A live show where the audience participate in a human dissection after tucking into a slap up meal is coming to Cardiff .

After selling out venues across the UK earlier this year, Anatomy Lab LIVE returns but even bigger, or even more disgusting, than ever before.

The show is a touring hands-on post-mortem suite, which serves a sumptuous two-course dinner to guests before the gory procedure begins.

Guests will will be given mortuary wear including protective surgical hats, masks and aprons as well as scalpels, scissors, forceps and bone saws before attempting a post mortem dissection, lead by the show's experts.

Those with a tough stomach will also be wined and dined, shortly before Samuel Piri and Scarlett Mellor will begin the dissection of VIVIT the world's only semi-synthetic human cadaver.

There will be an in-depth observation of various disease states before the mortuary technicians bring samples out into the audience for a closer look.

It will take place at The Village Hotel in Cardiff.

On Saturday, February 24.

The inner anatomy of the head including the cranial cavity, brain, spinal cord and the jaw.

The trachea, lungs, heart and diaphragm.

The digestive tract, including the stomach, liver, gall bladder, small intestine, large intestine, rectum and anus.

All of VIVITs organs come from pigs because of their anatomical similarities with humans.

Audiences will have the chance to put their questions to the anatomist and to leading medics who will be him on stage. Various samples will then be placed around the room in small pods where people will don surgical wear to dissect the samples revealing their internal structures.

You will get to:

There'll be an option of chicken or vegetarian.

Yes the event is for 16+.

Ticket prices start from 70 per person online from Eventbrite or you can buy a group ticket for six people for 430.

The cost includes a two-course sit down meal before the dissection starts. Vegetarian options can be requested in advance.

You can contact the box office on 01675 479818 Monday to Saturday 9am-8pm and Sundays from 10am-5pm.

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Anatomy Lab LIVE returns to Cardiff and this is when you can see it - WalesOnline

Now PlayingGrey's Anatomy Deleted Scene: Catherine Almost Side-Lined Bailey Over Karev

It turns out Karev's (Justin Chambers) violent takedown of DeLuca (Giacomo Gioniotti) at the end of Season 12 had even more ramifications than fans knew.

TV Guide has obtained a deleted scene from the Grey's Anatomy Season 13 DVD set that reveals the fallout from Karev's arrest for DeLuca's beatdown almost got Bailey (Chandra Wilson) sidelined as Chief of Surgery. In the wake of Karev leaving the hospital in handcuffs, Catherine (Debbie Allen) came in guns blazing and questioned if Bailey was ready to do what needed to be done if their pediatric resident was being arrested for aggravated assault.

Bailey wasn't ready to fire Karev before finding out the full story, but she wasn't ready to let Catherine bring in someone else either -- thank God. We all know how it turned out later in the season when Catherine steamrolled Bailey into bringing someone else into the hospital (Hello, Minnick!). Bailey never did fire Karev, and that ended up working out for everyone, except maybe DeLuca.

Grey's Anatomy Mega Buzz: Are Maggie and Jackson Actually a Thing?

Luckily, Bailey is still sitting pretty as Chief of Surgery and everything seems to have worked out -- for now.

Grey's Anatomy returns with a two-hour premiere on Thursday, Sept. 28 at 8/7c on ABC.

Visit link:
Grey's Anatomy: Catherine Almost Sidelined Bailey Over Karev's Assault - TV Guide

Abstract

In men and in women, middle age brings about changes to the reproductive system that eventually lead to infertility although men stay fertile for longer. These changes are partly due to dramatic fluctuations in the production of sex hormones such as oestrogen, progesterone and testosterone. In the perimenopause and menopause, most women experience physical and psychological symptoms that can be extremely disruptive. Although less dramatic, the changes prompted in men by the andropause can lead to erectile dysfunction and a loss of libido. Article 8 in our series on the effects of ageing explores the changes occurring in the female and male reproductive systems, and the role of hormone replacement therapy.

Citation: Knight J, Nigam Y (2017) Anatomy and physiology of ageing 8: the reproductive system. Nursing Times [online]; 113: 9, 44-47.

Authors:John Knight is senior lecturer in biomedical science; Yamni Nigam is associate professor in biomedical science; both at the College of Human Health and Science, Swansea University.

Throughout the fertile years, the male and female reproductive organs (testes and ovaries) produce gametes (sperm and ova) which, through sexual intercourse, may fuse to form an embryo. The production of gametes is orchestrated by a cascade of hormones and growth factors, many of which have complex effects on the body. In middle and old age, the reproductive systems undergo significant changes: a gradual decline in fertility and fluctuations in the production of sex hormones, the latter triggering anatomical and physiological changes in distant organs and tissues. This article examines these changes and explores some of the treatments available to alleviate their consequences.

