Bad Breath Fixer

Bad Breath Fixer

Erectile Dysfunction Protocol Review

Erectile Dysfunction Protocol Review

30 Minutes Body Review

30 Minutes Body Review

Section Of Uterus And Vagina

The oocyte is ovulated from the ovary and moves into the uterine tube. The uterine tube is fringed by small cylindrical structures called fimbriae. The uterus is a small, flask-shaped organ. The uterus has a domed fundus, a main body, a narrowed isthmus, and an inferior cervix. The uterosacral ligament attaches the uterus to the sacrum. Most of the uterine wall is made of the myometrium which is a thick layer of smooth muscle. The vagina is approximately ten centimeters in length and is lined...

How To Tell If You Are Lost

Once you have cut the flexor retinaculum proximal to the wrist, you should palpate the transverse carpal ligament with a hemostat or other similar blunt instrument and feel the grittiness of the transverse fibers. You should also feel the hook of the hamate from inside the carpal canal and then start your transection with the nerve protected. Once you are deep to the superficial fat and the palmar fascia, any further fat that is encountered distally indicates you are already distal to the end...

Defining the Target Population

Defining the target population for a screening program involves describing the settings and the characteristics of the collection of persons who would be eligible for screening Last 1995 . This should be the first step in planning a population-based screening program because screening programs should be tailored to meet the needs of a defined target population. In practice, however, screening programs are developed and implemented in response to the availability of an effective screening test...

History of Immunology

The metamorphosis of immunology from a curiosity of medicine associated with vaccination to a modern science focused at the center of basic research in molecular medicine is chronicled here. The people and events that led to this development are no less fascinating than the subject itself. A great number of researchers in diverse areas of medicine and science contributed to building the body of knowledge we now possess. It is possible to name only a few here, but we owe a debt to them all. We...

Interactions Between the Lymphatic and Immune Systems and Other Organ Systems

Indicates ways in which these systems affect other organ systems indicates ways in which other organ systems affect these systems Lymphatic system drains excess tissue fluid and removes cellular debris and pathogens. Immune system provides defense against pathogens and immune surveillance against cancer. Skin provides mechanical and chemical barriers to pathogens has antigen-presenting cells in epidermis and dermis and is a common site of inflammation Lymphocytes and macrophages arise from bone...

Interactions Between the Reproductive System and Other Organ Systems

Indicates ways in which this system affects other systems indicates ways in which other systems affect this one At puberty, androgens stimulate development of body hair and apocrine glands and increased sebaceous secretion estrogens stimulate fat deposition and breast development in females pregnancy may cause pigmentation changes and stretch marks Sensory stimulation of skin important to sexual arousal mammary glands nourish infant Androgens and estrogens stimulate adolescent skeletal growth...

Up Close Pics Of Warts

Close-up of the head and upper trunk of the same infant as in Figure 1.224. Note die thick, dry, rigid, hardened, cracked skin with deep crevices. The division of the thickened grey- to yellow-colored skin into polygonal, triangular or diamond-shaped plaques by the deep reddish to purple fissures has been said to simulate the traditional costume of a harlequin. The skin has been likened to die bark of a tree, crocodile skin, or Moroccan leather. Figure 1.223. Another example of a...

Transient Bullous Dermolysis Of The Newborn

Epidermolysis bullosa in which the lesions were present at birth. The feet are one of the most commonly affected sites because babies kick their feet. If the lesions are extensive, the infant is at risk for fluid and electrolyte loss as well as infection. Figure 1.213. Epidermolysis bullosa letalis junctional epidermolysis bullosa, Herlitz's disease in an infant with generalized involvement of the skin. Note the massive involvement of the lower extremities showing the denudation,...

Trigeminal Fasciculus

Pulvinars of thalami Pineal body Superior colliculi Inferior colliculi Trochlear nerve IV Superior medullary velum Superior cerebellar peduncle Thalamus cut surface Lateral geniculate body Optic tract Medial geniculate body Brachia of superior and inferior colliculi Cerebral crus Pons Trigeminal nerve V Middle cerebellar peduncle Glossopharyngeal IX and vagus X nerves Dorsal roots of 1st spinal nerve C1 Optic chiasm Optic tract Tuber cinereum Cerebral crus Lateral geniculate body Posterior...

Mindore Free Hair Building Fibers Review

Mindore Free Hair Building Fibers Review

Flat Belly Fix Review

Flat Belly Fix Review

Psoriasis Revolution Review

Psoriasis Revolution Review

Nail plate and soft tissue abnormalities

Robert Baran, Rodney PR Dawber, Eckart Haneke, Antonella Tosti Onycholysis Onychomadesis and shedding Hypertrophic nail and subungual hyperkeratosis Splinter haemorrhages and haematomas Dorsal and ventral pterygium Further reading Onycholysis refers to the detachment of the nail from its bed at its distal and or lateral attachments Figure 4.1 . The pattern of separation of the plate from the nail bed takes many forms. Sometimes it resembles closely the damage from a splinter under the nail, the...

Charge Syndrome Retina

This is another term infant with severe bilateral microphthalmia. The globes are small, and vision is extremely poor. There are several forms of microphthalmia including those associated with congenital infection, chromosomal abnormalities, and the CHARGE syndrome. Figure 2.47. At term birth, the normal ocular sagittal length is 17.5 mm, and the normal corneal diameter is 10 mm. This is a term infant with very severe bilateral microphthalmia. The globes are virtually absent and the...

Superficial Circumflex Iliac Artery

The superficial circumflex iliac artery arises from the femoral artery near the origin of the superficial epigastric artery. It pierces the deep fascia of the thigh lateral to the saphenous opening and courses laterally toward the anterior superior iliac spine to supply the superficial fascia and skin. It is considered the smallest branch of the femoral artery that anastomoses with the deep circumflex iliac, lateral femoral circumflex iliac and superior gluteal arteries. The course of this...

