Uterine malformations occur due to abnormal development of the Mullerian ducts during embryogenesis. Common types include septate uterus (35%), bicornuate uterus (26%), and arcuate uterus (18%). Uterine malformations can lead to infertility, dysmenorrhea, recurrent miscarriage, preterm birth, and obstructed labor due to the abnormal uterine anatomy. Diagnosis involves hysteroscopy, ultrasound, or MRI to visualize the internal and external uterine architecture. Surgical correction through hysteroscopic or abdominal metroplasty may be recommended for otherwise unexplained fertility or pregnancy complications.
The second stage of labor begins when the cervix is completely dilated (open), and ends with the birth of your baby. Contractions push the baby down the birth canal, and you may feel intense pressure, similar to an urge to have a bowel movement. Your health care provider may ask you to push with each contraction.
AMNIOINFUSION--
definition-An amnioinfusion is a technique of instilling an isotonic fluid {such as a normal saline or lactated ringer’s solution} into the amniotic cavity during labor to relieve umbilical cord compression and alleviate fetal distress from severe prolonged variable decelerations in the presence of oligohydramnios.
INDICATIONS
Fetal heart rate abnormalities
APGAR scores for those with low scores
Asphyxia during time of birth
Decreasing the rates of cesarean birth related with FHR problem
PROCEDURE
The amnio infusion procedure involves the use of an intrauterine pressure catheter (IUPC), or a single or double lumen type of IUPC.
The IUPC has been designed to attain an accurate monitoring of uterine contractions among women in the intrapartum period.
It has a special port from which the saline fluid or lactated ringer’s solution is being injected, passing through the tubing and going its way into the uterus.
An IUPC is inserted through standard technique once the membranes ruptures, and then it is attached to intravenous extension tubing. If IUPC is not available, a pediatric nasogastric tube can be used instead.
Lactated ringer’s solution without dextrose is infused into the amniotic cavity; normal saline can be an acceptable fluid alternative
Assisting Physician with Amnioinfusion
Explain the procedure to the patient.
Assist in dorsal recumbent position. Assist with draping and exposing vaginal area.
Connect IUPC tubing to IV fluid, flush
Connect the catheter to the monitor cable
Assist physician with insertion of double lumen IUPC and connect IV tubing to the amnioport to begin amnioinfusion.
The second stage of labor begins when the cervix is completely dilated (open), and ends with the birth of your baby. Contractions push the baby down the birth canal, and you may feel intense pressure, similar to an urge to have a bowel movement. Your health care provider may ask you to push with each contraction.
AMNIOINFUSION--
definition-An amnioinfusion is a technique of instilling an isotonic fluid {such as a normal saline or lactated ringer’s solution} into the amniotic cavity during labor to relieve umbilical cord compression and alleviate fetal distress from severe prolonged variable decelerations in the presence of oligohydramnios.
INDICATIONS
Fetal heart rate abnormalities
APGAR scores for those with low scores
Asphyxia during time of birth
Decreasing the rates of cesarean birth related with FHR problem
PROCEDURE
The amnio infusion procedure involves the use of an intrauterine pressure catheter (IUPC), or a single or double lumen type of IUPC.
The IUPC has been designed to attain an accurate monitoring of uterine contractions among women in the intrapartum period.
It has a special port from which the saline fluid or lactated ringer’s solution is being injected, passing through the tubing and going its way into the uterus.
An IUPC is inserted through standard technique once the membranes ruptures, and then it is attached to intravenous extension tubing. If IUPC is not available, a pediatric nasogastric tube can be used instead.
Lactated ringer’s solution without dextrose is infused into the amniotic cavity; normal saline can be an acceptable fluid alternative
Assisting Physician with Amnioinfusion
Explain the procedure to the patient.
Assist in dorsal recumbent position. Assist with draping and exposing vaginal area.
Connect IUPC tubing to IV fluid, flush
Connect the catheter to the monitor cable
Assist physician with insertion of double lumen IUPC and connect IV tubing to the amnioport to begin amnioinfusion.
