Monday, March 16, 2015
Rest Digest Parasympathetic nervous system
Parasympathetic Nervous System
Responses to activation of the parasympathetic system.
Parasympathetic nerves regulate processes connected with energy assimilation (food intake, digestion, absorption) and storage. These processes operate when the body is at rest, allowing a decreased tidal volume (increased bronchomotor tone) and decreased cardiac activity. Secretion of saliva and intestinal fluids promotes the digestion of foodstuffs; transport of intestinal contents is speeded up because of enhanced peristaltic activity and lowered tone of sphincteric muscles.
To empty the urinary bladder (micturition), wall tension is increased by detrusor activation with a concurrent relaxation of sphincter tonus.
Activation of ocular parasympathetic fibers (see below) results in narrowing of the pupil and increased curvature of the lens, enabling near objects to be brought into focus (accommodation).
Anatomy of the parasympathetic system.
The cell bodies of parasympathetic preganglionic neurons are located in the brainstem and the sacral spinal cord. Parasympathetic outflow is channeled from the brainstem (1) through the third cranial nerve (oculomotor n.) via the ciliary ganglion to the eye; (2) through the seventh cranial nerve (facial n.) via the pterygopalatine and submaxillary ganglia to lacrimal glands and salivary glands (sublingual, submandibular), respectively; (3) through the ninth cranial nerve (glossopharyngeal n.) via the otic ganglion to the parotid gland; and (4) via the tenth cranial nerve (vagus n.) to thoracic and abdominal viscera. Approximately 75 % of all parasympathetic fibers are contained within the vagus nerve. The neurons of the sacral division innervate the distal colon, rectum, bladder, the distal ureters, and the external genitalia.
Acetylcholine (ACh) as a transmitter.
ACh serves as mediator at terminals of all postganglionic parasympathetic fibers, in addition to fulfilling its transmitter role at ganglionic synapses within both the sympathetic and parasympathetic divisions and the motor endplates on striated muscle. However, different types of receptors are present at these synaptic junctions.
Thanks & Best Regards,
Mukesh Patel
Factors Causing Hyperkalemia and Hypokalemia
Factors Causing Hyperkalemia
Factors Causing Hypokalemia
- Acidosis
- ACEI
- Beta-Blockers (Propanolol)
- Digitalis toxicity
- Succinylcholine
- Renal Failure
- Mineralocorticoid deficiency (Hypoaldosteronism)
- Potassium-Sparing Diuretics (Spironolactone,Triamterene,Amiloride)
- Rhabdomyolysis
Factors Causing Hypokalemia
- Loop and Thiazide Diuretics
- Osmotic Diuretics
- Mineralocorticoid (Hyperaldosteronism)
- Alkalosis
- Insulin
- Beta-2 agonists(Albuterol)
- Eating disorder
- Diarrhea, Vomiting
- Laxatives
- ATN - recovery phase
- Elderly patients.
Metastasis of Ca Cx
Distant metastases, including para-aortic nodal involvement, remote organ involvement, or invasion of adjacent structures such as bladder or rectum, occur late in the course of disease
appear as white areas on colposcopic examination after application of dilute acetic acid
unexpected vaginal bleeding, leukorrhea, painful coitus (dyspareunia), and dysuria
Detection of precursors by cytologic examination and their eradication by laser vaporization or cone biopsy is the most effective method of cancer prevention
Sunday, March 15, 2015
32 Hemivertebrae
*First read this question that appeared in the May 2006 AIIMS Medical Postgraduation Entrance Examination .
Q: Lumbar hemivertebra results due to the abnormal development of ?
a. dorsal sclerotome
b. intermediate cell mass
c. notochord
d. ventral sclerotome
answer d. ventral sclerotome
Now after you have seen the answer, u have to know what hemivertebra actually means .
The congenital
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Q: Lumbar hemivertebra results due to the abnormal development of ?
a. dorsal sclerotome
b. intermediate cell mass
c. notochord
d. ventral sclerotome
answer d. ventral sclerotome
Now after you have seen the answer, u have to know what hemivertebra actually means .
The congenital
Anatomy of Larynx
Larynx
Larynx is the voice box &it also serves as an air passage
Extends from root of the tongue at the inlet of the larynx to the commencement of trachea at the level of 6th cervical vertebra
The cavity of the larynx is continuous below with the trachea, and above opens into the laryngopharynx.
SKELETON OF THE LARYNX
The skeletal framework of the larynx is formed
by a series of cartilages interconnected by
ligaments and fibrous membranes.
