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Few fibers inserted posteriorly with the similar fibers of the opposite side across the median fibrous raphe. Origin of straight head of the rectus femoris in the upper part of the anterior inferior iliac spine 2. It makes an angle of about 45 degrees with the sagittal plane and 30 degrees with the horizontal plane. Death, vegetative state, complete dependence on others, dependence on others for some activities, inability to return to work or participate in social activities, return to work with reduced capacity, and reduced participation in social activities, good recovery with mild mental and social deficits and good recovery with no deficit. Phase 4 (1-12 months after injury) is also characterized by hyperreflexia and results from cell-body-supported axon growth. The nerve may be injured in case of posterior dislocation of the knee joint or deep lacerated injury in the popliteal fossa. A point is taken slightly to the left side of the median plane opposite the center of manubrium sterni iv. The foramen ovale, through which the lesser petrosal nerve, the third portion of the trigeminal nerve, V3 or lower mandibular nerve emerge and the accessory meningeal artery enters and the foramen spinosum, through which the meningeal nerve (branch of V3) emerges and the middle meningeal artery enters (very important in trauma, as it is one of the most common causes of epidural bleeding). Lateral cutaneous nerve of the calf: It arises from the common peroneal nerve in the popliteal fossa. They are folds of mucous membrane containing palatoglossus and palatopharyngeus muscles respectively. All anterior pituitary hormones are secreted in a pulsatile fashion and tend to follow a diurnal pattern. Situation It is situated in the inferomedial part of the cerebral hemisphere between the head of caudate nucleus and thalamus medially and the lentiform nucleus laterally. Effect of hyperventilation on cerebral blood flow in traumatic head injury: Clinical relevance and monitoring correlates. This method, in turn, allows to differentiate the presence of bilirubin from other pigments derived from the blood such as oxyhemoglobin or iodinated antiseptics used to disinfect the skin. True "central" hypothyroidism occurs in 4 to 15% of patients following brain injury. Deviation of the nasal septum: the nasal septum may be deviated from the median plane, as a result of birth injury or any trauma like blow over the nose or repeated attack of common cold, allergic rhinitis, sinusitis, etc. It follows that any patient with head trauma or stroke should be treated as a patient with a full stomach at high risk for aspiration. High level of extracellular potassium and its correlates after severe head injury: relationship to high intracranial pressure. The objectives of surgery are to remove foreign bodies and devitalized tissue, and to repair of tissue layers (dural, subcutaneous tissue, skin); bone fragments may be replaced if they are adequately disinfected and debrided. Anterior ascending ramus: Extent: From the beginning up to the inferior frontal gyrus. The remaining 20% are due to pretruncal or perimesencephalic hemorrhage (10% of cases) or remote etiologies such as rupture of cavernous malformations, spinal arteriovenous malformations or mycotic aneurysms among others (Table 51. These are muscle fibers, arises from crista terminalis and spreads in the inner aspect of the anterior wall of the right atrium. Paralysis of the different branches of the facial nerve which are given below: 616 Human Anatomy for Students Cochlear Nerve i. These are the curved bony ridges passing laterally from the external occipital protuberance ii. Based on these results, both patient factors and medical management factors seem to play a role in the development of pressure ulcer. Situation In the ventromedial part of the periaqueductal central gray matter of the midbrain at the level of superior colliculus. On the basis of these results, there is no evidence to justify the use of oral anticoagulants in patients with first ischemic stroke and antiphospholipid antibodies; in such patients the use of antiplatelet agents is reasonable. Contemporary clinical series identifying deleterious markers, such as hypoxia, hypotension and hyperpyrexia have also contributed greatly. This pattern observed in the first 24 hours after injury was associated with a more favourable outcome (P=0. Steps of Dissection Position of the Body Body will be in pronated position with hip and knee joints extended.

