The thorax contains the heart and lungs and is protected by the thoracic cage. It is separated from the abdomen below by the diaphragm. The thoracic wall is formed by bones including the sternum in front and ribs and vertebrae on the sides and back. Within the chest cavity are the mediastinum, which contains the heart and major blood vessels, and the pleural cavities housing the lungs. Openings in the diaphragm allow passage of structures between the chest and abdomen.
Cardiac Surgery
Internal thoracic ( mammary ) artery
ORIGIN and Course Of IMA
BRANCHES
Thymic Artery
The Xiphoid branch
The sternal branches
The Pericardiacophrenic branch
Anterior intercostal branches
Perforating branches
Musculophrenic artery
Superior Epigastric Artery
Clinical significance
In this pppt I have described surgical anatomy of chest wall, lungs and mediastinum. This will be useful to medical students, surgical residents and surgons
The thorax refers to the region which forms a major part of the appendicular skeleton. Knowledge of its surface anatomy is essential for surgical techniques, to say the least.
Anatomy notes for the thorax. Describes all aspects of the thorax in detail including anatomy of the heart and lungs . Mentions all the muscles, all the inner actions of the arteries, veins and nerves. Explains osteology of the bones involved for example the ribs the sternum with it’s different dimensions.
Cardiac Surgery
Internal thoracic ( mammary ) artery
ORIGIN and Course Of IMA
BRANCHES
Thymic Artery
The Xiphoid branch
The sternal branches
The Pericardiacophrenic branch
Anterior intercostal branches
Perforating branches
Musculophrenic artery
Superior Epigastric Artery
Clinical significance
In this pppt I have described surgical anatomy of chest wall, lungs and mediastinum. This will be useful to medical students, surgical residents and surgons
The thorax refers to the region which forms a major part of the appendicular skeleton. Knowledge of its surface anatomy is essential for surgical techniques, to say the least.
Anatomy notes for the thorax. Describes all aspects of the thorax in detail including anatomy of the heart and lungs . Mentions all the muscles, all the inner actions of the arteries, veins and nerves. Explains osteology of the bones involved for example the ribs the sternum with it’s different dimensions.
The thorax is the body cavity, surrounded by the bony rib cage that contains the heart and lungs, the great vessels, the oesophagus and trachea, the thoracic duct and the autonomic innervations of these structures
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
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
- 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
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.
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.
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
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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
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
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
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.
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
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.
1. THORAX
• The thorax (or chest) is the region of the body
between the neck and the abdomen. It is
flattened in front and behind but rounded at
the sides. The framework of the walls of the
thorax, which is referred to as the thoracic
cage.
2. Thoracic Wall
• The thoracic wall is formed posteriorly by the
thoracic part of the vertebral column;
anteriorly by the sternum and costal cartilages
,laterally by the ribs and intercostal spaces;
superiorly by the suprapleural membrane; and
inferiorly by the diaphragm, which separates
the thoracic cavity from the abdominal cavity.
3. Sternum
• The sternum lies in the midline of the anterior
chest wall. It is a flat bone that can be divided
into three parts: manubrium sterni, body of
the sternum, and xiphoid process.
5. Ribs and costal cartilages
• True ribs: The upper seven pairs are attached
anteriorly to the sternum by their costal
cartilages.
• False ribs: The 8th, 9th, and 10th pairs of ribs
are attached anteriorly to each other and to
the 7th rib by means of their costal cartilages
and small synovial joints.
• Floating ribs: The 11th and 12th pairs have no
anterior attachment
9. joints
• Joints of the Chest Wall
• Joints of the Sternum: The manubriosternal joint is a cartilaginous joint
between the manubrium and the body of the sternum. A small amount of
angular movement is possible during respiration. The xiphisternal joint is a
cartilaginous joint between the xiphoid process (cartilage) and the body of
the sternum. The xiphoid process usually fuses with the body of the
sternum during middle age.
• Joints of the Ribs: Joints of the Heads of the Ribs The 1st rib and the three
lowest ribs have a single synovial joint with their corresponding vertebral
body. For the 2nd to 9th ribs, the head articulates by means of a synovial
joint with the corresponding vertebral body and that of the vertebra
above it. There is a strong intra-articular ligament that connects the head
to the intervertebral disc.
• Joints of the Tubercles of the Ribs The tubercle of a rib articulates by
means of a synovial joint with the transverse process of the corresponding
vertebra. This joint is absent on the 11th and 12th ribs.
10.
11. Openings of the Thorax
• The chest cavity communicates with the root of the
neck through an opening called the thoracic outlet. It is
called an outlet because important vessels and nerves
emerge from the thorax here to enter the neck and
upper limbs.
• The thoracic cavity communicates with the abdomen
through a large opening. The opening is bounded
posteriorly by the 12th thoracic vertebra, laterally by
the curving costal margin, and anteriorly by the
xiphisternal joint. Through this large opening, which is
closed by the diaphragm, pass the esophagus and
many large vessels and nerves, all of which pierce the
diaphragm.
19. Diaphragm
• The diaphragm is a thin muscular and tendinous
septum that separates the chest cavity above
from the abdominal cavity below
• Parts:
• A sternal part arising from the posterior surface
of the xiphoid process.
• A costal part arising from the deep surfaces of the
lower six ribs and their costal cartilages.
• A vertebral part arising by vertical columns or
crura and from the arcuate ligaments
20. • Shape of the Diaphragm
• Nerve Supply of the Diaphragm
• Action of the Diaphragm
• Muscle of inspiration
• Muscle of abdominal straining
• Weight-lifting muscle
• Thoracoabdominal pump
21.
22. Openings in the Diaphragm
• The aortic opening:
lies anterior to the body of the 12th thoracic
vertebra between the crura. It transmits the aorta,
the thoracic duct, and the azygos vein.
The esophageal opening :
lies at the level of the 10th thoracic vertebra in a
sling of muscle fibers derived from the right crus.It
transmits the esophagus, the right and left vagus
nerves, the esophageal branches of the left gastric
vessels, and the lymphatics from the lower third of
the esophagus.
23. • The caval opening lies at the level of the 8th
thoracic vertebra in the central tendon. It
transmits the inferior vena cava and terminal
branches of the right phrenic nerve.
24.
25. Chest Cavity
• The chest cavity is bounded by the chest wall
and below by the diaphragm.
• The chest cavity can be divided into a median
partition, called the mediastinum, and the
laterally placed pleurae and lungs.
26. Mediastinum
• The mediastinum, though thick, is a movable
partition that extends superiorly to the
thoracic outlet and the root of the neck and
inferiorly to the diaphragm. It extends
anteriorly to the sternum and posteriorly to
the vertebral column. It contains the remains
of the thymus, the heart and large blood
vessels, the trachea and esophagus, the
thoracic duct and lymph nodes, the vagus and
phrenic nerves, and the sympathetic trunks.
27. • Superior Mediastinum (a) Thymus, (b) large veins, (c)
large arteries, (d) trachea,
• (e) esophagus and thoracic duct, and (f) sympathetic
trunks. The superior mediastinum is bounded in front
by the manubrium sterni and behind by the first four
thoracic vertebrae.
• Inferior Mediastinum (a) Thymus, (b) heart within the
pericardium with the phrenic nerves on each side, (c)
esophagus and thoracic duct, (d) descending aorta, and
(e) sympathetic trunks. The inferior mediastinum is
bounded in front by the body of the sternum and
behind by the lower eight thoracic vertebrae.