Peri operative nursing is a nursing specialty that works with patients who are having injuries, invasive procedures. Peri-operative nurses work closely with surgeons, anesthesiologists, nurse anesthetist, surgical technologists, and nurse practitioners. They perform preoperative, intraoperative, post operative care primarily in the operating theater. The nurse assesses the patient data; establishing nursing diagnosis; identifies desired patient outcome; develop and implements a plan of care; and evaluates that care in terms of outcomes achieved by the patient
All aspects of peri operative care is described.
-preoperative care
-postoperative care
Role of nurse in pre operative nursing:
1.Pre operative assessment.
2.Obtaining informed consent.
3.Pre operative teaching.
4.Physical preparation of patients.
5.Psychological preparation
6.Informed Consent
POST OPERATIVE CARE: Post operative phase begins when the client is admitted to the post operative unit and ends with the client’s post operative evaluation in the physician’s office.
GOAL:
Restore homeostasis and prevent complication.
Maintain adequate cardio vascular and tissue perfusion
Maintain adequate respiratory function
Maintain adequate nutrition and elimination
Maintain adequate fluid electrolyte balance
Maintain adequate renal function
Promote adequate rest, comfort, and safety
Promote adequate wound healing
Promote and maintain activity and mobility
Provide adequate psychological support.
TRANSFER FROM OPERATION ROOM:
After sending the patient to operating room, prepare a bed to receive the patient undergone surgery.
Receive the patient without disturbing the devices attached to the patient.
Assessment A- Airway, B- Breathing, C- Circulation, C- Consciousness, S- Safety, D- Dressing, D- Drainage, D- Drugs , E- Elimination F- Foods, F- Fluids P- Pain.
Ask the theater staff about any complications during surgery.
Check vital signs.
Check the operation site for bleeding, discharge, etc. if drainage tube are filled.
Keep the patient well covered to prevent draught
Never leave the patient alone to prevent injury from fall
Observe the patient for swallowing reflexes
Quickly observe the functioning of all devices and make sure that they are in its functioning order.
Check the doctor’s order for other instruction and treatment.
POST OPERATIVE COMPLICATIONS:
Haematological: Hemorrhage
Respiratory: Atelectesis, Pneumonia, Pulmonary Embolism
Cardiovascular: Hypertension, cardiac dysrhythmias, venous thrombosis
Urinary: Urinary retention
Gastrointestinal: Constipation
Neurological: CVA/Stroke
Immunological: Infection
Wound healing: infection
Psychological: Body image problrms
POST OPERATIVE NURSING CARE:
Maintaining Respiratory function:
i.Encourage diaphragmatic breathing exercise at least every two hours while clients are awake
ii.Instruct to use incentive spirometers for maximum inspiration
iii.Encourage early ambulation
iv.Change position every one two hours.
Introduction
The sleep – wakefulness cycle is genetically determined rather than learned and is established sometime after birth.Sleep is a naturally recurring state of mind and body, characterized by altered consciousness, relatively inhibited sensory activity and [inhibition of nearly all voluntary muscle during REM sleep] reduced interactions with surroundings.
Sleep can be regarded as a physiological reversible reduction of conscious awareness. Nearly one third of human life is spent in sleep. Disorders of sleep can affect activities of daily living (ADL) of an individual.
Definition
It is an easily reversible state of relative unresponsiveness and serenity which occurs more or less regularly and repetitively each day.
The EEG recordings show typical features of sleep which is broadly divided into two broadly different phases:
1. D-sleep (desynchronised or dreaming sleep), also called as REM- sleep (rapid eye movement sleep),active sleep, or paradoxical sleep.
2. S-sleep (synchronised sleep), also called as NREM-sleep (non-REM sleep), quiet sleep, or orthodox sleep. S-sleep or NREM-sleep is further divided into four stages, ranging from stages 1 to 4. As the person falls asleep, the person fifi rst passes through these stages of NREM-sleep.
Stages of sleep
The EEG recording during the waking state shows alpha waves of 8-12 cycles/sec. frequency. The onset of sleep is characterised by a disappearance of the alpha-activity.
Stage 1, NREM-sleep is the first and the ligh test stage of sleep characterised by an absence of alphawaves, and low voltage, predominantly theta activity.
