SlideShare una empresa de Scribd logo
1 de 82
Thoracic and Lumbar Spine Anatomy
Lumbar Anatomy ,[object Object],[object Object],[object Object],[object Object],[object Object],1 2 3 4 5
Lumbar Spine Anatomy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],inferior Inferior superior Superior Anterior (oblique) A  Lateral  P Posterior (oblique) Superior
Lumbar Spine Anatomy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],1 3 4 5 6 2
Lumbar Spine Anatomy:  Nerve Structures ,[object Object],[object Object]
Lumbar Spine Anatomy:  Nerve Structures ,[object Object],[object Object],[object Object],Note: in this illustration, the posterior elements of the spine, along with the dura mater and arachnoid mater, are not shown.
Lumbar Spine Anatomy:  Nerve Structures ,[object Object],[object Object],Note: in this illustration, the posterior elements of the spine, along with the dura mater and arachnoid mater, are not shown.
Lumbar Spine Anatomy:  Vascular Structures ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Thoracic Vertebrae ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Thoracic Vertebrae and Rib Junction ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Spinal deformities
Introduction : ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
1-postural scoliosis : ,[object Object],[object Object],[object Object]
 
2-Structural scoliosis : ,[object Object],[object Object],[object Object],[object Object],[object Object]
 
 
 
 
Types of structural scoliosis : ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Clinical features : ,[object Object],[object Object],[object Object],[object Object],[object Object]
Examination: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Imaging: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
Cobb’s angle
 
Risser’s sign
 
Idiopathic scoliosis : ,[object Object],[object Object],[object Object],[object Object],[object Object]
1-adolescent idiopathic scoliosis : ,[object Object],[object Object],[object Object],[object Object]
 
Rx. : ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
Rx. : ,[object Object],[object Object],[object Object]
 
 
 
Complications : ,[object Object],[object Object]
Main Surgical Indications ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
2- juvenile idiopathic scoliosis : ,[object Object],[object Object],[object Object],[object Object]
3- infantile idiopathic scoliosis : ,[object Object],[object Object],[object Object],[object Object]
 
Osteopathic “congenital “ scoliosis : ,[object Object],[object Object],[object Object],[object Object],[object Object]
 
 
Neuropathic & myopathic scoliosis : ,[object Object],[object Object],[object Object],[object Object],[object Object]
Neuromuscular Deformity ,[object Object],[object Object],[object Object]
 
Neuropathic & myopathic scoliosis : ,[object Object],[object Object],[object Object],[object Object]
[object Object]
Neurofibromatosis ,[object Object],[object Object],[object Object],[object Object]
Post op.
 
 
 
Kyphosis:
Kyphosis : ,[object Object],[object Object],[object Object]
 
 
 
 
Thorax kyphosis
Types of kyphosis : ,[object Object],[object Object],[object Object],[object Object]
Congenital kyphosis : ,[object Object],[object Object],[object Object]
Failure of segmentation. Left: block vertebra. Right: unilateral unsegmented bar .
Adolescent kyphosis (Sheuermann’s disease) : ,[object Object],[object Object]
Clinical features : ,[object Object],[object Object],[object Object],[object Object],[object Object]
Examination : ,[object Object],[object Object],[object Object],[object Object]
Rare complications include : ,[object Object],[object Object],[object Object]
X-rays : ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Lateral X-ray
Preoperative lateral of a patient with an 85° thoracic deformity secondary to Scheuermann kyphosis .
Postoperative lateral
(Sheuermann’s disease) :
Kyphosis measure :
DDx. : ,[object Object],[object Object],[object Object]
Out come : ,[object Object],[object Object]
Rx. : ,[object Object],[object Object],[object Object]
Kyphosis in elderly ,[object Object],[object Object],[object Object],[object Object]
 
 
[object Object]

Más contenido relacionado

La actualidad más candente

Presentation1.pptx, normal spinal anatomy.
Presentation1.pptx, normal spinal anatomy.Presentation1.pptx, normal spinal anatomy.
Presentation1.pptx, normal spinal anatomy.Abdellah Nazeer
 
