Salivary glands, from the monitored organisms but varies between species. Only available in the parotid gland in mammals. Ectoderm of the oral cavity consists of all the salivary glands and oral epithelium proliferation in solid cell clusters as a result of the underlying mesenchymal tissue to form a draft of cloth with the correct occur.
The first draft of Primordium or organ, for the seventh embryonal week, appears in the parotid gland. Turning into the main channel of Primordium gland, the terminal secretory erosional channels form an expanding. Mesenchymal tissue surrounding glands and their surroundings, wrapping the capsule separates lobules creates
Developed a three-stage passes to Donath'a cloth. There is the first stage, primordium formation. Gland from an advanced stage of differentiation, monitored the formation of lobules and ducts. This phase continued until the end of the seventh month, allows the formation of functional units. Acinar cells in the third phase, beginning with the eighth month and be seen on intermediate channels.
With childbirth, with the effect of diet consists of salivary secretion. Erosion of the distal segments and channels around the myoepithelial cell, gradually decaying stages of organ development. After birth, these cells are composed of cells myoepithelial.
During fetal development of the parotid gland settles a large number of lymphocytes. This explains the frequent cause lymph nodes. In addition, drafts of the organ which is circling the cloth as a result of condensation in the lymph nodes. Salivary gland tissue in lymph nodes seen in the common. This is responsible for the development of embryonal tumors of the salivary gland cloth structures later. Parotid salivary gland occurring after the first growing but the capsule. Glands during the development of the autonomic nervous system and sympathetic nervous system stimulation of acinar differentiation, the parasympathetic nervous system is necessary for the development of the entire gland.
Anatomy of the parotid gland
In general, the major salivary glands (glandula salivariae majores) and minor (glandula salivariae minores) in two groups, including the salivary glands. Secretion and shedding in the oral cavity, located around the mouth, the salivary glands and a large symmetrical position of major salivary glands, oral cavity, nasal cavity, paranasal sinuses and pharynx mucosa just below the minor salivary glands are common to those who settled in the small. Salivary secretion by salivary glands of the teeth, gums, protects the integrity of the mucosa of the oral cavity and plays an important role in initiating and digestion of starchy foods. Parotid, submandibular and sublingual salivary gland, including 3 pairs of major salivary gland major role in the production of saliva, which has existed. Minor salivary glands of up to approximately 600-1000 units in the production of saliva, there is a small contribution.
Parotid gland the largest salivary gland with an average weight 20-30gr. In craniocaudal mean 5.8 cm, 3.4 cm in size as ventrodorsal. Retromandibular fossa in front of and below the ear, the sternocleidomastoid (SKM) muscle is located in front of the parotid space.
Retromandibular fossa, ramus of the mandible in front, rear and the SKM mastoideus muscle, below and behind the back of digastric muscle belly, processus stilohyoideus and surrounded by muscles that starts from the ledge. Therefore, these structures are limited to the parotid gland, fossa completely filling out the front, above and below the front cross borders and reaches over the masseter muscle. In fact, the three sides cloth, with three faces, the prism likened to the two ends of the upper and lower. Pre-inner and inner faces of the back-formations retromandibular fossa, external facial skin, subcutaneous tissue, and is adjacent to platisma.
Parotid gland, parotid and deep cervical fascia superficial layers that make up the gap with the internal and external, are encapsulated. Superficial and deep lobe of the parotid gland of two is said to occur frequently. Many anatomists glandinda parotid surgery, but not a true anatomic division argues that appears acceptable in terms of convenience. Terms of superficial and deep lobe, medial and lateral soft tissues simply refers to the facial nerve.
20% of the facial nerve deep in the parotid gland tissue, 80% of the surface of the facial nerve, that is localized in the superficial. Superficial lobe of the gland, the posterior wall of the masseter muscle and ramus of the mandible and salivary secretion surrounds% provides 85-89'nu. Is a very vascularized, which is close to the deep lobe of the pharynx behind the mandible and mastoid ramusu reaching deep inside the front of the parapharyngeal space, behind the mastoid bone, styloid processes as part, SKM, and styloid muscles, and digastric muscle to the back part of the neighborhood and creates.
Radiologically, it is not possible to always display the facial nerve lobes defining, almost always on the path of the facial nerve is the retromandibular vein as a reference.
Parotid compartment, surrounded by a triangular space is surrounded by muscles, as well as the parotid gland, facial nerve and its branches, sensory and autonomic nerves, the external carotid artery and its branches, retromandibular vein (posterior facial vein), and includes the parotid lymphatics.
Translated from the boundaries of the parotid compartment structures:
Superior border: zygomatic arch,
Posterior border: the external ear, mastoid bulge and SKM muscle,
Inferior border: processes as part styloid, styloid processes as part muscles, internal carotid artery and jugular vein,
Anterior Border: zygomatic diagonal line extending from the outer ear canal.
Parotid gland the largest salivary gland with an average weight 20-30gr. In craniocaudal mean 5.8 cm, 3.4 cm in size as ventrodorsal. Retromandibular fossa in front of and below the ear, the sternocleidomastoid (SKM) muscle is located in front of the parotid space.
Retromandibular fossa, ramus of the mandible in front, rear and the SKM mastoideus muscle, below and behind the back of digastric muscle belly, processus stilohyoideus and surrounded by muscles that starts from the ledge. Therefore, these structures are limited to the parotid gland, fossa completely filling out the front, above and below the front cross borders and reaches over the masseter muscle. In fact, the three sides cloth, with three faces, the prism likened to the two ends of the upper and lower. Pre-inner and inner faces of the back-formations retromandibular fossa, external facial skin, subcutaneous tissue, and is adjacent to platisma.
Parotid gland, parotid and deep cervical fascia superficial layers that make up the gap with the internal and external, are encapsulated. Superficial and deep lobe of the parotid gland of two is said to occur frequently. Many anatomists glandinda parotid surgery, but not a true anatomic division argues that appears acceptable in terms of convenience. Terms of superficial and deep lobe, medial and lateral soft tissues simply refers to the facial nerve.
20% of the facial nerve deep in the parotid gland tissue, 80% of the surface of the facial nerve, that is localized in the superficial. Superficial lobe of the gland, the posterior wall of the masseter muscle and ramus of the mandible and salivary secretion surrounds% provides 85-89'nu. Is a very vascularized, which is close to the deep lobe of the pharynx behind the mandible and mastoid ramusu reaching deep inside the front of the parapharyngeal space, behind the mastoid bone, styloid processes as part, SKM, and styloid muscles, and digastric muscle to the back part of the neighborhood and creates.
