The document describes the anatomy of bones that make up the thoracic wall, including the sternum, ribs, and thoracic vertebrae. It discusses the parts, features, attachments, and joints of these bones. The sternum consists of manubrium, body, and xiphoid process. Typical ribs are the 3rd to 9th ribs and have a costal groove, curved shaft, and articulate with the sternum via costal cartilage. Thoracic vertebrae are the 2nd to 8th vertebrae and have demifacets on the body and costal facets on the transverse processes.
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Specifically, this presentation talks about the bony thoracic region such as ribs, sternum and vertebrae.
To describe the structure of the thorax, cutaneous innervations of thorax (concept of the myotomes and dermatomes) and of bony framework that forms part of the thorax, and how it is adapted to their functions
To define the thorax, rib cage and thoracic wall.
To describe the structures that form the boundary of the rib cage i.e ribs, sternum, vertebrae.
To outline the clinical importance of the structures that form the rib cage.
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Highest burden of multidrug‑resistant tuberculosis,
Alarmingly high resistance among Gram‑negative and Gram‑positive bacteria even to newer antimicrobials such as carbapenems.
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Thoracic wall is made up of bones bones, cavity, muscles and organs. Also, the presence of blood vessels and lymphatics.
Specifically, this presentation talks about the bony thoracic region such as ribs, sternum and vertebrae.
To describe the structure of the thorax, cutaneous innervations of thorax (concept of the myotomes and dermatomes) and of bony framework that forms part of the thorax, and how it is adapted to their functions
To define the thorax, rib cage and thoracic wall.
To describe the structures that form the boundary of the rib cage i.e ribs, sternum, vertebrae.
To outline the clinical importance of the structures that form the rib cage.
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India is among the nations with the highest burden of bacterial infections.
India is one of the largest consumers of antibiotics worldwide.
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Highest burden of multidrug‑resistant tuberculosis,
Alarmingly high resistance among Gram‑negative and Gram‑positive bacteria even to newer antimicrobials such as carbapenems.
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Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
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Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
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
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
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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
4. PARTS OF A
STERNUM
It consist of three parts
1.Manubrium sterni
2.Body
3.Xiphoid process
5. Anatomical position
● Quadrilateral manubrium is directed
upwards & triangular xiphoid process is
directed downwards.
● Anterior surface of the manubrium is
convex from side to side and concave from
above downwards.
● Anterior surface of the body is flat and
marked by three transverse ridge and the
posterior surface of the body is smooth&
slightly concave.
6. Features
● It is morphologically a flat bone. It's ossification is intra
cartilaginous ossification.
● Manubrium has two surface
& Four borders.
● The superior border ia thik, rounded and marked by
jugular notch or suprasternal notch on middle &
clavicular notch on each side.
● Manubrium makes a slight angle with the body of
sternum called sternal angle of Luis.
● The lateral border of the sternum contain 7 pair of costal
facet.
7. Attachment
Manubrium
Anterior surface- sternocleidomastoid muscle & pectoralis major muscle .
Posterior surface - sternohyoid (upper) & Sternothyroid (lower)
Body of the sternum
Anterior surface- pectoralis major muscle (on each side)
Posterior surface - sternocostalis muscle (Lower lateral part)
Lateral border - internal intercostal muscle & external intercostal membrane
Xiphoid process
Anterior surface - rectus abdominalis muscle
Posterior surface - The diaphragm
8. Relations
Manubrium
Posterior surface: Arch of aorta (Lower
half), branches of arch of aorta (upper
half)& branches are brachiocephalic trunk,
left common carotid and left subclavian
artery
Body of the sternum
Right side: Right lung & right pleura
Left side: left lung & left pleura (upper
half)
9. Joints
1.Sternoclavicular joint is a saddle
synovial joint.
2.Manubrio-sternal joint is a secondary
cartilaginous joint.
3. Xiphisternal joint is primary
cartilaginous joint
4.1st chondrosternal joint is a primary
cartilaginous joint.
5.2nd-7th chondrosternal joint is synovial
joint.
10. Clinical importances of sternum
● Bone marrow collection: from Sternum
cause it contains red bone marrow
throughout the life.It is done in upper part
of manubrium to prevent injury to arch of
aorta which lies behind its lower half.
16. Anatomical position
❄️Posterior end is higher and medial than
the anterior end.
❄️The anterior end bears a concave
depression to receive its own costal
cartilage.
❄️The shaft is thin,flat and curved with
convexity directed outward.
