الحمل والولادة







Discuss
1 ) Function of autonomic supply to the thoracic organsالأعضاء الصدرية
1 ) heart         stimulates all properties of the cardiac muscles
                                                                                        A ) Increase heart rat  HR
B) Vasodilatation of coronary blood vesselsالاوعية الدموية التاجية  
C) Increase force of contraction
2) Lung
Bronchodilatation and inhibits bronchial  secretion
V.C pulmonary blood vessels leading to better ventilation
2) Function of autonomic supply to pelvic organsأعضاء الحوض ?
1) Relaxation of  the wall of urinary bladder and rectum -stimulation of the internal urethral
2) V.C of pelvic
3) V.C of the external genital organs .
4) in male :  Contraction of smooth muscles of epididymis leading to emission and ejaculation
5) In female : mainly inhibitory on uterus and fallopian tube late in pregnancy its excitatory to uterus. عامة لها تأثير مثبط على الرحم وقناة فالوب ولكن فى اواخر الحمل لها تأثير تحفيزى   
3) Discuss autonomic nerve supply to the eye ?
1) mydriasis = dilatation of the pupil due to contraction of the dilator papillae muscle توسع فى حدقة العين
2) Exophthalmos جحوظ العين   = forward protrusion of the eye ball
3) Widening of the pulpebral fissure اتساع الشق الجفنى
4) Accommodation for far vision  التأقلم على الرؤية البعيدة.
4) Plasma proteins ? types and function ?
A) Types of plasma protein
1) Albumin  -2) Globulines  -3) fibrinogen  -4) prothronbin
B) Function of plasma proteins   هــــــــام
1) used by tissue as nutrient
2) blood clot
3) regulates the volume of blood tissue fluid and urine by its osmotic pressure
4) affects peripheral resistance blood pressure and the blood flow by its viscosity اللزوجه
5) Has defensive function by globulins.
6) carries important material and prevents its loss in urine like iron
7) it affects capillary permeability نفاذية الشعيرات الدموية  
8) Has buffer function  
5) hypoprotinaemia (cases) نقص بروتين الدم
Define by marked decrease in plasma protein


 قد تكون أفضل الطرق أصعبها وأشقها و لكن عليك دائما السير فيها فالاعتياد على صعوبتها سيجعل غيرها يبدو سهلا للغاية

1 - intake (malnutrition)
2 - Absorption (malabsorption)
3 –formation due to liver disease
4 – loss Kidney disease
5 – congenital
ما قرن شيء إلى شيء أفضل من إخلاص إلى تقوى ، و من حلم إلى علم ، و من صدق إلى عمل ، فهي زينة الأخلاق و منبت الفضائل
6) Regulation of RBCS formation ?
1 – Hypoxia   O2 supply to tissue stimulates kidney .
2- Endocrine system : like testosterone and thyroxin
3 – liver :
. store Iron , cupper,B12 A and folic acid .
4 – Bone marrow : RBCS formation in Bone marrow  so damage of bone marrow by toxins , infection, radiation or malignancy lead to a plastic anemia
5 – Diet :
Protein : protein of high biological value is needed
Minerals :
·        Cupper : facilitates iron metabolism –catalyst for Rbcs formationيعمل كمادة حفازة لتكوين كريات الدم الحمراء  
·        Iron : Important for the formation of HB
·        Vit B6, B12 ,folic acid  and vit C
 (7) Discuss hemophilia?
- Hemorrhagic disease.
-Hereditary disease carried by female affect male
- Hemophilia A: Deficiency of factor VII
-Hemophilia B: Deficiency of factor IX
-Hemophilia C: deficiency of factor XI
8) mention precaution and complication of blood transfusion ?
A- Precaution
-Blood must be taken from healthy donor more than 55 kg age 15-55
-Blood must collected under complete aseptic
-Bl is  determined.
-Blood is stored in b.bank at 2-4 c for maximum 3 weeks
-Before b.transfusion   cross matching is done by mixing cells of donor
-Plasma of recipient and tested for agglutination.
B- Complication of blood transfusion
1-Of compatible blood
·       Over load heart
·        transmission of disease
·         ↑K stop heart in diastole
·       ↓Ca lead to tetany
·         Allergic and pyrogenic reaction ارتفاع فى درجة الحرارة مصحوبا برعشة شديدة due to  Wbc and platelet
2- Incompatible blood
·       pain in the back of the chest or else where due to clumping of of donor Rbcs blocking capillaries
·       jaundice due to hemolysis of Rbcs and increase bilirubin
·       -Renal failure
(9) Normal ECG
Definition : Record of electrical changes in the heart during cardiac cycle.
ECG is recorded by 2 electrodes
Wave
Charcter
Cause
Duration
P
+ve
Arterial depolarizationازالة الاستقطاب
0.1 sec
QRS