As women age, there is a progressive decline in the number of ovarian follicles, which gains speed in the fourth decade of life; the number and quality of ova diminish and oestrogen production declines, which in most women triggers the menopause around the age of 51. The speed of ovarian ageing is determined primarily by genetics, although oxidative stress, apoptosis and environmental factors also play a role. Premature ovarian failure (POF) can be triggered by surgery, radio- or chemotherapy, autoimmune reactions, and infections caused, for example, by the mumps virus and cytomegalovirus (Amanvermez and Tosun, 2016; Broekmans et al, 2009).

In women, the first episode of menstrual bleeding (menarche) marks the onset of puberty. The prime child-bearing years correspond to the period between menarche and perimenopause (Dutton and Rymer, 2015). Before the menopause, when menstruation ceases and women become infertile, the hormones that drive the menstrual cycle start to fluctuate. This perimenopausal phase, which can last 2-10 years, is often accompanied by increasing irregularity of the menstrual cycle. Although perimenopausal women are still fertile, pregnancy becomes more difficult.

The symptoms of the perimenopause are similar to those of the menopause. Some women experience few symptoms, but for others the perimenopause can be extremely challenging, since fluctuating hormone levels can cause physical and psychological symptoms such as hot flushes, night sweats, mood swings and feelings of sadness (Wagner, 2016).

The irregular menstrual cycles characteristic of the perimenopause eventually cease completely. Strictly speaking, the menopause is the cessation of periods for 12 months (Goodman et al, 2011). In most of the world it occurs in the early 50s, with some variation. Around 95% of women go through the menopause between 44 and 56 years, the average age being 50.7 (Freeman, 2015). Many factors that precipitate POF can also trigger early menopause (Dutton and Rymer, 2015). Since no more ova are being released, it is impossible for postmenopausal women to become pregnant without fertility treatment.

Follicle-stimulating hormone (FSH), secreted by the pituitary gland, drives the menstrual cycle. It stimulates the development of ovarian follicles, and as these enlarge they secrete the female sex hormone oestrogen. In perimenopausal and menopausal women, FSH levels remain high or are higher than in premenopausal women but FSH is unable to stimulate follicular development. Eventually, follicular activity ceases altogether, leading to a rapid decline in oestrogen secretion.

Similarly, luteinising hormone, which triggers ovulation, is secreted at normal or higher than normal levels (Burger et al, 2007), but without mature follicles, no ova can be released so menopausal women become infertile.

As during puberty and pregnancy, the transition to and through menopause is associated with dramatic fluctuations in the sex hormones oestrogen and progesterone. Symptoms are diverse and sometimes unique to the individual, but there are four that most women experience to varying degrees: hot flushes, vaginal dryness, mood changes and sleep disturbances (Santoro et al, 2015).

Hot flushesAround three in four women experience hot flushes in the perimenopause and menopause. They are described as a rapid heat increase, particularly in the face, neck and chest, often with sweating and palpitations. The length of time women experience them varies between 4 and 10 years; most experience them every day and a third have more than 10 a day (Committee on Practice Bulletins Gynecology, 2014).

Hot flushes appear to be related to increased levels of FSH and decreased levels of oestrogen. Decreased oestrogen seems to affect serotonin levels in the hypothalamus, causing fluctuations in the set point of the thermoregulatory centre; this leads to vasodilation and increased blood flow in the skin (Santoro et al, 2015).

Vaginal atrophy and drynessThe menopause is associated with a loss of elasticity and shrinkage in the length of the vagina. The epithelial lining becomes thinner and infiltrated by neutrophils, while the production of natural lubricating secretions slows down, increasing the risk of tears, bleeding and infection. In this changing environment, faecally derived species of bacteria may become dominant over the lactobacilli populations typically seen in premenopausal women. Lactobacilli produce lactic acid, so their depletion reduces the acidity of the vagina, resulting in a neutral or alkali pH that can encourage the growth of Candida albicans and other micro-organisms (Milsom, 2006). These vaginal changes can make sexual intercourse uncomfortable or painful (dyspareunia), and can reduce libido; 27-60% of menopausal women are affected by vaginal dryness and dyspareunia.

Menopausal woman are also at risk of urinary incontinence: the bladder and urethra are sensitive to oestrogen (both have oestrogen receptors), so it seems likely that decreased oestrogen levels contribute to urethral shrinkage and urinary incontinence (Santoro et al, 2015). Breast tissue is also oestrogen sensitive and women often notice a loss of supporting connective tissue in the breasts (Chahal and Drake, 2007); age-related skin thinning and loss of skin elasticity can exacerbate this.

Mood changes and depressionFluctuating concentrations of FSH, oestrogen and progesterone are often associated with mood changes. Despite inconsistencies in the literature, it is generally accepted that normal fluctuations in hormone levels whether in the premenstrual stage of the menstrual cycle, during pregnancy or in the perimenopausal years can be associated with negative psychological symptoms. The perimenopause is also associated with poor memory and concentration, problems with other people and low self-esteem. Other psychological symptoms are anxiety, irritability and rapid mood swings, but not necessarily low mood (Freeman, 2015; Cohen et al, 2005).