Axis III General Medical Conditions

On Axis III are listed general medical conditions that may be relevant to the disorder s listed on Axes I and II. The presence of Axis III should not be taken to suggest a mind-brain dualism, with Axes I and II representing problems of the mind in the absence of a physiological basis. On the contrary, mental experience is rooted in the function of the brain. Axis III is included in the DSM to encourage a comprehensive evaluation and a consideration of the various ways in which a general medical...

Inversion Radiography

Wangensteen and Rice 50 first described the use of inversion radiography in 1930 to indicate the distance between the gas bubble within the terminal colon and the perineal skin. Many authors 6, 8, 11, 13, 19, 22, 29, 39, 48 then subsequently related the distance from the skin to the underlying abnormality, although the measurement of the distance alone does not provide the essential information required, which is the relationship of the blind-ending rectum to the levator ani and sphincter...

Kennedy Disease Disabilities

Early on, there is decreased recruitment and interference, with decreased motor unit action potential amplitudes. In 2-4 weeks, fibrillations will develop, with possible fasciculations. Over time, reinnervation will lead to polyphasic motor units. Nerve conduction velocities and sensory studies are normal. Imaging Inflammation of the anterior spinal cord may be detected with MRI. Post-polio syndrome The diagnosis of PPS is by exclusion of other conditions and demonstration of progressive...

Grey Matter Versus White Matter Ischemia

In addition to the size of the stroke, its location, and the relative involvement of gray versus white matter are key determinants of outcome. For example, small white matter strokes often cause extensive neurologic deficits by interrupting the passage of large axonal bundles such as those within the internal capsule. Blood flow in white matter is lower than in gray matter, and white matter ischemia is typically severe, with rapid cell swelling and tissue edema because there is little...

Laurdan Probe the Tips

As is the case with the vast majority of UV-excited fluorescent probes, confocal or epifluorescence microscopy experiments are difficult to perform with LAURDAN. As already mentioned, the extent of LAURDAN photobleaching under epifluorescence and confocal microscopy is severe, making it almost impossible to collect images on LAURDAN-labeled specimens for more than a few seconds Bagatolli and Gratton 2001 . A way to circumvent this problem is by using two-photon-excitation fluorescence...

Nose Amd Nasal Septum

The nose consists of the nasal bones, the frontal process of the maxilla at the root of the nose, and a number of cartilages. These nasal cartilages are made of hyaline cartilage. These are the lateral nasal cartilages, the greater alar cartilages, and the lesser alar cartilages. The septal cartilage also forms part of these cartilages. The openings of the nose nostrils are the external nares external naris singular . The nasal cavity has a wall that runs down the middle of it called the nasal...

Felicitys Gluten Free Cookbook Review

Felicitys Gluten Free Cookbook Review

Natural PCOS Diet Review

Natural PCOS Diet Review

Incisional biopsy and punch biopsy

It is essential to have a working clinical diagnosis, but wherever there is doubt the pathologists can provide much more precise information regarding the nature and extent of the lesion. For example, a patch of Bowen's disease intraepidermal carcinoma may resemble sclerosing superficial basal cell carcinoma and a biopsy will usually distinguish them. Similarly, what seems to be a dysplastic pigmented naevus clinically may, on the one hand, prove to be benign or, on the other hand, turn out to...

Anovulation Is A Characteristic Feature Of Pcos. It Manifests As Menstrual Disturbance 80 Amenorrhoea Oligoamenorrhea

The features of PCOS may be elicited when obtaining the medical history or upon the physical examination. The ovarian morphological and the biochemical and metabolic features of the disorder are discussed in Chapters 16 and 17. The evaluation of patients with androgen excess, including PCOS, is discussed in Chapter 33. 2.1. Features Elicitable by Medical History In this section, we will outline important information that the medical history will elicit concerning the features of PCOS, including...

Ragged Cuticles And Hangnail

Thickened, hyperkeratotic, irregular ragged cuticles Figure 5.12 are most commonly seen in dermatomyositis Figure 5.13 . Perionychial tissues are constantly subjected to trauma. In nail biters and 'pickers' the cuticles and nail folds may show considerable damage, erosions, haemorrhage and crusting. The ulnar side of the nail fold and cuticle is most vulnerable and there may be small trian-gular tags of skin hangnail, Figure 5.14 and separated spicules of nail, still attached proxi-mally....

Onychomycosis and its treatment

Antonella Tosti, Robert Baran, Rodney PR Dawber, Eckart Haneke Candida onychomycosis Further reading Fungi may invade the nails in four different ways, leading to four separate types of onychomycosis with specific clinical features, prognosis and response to treatment. The type of nail invasion depends on the fungus responsible and the host susceptibility. Invasion occurs 1 Via the distal subungual area and the lateral nail groove, leading to distal lateral subungual onychomycosis Figure 8.1 ....

Imperforate Anal Membrane

Table 8.9 Wingspread Conference classification Table 8.9 Wingspread Conference classification 2. Anal agenesis without fistula 3. Anal agenesis without fistula 1. Anocutaneous perineal fistula 1. Anovestibular perineal fistula, 2. Anocutaneous perineal fistula Persistent cloacal anomaly Rare malformations complex, it allowed ARM to be viewed in a structured fashion. Intermediate was later added to this classification to describe those lesions where the rectum ends below the PC line. In 1964...

Coronal Section Of Heart

The heart is located in a tough, fibrous sac known as the parietal pericardium which has an outer fibrous layer and an inner serous layer. If this sac is opened you can see a space called the pericardial cavity. The heart is in this cavity. The outer surface of the heart is called the visceral pericardium or the epicardium. Inside of this is the main portion of the heart wall called the myocardium made of cardiac muscle and the innermost layer of the heart is the endocardium. Deoxygenated blood...

Estimating the Economic Burden of PCOS

We calculated the health care-related economic burden in PCOS based on the above prevalences of disease (64). We restricted the calculation to the United States only, although we recognize that PCOS is an international disorder. However, we should note that our estimation is highly conservative because we did not include a number of costs for which we did not have accurate and present-day prevalence and monetary estimates (Table 1). We did include the costs of the initial evaluation, detailed...