Stage 2, NREM-sleep follows the stage 1 within a few minutes and is characterised by two typical EEG changes:
i. Sleep spindles: Regular spindle shaped waves of 13-15 cycles/sec. frequency, lasting 0.5-2.0
seconds, with a charac teristic waxing and waning amplitude.
ii. K-complexes: High voltage spikes present intermittently.
Stage 3, NREM-sleep shows appearance of high voltage, 75 μV, δ-waves of 0.5-3.0 cycles/sec.
Stage 4, NREM-sleep shows predominant δ-activity in EEG. NREM-sleep is followed by REM-sleep, which is a light phase of sleep. The EEG is characterised by a return of α-waves (α-wave sleep); other changes are similar to stage 1 NREM-sleep. One of the most characteristic features of the REM-sleep is presence of REM or rapid (conjugate) eye move ments. The other features include generalised mus cular atony, penile erection, autonomic hyperactivity (increase in pulse rate, respiratory rate and blood pressure), and movements of small muscle groups, occurring intermittently. Although it is a light stage of sleep, arousal is diffificult. These stages occur regularly throughout the whole duration of sleep. The first REM period occurs typically after 90 minutes of the onset of sleep, although it can start as early as 7 minutes after going off to sleep, e.g. in narcolepsy, in major depression, and after sleep deprivation.
Legal issues related to nursing is of significant importance in regulation of profession as well as promotion of nursing practice.
All related aspects are briefly discussed in a nutshell according to INC syllabus of M.Sc. Nursing
An overhead projector (OHP), like a film or slide projector, uses light to project an enlarged image on a screen, allowing the view of a small document or picture to be shared with a large audience.
In the overhead projector, the source of the image is a page-sized sheet of transparent plastic film (also known as "foils" or "transparencies") with the image to be projected either printed or hand-written/drawn. These are placed on the glass platen of the projector, which has a light source below it and a projecting mirror and lens assembly above it (hence, "overhead"). They were widely used in education and business before the advent of video projectors.
Retroversion is the term used when the long axis of the Corpus or body and cervix are inline and the whole organs backwards in relation to the long axis of birth canal.
Retroflexion signifies bending backwards of the Corpus on the cervix at the level of internal OS.
These two conditions are usually present together and are loosely called retroversion or retro displacement.
It is discussed in briefly.
Problem based learning, A teaching strategySusmita Halder
Problem Based Learning or PBL is a self directed process of learning which enables students to learn from real life experiences and enhances their problem solving skills under guidance of teacher as the facilitator.
Bibliography-
• Kaur Sodhi Jaspreet, Comprehensive Textbook of Nursing Education, 1st ed. New Delhi, India :Jaypee Brothers Medical Publishers (P) Ltd.; 2017, Page No.- 70
• R Promila, Nursing Communication and Educational Technology, 1st ed. New Delhi, India :Jaypee Brothers Medical Publishers (P) Ltd.; 2010, Page No.- 270
• Suresh S. Communication and educational technology in nursing. 2nd ed. New Delhi, India: Elsevier; 2016., Page No.- 272-276
Breast self examination is discussed with brief outline-
Definition
Advantages
Barriers
Recommendations
Identification of clients at risk
Physical assessment
Steps
Points to be remembered
Brief description of urine Testing procedure includes
Definition
Purpose
Articles required
Steps of testing of urine test for sugar and albumin
Findings
Termination
Group Therapy is a form of psychotherapy given to group of carefully selected people under supervision of professional therapist to fulfill a common therapeutic objective. It is briefly discussed in this session
Play therapy is a form of psychotherapy used in children in order to explore their mind as well as to diagnose and treat issues related to developmental crisis and any disorders.
Several types of play therapies are available which are administered under guidance of a professional play therapist according to individualized need of children .
A brief outline is discussed over here.
Temperature is the balance between the heat production and heat loss.
