The trachea is a fibrocartilaginous tube that begins at the lower border of the cricoid cartilage and bifurcates into the two main bronchi. It contains 16-20 C-shaped rings of hyaline cartilage that help keep the lumen open. The trachea is located in the neck anterior to the esophagus and descends into the thorax where it ends at the level of T4. It has both cervical and thoracic portions and transports air to the lungs while its structure prevents collapse during movements. Congenital defects can cause tracheoesophageal fistulas.
The lungs are a pair of spongy, air-filled organs located on either side of the chest (thorax). The trachea (windpipe) conducts inhaled air into the lungs through its tubular branches, called bronchi. The bronchi then divide into smaller and smaller branches (bronchioles), finally becoming microscopic.
The bronchioles eventually end in clusters of microscopic air sacs called alveoli. In the alveoli, oxygen from the air is absorbed into the blood. Carbon dioxide, a waste product of metabolism, travels from the blood to the alveoli, where it can be exhaled. Between the alveoli is a thin layer of cells called the interstitium, which contains blood vessels and cells that help support the alveoli.
The lungs are a pair of spongy, air-filled organs located on either side of the chest (thorax). The trachea (windpipe) conducts inhaled air into the lungs through its tubular branches, called bronchi. The bronchi then divide into smaller and smaller branches (bronchioles), finally becoming microscopic.
The bronchioles eventually end in clusters of microscopic air sacs called alveoli. In the alveoli, oxygen from the air is absorbed into the blood. Carbon dioxide, a waste product of metabolism, travels from the blood to the alveoli, where it can be exhaled. Between the alveoli is a thin layer of cells called the interstitium, which contains blood vessels and cells that help support the alveoli.
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
Contact us if you are interested:
Email / Skype : kefaya1771@gmail.com
Threema: PXHY5PDH
New BATCH Ku !!! MUCH IN DEMAND FAST SALE EVERY BATCH HAPPY GOOD EFFECT BIG BATCH !
Contact me on Threema or skype to start big business!!
Hot-sale products:
NEW HOT EUTYLONE WHITE CRYSTAL!!
5cl-adba precursor (semi finished )
5cl-adba raw materials
ADBB precursor (semi finished )
ADBB raw materials
APVP powder
5fadb/4f-adb
Jwh018 / Jwh210
Eutylone crystal
Protonitazene (hydrochloride) CAS: 119276-01-6
Flubrotizolam CAS: 57801-95-3
Metonitazene CAS: 14680-51-4
Payment terms: Western Union,MoneyGram,Bitcoin or USDT.
Deliver Time: Usually 7-15days
Shipping method: FedEx, TNT, DHL,UPS etc.Our deliveries are 100% safe, fast, reliable and discreet.
Samples will be sent for your evaluation!If you are interested in, please contact me, let's talk details.
We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
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.
- 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
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.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
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
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
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
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.
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
263778731218 Abortion Clinic /Pills In Harare ,ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group of receptionists, nurses, and physicians have worked together as a teamof receptionists, nurses, and physicians have worked together as a team wwww.lisywomensclinic.co.za/
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
3. The Trachea
• The Trachea is also called windpipe and it is a
fibrocartilaginious , non-collapsible tube that
creates the beginning of the lower respiratory tract.
• 16-20 C-shaped rings of Hyaline cartilage keep its
lumen patent.
• A band of smooth muscle (Trachealis) and a
fibroelastic ligament that bridges the gap between
the posterior free ends of C-shaped cartilages, that
allow expansion of esophagus during the passage of
bolus of the food.
6. The Trachea
• The trachea, bronchi and bronchioles form
the tracheobronchial tree – a system of airways
that allow passage of air into the lungs, where gas
exchange occurs.
• These airways are located in the neck and thorax.
• The arrangement of cartilages and elastic tissue in
the tracheal wall prevents its kinking and
obstruction during the movements of the head and
neck.
7.
8. Anatomical Position
• The trachea marks the beginning of the
tracheobronchial tree.