❄️The inner surface of the shaft is
marked by costal groove near the lower
border
17. Parts
1.Two ends-
Anterior end bears a concave depression that forms the
costo- chondral joint.Posterior end bears - a)Head bears
two facets separated by crest b)Neck possesses two
surfaces-anterior and posterior.Two borders-upper and
lower.c)Tubercle bears two parts-Medial articular part that
forms costo- transverse joint and Lateral non-articular part.
2.Shaft-
It is curved with convexity directed outward and twisted.It
possesses two surfaces-external surface is convex and
smooth and internal surface is smooth .Two borders-
rounded upper and sharp lower borders.
18. Attachments
1.Radiate ligament,intra-articular ligament at the head.
2. Inferior costotransverse ligament at the rough posterior part, Superior
costotransverse ligament at the crest of the neck. The anterior surface is covered by
costal pleura.
3.The Lateral costotransverse ligament is attached to the lateral non-articular part of
Tubercle.
4.The thoracolumbar fascia, lateral fibres of Sacrospinalis muscle,lere attached to the
posterior angle. The anterior angle separates the origin of External oblique and
serratus anterior in 5th-8th ribs and External oblique from Latissimus dorsi in 9th-
10th rib.
19. Attachment
5. The Internal intercostal muscle arises
from the floor of costal groove and the
Innermost intercostal muscle arises from
the middle two-fourths of the ridge above
the groove.
6. The External intercostal muscle is
atteched on the outer lip and Internal &
Innermost intercostal muscle are
attached on the inner lip of the upper
border of the shaft.
26. Anatomical position
1.Anterior end is larger,thicker and
pitted
2.Posterior end is small and rounded.
3.Both ends touch the surface.
4.Posterior end is higher than the
anterior end.
27. Parts
1.Two ends -
Anterior end is largest and thickest which articulates with 1st costal
cartilage.
Posterior end bears a)Head bears single circular facete. b)Neck c)Tubercle
is prominent and thik.It faces upwards and backwards.
2.Shaft
It possesse two surfaces -Upper surface is marked by two shallow grooves
that ends in scalene tubercle.Lower surface is smooth and no costal
grooves.Two borders-convex outer and concave inner border.
28. Attachments
1.Capsular ligament and radiate ligament on head
2.Inferior costo-transverse ligament and superior costo-transverse ligament on neck.
3.Lateral costo-transverse ligament on tubercles.
4.Scalenus anterior,subclavius,scalenus medius, costo-clavicular ligament on upper
surface.External and Internal intercostal muscle on lower surface.1st digitation of
serratus anterior on outer border. Supra-pleural membrane and scalenus anterior on
inner border.
29. Relations
1.Sympathetic trunk,1st posterior intercoastal
vein,superior intercoastal artery,1st thoracic
nerve,lower trunk of branchial plexus lies
anteriorly on neck from medial to lateral.
2.Subclavian vein,artery and lower trunk of
branchial plexus on upper surface.
3.1st intercoastal vein and artery on outer border.
31. Identifications
1.More curved
2.Twice longer than 1st rib
3.Head is small and bears two facets .
4.Non-articular part of tubercle is small
5.No twist,slight angle,slight costal groove on
posterior internal surface.
6.Angle is close to the tubercle.
32. Anatomical position
1.Both ends touch surface
2.Posterior end is higher and medial
than the anterior end.
3.Tubercle is in middle of the external
surface.
33. Parts
1.Two ends-
Anterior end lies forward
and downward.Posterior
End lies backward,upward
and medially.
2.Shaft
Convex external surface faces upwards and outwards.Concave Internal
surface faces downwards and inwards.
34. Attachments
Scalenus posterior and serratus
posterior superior on angle.
Half of the 1st and whole of the
2nd digitation of serratus
anterior.
Others are as typical ribs.
36. Anatomical Points
❄️The posterior end is higher and nearer to the
medial plane.
❄️ Posterior end comprises head,neck,tubercle
and the anterior end bears a concave depression
to receive its own cartilage.
❄️The inner surface is smooth and marked by a
costal groove close to its lower border.
37. Joints
❄️Anterior end articulate with costal cartilage → costochondral junction.
❄️Head articulates with body of vertebrae → costovertebral joint.
40. Floating Rib
They are floating ribs becuase anterior ends are
free. They have no communication with the
sternum
41. Anatomical Position
❄️The posterior end is higher and nearer to the medial plane.
