NCLEX Review Liver Lecture ....

Organization of the enteric component of the visceral motor system......

PICKED: Portraits of the Mind     

Portraits of the Mind: Visualizing the Brain from Antiquity to the 21st Century, a book that sources its material in science, roots its aesthetic in art, and reads like a literary anthology, is making us swoon in all kinds of ways. Author Carl Schoonover explores — in breathtaking visual detail — the evolution of humanity’s understanding of the brain, from Medieval sketches to Victorian medical engravings to today’s most elaborate 3D brain mapping.

Axon Scaffolding Proteins (Photomicrograph, 2008) | The arrangement of proteins forming the inner scaffolding of axons, captured thanks to genetically engineered antibodies that help researchers study the molecular components neurons like specific types of proteins
Image by Michael Hendricks and Suresh Jesuthasan

Phrenological Skull (Drawing on human skull, 19th century) | A quasi-medical artifact of phrenology, the 19th-century pseudo-science positing that bumps on the head reflect the underlying shape and functionality of the brain, dividing the skull into regions that control specific aspects of one's organs and personality
Photograph by Eszter Blahak/Semmelweis Museum

The foreword by Jonah Lehrer, one of our favorite science-distillers, only adds to the tome’s already irresistable allure.

Dog Olfactory Bulb (Drawing on paper, 1875) | A drawing of the first area in the brain that processes smells by physician and scientist Camillo Golgi, who invented a revolutionary technique for staining neurons still in use today
Drawing by Camillo Golgi. Courtesy of Dr. Paolo Mazzarello, University of Pavia

Hippocampus (Photomicrograph, 2005) | Genetically-encoded fluorescent proteins illuminate neurons in different colors in a modern version of the Golgi stain, a simple chemical coloring traditionally done with silver nitrate
Image by Tamily Weissman, Jeff Lichtman, and Joshua Sanes

Schoonover curates images come from data laboratories around the world, many of which are revealed to the world for the first time, contextualized through essays by leading scientists. And while the history of brain research seems to be an extended exercise in Socratian the-more-we-learn-the-more-we-learn-how-little-we-know, Portraits of the Mind manages to construct a thrilling frame for hope in neuroscience by making the scientific understanding of the human brain both exciting and accessible, a digestible deluge of visual and intellectual fascination.

Brain training to combat addiction

There has been some very interesting research (published in Biological Psychiatry) into addiction on a neurological level and designing brain training programs that can start to tackle the fundamental reasons why addicts choose short term gain over long term damage, the interplay between so called “reward myopia” and “delay discounting”. See below for some more information but I have often thought that punishment and threats will never tackle the raw demand of addicts (be they chemical or gambling etc) but it must be the internal mental incentive system that must be addressed. In it’s simplest terms we must remove the urge to continue with the addiction and the benefit from indulging, simply attempting to prohibit the product / activity will almost certainly not succeed alone. Brain training in one form or another seems to make a lot of sense in helping to tackling this.

If you wish to read more click here.
One reason that education alone cannot prevent substance abuse is that people who are vulnerable to developing substance abuse disorders tend to exhibit a trait called “delay discounting”, which is the tendency to devalue rewards and punishments that occur in the future. Delay discounting may be paralleled by “reward myopia”, a tendency to opt for immediately rewarding stimuli, like drugs. 

Thus, people vulnerable to addiction who know that drugs are harmful in the long run tend to devalue this information and to instead be drawn to the immediately rewarding effects of drugs.

Delay discounting is a cognitive function that involves circuits including the frontal cortex. It builds upon working memory, the brain’s “scratchpad”, i.e., a system for temporarily storing and managing information reasoning to guide behavior.

In a new article in Biological Psychiatry that studied this process, Warren Bickel and colleagues used an approach borrowed from the rehabilitation of individuals who have suffered a stroke or a traumatic brain injury. They had stimulant abusers repeatedly perform a working memory task, “exercising” their brains in a way that promoted the functional enhancement of the underlying cognitive circuits.

They found that this type of training improved working memory and also reduced their discounting of delayed rewards.

“The legal punishments and medical damages associated with the consumption of drugs of abuse may be meaningless to the addict in the moment when they have to choose whether or not to take their drug. Their mind is filled with the imagination of the pleasure to follow,” commented Dr. John Krystal, Editor of Biological Psychiatry. “We now see evidence that this myopic view of immediate pleasures and delayed punishments is not a fixed feature of addiction. Perhaps cognitive training is one tool that clinicians may employ to end the hijacking of imagination by drugs of abuse.”

Dr. Bickel agrees, adding that “although this research will need to be replicated and extended, we hope that it will provide a new target for treatment and a new method to intervene on the problem of addiction.”

Is the amygdala our new best friend?