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They noted that the studies had several weaknesses: small cohorts; selected subpopulations of critically ill patients; lack of "urine output" criterion; and single-centre design. Secondary injury can take the form of systemic hypotension or hypoxia resulting in focal ischemia around the area of injury. Adams classifies axonal diffuse injury in to three grades of severity: mild, moderate and severe. Subconjunctival hemorrhages: It is a common condition shows bright or dark red patches deep to the bulbar conjunctiva results from the: i. A volume >100 ml of urine found by straight catheterization is considered an abnormal post-void residual. Thirst, for example, is a central mechanism to counteract the increased concentration of sodium in the blood. Is there any benefit from staged carotid and coronary revascularization using carotid stents Management strategy for simultaneous carotid endarterectomy and coronary revascularization. The torn arteries does not retract because they held open by the dense fibrous connective tissue in the second layer of the scalp iv. Once the airway is secured and ventilation is effective, the use of analgesics (narcotics) and sedatives (benzodiazepines) can be very helpful. Pterygoid hamulus and adjoining posterior margin of the medial pterygoid plate (sometimes) ii. Gender There was no strong evidence for an association between gender and poor outcome. Among these, intraventricular hemorrhage and subarachnoid hemorrhage should be mentioned. Antistress therapy can include the use of sedatives and analgetics and the avoidance of awakening tests. In the anterior part of the cavernous sinus the nerve crosses lateral to the oculomotor nerve. In the hyperacute stage (first 4 hours), the extravasated blood has not yet formed a clot, producing an irregular hyperdense collection within the cerebral parenchyma. However, what all lesions share is that they are produced by external forces: either by direct impact, sharp objects (knives or guns), heavy machinery, or rapid acceleration/deceleration. Brain and Spinal Cord 555 Filum Terminale It is a non-nervous thread like filament of connective tissue. It is pain in the lower part of the back and hip extending back of the thigh in to the leg ii. Uterus is anteflexed (it is the angle between body and the cervix, which is normally 125 degree) f. When pus accumulates near the middle of posterior border of sternocleidomastoid incision should be made across the sternocleidomastoid, but not along its posterior border, to avoid injury of the spinal part of the accessory nerve. Angiography is also recommended in patients with primary intraventricular hemorrhage and in those with perisylvian sulcal or fronto-orbital hemorrhage to dismiss the presence of aneurysms [16,23]. Unilateral mydriasis occurs when the third cranial nerve is injured in its journey through the fissure of Bichat, the most common cause being herniation of the hook of the hippocampus, with transtentorial wedge pressure which compresses the ipsilateral oculomotor nerve and midbrain peduncle. In severe bleeding of the anterior communicating artery, intracerebral hematomas in the frontobasal regions are frequently observed. Posterior part of the outer surface directed downwards and laterally, and inner surface upwards and medially. Dual antiplatelet therapy with clopidogrel and aspirin in symptomatic carotid stenosis evaluated using doppler embolic signal detection. This process often uses lecithins or similar molecules (adhesins) which interact with hydrocarbon fractions of the membrane of the microvilli. Current research in to new drugs is aimed to stop or minimise this pathophysiologic cascade of events which, in simplified form, sequentially and synergistically involves the release of excitatory amino acid, cellular entry of calcium, production of free oxygen radicals, gene activation, activation of pro-inflammatory molecules, and so on. Between inferior surface of right lobe of liver and anterior surface of right kidney there is a peritoneal pouch known as hepatorenal pouch of Morison. In necropsies of animals and patients, the latter has been observed in pericontusional and contusional areas where it leads to an increase in brain damage by extending tissue ischemia.