Medical History and Physical Examination in Patients With Possible Androgen Excess

We outline here the basics of the medical history and physical exam in the patient suspected of suffering from androgen excess. The timing and pace of pubertal development and its relation to complaints of unwanted hair growth, hair loss, acne, and or obesity should be established. The onset and progression of these complaints should also be established. Drug or medication use and exposure or use of skin irritants should be elicited. A detailed menstrual history should be obtained, with an...

Prominent Occiput Infant

Radiograph of an infant with metatropic dysplasia. This is another form of dwarfism associated with a narrow thorax, thoracic kyphoscoliosis and metaphyseal flaring giving the typical dumb-bell appearance . The proportion of the length of the trunk to the extremities reverses during childhood. At first the trunk is too long and the extremities too short. With increasing kyphoscoliosis the trunk becomes short. Figure 2.61. Radiograph of an infant with metatropic dysplasia. This is...

Cervical Thoracic And Lumbar Vertebrae

The opening where the spinal cord passes through the vertebra is known as the vertebral foramen. The body of the vertebra is the weight-bearing part of the vertebra and the spinous process is the part that extends posteriorly. This process is an extension from the vertebral arch that curves from the body enclosing the vertebral foramen. This arch is composed of the two pedicles and the two laminae. The superior articular process and the superior articular facet the flat surface on the process...

Free Autogenous Muscle Transplant for Strengthening of the Levator Ani Palmaris Longus Transplant

Hakelius 13 and Hakelius et al. 14-16 originally described the procedure in which a graft of muscle usually the palmaris longus, less commonly the sartorius, or extensor digitorum brevis is first de-nervated 2 weeks before transplantation and is then transplanted as a U-shaped sling around the rectum, in close contact with the puborectalis, and anchored to the pubic bone Figs. 31.6 and 31.7 . Denervation allows muscle survival as it initiates a lower level of energy consumption. The graft...

Fifth metatarsal head resection

This procedure is well suited for older sedentary individuals, and for patients with osteopenia or osteomyelitis of the metatarsal head, where a transpositional osteotomy is not appropriate. Although transfer lesions callus or ulcer have been reported to occur beneath adjacent Fig. 8.15 The Weil lesser metatarsal shortening osteotomy, a The lesser toe is plantarflexed, and the oblique osteotomy cut begins at the distal dorsal edge of the articular cartilage, b Proximal displacement of the...

Thrombopenia Absent Radii

A close-up of the face of the same infant with the typical Potter facies associated with oligohydramnios and renal agenesis. Note the low-set abnormal ears, the flat nose, and micrognathia. Epicanthal folds were also present. Figure 1.26. Radiograph of the lower extremities of the same infant with sirenomelia shows the presence of two separate femora with fusion of soft tissue, two separate tibiae, and a single fibula distally. Skeletal deficiencies may be longitudinal defects...

Table 42 Causes and associations of nail shedding

Local inflammation, e.g. acute paronychia Figures 4.7-4.12 Kawasaki's syndrome Fever or systemic upsets Syphilis Bullous dermatoses, e.g. pemphigus Stevens-Johnson syndrome Toxic epidermal necrolysis Lyell's syndrome Figures 4.7-4.9 Drugs Cytotoxics Antibiotics Retinoids Keratosis punctata Local trauma X-irradiation Hypoparathyroidism with amelogenesis imperfecta HYPERTROPHIC NAIL AND SUBUNGUAL HYPERKERATOSIS Ideally, the term 'hypertrophy of the nail plate' should be restricted to conditions...

The Dopaminergic Pathways

Figure 4.6 Representation of the primary dopamine-containing tracts in the human brain. The nigrostriatal tract is primarily involved in motor control, but also in reward- and goal-directed behavior. Blockade of D2 receptors here produces some of the antipsychotic effects of antipsychotics, but high levels of blockade gt 80 produce parkinsonian side-effects. Blockade of D2 receptors in the tuberoinfundibular pathway increases plasma prolactin. It is thought that it is the blockade of D2 and...

Transmural Or Transenteric Drainage

Transmural or transenteric endoscopic drainage procedures are performed through several endoscopic approaches through the stomach endoscopic cystogastrostomy or duodenum endoscopic cystoduodenostomy . Several prerequisites need to be fulfilled pursuant to endoscopic transmural drainage Table 1 . Ideally, the pseudocyst must be situated within the pancreatic head or body, and must be firmly adherent to the gastrointestinal tract to cause a visible impression on the gastric or duodenal wall at...

Venous Sinus Obstruction in Pseudotumor Cerebri Syndrome Cause or Effect

Whether venous sinus obstruction in PTS is cause or effect remains unresolved. The experimental and clinical evidence discussed above indicates that there is potential for primary venous sinus pathology to cause PTS and there is also potential for secondary venous sinus obstruction due to raised intracranial pressure. We discuss below the available evidence and also present a unifying theory based on the establishment of a disordered positive feedback cycle. The discussion will centre on the...

Normal Cecum and Ileocecal Valve

The short segment of the colon between the appendix and the ileocecal valve is the cecum. Cecum. The short segment of the colon between the appendix and the ileocecal valve is the cecum. Fig. 6.30 Cecal pole. One of the tenia leading to the appendiceal orifice from about the 9-o'clock position . Note the distinct vascular pattern of the normal mucosa. Fig. 6.30 Cecal pole. One of the tenia leading to the appendiceal orifice from about the 9-o'clock position . Note the distinct vascular...

Overview Of The Nervous System

The body must react to the external environment and the internal environment and communicate information between regions of the body. This job is primarily the task of the nervous system. Proper response to the external environment is critical for thermal regulation, response to threats, taking advantage of opportunities such as food availability, and a host of other stimuli. Response to the internal environment is important for sensing muscle tension, digestive processes, maintenance of blood...

