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In this chapter generic benicar 20 mg free shipping arteria gastrica sinistra, however order generic benicar canada blood pressure 68 over 48, you look at the living computer that choreographs the whole show order benicar 40mg amex arteria meningea, the one system that contributes the most to making us who we are as humans purchase benicar 40mg mastercard pulse pressure 33. The nervous system is the communications network that goes into nearly every part of the body, enervating your muscles, pricking your pain sensors, and letting you reach beyond yourself into the larger world. More than 80 major nerves make up this intricate network, and each nerve contains somewhere around 1 million neurons (individual nerve cells). It’s through this complex network that you respond both to external and internal stimuli, demonstrating a characteristic called irritability (the capacity to respond to stimuli, not the tendency to yell at annoying people). There are three functional types of cells in the nervous system: receptor cells that receive a stimulus (sensing); conductor cells that transmit impulses (integrating); and effector cells, or motor neurons, which bring about a response such as contracting a muscle. Put another way, there are three functions of the human nervous system as a whole: orientation, or the ability to generate nerve impulses in response to changes in the external and internal environments (this also can be referred to as perception); coordination, or the ability to receive, sort, and direct those signals to channels for response (this also can be referred to as integration); and conceptual thought, or the capacity to record, store, and relate information received and to form plans for future reactions to environmental change (which includes specific action). You practice identi- fying the parts and functions of nerves and the brain itself as well as the structure and activi- ties of the Big Three parts of the whole nervous system: the central, the peripheral, and the autonomic systems. In addition, we touch on the sensory organs that bring information into the human body. Part V: Mission Control: All Systems Go 238 Building from Basics: Neurons, Nerves, Impulses, Synapses Before trying to study the system as a whole, it’s best to break it down into building blocks first. Neurons The basic unit that makes up nerve tissue is the neuron (also called a nerve cell). Its properties include that marvelous irritability that we speak of in the chapter introduc- tion as well as conductivity, otherwise known as the ability to transmit a nerve impulse. The central part of a neuron is the cell body, or soma, that contains a large nucleus with one or more nucleoli, mitochondria, Golgi apparatus, numerous ribosomes, and Nissl bodies that are associated with conduction of a nerve impulse. Two types of cytoplasmic projections play a role in neurons: Dendrites conduct impulses to the cell body while axons (nerve fibers) usually conduct impulses away from the cell body (see Figure 15-1). Each neuron has only one axon; however, each axon can have many branches called axon collaterals, enabling communication with many target cells. In addition, each neuron may have one dendrite, several dendrites, or none at all. There are three types of neurons, as follows: Motor neurons, or efferent neurons, transmit messages from the brain and spinal cord to effector organs, including muscles and glands, triggering them to respond. Motor neurons are classified structurally as multipolar because they’re star-shaped cells with a single large axon and numerous dendrites. Sensory neurons, or afferent neurons, are triggered by physical stimuli, such as light, and pass the impulses on to the brain and spinal cord. Sensory fibers have special structures called receptors, or end organs, where the stimulus is propa- gated. Monopolar neurons have a single process (a projection or outgrowth of tissue) that divides shortly after leaving the cell body; one branch conveys impulses from sense organs while the other branch carries impulses to the central nervous system. Association neurons (also called internuncial neurons, interneurons, or interca- lated neurons) are triggered by sensory neurons and relay messages between neurons within the brain and spinal cord. Here are a couple of handy memory devices: Afferent connections arrive, and efferent connections exit. Sensory Neuron Dendrites Cell body Nucleolus Nucleus Nucleolus Axon Nucleus Nucleus of Schwann cell Figure 15-1: Cell body The motor neuron on Schwann cell Axon the left and Node of Ranvier sensory neuron on the right show the cell struc- tures and the paths of Synaptic bouton impulses.