A previous history of depression or premenstrual syndrome is associated with an increased risk of clinical depression in the perimenopause and menopause. Women may also have pre-existing pathologies such as metabolic syndrome, osteoporosis or cardiovascular disease that are associated with depression and depressive symptoms. It is unclear if there is an increased risk of clinical depression in the perimenopause (Freeman, 2015), so clinical depression should not be regarded as a normal feature of either perimenopause or menopause.

Sleep disturbancesSleep problems become more common with age. In women, the risk of insomnia is 41% greater than in men. Around 25% of women aged 50-64 report sleep problems rising to 50% in postmenopausal women (Santoro et al, 2015; Ameratunga et al, 2012). Many reasons for sleep disturbances during the menopause have been suggested: hot flushes and night sweats, anxiety, depressive symptoms and sexual dysfunction (Jehan et al, 2015). Not all studies agree that the menopause is directly linked to sleep problems. A recent study showed no statistically significant differences in sleep quality between premenopausal and menopausal women (Tao et al, 2016).

Decreased bone healthReduced oestrogen levels can lead to a decrease in bone density and increased risk of fractures. Menopausal women lose up to 15% of their bone mass (Riggs and Melton, 1986). Significant losses in the spongy bone of the vertebrae contribute to the curvature of the spine often seen in postmenopausal women with osteoporosis.

Shrinkage in the length of the Fallopian tubes, loss of ciliated epithelia and loss of mucosa have been reported (Hwang and Song, 2004). Since the Fallopian tubes are the site of fertilisation and are responsible for transporting the fertilised ovum to the uterus, these changes contribute to the age-related reduction in fertility, and may explain why older women are at increased risk of ectopic pregnancy (Bouyer et al, 2003).

The endometrium is the inner mucosal layer of the uterus that is shed during menstruation and then rebuilt under the influence of oestrogens. When oestrogen production decreases, this rebuilding is gradually compromised, until it becomes impossible and menstruation ceases.

The myometrium, the middle layer of the uterus, is composed almost entirely of smooth muscle fibres. In childbirth its contractions push the baby through the birth canal. In the menopause, it begins to shrink. Oestrogen helps to maintain the myometrium, so its reduction is thought to contribute to the loss of smooth muscle fibres although the mechanisms of myometrial atrophy remain unclear (Mwampagatwa et al, 2013).

The perimetrium the thin outer serous layer of the uterus appears to change little with age.

The cervix (neck of the womb) consists of a smooth muscle layer overlaid by a mucus-producing cervical epithelium. Cervical mucus is essential to female fertility, aiding sperm to pass through the cervical aperture and enhancing sperm motility and maturation. The menopause is associated with a reduction in cervical secretions which contributes to reducing fertility (Gorodeski, 2000).

Most men show an age-related reduction in testicular mass (Chahal and Drake, 2007) with an associated reduction in testosterone and sperm production. Since spermatozoa are produced in huge numbers, most men remain fertile until their 80s and 90s, although erectile dysfunction (ED) may be a problem. The sperm ducts, which carry sperm from the testes during ejaculation, gradually become less elastic because of an accumulation of collagen (sclerosis).

The secretions from the seminal vesicles and prostate gland, which form the semen in which sperm swim, decrease with age, so the volume of ejaculate is reduced. Due to the parallel decrease in sperm numbers, sperm concentration remains fairly constant, which helps maintain male fertility. Secretions from the prostate contain antibacterial factors, so their decrease may increase the risk of urinary tract infection.

A common age-related problem is benign prostatic hypertrophy (BPH), a gradual, non-malignant increase in the size of the prostate contributing to age-related micturition difficulties. BPH may cause symptoms that are similar to those of prostate cancer, so investigations may be needed to rule out malignancy.

Although most men do not experience the profound physiological and psychological changes that many women go through, they do undergo hormonal changes indicative of the so-called andropause often inaccurately referred to as the male menopause (Chahal and Drake, 2007). In their 30s, men start to experience a decline in serum testosterone levels of around 1-1.4% per year. This is thought to be due to a reduction in the number of interstitial cells that synthesise testosterone and a reduced availability of free testosterone in the blood (Matsumoto, 2002).

Compared with the literature on the perimenopause and menopause, there is little research on the andropause. Reduced testosterone levels are associated with various physiological and psychological changes:

Reduced testosterone levels can cause the penis to shrink, both in its flaccid and erect states. However, in most men, the earliest symptom of the andropause is a loss of libido, often accompanied with problems achieving an erection and maintaining it to the point of orgasm. The number of erections decreases and weaker erections become more common. Men who smoke or have pre-existing pathologies such as diabetes, blood pressure problems or atherosclerotic occlusion are at higher risk of ED. Today, ED can be treated by techniques such as counselling and medications such as sildenafil (Viagra) (Bansal, 2013).

Some effects of the perimenopause and menopause can be alleviated by hormone replacement therapy (HRT) usually either oestrogen alone or oestrogen and progesterone given orally or transdermally. HRT has been reported to be effective in:

Treating osteoporosis and reducing the risk of bone fractures;

HRT carries certain risks and there is growing evidence that HRT (particularly oestrogen plus progesterone) increases the risk of breast cancer (Sood et al, 2014). Evidence of other risks of HRT is conflicting.

