Vice Chair, Michigan State University College of Osteopathic Medicine
Consider that the brain occupies a relatively small space of about 1000 to 1500 cm3 pain medication for old dogs safe sulfasalazine 500 mg, roughly the size of a cantaloupe pain management service dogs proven 500 mg sulfasalazine. There is also an almost infinite number of possible connections that make up exceedingly complex networks tuomey pain treatment center proven 500mg sulfasalazine. From this complexity a sense of order and organization emerges that supports basic life pain treatment of herpes zoster proven sulfasalazine 500 mg, behavior, and consciousness. A n a t o m i c The r m s o f R e l a t i o n s h i p Because the brain is a three-dimensional structure, neuropsychologists use a number of terms that describe specific parts, planes, and directions. In some instances, anatomists disagree about the boundaries of a specific brain structure; thus, several terms may describe overlapping brain regions. Early anatomists used names to describe structures simply because they reminded them of something else. For example, the outer part of the brain was named cortex, meaning "bark," because it is a thin mantle or covering for the brain. Thus, whenever we use the original meaning of the names of brain structures to help the reader form association about the nomenclature, we also provide precise anatomic terms to clear up any resulting confusion. Additionally, these precise anatomic terms will enable the reader to accurately communicate about the geography and topology of the brain. Descriptions usually divide the brain into one of the three main planes (using the x-, y-, and z-axes). Coronal plane-plane (y-axis) that shows the brain as seen from the front (frontal section). Typically, this plane is viewed from behind to provide consistency for right and left directions of the brain and the picture. Sagittal plane-plane (z-axis) that shows the brain as seen from the side or perpendicular to the ground, bisecting the brain into right and left halves (derived from Latin sagitta, meaning "arrow"). Directional terms: Most often, directions in the human nervous system are related to the orientation of the spinal cord. Anterior: toward the front or front end Posterior: toward the back or tail Inferior: toward the bottom, or below Superior: toward the top or above Medial: toward the middle/midline, away from the side Lateral: toward the side, away from the midline Gross anatomic features: spinal nerves, internal organization of the spinal cord (gray and white matter) Function: relays information to and from the brain, responsible for simple reflexive behavior Structure Rostral: toward the head Caudal: toward the rear away from the head Proximal: near the trunk or center, close to the origin of attachment Distal: away from the center, toward the periphery, away from the origin of attachment Dorsal: toward the back; the top of the brain is dorsal in humans Ventral: toward the belly; the bottom of the brain is ventral in humans Ipsilateral: on the same side Contralateral: on the opposite side the spinal cord is continuous with the brain and extends downward along the back for about 46 cm. The spinal cord is physically housed in the spinal column, which consists of alternating bony vertebrae and intervertebral disks made up of cartilage that absorb mechanical shocks sustained to the spinal column. The spinal cord itself is considerably smaller than the vertebral canal and the meninges. At each of the 30 levels of the spinal cord, a pair of incoming (afferent) dorsal root fibers signals incoming sensory information and a pair of outgoing (efferent) ventral root fibers controls motor nerves and muscles (Figure 5. These nerves conduct information related to both the somatic and autonomic nervous systems in the periphery. In the spinal cord, white matter (myelinated axons) makes up the outside of the cord, whereas gray matter (cell bodies) is located on the interior. Each area of the spinal cord corresponds to a specific body location and controls sensation and movement of the associated body area: skin, muscle, and internal organs. There are 1 coccyx, 5 sacral (S), 5 lumbar (L), 12 thoracic (T), and 8 cervical (C) spinal cord levels. The spinal nerves form ringlike innervations around the trunk of the body at each level of the spinal cord. For example, the nerves to the arms and hands are extensions of C-6, C-7, and C-8 innervations from the trunk. Function the spinal cord relays somatosensory information from the trunk and limbs to the brain. Although neuropsychologist often place greater emphasis in their evaluations on whether sensory or motor impairments relate to brain lesions, similar symptoms may also reflect spinal cord or even peripheral nerve damage. A thorough neurologic evaluation in combination with a comprehensive neuropsychological evaluation often clarifies the location of the dysfunction. Spinal cord injuries frequently occur with brain injury caused by whiplash, which may go unnoticed until after the trauma of paralysis has been stabilized. The structural and physiologic protections extend to the spinal cord and the brain, although the focus is on the brain.
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