In severe cases order benicar cheap blood pressure chart medication, perforation discount benicar 20mg on line arteria carotis communis, paracolic abscess formation or septi- caemia may develop purchase 10 mg benicar visa arteria meningea media. The barium enema from 4 years ago shows evidence of diverticular disease with outpouch- ings of the mucosa in the sigmoid colon order benicar no prescription arrhythmia qt interval prolongation. This would be consistent with the long-standing history of abdominal pain of colonic type and tendency to constipation. In her case there is no evidence of peritonitis which would signal a possible perforation of one of the diverticula. The differential diagnosis, with the suggestion of a mass and change in bowel habit, would be carcinoma of the colon and Crohn’s disease. In the absence of evidence of perforation with leak of bowel contents into the peritoneum (no peritonitis) or obstruction (normal bowel sounds, no general distension), treatment should be based on the presumptive diag- nosis of diverticulitis. A colonoscopy should be performed at a later date to exclude the possibility of a colonic neoplasm. Treatment should include broad-spectrum antibiotics, intra- venous fluids and rest. Further investigations are indicated, including electrolytes, urea and creatinine, glucose, liver function tests and blood cultures. Her blood pressure has been difficult to control and she is currently taking four agents (ben- drofluazide, atenolol, amlodipine and doxazosin). She had normal blood pressure and no pre-eclampsia during her only pregnancy 9 years previously. Risk factors for essential hypertension include a family history of hypertension, obesity and lack of exercise. She does not have paroxysmal symptoms of sweating, palpitations and anxiety to suggest a phaeochromocy- toma. There are no clinical features to suggest coarctation of the aorta (radiofemoral delay) or neurofibromatosis (café-au-lait spots/neurofibromas). Serum potassium is not low mak- ing Conn’s syndrome or Cushing’s syndrome unlikely. The principal abnormality is the modestly raised creatinine suggesting mildly impaired renal function. The absence of a renal bruit does not exclude the possibility of reno- vascular disease. This is common in elderly patients with evidence of generalized atherosclerosis (peripheral vascular disease and coronary artery disease). The commonest form is medial fibroplasia with thinning of the intima and media leading to formation of aneurysms alternating with stenoses, leading to the classic ‘string of beads’ appearances on angiography. It predomi- nantly affects young and middle-aged women with a peak incidence in the fourth decade of life. Over the past 2 weeks she has developed multiple tender red swellings on her shins and forearms. She has had no genital ulceration but she has been troubled by intermittent abdominal pain and diarrhoea. She has had no other previous medical illnesses and there is no relevant family history that she can recall. Her joints are not inflamed and the range of movement is not restricted or painful. Erythema nodosum is due to inflammation of the small blood vessels in the deep dermis. Characteristically it affects the shins, but it may also affect the thighs and forearms.
This fact is puzzling cheap 20 mg benicar with mastercard blood pressure medication beginning with h, in part because the number of left-handers is so low order generic benicar line 4, and in part because other animals purchase benicar 10 mg with mastercard prehypertension how to treat, including our closest primate relatives purchase generic benicar from india arrhythmia quiz, do not show any type of handedness. The existence of right-handers and left-handers provides an interesting example of the relationship among evolution, biology, and social factors and how the same phenomenon can be understood at different levels of analysis (Harris,  1990; McManus, 2002). Ultrasound scans show that 9 out of 10 fetuses suck the thumb of  their right hand, suggesting that the preference is determined before birth (Hepper, Wells, & Lynch, 2005), and the  mechanism of transmission has been linked to a gene on the X chromosome (Jones & Martin, 2000). It has also been observed that left-handed people are likely to have fewer children, and this may be in part because the mothers of left-handers are more prone to miscarriages and other prenatal problems (McKeever, Cerone, Suter, & Wu,  2000). In the past, left-handed children were forced to write with their right hands in many countries, and this practice continues, particularly in collectivistic cultures, such as India and Japan, where left- handedness is viewed negatively as compared with individualistic societies, such as the United States. For example,  India has about half as many left-handers as the United States (Ida & Mandal, 2003). There are both advantages and disadvantages to being left-handed in a world where most people are right-handed. This may explain in part why left-handers suffer  somewhat more accidents than do right-handers (Dutta & Mandal, 2006). Despite the potential difficulty living and working in a world designed for right-handers, there seem to be some advantages to being left-handed. Throughout history, a number of prominent artists have been left-handed, including Leonardo da Vinci, Michelangelo, Pablo Picasso, and Max Escher. Because the right hemisphere is superior in imaging and visual abilities, there may be some advantage to using the left hand for drawing or painting (Springer &  Deutsch, 1998). Left-handed people are also better at envisioning three-dimensional objects, which may explain why there is such a high number of left-handed architects, artists, and chess players in proportion to their numbers  (Coren, 1992). However, there are also more left-handers among those with reading disabilities, allergies, and  migraine headaches (Geschwind & Behan, 2007), perhaps due to the fact that a small minority of left-handers owe  their handedness to a birth trauma, such as being born prematurely (Betancur, Vélez, Cabanieu, & le Moal, 1990). In sports in which handedness may matter, such as tennis, boxing, fencing, or judo, left-handers may have an advantage. They play many games against right-handers and learn how to best handle their styles. Right-handers, however, play very few games against left-handers, which may make them more vulnerable. In other sports, such as golf, there are fewer left-handed players because the handedness of one player has no effect on the competition. The fact that left-handers excel in some sports suggests the possibility that they may have also had an evolutionary advantage because their ancestors may have been more successful in important skills such as hand-to-hand combat  (Bodmer & McKie, 1994). At this point, however, this idea remains only a hypothesis, and determinants of human handedness are yet to be fully understood. Other areas of the cortex act as association areas, responsible for integrating information. Body parts requiring the most control and dexterity take up the most space in the motor cortex. Body parts that are the most sensitive occupy the greatest amount of space in the sensory cortex. Consider your own experiences and speculate on which parts of your brain might be particularly well developed as a result of these experiences. Which brain hemisphere are you likely to be using when you search for a fork in the silverware drawer? Which brain hemisphere are you most likely to be using when you struggle to remember the name of an old friend? Do you think that encouraging left-handed children to use their right hands is a good idea?