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Communication In to the floor of the hiatus semilunaris of the middle meatus of the nose. Lower end of tibia: Easily made out and the talo-tibial joint space is clearly visible. The only exception to this rule is in patients who present a dilated ventricular system secondary to trauma. Computed tomography sagittal reconstruction of a spinal column fracture with dislocation of C5-C6, canal stenosis and rupture of the posterior ligaments. The absolute value is not necessarily the best indication of vasospasm but instead the changes with increases >50 cm/sec over a 24-hour period. Rectus abdominis going upwards to become expanded from pubic crest and symphysis pubis to the lower costal cartilages It is adherent to the anterior wall of rectus sheath by tendinous intersections but free from posterior wall ii. In 1998 Agnelli published a randomized study of 307 patients undergoing elective neurosurgery (90% involving the brain, 97% of which brain tumours) who received 40 mg enoxaparin once daily + graduated compression stockings versus graduated compression stockings + placebo. We would recommend removing the patient from the spine board upon arrival to hospital and optimizing oxygenation, hemodynamics and nutrition. Academy of Neurology defines sports-related concussion as an alteration in mental state following an injury that may or may not be accompanied by a change in the level of consciousness and further emphasizes that the state of confusion that characterizes this circumstance can appear either immediately or some minutes afterwards. The forceps major produces an elevation in the upper part of the medial wall of posterior horn of lateral ventricle known as bulb of posterior horn c. Epidural hematoma is the most frequent and the etiology is similar to the lesions seen in the supratentorial compartment. Thus, from an organizational point of view, we can consider three levels of stroke care. It arises from the radial artery just distal to the elbow, which ascends between the superficial and deep branches of radial nerve ii. More glucose is delivered to the microdialysis catheter and the concentration in the dialysate increases. Muscular triangle Carotid triangle Digastric or submandibular triangle Submental triangle. Intravenous cholecystography-it may be used for visualization of the gall bladder if diarrhea, pyloric obstruction or any other factors interferes with absorption of the orally administered contrast medium. Traumatic subarachnoid hemorrhage: Demographic and clinical study of 750 patients from the European Brain Injury Consortium Survey of Head Injuries. Added to healthcare expenditures is the loss in years of productive work and revenue from taxable income. Blood should be quantified in the following spaces: frontal intercerebral fissure; lateral sylvian fissures; basal sylvian fissures; suprasellar cistern (bilateral quantification); ambiens cistern (bilateral quantification); and quadrigeminal cistern. Emissary sphenoidal foramen: (Foramen of Vesalius) Medial to foramen ovale sometimes presents a foramen called emissary sphenoidal foramen. When treating a severe head injury according to the Lund therapy, all components presented in the Appendix should be considered. Motor and/or sensory disorders in at least two of the following areas: face, upper limbs, lower limbs. While there are little official data, the incidence of stroke in Argentina is estimated to be between 110 and 285 cases per 100,000 individuals, with more than 500,000 people living with the sequelae of stroke. Image contrast can be adjusted by varying the amplitude (width) of the window and the grey scale by changing the level (level) of the window. Left vagus nerve the left vagus nerve enters in to the thorax, between the common carotid and subclavian arteries but behind the left brachiocephalic vein. It belongs to the group of acute phase reactive proteins and shows more precisely the changes in acute visceral proteins (depletion and repletion) due to its short half-life and small pool. Also included in the vasogenic category is cerebral venous thrombosis associated with hypercoagulable states (including pregnancy and oral contraceptive use as well as intrinsic coagulopathies) leading to a vascular back pressure causing intraparenchymal hemorrhage as well as edema.

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When cutdown in the groin the branches of the ilioinguinal nerve and the intermediate cutaneous nerve of thigh 1. Evolution over time is a highly relevant factor and not always recognized in studies. The risk of mortality is three times higher if there are associated lesions (subdural hematoma or contusions). This radiographic finding, called pseudo-subarachnoid hemorrhage, must be considered in the appropriate clinical context. Nerve Supply Branches from the ophthalmic nerve and they form following plexuses: i. Alveolar partial pressure of oxygen (PaO2) and hemoglobin (Hb) are determinants of arterial oxygen content (CaO2). As a result, thrombosis at the surgical site can be postoperatively detected in 2. Superior Angle Characters: Formed by the junction of the superior and medial borders. It prevents the entry of many bacteria and other harmful agents from mother to fetus. Attachment: Platysma is inserted in to lower border which extends anteriorly over external surface, where it forms the risorius muscle. Various studies in small series have shown good results related to a minor use of permanent peritoneal derivations and a reduction in mortality with acceptable functional prognosis; nevertheless, despite the high risk of complications such as infections or hemorrhages, prospective multicentre trials, have validated the effectiveness of this approach. This means that the period between the occurrence of symptoms and randomization (up to 6 months) should be added to the randomization-surgery time the studies reported. In addition, acoustic myogenic reflexes, which cannot be eliminated by averaging methods, have latencies similar to those of early