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Hi everyone! So, if you are a visual learner like me, then you know that learning all of the muscles in the human body can be a daunting task if you don't have visuals to aid in your studying. I spend a lot of time in the cadaver lab and in osteology lab (with skeletal models) to learn all of the di

CARTILAGE Key points: • Cartilage is connective tissue with a semi-solid extracellular matrix that comprises collagen fibers and ground substance, which provides both support and protection for other body tissues. • Three types covered here: hyaline, fibrous, and elastic. Hyaline cartilage • Most abundant type of cartilage in the body. • Hyaline cartilage forms most of the fetal skeleton and is important in endochondral bone growth until the end of adolescence. • In the adult, it persists in the nose, trachea, and larynx, thorax, and also covers the articular surfaces of long bones (where it has no perichondrium). • Degeneration and calcification of hyaline cartilage may either be physiologic or pathologic. It is physiologic in the case of endochondral bone formation but it is pathologic in the case of osteoarthritis, which leads to pain and restricted joint movement. There are other forms of arthritis, such as rheumatoid arthritis, which is an inflammatory form of arthritis in which the immune system aggressively attacks the cartilage, bone, and synovial membranes of the joints • Calcification (the processes by which cartilage is replaced by osseous tissue) is common in hyaline cartilage, but very rare in elastic or fibrous cartilages.Hyaline Cartilage Layers: • Perichondrium, outer surface • MatrixPerichondrium • Comprises inner and outer layers (although in slow-growing or inactive perichondrium, it is not always possible to visually distinguish two separate layers). • Inner layer is the chondrogenic (aka cellular) layer; it comprises chondrogenic cells. • Outer layer it he fibrous layer; it comprises Type I collagen fibers, blood vessels, which supply nutrients to the cartilage below, and, fibroblasts, which are thought to produce collagen fibers and/or chondroblasts (although intertextual variation exists regarding this point).Matrix • Appears glass-like under the microscope. • Is basophilic and stains purple on H & E section • Contains territorial matrixes that comprise the proteoglycan-rich, dark staining area around the lacunae. • Ground substance of the matrix, which is gel-like, comprises the following components: Proteoglycan aggregates, which are bound to collagen fibrils, and which provide a semi-solid structure to cartilage, Chondronectin, which adheres collagen fibers to chondrocytes, and, Itercellular Water, which is 60-80% of net weight of the cartilage (varies by location). • Matrix comprises type II collagen fibers, which are invisible in standard histologic preparations. • Houses lacunae, which are spaces in the matrix. • Inside the lacunae are the chondrocytes, which are mature cartilage cells that generate and maintain the matrix. • Chondroblasts are derived from chondrogenic cells, and eventually mature into chondrocytes. • Clusters of chondrocytes are called isogenous groups. • Interterritorial matrix outside of the isogenic groups; it stains lightly. Elastic Cartilage • Also known as yellow fibrocartilage. • Shares many similarities to hyaline cartilage (for instance, it also has perichondrium and contains invisible type II collagen fibers within the matrix). • Helpful distinguishing feature of elastic cartilage are its interwoven elastic fibers, which provide flexibility. • Elastic cartilage provides flexibility and resistance to permanent deformation. • Present in the external ear, the auditory (Eustachian) tube, and the epiglottis. Fibrous Cartilage • Also shares many similarities with hyaline cartilage • Two helpful distinguishing features are its lack of perichondrium and its rows of chondrocytes that have type I and type II fibers in between them. • The bundles of type 1 and type II collagen fibers provide strength and durability for shock absorption. • The matrix is dense and contains relatively little ground substance. • The type of joint and person's age determine the relative proportions of these two collagen fiber types within the fibrous cartilage. • NO perichondrium is present in fibrous cartilage. • Fibrous cartilage is found, most notably, in intervertebral discs, pubic symphysis, menisci of the knee, and tendons where properties of stress resistance are particularly important. Formation and Growth of Cartilage • Two types of growth: Interstitial and appositional growth; both types occur simultaneously during early development; the relative rate of each type of growth determines the shape and structure of the cartilage. Interstitial growth: • Interstitial growth occurs during early stages of cartilage formation, and in the growth plates and articular cartilages of growing long bones. • Cells divide within matrix to produce daughter cells that secrete their own matrix. Appositional growth • New matrix forms at the periphery of the cartilage. • Chondrogenic cells in perichondrium differentiate to become chondroblasts • Chondroblasts secrete new matrix, eventually become chondrocytes. • Older chondrocytes remain active and maintain matrix. Clincal Correlation: Hyaline cartilage that has been only nominally damaged can slowly repair itself via appositional growth, but severely damaged cartilage is often replaced by tougher, more fibrous connective tissue. Hormones that impact the growth of hyaline cartilage: • Stimulators: thyroxine, testosterone, and somatotropin. • Inhibitors: cortisone, hydrocortisone, and estradiol.Nutritional states affect bone growth: • Hypovitaminosis A diminishes the thickness of epiphyseal plates; decrease in growth rate. • Hypervitaminosis A accelerates ossification of epiphyseal plates; short stature (dwarfism). • Hypovitaminosis C inhibits matrix production and distorts cartilage columns in epiphyseal plates (bones are weak, repair of fractures obstructed; scurvy develops) • Hypovitaminosis D inhibits calcification of matrix, causing softening of the bones (osteomalacia); in children, growing bones become bowed (rickets)

