The vagus nerve is the longest cranial nerve. It interfaces with parasympathetic control of the heart, lungs, and digestive tract. It emerges from four nuclei in the medulla and travels through the neck and thorax to innervate organs. It controls functions like heart rate and gastrointestinal peristalsis. Symptoms of vagus nerve issues can include pain, organ dysfunction, fainting, difficulty swallowing, and changes in heart rhythm or vocal tone.
hypoglossal nerve, origin course an termination of hypoglossal nerve, function of hypoglossal nerve, clinical examination of hypoglossal nerve, hypoglossal nerve palsy
hypoglossal nerve, origin course an termination of hypoglossal nerve, function of hypoglossal nerve, clinical examination of hypoglossal nerve, hypoglossal nerve palsy
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.
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
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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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
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.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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.
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
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.
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.
2. Is the tenth cranial nerve or CN X
Interfaces with parasympathetic control of the heart, lungs
and digestive tract
It is the longest nerve of the autonomic nervous system in
the human body.
vagus nerve has two ganglia
1.Superior ganglion - round and lies in the jugular foramen
2.inferior ganglion - cylindrical and lies near the base of skull
3.
4. vagus nerve includes axons which emerge from or converge onto four
nuclei of the medulla:
The dorsal nucleus of vagus nerve — which sends parasympathetic
output to the viscera, especially the intestines
The nucleus ambiguus — which gives rise to the branchial efferent motor
fibers of the vagus nerve and preganglionic parasympathetic neurons that
innervate the heart
The solitary nucleus — which receives afferent taste information and
primary afferents from visceral organs
The spinal trigeminal nucleus — which receives information about
deep/crude touch, pain, and temperature of the outer ear, the dura of the
posterior cranial fossa and the mucosa of the larynx
5.
6. vagus nerve leaving the medulla oblongata between the pyramid and the
inferior cerebellar peduncle, the vagus nerve extends through the jugular
foramen, then passes into the carotid sheath between the internal carotid
artery and the internal jugular vein down to the neck, chest and abdomen,
where it contributes to the innervation of the viscera. Besides giving some
output to various organs, the vagus nerve comprises between 80% and 90% of
afferent nerves mostly conveying sensory information about the state of the
body's organs to the central nervous system
The vagus nerves are paired(right/left)
1. right vagus nerve gives rise to the right recurrent laryngeal nerve, which
hooks around the right subclavian artery and ascends into the neck between
the trachea and esophagus. The right vagus then crosses anterior to the right
subclavian artery, runs posterior to the superior vena cava, descends
posterior to the right main bronchus, and contributes to cardiac, pulmonary,
and esophageal plexuses. It forms the posterior vagal trunk at the lower part
of the esophagus and enters the diaphragm through the esophageal hiatus.
7. 2. The left vagus nerve enters the thorax between left common carotid artery and left
subclavian artery and descends on the aortic arch. It gives rise to the left recurrent
laryngeal nerve, which hooks around the aortic arch to the left of the ligamentum
arteriosum and ascends between the trachea and esophagus. The left vagus further
gives off thoracic cardiac branches, breaks up into the pulmonary plexus, continues into
the esophageal plexus, and enters the abdomen as the anterior vagal trunk in the
esophageal hiatus of the diaphragm.
Pharyngeal nerve
Superior laryngeal nerve
Superior cervical cardiac branches of vagus nerve
Inferior cervical cardiac branch
Recurrent laryngeal nerve
Thoracic cardiac branches
Branches to the pulmonary plexus
Branches to the esophageal plexus
Anterior vagal trunk
Posterior vagal trunk
Hering-Breuer reflex in alveoli
8.
9. The vagus nerve supplies motor parasympathetic fibres to all the organs
except the suprarenal (adrenal) glands, from the neck down to the second
segment of the transverse colon. The vagus also controls a few skeletal
muscles such as
Cricothyroid muscle
Levator veli palatini muscle
Salpingopharyngeus muscle
Palatoglossus muscle
Palatopharyngeus muscle
Superior, middle and inferior pharyngeal constrictors
Muscles of the larynx (speech)
10. vagus nerve is responsible for such varied tasks as heart rate,
gastrointestinal peristalsis, sweating, and quite a few muscle movements in
the mouth, including speech (via the recurrent laryngeal nerve).
It also has some afferent fibers that innervate the inner (canal) portion of
the outer ear (via the auricular branch, also known as Alderman's nerve) and
part of the meninges
(This is the reason why a person may cough when tickled on the ear, such as
when trying to remove ear wax with a cotton swab)
Efferent vagus nerve fibres innervating the pharynx and back of the throat are
responsible for the gag reflex. In addition, 5-HT3 receptor-mediated afferent
vagus stimulation in the gut due to gastroenteritis and other insults is a cause
of vomiting
11. • General visceral efferent (GVE) — provides parasympathetic innervation to
glands of mucous membranes of the pharynx, larynx, organs in the neck,
thorax, and abdomen.
• Special visceral efferent (SVE) — innervates skeletal muscles of the pharynx
and larynx.
• General somatic afferent (GSA) — carries sensation from the external auditory
meatus and tympanic membrane.
• General visceral afferent (GVA) — carries information from the thoracic and
abdominal viscera; aortic body and arch.
• Special visceral afferent (SVA) — carries taste of the epiglottis region of the
tongue.
