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Ministry of Education and Science of Ukraine Sumy State University 0 Ministry of Education and Science of Ukraine Sumy State University SPLANCHNOLOGY, CARDIOVASCULAR AND IMMUNE SYSTEMS STUDY GUIDE Recommended by the Academic Council of Sumy State University Sumy Sumy State University 2016 1 УДК 611.1/.6+612.1+612.017.1](072) ББК 28.863.5я73 С72 Composite authors: V. I. Bumeister, Doctor of Biological Sciences, Professor; L. G. Sulim, Senior Lecturer; O. O. Prykhodko, Candidate of Medical Sciences, Assistant; O. S. Yarmolenko, Candidate of Medical Sciences, Assistant Reviewers: I. L. Kolisnyk – Associate Professor Ph. D., Kharkiv National Medical University; M. V. Pogorelov – Doctor of Medical Sciences, Sumy State University Recommended for publication by Academic Council of Sumy State University as а study guide (minutes № 5 of 10.11.2016) Splanchnology Cardiovascular and Immune Systems : study guide / С72 V. I. Bumeister, L. G. Sulim, O. O. Prykhodko, O. S. Yarmolenko. – Sumy : Sumy State University, 2016. – 253 p. This manual is intended for the students of medical higher educational institutions of IV accreditation level who study Human Anatomy in the English language. Посібник рекомендований для студентів вищих медичних навчальних закладів IV рівня акредитації, які вивчають анатомію людини англійською мовою. УДК 611.1/.6+612.1+612.017.1](072) ББК 28.863.5я73 © Bumeister V. I., Sulim L G., Prykhodko О. O., Yarmolenko O. S., 2016 © Sumy State University, 2016 2 Hippocratic Oath «Ὄμνυμι Ἀπόλλωνα ἰητρὸν, καὶ Ἀσκληπιὸν, καὶ Ὑγείαν, καὶ Πανάκειαν, καὶ θεοὺς πάντας τε καὶ πάσας, ἵστορας ποιεύμενος, ἐπιτελέα ποιήσειν κατὰ δύναμιν καὶ κρίσιν ἐμὴν ὅρκον τόνδε καὶ ξυγγραφὴν τήνδε. Ἡγήσασθαι μὲν τὸν διδάξαντά με τὴν τέχνην ταύτην ἴσα γενέτῃσιν ἐμοῖσι, καὶ βίου κοινώσασθαι, καὶ χρεῶν χρηίζοντι μετάδοσιν ποιήσασθαι, καὶ γένος τὸ ἐξ ωὐτέου ἀδελφοῖς ἴσον ἐπικρινέειν ἄῤῥεσι, καὶ διδάξειν τὴν τέχνην ταύτην, ἢν χρηίζωσι μανθάνειν, ἄνευ μισθοῦ καὶ ξυγγραφῆς, παραγγελίης τε καὶ ἀκροήσιος καὶ τῆς λοιπῆς ἁπάσης μαθήσιος μετάδοσιν ποιήσασθαι υἱοῖσί τε ἐμοῖσι, καὶ τοῖσι τοῦ ἐμὲ διδάξαντος, καὶ μαθηταῖσι συγγεγραμμένοισί τε καὶ ὡρκισμένοις νόμῳ ἰητρικῷ, ἄλλῳ δὲ οὐδενί. Διαιτήμασί τε χρήσομαι ἐπ' ὠφελείῃ καμνόντων κατὰ δύναμιν καὶ κρίσιν ἐμὴν, ἐπὶ δηλήσει δὲ καὶ ἀδικίῃ εἴρξειν. Οὐ δώσω δὲ οὐδὲ φάρμακον οὐδενὶ αἰτηθεὶς θανάσιμον, οὐδὲ ὑφηγήσομαι ξυμβουλίην τοιήνδε. Ὁμοίως δὲ οὐδὲ γυναικὶ πεσσὸν φθόριον δώσω. Ἁγνῶς δὲ καὶ ὁσίως διατηρήσω βίον τὸν ἐμὸν καὶ τέχνην τὴν ἐμήν. Οὐ τεμέω δὲ οὐδὲ μὴν λιθιῶντας, ἐκχωρήσω δὲ ἐργάτῃσιν ἀνδράσι πρήξιος τῆσδε. Ἐς οἰκίας δὲ ὁκόσας ἂν ἐσίω, ἐσελεύσομαι ἐπ' ὠφελείῃ καμνόντων, ἐκτὸς ἐὼν πάσης ἀδικίης ἑκουσίης καὶ φθορίης, τῆς τε ἄλλης καὶ ἀφροδισίων ἔργων ἐπί τε γυναικείων σωμάτων καὶ ἀνδρῴων, ἐλευθέρων τε καὶ δούλων. Ἃ δ' ἂν ἐν θεραπείῃ ἢ ἴδω, ἢ ἀκούσω, ἢ καὶ ἄνευ θεραπηίης κατὰ βίον ἀνθρώπων, ἃ μὴ χρή ποτε ἐκλαλέεσθαι ἔξω, σιγήσομαι, ἄῤῥητα ἡγεύμενος εἶναι τὰ τοιαῦτα. Ὅρκον μὲν οὖν μοι τόνδε ἐπιτελέα ποιέοντι, καὶ μὴ ξυγχέοντι, εἴη ἐπαύρασθαι καὶ βίου καὶ τέχνης δοξαζομένῳ παρὰ πᾶσιν ἀνθρώποις ἐς τὸν αἰεὶ χρόνον. παραβαίνοντι δὲ καὶ ἐπιορκοῦντι, τἀναντία τουτέων». 3 INTRODUCTION Human anatomy is a scientific study of human body structure taking into consideration all its functions and mechanisms of its development. Studying the structure of separate organs and systems in close connection with their functions, anatomy considers a person's organism as a unit which develops basing on the regularities under the influence of internal and external factors during the whole process of evolution. The purpose of this subject is to study the structure of organs and systems of a person, features of body structure in comparison with animals revealing the anatomic frames of the age, sexual and individual variability, to study the adaptation of the form and structure of the organs to varying conditions of function and