A brief outline of diffrent aspects regarding body temperature is discussed here under following headings
*Normal body temperature regulation
*Fever of unknown origin
*Hyperthermia
*Hypothermia
*Frost bite
Introduction
Recreation is a form of activity therapy used in most psychiatric settings
Definition
Recreation is a form of psychotherapy which is a planned therapeutic activity that enables people with limitations to engage in recreational experiences
Aim
• To encourage social tendencies
• To decrease withdrawal tendencies
• To promote Socially acceptable behavior
• To encourage a feeling of confidence and feeling of self worth
• To develop skill feelings and abilities
Points to be kept in mind
• Provide a non threatening and non demanding environment
• Provide activities better relaxing and without rigid guidelines and timeframes
• Provide activities that are enjoyable and sell satisfying
Types of recreational activities
Motor:
Fundamentals: Hocky, Football
Accessory: play and dancing
Sensory
Visual- motion picture
Auditory- song
Intellectual
Reading debate quiz etc
Recreational activities for psychiatric disorders
Anxiety- aerobic activity like walking jogging etc
Depressive- non competitive sports which provides outlet for anger searches walking jogging
Manic- one to one basis individual games such as Badminton, balls etc
Paranoid schizophrenia- puzzle concentrate activities, cheese etc
Catatonic schizophrenia- dancing social activities to keep contact with reality athletics
Dementia- concentration replication craft and concrete craft that breed Familiarization and comfort
Childhood and adolescence disorder- one to one basis and giving a feeling of importance playing story telling painting etc
Adolescence play in groups therefore team play like sports games outdoor games which provides gross motor activities are indicated for them
Mental retardation- activities should be according to clients level of functioning such as walking dancing swimming ball playing etc
Role of nurse in recreational therapy
• Encourage the patient to communicate and express his feelings
• Nurse must provide a non-threatening and non-demanding environment where client can express inner feelings in a non-judgmental manner
• Nurse must provide activities which are relaxing and without any reason guidelines also she should keep in mind whether this therapy is appropriate for the client or not
• She must frequently observed client’s behaviour throughout the session
• Provide incentives for work
• allowed them to express their feelings so that development of skills and talents and abilities can be understood
• She must provide guidelines which are enjoying as well as self-satisfying
Definition:
individual psychotherapy is a method of bringing about change in a person by
exploring his or her feelings attitude thinking and behaviour.
Therapy is conducted on a one-to-one basis such as the therapies treats one patient at a time. Patients generally seek this kind of therapy based on their desire.
Such therapy helps to-
• Understand themselves and their behaviour
• Make personal changes
• Improve interpersonal relationships
• Get relief from emotional pain or unhappiness.
Indications:
• Stress related disorders
• Alcohol and drug dependence
• Sexual disorders
• Marital disharmony
Approaches
There are four main approaches to individual therapy which include
1. Psychodynamic therapy is primary key based on psychoanalytic theory, shamshan that when a patient has insight into early relationships and experiences as the source of his or her problems they can be resolved.
2. Humanistic therapy is on the patient’s view of the world and he is your heart problems. The goal is to help patients realise their full potential through the therapies genuineness unconditional positive regard which fosters the patient’s sense of self-worth and sympathetic understanding of patients point of view. Clarify his or her own feelings and choices.
3. Behaviour therapy does not foster awareness but emphasizes the principles of learning with positive or negative reinforcement and observational modelling
4. Cognitive therapy focuses on identifying and correcting distorted thinking patterns that can be to emotional distress and problem behaviours. Cognitive therapies believe that patients change their behaviour by changing their maladaptive thinking about themselves and their experiences. Patients are taught problem solving skills and stress reducing methods. The learning that their psychological difficulties or problems can be solved through cognitive processing.
Theory of Object Relations was given by, M. Mahler.
Margaret Schönberger Mahler (May 10, 1897 – October 2, 1985) was a Hungarian physician, who later became interested in psychiatry. She was a central figure on the world stage of psychoanalysis. Her main interest was in normal childhood development, but she spent much of her time with psychiatric children and how they arrive at the "self". Mahler developed the separation–individuation theory of child development.
She formulated the theory with Pine & Bergman on 1975.
➡️ Normal autistic phase – First few weeks of life. The infant is detached and self-absorbed. Spends most of his/her time sleeping.
➡️Normal symbiotic phase – Lasts until about 5 months of age. The child is now aware of his/her mother but there is not a sense of individuality. The infant and the mother are one, and there is a barrier between them and the rest of the world.
➡️Separation–individuation phase –
Separation refers to the development of limits, the differentiation between the infant and the mother, whereas individuation refers to the development of the infant's ego, sense of identity, and cognitive abilities.