Femoroacetabular%20 impingement[1]
Femoroacetabular%20 impingement[1]Femoroacetabular%20 impingement[1]
Femoroacetabular%20 impingement[1]orthoprince
 
Acetabulum fractures
Acetabulum fractures  Acetabulum fractures
Acetabulum fractures orthoprince
 
Free hand screw
Free hand screwFree hand screw
Free hand screwSumit2018
 
Subaxial Cervical Spine Injuries
Subaxial Cervical Spine InjuriesSubaxial Cervical Spine Injuries
Subaxial Cervical Spine InjuriesSumit2018
 
Cervical Spine Trauma Imaging
Cervical Spine Trauma ImagingCervical Spine Trauma Imaging
Cervical Spine Trauma ImagingSCGH ED CME
 
Anatomy of lumber spine Nishant kumar gaurav
Anatomy of lumber spine Nishant kumar gauravAnatomy of lumber spine Nishant kumar gaurav
Anatomy of lumber spine Nishant kumar gauravNISHANTKUMARGAURAV1
 
Fractures and dislocations of hand
Fractures and dislocations of handFractures and dislocations of hand
Fractures and dislocations of handAftab Alam
 
Radiological measurements
Radiological measurementsRadiological measurements
Radiological measurementsnoorulain89
 
Bajammal 2006 Upper Cervical Trauma
Bajammal 2006 Upper Cervical TraumaBajammal 2006 Upper Cervical Trauma
Bajammal 2006 Upper Cervical TraumaSohail Bajammal
 
Developmental displasia of hip
Developmental displasia of hipDevelopmental displasia of hip
Developmental displasia of hipPriyesh Jaiswal
 
Atlanto-axial subluxation
Atlanto-axial subluxationAtlanto-axial subluxation
Atlanto-axial subluxationShashank Gandhi
 
Clinical spinal anatomy for students v2
Clinical spinal anatomy for students v2Clinical spinal anatomy for students v2
Clinical spinal anatomy for students v2ess_online
 
Cervical Disc Replacement
Cervical Disc ReplacementCervical Disc Replacement
Cervical Disc Replacementfathi neana
 
Spine anatomy and xray of spine ppt by Dr Pratik
 Spine anatomy and xray of spine ppt by Dr Pratik Spine anatomy and xray of spine ppt by Dr Pratik
Spine anatomy and xray of spine ppt by Dr PratikDr. Pratik Agarwal
 

La actualidad más candente (20)

Presentation1.pptx, normal spinal anatomy.
Presentation1.pptx, normal spinal anatomy.Presentation1.pptx, normal spinal anatomy.
Presentation1.pptx, normal spinal anatomy.
 
Scoliosis
Scoliosis Scoliosis
Scoliosis
 
Femoroacetabular%20 impingement[1]
Femoroacetabular%20 impingement[1]Femoroacetabular%20 impingement[1]
Femoroacetabular%20 impingement[1]
 
MRI LSS
MRI LSSMRI LSS
MRI LSS
 
Acetabulum fractures
Acetabulum fractures  Acetabulum fractures
Acetabulum fractures
 
Free hand screw
Free hand screwFree hand screw
Free hand screw
 
Subaxial Cervical Spine Injuries
Subaxial Cervical Spine InjuriesSubaxial Cervical Spine Injuries
Subaxial Cervical Spine Injuries
 
Cervical Spine Trauma Imaging
Cervical Spine Trauma ImagingCervical Spine Trauma Imaging
Cervical Spine Trauma Imaging
 
Anatomy of lumber spine Nishant kumar gaurav
Anatomy of lumber spine Nishant kumar gauravAnatomy of lumber spine Nishant kumar gaurav
Anatomy of lumber spine Nishant kumar gaurav
 
X-ray spine
X-ray spineX-ray spine
X-ray spine
 
Fractures and dislocations of hand
Fractures and dislocations of handFractures and dislocations of hand
Fractures and dislocations of hand
 
