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Muscles are the only tissue in the body that has the ability to contract and therefore move the other parts of the body neck pain treatment quick fix order imdur 20mg mastercard. Attached to our bones are about 700 named muscles making up roughly half of our body weight myofascial pain treatment center boston imdur 40mg online. Visceral muscle: Found inside of organs such as the stomach, intestines, and blood vessels and is controlled by the unconscious part of the brain and is known as involuntary muscle. Cardiac muscle: It is only found in the heart and is involuntary muscle and auto rhythmic stimulated by a natural pacemaker and it is very strong. Cardiac and visceral muscles are primarily responsible for transporting substances, like blood or food, from one part of the body to another. When we exert ourselves, the extra muscle contraction leads to a rise in body temperature and eventually sweating. Every action that a person consciously performs, like talking and writing, is controlled by skeletal muscle. Most skeletal muscles are attached to two bones across a joint and are very strong. When everyone has completed the exercise on the A4 page, the participants should add their bone and muscular injuries and ailments, torn ligaments or tendons, old and current. They can mark these on the A4 page of the human body and write about the injury too in a few words. The entire bone that was broken is drawn on the body map and then colored in with white pencil crayon or white chalk pastel that must be sprayed with hair lacquer. Muscular pains, torn or damaged tendons and ligaments are included too, first in lead pencil with a few words about what happened, and then colored in with pencil crayons and the story behind the injury written in permanent markers. Note: If a participant did not break any bones and have muscle and tendon problems they can work on their early childhood life stories on their body maps. The facilitator vocalizes the questions that are either written on A1-size pieces of paper in neat handwriting or typed up and photocopied for each participant. When participants have finished the drawing, they must give it color, with reference to the meaning of color. Note: Should participants want to continue working after the workshop has wrapped up for the day, the facilitator must continue offering these participants the support they require. The facilitator is encouraged to write his or her reflections of the day, write up the one-word evaluations in her or his journal and prepare for Day Three by reading the toolkit and preparing the workshop venue and materials and the exercises. The facilitator should also review the body maps and assess progress each participant has made regarding the exercises and focus her or his attention on those whose progress is tentative and slower on Day Three. When writing and drawings are carefully arranged in the available space, they are gone over with permanent marker and given color. The session begins with information given by the facilitator about symbols and their meanings. The facilitator can select symbols from the template below, and/or come up with others she or he may think of, as examples. This self-reflective exercise requires of participants to decide on one symbol, that best represents their character and strength, and to draw the symbol on a large A3 piece of paper, and give it color, with reference to the meaning of color. Symbols are a visually important aspect of the body maps, so metallic paint can be used and the exercise should not be rushed. Materials: A3-size paper, pencils, erasers, oil pastels, pencil crayons, permanent markers and metallic paints. The facilitator allows time for participants to add all relevant details on their A4 sheets of paper of the human body after system. When participants have completed this exercise, they can move to their body maps and include details related to the three systems on their body maps. The shared anatomy book will useful, and the diagrams in the toolkit can assist participants to manage a degree of anatomical likeness too.

