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Vagal nerve endings secrete acetylcholine prostate cancer prevalence generic flomax 0.2 mg without a prescription, which stimulates the gastric secretion prostate adenoma order 0.4mg flomax otc. Unconditioned reflex of gastric secretion is prov ed by sham feeding along with Pavlov pouch (see above). Conditioned reflex of gastric secretion is proved by Pavlov pouch and belldog experiment (Chapter 162). Gastric juice secreted during this phase is rich in pepsinogen and hydrochloric acid. Hormonal mechanism through gastrin Stimuli, which initiate these two mechanisms are: 1. Nervous Mechanism Local myenteric reflex Local myenteric reflex is the reflex elicited by stimulation of myenteric nerve plexus in stomach wall. After entering stomach, the food particles stimulate the local nerve plexus (Chapter 36) present in the wall of the stomach. These nerve fibers release acetylcholine, which stimulates the gastric glands to secrete a large quantity of gastric juice. Vagovagal reflex Vagovagal reflex is the reflex which involves both afferent and efferent vagal fibers. Entrance of bolus into the stomach stimulates the sensory (afferent) nerve endings of vagus and generates sensory impulses. These sensory impulses are transmitted by sensory fibers of vagus to dorsal nucleus of vagus, located in medulla of brainstem. This nucleus in turn, sends efferent impulses through the motor (efferent) fibers of vagus, back to stomach and cause secretion of gastric juice. Since, both afferent and efferent impulses pass through vagus, this reflex is called vagovagal reflex (Fig. Mechanism involved in the release of gastrin may be the local nervous reflex or vagovagal reflex. Nerve endings release the neurotransmitter called gastrinreleasing peptide, which stimulates the G cells to secrete gastrin. Actions of gastrin on gastric secretion Gastrin stimulates the secretion of pepsinogen and hydrochloric acid by the gastric glands. Experimental evidences of gastric phase Nervous mechanism of gastric secretion during gastric phase is proved by Pavlov pouch. Hormonal mechanism of gastric secretion is proved by Heidenhain pouch, Bickel pouch and Farrel and Ivy pouch. Intestinal phase of gastric secretion is regulated by nervous and hormonal control. Initial Stage of Intestinal Phase Chyme that enters the intestine stimulates the duodenal mucosa to release gastrin, which is transported to stomach by blood. Later Stage of Intestinal Phase After the initial increase, there is a decrease or complete stoppage of gastric secretion. Enterogastric reflex Enterogastric reflex inhibits the gastric secretion and motility. It is due to the distention of intestinal mucosa by chyme or chemical or osmotic irritation of intestinal mucosa by chemical substances in the chyme. Cholecystokinin: Secreted by the presence of chyme containing fats and amino acids in intestine iii. In addition to these hormones, pancreas also secretes a hormone called somatostatin during Chapter 38 t Stomach 239 intestinal phase. Thus, enterogastric reflex and intestinal hormones collectively apply a strong brake on the secretion and motility of stomach during intestinal phase. Experimental evidences for intestinal phase Intestinal phase of gastric secretion is demonstrated by Bickel pouch and Farrel and Ivy pouch. Fractional gastric analysis After the ingestion of a test meal, gastric juice is collected at every 15th minute for a period of two and a half hours. Nocturnal Gastric Analysis Patient is given a clear liquid diet at noon and at 5 pm.

