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Fatigue of sensory receptors can be demonstrated easily with other senses premonitory symptoms buy strattera cheap online, such as touch symptoms bladder cancer strattera 40mg on-line. Our clothing is in constant contact with the nerves of our skin that respond to the stimulus of touch treatment that works cheap 25 mg strattera mastercard, but people rarely think consciously about their clothing being in contact with their skin symptoms crohns disease buy discount strattera 18mg. When we put on different clothes, the level of stimulus changes and we are more aware of our clothing next to our bodies. The first taste of a food or drink is the most acute and dulls within several bites. We are aware of music when we first turn on the radio, and then it tends to blend into the background until there is a news bulletin. A person becomes accustomed to the smell of a new car until someone reminds him/her of the smell, and the individual becomes aware of it once more. Blind or Visually Impaired s s s s For students who are blind, provide braille or other tactile symbols on dropper bottles so that the students will be able to identify them. A student who is blind can participate as a timer by using a talking clock or braille wristwatch. Students who are blind can complete the graphs using embossed graph sheets, available from the American Printing House for the Blind in 1/2-, 3/4-, and 1-inch squares. For students with low vision, use different colors of tape or marks on dropper bottles so that the students will be able to identify them. Such a student is increasingly sensitive to chemicals in the environment and may need to be excused from class. Procedure Introduce the activity by setting out an evaporating dish of suntan oil containing coconut. After students have been in the room two or three minutes, ask them if they notice the odor as much as they did when they first entered the room. Exploration the Exploration activity demonstrates the concept of olfactory fatigue and the relationship between smell and memories using aromatic oils based on the teacher-led introduction. Assign each student in a group of four one of the following roles: s Time keeper s Data recorder s Subject s Group manager. The manager should obtain two different bottles of aromatic oils, such as peppermint and cloves. The subject should close the left nostril by pressing his/her left index finger against the outside of the nostril. The time keeper should indicate to the subject to begin smelling the oil through the open nostril as described in Figure 1 in Directions for Students. The data recorder should record this time as the starting time in his/her data journal. The subject should keep the oil at a consistent distance (about 30 cm) from his/ her nose with his/her mouth closed. The subject should continue to smell the oil until the odor is no longer noticeable. At this time, he/she should indicate this to the time keeper and the data recorder should record this as the ending time. Steps 3 and 4 should be repeated immediately with the same subject using a different aromatic oil. After completing Steps 3 and 4 for the different aromatic oil, the subject should release the closed nostril and waft the scent of the second aromatic oil under the newly opened nostril and indicate if it is difficult to detect the odor. The group should indicate any memories that either of the aromatic oils brought to mind and compare to see whether they had the same memories. The group manager should obtain a bottle of each of the following concentrations of vanilla solution: 0. The subject should close one nostril as done in the Exploration phase of this activity. The time keeper should note the time and the data recorder should record the starting time. The subject should indicate to the time keeper when he/she can no longer smell the odor. The subject should repeat Step 2 using each of the remaining concentrations of vanilla solutions.