The rate at which these abnormalities develop varies widely depending on the magnitude of the imbalance between the total rate of water intake and excretion by renal and extrarenal routes prescription pain medication for shingles discount imdur 20 mg otc. If the defect in urinary dilution is minor or if insensible loss of water is abnormally high pain medication for dog injury quality 20 mg imdur, even markedly increased rates of water intake may be insufficient to induce hyponatremia. On the other hand, if urinary concentration is fixed at a high level and insensible loss is low, even an apparently normal basal rate of fluid intake may be sufficient to produce the syndrome (2). This is abnormal since the urine should be very dilute if the plasma is hypo-osmolar. Checking the serum and urine sodium levels are often sufficient since hyponatremia in conjunction with an elevated urine sodium is similarly abnormal, although this can also be caused by diuretics, mineralocorticoid deficiency (Addisonian crisis) and salt losing nephropathy. The most striking and potentially confusing variant is that caused by downward resetting of the osmostat. If the measurements of urine osmolality are repeated during therapeutic fluid restriction, the true cause becomes apparent because urinary concentration begins long before serum sodium rises to normal. These distinctions can usually be made on the basis of the clinical history, physical examination, and routine laboratory tests. Hypervolemic hyponatremia occurs in patients with severe congestive failure, cirrhosis, or nephrosis, and is always associated with edema. Because of this effective hypovolemia, plasma urea, uric acid, renin activity, and aldosterone are also usually elevated, and the urinary excretion of salt and water is decreased. Hypovolemic hyponatremia occurs in conditions such as diuretic abuse, mineralocorticoid deficiency, or gastroenteritis, which result in excessive loss of sodium and water. The resultant depletion of intravascular and interstitial fluid results in physical signs of hypovolemia, such as tachycardia and postural hypotension. Consequently, plasma urea, uric acid, renin activity, and aldosterone are elevated, whereas urinary excretion of salt and water are reduced (unless a diuretic or sodium-losing nephropathy is responsible). In others, it is an acute self-limited disorder that remits spontaneously within 2 to 3 weeks. This reduces free water retention and allows the hyponatremia to resolve gradually. If the hyponatremia is severe, or accompanied by symptoms such as nausea, vomiting, coma, or seizures, it may be desirable to correct part of it more rapidly by combining fluid restriction with a slow intravenous infusion of hypertonic (3%) saline. Hypertonic saline infusion is dangerous, requiring close monitoring and frequent stat sodium measurements (a turnaround time of 1 hour is not fast enough since the sodium may have risen to excessive levels before then). The objective should be to raise serum sodium no faster than 24 mEq/L in 24 hours and to a final level no greater than 135 mEq/L. Although this issue is not yet settled, raising the serum sodium faster or farther may cause acute osmotic demyelinization, a serious complication characterized by severe neurologic abnormalities, including quadriparesis, mutism, pseudobulbar palsy, seizures, behavioral disturbances, and movement disorders (2). This effect may not occur for several weeks and is usually reversible when treatment is stopped. Demeclocycline may also cause photosensitivity, azotemia, or other signs of nephrotoxicity, but these side effects are usually also reversible. The principal side effects are hypokalemia and hypertension, which may necessitate potassium supplementation or reduction of the dose. Besides polyuria and polydipsia, physical exam and lab studies are typically within normal limits. However, in severe cases, signs and symptoms of hypernatremia and dehydration may be present. Vasopressin challenge test: polyuria and polydipsia are corrected in central diabetes insipidus, but not corrected with standard doses in nephrogenic diabetes insipidus. There are 4 types, only one is regulated by osmolality; however, the osmostat is reset to a lower osmolality. If the urine sodium is low, then the hyponatremia is due to total body sodium depletion. Her parents report that she cries when touched in her hands and feet and has refused to walk. She had a low-grade fever, vomiting, diarrhea, and decreased urine output attributed to a viral gastroenteritis beginning four days ago.

