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The Cyclist's Vulva
The Cyclist’s Vulva Dr. Chimsom T. Oleka, MD FACOG Board Certified OBGYN Fellowship Trained Pediatric and Adolescent Gynecologist National Medical Network –USOPC Houston, TX DEPARTMENT NAME DISCLOSURES None [email protected] DEPARTMENT NAME PRONOUNS The use of “female” and “woman” in this talk, as well as in the highlighted studies refer to cis gender females with vulvas DEPARTMENT NAME GOALS To highlight an issue To discuss why this issue matters To inspire future research and exploration To normalize the conversation DEPARTMENT NAME The consensus is that when you first start cycling on your good‐as‐new, unbruised foof, it is going to hurt. After a “breaking‐in” period, the pain‐to‐numbness ratio becomes favourable. As long as you protect against infection, wear padded shorts with a generous layer of chamois cream, no underwear and make regular offerings to the ingrown hair goddess, things are manageable. This is wrong. Hannah Dines British T2 trike rider who competed at the 2016 Summer Paralympics DEPARTMENT NAME MY INTRODUCTION TO CYCLING Childhood Adolescence Adult Life DEPARTMENT NAME THE CYCLIST’S VULVA The Issue Vulva Anatomy Vulva Trauma Prevention DEPARTMENT NAME CYCLING HAS POSITIVE BENEFITS Popular Means of Exercise Has gained popularity among Ideal nonimpact women in the past aerobic exercise decade Increases Lowers all cause cardiorespiratory mortality risks fitness DEPARTMENT NAME Hermans TJN, Wijn RPWF, Winkens B, et al. Urogenital and Sexual complaints in female club cyclists‐a cross‐sectional study. J Sex Med 2016 CYCLING ALSO PREDISPOSES TO VULVAR TRAUMA • Significant decreases in pudendal nerve sensory function in women cyclists • Similar to men, women cyclists suffer from compression injuries that compromise normal function of the main neurovascular bundle of the vulva • Buller et al. -
Female Perineum Doctors Notes Notes/Extra Explanation Please View Our Editing File Before Studying This Lecture to Check for Any Changes
Color Code Important Female Perineum Doctors Notes Notes/Extra explanation Please view our Editing File before studying this lecture to check for any changes. Objectives At the end of the lecture, the student should be able to describe the: ✓ Boundaries of the perineum. ✓ Division of perineum into two triangles. ✓ Boundaries & Contents of anal & urogenital triangles. ✓ Lower part of Anal canal. ✓ Boundaries & contents of Ischiorectal fossa. ✓ Innervation, Blood supply and lymphatic drainage of perineum. Lecture Outline ‰ Introduction: • The trunk is divided into 4 main cavities: thoracic, abdominal, pelvic, and perineal. (see image 1) • The pelvis has an inlet and an outlet. (see image 2) The lowest part of the pelvic outlet is the perineum. • The perineum is separated from the pelvic cavity superiorly by the pelvic floor. • The pelvic floor or pelvic diaphragm is composed of muscle fibers of the levator ani, the coccygeus muscle, and associated connective tissue. (see image 3) We will talk about them more in the next lecture. Image (1) Image (2) Image (3) Note: this image is seen from ABOVE Perineum (In this lecture the boundaries and relations are important) o Perineum is the region of the body below the pelvic diaphragm (The outlet of the pelvis) o It is a diamond shaped area between the thighs. Boundaries: (these are the external or surface boundaries) Anteriorly Laterally Posteriorly Medial surfaces of Intergluteal folds Mons pubis the thighs or cleft Contents: 1. Lower ends of urethra, vagina & anal canal 2. External genitalia 3. Perineal body & Anococcygeal body Extra (we will now talk about these in the next slides) Perineum Extra explanation: The perineal body is an irregular Perineal body fibromuscular mass. -
The Complexity and Origins of the Human Eye: a Brief Study on the Anatomy, Physiology, and Origin of the Eye