There has been much research into the benefits and risks of HRT in women, but HRT in men going through the andropause has received less attention. Recent research has shown that testosterone replacement therapy (TRT) can have positive effects (Sofiajidpour et al, 2015).

However, increasing the level of circulating testosterone is associated with a variety of side-effects and risks including oily skin, acne, increased haematocrit count, gynaecomastia (breast tissue development) and increased risk of prostate cancer. The effect of TRT on cardiovascular health remains unclear (Nandy et al, 2008).

The ageing of the reproductive tracts, and the changes and symptoms brought about by the menopause and andropause, are inevitable. However, certain lifestyle changes may delay, or reduce the effects of the menopause or andropause although some of the evidence is contradictory.

Smoking is the main modifiable risk factor. The inhalation of cigarette smoke increases the risk of infertility and early menopause in women, and the same risks exist for women exposed to second-hand smoking (Hyland et al, 2016). In men, smoking increases the risk of ED and lowers sperm count and quality (Sengupta and Nwagha, 2014).

A low body mass index (BMI) and being undernourished are both associated with an earlier menopausal onset. The effect of an increased BMI is less clear: some studies show that it is linked with a later menopausal onset (Akahoshi et al, 2002), others suggest no influence (Hardy et al 2008). A high BMI and obesity seem to be associated with more severe hot flushes and other perimenopausal symptoms (Saccomani et al, 2017). In men, a high BMI is associated with lower circulating testosterone levels, which can exacerbate the effects of the andropause (Bansal, 2013).

Akahoshi M et al (2002) The effects of body mass index on age at menopause. International Journal of Obesity and Related Metabolic Disorders; 26: 7, 961-968.

Amanvermez R, Tosun M (2016) An update on ovarian aging and ovarian reserve tests. International Journal of Fertility and Sterility; 9: 4, 411-415.

Ameratunga D et al (2012) Sleep disturbance in menopause. Internal Medicine Journal; 42: 7, 742-747.

Bansal VP (2013) Andropause, a clinical entity. Journal of Universal College of Medical Sciences; 1: 2, 54-68.

Bouyer J et al (2003) Risk factors for ectopic pregnancy: a comprehensive analysis based on a large case-control, population-based study in France. American Journal of Epidemiology; 157: 3, 185-194.

Broekmans FJ et al (2009) Ovarian aging: mechanisms and clinical consequences. Endocrine Reviews; 30: 5, 465-493.

Burger HG et al (2007) A review of hormonal changes during the menopausal transition: focus on findings from the Melbourne Womens Midlife Health Project. Human Reproduction Update; 13: 6, 559-565.

Chahal HS, Drake WM (2007) The endocrine system and ageing. Journal of Pathology; 211: 2, 173-180.

Cohen LS et al (2005) Diagnosis and management of mood disorders during the menopausal transition. American Journal of Medicine. 118(Suppl 12B), 93-97.

Committee on Practice Bulletins Gynecology (2014) Management of menopausal symptoms. Obstetrics and Gynecology; 123: 1, 202-216.

Dutton PJ, Rymer JM (2015) Physiology of the menstrual cycle and changes in the perimenopause. In: Panay N et al (eds) Managing the Menopause: 21st Century Solutions. Cambridge: Cambridge University Press.

Freeman EW (2015) Depression in the menopause transition: risks in the changing hormone milieu as observed in the general population. Womens Midlife Health; 1: 2, 1-11.

Goodman NF et al (2011) American Association of Clinical Endocrinologists Medical Guidelines for Clinical Practice for the diagnosis and treatment of menopause. Endocrine Practice; 17(Suppl6): 1-25.

Gorodeski GI (2000) Effects of menopause and estrogen on cervical epithelial permeability. Journal of Clinical Endocrinology and Metabolism; 85: 7, 2584-2595.

Hardy R et al (2008) Body mass index trajectories and age at menopause in a British birth cohort. Maturitas; 59: 4, 304-314.

Hwang TS, Song J (2004) Morphometrical changes of the human uterine tubes according to aging and menstrual cycle. Annals of Anatomy; 186: 3, 263-269.

Hyland A et al (2016) Associations between lifetime tobacco exposure with infertility and age at natural menopause: the Womens Health Initiative Observational Study. Tobacco Control; 25: 6, 706-714.

Jakiel G et al (2015) Andropause state of the art 2015 and review of selected aspects. Menopause Review; 14: 1, 1-6.

Jehan S et al (2015) Sleep disorders in postmenopausal women. Journal of Sleep Disorders and Therapy; 4: 5, 1000212.

Matsumoto AM (2002) Andropause: clinical implications of the decline in serum testosterone levels with aging in men. Journals of Gerontology. Series A, Biological Sciences and Medical Sciences; 57: 2, M76-99.