Q
- ve
Septal depolarization
0.02
R
+ ve
Ventricular depolarization
0.04
S
- ve
Depolarization of  the base ventricular
0.02
T
+ ve
Ventricular Repolarization
0.25

 
10) factor regulation heart rate ?
1- Arterial blood pressure (ABP) → ↑HR
2- venous return   ↑HR
3- B.gass O2 ↑HR
4- Pain : mild moderate pain↑HR  - sever pain HR
5- Temperature (T) T lead to   ↑HR


ما استولي اليأس علي امة الا اخملها ولا خالط قلوب قوم الا اضعفها # الشيخ مصطفي الغلاييني

6- Hormones : adrenalin ,thyroxin ↑HR
11 ) Factor affecting C.O.P?
1 –Venous return (VR)
                                                                                                  2 –Heart rate (HR)
3- force of contraction
12) Blood coagulation steps ?
1- Formation of prothrombin activator 
2- Conversion of prothrombin to thrombin
3- conversion of fibrinogen → Fibrin → Stable Fibrin network which entangles blood cells in its meshes تربط خلايا الدم مع شبكات الفبرين
Mechanism of blood coagulation
-Intrinsic mechanism الية داخلية → depend on blood component only
-Extrinsic mechanism الية خارجيه → needs  tissue factor
13) Significanceاهمية   of arterial pulse ?
1- Presence of pulse indicates that the arterial tree is patent from the heart till the point at which pulse is left
2- It gives idea about HR   3-Its gives idea about rhythm
4- it gives idea about  the force of ventricular contraction.
5- Its gives idea about the wall of artery
14) Factor maintaining the blood pressure ?
1- Stroke volume (S.V) ↑S.V  → ABP-- S.V affect systolic blood pressure
2- HR :↑HR → ABP . HR affect mainly systolic blood pressure
3- Peripheral resistance (PR) : PR ↑→ ABP
 4- Elasticity مرونة of arterial wall
5- total blood volume in relation to capacity of circulation ↑capacity  
15) Discus causes  of edema
1-Cardiac: due to↑ venous pressure more fluid leave capillaries to tissue .
2-Pregnancy edema : due to compression of veins lower limb by pregnant uterus
3-Nutritional edema : due to ↓formation of plasma protein .
4- hepatic edema : dye to ↓formation of plasma protein .
5- Renal : due to loss of plasma protein
6- ↑Capillary permeability نفاذية الشعيرات الدموية  .
7- Lymphatic obstruction :  ↓drainage of tissue fluid
16) Types of pneumothorax
1- Open type:
    Air in pleural sac in direct contact with atmospheric air  stab wound
2- Closed type :
 Due to rupture of alveoli  تمزق فى الاوعية الدموية   and injury of visceral pleura.
3- Tension type:
  injury of visceral pleura and a flape tissue acts as a valve allows air entry to pleural sac during inspiration with no air exit during expiration
4- Therapeutic type:
   Injection of sterile air into pleural sac to collapse diseased lung for rest and prevent spread of infection    
 (17)Vital capacity
- The volume of air which can be expired by forced expiration after deep inspiration =IRV+T.V+ERV=4600 ml
-Importance : test for physical fitness of chest .. its higher in athletes
Its less in :
·         Recumbence  due to stagnation of blood in lungs يقل فى الاستلقاء نتيجة ركود الدم فى الرئتين  
·       In pregnancy
·       In female than male.
Decreased pathologically in :
1)   Chest diseases → bone –muscle diseases
2)   Pleural diseases
3)   Obstruction of pathway  → Asthma مرض الربو
4)   Lung diseases→   Pneumonia الالتهاب الرئوى
5)   Heart diseases → Heart failure  
6)   Abdominal and pelvic tumor
18) Discuss chemical regulation respiration ?
This regulation takes place via changes in the blood gases which act on chemoreceptor to adjust respiration in order to keep
- O2 supply to tissue adequate
- CO2 level in  blood within normal range
-H+ concentration in blood within normal ranges .
19) Dyspnea ضيق التنفس?
Difficult breathing – Awareness of breathing –Dyspnea occurs when the dyspnic index become less 60% or when the resting ventilation become tripled
Causes of Dyspnea ?
1 – Pulmonary causes :
A – Obstructive lung disease .
B – Restrictive lung disease .
2- Cardiac causes : - mitral stenosis ضيق الصمام التاجى  on left sided H.F  
3- Neurogenic psychic : -Fear or emotion causes hypertension
4- Anemia → dyspnea occurs only during exertion المجهود
5-General causes
1- O2 lack in high altitude
2- Thyrotoxicosis زيادة نشاط الغدة الدرقية→ ↑metabolism →↑CO2 →↑Respiration
3- Renal failure  
6- Abdominal causes : Ascites الاستسقاء ….. Distension
(20) Function of kidney
1-  Hemeostasis
·      