Radiological measurements
Radiological measurementsRadiological measurements
Radiological measurements
 
Bajammal 2006 Upper Cervical Trauma
Bajammal 2006 Upper Cervical TraumaBajammal 2006 Upper Cervical Trauma
Bajammal 2006 Upper Cervical Trauma
 
Developmental displasia of hip
Developmental displasia of hipDevelopmental displasia of hip
Developmental displasia of hip
 
Atlanto-axial subluxation
Atlanto-axial subluxationAtlanto-axial subluxation
Atlanto-axial subluxation
 
Scoliosis
ScoliosisScoliosis
Scoliosis
 
Clinical spinal anatomy for students v2
Clinical spinal anatomy for students v2Clinical spinal anatomy for students v2
Clinical spinal anatomy for students v2
 
MRI of the shoulder
MRI of the shoulderMRI of the shoulder
MRI of the shoulder
 
Cervical Disc Replacement
Cervical Disc ReplacementCervical Disc Replacement
Cervical Disc Replacement
 
Spine anatomy and xray of spine ppt by Dr Pratik
 Spine anatomy and xray of spine ppt by Dr Pratik Spine anatomy and xray of spine ppt by Dr Pratik
Spine anatomy and xray of spine ppt by Dr Pratik
 

Destacado

Anatomy of spine and autonomic ns
Anatomy of spine and autonomic nsAnatomy of spine and autonomic ns
Anatomy of spine and autonomic nsJoey Hulleza
 
Spine Examination And Scoliosis
Spine Examination And ScoliosisSpine Examination And Scoliosis
Spine Examination And Scoliosisdrkmliau
 
Poster Tl Sciatic Scoliosis
Poster Tl Sciatic ScoliosisPoster Tl Sciatic Scoliosis
Poster Tl Sciatic Scoliosislavosky
 
Imaging of thoracic spine Trauma
Imaging of thoracic spine TraumaImaging of thoracic spine Trauma
Imaging of thoracic spine TraumaSunil Jeph MD
 
Endocrine disorders of adrenal gland
Endocrine disorders of adrenal glandEndocrine disorders of adrenal gland
Endocrine disorders of adrenal glandSubhasish Deb
 
Summary of differentiating features of neurological deficits (motor)
Summary of differentiating features of neurological deficits (motor)Summary of differentiating features of neurological deficits (motor)
Summary of differentiating features of neurological deficits (motor)Christiane Riedinger
 
Visible Body - Sternocleidomastoid and the Scalene Muscles
Visible Body - Sternocleidomastoid and the Scalene MusclesVisible Body - Sternocleidomastoid and the Scalene Muscles
Visible Body - Sternocleidomastoid and the Scalene MusclesVisible Body
 
Intervertebral disc prolapse
Intervertebral disc prolapseIntervertebral disc prolapse
Intervertebral disc prolapseHari Chandan
 
spine examination by Dr.guru prasad
spine examination by  Dr.guru prasad spine examination by  Dr.guru prasad
spine examination by Dr.guru prasad sguruprasad311286
 
Intervertibral disc prolapse
Intervertibral disc prolapseIntervertibral disc prolapse
Intervertibral disc prolapsemohammedalhussein
 
Lumbar disc prolapse
Lumbar disc prolapseLumbar disc prolapse
Lumbar disc prolapseAnand Dev
 
Examination of spine
Examination of spineExamination of spine
Examination of spinegroup7usmkk
 
Lower limb anatomylect 2
Lower limb anatomylect 2Lower limb anatomylect 2
Lower limb anatomylect 2Yasir Jameel
 
Lower limb anatomy (hip and thigh)
Lower limb anatomy (hip and thigh)Lower limb anatomy (hip and thigh)
Lower limb anatomy (hip and thigh)Yasir Jameel
 
Spinal cord injuries | spine fracture | thoracolumbar fracture | colorado spi...
Spinal cord injuries | spine fracture | thoracolumbar fracture | colorado spi...Spinal cord injuries | spine fracture | thoracolumbar fracture | colorado spi...
Spinal cord injuries | spine fracture | thoracolumbar fracture | colorado spi...Dr. Donald Corenman, M.D., D.C.
 

