Individualized Webcam facilitated and e-Classroom USMLE Step 1 Tutorials with Dr. Cray. For questions or more information.. drcray@imhotepvirtualmedsch.com
The portion of the nervous system that controls most visceral functions of the body that are generally not under conscious control is called the autonomic nervous system.
This system helps to control arterial pressure,
Gastrointestinal motility,
Gastrointestinal secretion,
Urinary bladder emptying,
Sweating,
Body temperature,
Individualized Webcam facilitated and e-Classroom USMLE Step 1 Tutorials with Dr. Cray. For questions or more information.. drcray@imhotepvirtualmedsch.com
The portion of the nervous system that controls most visceral functions of the body that are generally not under conscious control is called the autonomic nervous system.
This system helps to control arterial pressure,
Gastrointestinal motility,
Gastrointestinal secretion,
Urinary bladder emptying,
Sweating,
Body temperature,
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
The Gram stain is a fundamental technique in microbiology used to classify bacteria based on their cell wall structure. It provides a quick and simple method to distinguish between Gram-positive and Gram-negative bacteria, which have different susceptibilities to antibiotics
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
3. A. Visceral Afferent Fibers:
qInformation on the status of the visceral organs is transmitted to the CNS through
two main sensory systems:
§ the cranial nerve (parasympathetic) visceral sensory system and
§ the spinal (sympathetic) visceral afferent system.
qCranial visceral sensory information enters the CNS by four cranial nerves: the
trigeminal (V), facial (VII), glossopharyngeal (IX), and vagus (X) nerves.
qThese four cranial nerves transmit visceral sensory information from the internal
face and head (V); tongue (taste, VII); hard palate and upper part of the
oropharynx (IX); and carotid body, lower part of the oropharynx, larynx, trachea,
esophagus, and thoracic and abdominal organs (X), with the exception of the
pelvic viscera. The pelvic viscera are innervated by nerves from the second
through fourth sacral spinal segments.
In body, nerve fibers are divided in to following types:
4. B. Visceral Efferent Fibers:
On the efferent side, Information on the status of the CNS/Spinal Cord is transmitted to the visceral
organs.
The neurons consists of two large divisions:
(1) the sympathetic or thoracolumbar outflow
(2) the parasympathetic or craniosacral outflow.
5. Autonomic Nervous System (ANS):
§ Also called as Visceral, vegetative or involuntary nervous system
§ Regulates all autonomic functions that occur without conscious control
§ The autonomic nervous system conveys all the outputs from the CNS to the
rest of the body, except for the motor innervation of skeletal muscle.
§ The terms cholinergic and adrenergic describe neurons that liberate
Acetylcholine (Ach) or Norepinephrine (NE), respectively.
§ ANS consists of three main anatomical divisions:
1. Sympathetic NS
2. Parasympathetic NS
3. Enteric NS
6. A. Sympathetic Nervous System: ‘fight or flight’ state
q The cell bodies of the sympathetic preganglionic neurons lie in the lateral horn of the grey
matter of the thoracic and lumbar segments of the spinal cord, and the fibres leave the spinal
cord in the spinal nerves as the thoracolumbar sympathetic outflow.
q The intervening synapses lie in autonomic ganglia, which are outside the CNS, and contain
the nerve endings of preganglionic fibres and the cell bodies of postganglionic neurons.
q Sympathetic ganglia are found in three locations: paravertebral, prevertebral, and terminal.
q The white rami are restricted to the segments of the thoracolumbar outflow; they carry the
preganglionic myelinated fibers that exit the spinal cord by the anterior spinal roots.
q The gray rami arise from the ganglia and carry postganglionic fibers back to the spinal
nerves for distribution to effector organ.
9. A. Sympathetic Nervous System:
q The 22 pairs of paravertebral sympathetic ganglia form the lateral chains on either side of
the vertebral column. The ganglia are connected to each other by nerve trunks and to the
spinal nerves by rami communicantes.
q The prevertebral ganglia lie in the abdomen and the pelvis near the ventral surface of the
bony vertebral column and consist mainly of the celiac (solar), superior mesenteric,
aorticorenal, and inferior mesenteric ganglia.
q The terminal ganglia are few in number, lie near the organs they innervate, and include
ganglia connected with the urinary bladder and rectum and the cervical ganglia in the
region of the neck.
q Preganglionic fibers issuing from the spinal cord may synapse with the neurons of more
than one sympathetic ganglion, and Postganglionic fibers arising from sympathetic ganglia
innervate visceral structures of the thorax, abdomen, head, and neck.
