This document discusses motor neurophysiology and motor control pathways in the central nervous system. It begins by describing the hierarchy of motor control areas in the cortex, including the primary motor cortex, premotor area, and supplementary motor area. It then discusses the descending motor pathways, dividing them into direct pathways like the pyramidal tracts and indirect extrapyramidal pathways. The main pathways discussed are the lateral corticospinal tract, rubrospinal tract, reticulospinal tract, and vestibulospinal tract. The functions and locations of termination of these tracts are described. Clinical features of upper and lower motor neuron lesions are also summarized.
Pyramidal tract by Sunita.M.Tiwale,Prof. Dept of physiology,D.Y.Patil Medical...Physiology Dept
Specific Learning Objectives:
At the end of session the students should be able to :
Enumerate the descending tracts.
Describe the origin, course, termination, collaterals of Pyramidal tract.
Describe the functions of the pyramidal tract.
here i am to explain the Anatomy and physiology of part of the Pyramidal tract, that is the corticospinal tract. I also added the clinical significance of corticospinal tract. The course of the corticospinal tract are well explained.
Pyramidal tract by Sunita.M.Tiwale,Prof. Dept of physiology,D.Y.Patil Medical...Physiology Dept
Specific Learning Objectives:
At the end of session the students should be able to :
Enumerate the descending tracts.
Describe the origin, course, termination, collaterals of Pyramidal tract.
Describe the functions of the pyramidal tract.
here i am to explain the Anatomy and physiology of part of the Pyramidal tract, that is the corticospinal tract. I also added the clinical significance of corticospinal tract. The course of the corticospinal tract are well explained.
USMLE NEUROANATOMY 03 Descending pathway motor tract anatomy .pdfAHMED ASHOUR
Descending tracts are neural pathways in the central nervous system (CNS) that carry motor signals from the brain to the spinal cord. These tracts are responsible for transmitting commands from the brain to motor neurons, which then execute voluntary movements. These descending tracts collectively contribute to the coordination and execution of voluntary and involuntary movements. Injuries or lesions affecting the descending tracts can lead to various motor deficits, depending on the location and extent of the damage. Understanding the organization and function of these tracts is essential for diagnosing and treating motor disorders and neurological conditions.
This powerpoint was prepared to be presented at University of Health Sciences Cambodia for the Neurosurgery , Medicine and Psychiatry Residents, by shaweta khosa
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
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.
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Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
2. OBJECTIVES
1. Locate the various motor areas of cerebral cortex
2. Describe the pathway of the pyramidal tract
3. Describe the pathways and functions of major
extrapyramidal tracts
4. Express the function of brainstem in controlling
motor functions of the body.
3. The human skeleton is a system of levers that
are moved by contraction of skeletal muscles.
The motor system is comprised of skeletal muscles
and the neurons that control them.
Muscle contraction only occurs in response to
action potentials in alpha motor neurons, which
originate in the ventral gray matter of the spinal cord
(and brainstem nuclei) and constitute
the final common path for motor control
5. Cortical motor areas
• Four areas
• Primary motor cortex
• Premotor area
• Suplementary motor
area
• Parietal cortex
6.
7.
8.
9.
10.
11.
12. Inputs to Motor Cortex
1. Subcortical fibers from other cortical areas:
somatosensory, frontal, auditory, visual.
2. Subcortical fibers from contralateral cortex through
the corpus callosum.
3. Somatosensory fibers from thalamic ventrobasal
complex.
4. Fibers from thalamic VL and ventroanterior nuclei –
from cerebellum and basal ganglia.
5. Fibers from thalamic intralaminar nuclei – arousal.
13. Motor Cortex
1. Primary motor cortex=4
1. Somatotopic arrangement
2. > 1/2 area ---controls hands & speech
3. More of neuron stimulate movements instead
of contracting a single muscle
14. 2. Premotor area= 6
Anterior to lateral portions of primary motor cortex for
1-3 cm below supplemental area
-topographical organization ---same
1. Receive information from parietal and prefrontal
areas
2. Project to primary Motor cortex, Basal ganglion
and Spinal cord
3. For planning and coordination of complex planned
movements
15. 3. Supplemental motor area= 6
-superior to premotor area lying mainly
in the longitudinal fissure, but extends
a few cm. into the superior frontal
cortex
-functions in concert with premotor area
to provide bilateraly;-
1. attitudinal movements
2. fixation movements
3. positional movements of head & eyes
4. background for finer motor control of
arms/hands
16. DESCENDING MOTOR PATHWAYS
traditionally subdivided into
1.Pyramidal tract OR lateral pathways
(i.e,corticospinal tract 80%)
2. Extrapyramidal pathways OR Medial
pathways(everything else: basal
ganglia, cerebellum, brain stem
17. Motor Control
1. Lateral motor system
1. Lateral corticospinal tracts 80%
2. Rubrospinal tracts
Controls more distal muscles of limbs
2. Medial motor system of the cord
1. Reticulospinal,
2. Vestibulospinal,
3. Tectospinal
4. Anterior corticospinal tracts– 20%
Controls mainly the axial & girdle
muscles
18.