External Abdominal Oblique

The external abdominal oblique muscle Figs. 1.6,1.7 is the most superficial abdominal muscle that originates from the external surfaces of the lower seven or eight ribs and interdigitates with the serratus anterior and la-tissimus dorsi muscles. Most of the muscle fibers run downward and medially, forming an aponeurosis near the lateral border of the rectus abdominis. The muscle fibers from the lower two ribs descend vertically downward to attach to the iliac crest. Muscle fibers are rarely...

Overview Of Cell And Cell Membrane

Cells consist of an enclosing plasma membrane, an inner cytoplasm with numerous organelles, and other cellular structures. The fluid portion of the cell is called the cytosol. Color the cytosol in last after you color the rest of the cellular structures. One of the major structures in the cell is the nucleus. It is the genetic center of the cell and consists of fluid karyoplasm, chromatin containing DNA , and the nucleolus. Color these features and label them on the illustration. The...

Anterior Surface Of The Eye And Lacrimal Apparatus

The eye is located in the orbit of the skull and has several external features. Above the eye is the eyebrow. The corners of the eye have either a lateral commissure or a medial commissure. Next to the medial commissure is the caruncle, a small thickened tissue in the medial corner of the eye. The outer surface of the eye is protected by the upper and lower eyelids. The blink reflex rapidly closes the eyelids to keep dust from hitting the outer surface of the eye. Label and color the sclera the...

Neuroischemic Ulcers At Various Sites

Neuro-Ischemic Ulcer with Osteomyelitis Neuro-Ischemic Ulcer on the Hallux with Osteomyelitis A 68-year-old obese male patient with type 2 diabetes diagnosed at the age of 46 years visited the outpatient diabetic foot clinic because of two chronic ulcers on his right hallux. He was treated with a combination of sulfonylurea during the day and a mixture of 20 rapid acting-80 intermediate acting insulin before dinner he also had dislipidemia which was being treated with simvastatin. On...

Birth Trauma

Birth trauma refers to those injuries sustained during labor and delivery. Despite skilled and competent obstetric care, some may be unavoidable. Factors predisposing infants to injury include macrosomia, prematurity, cephalopelvic disproportion, dystocia, prolonged labor, and abnormal presentation. In 1988, birth injuries ranked eight as major causes of neonatal mortality and caused 4.6 deaths per 100,000 live births. The clinician who cares for newborn infants must be familiar with the...

Table 45 Causes of thick nails andor subungual hyperkeratosis Frequent

Onychomycosis Figure 4.19 Psoriasis Figures 4.14-4.15 Contact eczema Mineral oils Cement Hair styling products Repeated microtrauma Single major trauma Subungual clavus Less frequent Bowen's disease Lichen planus Figure 4.24 Norwegian scabies Pachyonychia congenita Figures 4.21-4.23 Pityriasis rubra pilaris Figure 4.20 Acrokeratosis paraneoplastica Bazex's syndrome Onychopapilloma of the nail bed Rare Alopecia areata Radiodermatitis Arsenic keratosis SPLINTER HAEMORRHAGES AND HAEMATOMAS The...

How Large Is 5 Mm Polyp

D Instruments left to right for polyp retrieval normal polypectomy snare, grasping forceps, four-pronged grasping forceps, dormia basket. e Polyp trap device. The specimen bag is placed in the trap so that suctioned polyp fragments or small polyps remain hanging in the bag. The bag is cut open with scissors to retrieve the polyp fragments. f Polyp retrieval net. The net is placed over the working channel of the instrument and the polyp or polyp pieces are caught in the net. The polyps are...

The Tympanic Membrane and its Landmarks

This is the most important structure for the clinician diagnostically, because its appearance, and what can be seen through it, are by and large the only anatomic clues to what goes on inside (Figs. 3.3 and 3.4). The most visible landmark beneath the TM is the manubrium, or handle, of the malleus, the lower portion of this first ossicle. The upper portion of the manubrium has a visible prominence, seen near the top of the TM, called the short process. The...

Larynx Trachea And Lungs Overview

Two main cartilages of the larynx can be seen from an anterior view. The thyroid cartilage is superior to the cricoid cartilage. Below the larynx is the trachea which divides into the right and left primary bronchi. The right primary bronchus leads to the right lung and the left primary bronchus leads to the left lung. Label the parts of the respiratory system illustrated. Color the two visible cartilages of the larynx different colors and the trachea another color. Color the bronchi in first...

Body Cavities and Membranes

The body is internally divided into two major body cavities, dorsal and ventral fig. A.7 . The organs within them are called the viscera VISS-er-uh singular, viscus9 . Various membranes line the cavities, cover the viscera, and hold the viscera in place table A.2 . The dorsal body cavity has two subdivisions 1 the cranial CRAY-nee-ul cavity, which is enclosed by the cranium braincase and contains the brain, and 2 the verte bral canal, which is enclosed by the vertebral column backbone and...

Thick Eyebrows Syndrome

Close-up of face of the same infant as in Figure 3.12. Note the hirsutism, bushy eyebrows, downward slanting palpebral fissures, and micrognathia. Figure 3.14. This infant with Cornelia de Lange's syndrome shows many of the characteristic findings coarse, mop-like hair bushy eyebrows and synophrys confluent, thick eyebrows long curly eyelashes short nose with small anteverted nostrils thin lips with a small midline beak of the upper lip long philtrum and downward curving of the...

Anterior Surface View Of Heart

The apex of the heart is inferior and the base is superior. Label each chamber of the heart and color them each a different color. Locate the coronary arteries and their branches and color them in red. The right coronary artery leads to the right marginal artery. The left coronary artery takes blood to the anterior interventricular branch and the circumflex branch. The cardiac veins can also be seen on the anterior side. The great cardiac vein runs in the interventricular sulcus on the anterior...