Milsom I (2006) Menopause-related symptoms and their treatment. In: Erkkola R (ed) European Practice in Gynaecology and Obstetrics. No 9. The Menopause. Edinburgh: Elsevier.

Mwampagatwa IH et al (2013) Morpho-physiological features associated with menopause: recent knowledge and areas for future work. Tanzania Journal of Health Research; 15: 2, 93-101.

Nandy PR (2008) Male andropause: a myth or reality. Medical Journal Armed Forces India; 64: 3, 244-249.

National Institute for Health and Care Excellence (2017) Benefits and risks of hormone replacement therapy.

Riggs BL, Melton LJ (1986) Involutional osteoporosis. New England Journal of Medicine; 314: 26, 1676-1686.

Saccomani S et al (2017) Does obesity increase the risk of hot flashes among midlife women? A population-based study. Menopause [Epub].

Santoro et al (2015) Menopausal symptoms and their management. Endocrinology and Metabolisn Clinics of North America; 44: 3, 497-515.

Sengupta P, Nwagha U (2014) The aging sperm: is the male reproductive capacity ticking to biological extinction? Journal of Basic and Clinical Reproductive Sciences; 3: 1, 1-7.

Sofimajidpour H et al (2015) The effect of testosterone on men with andropause. Iranian Red Crescent Medical Journal; 17: 12, e19406.

Sood R et al (2014) Prescribing menopausal hormone therapy: an evidence-based approach. International Journal of Womens Health; 6: 47-57.

Tao MF et al (2016) Poor sleep in middle-aged women is not associated with menopause per se. Brazilian Journal of Medical and Biological Research; 49: 1, e4718.

Wagner D (2016) Perimenopause: The untold story. Obstetrics and Gynecology International Journal; 5: 1, 00139.

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Anatomy and physiology of ageing 8: the reproductive system - Nursing Times

Preface

Preface Commentary: The continuing relevance of anatomy in current surgical practice and research, R Shane Tubbs

Acknowledgements

Contributors

Historical introduction: A brief history of Gray's Anatomy, Ruth Richardson

Anatomical nomenclature

Bibliography of selected titles

Section 1 - CELLS, TISSUES AND SYSTEMS

Section Editor: Caroline B Wigley

1 Basic structure and function of cells, Abraham L Kierszenbaum

2 Integrating cells into tissues, Caroline B Wigley

3 Nervous system, Helmut Kettenmann

4 Blood, lymphoid tissues and haemopoiesis, Andrew JT George

5 Functional anatomy of the musculoskeletal system, Michael A Adams

6 Smooth muscle and the cardiovascular and lymphatic systems, Jeremy PT Ward

7 Skin and its appendages, John A McGrath, Joey E Lai-Cheong

Commentaries

1.1 Fluorescence microscopy in cell biology today, Dylan M Owen

1.2 Stem cells in regenerative medicine, Jonathan M Fishman, Paolo De Coppi, Martin A Birchall

1.3 Merkel cells, Ellen A Lumpkin

1.4 Metaplasia, Jonathan MW Slack, Leonard P Griffiths, David Tosh

1.5 Electron microscopy in the twenty-first century, Roland A Fleck

1.6 The reaction of peripheral nerves to injury, Rolfe Birch

Videos

Video 1.1 - Mitosis in a cell with fluorescently-labelled chromosomes and microtubules, Jonathon Pines, Daisuke Izawa

Video 1.5.1 - Diagnostic histopathology by electron microscopy, Roland A Fleck

Video 1.5.2 - Serial block face scanning electron microscopy(SBFSEM), Roland A Fleck

Section 2 - EMBRYOGENESIS

Section Editor: Patricia Collins

8 Preimplantation development, Alison Campbell, Patricia Collins

9 Implantation and placentation, Eric Jauniaux, Graham J Burton

10 Cell populations at gastrulation, Patricia Collins

11 Embryonic induction and cell division, Patricia Collins

12 Cell populations at the start of organogenesis, Patricia Collins

13 Early embryonic circulation, Patricia Collins

14 Pre- and postnatal development, Patricia Collins, Girish Jawaheer

15 Development of the limbs, Cheryll Tickle

Commentaries

2.1 Human anatomy informatics, Jonathan BL Bard, Paul N Schofield

2.2 An evolutionary consideration of pharyngeal development, Anthony Graham, Victoria L Shone

Videos

Video 8.1 - Human in vitro fertilization and early development, Alison Campbell

Video 9.1 - Ultrasound features of the maternal placental blood flow, Eric Jauniaux

Video 14.1 - Ultrasound features of the fetus at 26 weeks, Jonathan D Spratt, Patricia Collins