Destacado (20)

Lumbar spine anatomy
Lumbar spine anatomy Lumbar spine anatomy
Lumbar spine anatomy
 
Anatomy of spine and autonomic ns
Anatomy of spine and autonomic nsAnatomy of spine and autonomic ns
Anatomy of spine and autonomic ns
 
Spine Examination And Scoliosis
Spine Examination And ScoliosisSpine Examination And Scoliosis
Spine Examination And Scoliosis
 
Poster Tl Sciatic Scoliosis
Poster Tl Sciatic ScoliosisPoster Tl Sciatic Scoliosis
Poster Tl Sciatic Scoliosis
 
Imaging of thoracic spine Trauma
Imaging of thoracic spine TraumaImaging of thoracic spine Trauma
Imaging of thoracic spine Trauma
 
Endocrine disorders of adrenal gland
Endocrine disorders of adrenal glandEndocrine disorders of adrenal gland
Endocrine disorders of adrenal gland
 
Pulmonary
PulmonaryPulmonary
Pulmonary
 
Summary of differentiating features of neurological deficits (motor)
Summary of differentiating features of neurological deficits (motor)Summary of differentiating features of neurological deficits (motor)
Summary of differentiating features of neurological deficits (motor)
 
Programul wiliams
Programul wiliamsProgramul wiliams
Programul wiliams
 
Spine examination
Spine examinationSpine examination
Spine examination
 
Visible Body - Sternocleidomastoid and the Scalene Muscles
Visible Body - Sternocleidomastoid and the Scalene MusclesVisible Body - Sternocleidomastoid and the Scalene Muscles
Visible Body - Sternocleidomastoid and the Scalene Muscles
 
Spine examination
Spine examinationSpine examination
Spine examination
 
Intervertebral disc prolapse
Intervertebral disc prolapseIntervertebral disc prolapse
Intervertebral disc prolapse
 
spine examination by Dr.guru prasad
spine examination by  Dr.guru prasad spine examination by  Dr.guru prasad
spine examination by Dr.guru prasad
 
Intervertibral disc prolapse
Intervertibral disc prolapseIntervertibral disc prolapse
Intervertibral disc prolapse
 
Lumbar disc prolapse
Lumbar disc prolapseLumbar disc prolapse
Lumbar disc prolapse
 
Examination of spine
Examination of spineExamination of spine
Examination of spine
 
Lower limb anatomylect 2
Lower limb anatomylect 2Lower limb anatomylect 2
Lower limb anatomylect 2
 
Lower limb anatomy (hip and thigh)
Lower limb anatomy (hip and thigh)Lower limb anatomy (hip and thigh)
Lower limb anatomy (hip and thigh)
 
Spinal cord injuries | spine fracture | thoracolumbar fracture | colorado spi...
Spinal cord injuries | spine fracture | thoracolumbar fracture | colorado spi...Spinal cord injuries | spine fracture | thoracolumbar fracture | colorado spi...
Spinal cord injuries | spine fracture | thoracolumbar fracture | colorado spi...
 

Similar a Orthopedics 5th year, 3rd lecture (Dr. Hamid)

Similar a Orthopedics 5th year, 3rd lecture (Dr. Hamid) (20)

The congenital and acquired diseases of spine
The congenital and acquired diseases of spineThe congenital and acquired diseases of spine
The congenital and acquired diseases of spine
 
Scoliosis
ScoliosisScoliosis
Scoliosis
 
Cervical myelopathy cme
Cervical myelopathy cmeCervical myelopathy cme
Cervical myelopathy cme
 
A Case of Syringomyelia with Arnold-Chiari Malformation
A Case of Syringomyelia with Arnold-Chiari Malformation A Case of Syringomyelia with Arnold-Chiari Malformation
A Case of Syringomyelia with Arnold-Chiari Malformation
 