Cartilages of Larynx
The cartilages of the larynx are nine in number, three single and three paired.
Three single are thyroid, cricoid and epiglottis.
Three paired are arytenoid ,corniculate and cuneiform .
Thyroid cartilage
It is the Largest cartilage
Made of 2 quadrangular plates
Each plate has 2 surfaces :Inner &outer
4 Borders : Upper,Lower,anterior,posterior
Anterior border
Anterior borders unites at an angle : Laryngeal prominence (Adams apple)
separated by Thyroid notch
Posterior border
Posterior borders : Prolonged upwards & downwards called Sup. &Inf. horns
Superior horn: Lateral thyrohyoid ligament
Inferior horn: Facet at the medial surface for cricoid arch
Cricoid cartilage
Signet ring shaped
Having posterior quadrilateral lamina & an anterior narrow arch
Cricoid Lamina:
Posterior surface:
Median ridge to which the tendinous bands from Longitudnal muscles of oesophagous are attached
Each side:
2 depressions for attatchment of posterior crico-arytenoid muscle
Upper border - 2 facets for articulation with the base of arytenoids
Cricoid arch
Rough external surface having circular facet on each side for articulation with the inferior horn of the thyroid cartilage
Lower border of cartilage:Attachment to Cricotracheal membrane
Epiglottis
Oblong leaf shaped
2ends, upper & Lower
2 surfaces, Anterior &Posterior
2Lateral borders
The lower end attachs to inner surface of thyroid cartilage below thyroid notch by the thyroepiglottic ligament
Arytenoid cartilage
These are placed on the upper border of the lamina of the cricoid
Pyramidal in shape
It has an apex ,base, 3 surfaces-Medial , Lateral & anterolateral
Base-a facet which articulates with the upper border of the cricoid lamina
Apex articulates with corniculate cartilage
Medial surfaces faces each other
Anterolateralsurface-------------- 2 depressions,seperated by a ridge , for muscle (vocalis) &
Ligament(vestibular ligament)
Lateral angle of the base projects laterally as muscular process
Anterior angle of the base projects forwards as the vocal processto which the vocal ligament is attached.
Ligaments of larynx
Extrinsic ligaments
These ligaments lie external to the larynx and connect the larynx with the hyoid bone and trachea.
Thyrohyoid membrane
It spans between the superior margin of the thyroid cartilage below and the hyoid bone above.
Its poserior borders thickened to form the lateral thyroid ligaments.
It thickens anteriorly in the the midline to form the median thyrohyoid ligament.
Hyo-epiglottic ligament
The hyo-epiglottic ligament extends from the midline of the epiglottis to the body of the hyoid bone.
It connects the epiglottis with the hyoid bone.
Cricotracheal ligament
The cricotracheal ligament runs from the lower border of the cricoid cartilage to the upper border of the first tracheal cartilage.
The larynx is attached to the trachea by this ligament.
Intrinsic ligaments
They lie within the cartilaginous skeleton of the larynx and connect the thyroid, cricoid and arytenoid cartilages .
Quadrangular membrane
It passes between lateral margin of the epiglottis and the arytenoid cartilage on the same side.
The upper border slopes posteriorly to form the aryepiglottic ligament which constitute the central component of aryepiglottic fold
The lower border forms the the vestibular fold (false vocal cord).
Cricovocal membrane
It is attached to the arch of cricoid cartilage and extends superiorly to end in a free upper margin.
The free upper margin attaches anteriorly to the thyroid cartilage and posteriorly to the vocal processes of the arytenoid cartilages
The upper free margin is thickened to form the vocal ligament, which is under the vocal fold (true vocal cord) of the larynx.
The cricothyroid ligament is also thickened anteriorly in the midline to form the median cricothyroid ligament.
Laryngeal joints
Cricothyroid joint
This joint happens between the inferior horns of the thyroid cartilage and lateral surface of the lamina of cricoid cartilage.
It is a synovial joint.
The cricothyroid joints enable the thyroid cartilage to move forward and tilt downwards on the cricoid cartilage and effectively lengthens and puts tension on the vocal ligaments.
Crico-arytenoid joints
It is between the articular facets on the superolateral surfaces of the cricoid cartilage and the bases of the arytenoid cartilages.
It is a synovial joint.
It enables the arytenoid cartilages to slide away or towards each other and to rotate.
These movements abduct and adduct the vocal ligaments .
Cavity of the larynx
The laryngeal cavity extends from the laryngeal inlet down to the lower border of the cricoid cartilage, where it continues into the trachea.