19. . Lateral motor system
1. Lateral corticospinal
tracts 80%
2. Rubrospinal tracts
Controls more distal
muscles of limbs
2. Medial motor system of
the cord
1. Reticulospinal,
2. Vestibulospinal,
3. Tectospinal
4. Anterior corticospinal
tracts– 20%
Controls mainly the
axial & girdle muscles
20. • The motor pathways
are divided into two
groups
– Direct pathways
(voluntary motion
pathways) - the
pyramidal tracts
– Indirect pathways
(postural pathways),
essentially all others
- the extrapyramidal
pathways
22. Primary Motor Cortex
Vertical Columnar Arrangement
1. An integrative processing system
+ 50-100 pyramidal cells to achieve
muscle contraction
2. Pyramidal cells or Betz cells 35000 3% (2 types
of output signals)
1. Dynamic signal
excessively excited at the onset of
contraction to initiate muscle contraction
2. Static signal
fire at slower rate to maintain contraction
23.
24. Corticospinal tract
Originates
1. Primary motor cortex- 30%
2. PMA+SMA- 30%
3. Somatic sensory areas- 40%
Synapses with:
1. Motor neurons controlling distal
muscles (alpha and gamma motor
neurons)
2. Interneurons controlling motor
neurons
25.
26. 1. Descends via the posterior
limb of the internal
capsule- (lies between
caudate & putamen)
2. Forms the pyramids of
medulla
3. Most fibers cross midline &
form lateral corticospinal
tract axons decussate at
the junction between
medulla and spinal cord.
4. Some fibers stay ipsilateral
& form ventral
corticospinal tract
27. • Origin: motor and sensory
cortices
• Axons pass through corona
radiata, internal capsule,
crus cerebri and pyramid of
medulla oblongata
• In the caudal medulla about
75-90% of the fibers
decussate and form the
lateral corticospinal tract
• Rest of the fibers remain
ipsilateral and form anterior
corticospinal tract. They
also decussate before
termination
28.
29.
30.
31.
32.
33.
34.
35.
36. • Distribution:
– 55% terminate at
cervical region
– 20% at thoracic
– 25% at lumbosacral
level
• Termination: Ventral
horn neurons (mostly
through interneurons, a
few fibers terminate
directly)
• Corticobulbar tracts end
at the motor nuclei of
CNs of the contralateral
side
37.
38.
39.
40.
41. Corticospinal Tracts
• Concerned with
voluntary, discrete,
skilled movements,
especially those of
distal parts of the limbs
(fractionated
movements)
• Innervate the
contralateral side of the
spinal cord
• Provide rapid direct
method for controlling
skeletal muscle
42.
43.
44. Motor Pathways
• Contain a sequence of TWO
neurons from the cerebral
cortex or brain stem to the
muscles
• Upper motor neuron : has cell
body in the cerebral cortex or
brain stem, axon decussates
before terminating on the
lower motor neuron
• Lower motor neuron: has cell
body in the ventral horn of the
spinal cord, axon runs in the
ipsilateral ventral root of the
spinal nerve and supply the
muscle.
UMN
LMN
57. Babinski sign
• feature of upper motor neuron
lesion
• extensor plantar reflex
• seen in infants during 1st year of
life (becuase of immature
corticospinal tract)
58. clonus
• rhythmical series of contractions in
response to sudden stretch
• feature of upper motor neuron lesion
59. superficial abdominal reflexes
• light scratch of the abdominal skin
• brisk unilateral contraction of the abdominal
wall
• upper motor neuron lesion causes reduced
or loss of these reflexes
60. Different types of lesions
monoplegia
only 1 limb is affected either UL or LL,
lower motor neuron lesion
hemiplegia
on half of the body including
UL and LL
lesion in the Internal capsule
paraplegia
both lower limbs
thoracic cord lesion
quadriplegia (tetraplegia)
all 4 limbs are affected
cervical cord or brain stem lesion
75. Rubrospinal Tract
• Controls the tone of limb
flexor muscles, being
excitatory to motor
neurons of these muscles
• Origin: Red nucleus
• Axons course ventro-
medially, cross in ventral
tegmental decussation,
descend in spinal cord
ventral to the lateral
corticospinal tract
• Cortico-rubro-spinal
pathway (Extrapyramidal)