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Amyotrophic lateral dicates a lesion in the area of the paramedian pontine reticular for- sclerosis is an inherited disease that affects spinal and/or brainstem mation and abducens nucleus (in this case on the right side) and the motor neurons and may result in upper or lower motor neuron adjacent medial longitudinal fasciculus (MLF) 10 mg maxalt with amex. The lesion damages symptoms; this disease is usually fatal within a few years order 10mg maxalt free shipping. Multiple the ipsilateral abducens motor neurons, internuclear neurons sclerosis is a demyelinating disease; Parkinson and Huntington dis- passing to the contralateral MLF, and internuclear axons in the ip- eases are neurodegenerative conditions that eventually have a de- silateral MLF coming from the contralateral abducens nucleus. Answer C: The history and the combination of signs and symp- Internuclear ophthalmoplegia is a deficit of medial gaze in one eye, toms seen in this woman indicate a probable diagnosis of myas- assuming a one-sided lesion. Answer A: Anterior trigeminothalamic collaterals that project clear terminals and to synaptic contacts within the basal nuclei and into the dorsal motor nucleus of the vagus are an important link in the cerebellum would result in motor deficits but not in the pat- the reflex pathway for vomiting. Answer A: The neurotransmitter at the neuromuscular junction Collaterals of primary afferent fibers to the mesencephalic nucleus is acetylcholine; a blockage of postsynaptic nicotinic acetylcholine that branch to enter the trigeminal motor nucleus mediate the jaw receptors is the cause of the motor deficits characteristically seen reflex. A loss of dopamine results in Parkinson disease, motor deficits that are not seen in this woman. Answer E: The most anterior (ventral) portion of the medial Glutamate and GABA are found in many pathways involved in mo- lemniscus at mid-olivary levels contains second order fibers con- tor function but are not located at the neuromuscular junction. Answer D: A lesion in the medial longitudinal fasciculus (MLF) diations (geniculocalcarine radiations). The visual loss is in the vi- on the right interrupts axons of the interneurons that arise from sual field contralateral to the side of the lesion. Lesions in the the left abducens nucleus and pass to oculomotor motor neurons lower portions of the radiations result in deficits in the contralat- on the right innervating the medial rectus muscle (internuclear eral superior quadrants, while lesions in the upper portions of the ophthalmoplegia). Damage to the abducens nucleus will indeed radiations result in deficits in the contralateral lower quadrants.

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The epicondyles buy 10mg maxalt with visa, coronoid and olecranon latter of which is the socket for anterior crest is a sharp ridge fossae best 10mg maxalt, a capitulum, and a trochlea. The antebrachium contains the ulna include the body, ramus, ischial 7 tarsal bones, 5 metatarsal bones, (medially) and the radius (laterally). The great toe lacks a (a) Proximally, distinguishing features of (c) Distinguishing features of the pubis middle phalanx. The clavicle articulates with (d) the clavicle arranged in two transverse rows of (a) the scapula and the humerus. The proximal process of the ulna is (b) All of the carpal bones are considered (c) the manubrium and the scapula. Skeletal System: The © The McGraw−Hill Anatomy, Sixth Edition Appendicular Skeleton Companies, 2001 Chapter 7 Skeletal System: The Appendicular Skeleton 195 (d) The trapezium, trapezoid, capitate, 2. Explain why the clavicle is more frequently been buried in Italy, it was reinterred in and hamate articulate with the fractured than the scapula. List the processes of the bones of the upper Smithsonian in Washington, D. Pelvimetry is a measurement of and lower extremities that can be palpated. Why are these bony landmarks important Smithsonian carefully examined (b) the symphysis pubis. Which of the following is not a structural important differences in structure and but athletic—he had a large chest and feature of the os coxae? His teeth were (a) the obturator foramen anatomy of these appendages, taking into worn on the left side from chewing a (b) the acetabulum account their functional roles. Define bipedal locomotion and discuss the “certain peculiarities of the right little (d) the greater sciatic notch adaptations of the pelvic girdle and lower finger suggest that he may have played (e) the linea aspera extremities that allow for this type of the harpsichord, piano, or a stringed movement. Explain how the female pelvis is adapted bones can serve as a storehouse of line would involve to the needs of pregnancy and childbirth. Explain the significance of the limb buds, technology, what other types of (b) the femur. What is meant by a congenital skeletal adaptation of the hand or adaptation of pelvis malformation?

