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Injuries ganglia (celiac discount toradol 10 mg fast delivery, superior mesenteric best 10 mg toradol, inferior mesen- teric) VI toradol 10mg amex. Usually have opposite effects on an organ Questions for Study and Review Building Understanding Fill in the blanks 1. With few exceptions, the sympathetic nervous system cell body by the. Matching Match each numbered item with the most closely related lettered item. The cells involved in most nervous system tu- tic neuron mors are called b. Afferent nerve fibers enter the part of the spinal pairs of spinal nerves are there? The “fight-or-flight” response is promoted by the thetic and parasympathetic divisions of the autonomic a. Clinical depression is associated with abnormal sero- Understanding Concepts tonin levels. Differentiate between the terms in each of the fol- neurotransmitter from the synapse can control the disor- lowing pairs: der. What effect does this have on action poten- along a myelinated fiber differ from conduction along an unmyelinated fiber? The Senses Taste from the tongue receptors Smell from receptors in the upper nasal cavities The sensory system protects a person by detecting General senses changes in the environment. An environmental change Pressure, temperature, pain, and touch from recep- becomes a stimulus when it initiates a nerve impulse, tors in the skin and internal organs which then travels to the central nervous system (CNS) Sense of position from receptors in the muscles, ten- by way of a sensory (afferent) neuron. A stimulus be- dons, and joints comes a sensation—something we experience—only when a specialized area of the cerebral cortex interprets the nerve impulse it generates. Many stimuli arrive from The Eye and Vision the external environment and are detected at or near the In the embryo, the eye develops as an outpocketing of the brain. The skull bones form the walls of the eye orbit (cavity) Sensory Receptors and protect more than half of the posterior part of the The part of the nervous system that detects a stimulus is eyeball. The eyelids can be closed to keep harmful materials out of the eye, and blinking helps The free dendrite of a sensory neuron, such as the re- to lubricate the eye. If the muscle becomes weaker with afferent neuron, such as those for touch and temperature age, the eyelids may droop and interfere with vision, a A specialized cell associated with an afferent neuron, condition called ptosis. A thin membrane, the conjunctiva (kon-junk-TI-vah), Receptors can be classified according to the type of lines the inner surface of the eyelids and covers the visible stimulus to which they respond: portion of the white of the eye (sclera). These include pressure Eyelashes Eyebrow receptors in the skin, receptors that monitor body posi- tion, and the receptors of hearing and equilibrium in the ear, which are activated by the movement of cilia on specialized receptor cells. Any receptor must receive a stimulus of adequate in- Upper eyelid tensity, that is, at least a threshold stimulus, in order to (superior respond and generate a nerve impulse. The choroid may be compared to the dull black lining of Tears, produced by the lacrimal (LAK-rih-mal) glands a camera in that it prevents incoming light rays from scat- (Fig. As tears flow across the The blood vessels at the posterior, or fundus, of the eye from the lacrimal gland, located in the upper lateral 11 eye can reveal signs of disease, and visualization of part of the orbit, they carry away small particles that these vessels with an ophthalmoscope (of-THAL- may have entered the eye. An excess of tears causes cells known as rods and cones, which generate the nerve a “runny nose”; a greater overproduction of them re- impulses associated with vision. With age, the lacrimal glands produce less secretion, but tears still may overflow onto the cheek if the nasolacrimal ducts Checkpoint 11-2 What are the names of the tunics of the eye- ball? Pathway of Light Rays and Refraction As light rays pass through the eye to- ward the retina, they travel through a series of transparent, colorless parts de- scribed below and seen in Figure 11-3. On the way, they undergo a process known as refraction, which is the bending of light rays as they pass from one substance to another substance of different density. Note the three tunics, the refractive parts of the eye (cornea, rior continuation of the sclera, but it aqueous humor, lens, vitreous body), and other structures involved in vision. The aqueous (A-kwe-us) humor, a watery fluid that fills The rods are highly sensitive to light and thus function much of the eyeball anterior to the lens, helps maintain in dim light, but they do not provide a sharp image.