existence. Such functional and anatomic, evolutionary and causal treatment of the information about morphological features of an organism of a person has huge value for clinical manifestation in the anatomy course as it promotes comprehension of the nature of a healthy and sick person. This educational and methodical practical work is based on the sample of educational and working programs on human anatomy according to the credit– modular system of the organization of the educational process. It is directed toward the assistance to the students and teachers in the organization and realization of the most effective methods of studying and teaching this subject. 4 undigested remnants of the food. It consists of THE GENERAL PART digestive tract and alimentary glands (salivary glands, liver, pancreas). Position of the viscera in anatomy is THE ORAL CAVITY is the initial considered from 3 main positions – holotopy, portion of digestive tract. It is divided into two syntopy and skeletotopy. parts: Holotopy is referred to relation of the – vestibule of the mouth; organ to a certain body area, its surface – cavity of the mouth proper. projection. The vestibule of the mouth is bounded Syntopy means relative position of by lips and cheeks externally and teeth and viscera, blood vessels and nerves. gums internally. Skeletotopy is referred to relative The cavity of the mouth proper is position of the organ and skeletal bones (as a bounded by teeth and gums in front and rule vertebral column and ribs). laterally, by palate – superiorly, by oral To map the relations of the internal diaphragm - inferiorly. Posteriorly it organs of the abdomen, the anterior abdominal communicates with the pharynx via fauces. The wall is marked with imaginary lines which vestibule of the mouth and cavity of the mouth divide the abdomen into certain regions. proper communicate via the space behind upper The horizontal line drawn between the third molar teeth. lower ends of the tenth rib separates the upper portion of the abdomen in the middle. The THE LIPS are fibers of orbicularis oris horizontal line drawn between the anterior muscle that are covered by skin from outside superior iliac spines separates the middle and lined with mucous membrane from inside. portion from below. These lines divide the The opening between upper and lower lips is surface of the abdomen into 3 regions: superior called the oral fissure (rima oris). It epigastric, middle mesogastric and inferior communicates the vestibule of the mouth with hypogastric. the external environment. When the mouth is Two vertical lines which are drawn closed, both lips form a labial comissure on along the lateral margins of the rectus both sides of the oral fissure. When the mouth abdominis muscle divide each region into 3 is opened, lips form the angle of the mouth. parts. The lips have following structures: As a result the epigastric region is – the philtrum. It is located in the middle of the divided into the proper epigastric region upper lip; located between vertical lines, right and left – the tuberculum. It is located directly below hypochondrium regions located under the the philtrum; costal arch. – the frenulum of upper lip. It runs upwards The mesogastrium is divided into from the upper lip to the upper jaw gums. umbilical region located in the center, and right – the frenulum of lower lip. It runs downwards and left lateral regions located hear the from the lower lip to the lower jaw gums. umbilical region. – the labial glands. They are embedded into the The hypogastrium is divided into pubic mucous membrane and submucosa of the lips. region and right and left inguinal regions. The gums are projection of the oral mucosa which cover the alveolar processes, fixing to them. THE DIGESTIVE SYSTEM The cheeks are covered with skin from outside and with mucosa from inside. The buccinator muscle represents the deep layer of The digestive system is a