Mahler explains how a child with the age of a few months breaks out of an "autistic shell" into the world with human connections. This process, labeled separation–individuation, is divided into subphases, each with its own onset, outcomes and risks. The following subphases proceed in this order but overlap considerably
Separation refers to the development of limits, the differentiation between the infant and the mother, whereas individuation refers to the development of the infant's ego, sense of identity, and cognitive abilities.
Mahler explains how a child with the age of a few months breaks out of an "autistic shell" into the world with human connections. This process, labeled separation–individuation, is divided into subphases
▶️Hatching / differentiation
▶️Practicing –
▶️Rapprochement-Rapprochement is divided into a few sub phases:
Beginning – Motivated by a desire to share discoveries with the mother.
Crisis – Between staying with the mother, being emotionally close and being more independent and exploring.
Solution – Individual solutions are enabled by the development of language and the superego.
Disruptions in the fundamental process of separation–individuation can result in a disturbance in the ability to maintain a reliable sense of individual identity in adulthood.
▶️Object constancy or Consolidation phase-
The Power Point Presentation was prepared for micro-teaching session. It gives a basic outline regarding preparation and use of posters.
The PPT is based on following points-
1. Definition
2. Parts
3. Rules to prepare posters
4. Uses
5. Advantages
6. Disadvantages
Bibliography:
Basavanthappa BT. Nursing Education. New Delhi, India: Jaypee Brothers Medical; 2009.
Neeraja KP. Textbook of nursing education. Jaypee Brothers Medical Publishers (P) Ltd.; 2003.
Suresh S. Communication and educational technology in nursing. 2nd ed. New Delhi, India: Elsevier; 2016.
Nervous system consists of highly complex structure co-ordinates and controls the body along with the endocrine system.
Here we discussed about some important outlines concerned of psychobiology which is coming under unit 2 of syllabus of clinical speciality - mental health nursing.
The key points are,
- The anatomic review
- Brain & limbic system
- Nerve tissue-> Neurons & Neuroglia, Synapses, Synaptic cleft
- Neurotransmitters
- Autonomic nervous system, - sympathetic and parasympathetic nervous system.
Apart from these, its relation with different psychiatric disorders are also explained in brief.
Health Care delivery system is the skeleton of meeting healthcare needs of enormous population of every country.
In order to have a clear view of community medicine, it is essential to know about different health care systems in order to fulfill learning objectives of students.
ECG or electrocardiography is the graphical representation of electrical impulses produced by the heart.
The electrical impulses form due to movement of ions in the myocardial cells representing depolarization and repolarization, denotes the conduction pathway of heart, which coincides with cardiac cycle. Apart from normal electrocardiography common arrhythmias are also discussed during this session.
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
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.
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.
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
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
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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
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
2. Introduction
For pregnancy and labour to
be achieved with minimal
difficulty a woman must
have normal reproductive
anatomy.
When abnormality of pelvic
organ exist it can lead to An
extra burden on mother as
well as the fetus.
3. Definition
An uterine malformation is
a result of abnormal
development of mullerian
duct during embryogenesis
Uterine malformations are
often associated with
vaginal maldevelopment
7. Related
anatomyand
physiologyof
uterus
The uterus is a hollow pyriform muscular
organ situated in the pelvis between the
bladder informed and the rectum in behind
The normal position is one of anteversion
and anteflexion the uterus usually inclines
to the right (dextrorotation) so that the
cervix is directed to the left
(levorotation)and comes in close to relation
with the left ureter.
The uterus measures about 8 cm long 5 cm
wide at the fundus and its walls are 1.25 CM
thick
It waits around 50 to 80 grams.
8. Related
anatomyand
physiologyof
uterus
Uterus has got following part
1.Bodyy or Corpus is father divided into,
fundus the part which lies above the
openings of the uterine tube
The body is proper triangular and lies
between the opening of the tubes and the
isthmus.
2. Isthmus is constricted part between the
body and the cervix
3. Service is the lowermost part of uterus
10. Supportsof
uterus
Middle tier constitutes the strongest support of uterus
1. Paracervical ring is the coller of fibroelastic
connective tissue encircling the supravaginal cervix. It
is connected with the pubo cervical ligaments And
physical vaginal septum anteriorly cardinal ligaments
laterally and Ritu vaginal septum posteriorly. It’s
stabilizer service at the level of interspinous diameter
along the other ligaments.