Section 3 - NEUROANATOMY

Section Editor: Alan R Crossman

16 Overview of the nervous system, Alan R Crossman, Richard Tunstall

17 Development of the nervous system, Zoltn Molnr

18 Ventricular system and subarachnoid space, Jacob Bertram Springborg, Marianne Juhler

19 Vascular supply and drainage of the brain, Paul D Griffiths

20 Spinal cord: internal organization, Monty Silverdale

21 Brainstem, Duane E Haines

22 Cerebellum, Jan Voogd

23 Diencephalon, Ido Strauss, Nir Lipsman, Andres M Lozano

24 Basal ganglia, Tipu Aziz, Erlick AC Pereira

25 Cerebral hemispheres, Guilherme C Ribas

Commentary

3.1 The resting human brain and the predictive potential of the default mode network, Stefano Sandrone

Videos

Video 18.1 - Interactive 3D rotation of the subarachnoid space, Jose C Rios

Video 18.2 - Interactive 3D rotation of the ventricles and cisterns, Jose C Rios

Video 19.1 - Rotational angiography of an intracranial aneurysm, Paul D Griffiths

Section 4 - HEAD AND NECK

Section Editor: Michael Gleeson

26 Head and neck: overview and surface anatomy, Michael Gleeson, Richard Tunstall

Head and Neck

27 External skull, Sue Black

28 Intracranial region, Juan C Fernandez-Miranda

29 Neck, John C Watkinson, Michael Gleeson

30 Face and scalp, Simon Holmes

Upper Aerodigestive Tract

31 Oral cavity, Barry KB Berkovitz

32 Infratemporal and pterygopalatine fossae and temporomandibular joint, Barrie T Evans

33 Nose, nasal cavity and paranasal sinuses, Claire Hopkins

34 Pharynx, Stephen McHanwell

35 Larynx, Stephen McHanwell

36 Development of the head and neck, Gillian M Morriss-Kay

Special Senses

37 External and middle ear, Michael Gleeson

38 Inner ear, David N Furness

39 Development of the ear, Susan Standring

40 Development of the eye, Jane C Sowden

41 Orbit and accessory visual apparatus, John G Lawrenson, Ronald H Douglas

42 Eye, Ronald H Douglas, John G Lawrenson

Commentaries

4.1 Surgery of the skull base, Juan C Fernandez-Miranda

4.2 The role of three-dimensional imaging in facial anatomical assessment, Vikram Sharma, Bruce Richard

4.3 Anatomy of facial ageing, Bryan C Mendelson, Chin-Ho Wong

Videos

Video 28.1 - 3D surface rotation of the sella turcica in the horizontal plane, Michael D Luttrell

Video 28.2 - 3D surface rotation of the sella turcica in the multiaxial plane, Michael D Luttrell

Video 28.3 - 3D surface rotation of the sella turcica in the vertical plane, Michael D Luttrell

Video 30.1 - Pan-facial fractures, Simon Holmes

Video 30.2 - Postoperative cranio-orbital imaging, Simon Holmes

Video 30.3 - A comminuted zygomatic fracture (plus Le Fort I) pattern, Simon Holmes

Video 30.4 - A comminuted zygomatic fracture pattern - post reduction, Simon Holmes

More:
Gray's Anatomy - 9780702052309 | US Elsevier Health Bookshop

Welcome to the Anatomy of a Goal, where each week we dissect one goal (or near goal) from Columbus Crew SCs previous match.

For match 28 of the 2017 MLS Season, we take a look at Ola Kamaras 50th minute goal that put Crew SC up 1-0 as part of the 2-1 win over FC Dallas on Saturday.

Heres a look at the finish from the Columbus striker.

The Black & Gold returned to the teams typical 4-2-3-1 against Dallas after a successful run with that formation during a midweek match with LA Galaxy. For the first half of the game, Crew SC saw more of the ball than the Hoops but were ultimately unable to put that ball into the back of the net.

This Columbus goal was an excellent example of the Gregg Berhalter system taking the team from one end of the field to the other. The goal begins with a short goal kick played from Zack Steffen to center-back Jonathan Mensah. As Jonathan is pressured by Maximiliano Urruti, he is able to find midfielder Mohammed Abu at the top of the penaty box.

With the ball at the top of the box, Abu can pass the ball forward to creative midfielder Federico Higuain, continue to carry the ball, play a square pass to Wil Trapp, drop a pass back to Jonathan, another drop to Steffen or yet another drop back to Josh Williams.

Abu decides to send the ball forward to Higuain, who is very briefly undefended.

However, Higuain senses the impending pressure from Kellyn Acosta, so he plays the ball back to Abu who has moved a few yards forward and is still unmarked.

Again, Abu provides an important link between the midfield, defense, and attack, with multiple options. He can either continue his dribble up the field, play a quick pass back to Higuain who is marked by Acosta, drop the ball back to Trapp or Williams or a pass up the field to left back Jukka Raitala.

Abu plays a pass up the field to Raitala and continues his run forward while tracked by Lamah.

With the ball at his feet, Raitala can do one of three things. He can play a pass up the sideline to Justin Meram, continue to dribble around Carlos Gruezo or a diagonal pass to Higuain.

Raitala carries the ball across midfield and then slots a pass over to Meram.

With the ball at his feet and very little space to operate, Meram can play a difficult through pass to Pedro Santos, knock a tough diagonal ball to Higuain or drop the ball back to Raitala.