10.
11. B. Parasympathetic Nervous System: ‘rest and digest’ state
q The parasympathetic nervous system consists of preganglionic fibers that
originate in the CNS and their postganglionic connections.
q In parasympathetic pathways, the postganglionic cells are mainly found in the
target organs.
q The parasympathetic system is connected to the CNS via:
§ cranial nerve outflow (III, VII, IX, X) [Oculomotor nerve (III) (carrying
parasympathetic fibres destined for the eye), the facial (VII) (carrying fibres to the
salivary glands), glossopharyngeal nerves (IX) (carrying fibres to the
nasopharynx) and the vagus nerve (X) (carrying fibres to the thoracic and
abdominal viscera)]
§ sacral outflow [destined for the pelvic and abdominal viscera emerge in a bundle
of nerves known as the nervi erigentes]
12. C. Enteric Nervous System (ENS):
q The processes of mixing, propulsion, and absorption of nutrients in the GI tract are
controlled locally through a restricted part of the peripheral nervous system called the
ENS.
q The ENS comprises components of the sympathetic and parasympathetic nervous systems
and has sensory nerve connections through the spinal and nodose ganglia.
q Two nerve plexuses: (i) the myenteric (Auerbach) plexus and
(ii) the submucosal (Meissner) plexus.
q The myenteric plexus, located between the longitudinal and circular muscle layers, plays
an important role in the contraction and relaxation of GI smooth muscle.
q The submucosal plexus is involved with secretory and absorptive functions of the GI
epithelium, local blood flow, and neuroimmune activities.
q Neurotransmitters of ENS: ACh, ATP, Substance P, 5-HT.
14. q Autonomic nervous system supply all innervated structures of the body except
skeletal muscle, which is served by somatic nerves.
q The most autonomic ganglia that are entirely outside the cerebrospinal axis.
Somatic nerves contain no peripheral ganglia, and the synapses are located
entirely within the cerebrospinal axis.
q Many autonomic nerves form extensive peripheral plexuses; such networks are
absent from the somatic system.
q Postganglionic autonomic nerves generally are nonmyelinated; motor nerves to
skeletal muscles are myelinated.
q When the spinal efferent nerves are interrupted, smooth muscles and glands
generally retain some level of spontaneous activity, whereas the denervated
skeletal muscles are paralyzed.
Difference between Autonomic and Somatic Nervous System
15. Neurochemical transmission:
Steps Involved in Neurotransmission:
1. Axonal Conduction
2. Junctional Transmission
i. Storage and release of transmitter
ii. Interaction of the transmitter with postjunctional receptors
and production of the postjunctional potential
iii. Initiation of postjunctional activity
iv. Destruction or dissipation of the transmitter
v. Nonelectrogenic functions
18. q Conduction refers to the passage of an electrical impulse along an axon or muscle fiber.
q At rest, the interior of the typical mammalian axon is about 70 mV negative to the exterior.
q In response to depolarization to a threshold level, an action potential (AP) is initiated at a local region of the
membrane.
q The AP consists of two phases. Following depolarization that induces an open conformation of the channel, the
initial phase is caused by a rapid increase in the permeability and inward movement of Na+ through voltage-
sensitive Na+ channels, and a rapid depolarization from the resting potential continues to a positive overshoot.
q The second phase results from the rapid inactivation of the Na+ channel and the delayed opening of a K+ channel,
which permits outward movement of K+ to terminate the depolarization.
q Although not important in axonal conduction, Ca2+ channels in other tissues (e.g., L-type Ca2+ channels in heart)
contribute to the AP by prolonging depolarization by an inward movement of Ca2+.
q This influx of Ca2+ also serves as a stimulus to initiate intracellular events, and Ca2+ influx is important in
excitation-exocytosis coupling (transmitter release).
q The transmembrane ionic currents produce local circuit currents such that adjacent resting channels in the axon
are activated, and excitation of an adjacent portion of the axonal membrane occurs, leading to propagation of the
AP without decrement along the axon.