Spondylolithesis (1)
Spondylolithesis (1)Spondylolithesis (1)
Spondylolithesis (1)
 
Syringomyelia
SyringomyeliaSyringomyelia
Syringomyelia
 
Mariana Trench. Neck Exam.pptx
Mariana Trench. Neck Exam.pptxMariana Trench. Neck Exam.pptx
Mariana Trench. Neck Exam.pptx
 
Listhesis (2)
Listhesis (2)Listhesis (2)
Listhesis (2)
 
zf2 Spondylolisthesis.ppt
zf2 Spondylolisthesis.pptzf2 Spondylolisthesis.ppt
zf2 Spondylolisthesis.ppt
 
SCI
SCISCI
SCI
 
spondylolisthesis
spondylolisthesis spondylolisthesis
spondylolisthesis
 
Spondylolisthesis
SpondylolisthesisSpondylolisthesis
Spondylolisthesis
 
Spondylolisthesis
SpondylolisthesisSpondylolisthesis
Spondylolisthesis
 
Spondylolisthesis
SpondylolisthesisSpondylolisthesis
Spondylolisthesis
 
Spinal cord injuries
Spinal cord injuriesSpinal cord injuries
Spinal cord injuries
 
Spinal Injury Trauma.pptx
Spinal Injury Trauma.pptxSpinal Injury Trauma.pptx
Spinal Injury Trauma.pptx
 
Spinal Injury Trauma.pptx
Spinal Injury Trauma.pptxSpinal Injury Trauma.pptx
Spinal Injury Trauma.pptx
 
Final case presentation sci (kimberly walsh)
Final case presentation sci (kimberly walsh)Final case presentation sci (kimberly walsh)
Final case presentation sci (kimberly walsh)
 
Compressive Myelopathy
Compressive MyelopathyCompressive Myelopathy
Compressive Myelopathy
 
The spine & spinal cord
The spine & spinal cordThe spine & spinal cord
The spine & spinal cord
 

Más de College of Medicine, Sulaymaniyah

Más de College of Medicine, Sulaymaniyah (20)

Pediatrics 6th year, Tutorial (Dr. Tara Husain)
Pediatrics 6th year, Tutorial (Dr. Tara Husain)Pediatrics 6th year, Tutorial (Dr. Tara Husain)
Pediatrics 6th year, Tutorial (Dr. Tara Husain)
 
Pediatrics 6th year, Tutorial (Dr. Adnan)
Pediatrics 6th year, Tutorial (Dr. Adnan)Pediatrics 6th year, Tutorial (Dr. Adnan)
Pediatrics 6th year, Tutorial (Dr. Adnan)
 
Tubes, Suture Materials, IV Fluids photos
Tubes, Suture Materials, IV Fluids photosTubes, Suture Materials, IV Fluids photos
Tubes, Suture Materials, IV Fluids photos
 
Surgery 6th year, Tutorial (Dr. Aram Baram)
Surgery 6th year, Tutorial (Dr. Aram Baram)Surgery 6th year, Tutorial (Dr. Aram Baram)
Surgery 6th year, Tutorial (Dr. Aram Baram)
 
Surgery 6th year, Tutorial (Dr. Aram Baram)
Surgery 6th year, Tutorial (Dr. Aram Baram)Surgery 6th year, Tutorial (Dr. Aram Baram)
Surgery 6th year, Tutorial (Dr. Aram Baram)
 
Surgery 6th year, Tutorial (Dr. Hamid)
Surgery 6th year, Tutorial (Dr. Hamid)Surgery 6th year, Tutorial (Dr. Hamid)
Surgery 6th year, Tutorial (Dr. Hamid)
 
Surgery 6th year, Tutorial (Dr. AbdulWahid)
Surgery 6th year, Tutorial (Dr. AbdulWahid)Surgery 6th year, Tutorial (Dr. AbdulWahid)
Surgery 6th year, Tutorial (Dr. AbdulWahid)
 