complex of the cheek. The fat pad is located in the organs the functions of which are mechanical thickness of the cheeks between the masseter and chemical treatment of food, absorbtion of and buccinator muscles. The fat pad is the treated nutrients and excretion of developed much better in a child than in an 5 adult. The buccal glands lie under the mucous of temporal bone anteriorly to the external membrane. The papilla of parotid duct is a part opening of carotid canal and the of mucosa which covers the opening of parotid cartilaginous part of the auditory tube and duct. It is located at the level of the second interlaces into palatine aponeurosis. It upper molar tooth. elevates the palatine veil and opens the orifice of auditory tube. THE PALATE forms the upper wall of the oral cavity proper and is divided into the 3. The uvulae muscle. It arises from the hard palate and soft palate. posterior nasal spine and terminates in the The hard palate is based on the bone tip of uvula. It shortens the uvula. elements covered with mucous membrane 4. The palatoglossus muscle. It runs in the which is fixed to periosteum. It has following thickness of palatoglossus arch and located structures: on the side of the tongue where it – the palatine raphe passes on midline along continuous with transversus linguae muscle. the mucosa; It pulls the palatine veil downwards and – the incisive papilla; narrows the pharynx. – the transverse palatine folds; – the palatine glands lie in the depth of 5. The palatopharyngeal muscle. It runs mucosa. within corresponding arch arising from the The soft palate is a duplication of posterior edge of thyroid cartilage and mucous membrane, in which muscles are posterior wall of pharynx and attach to located together with a fibrous plate, palatine palatine aponeurosis. It strains the arch, aponeurosis as well as glands. The anterior pulls the palatine veil downwards and margin of the soft palate attaches to the elevates the pharynx. posterior edge of the hard palate. Posterior portion of soft palate extends freely downward The inferior wall or floor of the oral and to the back and is called palatine veil.
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    M. H. RATZLAFF: The Superficial Lymphatic System of the Cat 151 Summary Four examples of severe chylous lymph effusions into serous cavities are reported. In each case there was an associated lymphocytopenia. This resembled and confirmed the findings noted in experimental lymph drainage from cannulated thoracic ducts in which the subject invariably devdops lymphocytopenia as the lymph is permitted to drain. Each of these patients had com­ munications between the lymph structures and the serous cavities. In two instances actual leakage of the lymphography contrrult material was demonstrated. The performance of repeated thoracenteses and paracenteses in the presenc~ of communications between the lymph structures and serous cavities added to the effect of converting the. situation to one similar to thoracic duct drainage .The progressive immaturity of the lymphocytes which was noted in two patients lead to the problem of differentiating them from malignant cells. The explanation lay in the known progressive immaturity of lymphocytes which appear when lymph drainage persists. Thankful acknowledgement is made for permission to study patients from the services of Drs. H. J. Carroll, ]. Croco, and H. Sporn. The graphs were prepared in the Department of Medical Illustration and Photography, Dowristate Medical Center, Mr. Saturnino Viloapaz, illustrator. References I Beebe, D. S., C. A. Hubay, L. Persky: Thoracic duct 4 Iverson, ]. G.: Phytohemagglutinin rcspon•e of re­ urctcral shunt: A method for dccrcasingi circulating circulating and nonrecirculating rat lymphocytes. Exp. lymphocytes. Surg. Forum 18 (1967), 541-543 Cell Res. 56 (1969), 219-223 2 Gesner, B. M., J. L. Gowans: The output of lympho­ 5 Tilney, N.