cortical acoustic components and can therefore mask them. Spinous process: It is less substantial and its upper border close to its dorsal end is rounded and down-turned. Anterior pituitary hormones are regulated by hypothalamic releasing and inhibitory hormones and the negative feedback action of the target glandular hormones at both the pituitary and hypothalamic levels. Table of evidence of the Brain Trauma Foundation (2007 edition) for the treatment of intracranial hypertension in patients with severe traumatic brain injury. They are curved shelf like bony projections directed downwards and medially in the posterior part of lateral wall of nose ii. A high index close to 1 indicates an almost linear transmission of the pulse wave to the intracranial space and therefore a low volume reserve (low compliance or high elastance status) [12]. Fibers from the nasal half of each retina including the nasal half of macula cross the midline and pass to the opposite optic tract (occupy the central part of the optic chiasma). Adventitia: It is moderately dense connective tissue continuous with that of adjacent Mucous Membrane It is stratified squamous epithelium, with under lying the mucous membrane. Colloid is the gel-like mass (thyroglobulin) present in the lumen of the thyroid follicles. Many patients with cerebral contusion or intracranial hematoma show secondary deterioration and often present with the clinical syndrome of "talk and deteriorate" [99]. The cerebellum receives sensations at unconscious level, they receive sensations from the vestibular system, tactile and pressure receptors of the head and body and sensation from the visual and auditory systems 3. However, since seizures have been associated with intracranial injury, it is important that they be aggressively treated especially in cases of status epilepticus. Anterior surfaces of maxillae contributes a large share, in the formation of facial skeleton. The distal end should be located in the distal part of the vena cava, without entering the right atrium or touching the tricuspid valve, as this can cause arrhythmias. Posterior nasal spine: Situated in the median plane of posterior free border of hard palate. In this way, it is possible to react to changes in brain chemistry during surgical procedures, for example, ischemia resulting from brain retraction [18]. Peripheralborder: To the fibrous capsule and the deeper aspect of the tibial collateral ligament of knee joint. Lipid infusions should be suspended 12 hours before any dialysis procedure so as to prevent lipid losses. The dissociation between metabolism and flow is pronounced in focal cerebral ischemia.

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The greater part of the corpus striatum is situated in front of the postcentral sulcus. Recanalisation occurs in 40-90% of patients, mostly within the first 4 months, but is not related to outcome. It is separated from the forebrain by the cerebellar tentorium, which is a splitting of dural tissue that separates the supratentorial from the infratentorial structures (anterior and middle fossae from the posterior fossa). After beginning the vein comes out from the skull through the posterior compartment of jugular foramen ii. As such, the sample size necessary to demonstrate a positive effect in this time window is quite large. The lacrimal fluid of the lacrimal gland flows in to the conjunctival sac where it lubricates the front of eye and the deep surface of the eyelid ii. Origin of lateral head of rectus abdominis and pyramidalis (if present) muscles d. Through the vertebral canal: Passes spinal cord with its coverings, (meninges), and spinal accessory nerve, the anterior and posterior spinal arteries. It is continue to ascend between the two heads of the gastrocnemius and terminates 3 to 7. Less glucose is delivered to the microdialysis catheter and the concentration in the dialysate decreases. However, the peripheral temperature (hands, feet, skin) var65 Intensive Care in Neurology and Neurosurgery ies widely depending on environmental temperature. Monitoring of brain tissue pO2 in traumatic brain injury: effect of cerebral hypoxia on outcome. Petrosal process: the posterior part of the dorsum sellae at its lateral angles is projected laterally, which articulate with the apex of the. Ramus of Mandible It projects upwards from the posterior end of the body and forms the square shaped flattened bone. Section of the right optic nerve: Blindness in the temporal and nasal visual fields of the right eye. The fibers arise from the red nucleus and decussate to form the rubrospinal tract. Pharyngeal bursa or pouch of Luschka: It is a small median recess extending in the mucosa covering the nasopharyngeal tonsil. One of the limitations was that most studies did not explicitly consider the clinical criteria to enter the variables in the model beyond the automatic procedures. In case of tearing of the menisci there is localized tenderness on the joint line. Despite this seeming lack of benefit, some patients with subocclusive lesions might benefit from this intervention. Fracture of the calcaneus: It occur when fall from a ladder on the heal or landing on the heel from high place ii. Below the superciliary arch present the curved supraorbital margin which forms a part of circumference of the base of the orbit and ends laterally in zygomatic process. It exits out of the orbit to supply the skin of eyelids, upper part of nose, conjunctiva, lacrimal sac and caruncle. There is rhythmical oscillation of the eyes, due to ataxia of the ocular muscles ii. Nerve Supply Anterior, middle and posterior superior alveolar nerves branches of the maxillary and infraorbital nerves. Secondary centers: Secondary center for the upper end-appears at the birth or shortly after birth. After emerging from the foramen transversarium of the atlas, the artery winds medially around the posterior aspect of the lateral mass of atlas and appears in the suboccipital triangle ii. Causes of neuromuscular weakness in the intensive care unit: a study of ninety-two patients.

