G. Garik. Lee College.

Urogenital and Pelvic Diaphragms in the Male 351 1 Right testis (reflected laterally and upward) 2 Bulbospongiosus muscle 3 Ischiocavernosus muscle 4 Adductor magnus muscle 5 Posterior scrotal nerves and superficial perineal arteries 6 Posterior scrotal artery and vein 7 Right artery of bulb of penis 8 Perineal body 9 Perineal branches of pudendal nerve 10 Pudendal nerve and internal pudendal artery 11 Inferior rectal arteries and nerves 12 Inferior cluneal nerve 13 Coccyx (location) 14 Penis 15 Left testis (reflected laterally) 16 Left posterior scrotal artery 17 Deep transverse perineal muscle 18 Left artery of bulb of penis 19 Posterior femoral cutaneous nerve 20 External anal sphincter muscle 21 Anus 22 Gluteus maximus muscle 23 Anococcygeal nerves 24 Acetabulum (femur removed) 25 Ligament of femoral head 26 Body of ischium (cut) 27 Sciatic nerve 28 Coccygeus muscle 29 Levator ani muscle a iliococcygeus muscle b pubococcygeus muscle c puborectalis muscle 30 Prostatic venous plexus 31 Body of pubis 32 Testis Urogenital diaphragm and external genital organs in the male with vessels and nerves (from below) purchase 800 mg viagra vigour amex erectile dysfunction 26. The 21 right half of the pelvis including 20 14 the obturator internus muscle and femur have been removed to 32 display the right half of the levator ani muscle discount 800mg viagra vigour erectile dysfunction treatment levitra. The left crus penis has been isolated and reflected laterally together with the bulb of the penis. Urogenital and Pelvic Diaphragms in the Male 353 1 Right testis (reflected) 2 Corpus spongiosum of penis 3 Corpus cavernosum of penis 4 Perineal branch of posterior femoral cutaneous nerve 5 Posterior scrotal arteries and nerves 6 Deep artery of penis 7 Deep transverse perineal muscle 8 Right perineal nerves 9 Inferior rectal nerves 10 Inferior cluneal nerve 11 Anococcygeal nerves 12 Left spermatic cord 13 Left testis (cut surface) 14 Dorsal artery and nerve of penis 15 Deep dorsal vein of penis 16 Urethra (cut) 17 Artery of bulb of penis 18 Superficial transverse perineus muscle 19 Left artery of bulb of penis 20 Perineal branch of pudendal nerve 21 Anus 22 External anal sphincter muscle 23 Gluteus maximus muscle 24 Internal pudendal artery and pudendal nerve 25 Sacrotuberous ligament 26 Coccyx 27 Urogenital diaphragm (deep 22 transverse perineus muscle) 28 Tendinous center of perineum (perineal body) 29 Levator ani muscle 30 Anococcygeal ligament 31 Obturator internus muscle 32 Dorsal artery of penis Urogenital diaphragm and external genital organs in the male (from below). The urinary bladder 37 Infundibulum of uterine tube is empty, position and shape of the uterus are normal. Female Urogenital System 355 1 Muscular coat of urinary bladder 2 Folds of mucous membrane of urinary bladder 3 Right ureteric orifice 4 Interureteric fold 5 Internal urethral orifice 6 Vesico-uterine venous plexus 7 Urethra 8 Pubic bone (cut edge) 9 External urethral orifice 10 Vestibule of vagina 11 Left ureteric orifice 12 Trigone of bladder 13 Obturator internus muscle 14 Levator ani muscle 15 Bulb of the vestibule 16 Left labium minus 17 Psoas major muscle 18 Ampulla of rectum 19 Uterus 20 Urinary bladder 21 Promontory 22 Sigmoid colon 23 Uterine tube 24 Head of femur 25 Vagina Coronal section through the female urinary bladder and urethra (anterior aspect). During embryonal development, the 7 uterus and ovary remain within the 25 pelvic cavity where, after puberty, 16 the ovulation takes place. The anterior wall of