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 Overview : The vulva is a part of the female reproductive system and is also part of the external genitalia. The vulva consists of labia minora, labia majora, mons pubis, clitoris, vestibular bulb, vulval vestibule, urinary meatus the vaginal opening, hymen, and Bartholin's glands. other parts of the vulva include sebaceous glands, urogenital triangle, and pudendal cleft. Pelvic floor muscles support the structures of the vulva and vulva including the entrance to the vagina. Vulva goes through changes during childhood, puberty, menopause, and post-menopause. Structure: A) Mons pubis: it is present in both sexes and act as a cushion during sexual intercourse and is more pronounced in female. the mons pubis is a soft fatty tissue at the front of the vulva in the pubic region covering the pubic bone. the lower part of the mons pubis is divided by a fissure called pudendal cleft. it separates mons pubis and labia majora, the mons pubis, and labia majora get covered by pubic hair at pu...

OVERVIEW : Perineum in humans is a diamond-shaped space at the lower end of the trunk between two thighs. The perineum forms the lower end of the pelvis and external genitalia are located in the perineum. In the male perineum, there are two openings one for the digestive system and the other for the urinary and genital system. In females, there are three openings one for the digestive system, one for the urinary system, and one for the genital system. The perineal body is the most important structure in the perineum which supports the reproductive system, especially in females. Unrepaired injury to the perineal body can lead to prolapse of the uterus. BOUNDARIES OF THE PERINEUM : A) Scrotum in the front B) Buttocks in the back C) Inner sides of the thighs on both sides. DIVISIONS OF THE PERINEUM : The perineum is divided into two triangular areas as follows - 1) Anal region: anal region as the name suggests contains the anus or digestive system opening in both males and females. Bounda...

OVERVIEW : The rectum is the last part of the large intestine and is placed between the sigmoid colon above and the anal canal below. Ironically the name comes from Latin rectum intestinal which means a straight line, but the rectum is not curved and is actually curved in front to back direction and also inside to side direction. Distension of the rectum causes the desire to defecate. LOCATION AND EXTENT :  The rectum is located in the posterior part of the pelvis right in front of the sacrum and coccyx. The rectum begins as a continuation of the sigmoid colon at the level of the 3rd sacral vertebra. The rectum ends by becoming continuous with the anal canal at the anorectal region. The anorectal junction lies 2-3 cm in front and a little below the tip of the coccyx. DIMENSIONS : In humans the rectum is 12 cm long, in the upper part, it has the same diameter of 4 cm as of sigmoid colon but in the lower part, it is dilated to form rectal ampulla. COURSE AND DIRECTION : Rectum first ...

 The penis is the external male genital organ that serves the purpose of the male organ of copulation as well as the urinal duct reaching its full size during puberty. PARTS OF PENIS : A) Root - the root of the penis is made of two erectile tissue as follows  1) Crus: They are two in number and are covered by ischiocavernosus muscle. 2) Bulb: it is located between two crura and covered by bulbospongiosus muscle. It is pierced by the urethra to reach the body of the penis and the urethra shows dilation within the bulb called the navicular fossa. B) Body of the penis - it is a continuation of the root of the penis and is completely covered by skin. The body of the penis is made of the three erectile masses and during the erection, these masses become engorged with blood leading to the erection and they are as follows;- 1) Corpora cavernosa: they are two in number and are a continuation of the root of the penis and are located on either side of the corpus spongiosus and they d...

OVERVIEW : The scrotum is the male external genital organ located at the base of the penis next to the upper thighs. It is a dual-chambered sac of skin that contains testicles, the two oval glands responsible for producing and storing sperm. The scrotum is hanging away from the body as it requires a slightly lower temperature for sperm production than the rest of the body. Scrotum also acts as a protective layer for inside structures like the testis and other major blood vessels. The left scrotum hangs a little lower than the right scrotum. In the influence of cold and in young person scrotum is corrugated and closely applied to the testis and in warm conditions and in old person scrotum is elongated and flaccid. STRUCTURE OF SCROTUM : Externally scrotum is divided into right and left parts by a ridge called the perineal raphe which joins with the internal septum of the scrotum. A) Layers of scrotum:- The scrotum is made of the following structures from outside-inwards : 1) Skin - it i...