Mean arterial pressure Total peripheral resistance Left ventricular end-diastolic volume Contractility of the left atrium the thickness of the free wall of the left ventricle 290 symptoms influenza buy strattera pills in toronto. The electrocardiographic changes are consistent with a diagnosis of which of the following? Hyperkalemia Hypokalemia Anterior infarction Posterior infarction Ventricular premature beat 222 Physiology 292 treatment of scabies purchase strattera overnight delivery. During aerobic exercise symptoms zyrtec overdose discount generic strattera canada, blood flow remains relatively constant within which of the following? Heart rate Myocardial contractility Total peripheral resistance Venous compliance Cardiac output 295 72210 treatment generic 40mg strattera with visa. Which of the following organs has the highest arteriovenous O2 difference under normal resting conditions? The graph below illustrates the pressure-volume curves for the arterial and venous systems. Which of the following is the approximate ratio of the arterial compliance to the venous compliance? Positive inotropic drugs can reduce ischemic cardiac pain (angina) in a dilated failing heart by doing which of the following? Decreasing preload Increasing diastolic filling time Decreasing total peripheral resistance Increasing heart rate Increasing coronary blood flow 224 Physiology 298. Which of the following characteristics is most similar in the systemic and pulmonary circulations? A 6-year-old girl undergoes a routine physical examination for entry into the first grade. A thrill and a continuous murmur with late systolic accentuation at the upper left sternal edge are detected upon auscultation. Which of the following best describes the function of the ductus arteriosus in the fetal circulation? It delivers oxygenated blood from the placenta to the left ventricle It is located in the septum between the left and right atrium It diverts oxygenated blood away from the lungs to the aorta It allows blood to flow from the aorta to the pulmonary artery It is a high resistance conduit, which helps to maintain normal fetal blood pressure 300. Ophthalmic and neurologic examinations were normal except for a loud right carotid bruit. A high velocity of blood within the carotid artery An increase in blood viscosity Widening of the carotid artery An increase in hematocrit Lengthening of the carotid artery 301. A 57-year-old woman is undergoing a femoral popliteal bypass for her peripheral vascular disease. The vascular surgeon wishes to induce a localized arteriolar constriction to help control hemostasis. An increase in the local concentration of which of the following agents will cause systemic vasoconstriction? Baseline and exercise levels of cardiac and venous function are measured and plotted on the graphs below. The point marked "Control" represents baseline cardiovascular function in the resting state in the supine position. During treadmill exercise, there will be a shift from the resting state to which of the following points? In the pressure-volume loop below, systole begins at which of the following points? Which of the following is true regarding the functional closure of the ductus arteriosus? It is independent of gestational age It occurs due to hypoxic pulmonary vasoconstriction It precedes closure of the foramen ovale It causes blood to flow from the aorta into the pulmonary artery It is the final event required for conversion of the transitional circulation in the newborn to the adult circulatory pattern 305. His physician recommends a new drug for hypertension that acts by decreasing vascular smooth muscle contractile activity without affecting ventricular contractility. A 64-year-old male was admitted to the hospital with edema and congestive heart failure. He was found to have diastolic dysfunction characterized by inadequate filling of the heart during diastole. The decrease in ventricular filling is due to a decrease in ventricular muscle compliance. Which of the following proteins determines the normal stiffness of ventricular muscle? At which of the following sites in the cardiovascular system does the blood flow lose the greatest amount of energy?