Myotonic Dystrophy Newborn

Right hand of the same infant with amyotonia congenita. Note the lack of finger creases and the abnormal appearance of the hand due to lack of intrauterine fetal movement. Finger creases normally develop at 11 to 12 weeks gesta-tional age. Figure 3.117. In this male infant with myotonic dystrophy, note the marked hypotonia, cryptorchidism, and clubfoot. Figure 3.118. The face of the same infant as shown in Figure 3.117 shows the typical lack of expression and the bilateral ptosis...

Tethered Spinal Cord Images

In this infant with a f9 lipomeningocele with a tethered cord, note the associated skin discoloration with a small skin tag. Figure 3.82. A lipomeningocele with an associated sinus tract is present in this infant. Figure 3.83. Infant with a large dermal sinus tract associated with cord tethering and spinal dysraphism. On MRI there was a tethered cord and spina bifida both above and below the lesion. Figure 3.84. Small finger-like dermal tag extending from the mid-line of the back...

Hair At Lower End Of Spinal Cord In Newborn

A cervical meningocele may be difficult to differentiate from an occipital encephalocele. Further study in this infant showed that this was a cervical meningocele. Figure 3.57. A cervical meningocele may be difficult to differentiate from an occipital encephalocele. Further study in this infant showed that this was a cervical meningocele. Figure 3.58. A midline hair tuft in the lumbosacral area. This infant had a tethered cord on MRI study. Hair tufts, skin tags, sinuses, and...

Traumatic disorders of the nail

Repeated microtrauma of the nail apparatus The painful nail Further reading This chapter looks at three distinct aspects of trauma, under the headings 1 Major trauma involving any digit . This section considers major trauma, single overwhelming injury, necessitating only minor 'office' surgery. Complex laceration and most of the traumatic abnormalities are beyond the intended scope of this book. Damage from acute trauma may have immediate and or delayed effects. Acute subungual haematoma is...

Axis II Personality Disorders and Mental Retardation

On Axis II are listed Personality Disorders and Mental Retardation. These disorders, by definition, are present for a substantial period of time (i.e., years). Although Axis I disorders may also be present for similar lengths of time, enduring symptoms are fundamentally part of these Axis II disorders. Also listed on Axis II are other traits or prominent features of a person's personality that a clinician deems maladaptive (e.g., frequent use of denial, excessive impulsivity). In addition to...

Overview Of The Cardiovascular System

The cardiovascular system consists of the heart as a pump, blood vessels that take blood away from the heart arteries , and blood vessels that take blood back to the heart veins . Locate the heart on the illustration and color it in purple. Label the common carotid artery and color it in red. Arteries are typically colored in red and veins are colored blue. Label and color in the internal jugular vein too. The internal jugular vein takes blood to the superior vena cava which takes blood to the...

Senescence of the Organ Systems

Organ systems do not all degenerate at the same rate. For example, from ages 30 to 80, the speed of nerve conduction declines only 10 to 15 , but the number of functional glomeruli in the kidneys declines about 60 . Some physiological functions show only moderate changes at rest but more pronounced differences when tested under exercise conditions. The organ systems also vary widely in the age at which senescence becomes noticeable. There are traces of atherosclerosis, for example, even in...

Stratified Epithelia Coloring

There are two common epithelial tissues that are many-layered. Stratified squamous epithelium is many layers of flattened cells. Label and color the basement membrane red, color the cytoplasm blue, and the nuclei purple. There are two major types of stratified squamous epithelium. Keratinized epithelium is found on the skin and is toughened by the protein keratin. Non-keratinized stratified squamous epithelium is found in the oral cavity and vagina and is a mucous Another main type of layered...

Retinal Hemorrhage In Newborns

Retinal hemorrhages occur frequently in the neonate, especially following vaginal delivery. In some studies, the incidence of small retinal hemorrhages is as high as 25 irrespective of whether the delivery was spontaneous or required the application of forceps. These retinal hemorrhages resolve spontaneously without any consequences. In contrast, hemorrhages into the vitreous gel may prevent light from getting through to the retina for several days or even weeks and will cause a...

Beckwith Wiedemann Syndrome

Transverse earlobe creases are a feature of some syndromes as in this infant with Beckwith-Wiedemann syndrome. Figure 1.140. This otherwise normal infant had bilateral cleft ear lobes. This occurs as a result of incomplete fusion between the most medial embryonic hillocks. Figure 1.140. This otherwise normal infant had bilateral cleft ear lobes. This occurs as a result of incomplete fusion between the most medial embryonic hillocks. Figure 1.139. Transverse earlobe creases are a...

Sphenoid Temporal Amd Ethmoid Bones

A few bones of the skull are frequently studied as separate bones. The sphenoid bone has a superficial resemblance to a bat or butterfly. There are the lesser wings, the greater wings, and the pterygoid plates, all of which resemble wings. The dorsum sellae is the posterior part of the sella turcica a depression that holds the pituitary gland . Locate the foramen rotundum and the foramen ovale on the sphenoid bone. These holes enclose parts of the trigeminal nerve. The temporal bone has a flat...

Caudal Regression Syndrome

Frontal view of another infant with arthrogryposis. Extreme intrauterine compression over an extended period of time can produce such severe distortion in multiple joints that supporting ligaments become contracted and opposing tendons stretch. The muscles acting across these joints may atrophy, creating a picture indistinguishable from the intrinsic forms of arthrogryposis multiplex congenita. Figure 5.56. This infant with arthrogryposis demonstrates the severe congenital joint...

Bone Growth and Remodeling

Bones continue to grow and remodel themselves throughout life, changing size and shape to accommodate the changing forces applied to the skeleton. For example, in children the femurs become longer, the curvature of the cranium increases to accommodate a growing brain, and many bones develop surface bumps, spines, and ridges described in chapter 8 as a child begins to walk and the muscles exert tension on the bones. The prominence of these surface features and the density of bone depend on the...