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F The cytoplasmic projection of a neuron that carries impulses away from the cell body is called c buy benicar online pre hypertension and diabetes. Each neuron cell usually has only one axon cheap benicar 10 mg without a prescription blood pressure drops after eating, although it may branch off several times purchase 40mg benicar fast delivery blood pressure chart stage 2. First we focus on how bones are formed before broadening the view to the axial skeleton (the parts that line up from head to toe) and the appendicular skeleton (the parts that reach out from the central axis) discount 20mg benicar fast delivery blood pressure chart for 80 year old woman. You review how muscles attach to that framework and watch the body take shape before wrapping this newly layered package in the body’s largest single organ: the skin. Chapter 5 A Scaffold to Build On: The Skeleton In This Chapter Getting to know your bones Keeping the axial skeleton in line Checking out the appendicular skeleton Playing with joints uman osteology, from the Greek word for “bone” (osteon) and the suffix –logy, which Hmeans “to study,” focuses on the 206 bones in the adult body endoskeleton. But it’s more than just bones; it’s also ligaments and cartilage and the joints that make the whole assembly useful. In this chapter, you get lots of practice exploring the skeletal functions and how the joints work together. Understanding Dem Bones The skeletal system as a whole serves five key functions: Protection: The skeleton encases and shields delicate internal organs that might other- wise be damaged during motion or crushed by the weight of the body itself. For exam- ple, the skull’s cranium houses the brain, and the ribs and sternum of the thoracic cage protect organs in the central body cavity. Movement: By providing anchor sites and a scaffold against which muscles can con- tract, the skeleton makes motion possible. The bones act as levers, the joints are the fulcrums, and the muscles apply the force. For instance, when the biceps muscle con- tracts, the radius and ulna bones of the forearm are lifted toward the humerus bone of the upper arm. Support: The vertebral column’s curvatures play a key role in supporting the entire body’s weight, as do the arches formed by the bones of the feet. Upper body support flows from the clavicle, or collarbone, which is the only bone that attaches the upper extremities to the axial skeleton and the only horizontal long bone in the human body. Mineral storage: Calcium, phosphorous, and other minerals like magnesium must be maintained in the bloodstream at a constant level, so they’re “banked” in the bones in case the dietary intake of those minerals drops. The bones’ mineral content is con- stantly renewed, refreshing entirely about every nine months. Blood cell formation: Called hemopoiesis or hematopoiesis, most blood cell formation takes place within the red marrow inside the ends of long bones as well as within the ver- tebrae, ribs, sternum, and cranial bones. Marrow produces three types of blood cells: erythrocytes (red cells), leukocytes (white cells), and thrombocytes (platelets). Most of these are formed in red bone marrow, although some types of white blood cells are pro- duced in fat-rich yellow bone marrow. In cases of severe blood loss, the body can convert yellow marrow back to red marrow in order to increase blood cell production. If you hesitated to choose “all of hemostasis, which is the stoppage the above,” ask yourself this: If you of bleeding or blood flow. Besides support and protection, the skeleton serves other important functions, including a. Divide different body areas Chapter 5: A Scaffold to Build On: The Skeleton 63 Boning Up on Classifications, Structures, and Ossification Adult bones are composed of 30 percent protein (called ossein), 45 percent minerals (including calcium, phosphorus, and magnesium), and 25 percent water. Mineral in the bones increases with age, causing them to become more brittle and easily fractured. Various types of bone make up the human skeleton, but fortunately for memorization purposes, bone type names match what the bones look like.