For example medicine plies purchase strattera 18 mg, nearly half of men with low sexual desire have another sexual dysfunction medicine holder buy cheapest strattera and strattera, and 20% of men with erectile dysfunction have low sexual desire medications names buy 10mg strattera mastercard. It refers to a culture bound clinical condition characterized by guilt about loss of semen in young men medicine used during the civil war buy strattera us, often leading to undue concern with its debilitating effect on physical and psychological health. Patient presents with vague and multiple somatic and psychological symptoms like lack of physical strength, fatigue, listlessness, poor concentration, forgetfulness etc. The core feature is the undue concern with the passage of semen during micturation or while straining to pass stools, although there is no objective evidence of semen in urine or its passage otherwise. There may be accompanying anxiety or depressive symptoms and the patient may present with or without sexual dysfunction and accordingly some researchers have described subgroups of Dhat syndrome, viz. Dhat syndrome alone, Dhat syndrome with anxiety or depressive symptoms and Dhat syndrome with sexual dysfunction. Another clinical entity commonly encountered in the clinical practice is Apprehension about potency. It is a common held belief in most of the Indian sub-cultures that masturbation and night emissions before marriage result in loss of potency in marital conjugal relations. Masturbation is considered to be responsible for shrinkage or sideward curvature of penis and watery semen. Thus, there are exaggerated apprehensions in males centered on sexual performance on "First wedding night (Suhaag raat)" (Avasthi & Nehra, 2000). Loss of sexual desire is the principal problem and is not secondary to other sexual difficulties, such as erectile failure or dyspareunia. Lack of sexual desire does not preclude sexual enjoyment or arousal, but makes the initiation of sexual activity less likely. Sexual aversion: the prospect of sexual interaction with a partner is associated with strong negative feelings and produces sufficient fear or anxiety that sexual activity is avoided. Lack of sexual enjoyment: Sexual responses occur normally and orgasm is experienced but there is a lack of appropriate pleasure. Failure of genital response (In men, erectile dysfunction and in women vaginal dryness or failure of lubrication): Erectile dysfunction defined as difficulty in developing or maintaining an erection suitable for satisfactory intercourse. It is unusual for women to complain primarily of vaginal dryness except as a symptom of postmenopausal estrogen deficiency. Premature ejaculation: the inability to control ejaculation sufficiently for both partners to enjoy sexual interaction. Nonorganic vaginismus: Spasm of the muscles that surround the vagina, causing occlusion of the vaginal opening. This category is to be used only if there is no other more primary sexual dysfunction. Excessive sexual drive: Both men and women may occasionally complain of excessive sexual drive as a problem is its own right, usually during late teenage or early adulthood. Hypoactive Sexual Desire Disorder: Persistently or recurrently deficient (or absent) sexual fantasies and desire for sexual activity. Female Sexual Arousal Disorder: Persistent or recurrent inability to attain, or to maintain until completion of the sexual activity, an adequate lubrication-swelling response of sexual excitement. Female Orgasmic Disorder: Persistent or recurrent delay in, or absence of, orgasm following a normal sexual excitement phase. Women exhibit wide variability in the type or intensity of stimulation that triggers orgasm. Premature Ejaculation: Persistent or recurrent ejaculation with minimal sexual stimulation before, on, or shortly after penetration and before the person wishes it. The clinician must take into account factors that affect duration of the excitement phase, such as age, novelty of the sexual partner or situation, and recent frequency of sexual activity Dyspareunia: Recurrent or persistent genital pain associated with sexual intercourse in either a male or a female. Vaginismus: Recurrent or persistent involuntary spasm of the musculature of the outer third of the vagina that interferes with sexual intercourse. Sexual arousal disorders, including erectile dysfunction in men and female sexual arousal disorder in women, are found in 10% to 20% of men and women, and is strongly agerelated in men (Laumann et al, 1999; Laumann