It occurs in conditions like stroke mens health 042013 cheap flomax 0.2mg free shipping, brain injury mens health getting abs pdf generic flomax 0.4mg visa, degenerative disease like Parkinson disease and Huntington disease. Hoarseness means the difficulty in producing sound while trying to speak or a change in the pitch or loudness of voice. Trauma of vocal cords Paralysis of vocal cords Lumps (nodules) on vocal cords Inflammation of larynx Hypothyroidism Stress (psychological dysphonia). It is also described as a speech disorder in which normal flow of speech is disturbed by repetitions, prolongations or abnormal block or stoppage of sound and syllables. It is due to the neurological incoordination of speech and it is common in children. It is thought that stammering may be due to genetic factors, brain damage, neurological disorders or anxiety. Choroid plexuses are tuft of capillary projections present inside the ventricles and are covered by pia mater and ependymal covering. Small amount is absorbed along the perineural spaces into cervical lymphatics and into the perivascular spaces. The mechanism of absorption is by filtration due to pressure gradient between hydrostatic pressure in the subarachnoid space fluid and the pressure that exists in the dural sinus blood. The increased intracranial pressure is reduced by injection of 30% to 35% of sodium chloride or 50% sucrose. Lateral recumbent position: 10 to 18 cm of H2O Lying position: 13 cm of H2O Sitting position: 30 cm of H2O Certain events like coughing and crying increase the pressure by decreasing absorption. However, if the head receives a severe blow, the brain moves forcefully and hits against the skull bone, leading to the damage of brain tissues. Brain strikes against the skull bone at a point opposite to the point where the blow was applied. Regulation of Cranial Content Volume Regulation of cranial content volume is essential because, brain may be affected if the volume of cranial content increases. In lumbar puncture, the lumbar puncture needle is introduced into subarachnoid space in lumbar region, between the third and fourth lumbar spines. After determining the area of fourth lumbar spine, third lumbar spine is palpated. The needle is introduced into subarachnoid space by passing through soft tissue space between the two spines. Spinal cord will not be injured, because, it terminates below the lower border of the first lumbar vertebra. Opposite to midplane, this back of the subject by joining the highest points of Posture of Body for Lumbar Puncture the reclining body is bent forward, so as to flex the vertebral column as far as possible. Injecting drugs (intrathecal injection) for spinal anesthesia, analgesia and chemotherapy 3. However, in capillaries of brain, fenestra are absent because, the endothelial cells fuse with each other by tight junctions (Fig. Tight junctions are formed between endothelial cells of the capillaries at childhood. At the same time, cytoplasmic foot processes of astrocytes (neuroglial cells) develop around capillaries and reinforce the barrier. These cells play an important role in formation and maintenance of tight junction and structural stability of the barrier. In brain, pericytes function as macrophages and play an important role in the defense. It prevents potentially harmful chemical substances and permits metabolic and essential materials into the brain tissues. It was observed more than 50 years ago, that when trypan blue, the acidic dye was injected into living animals, all the tissues of body were stained by it, except the brain and spinal cord. This observation suggested that there was a hypothetical barrier, which prevented the diffusion of trypan blue into the brain tissues from the capillaries. It exists in the capillary membrane of all parts of the brain, except in some areas of hypothalamus.

Properties of Endplate Potential Endplate potential is a graded potential (Chapter 31) and it is not action potential prostate cancer 12 tumors buy 0.4 mg flomax visa. When more and more quanta of acetylcholine are released continuously prostate cancer overtreatment purchase 0.4 mg flomax with amex, the miniature endplate potentials are added together and finally produce endplate potential resulting in action potential in the muscle. However, the acetylcholine is so potent, that even this short duration of 1 millisecond is sufficient to excite the muscle fiber. Rapid destruction of acetylcholine has got some important functional significance. It prevents the repeated excitation of the muscle fiber and allows the muscle to relax. Reuptake Process Reuptake is a process in neuromuscular junction, by which a degraded product of neurotransmitter reenters the presynaptic axon terminal where it is reused. Acetylcholinesterase splits (degrades) acetylcholine into inactive choline and acetate. Neuromuscular blockers used during anesthesia relax the skeletal muscles and induce paralysis so that surgery can be conducted with less complication. Following are important neuromuscular blockers, which are commonly used in clinics and research. Curare Curare prevents the neuromuscular transmission by combining with acetylcholine receptors. Since curare blocks the neuromuscular transmission by acting on the acetylcholine receptors, it is called receptor blocker. It affects the neuromuscular transmission by blocking the acetylcholine receptors. And, each quantum of this neurotransmitter produces a weak miniature endplate potential. Succinylcholine and Carbamylcholine these drugs block the neuromuscular transmission by acting like acetylcholine and keeping the muscle in a depolarized state. Botulinum Toxin Botulinum toxin is derived from the bacteria Clostridium botulinum. It prevents release of acetylcholine from axon terminal into the neuromuscular junction. For example, Laryngeal muscles: 2 to 3 muscle fibers per motor unit Pharyngeal muscles: 2 to 6 muscle fibers per motor unit Ocular muscles: 3 to 6 muscle fibers per motor unit Muscles concerned with crude or coarse movements have motor units with large number of muscle fibers. The process by which more and more motor units are put into action is called recruitment of motor unit. Thus, the graded response in the muscle is directly proportional to the number of motor units activated. Stimulation of a motor neuron causes contraction of all the muscle fibers innervated by that neuron. These muscles are present in almost all the organs in the form of sheets, bundles or sheaths around other tissues. Wall of organs like esophagus, stomach and intestine in the gastrointestinal tract 2. Mammary glands, uterus, genital ducts, prostate gland and scrotum in the reproductive system 8. Smooth muscles in the ureters propel urine from kidneys to urinary bladder through ureters. In females, these muscles accelerate the movement of sperms through genital tract after sexual act, movement of ovum into uterus through fallopian tube, expulsion of menstrual fluid and delivery of the baby. These fibers are generally very small, measuring 2 to 5 microns in diameter and 50 to 200 microns in length. Myofibrils and Sarcomere Well-defined myofibrils and sarcomere are absent in smooth muscles. Absence of dark and light bands gives the non-striated appearance to the smooth muscle. Myofilaments and Contractile Proteins Contractile proteins in smooth muscle fiber are actin, myosin and tropomyosin.