1. Axonal Conduction
20. q Transmission refers to the passage of an impulse across a synaptic or neuroeffector junction.
q The arrival of the action potential at the axonal terminals initiates a series of events that trigger transmission of
an excitatory or inhibitory biochemical message across the synapse or neuroeffector junction.
i. Storage and release of transmitter:
§ The nonpeptide (small-molecule) neurotransmitters, such as biogenic amines, are largely synthesized in
the region of the axonal terminals and stored there in synaptic vesicles.
§ Neurotransmitter transport into storage vesicles is driven by an electrochemical gradient generated by the
vesicular proton pump (vesicular ATPase).
§ Synaptic vesicles cluster in discrete areas underlying the presynaptic plasma membrane, termed active
zones, often aligning with the tips of postsynaptic folds. Proteins in the vesicular membrane (e.g., synapsin,
synaptophysin, synaptogyrin) are involved in development and trafficking of the storage vesicle to the
active zone.
§ The processes of priming, docking, fusion, and exocytosis involve the interactions of proteins in the
vesicular and plasma membranes and the rapid entry of extracellular Ca2+ and its binding to
synaptotagmins.
2. Junctional Transmission
21. Molecular basis of exocytosis: Docking and fusion of
synaptic vesicles with neuronal membranes:
1. Vesicular docking in the active zone: Munc18
binds to syntaxin 1, stabilizing the neuronal
membrane SNARE proteins.
2. Priming I: Syntaxin assembles with SNAP25,
allowing for the vesicle SNARE protein
synaptobrevin to bind to the complex.
3. Priming II: Complexin binds to the SNARE
complex and allows for the vesicular
synaptotagmin to bind Ca2+ that drives the full
fusion process.
4. Fusion pore opening: Synaptotagmin interacts
with the SNARE complex and binds Ca2+,
permitting pore fusion and exocytosis of
neurotransmitter.
5. Return to ground state: After fusion, the
chaperone ATPase NSF and its SNAP adapters
catalyze dissociation of the SNARE-complex
2. Junctional Transmission
22. ii. Interaction of the transmitter with postjunctional receptors and production of the
postjunctional potential:
§ The transmitter diffuses across the synaptic or junctional cleft and combines with
specialized receptors on the postjunctional membrane; this often results in a localized
increase in the ionic permeability, or conductance, of the membrane.
§ One of three types of permeability change can occur:
-Generalized increase in the permeability to cations (notably Na+ but occasionally
Ca2+), resulting in a localized depolarization of the membrane, that is, an EPSP.
-Selective increase in permeability to anions, usually Cl–, resulting in stabilization or
actual hyperpolarization of the membrane, which constitutes an IPSP.
-Increased permeability to K+. Because the K+ gradient is directed out of the cell,
hyperpolarization and stabilization of the membrane potential occur (an IPSP).
2. Junctional Transmission
23. iii. Initiation of postjunctional activity:
§ If an EPSP exceeds a certain threshold value, it initiates a propagated action
potential in a postsynaptic neuron or a muscle action potential in skeletal or
cardiac muscle by activating voltage-sensitive channels in the immediate vicinity.
§ An IPSP, which is found in neurons and smooth muscle but not in skeletal
muscle, will tend to oppose excitatory potentials simultaneously initiated by other
neuronal sources.
§ Whether a propagated impulse or other response ensues depends on the
summation of all the potentials.
2. Junctional Transmission
24. iv. Destruction or dissipation of the transmitter:
§ When impulses can be transmitted across junctions at frequencies up to several hundred
per second, there must be an efficient means of disposing of the transmitter following each
impulse.
§ At cholinergic synapses involved in rapid neurotransmission, high and localized
concentrations of Acetylcholinesterase (AChE) are available for this purpose. When AChE
activity is inhibited, removal of the transmitter is accomplished principally by diffusion.
§ Rapid termination of Norepinephrine (NE) occurs by a combination of simple diffusion and
reuptake by the axonal terminals of most of the released NE.
§ Termination of the action of amino acid transmitters results from their active transport into
neurons and surrounding glia.
§ Peptide neurotransmitters are hydrolyzed by various peptidases and dissipated by
diffusion.
2. Junctional Transmission
25. v. Nonelectrogenic functions:
The activity and turnover of enzymes involved in the synthesis and inactivation
of neurotransmitters, the density of presynaptic and postsynaptic receptors, and
other characteristics of synapses are controlled by trophic actions of
neurotransmitters or other trophic factors released by the neuron or target cells.
2. Junctional Transmission