Overview - Rheumatoid arthritis is an autoimmune disorder that is characterized by inflammation of the joints. Rheumatoid arthritis typically affects smaller joints in the initial stages mainly of the hands and feet. It can affect the neck but spare the other parts of the spine and never affect the sacroiliac joints. Rheumatoid arthritis is more common in females with a female: male ratio of 3:1. It can occur at any age but the peak incidence is in a fourth or fifth decade for females and sixth or eighth decade for males. Rheumatoid arthritis is passed on to the generations(genetic) with males being carriers of the disease in many cases. Untreated cases of rheumatoid arthritis can cause joint erosions and consequent disability of the joint. Quick facts about rheumatoid arthritis - 1) Rheumatoid arthritis has no cure. 2)It significantly decreases life expectancy. 3)The exact cause of rheumatoid arthritis is unknown. 4)Rheumatoid arthritis is a genetic disease. 5)Heart di...

mesothelioma treatment mesothelioma can be treated at all stages and there are several treatment options for patients with mesothelioma. though these treatments do not cure the disease but can increase life expectancy and improve the quality of life. combination of surgery, chemotherapy, and radiotherapy is the most common form of mesothelioma treatment. the overall outcome depends on the stage and the type of mesothelioma. mesothelioma treatment by type : 1) pleural mesothelioma: pleural mesothelioma can be treated with 2 surgical options A)Extrapleural pneumectomy: This is a treatment option for early-stage mesothelioma with the most promising results amongst all other surgical options for mesothelioma. hence early diagnosis is a crucial step. this surgery is developed by Dr.David Sugarbaker. SURGERY: 1) Preoprative traetment  chemotherapy with cisplatin and pemetrexed prior to surgery is very effective. combination of these two drugs is more effec...

Perineal care also called  peri-care or perineal genital care is a procedure involving washing of the perineal area with soap and water or by any commercially prepared peri-wash. The perineal area is prone to infections as it is warm, moist, and not well ventilated. In a normal person, a daily bath is enough to prevent any perineal infections but, in some cases,  perineal care is required for a certain period of time. What are indications of perineal care : 1)Postpartum females with repaired perineal tears. 2)Patients with genitourinary tract infections. 3) Patients recovering from surgeries of the genital region. 4) Patients suffering from incontinence. 5) Patients who are unable to do self-care. Preparation of the patient : Thoroughly wash your hands and medical gloves before you begin the procedure. Explain the procedure to the patient and take the consent before starting the procedure. Tell the patient to separate legs if the patient is unable to do that caregiver will...

A perineal tear is the laceration of skin and other soft tissue of the perineum which is the area separating the vaginal opening and the anus. The perineal tear is the most common form of obstetric injury and occurs as a result of childbirth in women. While minor tears are quite common and require no treatment, gross injury is a result of the mismanaged second stage of the labour and can cause significant bleeding and dysfunction. What is the difference between perineal tear and episiotomy? A perineal tear is different from episiotomy in which the perineum is intentionally incised for ease of delivery. An episiotomy is generally done in the second stage of the labour under local anaesthesia and is done to prevent perineal tear and facilitate easy delivery of the baby whereas, a perineal tear is a result of the overstretched perineum. Your doctor(an obstetrician) should take your consent prior to doing the episiotomy. How are  perineal tears classified? Perineal tears ca...

Spinal stenosis - causes | symptoms | treatment  Overview Spinal stenosis is a narrowing of a spinal canal. It is a senile disease occurring most commonly in patients aged 50 years or more, the risk of getting spinal stenosis increases with age, and males are affected more than females. The most common site for spinal stenosis is a lumbar spine affecting nearly 70% of the cases. Osteoarthritis and disc herniation are the most common causes of  spinal stenosis . Symptoms and signs - 1) Worsening of pain on extension of the spine, on examination patient show limited movements of the lumbar spine due to severe pain. Extension of the spine may also produce leg symptoms. 2) Leg symptoms - pain in legs (single or bilateral) after walking for several minutes and relieved on sitting. This phenomenon is called neurogenic claudication. Treatment of spinal stenosis - Early treatment in spinal stenosis help to avoid complication and improve the quality of life of a patien...

Frozen shoulder (Adhesive capsulitis): Symptoms | Diagnosis | Treatment Overview Frozen shoulder also is known as adhesive capsulitis is a common condition in people aged 40 - 65 years and is characterized by stiffness and pain in the shoulder joint. Symptoms typically begin gradually and worsen over time. It is more common in women and people with disorders like diabetes and thyroid. It can occur due to trauma, immobility, or reduced mobility as seen in patients recovering from other medical conditions. However, the exact cause of the disease is not yet clear. Treatment is mainly aimed at reducing pain and stiffness and restoring the function of the joint. Frozen shoulder/Adhesive capsulitis is a self-limiting disease and the usual recovery time is around 2-3 years. What are the symptoms of the frozen shoulder? Pain and stiffness along with the limited range of motion with both active and passive movements are the principal symptoms. However, the disease progresses slo...

