URETHRA

 Urethra

Preprostatic	Intramural
Prostatic	widest most dilatable spindle shaped cross section-----horse shoe shaped urethral crest/veru montanum On either side of the crest is a slightly depressed fossa, the prostatic sinus; the floor of which is perforated by numerous apertures, the orifices of the prostatic ducts from the lateral lobes of the prostate; At the forepart of the urethral crest, below its summit, is a median elevation, the colliculus seminalis
Membranous	pases through external urethral sphincter narrowest part (except external orifice) surrounded by fibres of sphincter uethrae shortest least dilatable ducts of bulbo-urethral glands enter here
Spongy (penile + bulbar)	Longest in corpus spongiosum ducts from urethral/littrre’s glands 2 parts                             1.        bulbous                             2.       pendulous
external urethral orifice	5mm

Type of epithelium lining

Preprostatic	transitional epithelium
Prostatic	transitional epithelium
Membranous	pseudo stratified columnar
Spongy (penile + bulbar)	proximally---pseudostratified columnar distally ----stratified squamous
external urethral orifice	----------------------------------------------

LYMPHATIC DRAINAGE of URETHRA

Posterior urethra §      Proximal 2/3rd  of female urethra §      Prostatic  & membranous parts of male urethra	·         External iliac     ·           Obturator(along internal pudendal a.)     ·         Internal iliac(Hypogastric)     ·         Presacral
Anterior urethra §        Distal 1/3rd of female urethra   §       Bulbous & penile /spongy/distal urethra in males	superficial inguinal LN à deep inguinal LN à external iliac LNàLateral aortic

Whole of female urethra drains mainly into------------- internal iliac nodes

Skeletal muscle relaxants

shoulder joint

Muscles acting at shoulder joint

Flexion	§  Clavicular head of pectoralis major    §  Anterior fibres of deltoid    §  Coracobrachialis
Extension	§  Posterior fibres of deltoid    §  Teres major    §  Lattisimus dorsii
Abduction	§  Supraspinatous    §  Deltoid
Adduction	§  Pectoralis major    §  Teres major    §  Lattisimus dorsi
Medial rotation	§  Pectoralis major    §  Teres major    §  Latissimus dorsi    §  Subscapularis
Lateral rotation	§  Infraspinatus    §  Teres minor    §  Posterior fibres of deltoid

Movements during shoulder abduction

o   Lateral rotation of scapula

o   Elevation of humerus

o   Movements at clavicular end of sterno-clavicular joint

o   Axial rotation of humerus at acromioclavicular joint

o   For every 3^o abduction, 2^o abduction occurs in shoulder joint ,1^o abduction occurs by lateral/forward  rotation of scapula

o   Abduction is initiated by supra spinatus but main abductor is deltoid

Shoulder abduction

For every 15^O of abduction,  shoulder joint contributes 10^O but girdle contributes 5^O(in the ratio of 2:1)

After 90^O abduction,this ratio is reversed

Supraspinatus –initiates abduction of shoulder  & assisted by middle fibres of deltoid

First 90-120  degrees of shoulder abduction takes place at ----------- glenohumeral joint

After this fixation is NOT d/t  bony interlocking b/w greater tuberosity and acromion d/t no further articular surface  available on humerus

Abduction of shoulder > 90  degree requires --------------- rotation of scapula(achieved by contraction of trapezius & serratus anterior)

Stages of shoulder abduction--------

§  Stages I –initial 15 to 30^O --------supraspinatous

§  Stage II—30 to  90-120^O----------deltoid (acromial fibres)

§  Stage III(Hyperabduction)—90-120 to 180^O------- trapezius,serratus anterior

From 120-150^O----------- infraspinatus is more active than supraspinatous

gram negative cocci & bacilli

Gm-ive bacteria

§  Gram-negative cocci-------	§  Gram-negative bacilli ----------
Neisseria gonorrhoeae, Neisseria meningitidis, Moraxella catarrhalis	Hemophilus influenzae,  Klebsiella pneumoniae,  Legionella pneumophila, Pseudomonas aeruginosa, Escherichia coli,  Proteus mirabilis,  Enterobacter cloacae,  Serratia marcescens, Helicobacter pylori, Salmonella enteritidis,  Salmonella typhi

RUNYON CLASSIFICATION

Runyon classification

Slowly growing Mycobacteria	Runyon IV: Rapid Growers
Runyon I: Photochromogens produce a yellow-orange pigment when exposed to light §  Mycobacterium kansasii,  §  Mycobacterium marinum,  §  Mycobacterium simiae Mycobacterium asiaticum §	colonies in 5 days do not produce pigment.  §  Mycobacterium fortuitum,  §  Mycobacterium chelonae,  §  Mycobacterium peregrinum,  §  Mycobacterium abscessus, §  Mycobacterium thermoresistible Some rapidly growing mycobacteria are considered "late-pigmenting"
Runyon II: Scotochromogens produce a yellow-orange pigment in light or in the dark. Some become darker with exposure to light §  Mycobacterium scrofulaceum, §  Mycobacterium gordonae,  §  Mycobacterium szulgai,  §  Mycobacterium xenopi,  §  Mycobacterium celatum,  §  Mycobacterium flavescens
Runyon III: Nonchromogenic do not produce pigment some may produce very pale yellow, buff, or tan pigment but do not intensify upon light exposure §  Mycobacterium avium-intracellulare,  §  Mycobacterium paratuberculosis,  §  Mycobacterium terrae,  §  Mycobacterium shimoidae,  §  Mycobacterium genavense