Most protocols for lymphatic imaging of the lower limb conventionally inject tracer materials only into the interdigital space; however, recent studies indicate that there are four independent lymphatic vessel groups (anteromedial, anterolateral, posteromedial, and posterolateral) in the lower limb. Thus, three additional injection sites are needed for lymphatic imaging of the entire lower limb. We aimed to validate a multiple injection designed protocol and demonstrate its clinical benefits. Overall, 206 lower limbs undergoing indocyanine green fluorescent lymphography with the new injection protocol were registered retrospectively. To assess the influence of predictor variables on the degree of severity, multivariable logistic regression models were used with individual known risk factors. Using a generalized linear model, the area under the curve (AUC) of the conventional clinical model, comprising known severity risk factors, was compared with that of the modified model that included defects in the posterolateral and posteromedial groups. Multivariable logistic regression models showed a significant difference for the posteromedial and posterolateral groups. The AUC of the modified model was significantly improved compared to that of the conventional clinical model. Finding defects in the posteromedial and posterolateral groups is a significant criterion for judging lymphedema severity and introducing a new lymphedema severity classification.

Procambium forms -(a) Vascular cambium(b) Vascular tissues(c) Cork cambium(d) Intercalary meristem . Ans: Hint: Procambium, as seen from the name, is a precursor to cambium which is a meristematic tissue. Meristematic tissues give rise to specific t...

License Image Pelvic Floor Muscles The muscles of the “pelvic floor” or “pelvic diaphragm” are the levator ani, and the coccygeus. The levator ani is divided into two parts: the pubococcygeus and the iliococcygeus. Kegel exercises are designed to strengthen the muscles of the pelvic floor, primarily the pubococcygeus muscle. These exercises are usually done …

What are the causes and risk factors of an ascending aortic aneurysm? What are the different types, how is it diagnosed and can it be prevented?

Hi everyone! So, if you are a visual learner like me, then you know that learning all of the muscles in the human body can be a daunting task if you don't have visuals to aid in your studying. I spend a lot of time in the cadaver lab and in osteology lab (with skeletal models) to learn all of the di

An interactive tutorial showing the location, attachments, actions and innervation of Extensor Carpi Radialis Longus muscle using anatomical illustrations. Click and start learning now!

White Calcite Cluster - Size #0 White Calcite is a common calcium mineral that crystallizes in the form of masses and cubic formations. It can be found as pearly/chalky white, as well as pale white to light grey. Calcite clusters such as these have another name called “flowers of iron” which is fitting for these beautiful clusters. These specimens makes for a wonderful display piece and extra care should be taken when handling it as it is delicate. White calcite cluster specimens sought by collectors for their remarkable variety of crystal habits and colors, unusual size, affordability, and crystal form. Mineralogists recognized aragonite as a mineral species in 1790, a time when it served as a white paint pigment. Metaphysical practitioners believe that aragonite enhances patience and responsibility, reduces stress and anger, channels energy to constructive ends, and balances emotions. it is an industrial source of calcium carbonate for use in plaster, cement, white pigments, and agricultural lime. Although too soft for use in jewelry, though is carved into decorative objects such as bookends and figurines.