Meram decides to force the ball into the area between Santos and Higuain, but Acosta is quick to pounce on the weak pass.

However, Kamara approaches the ball at the same time as Acosta. The forwards pressure causes Acosta to play a heavy touch on the ball, right into the body of Kamara.

The above video shows Kamara and Acostas battle for this ball, and the potential goal-voiding situation that resulted from this battle. As Acosta and Kamara clash, the ball pops up into the Crew SC players midsection. Both Acosta and Walker Zimmerman shout for a hand ball, but the official allows the play to continue.

Zoomed in, judge for yourself whether this was a handball. Acosta gave the referee his thoughts after the goal, but from here it looks like Kamara settles the ball with his chest/stomach and not his arm.

As with last weeks potentially offside goal, every play is reviewed by the video assistant referee. So, it appears that VAR decided that this was not a handball.

Having won the ball from Acosta, Kamara plays a quick pass over to Higuain.

At the top of the box, Higuain can continue to dribble toward the goal or play a through ball to Hector Jimenez.

Higuain could also chip a ball into the path of Kamara or Santos, but from this angle it is clear to see that both attacking players are offside.

Seeing little attacking space to move forward, Higuain plays a perfectly weighted through ball to Jimenez.

As Jimenez sprints toward Higuains pass, he must quickly decide whether to shoot or whether to cross the ball to Kamara or Santos. With Tesho Akindele bearing down, Jimenez has to play the ball with his first touch.

Jimenez approaches the ball, and squares his hips toward Kamara to play a cross on the ground toward the striker.

From the side angle, its clear that Kamara is onside right as Jimenez squares the ball.

Jimenezs pass is a half step behind Kamara, so the striker must alter his run in order to fire in a shot on goal.

Kamara contorts his body in order to get his foot behind the ball . . .

. . . and finds the back of the net.

Findings:

Excerpt from:
Anatomy of a Goal: Ola Kamara finishes the transition - Massive Report

Team Selection: Dj Vu

With the exception of Robbin Ruiter between the sticks, and Bryan Oviedo slotting in at left-back it was a case of Grayson fielding the same side that has played every other league game this season. Unfortunately they couldnt muster a performance worth cheering about.

Now, Im not going to be harsh here, because what other options does Grayson have? Weve got an incredibly thin squad that isnt blessed with strength in depth, and as Grayson has mentioned several times recently, were vulnerable to losing more players this week.

Either the side thats fielded secures the win, or we struggle through with few to call on when in need of inspiration. Khazri looked uninterested, Gibson isnt that kind of player, Asoro is inexperienced, and Gooch needs time. Its tough for Grayson, and theres little he can do to really change things up.

Verdict: What else can Grayson really do?

This is an area in which Sunderland can, and must, improve.

The 4-4-2 used thus far this season saw early success, but unfortunately its not particularly difficult to combat when you know what to expect. I spoke about this very issue in an article yesterday, and I really do think were tactically limited with the players at our disposal.

If anything, Grayson could revert to the 3-5-1-1 he used against Carlisle in order to provide a more stable core to the side, but the issue is a lack of creative options. McGeady cannot be expected to be the crux of our attack - he needs reinforcements.

If we want to be successful this season (whatever that may be construed as), we must secure quality additions before the week is out.

Verdict: We need more players to become more tactically flexible, and if we want to do well this season.

Grayson did try to shake things up, but as already mentioned we just dont have the personnel to make a real difference.

What else can Grayson do, though?

Right now either plan A works, or it doesnt and we try to hang on. Hopefully the next couple of weeks give the boss time to work on tactics and to bed new players (fingers crossed) into the side.

Verdict: The manager tried his best, but what else can he realistically do?

One thing Grayson had perfect was his comments in the wake of the defeat. Sunderland fans were upset with his sides commitment and quality - something Grayson acknowledged and will be keen to rectify:

They deserved to win the game because they did the basics right. They ran further and harder, they made tackles and that's what the Championship is about.

It's never acceptable to lose a game and it's certainly not acceptable to lose a game in the manner that we did.

He also noted the fact that players didnt stick to the plan, which of course wouldnt have helped one bit. In all it was pleasing to see him accept the anger of the fans - it makes me feel like hes not here merely to pay us lip service:

Too many players wanted to do their own individual stuff instead of playing for the shape of the team. Our fans had a go and rightly so.

Grayson has about two weeks to prepare his men for their next league game at home to Sheffield United on September 9th.

Verdict: Fair play! Hopefully we respond to that poor performance.

See the original post here:
Grayson's Anatomy: How did the Sunderland manager rate after Saturday's heavy defeat v Barnsley? - Roker Report (blog)

Johnni Macke 2:04 pm on August 28, 2017

(Photo Courtesy: ABC)

With Greys Anatomy heading into season 14 this fall, fans cant help but wonder how much longer the veteran drama will continue. Now, thanks to star Ellen Pompeo, theyre getting some insight into when the series might bid farewell.