Radiologically, it is not possible to always display the facial nerve lobes defining, almost always on the path of the facial nerve is the retromandibular vein as a reference.
Parotid compartment, surrounded by a triangular space is surrounded by muscles, as well as the parotid gland, facial nerve and its branches, sensory and autonomic nerves, the external carotid artery and its branches, retromandibular vein (posterior facial vein), and includes the parotid lymphatics.
Translated from the boundaries of the parotid compartment structures:
Superior border: zygomatic arch,
Posterior border: the external ear, mastoid bulge and SKM muscle,
Inferior border: processes as part styloid, styloid processes as part muscles, internal carotid artery and jugular vein,
Anterior Border: zygomatic diagonal line extending from the outer ear canal.
Histology of the parotid gland
Salivary glands, the glands are tubular secretion and a duct on the outside structure out with the help of cloth are included in the group.
Salivary glands and stroma is composed of parenchyma. Parenchyma of the glands, secretions produced by erosion and electrolyte secretion, oral cavity, with the duct system that regulates the concentration of the water occurs. Parenchyma occurring in connective tissue stroma provides support. Stroma, blood vessels, lymph vessels, and is located in the salivary ducts. Some of the glands that make up the stroma of fibrous connective tissue that makes up the capsule. Connective tissue septa in the right lobe of the capsule gland. Salivary gland stroma is also rich in lymphocytes and plasma cells, these cells are immunoglobulin A (IgA) responsible for the production. Adhesion to basement membrane components on the secretory IgA and secretory IgA in the lumen in the form of ductal epithelial cells were released over.
Branched parotid, a salivary gland acinar structure and the serous type. Significant erosion of the basement membrane, surrounded by a serous epithelial cell groups consist of pyramidal-shaped. Basophilic nuclei and a basal epithelial cells (PAS-positive) and a cytoplasm filled with zymogen granules are. This cell is the number of secretory granules depends on the state. This is the primary enzyme in the starch granules are smaller than the water-soluble carbohydrates that break down amylase (ptyalin), respectively. Other enzymes such as lysozyme and lactoferrin found in the cytoplasm of acinar cells.
Secretory unit (salivary unit), asinus, myoepithelial cells, connective channels, secretory (lined channel) consists of channels and drainage canals. All salivary acinar cells contain secretory granules. Granules of this amylase in serous glands, mucous glands include the mucin.
Asinus is responsible for the construction of the primary secretion. Myoepithelial cells are contractile cells located around asinus and swagger through the secretory product pushing to help the drainage channels. The sympathetic system, myoepithelial cells are shown to carry the motor nerve. In addition, with the parasympathetic system is stimulated. This will help to ensure the movement of cells in the first contraction of the saliva.
Asinus lumen of the ductal system continues. Respectively, unifying, secretion (line channel) and creates drainage channels. Part of the neck, also called connective channel, carbonic small cuboid epithelial cells surrounded by the rich. These cells secrete bicarbonate and ductal lumen, the lumen is absorbed chloride.
Lumina of the simple cuboidal epithelial cells are surrounded by secretory ducts overhangs and recesses in the basal poles and numerous mitochondria are formed by cytoplasmic invaginations. The main task of the primary saliva ducts and modification of the active fluid secretion. These cells absorb sodium and potassium in the lumen and secrete secrete excessive hypotonic fluid. Salivary flow increases, decreases, and less elapsed time for the activation of these cells in a hypotonic saliva occurs. Drainage channels are responsible for taking out the organ secretions proximally and stratified simple cells, distally borders the columnar epithelium. Each discharge channel paved with non-keratinizing squamous epithelium by the oral cavity is opened. Oral mucosa before penetrating the Steno duct travels a short distance to the connective tissue in the face and neck. These channels around the elastic fibers, smooth muscle fibers, blood vessels, nerves and the parotid cup selection of the channel that drains close to the epithelial cells (cellula caliciformis) is located.
Parotid gland, a serous gland is completely unique, as well as the other one, also that the gland contains many fat cells, adipocytes / acinar cell ratio 1 / 1 'is. Gland parenchyma is increased fat tissue, especially in the 40s.
Salivary glands and stroma is composed of parenchyma. Parenchyma of the glands, secretions produced by erosion and electrolyte secretion, oral cavity, with the duct system that regulates the concentration of the water occurs. Parenchyma occurring in connective tissue stroma provides support. Stroma, blood vessels, lymph vessels, and is located in the salivary ducts. Some of the glands that make up the stroma of fibrous connective tissue that makes up the capsule. Connective tissue septa in the right lobe of the capsule gland. Salivary gland stroma is also rich in lymphocytes and plasma cells, these cells are immunoglobulin A (IgA) responsible for the production. Adhesion to basement membrane components on the secretory IgA and secretory IgA in the lumen in the form of ductal epithelial cells were released over.
Branched parotid, a salivary gland acinar structure and the serous type. Significant erosion of the basement membrane, surrounded by a serous epithelial cell groups consist of pyramidal-shaped. Basophilic nuclei and a basal epithelial cells (PAS-positive) and a cytoplasm filled with zymogen granules are. This cell is the number of secretory granules depends on the state. This is the primary enzyme in the starch granules are smaller than the water-soluble carbohydrates that break down amylase (ptyalin), respectively. Other enzymes such as lysozyme and lactoferrin found in the cytoplasm of acinar cells.
Secretory unit (salivary unit), asinus, myoepithelial cells, connective channels, secretory (lined channel) consists of channels and drainage canals. All salivary acinar cells contain secretory granules. Granules of this amylase in serous glands, mucous glands include the mucin.
Asinus is responsible for the construction of the primary secretion. Myoepithelial cells are contractile cells located around asinus and swagger through the secretory product pushing to help the drainage channels. The sympathetic system, myoepithelial cells are shown to carry the motor nerve. In addition, with the parasympathetic system is stimulated. This will help to ensure the movement of cells in the first contraction of the saliva.
Asinus lumen of the ductal system continues. Respectively, unifying, secretion (line channel) and creates drainage channels. Part of the neck, also called connective channel, carbonic small cuboid epithelial cells surrounded by the rich. These cells secrete bicarbonate and ductal lumen, the lumen is absorbed chloride.