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The drill-down process to the document level combines the strengths of the graphical and the textual display: After zooming-in on a promising region discount 10mg toradol mastercard, the titles of documents pertaining to a particular node can be displayed by a double mouse click discount toradol 10mg online. Note generic 10mg toradol, that due to the ordering process of the SOM algorithm these documents are typically very similar to each other—and in the sense of the clustering hypothesis therefore might all provide an answer to the same query. A further double click on a document title then displays the selected abstract on the screen. In this way, the hyperbolic self-organizing map can provide a seamless interface offering rapid overview of large document collections while allowing at the same time the drill down to single texts. Benefits for a Hospital Information System In the framework of a hospital information system, such a context enriched interactive document retrieval system might be of great benefit to the clinical personal. Copying or distributing in print or electronic forms without written permission of Idea Group Inc. Interactive Information Retrieval Towards Effective Knowledge Management 67 to Chu and Cesnik (2001) a hospital may generate up to five terabytes of data a year, where 20 to 30 percent of such data are stored as free text reports such as medical history, assessment and progress notes, surgical reports or discharge letters. Free text fields in medical records are considered of invaluable importance for medical relevance (Stein, Nadkarni, Erdos, & Miller, 2000). However, many existing informa- tion systems do not yet take advantage of the complex CDA or the even more substantial Reference Information Model—because it is a very time consuming task to transfer documents to the new standards and to fit the enormous mass of model objects to free text data. Nevertheless, these systems store valuable information—just in a format which cannot be directly analyzed by structured methods. In order to provide access by content, the aforementioned Information Retrieval methodologies can significantly contribute to facilitate these tasks: a self-organizing map creates structure and context purely on the statistical word distributions of free text and thus allows a semantic browsing of clinical documents. This in turn offers the possibility to gain a problem orientated perspective on health records stored in information systems, that is, as Lovis et al (2000) have noted: “intelligent browsing of documents, together with natural language emerging tech- niques, are regarded as key points, as it appears to be the only pertinent way to link internal knowledge of the patient to general knowledge in medicine. Currently, many case studies are published which emphasize that data mining techniques provide efficient means to detect significant patterns in medical records. Interactive OLAP tools support best practice and allow for informed real time decision-making and therefore build the solid foundation for further improvements in patient care. The next step to further broaden the knowledge base in healthcare environments will be the integration of unstructured data, predominantly free narrative text documents. The nature of this type of data will demand for new approaches to deal with the inherently vague information contained in these documents. We have shown how artificial neural networks with their ability for self-organization of non-crisp data provide an almost natural link between the hard computational world and the soft-computing of the human brain. We believe that interactive information retrieval methodologies that account for the rich context of natural language will significantly contribute to knowledge acquisition through text analysis. Copying or distributing in print or electronic forms without written permission of Idea Group Inc. Knowledge representation and retrieval using conceptual graphs and free text document self-organisation techniques. Efficient literature searching: A core skill for the practice of evidence-based medicine. Integrating query of relational and textual data in clinical databases: A case study. Copying or distributing in print or electronic forms without written permission of Idea Group Inc. Interactive Information Retrieval Towards Effective Knowledge Management 69 Hearst, M. Proceedings of 19th ACM International Conference on Research and Development in Information Retrieval (pp.