• It arises at the lower border of cricoid cartilage in
the neck, as a continuation of the larynx.
• It travels inferiorly into the superior
mediastinum, bifurcating at the level of the sternal
angle (forming the right and left main bronchi).
• As it descends, the trachea is located anteriorly to
the oesophagus, and inclines slightly to the right.
9. EXTENT
• Trachea stretches from the lower
border of cricoid cartilage at the
lower border of the C6 vertebra to
the lower border of T4 vertebra in
supine position, where it ends by
dividing into left and right main
bronchi.
10.
11. MEASUREMENTS
• The upper half of trachea can be found in the neck
(cervical part) on the other hand the lower half is
located in the superior mediastinum of the thoracic
cavity (thoracic part).
• The trachea is a 4-4½ inches (10-11 cm) long tube.
• The diameter of trachea is 2 cm in men and 1.5 cm
in females.
• The lumen is smaller in living human than that in
cadavers.
12. LOCATION
• Thus upper half of the trachea lies in the neck
(cervical part).
• Lower half in the
superior mediastinum (thoracic part).
• Throught its whole course, it lies directly in
front of esophagus.
• Left recurrent laryngeal nerve lies in the
groove between it and left border of
esophagus.
13. STRUCTURE
• The trachea consists of about 16-20 C-shaped
rings of hyaline cartilage being located one
above the other the cartilages are deficient
posteriorly where the gap is filled up by
connective tissue and involuntary muscle
termed trachealis.
• The absence of cartilages on the posterior
aspect enables expansion
of esophagus during deglutition.
14. COURSE
• The trachea is the continuation of the larynx.
• It begins at the lower border of the cricoid cartilage
in the level of C6 vertebra, about 5 cm above
the jugular notch.
• It enters the thoracic inlet in the midline and enters
downwards and backwards behind the manubrium
to terminate by bifurcating into 2 principal bronchi,
a little to the right side at the lower border of T4
vertebra at the level of sternal angle where arch of
aorta deviates it to the right.
• As trachea descends, it receeds rapidly from the
surface to follow the curvature of vertebral column.
15. CERVICAL PART OF TRACHEA
• The cervical part of the trachea is all about 7
cm in length and stretches from the lower
border of cricoid cartilage to the upper
border of manubrium sterni (jugular notch).
• It goes downwards and somewhat
backwards in front of the esophagus
following curvature of the cervical spine and
enters the thoracic cavity in the median
plane with small deviation on the right side.
16. RELATIONSHIPS OF THE CERVICAL
PARTS OF TRACHEA
Anteriorly
(from
superfical
to deep)
1. Skin
2. Superficial fascia including anterior jugular veins and jugular venous
arch (crossing in the suprasternal space of Burns)
3. Investing layer of deep cervical fascia
4. Sternothyroid and sternohyoid muscles
5. Isthmus of thyroid gland in front of the second, third and 4th tracheal
rings
6. Inferior thyroid veins.
7. Left brachiocephalic vein in kids may rise in the neck
8. Thymus gland (in kids)
9. Brachiocephalic artery (occasionally) in kids
Posteriorly 1. Esophagus
2. Recurrent laryngeal nerve in the tracheoesophageal groove (on every
side)
On every side it’s related to:
3. Lobe of thyroid gland going to the 5th or 6th tracheal ring
4. Common carotid artery in the carotid sheath
17. The relations of the trachea in the superior
mediastinum of the thorax
Anteriorly: The sternum,
The thymus,
The left brachiocephalic vein,
The brachiocephalic trunk
Left common carotid arteries,
The arch of the aorta
Superior vena cava (anterolateral).
Deep cardiac plexus
Posteriorly: The esophagus
The left recurrent laryngeal nerve
Vertebral column
Right side: The azygos vein,
The right vagus nerve,
Right lung and the pleura
Left side: The arch of the aorta,
The left common carotid
Left subclavian arteries,
The left vagus and
Left phrenic nerves,
Left lung & pleura
18. The unit of 4 structures in the posterior part of
superior mediastinum
(3 tubes & 1 nerve)
1. The esophagus
2. The traches
3. The thoracic duct
4. The left recurrent laryngeal nerve
These structures are relared to each other and run parallel course
through posterior part of superior mediastinum.