the vagina has been opened to display the vaginal portion of the cervix. The fimbriae of the uterine tube have been reflected to show the abdominal ostium. Female Internal Genital Organs: Uterus and Related Organs 359 1 Ilio-inguinal nerve 2 Ureter 3 Psoas major muscle 4 Genitofemoral nerve 5 Common iliac vein 6 Common iliac artery 7 Ovary 8 Uterine tube 9 Peritoneum 10 Round ligament of uterus 11 Inferior vena cava 12 Abdominal aorta 13 Superior hypogastric plexus 14 Rectum 15 Recto-uterine pouch (of Douglas) 16 Uterus 17 Vesico-uterine pouch 18 Urinary bladder 19 Iliac crest 20 Pubic symphysis 21 Placenta 22 Amnion and chorion 23 Adnexa of uterus (uterine tube and ovaries) 24 Myometrium 25 Internal orifice of uterus 26 Cervix of uterus 27 Umbilical cord View of the female pelvis showing uterus and related organs (superior aspect). The anterior wall of the uterus has been removed to show the location of the placenta. Main drainage routes of lymph vessels of uterus and its adnexa (indicated by arrows). Female External Genital Organs 361 1 Glans of clitoris 2 Labium majus 3 Vestibule of vagina 4 Hymen 5 Posterior labial commissure 6 Body of clitoris 7 Labium minus 8 External orifice of urethra 9 Vaginal orifice 10 Ureter 11 Adnexa of uterus 12 Prepuce of clitoris 13 Crus of clitoris 14 Greater vestibular glands 15 Anus and internal anal sphincter muscle 16 Median umbilical ligament containing urachus 17 Urinary bladder 18 Infundibulum of uterine tube 19 Ovary 20 Ampulla of uterine tube 21 Suspensory ligament of the ovary 22 Bulbospongiosus muscle and bulb of vestibule 23 Central tendon of perineum (perineal body) 24 External anal sphincter muscle Female external genital organs (anterior aspect). Female external genital organs in relation to internal genital organs and urinary system, isolated (anterior aspect). Urogenital Diaphragm and External Genital Organs in the Female 365 1 Position of pubic symphysis 2 Body of clitoris 3 Prepuce of clitoris 4 Adductor longus and gracilis muscles 1 5 External orifice of vagina and labium minus 6 Posterior labial nerve 7 Perineal body 8 8 Deep artery of clitoris and dorsal nerve of clitoris 2 9 9 Adductor brevis muscle 10 Glans of clitoris 3 10 11 Crus of clitoris and 4 ischiocavernosus muscle 11 12 Bulb of vestibule and bulbospongiosus muscle 13 Anterior branch of obturator nerve 12 14 Labium minus 5 15 Vaginal orifice 16 Posterior labial nerves 13 17 Branches of pudendal nerve 6 18 External sphincter of anus 19 Anus 20 Bulb of vestibule (divided) 21 Dorsal artery of clitoris 22 Superficial transverse perineus muscle 7 23 Perineal branch of posterior femoral cutaneous nerve 24 Levator ani muscle External genital organs in the female (inferior aspect). The clitoris has been 25 Pudendal nerve and dissected and slightly reflected to the right. The prepuce of clitoris has been divided internal pudendal artery to display the glans. The bulb of vestibule has partly been removed; the left labium minus was cut away. The peritoneum at the left half of pelvic cavity has been 9 removed to display uterine tube, vessels, and nerves. Pelvic Cavity in the Female: Coronal and Horizontal Sections 367 1 Ilium 2 Rectum 3 Recto-uterine fold 4 Ovary 5 Uterine tube 6 Urinary bladder 7 Urethra 8 Labium minus 9 Recto-uterine pouch of Douglas 10 Uterus (uterovesical pouch) 11 Ligament of the head of the femur 12 Head of femur 13 Vestibule of vagina 14 Labium majus 15 Anal cleft 16 Coccyx 17 Rectum Coronal section through the pelvic cavity of the female (cf. Horizontal section through the pelvic