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By L. Jensgar. University of Saint Thomas, Saint Paul.

In primates purchase 25mg elavil free shipping, 10 to 20% of Upper motor corticospinal fibers ends directly on motor neurons; the neuron others end on interneurons associated with motor neurons cheap elavil 50 mg with mastercard. From the cerebral cortex, the corticospinal tract axons descend through the brain along a path located between the basal ganglia and the thalamus, known as the internal capsule. They then continue along the ventral brainstem as the cerebral peduncles and on through the pyramids of the medulla. Most of the corticospinal axons cross the midline in the medullary pyramids; thus, the motor cortex in each hemisphere controls the muscles on the contralateral side of the body. After crossing in the medulla, the corticospinal Lower motor axons descend in the dorsal lateral columns of the spinal neuron cord and terminate in lateral motor pools that control dis- tal muscles of the limbs. Axons arising from cortical neurons, including the primary motor cross in the medulla and descend in the ventral spinal area, descend through the internal capsule, decussate in the columns. These axons terminate in the motor pools and ad- medulla, travel in the lateral area of the spinal cord as the lateral jacent intermediate zones that control the axial and proxi- corticospinal tract, and terminate on motor neurons and interneu- mal musculature. Note the upper The corticospinal tract is estimated to contain about 1 and lower motor neuron designations. The largest-diameter, heavily myelinated axons are between 9 and 20 m in diameter, but that population accounts for only a small fraction of the total. Most corticospinal axons are small, 1 to 4 m in diameter, and half are unmyelinated. CHAPTER 5 The Motor System 103 In addition to the direct corticospinal tract, there are Cerebral other indirect pathways by which cortical fibers influence cortex motor function. Some cortical efferent fibers project to the reticular formation, then to the spinal cord via the reticu- lospinal tract; others project to the red nucleus, then to the spinal cord via the rubrospinal tract. Despite the fact that these pathways involve intermediate neurons on the way to Caudate the cord, volleys relayed through the reticular formation can nucleus Direct reach the spinal cord motor circuitry at the same time as, or Thalamus Striatum earlier than, some volleys along the corticospinal tract.

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Juxtamedullary nephrons are located cheap elavil 25 mg mastercard, for the most part buy elavil 10mg lowest price, within the outer portion of the renal medulla. Urinary System © The McGraw−Hill Anatomy, Sixth Edition Body Companies, 2001 684 Unit 6 Maintenance of the Body Knowledge Check 3. Trace the course of blood through the kidney from the Transitional renal artery to the renal vein. Trace the course of tubular fluid from the glomerular cap- Mucosa sules to the ureter. Draw a diagram of a nephron and label the renal cortexand renal medulla. The mu- cosa of the urinary bladder permits distension, and the muscles of the urinary bladder and urethra function in the control of micturition. Objective 6 Describe the location, structure, and function of the ureters. Objective 7 Describe the gross and histological structure and the innervation of the urinary bladder. Objective 9 Compare and contrast the structure of the male urethra with that of the female. Factors contributing to renal stone formation may include the ingestion of excessive mineral salts, a decrease in Ureters water intake, and overactivity of the parathyroid glands. The inner mucosa is continuous with the linings of the renal Branches from the renal artery serve the superior portion. The mucosa consists of transi- testicular (or ovarian) artery (also called gonadal artery) supplies tional epithelium (fig.

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US also detects intraarticular loose bodies purchase elavil 10mg on-line, Associated US signs of FTT [18 10 mg elavil overnight delivery, 17] are: (1) joint effu- fractures (radial head) and osteocartilaginous lesions sion, (2) effusion in the subdeltoid bursa, (3) surface ir-. Power Doppler can be used for the detection and regularities of the greater tuberosity, and (4) focal carti- follow-up of inflammatory pathology (e. Tears of the ulnar collateral liga- An irregularity in the cortical of the greater tuberosity ment appear as a focal discontinuity or a non-visualiza- and joint fluid are important signs of FTT of the tion, partial tears as (focal) thickening, decreased supraspinatus tendon. PTT appear as anechoic to hypoechoic clefts with ir- In epicondylitis (lateral or medial), a hypoechoic ten- regular hyperechoic borders, or as flattening of the bursal don thickening (Fig. Degenerative changes in tendinosis are, in general, hy- poechoic [17, 19], or hyperechoic. In calcified tendonitis, US localizes and quantifies the calcifications, which appear as hyperechoic foci that may produce shadowing. Associated hypoechoic tendon thick- ening and positive Doppler examination reflect inflam- mation. In impingement syndrome, US can demonstrate thick- ening of the subacromial-subdeltoid bursa, which accu- mulates in front of the acromion during elevation or ab- duction. Less frequently, a comparative study will show a difference of >2 mm in RC thickness due to tendonitis. A small effusion, surrounding the biceps tendon may accompany any of the above-mentioned findings. A fracture of the greater tuberosity may lead to a sec- ondary type of impingement. Dynamic examination can also demonstrate anterior and posterior shoulder im- pingement Effusion in the biceps tendon sheath reflects patholo- gy elsewhere in the joint in 90% of cases. In inflamma- tion, the biceps tendon is tender, enlarged, heterogeneous, surrounded by an effusion and may present longitudinal splits. When the bicipital groove is empty, the tendon may be ruptured, with variable retraction, or it may be dislo- Fig.