It has previously crossed my mind that the hunter gathering instinct that evolved traits such as strength, speed, stamina etc in our tribal forefathers may have gradually been replaced with other factors. Nowadays these physical attributes are not necessarily what makes the ‘best’ mate or those that give the highest rate of survival/prosperity. Although this change seems logical, what these other factors may be is not clear and how they directly relate to our physiological make-up is even more opaque.
In modern Western society it is more likely than not that a person with very strong attributes in areas such as intelligence, social ability, natural leadership, financial acumen, etc could lead to getting ahead in the social strata and/or achieving greater evolutionary ‘success’. This could help explain why research has found a long term increasing level of intelligence in our society (the so called ‘Flynn effect’) but could it also be the case that we are evolving to be more socially capable?
Recent research seems to link the size of ones amygdala, a small almond shaped structure deep within the temporal lobe, to a rich and varied social life among humans. The study for Nature Neuroscience found support for the ‘social brain hypothesis’. This suggests that evolutionarily, due to living in larger, more complex social groups preferable mates are selected for their social ability.
In some part, social ability now seems to be linked to the volume of the amygdala, where the larger the brain region the greater the capacity for performing relevant social computations (eg forming alliances, gauging social situations, gaining friends and limiting foes). It is intriguing that these things could potentially be located in one area of the brain. This could provide an area to concentrate future treatments for those suffering ‘social’ disorders, such as social alienation, depression, etc. It is not something traditionally connected to a specific element of ones physiology but seems to continue to merit further research on the brain and it’s amazing impact on how we interact with the world.

Some Digestive System Definitions and meanings..........

 

 

Digestive System

Question	Answer
celi/o	belly; abdomen
cheil/o	lip
amyl/o	starch
bil/i	gall; bile
chol/e	gall; bile
chlorhydr/o	hydrochloric acid
lith/o	stone
steat/o	fat
-ase	enzyme
-chezia	defecation; elimination of wastes
-iasis	abnormal condition
-prandial	meal
an/o	anus
append/o	appendix
appendic/o	appendix
bucc/o	cheek
cec/o	cecum
cholecyst/o	gall bladder
choledoch/o	common bile duct
col/o	colon
dent/i	tooth
duoden/o	duodeneum
enter/o	intestines
esophag/o	esophagus
faci/o	face
gastr/o	stomach
gingiv/o	gums
gloss/o	tongue
hepat/o	liver
ile/o	ileum
jejun/o	jejum
labi/o	lip
lapar/o	abdominal wall
lingu/o	tongue
mandibul/o	mandible
odont/o	tooth
or/o	mouth
palat/o	palate
pancreat/o	pancreas
peritone/o	peritoneum
pharyng/o	pharynx (throat)
proct/o	anus and rectum
pylor/o	pyloric sphincter
rect/o	rectum
sialaden/o	salivary gland
sigmoid/o	sigmoid colon
stomat/o	mouth
uvul/o	uvula
bilirubin/o	bilirubin
gluc/o	sugar
glycogen/o	glycogen, animal starch
lip/o	fat; lipid
prote/o	protein
sial/o	saliva, salivary
Passage of materials through the walls of the small intestine into the bloodstream	absorption
Building blocks of proteins, produced when proteins are digested	amino acids
Enzyme secreted by the pancreas to digest starch	amylase
Opening of the digestive tract to the outside of the body	anus
Blind pouch hanging from the cecum; RLQ	appendix
Digestive juice made in the liver and stored in the gall bladder. It breaks up (emulsifies) large fat globules	bile
Pigment released by the liver in bile	bilirubin
First part of the large intestine	cecum
Carries bile from the liver and gallbladder to the duodenum	common bile duct
First part of the small intestine; measures 12" long	duodenum
Small sac under the liver	gallbladder
Simple sugar	glucose
Starch; glucose is stored in the form of this in the liver cells	glycogen
Third part of the small intestine, often the area of obstruction	ileum
Hormone produced by the endocrine cells of the pancreas. It transports sugar from the blood into cells and stimulates glycogen formation by the liver	insulin
Second part of the small intestine	jejunum
Pancreatic enzyme necessary to digest fats	lipase
A large organ in the RUQ. Secretes bile, stores sugar, iron, vitamins, produces blood proteins and destroys worn out RBC's. Normally weighs 2 1/2-3 #	liver
Ring of muscles between the esophagus and the stomach. AKA cardiac sphincter	lower esophageal sphincter
Organ under the stomach; produces insulin and enzymes	pancreas
Salivary gland within the cheek; just anterior to the ear	parotid gland
Throat, the common passageway for food from the mouth and for air from the nose	pharynx
Large vein bringing blood to the liver from the intestines	portal vein
Ring of muscle at the end of the stomach, near the duodenum	pyloric sphincter
Distal region of the stomach, opening to the duodenum	pyloris
Parotid, sublingual and submandibular glands	salivary glands
Forth and last s-shaped segment of the colon	sigmoid colon
Inflammation of the liver caused by a virus	viral hepatitis
Inflammation of the pancreas	pancreatitis
Chronic degenerative disease of the liver	cirrhosis
Gallstones in the gallbladder	cholelithiasis
Twisting of the intestines on itself	volvulus
Chronic inflammation of the colon with presence of ulcers	ulcerative colitis
Group of gastraintestinal symptoms associated with stress and tension	irritable bowel syndrome-IBS
Telescoping of the intestines	intussusception
Failure of peristalsis with resulting obstruction of the intestines	ileus
Swollen, twisted varicose veins of the rectal region	hemorrhoids
Painful, inflamed intestines	dysentery
Abnormal side pockets in the intestinal wall	diverticulosis
Chronic inflammation of the intestinal tract	crohn's disease
Adenocarcinoma of the colon or rectum or both	colorectal cancer
Polyps protrude from the mucous membrane of the colon	colonic polyposis
Abnormal tube-like passage way near the anus	anal fistula
Open sore or lesion of the mucous membrane of the stomach or duodenum	peptic ulcer
Protrusion of an organ or part through the muscle that normally contains it	hernia
Solids and fluids return to the mouth from the stomach	gastroesophageal reflux disease-GERD
Malignant tumor of the stomach	gastric carcinoma
Swollen, varicose veins at the lower end of the esophagus	esophageal varices
Failure of the lower esophagus sphincter (LES) muscle to relax	achalasia
Inflammation and degeneration of gums, teeth, and surrounding bone	periodontal disease
White plaques or patches on the mucosa of the mouth	oral leukoplakia
Inflammation of the mouth by infection with the herpes virus	herpetic stomatitis
Tooth decay	dental caries
Inflammation of the mouth with small, painful ulcers	aphthous stomatitis
Fat in the feces; froth, foul-smelling fecal matter	steatorrhea
Unpleasant sensation in the stomach associated with a tendency to vomit	nausea
Black, tarry stools; feces containing digested blood	melena
Yellow-orange coloration of the skin and whites of the eyes caused by high levels of bilirubin in the blood	jaundice
Passage of fresh, bright red blood from the rectum	hematochezia
Gas expelled through the anus	flatus
Gas expelled from the stomach through the mouth	eructation
Difficulty in swallowing	dysphagia
Frequent passage of loose, watery stools	diarrhea
Difficulty in passing stools	constipation
Rumbling or gurgling noise produced by the movement of gas, fluid or both in the GI tract	borborygmus
Abnormal accumulation of fluid in the abdomen	ascites
lack of appetite	anorexia
The combining form eti/o means: A. cause B. disease C. beginning D. condition	A
Mr. Wayne is scheduled to have a visual examination of the distal end of his descending colon that leads into the rectum. This procedure is called a ____scopy. A. sigmoid/o B. jejun/o C. colon/o D. cecum/o	A
The medical term for gallstones is: A. calcia B. calcium C. calculi D. calculus	C
What is the term for a failure of the lower esophageal sphincter to relax? A. achalasia B. GERD C. esophageal varices D. borborygmus	A