It is divided into three parts by the vestibular and vocal folds ：the Vestibule, Sinus and Infraglottic space
Vestible
It is the part situated between the laryngeal inlet and the vestibular fold.
Sinus
Sinus is the middle part between the vestibular folds above and the vocal folds below.
Infraglottic space
The infraglottic space is the most inferior chamber of the laryngeal cavity and is between the vocal folds and the inferior opening of the larynx.
Named parts of parietal pleura
The names given to the parietal pleura correspond to the parts of the wall with which they are associated
pleura related to the ribs and intercostal spaces is termed the costal part;
pleura covering the diaphragm is the diaphragmatic part;
pleura covering the mediastinum is the mediastinal part;
the dome-shaped layer of parietal pleura lining the cervical extension of the pleural cavity is dome of pleura
Pleuracentesis
through the 7th or 8th intercostal space，on the posterior axillary line, along the superior border of the lower rib
20 thoracic duct
The thoracic duct This main lymphatic duct conveys all the lymph from the lower limbs, pelvis, abdomen, left side of the thorax and head and neck and left upper limb to the venous system; that is, all but the right superior quadrant of the body. It drains the cisterna chyli, which is an elongated sac that lies on the right side of the bodies of the 1st and 2nd lumbar vertebrae below the
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Letters to a Young Pharmacist
Letters to a Young Pharmacist: Sage Advice on Life & Career from Extraordinary Pharmacists [Kindle Edition]
Author: Susan Cantrell Sara J. White Bruce Scott | Language: English | ISBN: B00JMORFNA | Format: PDF, EPUB
- Description
- Book Details
- Table of Contents
- Reviews
Letters to a Young Pharmacist: Sage Advice on Life & Career from Extraordinary Pharmacists
Free download Letters to a Young Pharmacist: Sage Advice on Life & Career from Extraordinary Pharmacists for everyone book with Mediafire Link Download Link Most of us have received very little, if any, formal training on how to manage our lives and careers. In Letters to a Young Pharmacist: Sage Advice on Life & Career from Extraordinary Pharmacists, find expert advice and guidance for the choices and challenges you will face. Written by 35 leading pharmacists, these very personal letters offer sound advice and insight for seizing or creating opportunities, balancing career and family, avoiding mistakes, and overcoming setbacks.
Gain from the wisdom and practical advice offered in these letters on such topics as:
Finding the right job or residency
Developing productive partnerships
The importance of networking
Thinking creatively to design new therapies
Working well in the culture of your organization
Understanding your strengths and weaknesses
… and much more.
Learn from people who have faced many of the same career and life experiences that lie ahead of you.
More than a book, Letters to a Young Pharmacist is a companion guide for your life’s work— and a must-have for every new pharmacist. Books with free ebook downloads available Letters to a Young Pharmacist: Sage Advice on Life & Career from Extraordinary Pharmacists
Free download Letters to a Young Pharmacist: Sage Advice on Life & Career from Extraordinary Pharmacists for everyone book with Mediafire Link Download Link Most of us have received very little, if any, formal training on how to manage our lives and careers. In Letters to a Young Pharmacist: Sage Advice on Life & Career from Extraordinary Pharmacists, find expert advice and guidance for the choices and challenges you will face. Written by 35 leading pharmacists, these very personal letters offer sound advice and insight for seizing or creating opportunities, balancing career and family, avoiding mistakes, and overcoming setbacks.
Gain from the wisdom and practical advice offered in these letters on such topics as:
Finding the right job or residency
Developing productive partnerships
The importance of networking
Thinking creatively to design new therapies
Working well in the culture of your organization
Understanding your strengths and weaknesses
… and much more.
Learn from people who have faced many of the same career and life experiences that lie ahead of you.
More than a book, Letters to a Young Pharmacist is a companion guide for your life’s work— and a must-have for every new pharmacist. Books with free ebook downloads available Letters to a Young Pharmacist: Sage Advice on Life & Career from Extraordinary Pharmacists
- File Size: 676 KB
- Print Length: 149 pages
- Simultaneous Device Usage: Unlimited
- Publisher: American Society of Health-System Pharmacists (April 10, 2014)
- Sold by: Amazon Digital Services, Inc.
- Language: English
- ASIN: B00JMORFNA
- Text-to-Speech: Enabled
- Lending: Not Enabled
- Amazon Best Sellers Rank: #474,443 Paid in Kindle Store (See Top 100 Paid in Kindle Store)
Excellent book for pharmacists of all ages!By Barbara A.White
Letters to a Young Pharmacist: Sage Advice on Life & Career from Extraordinary Pharmacists Download
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