Anatomy 2nd semester 4th pepar
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Yog chikitasa pgd yog diploma 2nd sem 4th pepar 4th 爐爛爐爐 ( 爐謹ぐ爛爐 爐萎爐爐 爐爛爐萎た爐爐 爐朽た爐爛爐爐鉦え ) 1st 爐伍爐爛爐伍爐爐 爐爛爐爐鉦爐鉦ぐ爛爐 / pg 爐÷た爐爛爐迦爐爐 ...
4th 爐爛爐爐 ( 爐謹ぐ爛爐 爐萎爐爐 爐爛爐萎た爐爐 爐朽た爐爛爐爐鉦え ) 1st 爐伍爐爛爐伍爐爐 爐爛爐爐鉦爐鉦ぐ爛爐 / pg 爐÷た爐爛爐迦爐爐 ...AVNISH SINGH PARIHAR
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The document appears to contain numerous pages, but there are repeated errors indicating the filename is not specified. This suggests an issue with file handling or data retrieval. As a result, no coherent content can be summarized from the provided text.3rd 爐爛爐爐 ( 爐項爐爛爐 )1st 爐伍爐爛爐伍爐爐 爐爛爐爐鉦爐鉦ぐ爛爐 / pg 爐÷た爐爛爐迦爐爐 爐爛爐
3rd 爐爛爐爐 ( 爐項爐爛爐 )1st 爐伍爐爛爐伍爐爐 爐爛爐爐鉦爐鉦ぐ爛爐 / pg 爐÷た爐爛爐迦爐爐 爐爛爐AVNISH SINGH PARIHAR
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This document lists page numbers without any other text or context. It appears to be a table of contents or index for some other document, listing page numbers from 1 to 46. The document provides a listing of page numbers but no other summarizable information.2nd 爐爛爐爐 ( 爐爛爐むぞ ) 1st 爐伍爐爛爐伍爐爐 爐爛爐爐鉦爐鉦ぐ爛爐 / pg 爐÷た爐爛爐迦爐爐 爐爛爐
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The document consists of numerous pages, but does not provide any specific text or information to summarize. It appears to be a lengthy collection of pages without content to extract key details from. Therefore, no essential information can be derived.1st 爐爛爐爐 ( 爐爛爐 爐爛 爐爐оぞ爐萎き爛爐 爐むい爛爐 ) 1st 爐伍爐爛爐伍爐爐 爐爛爐爐鉦爐鉦ぐ爛爐 / pg 爐÷た爐爛爐迦爐爐 爐爛爐
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The document appears to contain numerous pages, but most pages include repeated errors indicating that linked images cannot be displayed, suggesting that the files may have been moved, renamed, or deleted. There are multiple instances of a message instructing to verify that links point to the correct location. The document ultimately contains minimal usable content due to these errors.Kundalini yoga-&-meditation
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Classification of Peptic Ulcers
Based on Location
Gastric Ulcers Occur in the stomach lining.
Duodenal Ulcers Occur in the first part of the small intestine (duodenum).
Based on Etiology
H. pyloriAssociated Ulcers
NSAID-Induced Ulcers
Stress-Related Mucosal Disease (SRMD)
ZollingerEllison Syndrome (gastrinoma-related)
Cushings Ulcer (due to intracranial injury)
Curlings Ulcer (seen in burn patients)
Pharmacological Management
1. Acid Suppression Therapy
Class Examples Mechanism
Proton Pump Inhibitors (PPIs) Omeprazole, Pantoprazole Irreversibly inhibit H+/K+ ATPase pump
H2-Receptor Antagonists Ranitidine, Famotidine Block histamine-mediated gastric acid secretion
2. Mucosal Protective Agents
Class Examples Mechanism
Prostaglandin Analogues Misoprostol Increases mucus & bicarbonate; decreases acid; protects mucosa
Mucosal Coating Agents Sucralfate Forms protective barrier over ulcer site
Bismuth Compounds Bismuth subsalicylate Antimicrobial, mucosal protective, and anti-inflammatory
3. Eradication Therapy (for H. pylori)
Combination of:
PPI + Two Antibiotics (e.g., amoxicillin + clarithromycin OR metronidazole + tetracycline)
Duration: 714 days depending on local guidelines
See BNF regimens above for detailed protocols
4. Cytoprotective/Adjunctive Agents
Class Examples Role in PUD
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Antacids Magnesium hydroxide, Aluminium hydroxide Neutralize gastric acid; provide symptomatic relief
Non-Pharmacologic Measures
Avoid NSAIDs, smoking, alcohol, and spicy foods
Small, frequent meals in symptomatic patients
Stress reduction
Endoscopic therapy in case of bleeding or perforation
Surgical Indications (rarely needed)
Perforated ulcer
Gastric outlet obstruction
Refractory ulcers not responding to medical therapy
Severe bleeding unresponsive to endoscopic management
Summary
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Anatomy of the Larynx
Larynx is a cartilaginous structure located in the **anterior neck** at the level of **C3C6 vertebrae**.