The salpingopharyngeus muscle (answer c) pain treatment centers of america cheap imdur 20mg with amex, also innervated by the pharyngeal branch of the vagus nerve chronic pain treatment uk imdur 20 mg low price, arises from the torus tubarius at the opening of the auditory tube and inserts into the pharyngeal musculature. The superior and middle pharyngeal constrictors (answer e) are innervated by the pharyngeal branch of the vagus nerve. The stylopharyngeus and styloglossus muscles (answer d) originate from the styloid process and insert onto the lesser horn of the hyoid and into the tongue, respectively. Levator veli palatini and tensor veli palatini muscles (answer a) are above the soft palate. Closure of the neural tube begins near the midpoint of its length and proceeds in both directions simultaneously (thus not answers a and c). The neurectoderm of the neural tube will give rise to neurons and some glial cells (astrocytes, oligodendroglia, and ependymal cells), but the precursors of microglia (the monocyte-macrophage lineage) migrate into the nervous system from the blood (thus not answer b). The sensory ganglia are formed by neural crest cells that migrated before the development of mature neurons (answer e). While most strokes present with sudden onset of neurological symptoms, the majority of stokes are ischemic (answer b) in nature due to blood clots blocking blood to the brain. In this man, however, he probably had a hemorrhagic stroke as a consequence of increased blood pressure due to straining, because of constipation. Subdural hematoma (answer c), while common in the elderly, would not result in a bloody spinal tap. Deviation of the tongue to the right on protrusion results from the unopposed action of the left genioglossus muscle, which is innervated by the left hypoglossal nerve. The hypoglossal nerve also innervates numerous other tongue muscles involved in deglutition. The question only asks about the cause of the tongue deviation so the other answers (answers a, b, d, e) are irrelevant. Loss of innervation to the lateral rectus results in unopposed tension by the medial rectus, which produces internal strabismus. Paralysis of this nerve (answer b) would result in lateral deviation of the eye (external strabismus) accompanied by ptosis (drooping eyelid). In addition, mydriasis (dilated pupil) results from loss of function of the parasympathetic component of the oculomotor nerve. The optic nerve (answer a) is responsible for receiving the special sense of sight. The distal tendon of the stylohyoid muscle is split by the digastric muscle (not answer d) passing through its trochlea attached to the lesser horn. The sphenomandibular ligament inserts onto the lingula of the mandibular foramen (answer c); the stylohyoid ligament inserts onto the lesser horn of the hyoid bone. Inflammation of the mucous membrane that lines the sinuses may sometimes lead to a build up of pus that can block the normal drainage pathways. In this instance, the anterior wall of the frontal sinus was compromised and pus escaped into the forehead and into the upper eyelid, since the frontalis muscle, a normal barrier, attaches only into skin of the forehead. In order to allow movement, the skin of the eyelid is only attached to underlying structures by loose areolar connective tissue, through which infections easily spread. The swelling spontaneously reduced after the first week of treatment and no visible defects were noted 1 month later. Trigeminal neuralgia or tic douloureux (answers a and b) is characterized by sudden sharp pains over the distribution of one or more branches of the trigeminal nerve. Although pain is perceived within the ophthalmic division, the teenager would not suffer from sudden sharp twinges of pain, rather a dull constant pain from swollen tissue. A sty (answer e) is an inflammation of the sebaceous gland, associated with each eyelash or cilia. A chalazion is an inflammation of a Meibomian or tarsal gland, which lies on the inner surface of the eyelid. This could cause a bulge in the upper eyelid but does not fit with the other clinical findings. If there is no projection of the spinal cord or its covering through the bony defect, the condition is generally hidden (spina bifida occulta). However, it is termed spina bifida cystica when spinal material traverses the defect.

Kidney 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Hepatic vein Anterior and posterior vagal trunk Inferior vena cava Lumbar part of diaphragm Right greater and lesser splanchnic nerves Celiac trunk Celiac ganglion and plexus Superior mesenteric artery Left renal vein Right sympathetic trunk and ganglion Abdominal aorta Left sympathetic trunk Esophagus (cut) pain treatment associates west plains mo imdur 40 mg generic, left greater splanchnic nerve Left suprarenal gland Left renal artery Renal pelvis Renal papilla with minor calyx Left testicular vein Ureter Psoas major muscle Quadratus lumborum muscle Lumbar vertebra (L2) Renal calyx Catheter 327 22 23 16 23 19 24 Renal pelvis with calices and ureter (X-ray pain treatment for pleurisy