cavity of the female at level of the urethral sphincter and vagina (from below). The two positions of the forearm essential to manual skills in the human, supination (right arm) and pronation (left arm), are shown. Skeleton of the Shoulder Girdle and Thorax 369 Vertebral column 1 Atlas 2 Axis 3 Third–seventh cervical vertebrae 4 First thoracic vertebra 5 Twelfth thoracic vertebra 6 First lumbar vertebra Ribs 7 First–third ribs True ribs 8 Fourth–seventh ribs 9 Eighth–tenth ribs False ribs 10 Eleventh and twelfth ribs (floating ribs) Clavicle 11 Sternal end 12 Articular facet for sternum 13 Acromial end 14 Articular facet for acromion 15 Impression for costoclavicular ligament 16 Conoid tubercle 17 Trapezoid line 18 Site of acromioclavicular joint 19 Site of sternoclavicular joint Scapula 20 Acromion 21 Coracoid process 22 Glenoid cavity 23 Costal surface Sternum 24 Manubrium 25 Body 26 Xiphoid process Skeleton of shoulder girdle and thorax (anterior aspect). Because of the human body’s upright posture, the upper limb has developed a high degree of mobility. The shoulder girdle is to a great extent movable in the thorax and is connected with the 16 trunk only by the sternoclavicular joint. Vertebral column Scapula 1 Atlas 12 Acromion 2 Axis 13 Spine of scapula 3 Third–sixth cervical vertebrae 14 Lateral angle 4 Seventh vertebra (vertebra prominens) 15 Posterior surface 5 First thoracic vertebra 16 Inferior angle 6 Sixth thoracic vertebra 17 Coracoid process 7 Twelfth thoracic vertebra 18 Supraglenoid tubercle 8 First lumbar vertebra 19 Glenoid cavity 20 Infraglenoid tubercle Clavicle 21 Lateral margin 9 Sternal end 10 Acromial end Thorax 11 Site of acromioclavicular joint 22 Body of sternum 23 Costal arch 24 Angle of ribs 25 Floating ribs Scapula 371 Right scapula (posterior aspect). Scapula A = superior border B = medial border C = lateral border D = superior angle E = inferior angle F = lateral angle 1 Acromion 2 Coracoid process 3 Scapular notch 4 Glenoid cavity 5 Infraglenoid tubercle 6 Supraspinous fossa 7 Spine 8 Infraspinous fossa 9 Articular facet for acromion 10 Neck 11 Supraglenoid tubercle 12 Costal (anterior) surface Right scapula (lateral aspect). Humerus 1 Greater tubercle 7 Deltoid tuberosity 13 Head 19 Trochlea 2 Lesser tubercle 8 Anterolateral surface 14 Anatomical neck 20 Posterior surface 3 Crest of lesser tubercle 9 Lateral supracondylar ridge 15 Anteromedial surface 21 Groove for ulnar nerve 4 Crest of greater tubercle 10 Radial fossa 16 Medial supracondylar ridge 22 Groove for radial nerve 5 Intertubercular sulcus 11 Lateral epicondyle 17 Coronoid fossa 23 Olecranon fossa 6 Surgical neck 12 Capitulum 18 Medial epicondyle 374 Skeleton of the Forearm Radius 1 Head 2 Articular circumference 3 Neck 4 Radial tuberosity 5 Shaft 6 Anterior surface 7 Styloid process 8 Articular surface 9 Posterior surface 10 Ulnar notch Ulna 11 Trochlear notch 12 Coronoid process 13 Radial notch 14 Ulnar tuberosity 15 Head 16 Articular circumference 17 Styloid process 18 Posterior surface 19 Olecranon Bones of right forearm, radius, and Bones of right forearm, radius, and ulna (anterior aspect). Articulations at the right elbow 20 Site of humero-ulnar joint 21 Site of humeroradial joint 22 Site of proximal radio-ulnar joint A = humerus B = radius C = ulna Bones of right elbow joint (lateral aspect). Skeleton of the Forearm and Hand 375 Skeleton of right forearm and hand in pronation. The human hand is one of the most admirable structures of appeared after the erect posture of the human body was the human body.

