By I. Iomar. Missouri Baptist College.

Parasagittal section through the left side of the abdomen 2 cm lateral to median plane robaxin 500 mg visa back spasms 6 weeks pregnant. Liver 299 1 Fundus of gallbladder 2 Peritoneum (cut edges) 3 Cystic artery 4 Cystic duct 5 Right lobe of liver 6 Inferior vena cava 7 Bare area of liver 8 Notch for ligamentum teres and falciform ligament 9 Ligamentum teres 10 Falciform ligament of liver 11 Quadrate lobe of liver 12 Common hepatic duct 13 Left lobe of liver 14 Hepatic artery proper 15 Common bile duct Portal triad 16 Portal vein 17 Caudate lobe of liver 18 Ligamentum venosum 19 Ligament of inferior vena cava 20 Appendix fibrosa (left triangular ligament) 21 Coronary ligament of liver 22 Hepatic veins Liver (inferior aspect) purchase robaxin 500mg muscle relaxant used in dentistry. It should be noted that the anatom- ical left and right lobes of the liver do not reflect the internal distribution of the hepatic artery, portal vein, and biliary ducts. With these structures, used as criteria, the left lobe includes both the caudate and quadrate lobes, and thus the line dividing the liver into left and right functional lobes passes through the gallbladder and inferior vena cava. The three main hepatic veins drain segments of the liver that have no visible external Liver (ventral aspect) (transparent drawing illustrating margins of peritoneal folds). In this case the accessory pancreatic duct represents the main excretory duct of the pancreas. Vessels of the Abdominal Organs: Portal Circulation 303 1 2 3 7 8 9 4 5 10 11 6 Tributaries of portal vein (blue) and branches of superior mesenteric artery (red) (anterior aspect). Stomach and transverse 33 Superior rectal artery colon have been removed and the liver elevated. Vessels of the Abdominal Organs: Inferior Mesenteric Artery 305 Vessels of the retroperitoneal organs. Direction of the inferior mesenteric artery and its anastomosis with the middle colic artery (arrow = Riolan’s anastomosis). Greater omentum and transverse colon have been reflected, the intestine partly removed. The normally retrocecally located vermiform appendix has been replaced anteriorly. Dissection of the Abdominal Organs 307 1 Diaphragm 2 Costal margin 3 Transverse colon 4 Ascending colon with haustra 5 Free taenia of cecum 6 Ileum 7 Cecum 8 Falciform ligament of liver 9 Liver 10 Stomach 11 Gastrocolic ligament 12 Jejunum 13 Sigmoid colon 14 Vermiform appendix 15 Terminal ileum 16 Meso-appendix 17 Mesentery Abdominal organs in situ. Ascending colon, cecum, and vermiform Variations in the position of the vermiform appendix. The transverse colon with mesocolon has been raised and the small intestine reflected. Dissection of the Abdominal Organs: Upper Abdominal Organs 311 Upper abdominal organs (anterior aspect). Thorax and anterior part of diaphragm have been removed and the liver raised to display the lesser omentum. Red arrows: 26 Pancreas routes of the arterial branches of celiac trunk to liver, stomach, 27 Lesser sac (omental bursa) duodenum, and pancreas (posterior aspect). The gastrocolic ligament has been divided and the whole stomach raised to display the posterior wall of the lesser sac. The lesser omentum has been removed and the lesser curvature of the stomach reflected to display the branches of the celiac trunk. Dissection of the Abdominal Organs: Upper Abdominal Organs 315 Arteries of upper abdominal organs (anterior aspect). The stomach, superior part of duodenum, and celiac ganglion have been removed to reveal the anterior aspect of the posterior wall of the lesser sac (omental bursa) and the vessels and ducts of the hepatoduodenal ligament. The gastrocolic ligament has been divided, the transverse colon and the stomach replaced to display the pancreas and superior mesenteric vessels. The stomach has been removed, the liver raised, and the duodenum anteriorly opened. Posterior Abdominal Wall: Root of the Mesentery and Peritoneal Recesses 319 Peritoneal recesses on the posterior abdominal wall. The 1 1 great center of the autonomic nervous system, the solar plexus (celiac ganglion, etc. In the male, the testis has moved out of the abdominal cavity and penetrated the 3 inguinal canal to be finally located within the extragenital organs. View of the female pelvis showing uterus with uterine ligaments, ovary, and urinary bladder (from Lütjen-Drecoll, Rohen, Innenansichten des 5 6 menschlichen Körpers, 2010). Retroperitoneal tissue, position of the right kidney Notice that the upper part of the kidney reaches the level of the (schematic drawing). Sections through the Retroperitoneal Region 325 1 Scalenus anterior, medius, and