Lumina of the simple cuboidal epithelial cells are surrounded by secretory ducts overhangs and recesses in the basal poles and numerous mitochondria are formed by cytoplasmic invaginations. The main task of the primary saliva ducts and modification of the active fluid secretion. These cells absorb sodium and potassium in the lumen and secrete secrete excessive hypotonic fluid. Salivary flow increases, decreases, and less elapsed time for the activation of these cells in a hypotonic saliva occurs. Drainage channels are responsible for taking out the organ secretions proximally and stratified simple cells, distally borders the columnar epithelium. Each discharge channel paved with non-keratinizing squamous epithelium by the oral cavity is opened. Oral mucosa before penetrating the Steno duct travels a short distance to the connective tissue in the face and neck. These channels around the elastic fibers, smooth muscle fibers, blood vessels, nerves and the parotid cup selection of the channel that drains close to the epithelial cells (cellula caliciformis) is located.
Parotid gland, a serous gland is completely unique, as well as the other one, also that the gland contains many fat cells, adipocytes / acinar cell ratio 1 / 1 'is. Gland parenchyma is increased fat tissue, especially in the 40s.
Gonococcal Urethritis
The anterior urethra of either gender, skin and perineum due to proximity of the same type includes a small number of microorganisms. These microorganisms are often coagulase-negative staphylococci, Corynebacterium, and Lactobacillus species.
A gram-negative diplococci urethritis Gonococcal factor of N. Gonorrhea is ". Although the incubation period for many exceptions GU ranged from 3 to 10 days. For example, some strains of the gonococcus in as little as 12 hours of symptoms, while some other strains of this period is up to 3 months.
Gonococcal urethritis "Most of the patients with disease during sexual intercourse. For men, sexual intercourse with an infected partner is the only possibility of getting 17% of gonorrhea is ". Infected partner, the risk increases as the number entered in the relationship. Uncircumcised men may be at highest risk of transmission of gonorrhea. The only way for the transition is not direct contact with vaginal gonococci. Pharynx through oral sex with an infected partner also is increasing evidence that could pass.
Classically, GU "is seen in the urethral discharge and burning during urination. This discharge is usually abundant and only a very small amount or not at all. GU can be seen in 40-60% of asymptomatic patients with known Gonorrheal spouses. Treatment of symptomatic gonorrhea, even though not recover. However, as the remaining carrier potentially also protect.
Gonorrhea, the use of condoms on a regular basis, and intravaginal antibiotic and antiseptic applications postexposure antibiotic use can be prevented.
Laboratory examinations are needed for initiating the correct diagnosis of gonorrhea. Gonococcic infections, such as the urethra to occur in regions with a very wide range of normal bacterial flora, contaminated not samples collect last degree It is important. Examples patient at least 1 hour after the making of urine calcium should be taken alginate bars. Swabs should be planted directly into the cultures. The same example can also be used for gram stain. Gram staining facing the trained lab personnel on a regular basis, 99% and 95% sensitivity and specificity of the diagnosis of gonorrhea in a way.
Pharynx, Anorectal, cervix and the urethra is now recommended for uncomplicated infections gonococcic drug. However, 30% of men with GU "u as well as C. Trachomatis with "because they were infected in the treatment of a tetracycline derivative, suggested the addition of azithromycin or ofloxacin.
A gram-negative diplococci urethritis Gonococcal factor of N. Gonorrhea is ". Although the incubation period for many exceptions GU ranged from 3 to 10 days. For example, some strains of the gonococcus in as little as 12 hours of symptoms, while some other strains of this period is up to 3 months.
Gonococcal urethritis "Most of the patients with disease during sexual intercourse. For men, sexual intercourse with an infected partner is the only possibility of getting 17% of gonorrhea is ". Infected partner, the risk increases as the number entered in the relationship. Uncircumcised men may be at highest risk of transmission of gonorrhea. The only way for the transition is not direct contact with vaginal gonococci. Pharynx through oral sex with an infected partner also is increasing evidence that could pass.
Classically, GU "is seen in the urethral discharge and burning during urination. This discharge is usually abundant and only a very small amount or not at all. GU can be seen in 40-60% of asymptomatic patients with known Gonorrheal spouses. Treatment of symptomatic gonorrhea, even though not recover. However, as the remaining carrier potentially also protect.
Gonorrhea, the use of condoms on a regular basis, and intravaginal antibiotic and antiseptic applications postexposure antibiotic use can be prevented.
Laboratory examinations are needed for initiating the correct diagnosis of gonorrhea. Gonococcic infections, such as the urethra to occur in regions with a very wide range of normal bacterial flora, contaminated not samples collect last degree It is important. Examples patient at least 1 hour after the making of urine calcium should be taken alginate bars. Swabs should be planted directly into the cultures. The same example can also be used for gram stain. Gram staining facing the trained lab personnel on a regular basis, 99% and 95% sensitivity and specificity of the diagnosis of gonorrhea in a way.
Pharynx, Anorectal, cervix and the urethra is now recommended for uncomplicated infections gonococcic drug. However, 30% of men with GU "u as well as C. Trachomatis with "because they were infected in the treatment of a tetracycline derivative, suggested the addition of azithromycin or ofloxacin.
Non-gonococcal Urethritis
NGU "in the most important and potentially the most dangerous pathogens C. Trachomatis is ". Of cases of NGU % 30-50 "Sinden C. Trachomatis is responsible. NGU "li 25-60% of heterosexual men, "then, Gonorrhea 4-40% of men" and STD clinics, but not seen in 0-7% of men without symptoms of urethritis "cynical C. Trachomatis detected. The United States "in 40% of PID are" the reasons for this C. Trachomatis is ".
NGU "with 20-50% of men" of Ureaplasma urealyticum "la become infected. In the etiology of NGU U.urealyticum "because it is difficult to ascertain the role of the pathogenic microorganism of genital colonization of the patient directly proportional to the number of previous sexual partners. From five to three the number of partners for men, 70% of samples taken from the Ureaplasma "or come across.
NGU "in the usual incubation period of 1-5 weeks. Typical symptoms of dysuria and urethral discharge. Although a small amount is usually dense and purulent urethral discharge may be. May not discharge, and the patient may complain of only the urethral pruritus.