et al, 1994). Orgasmic disorder is relatively common in women, affecting about 10% to 15% in community-based studies (Laumann et al, 1994; Dunn et al, 1998; Rosen et al, 1993). In contrast, premature ejaculation is the most common sexual complaint of men, with a reporting rate of approximately 30% in most studies (Metz et al, 1997; Cooper et al, 1993; Laumann et al, 1994). Sexual pain disorders have been reported in 10% to 15% of women and in less than 5% of men (Laumann et al, 1994). Nonetheless, in countries with sexual taboos and in other developing countries, the entity is usually infrequently and under-reported (Althof & Seftel, 1995; Korenman, 1995; Krane et al, 1989; Lester et al, 1980).

Loss of vibration sensation on the right side; loss of pain and temperature sensation on the left side 22 medicine 6mp medication buy strattera 25 mg fast delivery. Bilateral loss of pain and temperature sensation in the hands; muscle atrophy in both hands; spastic paresis on the right side only 24 medications given im order 10 mg strattera with visa. Urinary incontinence and quadriplegia Match each statement below with the syndrome that corresponds best to it symptoms 2015 flu order strattera 18mg on line. Lesion A involves degeneration of the ventral horns bilaterally at midcervical levels medications osteoarthritis pain discount 25mg strattera overnight delivery, resulting in flaccid paralysis in the upper extremities. Lesion B involves degeneration of the lateral corticospinal tracts bilaterally, resulting in spastic paresis of the lower extremities and primarily affecting the muscles distal to the knee. Spastic paresis of the upper extremities is masked by flaccid paralysis resulting from lesion A. Lesions A and B are the result of amyotrophic lateral sclerosis, a pure motor disease. A lesion of the cervical spinal cord could result in ipsilateral Horner syndrome, ipsilateral spastic paresis, and contralateral loss of pain and temperature sensation. Syringomyelia is a cavitation of the spinal cord most commonly seen in the cervicothoracic segments. This condition results in bilateral loss of pain and temperature sensation in a cape-like distribution as well as wasting of the intrinsic muscles of the hands. Amyotrophic lateral sclerosis is a pure motor syndrome; subacute combined degeneration includes both sensory and motor deficits; Werdnig-Hoffmann disease is a pure motor disease; and tabes dorsalis is a pure sensory syndrome (neurosyphilis). A loss of Purkinje cells as seen in cerebellar cortical atrophy (cerebello-olivary atrophy) results in cerebellar signs. Cell loss in the globus pallidus and putamen is seen in Wilson disease (hepatolenticular degeneration). Demyelination of axons in the posterior and lateral columns is seen in subacute combined degeneration. Demyelination of axons in the posterior limb of the internal capsule results in contralateral spastic hemiparesis. Transection of the spinothalamic tract results in loss of pain and temperature sensations, starting one segment below the lesion. Ventral horn destruction results in complete flaccid paralysis and areflexia at the level of the lesion. Dorsal spinocerebellar tract and ventral spinocerebellar tract transection results in cerebellar incoordination. Progressive bulbar palsy is a lower motor neuron component of amyotrophic lateral sclerosis, or Lou Gehrig disease. Loss of tactile discrimination, loss of vibratory sensation, stereoanesthesia, and dorsal root irritation are all sensory deficits found in dorsal column syndrome. Clasp-knife spasticity is an ipsilateral motor deficit found below a lesion of the lateral corticospinal tract. Epicomus syndrome involves segments L4 to S2 and results in loss of voluntary control of the bladder and rectum, motor disability, and an absent Achilles tendon reflex. Acute idiopathic polyneuritis, or Guillain-Barrй syndrome, is a peripheral nervous system lesion. It typically follows an infectious illness and results from a cell-mediated immunologic reaction. Dorsal column syndrome results in a sensory deficit known as sensory dystaxia, or Romberg sign. Patients are Romberg positive when they are able to stand with the eyes open but fall with the eyes closed. Multiple sclerosis is characterized by asymmetric lesions frequently found in the white matter of cervical segments. The cauda equina syndrome frequently results from intervertebral disk herniation; severe spontaneous radicular pain is common. Its symptoms include a painful stiff neck, arm pain and weakness, and spastic leg weakness with dystaxia; sensory disorders are frequent. Friedreich ataxia is the most common hereditary ataxia with autosomal recessive inheritance.