This product includes: 1. Editable Vector .AI file Compatibility: Adobe Illustrator CCIncludes Editable Text Font SuezOne (Under Free Open Font License) 2. Editable Vector .EPS-10 file Compatibility: Most Vector Editing Software 3. High-resolution JPG image 4700 x 3525 px License terms in short: Use for everything except reselling item itself. Read a full license here

Calliandra calothyrsus Meisn. Calliandra houstoniana var. calothyrsus

Hidden diagnosis

This product includes: 1. Editable Vector .AI file Compatibility: Adobe Illustrator CC Includes Editable Text Font SuezOne (Under Free Open Font License) 2. Editable Vector .EPS-10 file Compatibility: Most Vector Editing Software 3. High-resolution JPG image 3800 x 4560 px License terms in short: Use for everything except reselling item itself. Read a full license here

Hyperparathyroidism OverviewParathyroid hormone increases ECF calcium levels. Regulated by calcium and vitamin D.Parathyroid hormone protects against hypocalcemia by causing calcium release from the bones and reabsorption from the kidneys. Calcium is a vital mineral that participates in various cellular processes, including muscle contraction, nerve conduction, bone and tooth formation, and blood clotting (for a full review of parathyroid hormone and calcium physiology, please see the tutorial on Parathyroid Hormone & Calcium Homeostasis). Physiology Review:Both calcium and phosphate are stored within the hydroxyapatite crystals of bone, and calcium can be retained or excreted in renal and digestive systems, depending on the body's needs. A typical reference blood calcium range is 2.2-2.6 mmol/L (8.6-10.3 mg/dL). Parathyroid gland location: posterior aspect of the thyroid gland.Other key organs that engage in calcium homeostasis: Kidneys, small intestine, particularly the duodenum and, bone. In response to reduced extracellular calcium concentration, the parathyroid glands secrete parathyroid hormone (PTH). Effects of parathyroid hormone on the bones and kidneys: - Prolonged exposure to parathyroid hormone promotes resorption of old bone, and, therefore, the release of calcium and phosphate into extracellular fluid (episodic, transient binding of parathyroid hormone causes an increase in new bone synthesis). - In the kidneys, parathyroid hormone works directly and indirectly to raise extracellular calcium levels:Parathyroid hormone increases calcium reabsorption in the distal convoluted tubule of the nephrons.It also stimulates activation of Vitamin D (activated form = 1,25(OH)2-VD). - Vitamin D acts on the nephron to increase reabsorption of calcium and phosphate. - In the small intestine, Vitamin D increases calcium and phosphate reabsorption. - In the bones, Vitamin D works with parathyroid hormone to facilitate skeletal remodeling, which requires both synthesis and resorption of bone. Thus, the total effect of parathyroid hormone is to elevate extracellular calcium levels. If Vitamin D levels are high, parathyroid hormone secretion is inhibited. Treatment In most cases of hyperparathyroidism, partial or total gland removal is prescribed. Hungry bone syndrome Parathyroid gland removal can lead to "hungry bone syndrome" which manifests as severe and prolonged hypocalcemia after gland removal. Prior to gland removal, the bones were heavily shifted towards resorption and calcium release; it is thought that, after the glands are removed, bones shift towards growth and high calcium uptake. Patients tend to feel tired and weak, or can have more severe responses to the hypocalcemia, which we address in the next section. Primary HyperparathyroidismToo much parathyroid hormone production.Causes:Hyperplasia, adenoma, or carcinoma of the parathyroi glands. Hypercalcemia: Elevated parathyroid hormones stimulate calcium release and retention, resulting in high calcium levels. Signs/Symptoms/Complications:Early and mild cases are often asymptomatic, or present with nonspecific symptoms like fatigue and depression. Because of increased screening for hormone and electrolyte imbalances, most people diagnosed with primary hyperparathyroidism fall into the asymptomatic or mild categories. Chronic and severe hyperparathyroidism experience a variety of signs and symptoms