A man suspected urethritis, urethral discharge is ideal for the accurate depiction as 4 hours after holding urine should be examined. Gram stain of urethral discharge in more than four polymorphonuclear leukocytes per 1000 magnification oil immersion field correlates with presence of urethritis. C. As far as possible Trachomatis should be made ??to determine the culture. C. Trachomatis is an intracellular parasite, the culture of urethral exudate or urine sample to be taken to be rather swab. Example 2 to 4 mm of the urethra, and a special transport medium should be taken with caution.
NGU "in the treatment of choice, or doxycycline, 100 mg single oral dose of azithromycin 1 g orally, 2 times a day 7 days. If culture, NGU "in the cause of C. Trachomatis should be considered. NGU "with 60% of men and women mate with 30% C. Trachomatis has been isolated. As part of the management of urethritis, for the treatment of the patient's sexual partner should also immediately make an attempt. In general, the regime used in the treatment of men, should also be used in the treatment of women.
NGU "with 20-50% of men" of Ureaplasma urealyticum "la become infected. In the etiology of NGU U.urealyticum "because it is difficult to ascertain the role of the pathogenic microorganism of genital colonization of the patient directly proportional to the number of previous sexual partners. From five to three the number of partners for men, 70% of samples taken from the Ureaplasma "or come across.
NGU "in the usual incubation period of 1-5 weeks. Typical symptoms of dysuria and urethral discharge. Although a small amount is usually dense and purulent urethral discharge may be. May not discharge, and the patient may complain of only the urethral pruritus.
A man suspected urethritis, urethral discharge is ideal for the accurate depiction as 4 hours after holding urine should be examined. Gram stain of urethral discharge in more than four polymorphonuclear leukocytes per 1000 magnification oil immersion field correlates with presence of urethritis. C. As far as possible Trachomatis should be made ??to determine the culture. C. Trachomatis is an intracellular parasite, the culture of urethral exudate or urine sample to be taken to be rather swab. Example 2 to 4 mm of the urethra, and a special transport medium should be taken with caution.
NGU "in the treatment of choice, or doxycycline, 100 mg single oral dose of azithromycin 1 g orally, 2 times a day 7 days. If culture, NGU "in the cause of C. Trachomatis should be considered. NGU "with 60% of men and women mate with 30% C. Trachomatis has been isolated. As part of the management of urethritis, for the treatment of the patient's sexual partner should also immediately make an attempt. In general, the regime used in the treatment of men, should also be used in the treatment of women.
What is urethral stricture
Urethral stricture, as the term is usually the anterior urethra, spongy erectile tissue that covers the corpus cavernosum defines or refers to the formation of scar. Impairing the urethral epithelium or the underlying corpus cavernosum to result in scarring healing processes as part of any degree of harm; the anterior urethra. Today, most urethral stricture is a result of trauma. (Usually consisting of straddle injuries). Symptoms of voiding dysfunction that often occurs with trauma to the urethra is not noticeable. Unfortunately, iatrogenic trauma of the urethra, but there are still small endoscopes development and male in children cystoscopy We see now as a result of limiting the indications for iatrogenic urethral more rare.
Obstructive voiding symptoms in patients with urethral stricture or urinary tract infection is often found. Some patients with urinary retention may also. However, a detailed medical history is taken, a considerable majority of these patients prior to full Obstructive voiding symptoms for a long time where the state of progress is revealed.
Obstructive voiding symptoms in patients with urethral stricture or urinary tract infection is often found. Some patients with urinary retention may also. However, a detailed medical history is taken, a considerable majority of these patients prior to full Obstructive voiding symptoms for a long time where the state of progress is revealed.
Intraprostatic ductal reflux
The possible channels of bacteria in urine and prostatic reflux, the most important etiologic role in the pathogenesis of prostatic inflammation has been proposed as one mechanism. Anatomically, the peripheral zone of prostatic ductal drainage zones compared to other more sensitive intraprostatic ductal reflux. Kirby and colleagues, who were diagnosed with nonbacterial prostatitis men had instilled into the urinary bladder of carbon particle solution. Nonbacterial prostatitis in men after surgery, the carbon particles in the PS, macrophages, prostatic ductal system of the vaccines and observed by Persson and Ronquist according to "PS" in the case of high urate and creatinine, urinary reflux would assume that the prostatic ducts.
Prostate stones, prostatic secretions consists not only of the ingredients in the urine. This is intraprostatic urinary reflux into the prostate is and it probably also contributes to the formation of stones is a proof. Reflux of pathogenic bacteria into the prostate glands of prostate stones if they can lodge in the prostate by creating a protected aggregate. With this type of protective bacterial aggregates or biofilms may be associated with bacterial colonization of prostate stones, and this despite the use of appropriate antibiotic-resistant, followed by CP and recurrent urinary tract infection (UTI) can cause the formation. Ludwig et al, inflammation of the prostate using transrectal ultrasonography in men compared to non-inflammatory chronic prostatitis in men with prostate chance of having a stone in a meaningful way, to rise. Chemical, bacterial, or inflammation caused by immunological stimulation, possibly because of increased intraprostatic pressure and this pressure increase seems to be a pressure gauge placed on the transperineal route can be saved.
Prostate stones, prostatic secretions consists not only of the ingredients in the urine. This is intraprostatic urinary reflux into the prostate is and it probably also contributes to the formation of stones is a proof. Reflux of pathogenic bacteria into the prostate glands of prostate stones if they can lodge in the prostate by creating a protected aggregate. With this type of protective bacterial aggregates or biofilms may be associated with bacterial colonization of prostate stones, and this despite the use of appropriate antibiotic-resistant, followed by CP and recurrent urinary tract infection (UTI) can cause the formation. Ludwig et al, inflammation of the prostate using transrectal ultrasonography in men compared to non-inflammatory chronic prostatitis in men with prostate chance of having a stone in a meaningful way, to rise. Chemical, bacterial, or inflammation caused by immunological stimulation, possibly because of increased intraprostatic pressure and this pressure increase seems to be a pressure gauge placed on the transperineal route can be saved.
