دانلود کتاب مامایی و زنان نتتر

No student of medicine, past or present, is unaware of the extraordinary series of medical illustrations created by Dr. Frank Netter. It is an incredible body of work that has been carried forward by the talented Carlos Machado, MD, John Craig, MD, and others since Dr. Netter’s passing. Older physicians have looked with envy at these images, wishing they had been available when they were learning; established physicians return to them as comfortable sources of information; and young physicians seek them out for the wealth of information they contain and their ability to make clear difficult clinical concepts. This spirit of concise reference and resource is the premise of this text. This fourth edition maintains the same consistent format in presenting topics to facilitate rapid access—the same information is in the same location—that was so well received in the first three editions. Chapters have been organized to provide a quick, concise resource for the diagnosis and treatment of common conditions encountered by anyone who provides care for women. In producing this fourth edition, more than 15 new topics have been added, terminology has been updated, evolving therapies have been incorporated, new artwork has been developed, all references have been updated, and subtle enhancements have been made throughout the work. It is the hope of all who contributed to this work that it will be both a useful resource and a celebration of the artistic richness that is clinical medicine. Genetic sex is determined by the complement and function of sex chromosomes (X and Y) that are present at the time of conception. A Y chromosome carrying specific genes is necessary for the development of testes. The testes are responsible for the organization of the sexual duct system into a male configuration and for the suppression of the paramesonephric (Müllerian) system responsible for female anatomic structures. In the absence of a Y chromosome, specifically required genes, or a functioning gonad, the development will be female. General phenotypic development of the female is viewed as a default event, although evidence of a more complex process is emerging. Sexual differentiation genes are located on the Y chromosome, the primary of which is the SRY gene, also called the testis-determining factor. The SRY gene is found on the short arm of the Y chromosome and influences Sertoli cell differentiation, mesonephric ridge cell development, and male architectural development of the gonad, including blood vessels and other structures of the testes. Several other genes, including those that express steroidogenic factor-1, WT1, and DAX1, on other chromosomes, are also necessary for normal testicular development. To date, multiple mutations of the SRY gene have been reported and all are associated with sex reversals (female phenotype).