buy imdur 20mg free shipping, retrograde injection; by courtesy of Prof. The anterior cortical layer of the kidney has been removed to display the renal pelvis and papillae. In the tubular system, 99% of this fluid, together with useful substances like glucose and ions, are reabsorbed. Diseases of the renal vascular system may impair the filtering process and thereby the composition of the blood. Kidney: Arteries and Veins 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 Diaphragm Hepatic veins Inferior vena cava Common hepatic artery Suprarenal gland 1 Celiac trunk Right renal vein Kidney Abdominal aorta 2 Subcostal nerve Iliohypogastric nerve Central tendon of diaphragm 3 Inferior phrenic artery Cardic part of stomach 4 Spleen 5 Splenic artery 6 Superior renal artery Superior mesenteric artery Psoas major muscle Inferior mesenteric artery 7 Ureter Glomerulus 8 Afferent arteriole of glomerulus 9 Glomeruli Radiating cortical artery 10 Subcortical or arcuate artery Subcortical or arcuate vein 3 Interlobular vein 11 Interlobular artery Interlobar artery and vein Retroperitoneal organs, kidneys, and suprarenal glands in situ (anterior aspect). Efferent arteriole of glomerulus Vasa recta of renal medulla Spiral arteries of renal pelvis 329 12 13 14 15 16 5 17 8 18 19 20 21 33 Glomeruli (210). Costal arch Right renal vein Right kidney Inferior vena cava Iliohypogastric nerve and quadratus lumborum muscle 6 Ureter (abdominal part) 7 Psoas major muscle and genitofemoral nerve 1 2 3 4 5 8 9 10 11 12 13 14 15 16 Iliacus muscle External iliac artery Ureter (pelvic part) Ductus deferens Testis and epididymis Celiac trunk Superior mesenteric artery Left kidney Abdominal aorta 17 18 19 20 21 22 23 24 Inferior mesenteric artery Common iliac artery Iliac crest Sacral promontory Rectum (cut) Medial umbilical ligament Urinary bladder Penis Retroperitoneal Region: Urinary System 331 Retroperitoneal organs, urinary system in situ (anterior aspect). Part of the left psoas major muscle has been removed to display the lumbar plexus. Retroperitoneal Region: Autonomic Nervous System 335 56 Ganglia and plexus of the autonomic nervous system within the retroperitoneal space (anterior aspect). The penis includes the urethra and thus serves for both ejaculation and micturition. The internal (involuntary) and external (voluntary) urethral sphincters are widely separated. The ureter, having crossed the ductus deferens, enters the urinary bladder at its base. The peritoneum is reflected off of the posterior surface of the bladder and onto the rectum, thus forming the rectovesical pouch. Male Genital Organs (isolated) 337 10 11 2 Male genital organs, isolated (right lateral aspect). Posterior half of male urethra and prostate in continuity with neck of bladder (anterior aspect). Male External Genital Organs 341 Male external genital organs with penis, testis, and spermatic cord, deeper layers (anterior aspect). The deep fascia of the penis has been opened to display the dorsal nerves and vessels. The corpus spongiosum of the penis with the glans penis has been isolated and reflected. The left figure shows the testicular septa after removal of the seminiferous tubules. Pelvic Cavity in the Male: Coronal Sections 345 Coronal section through pelvic cavity at the level of prostate and hip joint (anterior aspect). Left common iliac artery Right common iliac artery Right ureter Right internal iliac artery Right external iliac artery and vein Right obturator artery and nerve Umbilical artery Sigmoid and superior vesical artery Left ductus deferens Urinary bladder Pubic bone (cut) Prostate Vesicoprostatic venous plexus Deep dorsal vein of penis and dorsal artery of penis 15 Penis and superficial dorsal vein 16 Spermatic cord and testicular artery 17 Bulb of penis and deep artery of penis 1 2 3 4 5 6 7 8 9 10 11 12 13 14 18 Cauda equina and dura mater (divided) 19 Intervertebral disc between fifth lumbar vertebra and sacrum 20 Sacral promontory 21 Mesosigmoid 22 Left ureter 23 Left internal pudendal artery 24 Ischial spine (cut), sacrospinal ligament, inferior gluteal artery 25 Left inferior vesical artery 26 Seminal vesicle 27 Levator ani muscle 28 Branches of inferior rectal artery 29 Perineal artery 30 Anus 31 Posterior scrotal branches 32 Pudendal nerve and sacrotuberal ligament Pelvic Cavity in the Male: Vessels of the Pelvic Organs 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 Internal iliac artery External iliac artery Ureter Obturator nerve Umbilical artery Anulus inguinalis profundus (deep inguinal ring) Urinary bladder (vesica urinaria) Symphysis Prostatic part of urethra Sphincter muscle of urethra Urethra (spongy part) Cavernous body of penis Glans penis Sacrum Promontory Lateral sacral artery Plexus sacralis Inferior gluteal artery Internal pudendal artery Obturator artery Inferior