Surgery 6th year, Tutorial (Dr. Ali A. Nabi)
Surgery 6th year, Tutorial (Dr. Ali A. Nabi)Surgery 6th year, Tutorial (Dr. Ali A. Nabi)
Surgery 6th year, Tutorial (Dr. Ali A. Nabi)
 
Surgery 6th year, Tutorial (Dr. Khalid Shokor Mahmood)
Surgery 6th year, Tutorial (Dr. Khalid Shokor Mahmood)Surgery 6th year, Tutorial (Dr. Khalid Shokor Mahmood)
Surgery 6th year, Tutorial (Dr. Khalid Shokor Mahmood)
 
Surgery 6th year, Tutorial (Dr. Khalid Shokor Mahmood)
Surgery 6th year, Tutorial (Dr. Khalid Shokor Mahmood)Surgery 6th year, Tutorial (Dr. Khalid Shokor Mahmood)
Surgery 6th year, Tutorial (Dr. Khalid Shokor Mahmood)
 
Surgery 6th year, Tutorial (Dr. AbdulWahid)
Surgery 6th year, Tutorial (Dr. AbdulWahid)Surgery 6th year, Tutorial (Dr. AbdulWahid)
Surgery 6th year, Tutorial (Dr. AbdulWahid)
 
Surgery 6th year, Tutorial (Dr. Bakhtyar Rasul)
Surgery 6th year, Tutorial (Dr. Bakhtyar Rasul)Surgery 6th year, Tutorial (Dr. Bakhtyar Rasul)
Surgery 6th year, Tutorial (Dr. Bakhtyar Rasul)
 
Surgery 6th year, Tutorial (Dr. AbdulWahid)
Surgery 6th year, Tutorial (Dr. AbdulWahid)Surgery 6th year, Tutorial (Dr. AbdulWahid)
Surgery 6th year, Tutorial (Dr. AbdulWahid)
 
Surgery 6th year, Tutorial (Dr. AbdulWahid)
Surgery 6th year, Tutorial (Dr. AbdulWahid)Surgery 6th year, Tutorial (Dr. AbdulWahid)
Surgery 6th year, Tutorial (Dr. AbdulWahid)
 
Surgery 6th year, Tutorial (Dr. AbdulWahid)
Surgery 6th year, Tutorial (Dr. AbdulWahid)Surgery 6th year, Tutorial (Dr. AbdulWahid)
Surgery 6th year, Tutorial (Dr. AbdulWahid)
 
Surgery 6th year, Tutorial (Dr. Ahmed Al-Azzawi)
Surgery 6th year, Tutorial (Dr. Ahmed Al-Azzawi)Surgery 6th year, Tutorial (Dr. Ahmed Al-Azzawi)
Surgery 6th year, Tutorial (Dr. Ahmed Al-Azzawi)
 
Surgery 6th year, Tutorial (Dr. Sarwar Noori)
Surgery 6th year, Tutorial (Dr. Sarwar Noori)Surgery 6th year, Tutorial (Dr. Sarwar Noori)
Surgery 6th year, Tutorial (Dr. Sarwar Noori)
 
Surgery 6th year, Tutorial (Dr. AbdulWahid)
Surgery 6th year, Tutorial (Dr. AbdulWahid)Surgery 6th year, Tutorial (Dr. AbdulWahid)
Surgery 6th year, Tutorial (Dr. AbdulWahid)
 
Surgery 6th year, Tutorial (Dr. Bakhtyar Baram)
Surgery 6th year, Tutorial (Dr. Bakhtyar Baram)Surgery 6th year, Tutorial (Dr. Bakhtyar Baram)
Surgery 6th year, Tutorial (Dr. Bakhtyar Baram)
 
Surgery 6th year, Tutorial (Dr. Aso Omar)
Surgery 6th year, Tutorial (Dr. Aso Omar)Surgery 6th year, Tutorial (Dr. Aso Omar)
Surgery 6th year, Tutorial (Dr. Aso Omar)
 