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Answers may be used beliefs help or hinder him to feel at peace is more than once effective viagra vigour 800 mg can erectile dysfunction cause prostate cancer. A patient who tells a nurse that she no longer goes to church on Sunday may be experiencing b buy discount viagra vigour 800 mg on-line erectile dysfunction doctors in st. louis. A nurse explores with a patient the Match the type of spiritual distress listed in importance of learning to accept Part A with the appropriate example listed in himself, even with his faults. A Roman Catholic college student stops her relationship with her family and going to Mass on Sundays and moves in identify the origin of negative beliefs with her boyfriend; she tells you, “I really about people. A woman cannot accept the death of her newborn and says, “How long will it hurt 1. Study Guide for Fundamentals of Nursing: The Art and Science of Nursing Care, 7th Edition. A family who insists on care deemed med- ically futile for a terminally ill patient b. Christian Scientist parents of a child need- ing an appendectomy who refuse to sign a consent form for surgery: b. Give two examples of practices associated with healthcare that may have religious significance to a patient. As a source of strength and healing: statement you might use to assess a patient for the following types of spiritual distress. Give an example of how the following factors may influence a person’s spirituality. Life events: Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins. Study Guide for Fundamentals of Nursing: The Art and Science of Nursing Care, 7th Edition. She tells you she these beliefs influence the way you carry on believes God has abandoned her and her your daily routine in life? In what Suggest a nursing diagnosis for this patient ways might they affect the way you react to and develop a nursing care plan that includes patients of different faiths? Scenario: Margot Zeuner, a 75-year-old woman, is taking care of her 80-year-old hus- 11. Develop a prayer expressing a patient’s needs band with advanced Alzheimer’s disease, who that could be used for a patient facing was just discharged from the hospital and surgery. When visited at home, she says, “I really miss going to church and seeing everyone. How might the nurse use blended nursing skills to provide holistic, competent nursing b. What intellectual, technical, interpersonal, and/or ethical/legal competencies are most likely to bring about the desired outcome? What resources might be helpful for you to pray with them for their child’s recov- Mrs. Study Guide for Fundamentals of Nursing: The Art and Science of Nursing Care, 7th Edition. I guess there’s a whole lot more to Read the following patient care study and use life, and maybe this was my invitation to sort your nursing process skills to answer the out my priorities. Identify pertinent patient data by placing a Scenario: Jeffrey Stein, a 31-year-old attorney, single underline beneath the objective data in is in a step-down unit following his transfer the patient care study and a double underline from the cardiac care unit, where he was beneath the subjective data. During his second night in the strengths you hope to draw upon as you assist step-down unit, he is unable to sleep and tells this patient to better health. Pretend that you are performing a nursing I celebrate the holidays, but that’s about all. If assessment of this patient after the plan of there is a God, I wonder what He thinks about care is implemented. Study Guide for Fundamentals of Nursing: The Art and Science of Nursing Care, 7th Edition. For the purposes of this exercise, develop the one patient goal that demonstrates a direct resolution of the patient problem identified in the nursing diagnosis. Study Guide for Fundamentals of Nursing: The Art and Science of Nursing Care, 7th Edition. Nursing is respecting individual differences Prioritization Questions through unconditional acceptance, ensuring 1. Promoting health: The nurse prepares the patient for tests, explaining each test thoroughly to the 2.