Golden Har Sydrome In Babies

In this figure of the same infant, note the contractures of the toes. Talipes equinovarus may be present. Figure 3.57. In this figure of the same infant, note the contractures of the toes. Talipes equinovarus may be present. Figure 3.58. Goldenhar's syndrome facio-auriculovertebral spectrum oculoauriculoverte-bral dysplasia is associated with abnormalities of the first and second branchial arches. This infant shows the antimongoloid slant, bilateral macrostomia, and skin tags. Over...

Diverticulosis and Diverticulitis

Colonic diverticula are fingerlike outpouchings protruding outward from the intestinal lumen. True and pseudodiverticula. A distinction is made between true diverticula and pseudodiverticula. The seldom-occurring true diverticula are present at birth and usually only appear in the right hemicolon. Pseudodiverticula, which occur much more frequently, are acquired. They can be found anywhere in the colon, though they tend to appear in the left hemicolon. True diverticula are characterized by...

Gluteal Asymmetry And Newborn

Palmar adduction cortical thumb in a normal infant. The thumbs are freely mobile but are held adducted and flexed across the palms with the fingers tightly clutched over them. Cortical thumbs are a manifestation of hypertonicity when they are present beyond the first 3 to 4 months. Constant palmar adduction or clasped thumb after this age would alert one to the possibility of central nervous system pathology. Clasped thumbs are held in a flexed and adducted position across the palm...

Vacterl Syndrome Life Expectancy

Anorectal malformations ARM and cloacal anomalies are rare and complex malformations of the lower gastrointestinal and genitourinary tract. They affect approximately 1 3,500-1 5,000 live births 1 . They may occur in isolation or in association with abnormalities of the urogenital, cardiovascular and skeletal systems as well as with the vertebral, anal, cardiac, tracheoesophageal, renal and limb abnormalities VACTERL association. Treatment has traditionally focussed on achieving urinary and...

Size Shape and Position of the Heart

The heart is located in the thoracic cavity in the mediastinum, the area between the lungs. About two-thirds of it lies to the left of the median plane fig. 19.2 . The broad superior portion of the heart, called the base, is the point of attachment for the great vessels described previously. Its inferior end, the apex, tilts to the left and tapers to a blunt point figs. 19.3 and 19.4 . The adult heart is about 9 cm 3.5 in. wide at the base, 13 cm 5 in. from base to apex, and 6 cm 2.5 in. from...

Hormones Secreted By The Pituitary And Their Target Organs

The adenohypophysis produces and secretes many hormones that have diverse target areas. Growth hormone GH is released by the pituitary and causes growth and division of cells throughout the body. Prolactin is more specific in its function. Prolactin stimulates the mammary glands to become functional in milk production. Follicle stimulating hormone FSH and luteinizing hormone LH are gonadotropins that cause the ovaries and testes to release hormones. Thyroid stimulating hormone TSH causes the...

Images Of An Infants Gum Ridge

Gum hypertrophy in an infant born to a mother treated with phenytoin during pregnancy. Figure 1.91. The components for each individual tooth bud can often be seen on the alveolar ridges of the maxilla and mandible in normal infants. Note the milia on the nose and the demarcation on the lip where the skin meets the mucous membrane. The sucking calluses occur on the mucous membrane part of the lip and are most prominent on the central portion. Figure 1.92. Gum hypertrophy in an...

The Placenta Its Membranes and the Umbilical Cord

The human placenta is a highly sophisticated organ of interface between mother and fetus, often referred to as the gate-keeper to the fetus. Careful examination of the placenta, its membranes, and the umbilical cord can prove to be a valuable aid in the diagnosis and treatment of the neonate. Gross examination of the placenta takes five minutes, and more sophisticated examination should be considered when there is poor pregnancy outcome, recognizable malformations or abnormalities, multiple...

Median Section Of The

The cornea is the outermost part of the eye and it is responsible for most of the light refraction in the eye the bending of light rays . On the periphery of the cornea is the sclera which helps maintain eye shape. The space behind the cornea is the anterior cavity which is found in front of the lens. It is composed of two smaller chambers, the anterior chamber and the posterior chamber. The anterior chamber is between the cornea and the iris, the part that determines eye color. The posterior...

Treacher Collins Syndrome

Close-up of the face of the same infant showing the antimongoloid slant and colobomas of the lower eyelids which typically occur at the junction of the inner two-thirds and outer third of the lower eyelids. Note the absence of eyebrows and eyelashes, the prominent nose and the hypoplasia of the zygomatic bone. Figure 3.193. A less severe case of Treacher-Collins syndrome. Note the unilateral macros-tomia and the abnormal ear. Treacher-Collins syndrome is a familial malformation...

Regional Characteristics of Vertebrae

We are now prepared to consider how vertebrae differ from one region of the vertebral column to another and from the generalized anatomy just described. Knowing these variations will enable you to identify the region of the spine from which an isolated vertebra was taken. More importantly, these modifications in form reflect functional differences among the vertebrae. The cervical vertebrae C1-C7 are the smallest and lightest ones other than the coccygeals. The first two C1 and C2 have unique...

Conjunctival Lipodermoid

The same patient showing a residual right upper lid ectropion after five days of bilateral pressure patches. If this occurs as a unilateral condition, it is essential to tape both eyes closed to prevent deprivation amblyopia. Figure 2.41. Congenital ectro-pion occurs as a result of intrauterine prolapse of the conjunctiva. This may require temporary taping or suturing of the lid margins. In the absence of microphthalmos, buphthalmos, or eyelid defects, primary eyelid eversion is...

Russell Silver Syndrome

The lower extremities of the infant show the less severe changes in that the femora, tibiae, and fibulae are hypoplastic and the feet are abnormal. Figure 3.173. This infant with Rubenstein-Taybi syndrome presented at term with a birth-weight of 2700 g and a length of 48 cm. Note the prominent forehead, hypertrichosis, downslanting palpebral fissures, epicanthic folds, long eyelashes, hypertelorism, broad nasal bridge, a beaked nose with a nasal septum extending below the alae...