Último

Call Girls Gwalior Just Call 8617370543 Top Class Call Girl Service Available
Call Girls Gwalior Just Call 8617370543 Top Class Call Girl Service AvailableCall Girls Gwalior Just Call 8617370543 Top Class Call Girl Service Available
Call Girls Gwalior Just Call 8617370543 Top Class Call Girl Service AvailableDipal Arora
 
Bangalore Call Girl Whatsapp Number 100% Complete Your Sexual Needs
Bangalore Call Girl Whatsapp Number 100% Complete Your Sexual NeedsBangalore Call Girl Whatsapp Number 100% Complete Your Sexual Needs
Bangalore Call Girl Whatsapp Number 100% Complete Your Sexual NeedsGfnyt
 
Call Girls Kochi Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Kochi Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Kochi Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Kochi Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Call Girls Service Surat Samaira ❤️🍑 8250192130 👄 Independent Escort Service ...
Call Girls Service Surat Samaira ❤️🍑 8250192130 👄 Independent Escort Service ...Call Girls Service Surat Samaira ❤️🍑 8250192130 👄 Independent Escort Service ...
Call Girls Service Surat Samaira ❤️🍑 8250192130 👄 Independent Escort Service ...CALL GIRLS
 
All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...
All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...
All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...Arohi Goyal
 
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escorts
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore EscortsCall Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escorts
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escortsvidya singh
 
Call Girls Tirupati Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Tirupati Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Tirupati Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Tirupati Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...hotbabesbook
 
Top Rated Bangalore Call Girls Mg Road ⟟ 8250192130 ⟟ Call Me For Genuine Sex...
Top Rated Bangalore Call Girls Mg Road ⟟ 8250192130 ⟟ Call Me For Genuine Sex...Top Rated Bangalore Call Girls Mg Road ⟟ 8250192130 ⟟ Call Me For Genuine Sex...
Top Rated Bangalore Call Girls Mg Road ⟟ 8250192130 ⟟ Call Me For Genuine Sex...narwatsonia7
 
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...Dipal Arora
 
💎VVIP Kolkata Call Girls Parganas🩱7001035870🩱Independent Girl ( Ac Rooms Avai...
💎VVIP Kolkata Call Girls Parganas🩱7001035870🩱Independent Girl ( Ac Rooms Avai...💎VVIP Kolkata Call Girls Parganas🩱7001035870🩱Independent Girl ( Ac Rooms Avai...
💎VVIP Kolkata Call Girls Parganas🩱7001035870🩱Independent Girl ( Ac Rooms Avai...Taniya Sharma
 
Lucknow Call girls - 8800925952 - 24x7 service with hotel room
Lucknow Call girls - 8800925952 - 24x7 service with hotel roomLucknow Call girls - 8800925952 - 24x7 service with hotel room
Lucknow Call girls - 8800925952 - 24x7 service with hotel roomdiscovermytutordmt
 
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort ServicePremium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Servicevidya singh
 
Call Girls Ooty Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Ooty Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Ooty Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Ooty Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...
VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...
VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...jageshsingh5554
 
Call Girls Bangalore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bangalore Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Bangalore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bangalore Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
(Rocky) Jaipur Call Girl - 09521753030 Escorts Service 50% Off with Cash ON D...
(Rocky) Jaipur Call Girl - 09521753030 Escorts Service 50% Off with Cash ON D...(Rocky) Jaipur Call Girl - 09521753030 Escorts Service 50% Off with Cash ON D...
(Rocky) Jaipur Call Girl - 09521753030 Escorts Service 50% Off with Cash ON D...indiancallgirl4rent
 
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...Dipal Arora
 
VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...
VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...
VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...Garima Khatri
 
Call Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls Jaipur
Call Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls JaipurCall Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls Jaipur
Call Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls Jaipurparulsinha
 

Último (20)