* Also called the **voice box**responsible for **phonation**, **airway protection**, and **breathing regulation**.
**Cartilages of the Larynx**
**Unpaired Cartilages:**
1. **Thyroid cartilage**:
* Largest cartilage; forms the **Adams apple (laryngeal prominence)**.
* Composed of two laminae that fuse anteriorly.
2. **Cricoid cartilage**:
* Ring-shaped; **only complete ring** around the airway.
* Located below thyroid cartilage; articulates with thyroid & arytenoid cartilages.
3. **Epiglottis**:
* Leaf-shaped elastic cartilage.
* Covers the laryngeal inlet during swallowing.
**Paired Cartilages:**
1. **Arytenoid**:
* Pyramid-shaped; sit on top of cricoid.
* Attach vocal cords and muscles.
2. **Corniculate**:
* Small cartilages sitting atop the arytenoids.
3. **Cuneiform**:
* Embedded in the aryepiglottic folds; provide structural support.
**Intrinsic Muscles of the Larynx**
> Responsible for controlling **vocal cord movement**.
| Muscle | Action | Nerve Supply |
| **Cricothyroid** | Tenses vocal cords | External laryngeal nerve |
| **Thyroarytenoid** | Relaxes vocal cords | Recurrent laryngeal nerve |
| **Posterior cricoarytenoid** | Abducts vocal cords (opens glottis) | Recurrent laryngeal nerve |
| **Lateral cricoarytenoid** | Adducts vocal cords | Recurrent laryngeal nerve |
| **Transverse & oblique arytenoids** | Closes the posterior glottis | Recurrent laryngeal nerve |
| **Vocalis** | Fine-tunes pitch | Recurrent laryngeal nerve | **Nerve Supply*
* **Motor**:
* All intrinsic muscles (except cricothyroid): **Recurrent laryngeal nerve** (branch of vagus nerve).
* Cricothyroid: **External branch of superior laryngeal nerve**.
* **Sensory**:
* Above vocal cords: **Internal branch of superior laryngeal nerve**.
* Below vocal cords: **Recurrent laryngeal nerve**.
**Blood Supply**
* **Superior laryngeal artery** (branch of superior thyroid artery).
* **Inferior laryngeal artery** (branch of inferior thyroid artery).
**Laryngeal Cavity & Folds**
Divided into 3 regions:
1. **Vestibule** from inlet to vestibular folds (false cords).
2. **Ventricle** between vestibular and vocal folds.
3. **Infraglottic cavity** below vocal cords to trachea.
**Vocal folds (true cords)** involved in sound production.More Related Content
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Classification of Peptic Ulcers
Based on Location
Gastric Ulcers Occur in the stomach lining.
Duodenal Ulcers Occur in the first part of the small intestine (duodenum).