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Wernicke aphasia-Difficulty in comprehending spoken language; also called receptive treatment in spanish purchase strattera paypal, posterior symptoms 5 days before missed period order strattera canada, sensory symptoms jaw pain and headache cheap strattera 25 mg visa, or fluent aphasia symptoms you have cancer order strattera us. Index Note: Page numbers followed by f indicate illustrations; those followed by t indicate tables; and those followed by Q indicate end-of-chapter Question and Answer sections. See Cerebral aqueduct Arachnoid, 24, 25f, 27f Arachnoid granulations, 24, 27f Arachnoid villus, 24, 30 Archicortex, 71, 298 Arcuate fasciculus, 304 Arcuate nucleus, 135f, 136, 136f, 252f, 253, 257, 259Q Area postrema, 10, 32, 35, 35f, 138 Area subcallosa, 4f Argyll Robertson pupil, 233, 234f, 236Q Arhinencephaly, 76 Arnold-Chiari malformation, 74­75, 74f, 78Q Arterial circle of Willis, 42f, 46, 250 Arteries. See also specific arteries autonomic innervation of, 242t, 246 of brain, 41­46, 42f­44f of spinal cord, 40, 41f Artery of Adamiewicz, 40, 41f Ascending branch of lateral sulcus, 3f Ascending cervical artery, 41f Ascending sensory pathways, of pons, 138, 139f Ascending spinal tracts, 107­111, 108f, 110f, 114f Aseptic meningitis, 31t, 32 Aspartate, 292, 292f, 294Q Astatognosis, 311Q Astereognosis, 299, 304, 311Q Astrocyte, 63, 84, 94Q Astrocytoma, 86, 87f, 213, 214Q Astroglia, 63 Atrium, 28, 29f Auditory association cortex, 300f, 302 Auditory pathway, 160f, 161­162 Auditory radiation, 160f, 162 Auditory system, 159­167. See also under Hearing brainstem auditory evoked responses and, 164f, 165, 166Q disorders of, 163­165 ear in, 159­161 overview of, 159 peripheral/central connections in, 160f Autonomic ganglion, 60 Autonomic nervous system, 240­249 B Babinski sign, 116, 122, 201Q, 311Q Bacterial meningitis, 31, 31t, 36Q Ballism, 280 Basal ganglia, 274, 275f anatomy of, 6­7, 7f aphasia and, 316 development of, 71 Basal nucleus of Meynert, 285 Basal plate, 64, 64f, 65­66, 66f, 67f, 68, 69, 69f Basilar artery, 11f, 41, 41f, 42f, 49f, 51f, 52f Basilar membrane, 161 Basis pedunculi, 5f, 7f, 13f, 15f, 16f, 20f, 21f, 33f, 69, 114, 141, 142 Bell palsy, 185 Benedikt syndrome, 196f, 197 Benign intracranial hypertension, 30, 36Q Benign positional vertigo, 174, 175Q Berry aneurysm, 53, 53f, 57Q Biceps jerk reflex, 104 Binasal hemianopia, 228, 236Q Bipolar neurons, 80, 81f, 226 of spiral ganglion, 161 of vestibular ganglion, 169f, 161, 170 Bitemporal hemianopia, 228, 236Q, 237Q Bitemporal lower quadrantanopia, 53 Bladder, autonomic innervation of, 242t, 246­247 Blood-brain barrier, 90, 91f Blood­cerebrospinal fluid barrier, 84, 91f Blood vessels. See also Arteries; Veins autonomic innervation of, 242t, 246 Bony labyrinth, 160 Botulism, 247 Brachium conjunctivum, 5f Brachium of inferior colliculus, 5f, 9, 141 Brachium of superior colliculus, 3f, 9 Brachium pontis, 5f Brain abscess of, 87f anatomy of, 1­21 arteries of, 41­46, 42f­44f axial section of, 19f­21f coronal section of, 14f­18f divisions of, 1­21. See also Medulla oblongata; Mesencephalon; Pons anatomy of, 5f, 134f, 144f corticobulbar pathways in, 144f, 146 lesions of, 193­203 acoustic neuroma, 196­197 internuclear ophthalmoplegia and, 198 in jugular foramen syndrome, 198­199 of medulla, 193­194 of mesencephalon, 196­197 neoplastic, 86, 87f, 196­197 of pons, 194­196 in subclavian steal syndrome, 199, 199f vascular, 193­194, 194f overview of, 133 tumors of, 86, 87f, 196­197 Brainstem auditory evoked response, 164f, 165, 166Q Bridging veins. See Superior cerebral veins Broca aphasia, 303, 310Q, 315, 315f, 317Q Broca speech area, 300f, 303, 303f, 310Q, 311Q Brodmann areas, 299­302, 300f Brown-Sйquard syndrome, 122f, 124, 125f, 130Q Buccofacial apraxia, 301 