Midsagittal Brain To Label

When seen from an inferior view, many different features can be seen on the brain. The frontal lobe is anterior and the temporal lobe and cerebellum are visible as well. The cerebellum has small folds called folia. The medulla oblongata is attached to the spinal cord and the pons is anterior to the medulla oblongata. Anterior to the pons are the mammillary bodies which are responsible for the olfactory smell reflex. The pituitary gland is next to the mammillary bodies. Anterior to the pituitary...

Babies Born In The Caul

Fetus born in a caul with a nuchal cord. Cord around the neck once is present in about 20 of deliveries and, in about 2 of deliveries, there is a cord around the neck twice. This common finding generally does not cause problems unless the cord constricts the neck tightly. Klima, T. Figure 4.21. Fetus born in a caul with a nuchal cord. Cord around the neck once is present in about 20 of deliveries and, in about 2 of deliveries, there is a cord around the neck twice. This common...

Amniotic Band Syndrome Photos

Encephaloceles may occur at any midline point in the skull and result from failure of the neuroecto-dermal axis to develop normally. This results in bony defects of the skull with protrusion of the meninges which may contain neural tissue. They are most common in the occipital area. The prognosis is better if the rest of the skull is normal and there is no hernia-tion of neural tissue. Figure 3.39. Encephaloceles may occur at any midline point in the skull and result from failure...

Androgen Insensitivity Syndrome

Occasionally, a girl shows all the usual changes of puberty except that she fails to menstruate. Physical examination shows the presence of testes in the abdomen and a karyotype reveals that she has the XY chromosomes of a male. The testes produce normal male levels of testosterone, but the target cells lack receptors for it. This is called androgen-insensitivity syndrome AIS , or testicular feminization. The external genitals develop female anatomy as if no testosterone were present. At...

Mechanisms of Tear Drainage

Drainage of tears involves a number of different mechanisms Table 1.3 . Physical factors, such as gravity, respiration, and evaporation, have been suggested. A decisive role is played by capillary attraction, aided by contraction of the lacrimal portion of the orbicularis muscle with blinking, as well as distension of the lacrimal sac by the action of the orbicularis muscle 19 . The mucin diversity of the epithelium of the naso-lacrimal ducts together with TFF peptides that are able to...

Sigmoid Colon Infection

D, e Acute ulcerative colitis of uncertain genesis presumed cytomegalovirus infection was ruled out. Colon ulcer with adherent clot d . Visible vessel was seen after irrigation and removal of the clot and was closed with a hemoclip Olympus e . f Mild, acute hemorrhagic colitis in left hemicolon. No pathogen isolated. g, h Acute colitis with hemorrhagic erosions g and submucosal hemorrhages h . No pathogen detected. Acute colitis with massive mucosal edema, isolated hemorrhaging, and small,...

Blistering distal dactylitis

Blistering distal dactylitis is a variant of streptococcal skin infection. It presents as a superficial, tender, blistering beta-haemolytic streptococcal infection over the anterior fat pad of the distal phalanx of the finger Figure 5.40 . The lesion may or may not have a paronychial extension. This blister, containing thin, white pus, has a predilection for the tip of the digit and extends to the subungual area of the free edge of the nail plate. The area may provide a nidus for the...

Phases of the Cardiac Cycle

We now examine the phases of the cardiac cycle, the pressure changes that occur, and how the pressure changes and valves govern the flow of blood. A substantial amount of information about these events is summarized in figure 19.19, which is divided into colored bars numbered to correspond to the phases described here. Closely follow the figure as you study the following text. Where to begin when describing a circular chain of events is somewhat arbitrary. However, in this presentation we begin...

Functional Areas Of The Cerebrum

The cerebrum can be described not only physically but also in terms of the functional areas. The functions of language are many and have different areas of specialization. The motor speech area Broca's area is typically on the left side of the frontal lobe and it involves the formation of words. Coordination of the tongue and other parts of the vocal apparatus occur here. Wernicke's area is located in the parieto-temporal region and is involved in the syntax of speech. Wernicke's area allows...

Causes Of Aseptic Leukocyturia

Self-medication before urine culture Sample contamination by cleansing solution Vaginal discharge Urinary stone Urinary tract tumor Chronic interstitial nephritis especially due to analgesics Fastidious microorganisms requiring special culture medium Ureaplasma urealyticum, Chlamydia, Candida Leukocyturia. A significant number of leukocytes more than 10,000 per milliliter is also required for the diagnosis of urinary tract infection, as it indicates urothelial inflammation. Abundant...

Infant Umbilical Hernia

The same infant also had an omphalocele. The finding of cleft lip and palate with an omphalocele or large umbilical hernia should alert one to the possibility of the diagnosis of trisomy 13. Figure 4.17. Median cleft syndrome may be associated with chromosomal defects. This infant with tri-somy 13 had cyclops with anophthalmia. There is no proboscis present. There was arhinencephaly and alobar holoprosencephaly on CT scan. Figure 4.17. Median cleft syndrome may be associated with...

The Hofler diagram and the pressurevolume curve

Water relations parameters of plant tissues can be presented by the Hofler diagram and the pressure-volume curve PV curve . The Hofler diagram shows the relationship between water potential and relative water content Fig. 2.2a . The PV curve is a plot between the reciprocal of water potential -1 and RWC or water loss 1 - RWC during desiccation Fig. 2.2b . Both the Hofler diagram and the PV curve are widely used to characterize water relations of plant tissues. To construct a Hofler diagram or a...

Table 43 Causes and associations of onychogryphosis Dermatological

Ichthyosis Psoriasis Onychomycosis Syphilis, pemphigus, variola Local causes Isolated injury to the nail apparatus Repeated minor trauma caused by footwear Foot faults such as hallux valgus Regional causes Associated varicose veins Thrombophlebitis even in the upper limb Aneurysms Elephantiasis Disease involving the peripheral nervous system General causes Old age Vagrancy and senile dementia Disease involving the central nervous system Hyperuricaemia Idiopathic forms Subungual hyperkeratosis...