Running Head: THE COMPLEX HUMAN EYE 1 The Complexity and Origins of the Human Eye: A Brief Study on the Anatomy, Physiology, and Origin of the Eye Evan Sebastian A Senior Thesis submitted in partial fulfillment of the requirements for graduation in the Honors Program Liberty University Spring 2010 THE COMPLEX HUMAN EYE 2 Acceptance of Senior Honors Thesis This Senior Honors Thesis is accepted in partial fulfillment of the requirements for graduation from the Honors Program of Liberty University. ______________________________ David A. Titcomb, PT, DPT Thesis Chair ______________________________ David DeWitt, Ph.D. Committee Member ______________________________ Garth McGibbon, M.S. Committee Member ______________________________ Marilyn Gadomski, Ph.D. Assistant Honors Director ______________________________ Date THE COMPLEX HUMAN EYE 3 Abstract The human eye has been the cause of much controversy in regards to its complexity and how the human eye came to be. Through following and discussing the anatomical and physiological functions of the eye, a better understanding of the argument of origins can be seen. The anatomy of the human eye and its many functions are clearly seen, through its complexity. When observing the intricacy of vision and all of the different aspects and connections, it does seem that the human eye is a miracle, no matter its origins. Major biological functions and processes occurring in the retina show the intensity of the eye’s intricacy. After viewing the eye and reviewing its anatomical and physiological domain, arguments regarding its origins are more clearly seen and understood. Evolutionary theory, in terms of Darwin’s thoughts, theorized fossilization of animals, computer simulations of eye evolution, and new research on supposed prior genes occurring in lower life forms leading to human life. -
MR Imaging of Vaginal Morphology, Paravaginal Attachments and Ligaments
MR imaging of vaginal morph:ingynious 05/06/15 10:09 Pagina 53 Original article MR imaging of vaginal morphology, paravaginal attachments and ligaments. Normal features VITTORIO PILONI Iniziativa Medica, Diagnostic Imaging Centre, Monselice (Padova), Italy Abstract: Aim: To define the MR appearance of the intact vaginal and paravaginal anatomy. Method: the pelvic MR examinations achieved with external coil of 25 nulliparous women (group A), mean age 31.3 range 28-35 years without pelvic floor dysfunctions, were compared with those of 8 women who had cesarean delivery (group B), mean age 34.1 range 31-40 years, for evidence of (a) vaginal morphology, length and axis inclination; (b) perineal body’s position with respect to the hymen plane; and (c) visibility of paravaginal attachments and lig- aments. Results: in both groups, axial MR images showed that the upper vagina had an horizontal, linear shape in over 91%; the middle vagi- na an H-shape or W-shape in 74% and 26%, respectively; and the lower vagina a U-shape in 82% of cases. Vaginal length, axis inclination and distance of perineal body to the hymen were not significantly different between the two groups (mean ± SD 77.3 ± 3.2 mm vs 74.3 ± 5.2 mm; 70.1 ± 4.8 degrees vs 74.04 ± 1.6 degrees; and +3.2 ± 2.4 mm vs + 2.4 ± 1.8 mm, in group A and B, respectively, P > 0.05). Overall, the lower third vaginal morphology was the less easily identifiable structure (visibility score, 2); the uterosacral ligaments and the parau- rethral ligaments were the most frequently depicted attachments (visibility score, 3 and 4, respectively); the distance of the perineal body to the hymen was the most consistent reference landmark (mean +3 mm, range -2 to + 5 mm, visibility score 4). -
Study Guide Medical Terminology by Thea Liza Batan About the Author
Study Guide Medical Terminology By Thea Liza Batan About the Author Thea Liza Batan earned a Master of Science in Nursing Administration in 2007 from Xavier University in Cincinnati, Ohio. She has worked as a staff nurse, nurse instructor, and level department head. She currently works as a simulation coordinator and a free- lance writer specializing in nursing and healthcare. All terms mentioned in this text that are known to be trademarks or service marks have been appropriately capitalized. Use of a term in this text shouldn’t be regarded as affecting the validity of any trademark or service mark. Copyright © 2017 by Penn Foster, Inc. All rights reserved. No part of the material protected by this copyright may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from the copyright owner. Requests for permission to make copies of any part of the work should be mailed to Copyright Permissions, Penn Foster, 925 Oak Street, Scranton, Pennsylvania 18515. Printed in the United States of America CONTENTS INSTRUCTIONS 1 READING ASSIGNMENTS 3 LESSON 1: THE FUNDAMENTALS OF MEDICAL TERMINOLOGY 5 LESSON 2: DIAGNOSIS, INTERVENTION, AND HUMAN BODY TERMS 28 LESSON 3: MUSCULOSKELETAL, CIRCULATORY, AND RESPIRATORY SYSTEM TERMS 44 LESSON 4: DIGESTIVE, URINARY, AND REPRODUCTIVE SYSTEM TERMS 69 LESSON 5: INTEGUMENTARY, NERVOUS, AND ENDOCRINE S YSTEM TERMS 96 SELF-CHECK ANSWERS 134 © PENN FOSTER, INC. 2017 MEDICAL TERMINOLOGY PAGE III Contents INSTRUCTIONS INTRODUCTION Welcome to your course on medical terminology. You’re taking this course because you’re most likely interested in pursuing a health and science career, which entails proficiencyincommunicatingwithhealthcareprofessionalssuchasphysicians,nurses, or dentists. -