Overactive Bladder
AAM frequent urination, nocturia, urgency emergency, and / or urge incontinence, characterized by local pathological or metabolic cause of these symptoms could explain the absence of a definition symptomatology. AAM, Europe and America "in approximately 16% of men and women" to give effect. Similar proportions of men and women (16% - 16.9%), whereas a similar way with the prevalence of LUTS increases with aging. With urinary incontinence (wet) and without (dry) ratios close to AAM (9.3% - 7.6%), whereas men AMM dry, wet OAB is higher compared to
OAB symptoms in men are often DAA (overactive detrusor) or bladder dysfunction, such as impaired detrusor contractions, BOO "or, or BOO and bladder dysfunction is seen depending on the combination.
DAA, common cause of OAB symptoms and urodynamic detrusor involuntary contractions that occur during the bladder filling phase characterized by a urodynamic finding. DAA, and is often associated with BOO.
Detailed medical history and informed diagnosis is extremely important. Subjective history of bladder chart a more objective method of study is required to make. Ideally, the 3-day schedule is filled. A complete physical examination, urological, gynecological and neurological evaluation is required. Urine analysis, the patient must first apply for an examination to be done. Determination of creatinine in renal function needs to be done to give information about the advantages and disadvantages. AAM may be the cause, the possible causes of the high risk potential to affect primarily the upper urinary tract in question. In this case, ultrasonography is the most valuable and reliable method for the evaluation of upper urinary tract. Urine flow rate and residual urine determination of whether a simple uroflowmetry with ultrasound determination of residual can give very important information.
Aging bladder
Although aging is a decline in most physiological functions. The urodynamic studies in LUTS increases with age and decreased bladder capacity with advanced age, involuntary detrusor contractions are more frequent, the amount of urine flow rate is low, and increased post-void residual urine was found.
A decrease in the rate of contraction of the bladder increased with aging occurs due to fibrosis. "The old bladder", increased detrusor activity, impaired contractility, or both, is characterized by coexistence. Studies investigating the pathophysiologic mechanisms associated with the aging of the bladder symptoms is insufficient. The main reasons can be found with the current dysfunction of age or prostate enlargement, associated pathologies, such as neurological diseases or the drugs used most of the time is to distinguish whether that power is connected.
OAB symptoms in men are often DAA (overactive detrusor) or bladder dysfunction, such as impaired detrusor contractions, BOO "or, or BOO and bladder dysfunction is seen depending on the combination.
DAA, common cause of OAB symptoms and urodynamic detrusor involuntary contractions that occur during the bladder filling phase characterized by a urodynamic finding. DAA, and is often associated with BOO.
Detailed medical history and informed diagnosis is extremely important. Subjective history of bladder chart a more objective method of study is required to make. Ideally, the 3-day schedule is filled. A complete physical examination, urological, gynecological and neurological evaluation is required. Urine analysis, the patient must first apply for an examination to be done. Determination of creatinine in renal function needs to be done to give information about the advantages and disadvantages. AAM may be the cause, the possible causes of the high risk potential to affect primarily the upper urinary tract in question. In this case, ultrasonography is the most valuable and reliable method for the evaluation of upper urinary tract. Urine flow rate and residual urine determination of whether a simple uroflowmetry with ultrasound determination of residual can give very important information.
Aging bladder
Although aging is a decline in most physiological functions. The urodynamic studies in LUTS increases with age and decreased bladder capacity with advanced age, involuntary detrusor contractions are more frequent, the amount of urine flow rate is low, and increased post-void residual urine was found.
A decrease in the rate of contraction of the bladder increased with aging occurs due to fibrosis. "The old bladder", increased detrusor activity, impaired contractility, or both, is characterized by coexistence. Studies investigating the pathophysiologic mechanisms associated with the aging of the bladder symptoms is insufficient. The main reasons can be found with the current dysfunction of age or prostate enlargement, associated pathologies, such as neurological diseases or the drugs used most of the time is to distinguish whether that power is connected.
What is cystitis
U.S. "in the 4 to 6 million cases of acute bacterial cystitis in young women between the ages of 20 and 40 seen and 25% of women - 30" flour UTI "have been calculated. Emerged as risk factors for sexual intercourse and condom use. Urinary and fecal flora of sexual partners, similar to the E. Parcel "s, with an indication of uropathogens has been suggested that sexual transmission. Although very rare, urinary tract without underlying structural or functional disorder in young men can be seen in the acute cystitis. These infections often sexual activity is associated with HIV infection. A fairly narrow spectrum of etiologic agents causing acute cystitis: e. Package% 80 "When 5-15% "when the [31] of other organisms are a rare species of Klebsiella, P. Mirabilis, enterococci, or located. Acute uncomplicated cystitis, bladder and urethra causing inflammation. Dysuria, frequency, urgency, urinating small amounts, and suprapubic or lower abdominal pain located in the clinical symptoms. Hematuria, and foul-smelling urine can be seen. Acute cystitis may be a syndrome similar to men with urethritis.
Laboratory diagnosis of acute cystitis bacteriuria, pyuria and hematuria which is based on the urinalysis microscopy. Urine culture remains as the decisive test in symptomatic patients and in urine, 100 or more cfu / ml, they usually indicate infection.
Symptoms and signs suggestive of acute cystitis in women with and complicating factors are absent, deemed, hematuria or bacteriuria, or their combination was positive in a urine test, UTI, "provides sufficient information about the presence of a urine culture and be disabled. However, pre-treatment urine culture is recommended to all men.
Laboratory diagnosis of acute cystitis bacteriuria, pyuria and hematuria which is based on the urinalysis microscopy. Urine culture remains as the decisive test in symptomatic patients and in urine, 100 or more cfu / ml, they usually indicate infection.
Symptoms and signs suggestive of acute cystitis in women with and complicating factors are absent, deemed, hematuria or bacteriuria, or their combination was positive in a urine test, UTI, "provides sufficient information about the presence of a urine culture and be disabled. However, pre-treatment urine culture is recommended to all men.
Benign prostatic hyperplasia
BPH, the prostate histologically stromal and epithelial cell hyperplasia in the periurethral zone. Prostate is an organ of adult men and weighs approximately 20 grams of BPD develops until it remains the same. Calculation of the exact prevalence is difficult due to the absence of a clinical definition of life 6 approximately 50% of men, "Sinden histologically proven BPH While this rate is 7 decade to 70% and 9 decade of the 90% "reaches. Knows the exact etiology of BPH, BPH, "proved to the formation of the two absolute factor, dihydrotestosterone, and aging.