Transverse Facial Cleft

Another example of congenital amputation of the left leg and the toes of the right foot by amniotic bands. In primary limb reduction defects, the skin at the amputation is smooth and there is underlying subcutaneous tissue. In secondary limb reduction deformities, the skin shows ulceration or scarring and has no underlying subcutaneous tissue. Radiography shows the stump of the bone is smooth in primary limb reduction defects and the stump of the bone is jagged in secondary...

Overview Of The Endocrine System

The endocrine system is a collection of glands and organs that secrete hormones. This system is grouped according to the function that the individual organs have. Some of these organs have two roles and are called mixed organs. They secrete hormones and also perform other functions such as digestion or secretion. The pancreas is a good example of this. It secretes hormones an endocrine function that regulate blood sugar levels and also secretes enzymes exocrine secretions that break down...

Fungal Infection With Multimicrobial Colonization

Superficial ulcers of 10 days' duration on the facing sides of the left first and second toe of a 70-year-old type 2 diabetic lady with diabetic neuropathy, before debridement are shown in Figures 8.8 and 8.9. Note soaking of the skin. An X-ray excluded osteomyelitis. Staphylococcus coagulase-negative, Pseudomonas aerugi-nosa and enterobacteriaceae were recovered after swab cultures in addition to Candida albicans. She was treated successfully with itraconazole for 5 weeks. The patient used a...

Newborn Marfan Syndrome

A term newborn with Marfan syndrome who had a birth weight of 3720 g and a length of 54 cm. Note the tall stature with long slim limbs and hypotonia. In Marfan syndrome, limbs are disproportionately long and trunk length is usually normal resulting in a low upper lower segment ratio. Ophthalmologic and cardiovascular pathologies, such as dislocation of the lens and aneurys-mal dilatation of the aorta, are usually noted after the neonatal period. Figure 3.98. A term newborn with...

Infant Hemifacial Microsomia

Micrognathia in an infant with Goldenhar's syndrome hemifacial microsomia . In addition, note the preauricular skin tags, unilateral macrostomia, and skin tags due to the extra branchial arch anomalies. Figure 1.158. Micrognathia in an infant with Goldenhar's syndrome hemifacial microsomia . In addition, note the preauricular skin tags, unilateral macrostomia, and skin tags due to the extra branchial arch anomalies. Figure 1.159. A congenital midline cervical cleft is a rare...

Effects of Maternal Medication

During pregnancy, the average fetus is exposed to four physician-prescribed and five self-prescribed drugs. Every drug administered or taken by a pregnant woman presents the mother with both risks and benefits. The risks include the drug's potential as a teratogen or as a cause of toxicity in the fetus. Most human teratogens affect the embryo during a very narrow period of early development as illustrated by the time 24 to 33 days gestation during which the fetus is susceptible to limb...

Chapter One Introduction

ANATOMICAL POSITION AND TERMS OF DIRECTION When studying the human body it is important to place the body in anatomical position. Anatomical position is described as the body facing you, feet placed together and flat on the floor. The head is held erect, arms straight by the side with palms facing forward. All references to the body are made as if the body is in this position so when you describe something as being above something else it is always with respect to the body being in anatomical...

Frontal Lobe Sulci Gyri

From the superior aspect, the two cerebral hemispheres are divided by the longitudinal fissure. The frontal lobes are separated from the parietal lobe by the central sulcus. The precentral gyrus primary motor cortex and the postcentral gyrus primary somatosensory cortex are on either side of the central sulcus. The gyri are the raised areas of the cerebral cortex and the sulci are the shallow depressions of the cerebral cortex. Together, these compose the convolutions of the brain. Label and...

Noonan Syndrome Infant

Radiograph of the skulls of the same twins as in Figure 2.72 showing the marked lack of mineralization. Figure 2.73. Radiograph of the skulls of the same twins as in Figure 2.72 showing the marked lack of mineralization. Figure 2.74. Short-limbed dwarfism in an infant with the Saldino-Noonan syndrome. This infant demonstrates the marked narrowing of the thorax with a large abdomen. The large abdomen is commonly seen in infants with a narrow thorax because the subcostal space is too...

Krickenbeck Consensus for the Classification Grouping of Surgical Techniques and Scoring for Follow Up of Anorectal

Standards for diagnostic procedures International Classi- International grouping Krickenbeck of surgical proce-fication Krickenbeck dures for follow up Perineal cutaneous fistula Rectourethral fistula Bulbar Prostatic Rectovesical fistula Vestibular fistula Cloaca No fistula Anal stenosis Pouch Colon Rectal atresia stenosis Rectovaginal fistula H type fistula Others Perineal operation Anterior sagittal approach Sacroperinal procedure PSARP Abdominosacroperi-neal pull-through Abdominoperineal...

Cerebrospinal Fluid Pathway

Both the brain and spinal cord have layers that cover the nervous tissue. These are known as the meninges. The cerebrospinal fluid CSF is produced in the choroid plexuses and then exits to the outside of the brain where it is absorbed in the venous sinus. Label and color the structures and trace the flow of cerebrospinal fluid in the schematic from its source to its reabsorption in the cardiovascular system. Answer Key a. Cerebrospinal fluid, b. Choroid plexus, c. Venous sinus, d....

Maxie C Maultsby Jr and Rational Behavior Therapy RBT

While still a psychiatric resident, Maxie C. Maultsby, Jr., studied briefly with Joseph Wolpe in 1967 and with Ellis for the following 7 years. At the 1975 Chicago National Conference of Rational Emotive and Behavior Therapists, Maultsby described his unique method of psychotherapy called Rational Behavior Therapy, or RBT. Then RBT was and probably still is the only method of psychotherapy that is based on the well-established facts about the mental activities of normal human brains that make...