Based on Etiology
H. pyloriAssociated Ulcers
NSAID-Induced Ulcers
Stress-Related Mucosal Disease (SRMD)
ZollingerEllison Syndrome (gastrinoma-related)
Cushings Ulcer (due to intracranial injury)
Curlings Ulcer (seen in burn patients)
Pharmacological Management
1. Acid Suppression Therapy
Class Examples Mechanism
Proton Pump Inhibitors (PPIs) Omeprazole, Pantoprazole Irreversibly inhibit H+/K+ ATPase pump
H2-Receptor Antagonists Ranitidine, Famotidine Block histamine-mediated gastric acid secretion
2. Mucosal Protective Agents
Class Examples Mechanism
Prostaglandin Analogues Misoprostol Increases mucus & bicarbonate; decreases acid; protects mucosa
Mucosal Coating Agents Sucralfate Forms protective barrier over ulcer site
Bismuth Compounds Bismuth subsalicylate Antimicrobial, mucosal protective, and anti-inflammatory
3. Eradication Therapy (for H. pylori)
Combination of:
PPI + Two Antibiotics (e.g., amoxicillin + clarithromycin OR metronidazole + tetracycline)
Duration: 714 days depending on local guidelines
See BNF regimens above for detailed protocols
4. Cytoprotective/Adjunctive Agents
Class Examples Role in PUD
Somatostatin Analogues Octreotide Used in bleeding ulcers; reduces splanchnic blood flow and gastric secretions
Antacids Magnesium hydroxide, Aluminium hydroxide Neutralize gastric acid; provide symptomatic relief
Non-Pharmacologic Measures
Avoid NSAIDs, smoking, alcohol, and spicy foods
Small, frequent meals in symptomatic patients
Stress reduction
Endoscopic therapy in case of bleeding or perforation
Surgical Indications (rarely needed)
Perforated ulcer
Gastric outlet obstruction
Refractory ulcers not responding to medical therapy
Severe bleeding unresponsive to endoscopic management
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Anatomy of the Larynx
Larynx is a cartilaginous structure located in the **anterior neck** at the level of **C3C6 vertebrae**.
* Also called the **voice box**responsible for **phonation**, **airway protection**, and **breathing regulation**.
**Cartilages of the Larynx**
**Unpaired Cartilages:**
1. **Thyroid cartilage**:
* Largest cartilage; forms the **Adams apple (laryngeal prominence)**.
* Composed of two laminae that fuse anteriorly.
2. **Cricoid cartilage**:
* Ring-shaped; **only complete ring** around the airway.
* Located below thyroid cartilage; articulates with thyroid & arytenoid cartilages.
3. **Epiglottis**:
* Leaf-shaped elastic cartilage.
* Covers the laryngeal inlet during swallowing.
**Paired Cartilages:**
1. **Arytenoid**:
* Pyramid-shaped; sit on top of cricoid.
* Attach vocal cords and muscles.
2. **Corniculate**:
* Small cartilages sitting atop the arytenoids.
3. **Cuneiform**:
* Embedded in the aryepiglottic folds; provide structural support.
**Intrinsic Muscles of the Larynx**
> Responsible for controlling **vocal cord movement**.
| Muscle | Action | Nerve Supply |
| **Cricothyroid** | Tenses vocal cords | External laryngeal nerve |
| **Thyroarytenoid** | Relaxes vocal cords | Recurrent laryngeal nerve |
| **Posterior cricoarytenoid** | Abducts vocal cords (opens glottis) | Recurrent laryngeal nerve |
| **Lateral cricoarytenoid** | Adducts vocal cords | Recurrent laryngeal nerve |
| **Transverse & oblique arytenoids** | Closes the posterior glottis | Recurrent laryngeal nerve |
| **Vocalis** | Fine-tunes pitch | Recurrent laryngeal nerve | **Nerve Supply*
* **Motor**:
* All intrinsic muscles (except cricothyroid): **Recurrent laryngeal nerve** (branch of vagus nerve).
* Cricothyroid: **External branch of superior laryngeal nerve**.
* **Sensory**:
* Above vocal cords: **Internal branch of superior laryngeal nerve**.
* Below vocal cords: **Recurrent laryngeal nerve**.
**Blood Supply**
* **Superior laryngeal artery** (branch of superior thyroid artery).
* **Inferior laryngeal artery** (branch of inferior thyroid artery).
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Divided into 3 regions:
1. **Vestibule** from inlet to vestibular folds (false cords).
2. **Ventricle** between vestibular and vocal folds.
3. **Infraglottic cavity** below vocal cords to trachea.
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The updated standards include care recommendations designed to improve health outcomes. The ADA revises these guidelines annually through its Professional Practice Committee (PPC), which consists of experts from various fields including physicians, nurse practitioners, certified diabetes care and education specialists, registered dietitian nutritionists, pharmacists, and methodologists.
The Standards of Care in Diabetes - 2025 is available online as a supplement to the January 2025 issue of Diabetes Care. A mobile application compatible with iOS and Android devices, it offers the latest guidelines, interactive tables, and algorithms for quick reference.
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