Human Anatomy ( Muscles )
by DR RAI M. AMMAR
www.facebook.com/drraiammar
www.twitter.com/drraiammar
www.instagram.com/drraiammar
www.linkedin.com/in/drraiammar
www.themedicall.com/blog/auther/drraiammar/
For Any Book or Notes Visit Our Website:
www.allmedicaldata.wordpress.com
www.drraiammar.blogspot.com
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The sciatic nerves branches from your lower back through your hips and buttocks and down each leg. Sciatica refers to pain that travels along the path of the sciatic nerve
Nerve roots: L4-S3.
Motor functions:
Innervates the muscles of the posterior thigh (biceps femoris, semimembranosus and semitendinosus) and the hamstring portion of the adductor magnus (remaining portion of which is supplied by the obturator nerve).
Indirectly innervates (via its terminal branches) all the muscles of the leg and foot.
Sensory functions: No direct sensory functions. Indirectly innervates (via its terminal branches) the skin of the lateral leg, heel, and both the dorsal and plantar surfaces of the foot.
The sacral plexus is a network of nerves formed by the lumbosacral trunk (L4, L5) and sacral spinal nerves (S1 - S4). The sacral plexus is located on the posterior pelvic wall, posterior to the internal iliac vessels and ureter, and anterior to the piriformis muscle.
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.
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
- 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
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.
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
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
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
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.
Anti ulcer drugs and their Advance pharmacology ||
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||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
2. z
INTRO
• Sciatic nerve is the thickest
nerve in the body
• It begins in the pelvis and
terminates into popliteal fossa
by dividing into tibial and
common peroneal nerves.
3. z
ORIGIN AND ROOT VALUE
This is the largest branch of sacral plexus. Its root value is
L4,L5,S1,S2,S3.
It is made up of two parts , the tibial part and the common
peroneal part.
The tibial part is formed by the ventral divisions of anterior
primary rami (ventral rami) of L4,L5,S1,S2,S3.
The common peroneal part is formed by the dorsal divisions of
the anterior primary rami (ventral rami) of L4,L5,S1,S2
6. z
Course & Distribution
It leaves the pelvis through
greater sciatic foramen, below the
piriformis & passes in the gluteal
region (between ischial tuberosity
& greater trochanter) then to
posterior compartment of thigh.
Termination
In the middle of the back of the
thigh (apex of the popliteal fossa) It
divides into 2 terminal branches:
Tibial &
Common Peroneal (Fibular).
7. Anatomical Course
The sciatic nerve is derived from the lumbosacral plexus.
After its formation, it leaves the pelvis and enters the gluteal
region via greater sciatic foramen. It emerges inferiorly to
the piriformis muscle and descends in an inferolateral
direction.
As the nerve moves through the gluteal region, it crosses the
posterior surface of the superior gemellus, obturator internus,
inferior gemellus and quadratus femoris muscles. It then enters
the posterior thigh by passing deep to the long head of
the biceps femoris.
Within the posterior thigh, the nerve gives rise to branches
to the hamstring muscles and adductor magnus. When the
sciatic nerve reaches the apex of the popliteal fossa, it
terminates by bifurcating into the tibial and common fibular
nerves.
8. z
BRANCHES OF SCIATIC NERVE
1. Cutaneous:
To all leg & foot directly or indirectly EXCEPT:
Areas supplied by the saphenous nerve (branch of femoral
nerve).
9. z
BRANCHES OF SCIATIC NERVE
2. Muscular:
• To Hamstrings: It is one of the three posterior thigh muscles in
between the hip and knee (m-l, semimembranosus,
semitendonosus, and biceps femoris)
(flexors of knee & extensors of the hip).
(through tibial part) to:
1. Hamstring part of Adductor Magnus. ,(ischial part)
2. Long head of Biceps Femoris.
3. Semitendinosus.
4. Semimembranosus.
NB. The short head of biceps receives its branch (common
peroneal) nerve.
12. z
The sciatic nerve is most frequently injured by…?
I- Badly placed intramuscular injections in the gluteal region.
To avoid this,
injections should be done into the gluteus maximus or medius (into
the upper outer quadrant of buttock
In 90% of injuries, the common peroneal nerve is the mostly affected.
Why?
- The common peroneal nerve fibers lie superficial in the sciatic
nerve.
CAUSES OF SCIATIC NERVE INJURY
14. zEFFECT OF SCIATIC NERVE INJURY
MOTOR EFFECTS PARALYSIS OF MOVEMENTS AFFECTED
HAMSTRING Flexion of knee and
extension of hip
ALL MUSCLES OF LEG
AND FOOT
All muscles of leg and foot
SENSORY EFFECTS Loss of sensation of areas
supplied by sciatic nerve
(below knee)
EXCEPT area supplied by
saphenous nerve
17. z
OTHER CLINICAL ANATOMY
SLEEPING FOOT : When a person sits on the edge of a hard
table or chair, the nerve gets compressed between the edge of
the table and femur. It results in the numbness of lower limb. But
the sensations come back when foot is hit on the ground a few
times.
SCIATICA: It is the shooting pain along the cutaneous
distribution of the sciatic nerve and its terminal branches, chiefly
the common peroneal. Pain usually begins in the gluteal region,
and radiates along the back of the thigh, and the lateral side of
the leg, to the dorsum of the foot.