2. Pelvic cellular tissues and the in endopelvic fascia
consists of connective tissue and smooth muscles .
the blood vessels nerves supplying the uterus bladder
and vagina pass through it from the lateral pelvic wall.
As they passed the pelvic cellular tissues condense
surrounding them and give them direct support to the
viscera.
12. Supportsof
vagina
Supports of anterior vaginal wall
1. Positional support in the erect foster the vagina
makes an angle of 45 degree to the horizontal.
Normal vaginal axis is horizontal in the upper
two third and vertical in the lower third
2. the vagina is insured by strong condensation of
pelvic cellular tissue called endopelvic fascia.
Supports of posterior vaginal wall
1. Endopelvic fascia sheath covering the vagina
and the rectuM.
2. Attachment of the uterus after ligament to the
lateral wall of the vault
13. I Müllerian agenesis/ Hypoplasia- segmental
II Unicornuate Uterus
III Didelphys Uterus
IV Bicornuate Uterus
V Septate Uterus
VI Arcutate Uterus
VII Diethyl stilboestrol (DES) Related abnormality
AmericanFertility
Society(AFS)
Classificationof
Müllerian
Anomalies(1988)
18. Failure of
development
of one/both
Müllerian
ducts
The absence of both drugs leads to
absence of uterus including oviducts.
There is absence of vagina as well. Primary
amenorrhea is chief complaint.Absence of
one dog leads to unicornuate uterus with a
single oviduct.
20. Failure of
fusion of
mullerian
ducts
In majority in the presence of deformity
escape attention. In some detection is
made accidentally during investigation of
infertility or repeated pregnancy wastage.
In others the diagnosis is made during
dilation and evacuation operation manual
removal of placenta or during cesarean
section.
23. Arcutate
(18%)
The cornual parts of the uterus means
separated.The uterine fundus looks concave
with heart shaped cavity outline
24. Uterine
didelphys 8%
There is complete lack of fusion of mullerian ducts
with the w2s double cervix and double vagina
25.
26. Septate
Uterus 35%
The two Mullerian ducts fuse together but there is
persistence of September 2 into other partially or
completely
27. Uterus
Bicornis
26%
Uterus Bicornis Bicolis – there are
two uterine cavities with double
cervix with or without vaginal
septum
Uterus Bicornis unicolis – there are
two uterine cavity is with one
service the horns maybe equal or
one-horned maybe rudimentary
and have no communication with
developed horn
31. DES related
abnormality
Due to DES exposure during intrauterine life
varieties of malformations are included
Vagina- adenosis, Adenocarcinoma
Cervix – Cockscomb Cervix, Cervical Collar
Uterus – Hypoplasia, t shaped cavity, uterine
synaechiae
Fallopian tube- cornual budding, abnormal
fimbriae
32. Clinical
features
Gynaecological
Infertility and dyspareunia often related in
association with vaginal septum
Dysmenorrhea in by convert uterus or due
to cryptomenorrhea pent-up menstrual
blood in rudimentary horn
Menstrual disorders like menorrhagia
cryptomenorrhea are seen menorrhagia is
due to increased surface area in bi cornate
uterus
33. Clinical
features
Obstetrical
MidTrimester abortion which may be recurrent
Rudimentary hornpregnancy mein orchid due to transfer
internal migration of sperm for ovum from the opposite side.
Cornual pregnancy in rapture around 16th week
Cervical incompetence
Increased incidence of Mal presentation like transverse lie in
arcuate or subseptate breech in bicornuate with or complete
septate uterus
Preterm labour intrauterine growth retardation intrauterine
and death
Prolonged labour due to incoordinate uterine action
Obstructed labour due to obstruction by the non gravid horn of
bicornuate uterus or rudimentary horn
Retained placenta and postpartum hemorrhage where
placenta is implanted over the uterine septum
34. Investigation
Internal examination reveals vagina and 2 cervices
Passage of sound can diagnose to separate cavities.
Infact significant number of cases clinical diagnosis
is made during uterine curettage manual removal of
placenta cesarean section.
