By K. Larson. Denver Seminary.

A pregnant or breastfeeding woman needs extra foods discount raloxifene 60 mg with mastercard, especially those that are good sources of iron buy 60 mg raloxifene overnight delivery. Pregnant women need at least one additional meal (200 Kcal) per day during the pregnancy buy raloxifene 60 mg low cost. She should reduce her involvement in strenuous household tasks that lead to higher energy expenditure. Pregnant women should take vitamin A rich foods (such as papaya, mango, tomato, carrot, and green leafy vegetable) and animal foods (such as fish and liver). In the malarious areas, pregnant women should sleep under an insecticide- treated bed net. Pregnant women during the third trimester of pregnancy should be de- wormed using mebendazole or albendazole (you will learn about the doses for this in Study Session 7 of this Module). This should include as far as possible food from the different food groups (animal products, fruits, vegetables, cereals and legumes). A pregnant or lactating woman can get extra foods by eating a little more of ordinary meals. She should increase the amount of nourishment at one or two meals, not every meal. They may be anaemic, which in turn means that they may have difficulty in pregnancy and childbirth. A pregnant or breastfeeding mother should have enough iron to keep herself and her baby healthy. She should eat plenty of iron-rich foods every day such as dried beans, legumes, dark green leafy vegetables, liver, kidney and heart. A pregnant mother should go for her first antenatal care visit at the latest by the fourth month of her pregnancy. At the clinic, check her urine for excess sugar and proteins, and her blood for malaria (if she is showing signs of infection). You diagnose anaemia in the following way: Examine the lower eyelids, the inside of the lips and the palms which should be bright pink; if there is anaemia, all of these will be pale whitish. Give the mother iron tablets or tablets with iron and folate to build strong blood 27. If the iron tablets upset the mother or cause side effects, she should not stop taking iron, but eat more leafy vegetables. As a Health Extension Practitioner it is important that you identify the women who may need extra help and support. Encourage them to eat as good mixture of foods as they can afford (fruits, vegetables, animal source foods). Encourage other members of the household to do some of the work and lessen the work burden on the woman.

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The spinal nerve tracks up through the chain until it reaches the superior cervical ganglion discount raloxifene 60 mg visa, where it synapses with the postganglionic neuron (see Figure 15 purchase raloxifene 60mg line. The cervical ganglia are referred to as paravertebral ganglia buy raloxifene 60mg lowest price, given their location adjacent to prevertebral ganglia in the sympathetic chain. Additional branches from the ventral nerve root continue through the chain and on to one of the collateral ganglia as the greater splanchnic nerve or lesser splanchnic nerve. For example, the greater splanchnic nerve at the level of T5 synapses with a collateral ganglion outside the chain before making the connection to the postganglionic nerves that innervate the stomach (see Figure 15. Collateral ganglia, also called prevertebral ganglia, are situated anterior to the vertebral column and receive inputs from splanchnic nerves as well as central sympathetic neurons. They are associated with controlling organs in the abdominal cavity, and are also considered part of the enteric nervous system. The three collateral ganglia are the celiac ganglion, the superior mesenteric ganglion, and the inferior mesenteric ganglion (see Figure 15. The word celiac is derived from the Latin word “coelom,” which refers to a body cavity (in this case, the abdominal cavity), and the word mesenteric refers to the digestive system. Instead, it projects through one of the splanchnic nerves to a collateral ganglion or the adrenal medulla (not pictured). Because the sympathetic ganglia are adjacent to the vertebral column, preganglionic sympathetic fibers are relatively short, and they are myelinated. A postganglionic fiber—the axon from a ganglionic neuron that projects to the target effector—represents the output of a ganglion that directly influences the organ. Compared with the preganglionic fibers, postganglionic sympathetic fibers are long because of the relatively greater distance from the ganglion to the target effector. The problem with that usage is that the cell body is in the ganglion, and only the fiber is postganglionic. The adrenal medulla releases signaling molecules into the bloodstream, rather than using axons to communicate with target structures. The cells in the adrenal medulla that are contacted by the preganglionic fibers are called chromaffin cells. These cells are neurosecretory cells that develop from the neural crest along with the sympathetic ganglia, reinforcing the idea that the gland is, functionally, a sympathetic ganglion. The projections of the sympathetic division of the autonomic nervous system diverge widely, resulting in a broad influence of the system throughout the body. As a response to a threat, the sympathetic system would increase heart rate and breathing rate and cause blood flow to the skeletal muscle to increase and blood flow to the digestive system to decrease. All of those physiological changes are going to be required to occur together to run away from the hunting lioness, or the modern equivalent.

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This distinguishes the small intestine from the stomach raloxifene 60mg with mastercard; that is generic raloxifene 60mg on-line, enzymatic digestion occurs not only in the lumen raloxifene 60 mg, but also on the luminal surfaces of the mucosal cells. This is because chyme from the stomach is typically hypertonic, and if large quantities were forced all at once into the small intestine, the resulting osmotic water loss from the blood into the intestinal lumen would result in potentially life-threatening low blood volume. In addition, continued digestion requires an upward adjustment of the low pH of stomach chyme, along with rigorous mixing of the chyme with bile and pancreatic juices. Both processes take time, so the pumping action of the pylorus must be carefully controlled to prevent the duodenum from being overwhelmed with chyme. Small Intestine: Lactose Intolerance Lactose intolerance is a condition characterized by indigestion caused by dairy products. It occurs when the absorptive cells of the small intestine do not produce enough lactase, the enzyme that digests the milk sugar lactose. In contrast, some human populations, most notably Caucasians, are able to maintain the ability to produce lactase as adults. Symptom severity ranges from mild discomfort to severe pain; however, symptoms resolve once the lactose is eliminated in feces. Those with lactose intolerance exhale hydrogen, which is one of the gases produced by the bacterial fermentation of lactose in the colon. After the hydrogen is absorbed from the intestine, it is transported through blood vessels into the lungs. The primary function of this organ is to finish absorption of nutrients and water, synthesize certain vitamins, form feces, and eliminate feces from the body. Despite its being about one-half as long as the small intestine, it is called large because it is more than twice the diameter of the small intestine, about 3 inches. Subdivisions The large intestine is subdivided into four main regions: the cecum, the colon, the rectum, and the anus. The ileocecal valve, located at the opening between the ileum and the large intestine, controls the flow of chyme from the small intestine to the large intestine. However, at least one recent report postulates a survival advantage conferred by the appendix: In diarrheal illness, the appendix may serve as a bacterial reservoir to repopulate the enteric bacteria for those surviving the initial phases of the illness. Moreover, its twisted anatomy provides a haven for the accumulation and multiplication of enteric bacteria. Upon entering the colon, the food residue first travels up the ascending colon on the right side of the abdomen. At the inferior surface of the liver, the colon bends to form the right colic flexure (hepatic flexure) and becomes the transverse colon. Food residue passing through the transverse colon travels across to the left side of the abdomen, where the colon angles sharply immediately inferior to the spleen, at the left colic flexure (splenic flexure). From there, food residue passes through the descending colon, which runs down the left side of the posterior abdominal wall.

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