Benign Vulvar Lesions
PEER REVIEWED FEATURE 2 CPD POINTS A GP’s guide to benign vulvar lesions IAN JONES ChM, PhD, FRANZCOG, FRCOG Vulvar lesions may cause pain but are often asymptomatic. Identifying the type of lesion and the appropriate treatment course is an important role of the GP. arious lesions of the vulva are seen by GPs during routine Epithelial lesions examinations and when assessing women with symp- Epithelial lesions include benign cysts and squamous non- tomatic vulvar lumps. Although many lesions are neoplastic proliferations. asymptomatic and do not require treatment, some lesions Vcan cause symptoms when sitting or during coitus. Also, women Benign cysts may be concerned that the lesions are cancerous, which leads them Mucinous cysts to present to their GPs for assessment and reassurance. Mucinous cysts usually occur in adults (Figure 1). They can present Benign vulvar lesions can be classified several ways: anywhere on the vulva but are most commonly found in the • as common or uncommon (Box) vestibule, which extends from the clitoris to the fourchette and • of epithelial or connective tissue origin (Table) laterally from the hymenal ring to the labia minora. The major • by their appearance – many are similar in appearance to and minor vestibular glands are located on the lateral part of the skin lesions in other parts of the body and their manage- vestibule. ment is identical. The bilateral major vestibular glands, better known as Bartholin’s glands, are situated at about the four and eight o’clock positions on the vulva and vary in size from 1 to 10 cm. These glands contain a clear and sometimes mucoid material and mucinous cysts are caused by a blockage in a gland’s duct. -
Surgical Excision of Eyelid Lesions Reference Number: CP.VP.75 Coding Implications Last Review Date: 12/2020 Revision Log
Clinical Policy: Surgical Excision of Eyelid Lesions Reference Number: CP.VP.75 Coding Implications Last Review Date: 12/2020 Revision Log See Important Reminder at the end of this policy for important regulatory and legal information. Description: The majority of eyelid lesions are benign, ranging from innocuous cysts and chalazion/hordeolum to nevi and papillomas. Key features that should prompt further investigation include gradual enlargement, central ulceration or induration, irregular borders, eyelid margin destruction or loss of lashes, and telangiectasia. This policy describes the medical necessity requirements for surgical excision of eyelid lesions. Policy/Criteria I. It is the policy of health plans affiliated with Centene Corporation® (Centene) that surgical excision and repair of eyelid or conjunctiva due to lesion or cyst or eyelid foreign body removal is medically necessary for any of the following indications: A. Lesion with one or more of the following characteristics: 1. Bleeding; 2. Persistent or intense itching; 3. Pain; 4. Inflammation; 5. Restricts vision or eyelid function; 6. Misdirects eyelashes or eyelid; 7. Displaces lacrimal puncta or interferes with tear flow; 8. Touches globe; 9. Unknown etiology with potential for malignancy; B. Lesions classified as one of the following: 1. Malignant; 2. Benign; 3. Cutaneous papilloma; 4. Cysts; 5. Embedded foreign bodies; C. Periocular warts associated with chronic conjunctivitis. Background The majority of eyelid lesions are benign, ranging from innocuous cysts and chalazion/hordeolum to nevi and papillomas. Key features that should prompt further investigation include gradual enlargement, central ulceration or induration, irregular borders, eyelid margin destruction or loss of lashes, and telangiectasia. Benign tumors, even though benign, often require removal and therefore must be examined carefully and the differential diagnosis of a malignant eyelid tumor considered and the method of removal planned. -
Local Coverage Article: Billing and Coding: Removal of Benign Skin Lesions (A57044)