367 C Calcar avis, 3f Calcareous granules, 34 Calcarine artery, 43f, 49f, 51f, 52f Calcarine sulcus, 3f, 4f, 11f, 12f, 13f Callosomarginal artery, 42f, 49f, 50f Caloric nystagmus, 172­173, 172f, 175Q Cancer. See Tumors Capillaries, 90, 91f Carbocyanine dyes, 89f, 90 Carotid angiography, 48, 49f­51f Carotid artery, 22Q aneurysms of, 181 Carotid body, 186, 245 Carotid sinus, 186, 245 Carotid sinus reflex, 187 Catecholamines, 283. See also Neurotransmitters synthesis of, 284f Cauda equina, 26f, 65, 99 Cauda equina syndrome, 125f, 126, 130Q Caudal rhombencephalon, 65 Caudate nucleus, 3f, 5f, 7, 7f, 12f­20f, 19f, 22Q, 275, 275f, 276, 276f Cavernous internal carotid artery, 50f, 51f, 52f Cavernous sinus, 48, 50f, 149, 155f thrombosis of, 58Q Cavernous sinus syndrome, 156 Celiac ganglion, 248Q Center of Budge, 102, 105Q Central canal, 27f, 101f, 134f, 135f Central facial palsy, 185 Central nervous system. See Diplopia Dressing apraxia, 306 Dural sinuses, 25, 27f Dura mater, 24­25, 25f, 26f, 27f Duret hemorrhage, 33f Dyes, carbocyanine, 89f, 90 Dysarthria in cerebellar dysfunction, 210 in vagal nerve dysfunction, 187 Dyscalculia, 301 Dysdiadochokinesia, 187 Dysmetria, 187 Dysphagia, in vagal nerve dysfunction, 187, 188f Dysphonia, 187, 187f Dyspnea, 187 Dysprosody, 302, 306, 316, 317Q Dyssynergia, in cerebellar dysfunction, 210 Dystaxia, 187 E Ear anatomy of, 159­161 disorders of, 163, 167Q inner, 160, 168­170, 169f middle, 159, 167Q outer, 159, 186 Edinger-Westphal nucleus, 69, 134f, 143, 179, 180f, 230, 232, 246 Efferent cochlear bundle, 162 Electrical synapses, 83 Emboliform nucleus, 137f, 208f Encephalocele, 73­74, 73f End feet, 84 Endolymph, 170 Endorphins, 288, 288f, 294Q Enkephalins, 288, 289f Enteric nervous system, 244. See Hippocampal commissure Fornix, 11f, 15f­20f, 22Q, 252f, 254f, 255, 259Q, 268 Fornix column, 4f Foster Kennedy syndrome, 237Q, 263, 271Q Fourth ventricle anatomy of, 4f, 11f, 27f, 29, 29f, 67f development of, 67 Fovea centralis, 224 Fracture cribriform plate, 263, 271Q skull, 34 Friedreich hereditary ataxia, 122f, 127, 130Q, 213, 214Q Frontal eye field, 232, 300f, 302 Frontal horn, 28, 29f Frontal lobe, 1­2, 3f, 4f Frontal lobe syndrome, 303 Frontopolar artery, 42f Frontopolar branch of anterior cerebral artery, 50f Fusiform gyrus, 5 Equilibrium, 185 Esotropia, 182 Ethmoid fracture, 263, 271Q Exotropia, 200Q Expressive aphasia, 303 Expressive dysprosody, 306, 316, 317Q External capsule, 3f External ear, 159, 186 External granular layer, 68 Extrapyramidal motor system. See Mesencephalon Middle cerebellar peduncle, 7f, 10, 17f, 137f, 139, 139f, 205, 208f Middle cerebral artery, 14f, 42f, 43f, 44f, 45, 49f­52f, 308­309 occlusion of, 222Q, 308 rupture of, 53 Middle ear, 159, 167Q Middle frontal gyrus, 1, 3f Middle internal frontal artery, 42f Middle meningeal artery, 46, 191Q rupture of, 53, 54f Middle temporal gyrus, 3f, 5 Millard Gubler syndrome, 202 Mitochondrial transport, 88, 89f Mцbius syndrome, 185 Motor aphasia, 303, 315 Motor areas, cortical, 300f, 301f, 302 Motor axons, 83t Motor facial nucleus, 134f Motor homunculus, 301f, 302 Motor neuroblasts, 65 Motor neurons, 80, 81f. See also specific muscles facial expression, 185 masticatory, 153f, 157Q, 182 oculomotor, 178­179 paralysis of, 180, 181, 181f, 210Q, 233­234, 234f, 237Q Muscle receptors, 92­93 Muscle stretch reflex, 92, 94Q Mutism, akinetic, 303 Myasthenia gravis, 293, 294Q Myasthenic ptosis, 235 Myelencephalon. See also specific nerves cranial, 2f, 7f, 177­192, 349t­352t peripheral lesions of, 123­124, 125f regeneration of, 88 tumors of, 85­86, 87f spinal, 98­100, 98f, 100f Nerve cell. See Neurons Nerve cell body, 81­83 Nerve deafness, 163, 166Q Nerve fibers, 82, 83t degeneration of, 86­88 myelinated, 100 regeneration of, 88, 94Q unmyelinated, 99 Nervous system autonomic, 240­249. See Brain; Central nervous system; Spinal cord development of, 59­79 parasympathetic, 242­244, 242t, 243f peripheral, 59. See also Peripheral nerves sympathetic, 240­242, 241f, 242t Neural crest, 59, 60­61, 61f, 78Q Neural fold, 59, 60f, 61f Neural groove, 59, 60f Neural plate, 59 Neural tube defects, 72­73, 73f Neural tube, development of, 59­60, 60f, 61f, 62­64, 78Q Neural tube wall, 64 Neurilemmoma. See Schwannoma Neuroblasts, 63 