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It is also often applied in other circumstances for evaluating only functional alterations of cerebral metabolism or causes of a systemic nature, coma, renal failure, hepatic, pulmonary, metabolic diseases, in the context of septic shock. Patella commonly dislocated laterally because of the lateral angulations between long axis of the thigh and leg. It is contraindicated in patients with abdominal sepsis; it can impede optimum healing. Arterial bifurcations are easily recognized because two flow velocity signals (waveforms) seen on the screen travel in opposite directions (towards and away from the transducer or positive and negative signal respectively). When this pattern is found bilaterally in the anterior circulation and in the posterior sector and these alterations persist for at least 30 minutes (is not a transitory state), it can be used to support the diagnosis of brain death. There are arguments for the use of red blood cell transfusions to achieve normal hemoglobin values, and the Lund therapy recommends erythrocyte transfusions up to a lowest hemoglobin concentration of 12 g/dl. This border separates the superolateral surface from the orbital surface of the frontal lobe i. With the fast and inexplicable fall of SjO2, blood was extracted and SjO2 changed. Randomized controlled trials with time-to-event outcomes: how much does prespecified covariate adjustment increase power Covariate adjustment in randomized controlled trials with dichotomous outcomes increases statistical power and reduces sample size requirements. Collateral trigone which is the flattened triangular continued part of the collateral eminence. These ducts are formed by the union of intercalated ducts from the different alveoli ii. Additionally, magnesium and phosphorous should be followed on a daily basis to monitor for depletion associated with osmotic dieresis. Posterior wall of rectus sheath formed by the posterior lamina of the internal oblique and transversus abdominis muscles It is deficient above the costal margin where the rectus abdominis lies directly on the costal cartilages to give entry to superior epigastric vessels. Sometimes a piece of bone grafted from the shaft to repair a defect in some other bone. Medial patellar retinaculum-on the anterior and medial surfaces of the medial condyle. The internal cerebral veins are formed behind the foramen of Monro by the confluence of the thalamo-striatal and caudate veins. Physiotherapy may reduce the need for albumin infusions by activating the lymphatic system. Some unnamed arteries arise from the occipital, transverse cervical and suprascapular arteries. The recanalization rate was 53%, the survival rate was 50%, and 22% had good outcomes. Median sulcus: It divides the floor in to two symmetrical halves extending from the rostral to the caudal angles. Commonly fracture occurs at the surgical neck, middle one-third of the shaft or supracondylar region 3. Markedly impair liver function so that bile formation is impeded and the dye is not excreted ii. The concentration and volume of nutrients should not be modified simultaneously, but the required volume and concentration should be obtained within 24 to 48 hours. Until we have other diagnostic tools, different from the current ones, and in the absence of validated new biomarkers, prerenal azotemia is often a retrospective diagnosis made only after fluids challenge. Procedure of Indirect Laryngoscopy the anterior part of the tongue is gently pulled from the oral cavity to clear the area of epiglottis and laryngeal inlet. However, a prospective study of 106 patients, designed to detect potential risks for the administration of NaCl at 7. Special visceral afferent: these fibers carry taste sensations from the anterior twothirds of the tongue (except vallate papillae) and from the soft palate. In restrictive ventricles (ischemic or hypertrophic) a higher filling pressure is needed to have an adequate volume at the end of diastole. Steps of Dissection Position of Body Body should be placed in prone position with neck is flexed as far as possible (it will be convenient to place the chest upon a block, so that neck will be flexed fully).