posterior muscles 2 Left subclavian artery 3 Left subclavian vein 4 Pulmonic valve 5 Arterial cone 6 Right ventricle of heart 7 Liver 8 Stomach 9 Transverse colon 10 Small intestine 11 Left lung 12 Left main bronchus 13 Branches of pulmonary vein 14 Left ventricle of heart 15 Spleen 16 Splenic artery and vein and pancreas 17 Left kidney 18 Psoas major muscle 19 Inferior vena cava 20 Renal vein 21 Body of twelfth thoracic vertebra and vertebral canal 22 Right kidney 23 Superior mesenteric artery 24 Superior mesenteric vein 25 Pancreas 26 Abdominal aorta 27 Left psoas major and quadratus lumborum muscles 28 Anterior layer of renal fascia of Gerota 29 Posterior layer of renal fascia 30 Perirenal fatty tissue 31 Abdominal cavity 32 Descending and sigmoid colon Parasagittal section through the thoracic and abdominal cavities at the level of the left kidney (5. The renal pelvis has been opened and the fatty tissue removed to display the renal vessels.

Severe skin itching is a feature of some cases of lymphoma and other myeloproliferative illnesses order 500mg robaxin fast delivery spasms right upper quadrant. Radiotherapy alone is reserved for patients with limited disease cheap robaxin 500 mg without prescription spasms translation, but this patient has wide- spread disease. He should be given allopurinol prior to starting chemotherapy, to prevent massive release of uric acid as a consequence of tumour lysis, which can cause acute renal failure. The pain has been colicky in nature and is associated with a feeling of distension in the left iliac fossa. Four years previously she passed some blood with her bowel motion and had a barium enema performed. Over the last week her pain has worsened and now she has continuous pain in the left iliac fossa and feels generally unwell. In her previous medical history she had a hysterec- tomy for fibroids 20 years ago. Colonic diverticula are small outpouchings which are most commonly found in the left colon. They are very common in the elderly Western popula- tion probably due to a deficiency in dietary fibre. Symptomatic diverticular disease has many of the features of irritable bowel syndrome. In severe cases, perforation, paracolic abscess formation or septi- caemia may develop. The barium enema from 4 years ago shows evidence of diverticular disease with outpouch- ings of the mucosa in the sigmoid colon. This would be consistent with the long-standing history of abdominal pain of colonic type and tendency to constipation. In her case there is no evidence of peritonitis which would signal a possible perforation of one of the diverticula. The differential diagnosis, with the suggestion of a mass and change in bowel habit, would be carcinoma of the colon and Crohn’s disease. In the absence of evidence of perforation with leak of bowel contents into the peritoneum (no peritonitis) or obstruction (normal bowel sounds, no general distension), treatment should be based on the presumptive diag- nosis of diverticulitis. A colonoscopy should be performed at a later date to exclude the possibility of a colonic neoplasm. Treatment should include broad-spectrum antibiotics, intra- venous fluids and rest. Further investigations are indicated, including electrolytes, urea and creatinine, glucose, liver function tests and blood cultures. Her blood pressure has been difficult to control and she is currently taking four agents (ben- drofluazide, atenolol, amlodipine and doxazosin). She had normal blood pressure and no pre-eclampsia during her only pregnancy 9 years previously. Risk factors for essential hypertension include a family history of hypertension, obesity and lack of exercise. She does not have paroxysmal symptoms of sweating, palpitations and anxiety to suggest a phaeochromocy- toma. There are no clinical features to suggest coarctation of the aorta (radiofemoral delay) or neurofibromatosis (café-au-lait spots/neurofibromas). Serum potassium is not low mak- ing Conn’s syndrome or Cushing’s syndrome unlikely. The principal abnormality is the modestly raised creatinine suggesting mildly impaired renal function. The absence of a renal bruit does not exclude the possibility of reno- vascular disease. This is common in elderly patients with evidence of generalized atherosclerosis (peripheral vascular disease and coronary artery disease). The commonest form is medial fibroplasia with thinning of the intima and media leading to formation of aneurysms alternating with stenoses, leading to the classic ‘string of beads’ appearances on angiography. It predomi- nantly affects young and middle-aged women with a peak incidence in the fourth decade of life.