that can be remembered with the expression "stones, bones, abdominal groans, thrones, moans, neuropsychiatric overtones and blood flows." Stones - Renal: Renal effects include kidney stones (from excessive calcium retention), polyuria, and renal insufficiency – this accounts for the "stones and thrones" (thrones meaning the "porcelain throne" that patients spend more time on, thanks to the kidney stones and polyuria)."Bones": Bone pain, fractures, and osteitis fibrosis cystica caused by hyperparathyroidism. In areas where detection of hyperparathyroidism is delayed, osteitis fibrosis cystica is still a classic marker of the disorder. We show three key features of osteitis fibrosis cystica: - "Brown tumor" (shown in a distal phalange). Brown tumors are giant cell lesions caused by excessive bone resorption with fibrovascular tissue replacement and hemorrhaging (hence the reddish-brown color of the lesions and their name). These tumors are most often found in the extremities, clavicles, ribs, mandible, and pelvic girdle. - Subperiosteal resorption of cortical bone (shown on middle phalange) - "Salt and pepper skull" (aka, pepper pot skull) has numerous small but well-defined spots of trabecular bone resorption. Be aware that osteitis fibrosis cystica is also associated with secondary hyperparathyroidism, which we'll address, soon."Abd. Groans" - Gastrointestinal Effects: GI effects include nausea, vomiting, constipation, pancreatitis, and peptic ulcers.The volume depletion caused by renal and gastrointestinal effects of primary hyperparathyroidism (vomiting, polyuria) exacerbates hypercalcemia, so we need to pay attention to fluid loss in these patients."Moans": Muscle weakness is common, and accounts for the "moans.""Neuropsychiatric overtones": Lethargy and confusion; severe cases of hyperparathyroidism can lead to coma. "Blood flows" - Cardiovascular Effects Including hypertension, left ventricular hypertrophy, arrhythmias, calcium valvular deposit, a shortened QT interval, and heart failure. Normocalcemic primary hyperparathyroidism Patients present with primary hyperparathyroidism but have calcium levels within the normal range. In some studies, patients progressed to hypercalcemia over time, leading some authors to wonder if this is merely an early stage of Primary hyperparathyroidism. Secondary Hyperparathyroidism Causes: Chronic kidney disease Vitamin D or calcium deficiency. Chronic kidney disease is a significant cause of secondary hyperparathyroidism in the United States. As a result of diseased, ineffective renal functioning: Phosphate excretion and activation of Vitamin D are both reduced, and calcium reabsorption falls. As a result of low calcium and high phosphate levels, parathyroid hormone is elevated (recall that a key signal for parathyroid hormone release is low extracellular calcium levels). Signs, Symptoms, Complications:Renal osteodystrophy in patients with chronic kidney disease. Similar to patients with primary hyperparathyroidism, patients experience bone pain, increased fractures, and osteitis fibrosa cystica.Calciphylaxis can also occur; indicate that calcium-phosphate products deposit in the blood vessels, fat, and skin, leading to thrombosis and necrosis. Though rare, this is a serious complication of secondary hyperparathyroidism.

Thorax: Coronal Section (Midaxillary Line, Tracheal Bifurcation, Left Atrium) Anatomy Arch of azygos vein, Trapezius muscle, Supraspinatus muscle, Subscapularis muscle, Oblique fissure of right lung, Middle lobe of right lung, Right pulmonary artery, Right intermediate bronchus, Horizontal fissure of right lung, Left atrium, Coronary sinus, Respiratory diaphragm, Esophagus, Costodiaphragmatic recess, Liver, Thoracic duct, Esophagus, Left vertebral artery, Middle scalene muscle, Anterior scalene muscle, Posterior scalene muscle, Trachea, Subscapularis muscle, Axillary artery Axillary vein, Arch of aorta, Axillary lymph nodes, Superior lobe of left lung, Oblique fissure of left lung, Left pulmonary artery Left main bronchus, Inferior lobe of left lung, Left auricle, Entry of left inferior pulmonary vein, Stomach, Pancreas, Right crus of respiratory diaphragm, Right suprarenal gland, Carina of trachea, Abdominal aorta.