1. The esophagus, lies directly on the vertebral bodies of
the region.
2. The trachea, lies directly in front of esophagus.
3. The thoracic duct, ascends along the left border of the eso
4. The left recurrent laryngeal nerve ascends in the angle
between the trachea and the esophagus.
19.
20. Sites of constrictions of the trachea
• The trachea may be constricted at
a) At its upper end:
By the thyroid gland
b) At its lower end(near bifurcation):
by the arch of aorta
a) Behind the manubrium:
by the brachiocephalic artery
21. Histology
• MUCOSA
It is composed of lining epithelium and lamina propria.
• Lining epithelium is pseudostratified ciliated columnar with few goblets
cells.
• Lamina propria is composed of longitudinal elastic fibres.
• SUBMUCOSA
• It is composed of loose areolar tissue consisting of large number of serous
and mucous glands.
• Cartilage and smooth muscle layer: It’s created from horseshoe-shaped (C-
shaped) hyaline cartilaginous rings, that are deficient posteriorly. The
posterior gap is filled up chiefly by the smooth muscle (trachealis) and
fibroelastic fibres.
• Perichondrium: It encloses the cartilage.
• Fibrous membrane: It is a layer of dense connective tissue, consisting of
neurovascular structure.
• There’s no clear difference between lamina propria and submucosa.
22. VASCULAR SUPPLY AND LYMPHATIC DRAINAGE
• A. Blood supply to the trachea is by
inferior thyroid arteries.
• B. Venous drainage of the trachea takes
place into the left brachiocephalic
(innominate) vein.
• C. Lymphatic drainage of the trachea is
into pretracheal and paratracheal lymph
nodes.
23. NERVE SUPPLY
• This is by sympathetic and parasympathetic fibres.
• The parasympathetic fibres are originated from
vagus via the recurrent laryngeal nerve.
– These are secretomotor and sensory to the mucus
membrane and motor to the trachealis muscle.
• The sympathetic fibres are originated from the
middle cervical sympathetic ganglion.
– These are vasomotor in nature.
24. TRACHEAL SHADOW IN RADIOGRAPH
• It is viewed as a vertical translucent
shadow in front of cervico-thoracic
spine.
• The translucency is because of the
presence of air in the trachea.
25.
26. PALPATION OF TRACHEA
• Medically, trachea is palpated in
the suprasternal notch.
• Normally, it is median in position but
appreciable shift of trachea to left or
right side indicates the mediastinal
shift
27.
28. IMPORTANCE OF CARINA
• It is a keel-like (hook-shaped) median ridge in the lumen in
the bifurcation of trachea. It is both functional and
pathological importance.
• Functional importance: The mucosa of trachea over the
carina is most sensitive. The cough reflex is generally started
here, which helps to clear the sputum.
• Pathological importance: It is visible as a sharp sagittal ridge
in the tracheal bifurcation during bronchoscopy, for this
reason acts as a useful landmark.
• It is located about 25 cm from the incisor teeth and 30 cm
from the nostrils. If the tracheobronchial lymph nodes in the
angle between the main (principal) bronchi are enlarged
because of spread of bronchiogenic carcinoma, the carina
becomes distorted and flattened.
29.
30. Tracheoesophageal Fistula (TEF)
• The most common congenital. Usually, it is combined
with some form of esophageal atresia.
• In the most common type of TEF (approximately 90% of
cases), the superior part of the esophagus ends in a
blind pouch and the inferior part communicates with
the trachea (A).
• In some cases, the superior esophagus communicates
with the trachea and the inferior esophagus joins the
stomach (B).
• Sometimes, TEF exits with esophageal atresia (C).
– TEFs result from abnormalities in partitioning of the
esophagus and trachea by the tracheoesophageal septum