الأسباب الخمسة للنجاح : التركيز، التميز، التنظيم، التطوير، والتصميم


Body fluid
·       H2O
·       ABP
·       Minerals :Na – Ca
·       PH
·       A Rbcs
·       Glucose
2- Endocrine function
Secrete
1.    Erythropoietin
2.    Renin angiotensinogen
3.    Active V.D
(21) Mechanism of urine formation
1.    Filtration
2.    Reabsorption → Transport material from lumen to blood
3.    Secretion
4.    Formation new material →  NH3
5.    Excretion → Final appearance of material in urine
(22)Discuss function of Thyroxin and triiodothyronim (T4.T3)
-It stimulates the metabolism of nearly all body cells by ↑the use of food for emergency , increase O2 consumption ↑BMR ↑ Blood glucose level
↓blood cholesterol and phospholipids
↑ protein synthesis in normal level of Thyroxin hormone , however with high level of T3 and T4.
-Diuresis – Its stimulates conversion of carotin to vitamin A       -It stimulates physical and mental growth.
Its needed for normal development and function of C.N.S
-Heart ↑HR --↑Force contraction --↑Systolic ABP --↓Diastolic ABP
-↑RBCs formation –need for normal gonad function( الغدد التناسلية)
-It is stimulates motility and secretion – it ↑pulmonary ventilation – need for normal development of muscle
 (23) Discuss Hyperthyroidismفرط نشاط الغدة الدرقية ?
Hyperthyroidism= Grave.s disease =Thyrotoxicosis
Causes → The most cause is due to autoimmune disease caused by long acting thyroid stimulator produced by Blymphatosyit
*Clinical picture:
1-Introlerance to heat to ↑BMR with excessive sweating
2- loss of body weight in spite of increase appetite due to diarrhea and expend catabolism كثرة الهدم
3-Decrease cholesterol level.
4- Hyperglycemia. 5- Bradycardia 6- poor memory
24) Discuss Myxoedema  ?
-Hypothyroidism in adult the most common causes is surgical removal of gland
Other causes →
-Endemic due to decrease iodine intake
- Thyroiditis التهاب الغدة الدرقية
-Damage of gland by autoimmune.
Clinical picture
1.    Intolerance to cold due to ↓ BMR
2.    Loss of appetite and constipation .
3.    poor memory
4.    Lethargy الخمول
5.    sleepiness
6.    Dry ,cold skin
7.    loss of hair
8.    Hypochromic microcytic anemia نوع من الانيميا تكون فية كرات الدم الحمراء شكلها وحجمها صغير والهيموجلبين قليل ايضا
9.    ↑Cholesterol
25) Function of cortisol?  
1-Carbohydrate metabolism :it ↑blood glucose level.
2-Fat metabolism lipolysis and  redistribution اعادة توزيع  of fat in face and upper part s of body and buttocks
3-Mineral metabolism ↑Na reabsorption in exchange with K secretion
4- Protein metabolism ↑protein breakdown
5- GIT →↑acidity and promotes peptic ulcer قرحة المعدة formation
6-Anti inflammatory →blocks early stage of inflammation مضاد للالتهابات  
7- Anti allergic →Inhabitation of histamine مضاد للحساسية
8- decrease calcium absorption from intestine .
9- It increase Rbcs and decrease T lymphocyte  
26) Cushing syndrome ?
-Result from excessive production of cortisol
 Clinical picture
-Hyperglycemia and glucosuria
-Muscle weakness.
-Pendulous abdomen with purplish striae تدلى البطن وظهور خطوط أرجوانية عليها
-Abnormal fat distribution.
-Osteoporosis هشاشة العظام
- Hypokalemia
-Atrophy of gonads ضمور الغدد التناسلية ,amenorrhea in female and impotence of male  فى الرجال العقم  .
(27) Adrenogenital syndrome
Excessive production of sex hormones especially androgen
Clinical picture
A) Before birth
·       In male : Macrogenitosomia زيادة فى حجم الاعضاء التناسلية
28) Function of insulin hormone ?
1- Hypoglycemia is decrease blood glucose level by 
·       Stimulation of glucose uptake storage by the cell
·       Increase formation of glycogen from glucose.
·       Excess glucose is transformed to fat .
·       4- inhibition of gluconeogenesis   
 2- Stimulates lipogenesis and inhibits lipolysis
3- Stimulates protein anabolism بناء البروتين