BACKGROUND AND PURPOSE: Different lesion locations in the atherosclerotic carotid bulb stenosis have not been clearly defined. We sought to evaluate 2 locations of carotid bulb stenosis in high-risk patients and to determine the relationship of each location to atherosclerotic risk factors and clinical features. MATERIALS AND METHODS: Atherosclerotic carotid plaques of apical versus body lesions, defined according to the area and extent of plaque involvement, were retrospectively analyzed in 200 consecutive high-risk patients who underwent carotid stent placement because of ≥50% symptomatic stenosis. We evaluated interobserver concordance and assessed each type of lesion relative to 13 atherosclerotic risk factors, mode of symptom presentation, infarct pattern, procedure-related factors, and clinical outcomes, by univariate and multivariable logistic regression analysis. RESULTS: Interobserver concordance showed good agreement for differentiating apical and body lesions (κ = 0.745). Univariate analysis revealed that apical lesions ( n = 108, 54%) were associated with pseudo-occlusion ( P = .027), older age ( P = .073), and alcohol intake ( P = .080), whereas body lesions ( n = 92, 46%) were associated with hyperlipidemia ( P = .001), a wedge-shaped cortical infarct pattern ( P = .057), and hyperperfusion syndrome ( P = .083). Multivariable logistic regression analysis adjusted by age revealed that hyperlipidemia ( P = .002; OR, 3.462; 95% CI, 1.595–7.515) and hyperperfusion ( P = .026; OR, 6.727; 95% CI, 1.261–35.894) were independent predictors of body-type lesions. CONCLUSIONS: Atherosclerotic carotid bulb stenosis was found to have 2 distinct locations, body and apical. Hyperlipidemia and cortical wedge-shaped infarcts were more frequently associated with body than with apical stenosis at the time of presentation. CCA : common carotid artery CI : confidence interval ECA : external carotid artery FEV : forced expiratory volume ICA : internal carotid artery mRS : modified Rankin scale OR : odds ratio NASCET : North American Symptomatic Carotid Endarterectomy Trial NIHSS : National Institutes of Health Stroke Scale WSS : wall shear stress

Goodpasture syndrome (GPS), also known as anti-glomerular basement membrane disease, is a rare autoimmune disease in which antibodies attack the basement

lymphadenopathy

“What's the deal with Ammonia in hepatic encephalopathy? A #cirrhosis QI #tweetorial Aims Try to answer this question while also showing 1) Ammonia levels dont matter 2) U should not restrict protein in patients with HE Keywords: "ammonia hypothesis", sarcopenia”

Giotikas Orthopaedics specializes in Cosmetic Limb Lengthening surgery in India, Singapore and London which aims to increase the body height of the patient. Learn more today.

Caudiciform plants form a caudex—a fat, swollen stem, trunk, or aboveground roots—giving rise to colorful names like elephant’s foot, Buddha belly, pregnant onion, and turtle back.

✨Calcite can be used when you need a surge of energy, to encourage creative expression and nurture emotional healing. ✨You will receive one calcite goethite cluster - choose your favorite! These have been cleared and are ready to enter your home! Each crystal will come with a digital download affirmation card that describes what the crystal's properties are. ✨As always, we categorize crystals by weight and they may vary in size, shape and color and we have done our best to take pictures that show the variance between them. Please read the listing carefully before purchasing. ✨Country of Origin: Morocco

Isotoma Axillaris [Laurentia] does well in warm climates as a perennial, annual in cool climates, abundance of fragrant, star-shaped flowers [DETAILS]

This workout is GREAT for cardio AND strengthening your legs. The alternating side lunge targets your glutes, quads, hamstrings, and inner thighs, and helps to strengthen your core, calves, and...

Abdominal testis, bilateral, ICD-10: Q53.21. Symptoms, Chapter, Cases. Abdominal Testis, Bilateral: Causes, Symptoms, and Treatment Abdominal testis is a rare condition in which one or both testicles fail to descend into the scrotum during fetal develo...