12. Parasympathetic innervation of the heart is partially controlled by the vagus
nerve and is shared by the thoracic ganglia
vagal and spinal ganglionic nerves mediate the lowering of the heart rate.
right vagus branch innervates the sinoatrial node.
Parasympathetic tone from these sources are obviously well matched to
sympathetic tone in healthy people
Hyperstimulation of parasympathetic influence promotes bradyarrhythmias
hyperstimulated, the left vagal branch predisposes the heart to conduction
block at the atrioventricular node.
13. Activation of the vagus nerve typically leads to a reduction in heart rate,
blood pressure, or both. This occurs commonly in the setting of
gastrointestinal illness such as viral gastroenteritis or acute cholecystitis, or
in response to other stimuli, including carotid sinus massage, Valsalva
maneuver or pain from any cause, in particular, having blood drawn.
Activation of the vagus nerve typically leads to a reduction in heart rate,
blood pressure, or both. This occurs commonly in the setting of
gastrointestinal illness such as viral gastroenteritis or acute cholecystitis, or
in response to other stimuli, including carotid sinus massage, Valsalva
maneuver or pain from any cause, in particular, having blood drawn.
Symptoms of irritable Bowel Syndrome are thought to cause activation of
the vagus nerve with many people reporting fainting, vision disturbances
and dizziness
14. Excessive activation of the vagal nerve during emotional stress, which is a
parasympathetic overcompensation of a strong sympathetic nervous system
response associated with stress, can also cause vasovagal syncope due to a
sudden drop in cardiac output, causing cerebral hypoperfusion. Vasovagal
syncope affects young children and women more than other groups. It can
also lead to temporary loss of bladder control under moments of extreme
fear
1. Pain - most common nerve pain symptoms are due to pinched nerve (when
nerve exits through tiny foramina in the skull).
2. Organ Dysfunction - a branch or tributary of nerve is affected that leads to
localized symptoms of organ dysfunction due to damage to nerve fibers or
discrepancy in the synthesis of neurotransmitters.
15. 3. Muscle Cramps - painfull and involuntary muscular contraction
4. Difficulty in Swallowing - Glottis is normally closed when a person is
swallowing in order to prevent the aspiration of food. This is managed by gag -
reflex (gagging sensation if the back of throat is touched). In patients of head
injury or stroke, gag reflex may get impaired leading to choking while eating and
difficulty in swallowing.
5. Peptic Ulcer - Defects in the normal functioning of Vagus nerve may impair
the normal control mechanisms that modulate the gastric acid secretion.
Excessive secretion of peptic acid can lead to ulceration, dyspepsia and gastro-
esophageal reflux disease.
6. Gastroparesis - under-activity of vagus nerve may interfere with the blood
supply of stomach after ingestion of food that leads to improper digestion.
Gastroparesis is marked by painful spasms in the stomach that affect normal
food intake, heartburn, nausea and weight loss.
16. 7. Fainting - Over-activity of Vagus nerve increases the firing rate of receptors that
presents with sudden episodes of collapse and fainting (also referred to as vasovagal
reflex). Although, it is not dangerous, but fainting episodes may increase the risk of
accidental injuries that may prove life threatening.
8. Other Symptoms - Other symptoms include changes in the rhythm of heart, urinary
difficulties and changes in vocal tone.
Nerves are protected by myelin sheaths that serve to prevent the delicate nerve fibers
from damage and destruction; however, aberrations in normal biochemical
environment due to excessive alcoholism or persistently raised blood sugar levels can
lead to swelling of myelin sheaths that lead to permanent destruction of nerve fibers
leading to inactivity of nerves. Other causes includes inflammatory disorders,
autoimmune destruction of nerves (in the setting of diseases like amyotrophic lateral
sclerosis, multiple sclerosis and other), viral infections and damage due to neoplastic
conditions that press upon nerves causing mechanical damage.
17. Ask person to swallow
Ask person to say ah-h-h to check movement of the plate uvula
Back of the throat may be touched with a tounge blade which evokes the gag
reflexin most peoples
Person is asked to speak to determine whether the voice sounds nasal (for
palate movement)
18. 1. Vagus Nerve Stimulation - Vagal nerve stimulation can be achieved by
a device (similar in activity to cardiac pacemaker) that is implanted
beneath the skin and helps in generating impulses that can help in
managing symptoms of depression and seizures.
2. Neck Extension Exercises - Often times, pressure in the tendons or
tense muscles can press upon vagus nerve that may lead to hyper or
hypoactivity of nerves. 3- Dimensional exercises like neck extension
(moving your chin away from chest as far as possible), neck flexion
(touching your chin with your chest) and neck retraction exercises can
help in decreasing pressure on nerve.
19. 3. Yoga
4. For Gastroparesis - In order to manage symptoms of Gastroparesis and reduce
the risk of severe malnutrition, healthcare providers suggest the use of feeding
tube that supply the nutrients directly to intestines without crossing stomach. In
order to reduce the symptoms of nausea and vomiting, medications like
ondansetron can be employed. Metoclopramide is usually reserved for severe
cases
5. For Fainting - Different medications are employed to manage the fainting
episodes (that mostly involve controlling vasovagal discharge). Sertraline or
paroxetine are currently the treatment of choice for such cases.