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However, the lack of a clear proposal as to when and how to apply the various measures has generated some confusion. The auditory radiation pass through the sublentiform part of the internal capsule to reach the auditory area of the temporal lobe of the cerebrum. Dura Mater It extends from the foramen magnum to the 2nd sacral vertebra, where it blends with the filum terminale. Every effort should be made to ensure that all the above measures, including analysis of the images, take no longer than 762 Acute Ischemic Stroke: General Approach 45 minutes. Of note is that the dose delivered in the two groups was 17 and 29 ml/kg/h, respectively. Sahuquillo, describing 244 simultaneous jugular and ptbO2 measurements, reported 31 episodes of tissue hypoxia <15 mmHg (12. Concomitant squint: It is a congenital condition, there is no limitation of movement of eyeball and no diplopia. It articulates on either side with the second costal cartilages (important for counting the ribs). Upper surface of the head is disk like concave and articulates with the capitulum of the humerus. Other products should not be added to these solutions, except insulin which is added to hypertonic dextrose. The authors tested ptbO2 response only on a mean of 62 hours over time, ptbO2 increased 5 mmHg. Posterior Lobe this lobe is developed as a diverticulum grows downwards from the floor of the diencephalon. It occurs among thirty to forty five years old people having history of calcaneal tendinitis ii. Therefore, airway management should be controlled early in patients with progressive drowsiness and coma. Fibers from the mamillary body reach the anterior nucleus of the thalamus via the mammillo-thalamic tract and via the mammillo-tegmental tract to reach the subthalamic region and the tegmentum v. Superficial fascia, containing platysma, three branches of supraclavicular nerve and external jugular vein iii. End It ends as terminal branches (superficial temporal and maxillary arteries), in the substance of parotid gland. Monitoring brain tissue oxymetry: will it change management of critically ill neurologic patients Moderate hypothermia in patients with severe head injury: cerebral and extracerebral effects. Paralysis of zygomatic branch: Lower lid droops where the lower lid falls away from the eyeball as a result, tears does not spread over cornea therefore cornea become dry and producing corneal ulcer. Pneumoarthrography: It is one of the diagnostic technique in which air can be injected in to the synovial cavity of the knee joint to visualized the outline of the structures in the knee joint like medial and lateral menisci on X-ray, because air is less radiopaque than the structures present in the knee joint. Below: Calcar avis produced by the inward projection of the anterior part of the calcarine sulcus. The increased risk of symptomatic hemorrhagic transformation is associated with a history of diabetes, elevated blood glucose, severe stroke, advanced age, longer delay of treatment, use of aspirin, history of congestive heart failure, and protocol violations. The epithelium differs throughout the gastrointestinal tract depending on the specific functions of each part of the tube b. The oxygen debt that is generated depends on shock duration and depth, and thus, the possibility of recovery, the degree of organ dysfunction or multiple organ failure and survival or death. Brain energy metabolism during controlled reduction of cerebral perfusion pressure in severe head injuries. Part of the globus pallidus lies below the level of the anterior commissure known as ventral pallidum. When seizure prophylaxis has been instituted, limiting it to a duration of 7-14 day appears reasonable. The upper part of lateral border and adjoining part of the acetabular margin give attachment of ischio-femoral ligament. The score reflects an intact cortex and cortical pathways but is associated with brain dysfunction within a hemisphere.

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Maintaining a mean arterial pressure 85 mmHg, appropriate administration of methylprednisolone, and early surgical decompression are essential to optimizing the neurological outcome. A state of hyponatremia leads to an increase in cell volume, resulting in cerebral edema, whereas hypernatremia leads to cellular dehydration, with shrinkage of the brain parenchyma [8]. Also, the study showed that the need for retreatment of the aneurysm persisted in the long term after coiling as opposed to surgical clipping. It is a nonperitoneal rough area just behind the cardiac orifice and adjoining body of stomach. Nerve Supply the gland is supplied by the lacrimal nerve (contains both sensory and secretomotor fibers). Higher rates of adherence to key processes of stroke unit care compared with other care models Reduction in mortality in the monitored stroke units Better functional outcome in monitored stroke unit Cadilhac e Ibrahim 2004 Sulter et al. It is important to maintain aggressive pulmonary toilet and to screen all patients for dysphagia. This intravascular coagulation can be generalized (disseminated intravascular coagulation leading to the development of extracranial organ failure), as well as localized. The mediator cascade that links extracellular pH to cerebral vascular tone is complex and interrelated, the final mediator being intracellular calcium. Optic nerve injury may be by inflammatory degenerative, demyelinating or toxic effect like methyl and ethyl alcohol, tobacco, lead or mercury iii. Hyperglycemia also occurs frequently and is observed in 25% of patients receiving parenteral nutrition. The criteria for defining whether a bicoronal or hemicraniectomy should be performed (Table 35. Upper part of the nucleus tractus solitarius- receives taste and other general visceral sensations. Minimum hemorrhage in internal capsule may cause hemiplegia of the opposite side of lesion, as the lesion is in the upper motor neuron type. The medial Surface of the Cerebral Hemisphere Features section, the medial surface of the cerebral hemisphere is exposed which is flat and presents the following features. In this multicentre, international trial involving 15,200 patients, no benefit in survival was observed between the two treatment modalities. Commissural Fibers the commissural fibers connect the corresponding parts of the two hemispheres most of the fibers are (homotypical) across the midline. It lies between the flexor digitorum profundus and flexor digitorum superficialis iii. A similar though not significant trend has been observed for the risk of stroke and postoperative death in both age groups. The corticospinal fibers enter the midbrain from the posterior limb of the internal capsule. Also, it requires very low infusion volumes and it has good effectiveness and safety profiles. Nevertheless, these data should be analyzed carefully since the size of the samples is usually small. Grief: Depressor anguli oris by depressing the angle of mouth assisted by platysma. Nasal mucous membrane (lined by mainly ciliated columnar except posterior part which is lined by stratified squamous epithelium) 2. The SjO2 was approximately 65% in the initial 24 hours after trauma, increasing to 80% after 60 hours. The small object is then moved in an arc around the periphery of the visual field and the patient is asked whether he or she can see the object iv. Descending aorta: Situated at the retrocardiac space just anterior to the bodies of the vertebrae. Although its frequency is high, more alarming is the impact it can have on outcome.