Sympathetic and parasympathetic innervation of the prostate as well as an organ. Sexual stimulation of the nerves in the sympathetic noradrenergic system with the task of accumulated prostatic fluid during ejaculation to ensure passage of the urethra in an antegrade. Parasympathetic system is responsible for the secretion of cholinergic nerves. Of neuronal systems that are effective on prostate alpha-and beta-adrenergic and cholinergic systems, peptidergic systems. These systems include alpha 1 the formation and development of resistance to urethral obstruction due to prostate-adrenergic system plays a primary role.
BPH is a disease, but not life-threatening, LUTS, "to cause to deteriorate the quality of life of patients. BPH, "the voiding symptoms, enlarged prostate physical effect glandının (static component) and the prostatic stroma increased smooth muscle tone (dynamic component) connected to the storage symptoms associated with bladder dysfunction caused by BOO. Static component of androgen-dependent growth of prostate tissue, and this is due directly to the represents the dynamic component as a result of increased autonomic activity and stimulation of alpha receptors is composed by contraction of prostatic smooth muscle tissue.
BPH, benign prostatic hyperplasia, or LUTS and BOO ", or may cause, is a common benign disease. Symptomatic BPH, "60% of patients with" when, asymptomatic BPH, "52% of patients with" BOO Sinden have been identified. Studies, LUTS, BPH, and found a clear correlation between BOO.
Sympathetic and parasympathetic innervation of the prostate as well as an organ. Sexual stimulation of the nerves in the sympathetic noradrenergic system with the task of accumulated prostatic fluid during ejaculation to ensure passage of the urethra in an antegrade. Parasympathetic system is responsible for the secretion of cholinergic nerves. Of neuronal systems that are effective on prostate alpha-and beta-adrenergic and cholinergic systems, peptidergic systems. These systems include alpha 1 the formation and development of resistance to urethral obstruction due to prostate-adrenergic system plays a primary role.
BPH is a disease, but not life-threatening, LUTS, "to cause to deteriorate the quality of life of patients. BPH, "the voiding symptoms, enlarged prostate physical effect glandının (static component) and the prostatic stroma increased smooth muscle tone (dynamic component) connected to the storage symptoms associated with bladder dysfunction caused by BOO. Static component of androgen-dependent growth of prostate tissue, and this is due directly to the represents the dynamic component as a result of increased autonomic activity and stimulation of alpha receptors is composed by contraction of prostatic smooth muscle tissue.
BPH, benign prostatic hyperplasia, or LUTS and BOO ", or may cause, is a common benign disease. Symptomatic BPH, "60% of patients with" when, asymptomatic BPH, "52% of patients with" BOO Sinden have been identified. Studies, LUTS, BPH, and found a clear correlation between BOO.
What are the stages of sleep I
Rechtschaffen and Kales sleep staging, "in 1968" in the developed and the criteria are still used today. Accordingly, the normal sleep phase consists of 2 main sections and 5:
1) Non-REM sleep phases formed 4 education:
Stage I: 2-5% on All night's sleep, "it constitutes.
Stage II: Total sleep 45-55% "constitutes.
Stage III and IV: 20-25% of total sleep "constitutes.
sleep stage I and II, stage III and IV of the phases of deep sleep.
2) REM sleep, 20-25% of the total night's sleep, "it constitutes.
Glare provides physical rest in non-REM sleep. Secretion of growth hormone in children, adults, the cell renewal and repair was during this period. Drop in body temperature, heart rate and breathing rate decreases.
Non-REM stage I, stage of transition matching drowsiness. EEG "alpha waves also disappear. And vertex sharp theta activity occurs in the late period. Begins to decrease muscle tone and slow eye movements (SEM) is monitored. Non-REM stage II "in the cortical activity has slowed down even more. Theta waves, sleep spindles and K complexes, which together with the thread-specific shows. SEM thoroughly monitored and decreased muscle tone. The majority of the night's sleep, this stage is passed. Non-REM stage III "in the delta waves begin to form. During this period, much of the delta waves are 20-50% of the universe. Non-REM stage IV "in the delta waves, EEG," is also evident in 50% of the universe "accounted for more than. Eye movements are lost. However, SEM can be monitored from time to time. Muscle tone is reduced.
REM sleep, the stabilization of the membrane. This period is easy to arouse people. Dreams occur during this period. The autonomic nervous system is activated during this period because of the heart rate, respiratory rate, blood pressure rises and irregular. Sawtooth waves in the form of REM sleep occurs. Rapid eye movement (REM) is monitored. Muscle tone is completely lost.
Connected to the first REM sleep period to the end of the period called sleep cycles. Approximately 90-120 minute cycles throughout the night, this is 4-6 times again. In the first half of the number and duration of the night was dominated by non-REM REM sleep, weight gain in the second half.
In the end output, non-REM stage III-IV, growth and cell repair, REM plays a role in the process of memory and learning. Non-REM stage I and II "of the function is not fully understood yet.
1) Non-REM sleep phases formed 4 education:
Stage I: 2-5% on All night's sleep, "it constitutes.
Stage II: Total sleep 45-55% "constitutes.
Stage III and IV: 20-25% of total sleep "constitutes.
sleep stage I and II, stage III and IV of the phases of deep sleep.
2) REM sleep, 20-25% of the total night's sleep, "it constitutes.
Glare provides physical rest in non-REM sleep. Secretion of growth hormone in children, adults, the cell renewal and repair was during this period. Drop in body temperature, heart rate and breathing rate decreases.
Non-REM stage I, stage of transition matching drowsiness. EEG "alpha waves also disappear. And vertex sharp theta activity occurs in the late period. Begins to decrease muscle tone and slow eye movements (SEM) is monitored. Non-REM stage II "in the cortical activity has slowed down even more. Theta waves, sleep spindles and K complexes, which together with the thread-specific shows. SEM thoroughly monitored and decreased muscle tone. The majority of the night's sleep, this stage is passed. Non-REM stage III "in the delta waves begin to form. During this period, much of the delta waves are 20-50% of the universe. Non-REM stage IV "in the delta waves, EEG," is also evident in 50% of the universe "accounted for more than. Eye movements are lost. However, SEM can be monitored from time to time. Muscle tone is reduced.
REM sleep, the stabilization of the membrane. This period is easy to arouse people. Dreams occur during this period. The autonomic nervous system is activated during this period because of the heart rate, respiratory rate, blood pressure rises and irregular. Sawtooth waves in the form of REM sleep occurs. Rapid eye movement (REM) is monitored. Muscle tone is completely lost.