motor, 65 sensory, 65 Neurofilaments, 82 Neuroglia, 83­96 Neuroglial tumors, 85­86 Neurohistology, 80­95 Neurohypophysis, 69, 70. See also Hypophysis Neuroma, acoustic, 154­156, 163, 174, 175Q, 197, 198f Neuromelanin, 82 Neurons, 80­83 bipolar, 80, 81f cholinergic, 81, 81f classification of, 80­81, 81f degeneration of, 86­88 Golgi, 80 interneurons, 81, 81f lower motor, 116. See also Lower motor neuron lesions multipolar, 80, 81f properties of, 80 pseudounipolar, 99 sensory, 81, 81f unipolar, 80, 81f upper motor, 115­116. See also Upper motor neuron lesions Neuropeptides 375 nonopioid, 289, 290f opioid, 288, 288f in striatal system, 279 Neuropore, 60, 60f Neurotransmitters, 81, 81f, 240­244, 248Q, 283­297. See also specific types classification, 283 clinical correlations for, 292­293, 294Q­295Q definition, 283 in pain control, 292­293 of parasympathetic nervous system, 244 pathways for, 283 of striatal system, 278­279 of sympathetic nervous system, 240­242 Nigrostriatal pathway, 285, 285f Nissl substance, 81, 81f Nitric oxide, 244, 248Q, 283, 292, 294Q Node of Hensen, 60f Node of Ranvier, 81f, 84 Noncommunicating hydrocephalus, 30, 36Q, 76 Nonfluent aphasia, 303 Nonverbal ideation, 304 Norepinephrine, 240, 248Q, 286­287, 286f Normal-pressure hydrocephalus, 30, 314, 317Q Nuclear bag factors, 92 Nuclear chain factors, 93 Nuclei. See Paralysis Papez circuit, 265, 267f, 269, 271Q Papilledema, 178, 235 Papilloma, of choroid plexus, 87 Parabrachial nucleus of pons, 264 Paracentral artery, 42f Paracentral lobule, 4f, 111, 299, 302 ischemia of, 308 Paracentral sulcus, 4f Parafascicular nucleus, 217f, 218f, 219 Parahippocampal gyrus, 4f, 6, 21f, 33f, 265, 271Q Paralysis laryngeal, 189 medial rectus muscle, 232 in motor neuron disease, 116, 129Q oculomotor, 180, 181, 181f, 210Q, 233­234, 234f, 237Q sternocleidomastoid muscle, 189 superior oblique muscle, 181f, 191Q trapezius muscle, 189 Paramedian midbrain syndrome, 196f, 197 Paramedian reticular formation, 142 Paramedian zone of hemisphere, 204, 205f Parasympathetic nervous system, 242­244, 242t, 243f. See also Aphasia Sphenoparietal sinus, 47 Spina bifida, 72­73, 73f Spinal accessory nerve, 102 Spinal accessory nucleus, 102, 105Q, 180f Spinal artery occlusion, 122f Spinal border cells, 102, 111 Spinal cistern, 27f 379 Spinal cord, 96­106 arteries of, 40, 41f attachments of, 96 complete transection of, 125f, 126 development of, 64­65, 64f divisions of, 96, 97f, 103, 105Q external morphology of, 96­101 gray matter of, 64 hemisection of, 122f, 124, 125f, 130Q internal morphology of, 101­103, 101f, 121f lesions of, 120­132 lower motor neuron, 116, 120­121, 122f upper motor neuron, 115­116, 117Q, 121­123 location of, 96, 97f myelination of, 65 segmental vulnerability of, 40 shape of, 96 tethered, 77, 126 transverse section of, 101f, 121f tumors of, 87 veins of, 40 white matter of, 64 Spinal epidural space, 25 Spinal ganglion, 25f Spinal lemniscus, 133, 135f­137f, 136f, 137f, 138, 139f, 143, 145 Spinal nerve(s), 98­100, 98f, 100f Spinal nerve roots, 96 Spinal nucleus, 134f, 135f Spinal tracts, 107­119 ascending, 107­111, 108f, 110f, 114f descending, 111­115, 112f­115f Spinal trigeminal nucleus, 66, 134f­137f, 138, 151f, 152, 179f Spinal trigeminal tract, 134f­137f, 138, 150, 179f Spine. Caputo, Dovetail Content Solutions Cover Illustration: Karl Wesker International Production Director: Andreas Schabert Vice President, International Marketing and Sales: Cornelia Schulze Chief Financial Officer: James W. Scanlan Compositor: Maryland Composition Printer: Transcontinental Printing Library of Congress Cataloging-in-Publication Data Handbook of otolaryngology­head and neck surgery / edited by David Goldenberg, Bradley J. Summary: "As the title indicates, this book is meant to be a comprehensive clinical resource. It is intentionally designed to fit in a lab coat pocket so it may be carried at all times as a ready reference. The chapters follow a standard outline or template, so that the reader can easily focus on the desired subject matter. Most chapters include key features, a brief discussion or overview, a section on epidemiology followed by symptoms, signs, differential diagnosis, physical exam, imaging, labs, treatment options, and outcome and follow-up.