❄️Posterior end comprises only head. There is no neck and tubercle.
❄️The inner surface is marked by shallow costal groove only on its posterior aspect.
❄️There is an angle on the shaft.
❄️Anterior end is pointed.
48. Typical thoracic vertebra
Vertebra are the interlocking bones
that form the spinal column. Among
the 33 individual, 12 are thoracic
vertebra.
Out of 12 thoracic vertebta, the second
to eighth are marked as the typical
thoracic vertebra because they carry
some common carecteristic features
Vertebra are the interlocking bones
that form the spinal column. Among
the 33 individual, 12 are thoracic
vertebra.
Out of 12 thoracic vertebta, the
second to eighth are marked as the
typical thoracic vertebra because
they carry some common
carecteristic features
Vertebra are the interlocking bones
that form the spinal column. Among
the 33 individual, 12 are thoracic
vertebra.
Out of 12 thoracic vertebta, the
second to eighth are marked as the
typical thoracic vertebra because
they carry some common
carecteristic features
49. Identification
● The thoracic vertebra are identified by two
demifacets on the both sides of the body.
● the typical thoracic vertebra are identified by
costal facets on the anterior surface of
transverse process
50. Anatomical
position
● The body lies anteriorly
● The arch lies posteriorly
● The large transverse process
is directed backward and
laterally from the junction of
pedicle and lamina.
● The long spinous process is
directed backwards and
downwards
.
51. Features
● The body is heart shapef.That is the anteroposterior
diameter and the transverse diameter are almost
equal. On each sidel,it bears two demi facets.
● The vertebral foramen is circular and small. The
pedicles are short.The superior articular process is not
well marked but the inferior articular process is
conspicuous. The laminae are short, thick and board
and overlap from above downwards.
● And the large transverse process arises from the
junction of pedical and lamina and directed backwards
and somewhat laterally. In the anterior surface, it has
a concave costal facet
● The spinous process is long and directed backwards
and downwards
52. Attachment
● The anterior part of the body is attached to the
anterior longitudinal ligament and the posterior
part of the body is attached to the posterior
longitudinal ligament.
● The laminae of adjacent vertebra are connected
with a series of fibro-elastic membrane which is
named ligamenta flava.
● The transverse process gives attachment to
● . The lateral costotransverse ligament at the
tip.
● . The intertransverse muscles and ligaments
along the upper and lower border.
● . The superior costotransverse ligament along
the lower border
● . The inferior costotransverse ligament along
the anterior surface
● . The levator costae and deep muscle of the
back to the posterior surface
53. The spinous process gives attachment to the supraspinous and
interspinous ligaments
They also give attachment to several muscles including :
Trapezius
Rhomboids major and minor
Latissimus dorsi
serratus posterior superior
serratus posterior inferior
multifidus
sacrospinalis
semispinalis capitis
the content of vertebral foramen in spinal cord with its meninges
54. Joints
● Facet joint or zygacophyseal joint : the joint between
superior articular process and inferior articular process
of adjoining vertebrae.It is a plane type of Synovial
Joint.
● Intervertebral joint :the joint between the body of two
corresponding vertebra. it is a secondary cartilaginous
joint.
● Costovertebral joint: the joint between superior costal
demifacet of a vertebra and head of corresponding rib.
It’s a plane type of synovial joint.
● Costotransverse joint: The joint between costal facet of
a vertebra and tubercle of corresponding rib.It is also a
plane type of synovial joint
57. First Thoracic vertebra
1.Body is cervical in form as transverse diameter
is twice than anterior-posterior diameter.
2.Upper costal facetes are circular and lower
costal facetes are semicircular
3.Spine is thik amd lies horizontally
4.No foramen transversarium
58. 9th Thoracic vertebra
1.Large semicircular facate above
2.Small semilunar facate below or may ne
absent
10th Thoracic vertebra
1.Large facetes above and lower facetes are
absent.Facetes of transverse processmay be absent
2.Upper facetes enroach upon the pedicle
59. 11th Thoracoc vertebra
1.Complete circular facet which extends back on pedicle
2.No facet on transverse process
12t Thoracic vertebra
1. circular facet which enroaches on pedicle
2.Body is large and resembles tjat of lumbar vertebra
3.No facet on transverse process
4.Inferior articular facet is convex and twisted laterally.
5..Transverse process has three tubercles-(a).Superior, which corresponds to mamillary process (b)
Lateral, which corresponds to transverse process and (c)Inferior, which corresponds to accessory process.