Local Coverage Article: Billing and Coding: Removal of Benign Skin Lesions (A57044) Links in PDF documents are not guaranteed to work. To follow a web link, please use the MCD Website. Contractor Information CONTRACTOR NAME CONTRACT TYPE CONTRACT NUMBER JURISDICTION STATE(S) CGS Administrators, LLC MAC - Part A 15101 - MAC A J - 15 Kentucky CGS Administrators, LLC MAC - Part B 15102 - MAC B J - 15 Kentucky CGS Administrators, LLC MAC - Part A 15201 - MAC A J - 15 Ohio CGS Administrators, LLC MAC - Part B 15202 - MAC B J - 15 Ohio Article Information General Information Article ID Original Effective Date A57044 09/26/2019 Article Title Revision Effective Date Billing and Coding: Removal of Benign Skin Lesions 09/26/2019 Article Type Revision Ending Date Billing and Coding N/A AMA CPT / ADA CDT / AHA NUBC Copyright Retirement Date Statement N/A CPT codes, descriptions and other data only are copyright 2018 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply. Current Dental Terminology © 2018 American Dental Association. All rights reserved. Copyright © 2019, the American Hospital Association, Chicago, Illinois. Reproduced with permission. No portion of the AHA copyrighted materials contained within this publication may be copied without the express written consent of the AHA. AHA copyrighted materials including the UB-04 codes and descriptions may not be removed, copied, or utilized within any software, product, service, solution or derivative work without the written consent of the AHA. If an entity Created on 11/07/2019. Page 1 of 18 wishes to utilize any AHA materials, please contact the AHA at 312-893-6816. -
The Relationship Between Eyebrow Elevation and Height of The
ORIGINAL http://dx.doi.org/10.14730/aaps.2014.20.1.20 aaps Arch Aesthetic Plast Surg 2014;20(1):20-25 Archives of ARTICLE pISSN: 2234-0831 Aesthetic Plastic Surgery The Relationship Between Eyebrow Elevation and Height of the Palpebral Fissure: Should Postoperative Brow Descent be Taken into Consideration When Determining the Amount of Blepharoptosis Correction? Edward Ilho Lee1, Nam Ho Kim2, Background Combining blepharoptosis correction with double eyelid blepharoplasty Ro Hyuk Park2, Jong Beum Park2, is common in East Asian countries where larger eyes are viewed as attractive. This Tae Joo Ahn2 trend has made understanding the relationship between brow position and height of the palpebral fissure all the more important in understanding post-operative re- 1 Division of Plastic Surgery, Baylor sults. In this study, authors attempt to quantify this relationship in order to assess College of Medicine, Houston, TX, USA; whether the expected postoperative brow descent should be taken into consider- 2Gyalumhan Plastic Surgery, Seoul, Korea ation when determining the amount of ptosis to correct. Methods Photographs of ten healthy female study participants were taken with brow at rest, with light elevation and with forceful elevation. These photographs were then viewed at 2×magnification on a computer monitor and caliper was used to measure the amount of pull on the eyebrow in relation to the actual increase in vertical fissure of the eye. Results There was a positive, linear correlation between amount of eyebrow eleva- tion and height of the palpebral fissure, which was statistically significant. Brow ele- vation increased vertical fissure, and thereby aperture of the eye, by 18%. -
A Pictorial Anatomy of the Human Eye/Anophthalmic Socket: a Review for Ocularists
A Pictorial Anatomy of the Human Eye/Anophthalmic Socket: A Review for Ocularists ABSTRACT: Knowledge of human eye anatomy is obviously impor- tant to ocularists. This paper describes, with pictorial emphasis, the anatomy of the eye that ocularists generally encounter: the anophthalmic eye/socket. The author continues the discussion from a previous article: Anatomy of the Anterior Eye for Ocularists, published in 2004 in the Journal of Ophthalmic Prosthetics.1 Michael O. Hughes INTRODUCTION AND RATIONALE B.C.O. Artificial Eye Clinic of Washington, D.C. Understanding the basic anatomy of the human eye is a requirement for all Vienna, Virginia health care providers, but it is even more significant to eye care practition- ers, including ocularists. The type of eye anatomy that ocularists know, how- ever, is more abstract, as the anatomy has been altered from its natural form. Although the companion eye in monocular patients is usually within the normal range of aesthetics and function, the affected side may be distorted. While ocularists rarely work on actual eyeballs (except to cover microph- thalmic and blind, phthisical eyes using scleral cover shells), this knowledge can assist the ocularist in obtaining a naturally appearing prosthesis, and it will be of greater benefit to the patient. An easier exchange among ocularists, surgeons, and patients will result from this knowledge.1, 2, 3 RELATIONSHIPS IN THE NORMAL EYE AND ORBIT The opening between the eyelids is called the palpebral fissure. In the nor- mal eye, characteristic relationships should be recognized by the ocularist to understand the elements to be evaluated in the fellow eye. -