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Pivot (or rotary): One bone pivots or rotates around a stationary bone buy cheap robaxin 500mg on line spasms after stent removal, such as the atlas rotating around the odontoid process at the top of the vertebral column best 500 mg robaxin spasms spanish. Condyloid: The oval head of one bone fits into a shallow depression in another, allowing the joint to move in two directions, such as the carpal-metacarpal joint at the wrist, or the tarsal-metatarsal joint at the ankle. Saddle: Each of the adjoining bones is shaped like a saddle (the technical term is reciprocally concavo-convex), allowing various movements, such as the car- pometacarpal joint of the thumb. Ball-and-socket: The round head of one bone fits into a cup-like cavity in the other bone, allowing movement in many directions so long as the bones are nei- ther pulled apart nor forced together, such as the shoulder joint between the humerus and scapula and the hip joints between the femur and the os coxa. Use the terms that follow to identify the structures that form a synovial joint shown in Figure 5-11. The structure in the knee that divides the synovial joint into two separate compartments is the a. Movement toward the midline of the body Chapter 5: A Scaffold to Build On: The Skeleton 87 Answers to Questions on the Skeleton The following are answers to the practice questions presented in this chapter. The term hemopoiesis also would be correct here, but it’s not one of the answer options. Back to Greek again: peri means “around” and osteon means “bone,” so the periosteum is “around the bone. Described by anatomist William Sharpey in 1846, these are also called perforating fibers. This is where you’ll find yellow marrow, although in infants red marrow also is present. These separate floating plates are why you can see a bald baby’s pulse throbbing on the top of its head. Ironically, anatomist Alfred Wilhelm Volkmann was most noted for his observations of the physiology of the nervous system, not bones. The epiphyseal and diaphyseal areas remain separated by a layer of uncalcified cartilage called the 20. Later it helps absorb bone tissue from the center of the long bone’s shaft, forming the 22. After ossification, the spaces that were formed by the osteoclasts join together to form 23. Haversian canal systems, which contain the blood vessels, lymphatic vessels, and nerves. Unlike bones in the rest of the body, those of the skull and mandible (lower jaw) are first laid down as 24. In the skull, the edges of the bone don’t ossify in the fetus but remain membranous and form 25. Crest O A large, rounded articular end of a bone; often set off from the shaft by the neck: f. Distal epiphysis Chapter 5: A Scaffold to Build On: The Skeleton 89 5–( Following is how Figure 5-2, the lateral view of the skull, should be labeled. Squamosal suture +– Following is how Figure 5-3, the inferior view of the skull, should be labeled. Foramen magnum ;–> Following is how Figure 5-4, the frontal view of the skull, should be labeled. Occipital bone ®–ö Following is how Figure 5-6, the sinus view of the skull, should be labeled. Maxillary sinus õ –§ Following is how Figure 5-7, the vertebral column, should be labeled. A spinous process ¶ –« Following is how Figure 5-8, the vertebra, should be labeled. The first seven pairs of ribs attach to the sternum by the costal cartilage and are called 136. Pairs 8 through 10 attach to the costal cartilage of the seventh pair and not directly to the sternum, so they’re called 137. The last two pairs, 11 and 12, are unattached anteri- orly, so they’re called 138. There’s one bone in the entire skeleton that doesn’t articulate with any other bones but nonetheless is considered part of the axial skeleton.