29)Hormonal control of breast ?
1- Estrogen
2- progesterone
 3 – prolactin
  4- Oxytocin
 5- General hormone
30) Phases of swallowing
Consist from 3 phases
1-Buccal phase مرحلة الفم (الشدقية): (Voluntary)
·       presence of bolus of food on back of tongue.
·       Tip of tongue is elevated and press against hard palate
·       Tongue is pushed toward its root and pushing bolus
·       This phase need to closed mouth .
2- Pharyngeal phase (involuntary) مرحلة البلعوم
Very rapid . occurs reflexly via swallowing reflex
Stimulus bolus of food
Receptor  swallowing receptor in oropharynx
Afferent : Glussopharyngeal nerve (IX)
Center: Swallowing center in medulla oblongata
Efferent: Motor fibers of cranial nerves
Response : many reflex to
1- Prevent entry of food into air passage  Elevation of soft palate to close the posterior opening of nose
·        Approximation of palatopharngeal fold to form narrow slit
·       Approximation of vocal cord and folding of epiglottis to close glottis
·       Swallowing apnea
2- Forces the food into esophagus
·       Contraction of superior pharyngeal muscle and relaxation of upper end of esophagus
3- Esophageal phase (involuntary phase)مرحلة المرىء
·       Presistalteic movementحركة دودية  in esophagus forces food toward stomach
·       The lower end of esophagus is relaxed in front of food
·       Food enters stomach
31) Causes and complication of vomiting.
1-Centeral vomiting
Stimulation of CTZ by drugs asmorphine- apomorphine –alcohol –digitalis  pathologic : renal failure diabetic ketoacidosis.
2- Reflex vomiting :
Conditioned :
visual –olfactoryذو علاقة بحاسة الشم  – psychic stimulation التأثر النفسى.
Unconditioned :
·       Irritation of back tongue.
·       Irritation of gastric mucosa
·       Visceral pain  
Afferent : According the site of stimuli
Central : direct to central vomiting
Complication of vomiting
1- Dehydration
2- Alkalaemia :  decrease Ca lead to tetany
3- Hypokaleamia
4-destruction of the tooth enamel due to the acidity
32) function of bile salt أملاح الصفراء?
1- Absorption of fat and fat soluble vitamins
2-Antibacterial effect and stimulate intestinal motility حركة الامعاء
3- Solvent action  : keep cholesterol and fatty acids in solution preventing formation of gall bladder stone
4- choleretic: stimulate intestinal motility
5- Prevent protein putrefactionتمنع تعفن البروتين  by digestion and absorption by digestion and absorption of fat
6- help digestion of fat by emulsification of fat by decrease the surface tension thus increase the surface of the area exposed to enzymes
33) function of gallbladderالمرارة  ?
1-Storage of bile in between meals as the sphincter of it chos
And liver continuous to secrete bile
2-Helps continuous  flow of hepatic bile in-between meal by storage of bile as  it prevents back pressure .
3- concentration of bile by absorption of water
4- Acidification of bile by absorption of bicarbonate
5- Prevent stone formation
34) Function of large intestine ?
1-Absorption of water ,electrolytes,some vitamins and some drugs .
-about 2 L of water is absorbed by osmosis .
-Some drugs could be taken as suppository
-Absorption of electrolytes .
2-Storage and evacuation of stool
-The colon stores faces and the rectum is usually empty except just before defecation.
3- Bacterial action in large intestine.
Useful bacteria: synthesis of vitamins →Vit K
-Digest macromolecules thus prevent caecal  enlargement and obstruction.
-Stimulate the intestinal wall to secrete IgA
-Harmful bacteria
-Ammonia formation
–Cholesterol
-Histamin- serotonin – Vit B 12  and ascorbic acid utilization
4-Secretion of alkaline mucus to protect the mucosa from acids
35) Uterine cycle دورة الرحم?
-It’s the cycling changes occurs in endometrium of uterus بطانة الرحم every month → it’s the weeping of crying non pregnant uterus lack of baby 
(phases of it )
1 – Destructive or menstrual phase
 - From the first day to the 5th day of the cycle .
Causes : Vasospasm of spiral arteries leading to ischaemia of superficial layers of the endometrium  of uterus leading to necrosis and shedding of superfacial layers of the endometrium  loss of unclotted blood .about 100ml .most of blood is arterial تشنج الشرايين الحلزونية يؤدى الى نقص الدم الواصل الى الطبقات السطحية لبطانة الرحم فيؤدى الى موت الخلايات وفقد الدم الغير متجلط
2- Proliferative phase مرحلة التكاثر والنمو:
From 5th day of cycle – Regeneration of surface of epithelium
↑ thickness of endothelium –uterine gland elongated  تمدد غدد الرحم
↑ vascularity and blood vessels  become spiral
المرحلة الافرازية 3- Secretory phase 
-From 15th day beginning of the next cycle .
-  ↑ thickness of the endometrium to reach full thickness
- Uterine glands  become coiled تصبح ملفوفة and full of secretion
-this phase is under effect of estrogen and progesterone .