For exact diagnosis internal as well as external
architecture of uterus mass be visualised leave for
following investigations are carried out
Hysteography/ hysteroscopy / LAPAROSCOPY
Ultrasound with vaginal probe
MRI
36. Reproductive
Outcome
Better Obstratic outcomes in septate uterus
86% bicornuate uterus 50% unicornuate
Uterus 40% pregnancy outcome. No
treatment is generally effective. Uterine
didelphys has best possiblity of successful
pregnancy. Unification operation is
generally not needed.Other causes of
infirtility or recurrent fetal loss must be
excluded
Rudimentary horn should be excised to
reduce the risk of ectopic pregnancy
37.
38. Surgical
management
ofpelVicorgan
prolapse
Unification operation is therefore
indicated in otherwise unexplained cases
with uterine malformation. Abdominal
metroplasty should be done either by
excising septum ( Strassman Jones and
Jones ) or by incising the septum.
Success rate of abdominal metroplasty is
in terms of Live birth is high 5-75%
39. Surgical
management
ofpelVicorgan
prolapse
Hysteroscopic metroplasty is more commonly
done
Resection of septum can be done either by
resectoscope or by lasers
Advantages
High success rate 80- 90%
Short hospital stay
Reduced postoperative morbidity ( infections or
adhesion)
Subsequent chances of vaginal delivery is high
compared to abdominal metroplasty where
cessation section is mandatory
40. ABNORMALITIES
of FallopianTubes
The tubes maybe unduly elongated,may
have accessory ostia or diverticula. Rarely
the tube may be absent on one side.These
conditions may lower fertility or favour
ectopic pregnancy
41. Anomalies of the
Ovaries
There maybe streak gonadsvor gonadal
dysgenesis which are usually associated with
errors off sex chromosomal pattern. No
treatment is of any help. Accessory ovary
(division of original ovary into two) maybe rarely
( 1 in 93000) present. Rarely supernumerary
ovaries maybe found ( 1 in 29000) in broad
ligament or elsewhere.This can explain a rare
event where menstruation continues even after
removal of two ovaries.
42. Wolffian Remnant
Abnormalities
The outer end ofWolffian duct may be cystic size of
pea, often penductulated ( Hydatid of Morgagani) and
attached near the outer end of the tube.The tubules of
the Gartner’s duct maybe cystic the outer one’s are
Kobelts tubules the middle set epoophoron and the
proximal set the parophoron. Small cyst may arise
from any of the tubules . A cystic swelling from the
Gartner’s duct may appear in the anterolateral wall of
vagina which maybe confused with cystocele
43. ParovarianCyst
It arises from the vestigial remanence of wolffian
tissue situated in the mesosalpinx between the
tube and the ovary.This can attend a big size.
The cyst is unilocular the wall is thin and
contains clear translucent fluid.The ovary
inferior with ovary is chest over the cyst.The
world consists of connective tissue line by single
layer of lower columnar epithelium.
44. Other
Abnormalities
1. Labia Minora
A. True- due to developmental defect
B. Inflammatory
2. Labia Majora
A. Hyperplasic or hypoplasic labia
B. Abnormal fusion in adrenogenital syndrome
3. Clitoris- Clitorial hypertrophy – often associated with various
intersex problems
4. Perineum- perineum differentes from the area of contact
between the urorectal septum ( mesoderm) and dorsal wall of
cloaca( endodrem) at 7th week.This site of contact between
the two is the perineal body. Malformations of the perineum
are rare. Imperforate anus anal stenosis or fistula are result of
abnormal development of urorectal septum.This is due to
posterior deviation of septum as it approaches cloacal
memberane. Anal fistula may open into posterior aspect of
vestibule of the vagina ( anovestibular Fistula)
45. Key
points
📝
While minor abnormality at skips attention it is
moderate or severe from which will produce
gynaecology and obstetrics problems. For exact
diagnosis of malformation both the internal and
external architecture of uterus must be viewed.
Failure of fusion of mullerian duct leads to arcuate
bicornuate septate uterus
While gynaecological symptoms are far and few but at
times they may produce infertility objective problems
like recurrent miscarriage for no pregnancy preterm
labour or even obstructed labour
Nearly 15 to 20% of women with recurrent miscarriage
are associated with malformation of uterus