hypogastric plexus Ductus deferens Seminal vesicle (vesicula seminalis) Rectum Prostatic venous plexus Prostate Anal canal Spongy part of penis Pampiniform plexus Testis and epididymis Common iliac artery Umbilical artery Medial umbilical ligament Branches of superior vesical artery Urogenital diaphragm Deep artery of penis Dorsal artery of penis Penis Iliolumbar artery Superior gluteal artery Middle rectal artery Levator ani muscle Inferior rectal artery Inferior vesical artery 347 1 2 3 4 5 14 15 16 17 18 19 20 21 6 7 8 9 10 22 24 23 25 26 27 11 28 12 29 13 Vessels of the pelvic cavity in the male (medial aspect, midsagittal section). Above = horizontal sections through the abdominal cavity, showing different contrast medium concentrations within the aorta and the aneurysm; below = 3-D reconstruction of the aneurysm; red = aorta; green = thrombotic areas; blue = vein (vena cava inferior, partly compressed). Pelvic Cavity in the Male: Vessels and Nerves of the Pelvic Organs 349 17 1 2 3 4 5 19 18 20 6 21 7 8 22 9 23 10 11 12 24 13 14 25 15 26 16 27 Vessels and nerves of the pelvic cavity in the male (medial aspect, midsagittal section). Urogenital and Pelvic Diaphragms in the Male 1 Right testis (reflected laterally and upward) 2 Bulbospongiosus muscle 3 Ischiocavernosus muscle 4 Adductor magnus muscle 5 Posterior scrotal nerves and superficial perineal arteries 6 Posterior scrotal artery and vein 7 Right artery of bulb of penis 8 Perineal body 9 Perineal branches of pudendal nerve 10 Pudendal nerve and internal pudendal artery 11 Inferior rectal arteries and nerves 12 Inferior cluneal nerve 13 Coccyx (location) 14 Penis 15 Left testis (reflected laterally) 16 Left posterior scrotal artery 17 Deep transverse perineal muscle 18 Left artery of bulb of penis 19 Posterior femoral cutaneous nerve 20 External anal sphincter muscle 21 Anus 22 Gluteus maximus muscle 23 Anococcygeal nerves 24 Acetabulum (femur removed) 25 Ligament of femoral head 26 Body of ischium (cut) 27 Sciatic nerve 28 Coccygeus muscle 29 Levator ani muscle a iliococcygeus muscle b pubococcygeus muscle c puborectalis muscle 30 Prostatic venous plexus 31 Body of pubis 32 Testis 351 Urogenital diaphragm and external genital organs in the male with vessels and nerves (from below). The right half of the pelvis including the obturator internus muscle and femur have been removed to display the right half of the levator ani muscle. The left crus penis has been isolated and reflected laterally together with the bulb of the penis. Urogenital and Pelvic Diaphragms in the Male 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 Right testis (reflected) Corpus spongiosum of penis Corpus cavernosum of penis Perineal branch of posterior femoral cutaneous nerve Posterior scrotal arteries and nerves Deep artery of penis Deep transverse perineal muscle Right perineal nerves Inferior rectal nerves Inferior cluneal nerve Anococcygeal nerves Left spermatic cord Left testis (cut surface) Dorsal artery and nerve of penis Deep dorsal vein of penis Urethra (cut) Artery of bulb of penis Superficial transverse perineus muscle Left artery of bulb of penis Perineal branch of pudendal nerve Anus External anal sphincter muscle Gluteus maximus muscle Internal pudendal artery and pudendal nerve Sacrotuberous ligament Coccyx Urogenital diaphragm (deep transverse perineus muscle) Tendinous center of perineum (perineal body) Levator ani muscle Anococcygeal ligament Obturator internus muscle Dorsal artery of penis 353 22 Urogenital diaphragm and external genital organs in the male (from below). Female Urogenital System 1 Muscular coat of urinary bladder 2 Folds of mucous membrane of urinary bladder 3 Right ureteric orifice 4 Interureteric fold 5 Internal urethral orifice 6 Vesico-uterine venous plexus 7 Urethra 8 Pubic bone (cut edge) 9 External urethral orifice 10 Vestibule of vagina 11 Left ureteric orifice 12 Trigone of bladder 13 Obturator internus muscle 14 Levator ani muscle 15 Bulb of the vestibule 16 Left labium minus 17 Psoas major muscle 18 Ampulla of rectum 19 Uterus 20 Urinary bladder 21 Promontory 22 Sigmoid colon 23 Uterine tube 24 Head of femur 25 Vagina 355 Coronal section through the female urinary bladder and urethra (anterior aspect). During embryonal development, the uterus and ovary remain within the pelvic cavity where, after puberty, the ovulation takes place.

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References:

• https://www.plannedparenthood.org/uploads/filer_public/00/0b/000b0b36-c257-446d-a63b-453efe9298c1/providing-transgender-nonbinary-care-book-2018.pdf
• https://ucfoodsafety.ucdavis.edu/sites/g/files/dgvnsk7366/files/inline-files/286522_0.pdf
• https://www.cyberpt.com/documents/OriginsAndInsertions.pdf
• https://www.bjan-sba.org/article/10.1590/S0034-70942011000100007/pdf/rba-61-1-65-trans1.pdf