36) Ovarian cycle دورة المبيض
*At puberty – under the capsule of ovaries about 400.000 primary follicles حويصلات المبيض  ,each one passing into the following phases
1- follicular or maturation phaseمرحلة نضوج الحويصلة
·       Each month 6-12 primary follicles enlarge in size under the effect of FSH
·        after one week follicles continues to enlarge until it become mature graffian follicle
·        the growing follicle secrete Estrogen
2-Ovulation phaseمرحلة التبويض
-it occurs in 14th day of the cycle under the effect of LH
-The mature graffian follicle rupture with expulsion of mature ovum into peritoneal cavity to be picked up by fimbriated end of fallopian tube .يتم التقاطها بأهداب قناة فالوب
 3- Luteal phaseمرحلة الجسم الاصفر
The remaining part of mature graffian follicle become loaded with yellow pigment which called corpus luteum الجسم الاصفر that secretes estrogen and progesterone .


لا نحقق الأعمال بالأمنيات وإنما بالإرادة نصنع المعجزات


Define
Homeostasis        process by which physical and chemical composition of internal environment is kept constant.
Erythroprotein hormone  Glycoprotein secreted from lover and kidney
Purpura  haemorrhagic disease characterized by bleeding under th skin and mucos membrane in the form of petichae and ecchymosis.
Bleeding time       time neesed for bleeding from small wound to stop without coagulation.
Cardiac out put      volume of blood pumped by each ventricle per minute
Pneumothorax       Presence of air in pleural sac
Hypoprotinaemia         Marked decrease in plasma protein
Polycythaemia      Rbcs (physiological  high altitude )  pathological:  malignant tumor in bone marrow. 
Cardiac index                 C.O.P /M2
Edema                               Accumulation of fluid in  excess
Pneumothorax          presence of air in the pleural sac
Tidal volume                volume of air which can be taken by normal inspiration or expired by normal expiration during rest =500 ml.
Vital capacity(IC)                  volume of air which can be expired by forced expiration after deep inspiration = IRV+TV+ERV=4600 L.
Hypoxia                      Diminished O2 supply at tissue level
cyanosis                               Bluish coloration of skin and mucous membrane due to amount of reduced HB in capillary blood .more than 5gm/100
Dyspnea                 Difficult breathing its occurs when the dyspnic index become less than 60% or when the resting ventilation becomes tripled
Orthopnea                           dyspnea on lying down relieved by sitting or standing position.
vomiting                              it is the explosion of upper   GIT contents through the esophagus .pharynx and mouth .its controlled by vomiting centre and chemoreceptor trigger zone
Jaundice                         yellowish discolouration of the skin and mucous membrane due to increase bilirubin more than 2mg%
-Def : propelling of food bolus from mouth to stomch by pharynx and esophagus  
          Purpura     
           Hemophilia
In and-