Skeletal System.........

I).  Function of the skeletal system A).  support B).  protection C).  movement D).  mineral storage E).  blood cell formation
II).  Bones & Muscles  as Levers Levers have 4 components 1).  Rigid bar 2).  Pivot/fulcrum 3).  Object that creates resistance 4). Force that supplies movement http://www.vias.org/physics/bk2_06
When the arm bends the bone represents the rigid bar The elbow joint is the pivot The hand is moved against the resistance or weight (weight of hand) The muscles supply force
III). Skeletal Cartilage:  Hyaline Cartilage Provides support with  flexibility and resilience. A).  Articular cartilage B).  Costal cartilage C).  Nasal cartilage D). Epiphyseal cartilage E).  Embryonic  cartilage
IV). Long Bone Anatomy: A). diaphysis B). epiphysis The epiphysis is usually covered in articular cartilage C). epiphyseal line or plate
http://anatomyforme.blogspot.com/
V). Bone Structure A). compact bone structural units called osteons. Ostean consists of long cylinders that run parallel to the long axis of the bone. Structure of an osteon 1). lamella   2). Haverson’s canal: (oseonic canal) 3). canaliculi or perforating canals 4). lacuna: contain osteocytes (mature bone cells) Types of osteocytes i). osteoblasts: build bone ii). osteoclasts: consume or remove bone

 B). spongy (trabecular) bone

A honeycomb or network of flat pieces called trabeculae that are organized along stress lines

C).  Medullary Cavity

D). Bone Marrow

Soft tissue in the medullary cavity and the trabeculae of the spongy bone

1). red bone marrow:

2). yellow bone marrow:

E). periosteum

The periosteum is supplied with nerve fibers, lymphatic vessels and blood vessels, which enter the bone.
It also contains osteoblasts (bone builders) & osteoclasts (bone breakers)

VI). bone development

A). osteogenesis: Bone tissue formation

1. cell types

i. oseteoblasts: build calcium matrix
ii. osteoclasts: reabsorb calcium matrix

2. ossification: formation of bone

Ossification replaces cartilage with bone matrix

3. Ossificantion Processes

i. Endochondral Ossification:  Long bones ossify---

along hyaline cartilage model

ossify on the outside with compact bone and move inward

ii. Intramembranous Ossification: Flat bones ossify--

from layers of unspecified connective tissue.

ossify inside with spongy bone and work outward to compact bone

B). Intramembranous Ossification of flat bones

1). An ossification center appears in the connective tissue.
2). A bone matrix is secreted in the fibrous membrane.
3). Woven bone and periosteum form.
4). Bone collar of compact bone forms and red bone marrow appears.
Fontanels:  Unossified fibrous membranes

C). Endochrondral Ossification of long bones

1). Formation of hyaline cartilage model
2). A bone collar forms around the diaphysis of the hyaline cartilage
3). Cartilage in the center of the diaphysis calcifies and then cavitates
4). The periosteal bud invades the internal cavity and spongy bone forms.   

                            The bud contains a nutrient artery and osteoclasts

5). The diaphysis elongates and a medullary cavity forms
6). The epiphysis ossify.

*Hyaline cartilage remains on the growth plate and the articulating surface.

VII). Bone Remodeling

Weekly recycle 5% to 7% of bone mass. With a replacement of spongy bone every 4 years and a replacement of compact bone every 10 years.

Bone deposit:

Bone reabsorption:

Controlled by:

1). Negative feedback

Ca++loop that maintains blood calcium.
It involves the hormones: Parathyroid Hormone and Calcitonin.

PARATHYROID HORMONE if blood Ca++ is low  Parathyroid Hormone is released   Ca++ is reabsorbed from bone by osteoclasts

CALCITONIN HORMONE if blood Ca++ is high    Calcitonin is released   Ca++ is absorbed into the bone by osteoblasts

2). Mechanical & gravitational forces.

Wolf’s Law Bone grows where stressors are placed on it.

VIII). Bone Fractures

A).  Classification of fractures

1). non-displaced fractures
2). displaced fractures
3). complete fracture
4). incomplete fracture
5). open (compound) fracture
6). closed (simple) fracture
7). closed reduction
8). open reduction

Mnemonic
	Go C3PO (use 3 Cs) Greenstick Open Complete Closed Comminuted Partial Other

B).  Types of fractures

1). green stick
2). partial or fissure
3). comminuted fractures
4). transverse fractures
5).  oblique fractures
6).  spiral fractures
7).  depressed fractures
8). compressed fractures

IX). Repair of Fractures

STEP1:  A hematoma forms over the fracture site.
STEP2:  Fibrocartilaginous callus formation.
STEP3:  Bony callus formation
STEP4:  Bone remodeling

Movement ........ Movement along the Axis or Range of motion

A). Nonaxial Movement:
B). Uniaxial Movement
C). Biaxial Movement
D). Multiaxial Movement

II). Types of motion

A). Gliding Movements

One flat bone slides over another.

B). Angular Movements

Increase or decrease the angle between 2 bones.

1). Flexion

 

Bending motion that decreases the angle of the joint bringing the 2 bones closer together.

2). Extension

Movement that increases the angle between the 2 bones.

Hyperextension: bending the head backward.

3). Dorsiflexion (of the foot)

Lifting the foot up so that it points to the shin.

4). Plantar (of the foot)

Pointing the foot down.

5). Abduction

	Movement of the limb along the frontal plane.
	Raising an arm laterally or spreading the fingers.

6). Adduction

Movement of the limb toward the body.

 7). Circumduction

Movement of a limb in a circle or cone shape.

C). Rotation

Turning of the bone along its own long axis.

Only movement allowed between first 2 cervical vertebra

D). Special Movements

1). Supination

	Movement of the radius around the ulna.
	palm faces up

2). Pronation

Movement of the radius around the ulna.

palm faces down

3). Inversion

Sole of the foot turns medially

4). Eversion

Sole of the foot turns laterally.

5). Protraction

	Nonangular anterior motion along the transverse plane.
	Jutting the jaw out

6). Retraction

	Nonangular posterior motion along the transverse plane.
	Pulling the jaw back.

7). Elevation

	Lifting a body part superiorly
	Shrugging  shoulders closing the mouth.

8). Depression

	Moving a body part inferiorly
	Opening the mouth.

9). Opposition

Movement of the thumb in relation to other digits.