  • MSS 1. a Patient Presented to a Traumatologist with a Trauma Of

    MSS 1. a Patient Presented to a Traumatologist with a Trauma Of

    MSS 1. A patient presented to a traumatologist with a trauma of shoulder. What wall of axillary cavity contains foramen trilaterum and foramen quadrilaterum? a) anterior b) posterior c) lateral d) medial e) intermediate 2. A patient presented to a traumatologist with a trauma of leg, which he had sustained at a sport competition. Upon examination, damage of posterior muscle, that is attached to calcaneus by its tendon, was found. This muscle is: a) triceps surae b) tibialis posterior c) popliteus d) fibularis longus e) fibularis brevis 3. In the course of a cesarean section, an incision was made in the pubic area and vagina of rectus abdominis muscle was cut. What does anterior wall of the vagina of rectus abdominis muscle consist of? A. aponeurosis of m. transversus abdominis, m. obliquus internus abdominis. B. aponeurosis of m. transversus abdominis, m. pyramidalis. C. aponeurosis of m. obliquus internus abdominis, m. obliquus externus abdominis. D. aponeurosis of m. transversus abdominis, m. obliquus externus abdominis. E. aponeurosis of m. transversus abdominis, m. obliquus internus abdominis 4. A 30 year-old woman complained of pain in the lower part of her forearm. Traumatologist found that her radio-carpal joint was damaged. This joint is: A. complex, ellipsoid B.simple, ellipsoid C.complex, cylindrical D.simple, cylindrical E.complex condylar 5. A woman was brought by an ambulance to the emergency department with a trauma of the cervical part of her vertebral column. Radiologist diagnosed a fracture of a nonbifid spinous processes of one of her cervical vertebrae. Spinous process of what cervical vertebra is fractured? A.VI.
  • Collaborative Stage Manual Part II

    Collaborative Stage Manual Part II

    SEER Program Coding and Staging Manual 2004, Revision 1 Collaborative Staging Codes Nasal Cavity C30.0 C30.0 Nasal cavity (excludes nose, NOS C76.0) Note: Laterality must be coded for this site, except subsites Nasal cartilage and Nasal septum, for which laterality is coded 0. CS Tumor Size CS Site-Specific Factor 1 - Size of The following tables are available CS Extension Lymph Nodes at the collaborative staging CS TS/Ext-Eval CS Site-Specific Factor 2 - website: CS Lymph Nodes Extracapsular Extension, Lymph Nodes Histology Exclusion Table CS Reg Nodes Eval for Head and Neck AJCC Stage Reg LN Pos CS Site-Specific Factor 3 - Levels I- Lymph Nodes Size Table Reg LN Exam III, Lymph Nodes for Head and Neck CS Mets at DX CS Site-Specific Factor 4 - Levels IV- CS Mets Eval V and Retropharyngeal Lymph Nodes for Head and Neck CS Site-Specific Factor 5 - Levels VI- VII and Facial Lymph Nodes for Head and Neck CS Site-Specific Factor 6 - Parapharyngeal, Parotid, Preauricular, and Sub-Occipital Lymph Nodes, Lymph Nodes for Head and Neck Nasal Cavity CS Tumor Size SEE STANDARD TABLE Nasal Cavity CS Extension Code Description TNM SS77 SS2000 00 In situ; non-invasive Tis IS IS 10 Invasive tumor confined to site of origin T1 L L Meatus (superior, middle, inferior) Nasal chonchae (superior, middle, inferior) Septum Tympanic membrane 30 Localized, NOS T1 L L 40 Extending to adjacent connective tissue within the nasoethomoidal T2 RE RE complex Nasolacrimal duct 60 Adjacent organs/structures including: T3 RE RE Bone of skull Choana Frontal sinus Hard palate