Anatomy of the Periorbital Region Review Article Anatomia Da Região Periorbital
RevSurgicalV5N3Inglês_RevistaSurgical&CosmeticDermatol 21/01/14 17:54 Página 245 245 Anatomy of the periorbital region Review article Anatomia da região periorbital Authors: Eliandre Costa Palermo1 ABSTRACT A careful study of the anatomy of the orbit is very important for dermatologists, even for those who do not perform major surgical procedures. This is due to the high complexity of the structures involved in the dermatological procedures performed in this region. A 1 Dermatologist Physician, Lato sensu post- detailed knowledge of facial anatomy is what differentiates a qualified professional— graduate diploma in Dermatologic Surgery from the Faculdade de Medician whether in performing minimally invasive procedures (such as botulinum toxin and der- do ABC - Santo André (SP), Brazil mal fillings) or in conducting excisions of skin lesions—thereby avoiding complications and ensuring the best results, both aesthetically and correctively. The present review article focuses on the anatomy of the orbit and palpebral region and on the important structures related to the execution of dermatological procedures. Keywords: eyelids; anatomy; skin. RESU MO Um estudo cuidadoso da anatomia da órbita é muito importante para os dermatologistas, mesmo para os que não realizam grandes procedimentos cirúrgicos, devido à elevada complexidade de estruturas envolvidas nos procedimentos dermatológicos realizados nesta região. O conhecimento detalhado da anatomia facial é o que diferencia o profissional qualificado, seja na realização de procedimentos mini- mamente invasivos, como toxina botulínica e preenchimentos, seja nas exéreses de lesões dermatoló- Correspondence: Dr. Eliandre Costa Palermo gicas, evitando complicações e assegurando os melhores resultados, tanto estéticos quanto corretivos. Av. São Gualter, 615 Trataremos neste artigo da revisão da anatomia da região órbito-palpebral e das estruturas importan- Cep: 05455 000 Alto de Pinheiros—São tes correlacionadas à realização dos procedimentos dermatológicos. -
Lower Eyelid Blepharoplasty 23 Roger L
Lower Eyelid Blepharoplasty 23 Roger L. Crumley, Behrooz A. Torkian, and Amir M. Karam Anatomical Considerations the orbicularis oculi muscle and (2) an inner lamella, which includes tarsus and conjunctiva. The skin of the lower 2 In no other area of facial aesthetic surgery is such a fragile eyelid, which measures less than 1 mm in thickness, balance struck between form and function as that in eye- retains a smooth delicate texture until it extends beyond lid modification. Owing to the delicate nature of eyelid the lateral orbital rim, where it gradually becomes thicker structural composition and the vital role the eyelids serve and coarser. The eyelid skin, which is essentially devoid of in protecting the visual system, iatrogenic alterations in a subcutaneous fat layer, is interconnected to the under- eyelid anatomy must be made with care, precision, and lying musculus orbicularis oculi by fine connective tissue thoughtful consideration of existing soft tissue structures. attachments in the skin’s pretarsal and preseptal zones. A brief anatomical review is necessary to highlight some of these salient points. With the eyes in primary position, the lower lid should Musculature be well apposed to the globe, with its lid margin roughly The orbicularis oculi muscle can be divided into a darker tangent to the inferior limbus and the orientation of its re- and thicker orbital portion (voluntary) and a thinner and spective palpebral fissure slanted slightly obliquely upward lighter palpebral portion (voluntary and involuntary). The from medial to lateral (occidental norm). An inferior palpe- palpebral portion can be further subdivided into preseptal bral sulcus (lower eyelid crease) is usually identified ϳ5 to and pretarsal components (Fig.