Connected to the first REM sleep period to the end of the period called sleep cycles. Approximately 90-120 minute cycles throughout the night, this is 4-6 times again. In the first half of the number and duration of the night was dominated by non-REM REM sleep, weight gain in the second half.
In the end output, non-REM stage III-IV, growth and cell repair, REM plays a role in the process of memory and learning. Non-REM stage I and II "of the function is not fully understood yet.
About Sleep Disorders
I sleep duration and quality of what is happening in how it affects reputation, quality of night sleep in the same way the process affects their daily lives. Situations that deviate from the average sleep duration and quality, sleep disturbance (UB) is defined as. UB's quality of life, is an important condition affecting the physical and mental performance. Sleep disorders have a wide range of disease diagnosis, monitoring and treatment requires a multidisciplinary approach.
Classification of sleep disorders beam which
Beam which in 1979 was the first classification of sleep disorders. Then, in line with experience in this field, sleep disorders and diagnostic criteria for sub-groups were determined. Finally, the American Academy of Sleep Medicine (AASM) in 2005 by the International Classification of Sleep Disorders-2 (ICSD-2) developed and is now available. Accordingly, sleep disorders grouped under 8 main groups:
1. Insomnia
2. I sleep-related breathing disorders
3. Central origin Hypersomnia
4. Circadian rhythm disorders, then
5. Parasomnias
6. Sleep with the skin can be the province of movement disorders
7. Isolated symptoms, normal variants
Classification of sleep disorders beam which
Beam which in 1979 was the first classification of sleep disorders. Then, in line with experience in this field, sleep disorders and diagnostic criteria for sub-groups were determined. Finally, the American Academy of Sleep Medicine (AASM) in 2005 by the International Classification of Sleep Disorders-2 (ICSD-2) developed and is now available. Accordingly, sleep disorders grouped under 8 main groups:
1. Insomnia
2. I sleep-related breathing disorders
3. Central origin Hypersomnia
4. Circadian rhythm disorders, then
5. Parasomnias
6. Sleep with the skin can be the province of movement disorders
7. Isolated symptoms, normal variants
Sleep Related Breathing Disorder
Snoring is as old as humanity's first built-in light periods in the transition from life in a remarkable situation, and was the subject of ridicule. The most important of these settlements, establishment of 7000 BC "Çatalhöyük near Konya, dating from the years with" kind. Humanity first began to snore a speculative approach and social impacts that are experiencing this situation can be said that the place of Çatalhöyük.
Sleep apnea, 19 been described in detail by the author Charles Dickens in the early years. Dickens "s, published in 1837" The posthumous Papers of The Pickwick Club "in his book," Pickwick "and explained what happened at the club," Joe "that's overweight servant, his eyes are half closed, almost standing, perception is weak, and very noisy depicted quite well.
I a 120 years after that, but Burwell and his colleagues in the journal American Journal of Medicine, along with extreme obesity Hypoventilation, Dickens' novel, inspired by the "Pickwick syndrome" as described.
Search for sleep in turning point for the first time in 1965 by Henri Gastaut PSG "has been the introduction of. This can be seen in the sleep apnea, the only thought that excessive. For the first time in 1972, demonstrated the presence of this disease to the normal. Obstructive sleep apnea is the term for the first time in 1973, Stanford University "at the sleep clinic who were used by Guilleminault et al. Guilleminault and colleagues also examined the effects of disease on the cardiovascular system.
The effects of sleep on breathing in the last decades, however, are fully understood.
Alterations in breathing during sleep
Matching resistive breathing during sleep period and the so-called voluntary and the autonomic system is controlled by two independent. While both systems during wakefulness, sleep during the medulla respiratory completely depends on the rhythm of autonomic respiratory control center. Normal sleep tidal volume, alveolar ventilation, blood gases, respiratory rate and rhythm of the significant changes are seen.
Changes of ventilated: Non-REM sleep, minute ventilation, tidal volume is equal to 5-10% due to a decrease (0.5-1.5 L / min) is reduced. Decrease in REM sleep, especially in the respiratory intensive eye movements is highly variable, and the minutes phasic REM period, 40% watched "Lara evident until arrive.
Changes in blood gases: alveolar ventilation during sleep with a reduction in PaCO 2 rises up to 2-8 mm Hg, PaO 2 and SaO 2 falls from 30 to 10 mm Hg is reduced to 1-2%.
Respiratory rate and rhythm when going outside: the first 10-60 minutes of wakefulness and non-REM sleep stage I-II transitions occur frequently between. Breathing is irregular. Reduction in tidal volumes and enhancements are tracked. Non-REM stage III-IV "fame with the start of breathing becomes regular, and completely under the control of the autonomic system. Phasic REM sleep and REM in particular "in the back of the irregular breathing, tidal volume is reduced, rapid and shallow breathing is observed.
All stages of sleep in Hypercapnic and hypoxic ventilatory response is reduced as well. Hypercapnic ventilatory response, non-REM period, 20-50%, "is thoroughly up to a reduction, REM became more obvious in the period.
Functional capacity UEL: stay in a supine position during sleep and REM period, functional residual capacity is reduced due to hypotonia of respiratory muscles.
Arousal side: hypercapnia during sleep, a stronger arousal Hypoxaemia (waking up). PaCO 2 "in the 6-15 and" Arousal causes increased health, SaO 2 "75% of the normal individual" to be falling.
Metabolism slows down metabolism and in the morning hours of sleep due begins to accelerate again. Ventilation during sleep is reduced in parallel with metabolism to slow down.
It was made from G as sleep, respiratory system resistance increased, respiratory rate and
rhythm Gu is broken, chemical and mechanical receptors sensitivity and ventilation
LIGHT decreased, blood gases negative changes experienced, results as a period of the respiratory system is damaged.
Sleep apnea, 19 been described in detail by the author Charles Dickens in the early years. Dickens "s, published in 1837" The posthumous Papers of The Pickwick Club "in his book," Pickwick "and explained what happened at the club," Joe "that's overweight servant, his eyes are half closed, almost standing, perception is weak, and very noisy depicted quite well.
I a 120 years after that, but Burwell and his colleagues in the journal American Journal of Medicine, along with extreme obesity Hypoventilation, Dickens' novel, inspired by the "Pickwick syndrome" as described.