Circulation in the capillaries surrounding to take in extra oxygen by continued rapid breathing the alveoli (air sacs) is increased buy 10 mg toradol fast delivery, and this brings about (panting) until the debt is paid in full 10 mg toradol with mastercard. In ad- moderate regular exercise has the additional benefits of dition buy toradol 10 mg visa, the glycogen, myoglobin, and creatine phosphate weight control, strengthening of the bones, decreased that are stored in the cells must be replenished. The after strenuous exercise during which extra oxygen is effects of exercise on the body are studied in the fields of THE MUSCULAR SYSTEM ✦ 159 8 Box 8-2 Hot Topics Anabolic Steroids: Winning at All Costs? Steroids damage the liver, making it more susceptible Amone testosterone by promoting metabolism and stimu- to disease and cancer, and suppress the immune system, in- lating growth. However, athletes also purchase them illegally, using tility, and the development of female sex characteristics such them to increase muscle size and strength and improve en- as breasts (gynecomastia). They increase blood cholesterol levels, which may increase the risk for baldness and, especially in men, cause lead to atherosclerosis, heart disease, kidney failure, and mood swings, depression, and violence. Types of Muscle Contractions ◗ Isometric (i-so-MET-rik) contractions are those in which there is no change in muscle length but there is Muscle tone refers to a partially contracted state of the a great increase in muscle tension. The maintenance of this tone, or tonus (TO-nus), is For example, if you push the palms of your hands hard due to the action of the nervous system in keeping the against each other, there is no movement, but you can muscles in a constant state of readiness for action. When walking, sible for muscle tone, there are two other types of con- for example, some muscles contract isotonically to propel tractions on which the body depends: the body forward, but at the same time, other muscles are contracting isometrically to keep your body in position. All of the connective tissue within and around Insertion the muscle merges to form the tendon, which then at- taches directly to the periosteum of the bone (see Fig. Radius In moving the bones, one end of a muscle is attached to Ulna a more freely movable part of the skeleton, and the other Humerus end is attached to a relatively stable part. The less movable Tendon (more fixed) attachment is called the origin; the attachment to the part of the body that the muscle puts into action is Figure 8-7 Muscle attachments to bones. Figure 8-7 shows the action of the biceps sistance and the effort; a see-saw or a scissors is an exam- brachii (in the upper arm) in flexing the arm at the elbow. The second-class lever has the The insertion on the radius of the forearm is brought to- resistance located between the fulcrum and the effort; a ward the origin at the scapula of the shoulder girdle. The musculoskeletal system can be considered a sys- tem of levers, in which the bone is the lever, the joint is Muscles Work Together the fulcrum, and the force is applied by a muscle. A move- ample of a first-class lever in the body is using the mus- ment is performed by a muscle called the prime mover; cles at the back of the neck to lift the head at the joint be- the muscle that produces an opposite movement to that tween the occipital bone of the skull and the first cervical of the prime mover is known as the antagonist. A second-class lever is ex- for any given movement, the antagonist must relax when emplified by raising your weight to the ball of your foot the prime mover contracts. In addition to prime movers and an- over a joint and exerts force between the fulcrum and the tagonists, there are also muscles that serve to steady body resistance. As shown in Figure 8-8 C, when are called synergists (SIN-er-jists), because they work the biceps brachii flexes the forearm at the elbow, the with the prime movers to accomplish a movement. The As the muscles work together, body movements are co- weight of the hand and forearm creates the resistance, ordinated, and a large number of complicated movements and the fulcrum is the elbow joint, which is behind the can be carried out. By understanding and applying knowledge of levers to Think of a child learning to walk or to write, and consider body mechanics, the healthcare worker can improve his the number of muscles she or he uses unnecessarily or for- or her skill in carrying out numerous clinical maneuvers gets to use when the situation calls for them. A number of freedom from strain and fatigue; conversely, such ailments different characteristics are used in naming muscles, in- as lower back pain—a common complaint—can be traced cluding the following: to poor body mechanics. Body mechanics have special sig- nificance to healthcare workers, who are frequently called ◗ Location, named for a nearby bone, for example, or for on to move patients and handle cumbersome equipment. There are three classes of levers, (oblique) which differ only in the location of the fulcrum (F), the ef- ◗ Number of heads (attachment points) as indicated by fort (E), or force, and the resistance (R), the weight or load. The muscle surrounding each eye is called the to Figures 8-9 and 8-10 as you study the locations and orbicularis oculi (OK-u-li), whereas the muscle of the functions of some of the skeletal muscles and try to figure lips is the orbicularis oris.