Complementary Supplements B-complex: Vitamins B2 and B3 protect glutathione in the eye buy viagra vigour 800 mg low cost impotence vasectomy, and some evidence shows protective benefits with supplements viagra vigour 800 mg fast delivery erectile dysfunction melanoma. Boost antioxidant and carotenoid intake by eating lots of berries, carrots, peppers, kale, collard greens, spinach, and broccoli. When a person with celiac disease eats gluten-containing food, the immune sys- tem reacts by producing antibodies, which attack the villi in the small intestine, reducing their ability to absorb nutrients. Over time, the reduced absorption of nutri- C ents leads to malnutrition and vitamin, mineral, and essential fatty acid deficiencies. This can damage the health of every organ and body system and increase the risk of many diseases, such as osteoporosis and depression. The cause of celiac is not known; however, three factors are typically present in those who develop the disease: genetic predisposition, a diet containing gluten, and a triggering event. Possible triggers include: introduction of grains into a baby’s diet, puberty, pregnancy, menopause, stress, viral or bacterial infection, and trauma (ac- cident, surgery). There is no cure for celiac disease, but the condition can be managed by following a gluten-free diet for life. Those who do not adhere to a gluten-free diet are at greater risk of developing os- teoporosis; cancer of the intestines, mouth, esophagus, or bowel; and neurological diseases (seizures and nerve damage). Once gluten is removed from the diet, the villi start to heal and intestinal inflammation subsides. Complete healing and regrowth of the villi may take several months in younger people and as long as two to three years in older people. For severe cases that don’t respond to dietary changes, medications such as prednisone are temporarily used to suppress the immune response. Vitamin, mineral, and essential fatty acid supplements are recommended to correct deficiencies and restore health. Dietary Recommendations Read labels carefully; look for products labelled gluten-free. When eating out, ask to speak directly to the chef as service staff may not be familiar with gluten and the many possible hidden sources. Cross-contamination can occur if gluten-free foods are prepared in unwashed bowls previously containing gluten, or cooked in the same pots or deep-fryer. Foods to include: • Lean meats, fish and poultry, fruits, vegetables, corn, potato, rice, quinoa, and soy. Healthy fats (fish, nuts, and seeds) are very important to help restore essential fatty acids, which are depleted in those with celiac disease. Foods to avoid: • Foods containing wheat, barley, rye, bulgur, Kamut, spelt, and triticale, such as breads, pasta, cereals, baked goods, crackers, and pies. Note: Dairy should be limited initially as damage to the intestines reduces the ability to di- gest lactose (dairy sugar). These studies used pure oats, free of gluten contamination, and the amount per day was limited. The Canadian Celiac Association has stated that consump- tion of pure, uncontaminated oats is safe in the amount of 50–70 g per day (1/2–3/4 166 cup of dry rolled oats) by adults and 20–25 g per day (1/4 cup of dry rolled oats) by children with celiac disease. Note: Some individuals may not tolerate even pure oats, in which case they should be completely avoided. Lifestyle Suggestions To promote healing and support immune function, it is important to get adequate rest, reduce stress, and strictly adhere to the gluten-free diet. C Top Recommended Supplements Digestive enzymes: May be depleted in those with celiac; they aid proper digestion of food and are particularly important in newly diagnosed individuals. Essential fatty acids: Are highly recommended to correct deficiencies, reduce inflammation, and promote healing of intestinal cells. Look for a product that provides both omega-3 (fish) and omega-6 (borage, primrose) fatty acids. Multivitamin and mineral complex: This is absolutely essential to correct deficiencies and promote healing. The most common deficiencies include calcium, magnesium, iron, zinc, vitamins D and K, and folic acid. Even those who are stable on a gluten-free diet and in remission may still have nutrient deficiencies and would benefit from a supplement. Those with severe malnutrition and deficiencies may require higher than typical amounts. Complementary Supplements Fibre: Often deficient in a gluten-free diet due to the elimination of many grains, so supple- ments can help improve bowel function and prevent constipation.