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Above the aortic arch, it is anterolaterally crossed by the left phrenic nerve but anterior to the aortic arch by the left superior intercostal vein iv. Anterior para-olfactory sulcus: It is a short vertical sulcus a little anterior to the paraterminal gyrus. These symptoms are very difficult to manage if sodium levels are not increased reasonably. Medial side of the base of the proximal phalanx of the great toe (hallux) 348 Human Anatomy for Students Insertion It divides in to four tendons. It passes through a triangular space (vertebral triangle) between longus coli and scalenus anterior muscles. It requires the administration of iodinated contrast material by a pump operated by trained personnel, exposing the patient to high doses of radiation. They may be related to autonomous nervous system disorders affecting the cortical structures, particularly the insula (resulting in cardiovascular malfunction). Nevertheless, it is appropriate to give at least high doses of dexamethasone in patients with suspected traumatic or nontraumatic (especially related to tumour) cord compression pending a definitive diagnosis. Lower motor neuron lesion of oculomotor nerve, resulting ipsilateral paralysis of muscles of eyeball supplied by oculomotor nerve. It has good propV Confused-inappropriate erties of concurrent validity and test-retest unreliability. In male, the lateral end is either at the same level or slightly higher than the medial end. Begins as a single line from zygomatic pro cess of frontal bone and run upwards and backwards. Consist of a small oval facet covered by a layer of cartilage, which articulates with the upper end of the body to form a cartilaginous manubriosternal joint. In the superior orbital fissure: Occasionally sends a branch to the lacrimal nerve. The most common technique for regional monitoring is to measure the brain oxygen tension (ptbO2). The first positive deflection, P1 (percussion wave), corresponds to the arterial pulse wave and represents the arrival of blood to the intracranial cavity. Third and fourth digitations from the opposite the apex of the spinous of the scapula to the superior part of the inferior angle of the scapula. There is a direct correlation between albumin, transferrin and fibronectin depletion with higher morbidity and mortality, delayed healing and decreased resistance to infection. Posterior cerebellar notch: Posteriorly the two hemispheres separated from each other by the posterior cerebellar notch. Early neurologic deterioration in the first few days tends to be related to a neurologic reason compared with deterioration in the subacute setting which is usually due to systemic reasons [48]. In a Swedish study comparing the use of tranexamic acid initiated within a mean of 4. The accuracy, reliability and utility of this technique have been extensively studied in the clinical setting [15,18,10,142]. Between this two extremes lie all kinds of intermediate situations, and the physician will need to consider the time factor when making decisions. Early diagnosis and rapid initiation of immunosuppressive therapy have a direct impact on the prognosis of these patients. Sciatica: It is a condition in which patient has pain along the sensory distribution of the sciatic nerve. Serial examinations are useful to detect variability in the level of consciousness. Anterior lobe: It is situated on the anterior part of the superior surface which is separated from the middle lobe by the fissura prima present on the superior surface. It forms the anterior and part of the posterior wall and floor of the external acoustic meatus. The prognostic importance of a small acute decrement in kidney function in hospitalized patients: a systematic review and metaanalysis.

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