Rotator cuff tear - symptoms | Diagnosis | Treatment - Sentelhealth Your shoulders do a lot of things that you might take for granted. The shoulder joint is one of the most important joints in the body and has a maximum range of motion. Movements at the shoulder joints are especially important in sports like tennis, baseball, and swimming and to perform such activities the joint has to be very stable and has to be well supported and that is the rotator cuff's function. It is a group of muscles that provides stability and strength to the shoulder joint. Injury or a tear to such a group of muscles can cause a significant effect on the quality of a life. Rotator cuff tear can be caused by acute injuries related to falling on an outstretched hand or pulling on the shoulder. It can also be caused by repetitive overhead activities and lifting. The most commonly affected tendon in rotator cuff tear is the supraspinatus tendon.  Rotator cuff tears can be classified as : 1) Part...

Subacromial/Shoulder impingement syndrome - symptoms | diagnosis | treatment overview subacromial/shoulder impingement syndrome  also known as the swimmer's shoulder is an inflammation of the muscles in the shoulder area. The condition is commonly seen in active people and risk increases with age. It is one of the most commonly seen conditions in outpatient clinics and is related to muscle strength imbalances, rotator cuff tear, and poor scapula control. Pain, instability, and weakness with loss of range of motion are common presenting complaints. With any shoulder problem, it is important to inquire about the patient's occupation, recreational activities, and hand dominance as it helps to understand how it affected the quality of life of a patient. For eg., an athlete can complain of pain with mild impingement while an elderly even with full-thickness rotator cuff tear can have no symptoms. shoulder impingement syndrome is one of the most common causes of shoulder p...

Shoulder pain relief - Shoulder pain remedies Pain in the shoulder is a fairly common issue, we don't think about our shoulder until we experience sudden and sharp pain in the shoulder. The chances of getting shoulder pain increases as you age and there are a variety of causes of shoulder pain ranging from a simple act of grabbing something overhead to serious medical conditions like arthritis and heart attack. Some of the common causes of shoulder pain include : 1)Muscle strain 2)Rotator cuff injuries 3)Arthritis 4)Bursitis 5)Tendonitis 6)Rheumatoid arthritis 7)Heart attack (in heart attack pain is referred to the shoulder and to the medial aspect of the hand) Treatment of the shoulder pain Treatment of shoulder pain depends on the underlying cause for the pain, shoulder pain due to simple injuries can be treated at home with primary treatment while serious shoulder injuries need medical and surgical treatment. Getting shoulder pain relief can...

Left lower back pain - causes | symptoms | Treatment  Overview Lower back pain is a fairly common issue. According to the American chiropractic association, 80% of the population in the U.S. suffers from back pain in their lifetime. when the back pain is isolated to one side it may indicate something minor like a simple muscle spasm/strain which can be relieved by simple medications and rest or an underlying serious condition. The pain in the lower left back can come suddenly or grow slowly over a period of time. It can be a sharp or dull ache type of pain. The pain can radiate from bones, joints, ligaments and internal organs. Causes - The lower back pain isolated to one side can be caused by either one or the combination of the following causes 1)Trauma  Trauma to the muscles, joints, ligaments and bones in the lower back accounts for the most number of cases of  lower left back pain . Muscle strains are the most common cause of  lower left back pai...

References for erectile dysfunction : Inman BA et al. A population-based, longitudinal study of erectile dysfunction and future coronary artery disease. Mayo Clin Proc 84:108, 2009 Doggrell SA: Comparison of clinical trials with sildenafil, vardenafil, and tadalafil in erectile dysfunction. Expert Opin Pharmacother 6:75, 2005  Esposito K et al: Effect of lifestyle changes on erectile dysfunction in obese men: A randomized controlled trial. JAMA 291:2978, 2004 Bhasin S et al: Sexual dysfunction in men and women with endocrine disorders.  Pauls RN et al: Female sexual dysfunction : Principles of diagnosis and therapy. Obstet Gynecol Surv 60:196, 2005 Lancet 369:597, 2007 Burnett AL: Erectile dysfunction . J Urol 175:S25, 2006 Cappelleri  JC et al: A 5-year review of research and clinical experience. Int J Impot Res 17:307, 2005  SR et al: Endocrine aspects of female sexual dysfunction. J Sex Med 1:82, 2004 PM et al: Sexual...