1 -  Hereditary disease carried by
Affected .


Spontaneously



 2- usually after trauma





-Defect platelets or blood vessels wall






3- causes :
-Hemophillia A: deficiency of factor v11
-HemophilliaB : deficiency of factor 1x
-Hemophillia C : deficiency of factor X1





 Clotting  time normal
4- bleeding time → prolonged
   




3-clotting time   Prolonged
4- bleeding time → normal    


    Cretinism     
         Dwarfism

-Slow physical and mental growth


-Slow physical growth



Disproportionate -

- Proportionate



Thyroid hormone in child

GH child

anterior pituitary H

 ↓ somatomedin





diabetes insipidus (D.I)

Diabetes mellitus (DM)

-Disease caused by ADH Hormone shortage .


-Syndrome characterized by metabolic and vascular events


Caused by  antidiuretic Hormone

ADH .

Caused by insulin deficiency




Poly uria
Polydipsia

*****
Symptoms :
Polyuria   -polydipsia 

-Glucose may appears in urine
  
Zagazig University                                                   Date :2015
Faculty of nursing                                                     mark :60
Physiology

Answer the following questions

1- Enumerate functions of autonomic nerve to pelvic organs.
2-List function of insulin hormone.
3- Identify roles of gal bladder.
4- Compare dwarfism and cretinism.
5- Discuss Rh incompatibility.
6- Describe pharyngeal phase of deglutition.
7- Explain ovarian cycle.
8- Describe adrenogenital syndrome.
10- Outline causes and complication of vomiting.









Zagazig University                                                   Date :2014
Faculty of nursing                                                     mark :60
A) Enumerate functions of
                                                                   1- A.N.S to eye
2- Growth hormone
                                                                           3- Bile salt
B) Compare between:
4-Hemophilia and purpura.
5-Diabetes incipidus and diabetes mellitus.
C) Discuss


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6- Blood transfusion.
7-Uterine cycle.
8-Normal ECG.
9-Edema
10-Causes and complications of vomiting.
Physiology  2013

Define
A.  Homeostasis
B. Pneumothorax
C. Residual volume
D.  Cardiac index
E.   Polycythamia
Enumerate the functions :
A.  Thyroxin hormone
B.  Plasma protein
C.  Large intestine
D. Autonomic nerve supply to pelvic organs .
E.  Kideny
Discuss
A.  Cushing syndrome
B.  Ovarian cycle
Choose the correct answer
1- In horner's syndrome all correct except :
1.     Mitosis
2.     Ptosis
3.     Enophthalmos
4.     Cold skin

2-The defensive function of plasma protein is due to
1.     Globulins
2.     Albumin
3.     Fibrinogen
4.     Prothrombin
3- Complication of vomiting includes all the following except
1.     Dehydration
2.     Tetany
3.     K loss
4.     Acidaemia
4- Stimulation of parasympathetic leads to
1.     Sweating
2.     Ejaculation
3.     Erection
4.     Exophthalmos
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Physiology  2008
Give account on :
1- Function of vagus nerve
2- Regulation of Rbcs formation
3- Causes and manifestation of hypoprotinaemia.
4-Hemophailia
5-Factor regulating heart rate
6- Dyspnea
7- Function of cortisol
8- Myxoedema
9- Ovarian cycle
10- Function of bile salt

tages :كلمات بحثية
short notes in physiology for nursing student - nursing review in physiology - Mcq question in physiology for nursing -مراجعة فسيولوجى لطلاب كليات التمريض - فسيولوجى لطلاب تمريض - ملاحظات في الفسيولوجى لطلاب تمريض  - منهج الفسيولوجى كلية التمريض جامعة الزقازيق

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