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A maxillary buy cheap maxalt 10 mg on-line, muscle tonus to the lateral rectus muscle discount maxalt 10mg online, the eyeball will be or second-division, nerve block, performed by injecting near the pulled medially. Peripheral Nervous © The McGraw−Hill Anatomy, Sixth Edition Coordination System Companies, 2001 Chapter 12 Peripheral Nervous System 407 Eyeball Retina Optic nerve Optic chiasma Optic tract Lateral geniculate nucleus of thalamus Optic radiation Visual cortex of occipital lobes (a) Frontal lobe Olfactory bulb Longitudinal cerebral Olfactory tract fissure Optic nerve (cut) Optic chiasma Pituitary gland Optic tract Mammillary body Cerebral aquaduct Cerebral peduncle Lateral geniculate nucleus of thalamus Optic radiation Corpus callosum Visual cortex of occipital lobe (b) FIGURE 12. Peripheral Nervous © The McGraw−Hill Anatomy, Sixth Edition Coordination System Companies, 2001 408 Unit 5 Integration and Coordination Trochlea Superior oblique m. Peripheral Nervous © The McGraw−Hill Anatomy, Sixth Edition Coordination System Companies, 2001 Chapter 12 Peripheral Nervous System 409 Temporal nerve Zygomatic nerve Posterior auricular nerve Facial nerve Nerve to digastric and stylohyoid mm. VII Facial Trauma to the facial nerve results in inability to contract facial muscles on the affected side of the face and distorts taste The facial nerve arises from nuclei within the lower portion perception, particularly of sweets. The affected side of the face of the pons, traverses the petrous part of the temporal bone (see tends to sag because muscle tonus is lost. Impulses through the motor fibers cause contraction of the posterior belly of the digas- tric muscle and the muscles of facial expression, including the VIII Vestibulocochlear scalp and platysma muscles (fig. A purely sen- Sensory fibers of the facial nerve arise from taste buds on sory nerve, the vestibulocochlear is composed of two nerves that the anterior two-thirds of the tongue. The vestibular nerve arises chemoreceptors because they respond to specific chemical stimuli. Bipolar neurons from the vestibular organs (saccule, utri- of the facial nerve just before the entrance of the sensory portion cle, and semicircular ducts) extend to the vestibular ganglion, into the pons. Sensations of taste are conveyed to nuclei within the medulla oblongata, travel through the thalamus, and ulti- mately to the gustatory (taste) area in the parietal lobe of the Bell’s palsy: from Sir Charles Bell, Scottish physician, 1774–1842 cerebral cortex. Peripheral Nervous © The McGraw−Hill Anatomy, Sixth Edition Coordination System Companies, 2001 410 Unit 5 Integration and Coordination Semicircular canals Facial nerve Vestibular nerve Utricle Cochlear nerve Vestibulocochlear nerve Cochlea Saccule FIGURE 12. The semicircular ducts, concerned with balance and equilibrium, form the membranous labyrinth within the semicircular canals. From there, fibers convey im- Glossopharyngeal pulses to the vestibular nuclei within the pons and medulla ob- nerve longata.

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Na entry In summary purchase maxalt 10mg with amex, though the osmolality (total solute concen- into the cell occurs via several cotransporter and antiport tration) does not detectably change along the proximal mechanisms generic 10 mg maxalt with visa. Na is reabsorbed together with glucose, convoluted tubule, it is clear that the concentrations of in- amino acids, phosphate, and other solutes by way of sepa- dividual solutes vary widely. The downhill (energetically substances fall (glucose, amino acids, HCO3 ), others rise speaking) movement of Na into the cell drives the uphill (inulin, urea, Cl , PAH), and still others do not change transport of these solutes. By the end of the proximal convoluted tubule, acids, phosphate, and so on are reabsorbed by secondary only about one-third of the filtered Na , water, and K re- active transport. Na is also reabsorbed across the luminal main; almost all of the filtered glucose, amino acids, and cell membrane in exchange for H. The Na /H ex- HCO3 have been reabsorbed, and several solutes destined changer, an antiporter, is also a secondary active transport for excretion (PAH, inulin, urea) have been concentrated in mechanism; the downhill movement of Na into the cell the tubular fluid. This mechanism is important in the acidification of urine (see Na Reabsorption Is the Major Driving Force Chapter 25). Cl may enter the cells by way of a luminal cell membrane Cl -base (formate or oxalate) exchanger. This membrane ATPase pumps three Na out ters the cell from the lumen across the apical cell mem- of the cell and two K into the cell and splits one ATP mol- brane and is pumped out across the basolateral cell mem- ecule for each cycle of the pump. K pumped into the cell diffuses out the basolateral cell membrane mostly through brane by Na /K -ATPase. The Na and accompanying anions and water are then taken up by the blood sur- a K channel. Glucose, amino acids, and phosphate, accu- CHAPTER 23 Kidney Function 393 mulated in the cell because of active transport across the ies was previously filtered in the glomeruli. Because a pro- luminal cell membrane, exit across the basolateral cell tein-free filtrate was filtered out of the glomeruli, the [pro- membrane by way of separate, Na -independent facilitated tein] (hence, colloid osmotic pressure) of blood in the per- diffusion mechanisms. HCO3 exits together with Na by itubular capillaries is high, providing an important driving an electrogenic mechanism; the carrier transports three force for the uptake of reabsorbed fluid. Cl may leave the cell by way of an pressure in the peritubular capillaries (a pressure that op- electrically neutral K-Cl cotransporter. The bal- tablishes an osmotic gradient across the proximal tubule ance of pressures acting across peritubular capillaries favors epithelium that is the driving force for water reabsorption.