Search for sleep in turning point for the first time in 1965 by Henri Gastaut PSG "has been the introduction of. This can be seen in the sleep apnea, the only thought that excessive. For the first time in 1972, demonstrated the presence of this disease to the normal. Obstructive sleep apnea is the term for the first time in 1973, Stanford University "at the sleep clinic who were used by Guilleminault et al. Guilleminault and colleagues also examined the effects of disease on the cardiovascular system.
The effects of sleep on breathing in the last decades, however, are fully understood.
Alterations in breathing during sleep
Matching resistive breathing during sleep period and the so-called voluntary and the autonomic system is controlled by two independent. While both systems during wakefulness, sleep during the medulla respiratory completely depends on the rhythm of autonomic respiratory control center. Normal sleep tidal volume, alveolar ventilation, blood gases, respiratory rate and rhythm of the significant changes are seen.
Changes of ventilated: Non-REM sleep, minute ventilation, tidal volume is equal to 5-10% due to a decrease (0.5-1.5 L / min) is reduced. Decrease in REM sleep, especially in the respiratory intensive eye movements is highly variable, and the minutes phasic REM period, 40% watched "Lara evident until arrive.
Changes in blood gases: alveolar ventilation during sleep with a reduction in PaCO 2 rises up to 2-8 mm Hg, PaO 2 and SaO 2 falls from 30 to 10 mm Hg is reduced to 1-2%.
Respiratory rate and rhythm when going outside: the first 10-60 minutes of wakefulness and non-REM sleep stage I-II transitions occur frequently between. Breathing is irregular. Reduction in tidal volumes and enhancements are tracked. Non-REM stage III-IV "fame with the start of breathing becomes regular, and completely under the control of the autonomic system. Phasic REM sleep and REM in particular "in the back of the irregular breathing, tidal volume is reduced, rapid and shallow breathing is observed.
All stages of sleep in Hypercapnic and hypoxic ventilatory response is reduced as well. Hypercapnic ventilatory response, non-REM period, 20-50%, "is thoroughly up to a reduction, REM became more obvious in the period.
Functional capacity UEL: stay in a supine position during sleep and REM period, functional residual capacity is reduced due to hypotonia of respiratory muscles.
Arousal side: hypercapnia during sleep, a stronger arousal Hypoxaemia (waking up). PaCO 2 "in the 6-15 and" Arousal causes increased health, SaO 2 "75% of the normal individual" to be falling.
Metabolism slows down metabolism and in the morning hours of sleep due begins to accelerate again. Ventilation during sleep is reduced in parallel with metabolism to slow down.
It was made from G as sleep, respiratory system resistance increased, respiratory rate and
rhythm Gu is broken, chemical and mechanical receptors sensitivity and ventilation
LIGHT decreased, blood gases negative changes experienced, results as a period of the respiratory system is damaged.
Upper airway resistance syndrome
Temporary narrowing of the upper airway during sleep due to limited or there is an increase in respiratory effort. ÜSYRS apnea and / or without hypopnea (AHI <5) as a result of increased upper airway resistance in the clinical condition characterized by a marked increase in intrathoracic negative pressure. Short-term and often due to repeated arousals from sleep fragmentation and daytime sleepiness is often evident. However, oxygen saturation does not change. Snoring, OSAS, although intense, "according to the lighter.
OSAS, compared with a table in individuals younger and weaker. 10-15% of patients presenting with snoring, sleep centers, "reported that when the ÜSYRS. During childhood and are more common in young women. Children with behavior disorders, attention deficit, learning disabilities, hyperactivity, sleep state is more common during the day. In females, weakness, fatigue, menstrual disturbances, and marital incompatibility in the foreground.
Although there is significant incidence of obesity in patients with retrognathia ÜSYRS noteworthy. Symptomatology and complications of OSAS "substantially similar to the one in this syndrome, surgical and CPAP (Continuous Positive Airway Pressure) treatment takes precedence. Symptoms can be dimmed, making it difficult to identify the table. Sleep complaints, mainly due to binding frequent use of sedative. ÜSYRS sedatives "in the table have a heavy, apnea may lead to the emergence of contra-indicated.
Central sleep apnea syndrome
Studies have ray in a rare event. Developed in relation to the central nervous system dysfunction. For a period of 10 seconds or more during sleep with oronasal breathing effort to stop the flow of air is called central sleep apnea or not.
Ray in central respiratory center respiratory muscles, sleep consists of stops to give the command. AHI 5 "in over 50% and Apnea-hypopnea" more than the central type. Frequently throughout the day due to repeated arousals, or sleep fragmentation is associated with somnolence. Usually the sensory impairment component, component assembly and executive and motor neuron disorder that causes defects in neuromuscular diseases, neurological disorders, such as accompanies. Ray in this group in the primary, primary and infant sleep apnea, Cheyne-Stokes breathing pattern is located.
OSAS, compared with a table in individuals younger and weaker. 10-15% of patients presenting with snoring, sleep centers, "reported that when the ÜSYRS. During childhood and are more common in young women. Children with behavior disorders, attention deficit, learning disabilities, hyperactivity, sleep state is more common during the day. In females, weakness, fatigue, menstrual disturbances, and marital incompatibility in the foreground.
Although there is significant incidence of obesity in patients with retrognathia ÜSYRS noteworthy. Symptomatology and complications of OSAS "substantially similar to the one in this syndrome, surgical and CPAP (Continuous Positive Airway Pressure) treatment takes precedence. Symptoms can be dimmed, making it difficult to identify the table. Sleep complaints, mainly due to binding frequent use of sedative. ÜSYRS sedatives "in the table have a heavy, apnea may lead to the emergence of contra-indicated.
Central sleep apnea syndrome
Studies have ray in a rare event. Developed in relation to the central nervous system dysfunction. For a period of 10 seconds or more during sleep with oronasal breathing effort to stop the flow of air is called central sleep apnea or not.
Ray in central respiratory center respiratory muscles, sleep consists of stops to give the command. AHI 5 "in over 50% and Apnea-hypopnea" more than the central type. Frequently throughout the day due to repeated arousals, or sleep fragmentation is associated with somnolence. Usually the sensory impairment component, component assembly and executive and motor neuron disorder that causes defects in neuromuscular diseases, neurological disorders, such as accompanies. Ray in this group in the primary, primary and infant sleep apnea, Cheyne-Stokes breathing pattern is located.
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