During a recent interview withVariety,Pompeo, who plays the lead, Dr. Meredith Grey, revealed that the fate of Greys Anatomyis directly tied to her interest in continuing her role, explaining thatshowrunner Shonda Rhimes has committed to ending the show whenever the actress decides the time is right to walk away.

Shonda [Rhimes] and I have both said that when Im ready to stop, were going to stop the show, Pompeo told Variety in March about how much longer Greys might go on. The story is about Meredith Greys journey and when Im done, the show will end.

The good news is that Pompeo doesnt think that journey is close to ending just yet, and shes not ready to walk away from something that people love.

You dont walk away from something for nothing, she toldVariety, after pointing out that someday, when the audience feels the time as right, and she thinks Meredith has finished her mission (or journey), the drama will come to a close.

Im really open to whatever the universe presents. I dont know how long the show will go on. I know the network and the studio like to say they see no end in sight, but I think the audience will tell us when the show is no-longer a fan favorite, Pompeo continued. I think its quite arrogant to assume the show can go on forever I dont like that approach. Right now, were very lucky to have the fans still hanging on, and I think the fans will let us know when its time to stop the show.

Seeing as fans still cant seem to get enough of doctor drama and are BIG supporters of Pompeos character, were hoping the actress sticks with her plan to stay until the series meets its natural end.

Greys Anatomy returns for season 14 with a two-hour premiere on September 28, 2017 at 8 p.m. on ABC.

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Excerpt from:
Ellen Pompeo Reveals 'Grey's Anatomy' Will End When - People's Choice

By Crime and Justice News | 11 hours ago

The Washington Post analyzes the failure of police in Charlottesville, Va., to maintain control during the Aug. 12 showdown between white nationalists and counterprotesters.

Despite weeks of planning and warnings to the city manager and police chief that a more aggressive approach was needed, including an appeal from Gov. Terry McAuliffe, the local police in charge temporarily lost control of the city as people brawled on the streets. And though a torch-lit march the night before ended with white nationalists attacking college students, city officials said police stuck to a tactical plan that included an insufficient buffer zone between armed white nationalists and their armed opponents.

The police tactics mystified some law enforcement experts. Most dangerously, officers initially deployed without adequate protective gear to break up fighting and were not well positioned to keep the peace. As fights erupted, police stayed back. They stood not between the two opposing groups but behind them and off to the sides.

And when they cleared the park where rallygoers had gathered near a statue of Confederate Gen. Robert E. Lee, police flushed many of them directly onto the same street where counterprotesters were gathered. How do you allow two completely divergent and armed groups to come in contact with one another, knowing full well for weeks in advance that there were warnings of violence? said former Charlottesville police chief Timothy Longo, who now teaches about the use of force by police.

The rest is here:
Anatomy of Failure: How Charlottesville PD Lost Control - Crime Report (subscription)

The doctors of Greys Anatomy are sharing theirlove for Houston on Twitter.

Debbie Allen, who portrays Dr. Catherine Avery on the ABC show, posted a video to her Twitter account Monday alongsideChandra Wilson (Chief Miranda Bailey) and one of the shows writers Meg Marinis,to express well wishes for those facing dangerous weather conditions in Houston, Texas due to tropical storm Harvey.

Houston, we love you and we are thinking about you. From all of us at Greys Anatomy, say the three women in the clip. Allen, who is from Houston, also added a caption to the short video that shares a link to the Red Cross site, encouraging people to donate to the flooded city: To Houston from @GreysABC Help here: http://redcross.org.

RELATED:How to help the victims of Hurricane Harvey

The actress had previously tweeted a still from a news report with a caption, My hometown Houston God Speed. The photo shows victims of the flood being aided by good samaritan efforts after they had become trapped due to treacherous conditions and heavy rainfall.

Harvey has dumped some 25 inches of rain on Houston two days after the then-hurricane landfall northeast of Corpus Christi (around 220 miles southeast of Houston) Friday night. The extreme flooding has left many Houston residents stranded in their homes while emergency and rescue crews scramble to reach the overwhelming number of people calling for aid.

Greys Anatomy returns for its 14th season onThursday, Sept. 28 at 8 p.m. ET on ABC.

See the original post here:
Grey's Anatomy stars send love to Houston - EW.com

Together one last time. An hour after Taylor Swift released her new songLook What You Made Me Do on Thursday night, ABC unveiled a promo for its Thursday Shondaland TGIT lineup set to the provocative tune.

With Scandal heading into its final season, this is the last time the block will feature all three Shondaland series that launched it:Scandal, Greys Anatomy and How To Get Away With Murder. In typical Shonda Rhimes fashion, the promo is free of spoilers about the upcoming seasons of the three dramas, featuring all-old footage.

At least for one more season, TGIT will carry on Rhimes legacy at ABC where she has been for more than a decade, after she moves to her new Netflix home.

Watch the promo above.

Continue reading here:
TGIT Fall 2017 Promo: ABC Teases Return Of 'Scandal', 'Grey's Anatomy', 'HTGAWM' - Deadline