Summarize the important processes of social development that occur in infancy and childhood robaxin 500 mg with mastercard muscle relaxant m 751. The fetus is responsible discount robaxin 500 mg on line infantile spasms 9 month old, at least in part, for its own birth because chemicals released by the developing fetal brain trigger the muscles in the mother‘s uterus to start the rhythmic contractions of childbirth. The contractions are initially spaced at about 15-minute intervals but come more rapidly with time. When the contractions reach an interval of 2 to 3 minutes, the mother is requested to assist in the labor and help push the baby out. The Newborn Arrives With Many Behaviors Intact Newborns are already prepared to face the new world they are about to experience. Helps develop hand-eye coordination The baby grasps the object An object is pressed into the pressed and can even hold its own Grasp reflex palm of the baby. Helps in exploratory learning Loud noises or a sudden drop The baby extends arms and legs Protects from falling; could have in height while holding the and quickly brings them in as if assisted infants in holding onto their Moro reflex baby. Helps encourage motor development In addition to reflexes, newborns have preferences—they like sweet tasting foods at first, while becoming more open to salty items by 4 months of age (Beauchamp, Cowart, Menellia, & [1] Marsh, 1994; Blass & Smith, 1992). An infant only 6 days old is significantly more likely to turn toward its own mother‘s breast pad than to the [2] breast pad of another baby‘s mother (Porter, Makin, Davis, & Christensen, 1992), and a newborn also shows a preference for the face of its own mother (Bushnell, Sai, & Mullin, [3] 1989). Although infants are born ready to engage in some activities, they also contribute to their own development through their own behaviors. The child‘s knowledge and abilities increase as it babbles, talks, crawls, tastes, grasps, plays, and interacts with the objects in the environment [4] (Gibson, Rosenzweig, & Porter, 1988; Gibson & Pick, 2000; Smith & Thelen, 2003). Parents may help in this process by providing a variety of activities and experiences for the child. Similar effects are likely occurring in children who have opportunities to play, explore, and interact with their [6] environments (Soska, Adolph, & Johnson, 2010). Research Focus: Using the Habituation Technique to Study What Infants Know It may seem to you that babies have little ability to view, hear, understand, or remember the world around them. Indeed, the famous psychologist William James presumed that the newborn experiences a ―blooming, buzzing [7] confusion‖ (James, 1890, p. And you may think that, even if babies do know more than James gave them credit for, it might not be possible to find out what they know. After all, infants can‘t talk or respond to questions, so how would we ever find out? But over the past two decades, developmental psychologists have created new ways to determine what babies know, and they have found that they know much more than you, or William James, might have expected. One way that we can learn about the cognitive development of babies is by measuring their behavior in response to the stimuli around them. For instance, some researchers have given babies the chance to control which shapes they get to see or which sounds they get to hear according to how hard they suck on a pacifier (Trehub & Rabinovitch, [8] 1972). The sucking behavior is used as a measure of the infants‘ interest in the stimuli—the sounds or images they suck hardest in response to are the ones we can assume they prefer. Another approach to understanding cognitive development by observing the behavior of infants is through the use of the habituation technique. Habituation refers to the decreased responsiveness toward a stimulus after it has been presented numerous times in succession. Organisms, including infants, tend to be more interested in things the first few times they experience them and become less interested in them with more frequent exposure. Developmental psychologists have used this general principle to help them understand what babies remember and understand. In the habituation procedure, a baby is placed in a high chair and presented with visual stimuli while a video camera records the infant‘s eye and face movements. Over time, the baby starts to habituate to the face, such that each presentation elicits less gazing at the stimulus. You can see that, if the infant‘s gaze time increases when a new stimulus is presented, this indicates that the baby can differentiate the two stimuli. Although this procedure is very simple, it allows researchers to create variations that reveal a great deal about a newborn‘s cognitive ability. The trick is simply to change the stimulus in controlled ways to see if the baby ―notices the difference.

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