The other subjective parameter assessed is the ability of the individu- al to carry out daily activities in relation to work cheap toradol 10 mg with amex, recreation buy toradol 10mg amex, and ability to sleep (Table 11) buy toradol 10mg low price. The ability of the patient to perform everyday activ- ities in terms of the position of the arm in relation to the trunk is also evaluated. Twenty points may be allocated for activities of daily living, as shown in Table 11. Scoring for individual parameters Parameter Score Pain 15 Activities of daily living 20 Range of motion 40 Power 25 Total 100 200 19 Scores Table 10. Scoring for pain experienced during normal daily activity Pain experienced Score None 15 Mild 10 Moderate 5 Severe 0 Table 11. Scoring for activities of daily living Activity Score Activity level Full work 4 Full recreation/sport 4 Unaffected sleep 2 Positioning Up to waist 2 Up to xiphoid 4 Up to neck 6 Up to top of head 8 Above head 10 Total 20a a Only one of the five positions is found in each patient. The maximum points attain- able by a normal individual in this section can only be 20 activities outside work and two to unaffected sleep. The patient is asked to say what percentage of work and recreation has to be abolished as a result of the shoulder problems. One must be sure that sleep disturbance is caused by the shoulder and not by other problems, before reducing the allocated points. The other 10 points allocated to activities of daily living are given for the ability to perform tasks at a variety of levels, ranging from below waist to above head level. This is not the assessment of pure motion; it is the assessment of the ability of the hand to work at the levels de- scribed. Since the shoulder at rest will allow below-waist activities to be undertaken without much shoulder function, such activ- ities get only 2 points. Increasing point for activities above the level are allocated as shown in Table 11. The objective assessment rates the patient on painless active motion in the planes of pure forward and lateral elevation (Table 12), as well as composite functional external and internal rotation (Tables 13 and 14). Finally the shoulder power is included in the assessment, and is mea- sured as abduction power at 908 (or less if the patient is unable to ab- duction to that level). He used a tensiometer to measure isometric power of the shoulder at 908 of lateral elevation. In patients whose active range of abduction is less than 908, the power at whatever maximum active abduction can be performed is taken using Table 12. Points awarded for forward and lateral elevation Elevation (8) Points 0±30 0 31±60 2 61±90 4 91±120 6 121±150 8 151±180 10 Table 13. External rotation scoring Position Points Hand behind head with elbow held forward 2 Hand behind head with elbow held back 2 Hand on top of head with elbow held forward 2 Hand on top of head with elbow held back 2 Full elevation from on top of head 2 Total 10 202 19 Scores Table 14. Internal rotation scoring Position Points Dorsum of hand to lateral thigh 0 Dorsum of hand to buttock 2 Dorsum of hand to lumbosacral junction 4 Dorsum of hand to waist (third lumbar vertebra) 6 Dorsum of hand to 12th dorsal vertebra 8 Dorsum of hand to interscapular region (DV 7) 10 the spring balance in the way already described. Although this method of estimating shoulder power is not as exact as that obtained with the Cybex II, it gives a reasonable reflection of shoulder power, compared with the more sophisticated methods described. It appears that graphic representation of isokinetic power to 908 abduction, as reported by Wal- lace et al. The score given for normal power is 25 points, with propor- tionately less for less power. The spring balance can have handles at- tached to make the procedure easier for the patient, especially for those with rheumatoid deformities of the hands. The power of the normal shoulder, as measured by this method, diminishes with advancing age. The complete shoulder functional assessment form as used by the author is shown in Table 15. Shoulder functional assessment Pain Score Right Left Activities of daily living 15 15 Work 4 4 Recreation 4 4 Sleep 2 2 Position 10 10 Range Abduction 10 10 Flexion 10 10 Internal rotation 10 10 External rotation 10 10 Power 25 25 Total 100 100 Table 16. Valuation of the age- and gender-related Constant score Valuation Constant score (%) Excellent 91±100 Good 81±90 Satisfactory 71±80 Adequate 61±70 Poor < 60 a 19.

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