Call Girls Gwalior Just Call 8617370543 Top Class Call Girl Service Available
Call Girls Gwalior Just Call 8617370543 Top Class Call Girl Service AvailableCall Girls Gwalior Just Call 8617370543 Top Class Call Girl Service Available
Call Girls Gwalior Just Call 8617370543 Top Class Call Girl Service Available
 
Bangalore Call Girl Whatsapp Number 100% Complete Your Sexual Needs
Bangalore Call Girl Whatsapp Number 100% Complete Your Sexual NeedsBangalore Call Girl Whatsapp Number 100% Complete Your Sexual Needs
Bangalore Call Girl Whatsapp Number 100% Complete Your Sexual Needs
 
Call Girls Kochi Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Kochi Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Kochi Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Kochi Just Call 9907093804 Top Class Call Girl Service Available
 
Call Girls Service Surat Samaira ❤️🍑 8250192130 👄 Independent Escort Service ...
Call Girls Service Surat Samaira ❤️🍑 8250192130 👄 Independent Escort Service ...Call Girls Service Surat Samaira ❤️🍑 8250192130 👄 Independent Escort Service ...
Call Girls Service Surat Samaira ❤️🍑 8250192130 👄 Independent Escort Service ...
 
All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...
All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...
All Time Service Available Call Girls Marine Drive 📳 9820252231 For 18+ VIP C...
 
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escorts
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore EscortsCall Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escorts
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escorts
 
Call Girls Tirupati Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Tirupati Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Tirupati Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Tirupati Just Call 9907093804 Top Class Call Girl Service Available
 
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
 
Top Rated Bangalore Call Girls Mg Road ⟟ 8250192130 ⟟ Call Me For Genuine Sex...
Top Rated Bangalore Call Girls Mg Road ⟟ 8250192130 ⟟ Call Me For Genuine Sex...Top Rated Bangalore Call Girls Mg Road ⟟ 8250192130 ⟟ Call Me For Genuine Sex...
Top Rated Bangalore Call Girls Mg Road ⟟ 8250192130 ⟟ Call Me For Genuine Sex...
 
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
 
💎VVIP Kolkata Call Girls Parganas🩱7001035870🩱Independent Girl ( Ac Rooms Avai...
💎VVIP Kolkata Call Girls Parganas🩱7001035870🩱Independent Girl ( Ac Rooms Avai...💎VVIP Kolkata Call Girls Parganas🩱7001035870🩱Independent Girl ( Ac Rooms Avai...
💎VVIP Kolkata Call Girls Parganas🩱7001035870🩱Independent Girl ( Ac Rooms Avai...
 
Lucknow Call girls - 8800925952 - 24x7 service with hotel room
Lucknow Call girls - 8800925952 - 24x7 service with hotel roomLucknow Call girls - 8800925952 - 24x7 service with hotel room
Lucknow Call girls - 8800925952 - 24x7 service with hotel room
 
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort ServicePremium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
 
Call Girls Ooty Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Ooty Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Ooty Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Ooty Just Call 9907093804 Top Class Call Girl Service Available
 
VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...
VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...
VIP Service Call Girls Sindhi Colony 📳 7877925207 For 18+ VIP Call Girl At Th...
 
Call Girls Bangalore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bangalore Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Bangalore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bangalore Just Call 9907093804 Top Class Call Girl Service Available
 
(Rocky) Jaipur Call Girl - 09521753030 Escorts Service 50% Off with Cash ON D...
(Rocky) Jaipur Call Girl - 09521753030 Escorts Service 50% Off with Cash ON D...(Rocky) Jaipur Call Girl - 09521753030 Escorts Service 50% Off with Cash ON D...
(Rocky) Jaipur Call Girl - 09521753030 Escorts Service 50% Off with Cash ON D...
 
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...
 
VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...
VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...
VIP Mumbai Call Girls Hiranandani Gardens Just Call 9920874524 with A/C Room ...
 
Call Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls Jaipur
Call Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls JaipurCall Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls Jaipur
Call Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls Jaipur
 

Orthopedics 5th year, 3rd lecture (Dr. Hamid)