Organization of Neurons in Gray Matter Organization of neurons in the gray matter of spinal cord is described in two methods: 1 mens health best protein powder discount flomax 0.4mg with mastercard. Disadvantage is that some neurons like internuncial neurons mens health zumba buy 0.4mg flomax, which are outside the distinct nuclei are not included. Nuclei in Posterior Gray Horn Posterior gray horn contains the nuclei of sensory neurons, which receive impulses from various receptors of the body through posterior nerve root fibers. Marginal nucleus Marginal nucleus is also called posteromarginal nucleus, marginal zone nucleus or border nucleus. It Nuclei in Lateral Gray Horn Lateral gray horn has cluster of neurons called intermediolateral nucleus. The neurons of this nucleus give rise to sympathetic preganglionic fibers, which leave the spinal cord through the anterior nerve root. Substantia gelatinosa of Rolando Substantia gelatinosa of Rolando is a cap-like gelatinous material at the apex of posterior horn situated in all levels of spinal cord. Chief sensory nucleus or nucleus proprius Chief sensory nucleus is situated in the posterior gray horn ventral to substantia gelatinosa. Dorsal nucleus of Clarke Clarke nucleus is also called Clarke column of cells and it is the collection of well-defined neurons. Axons of these neurons leave the spinal cord through the anterior root and end in groups of skeletal muscle fibers called extrafusal fibers. Gamma motor neurons Gamma motor neurons are smaller cells scattered among alpha motor neurons. Renshaw cells are the inhibitory neurons, which play an important role in synaptic inhibition at the spinal cord (Chapter 140). This cytoarchitectural lamination was identified in 1950 by Brian Burke and Rexed. He classified the neurons in 10 laminae based on his observation on sections of brain in a neonatal cat. These laminae contain nuclei of sensory neurons, which are concerned with sensory functions. These laminae contain nuclei of motor neurons, which are concerned with motor functions. It is formed by the bundles of both myelinated and nonmyelinated fibers, but predominantly the myelinated fibers. Anterior median fissure and posterior median septum divide the entire mass of white matter into two lateral halves. The band of white matter lying in front of anterior gray commissure is called anterior white commissure (Fig. Each half of the white matter is divided by the fibers of anterior and posterior nerve roots into three white columns or funiculi: I. Anterior or Ventral White Column Ventral white column lies between the anterior median fissure on one side and anterior nerve root and anterior gray horn on the other side. Lateral White Column Lateral white column is present between the anterior nerve root and anterior gray horn on one side and posterior nerve root and posterior gray horn on the other side. Posterior or Dorsal White Column Dorsal white column is situated between the posterior nerve root and posterior gray horn on one side and posterior median septum on the other side. Short Tracts Fibers of the short tracts connect different parts of spinal cord itself. Association or intrinsic tracts, which connect adjacent segments of spinal cord on the same side ii. Long Tracts Long tracts of spinal cord, which are also called projection tracts, connect the spinal cord with other parts of central nervous system. Fibers of these neurons carry the sensory impulses from subcortical areas to cerebral cortex. Situation Anterior spinothalamic tract is situated in anterior white funiculus near the periphery. Origin Fibers of anterior spinothalamic tract arise from the neurons of chief sensory nucleus of posterior gray horn, which form the second order neurons of the crude touch pathway. These neurons receive the impulses of crude touch sensation from the pressure receptors. Axons of the first order neurons reach the chief sensory nucleus through the posterior nerve root. After taking origin, these fibers cross obliquely in the anterior white commissure and enter the anterior white column of opposite side.

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