By U. Irhabar. Emory & Henry College.

Convoluted cerebrum Characteristics of Humans Hair As human beings trandate 100mg otc arteria circumflexa femoris lateralis, certain of our anatomical characteristics are so Three auditory specialized that they are diagnostic in separating us from other ossicles animals generic trandate 100mg on line arrhythmia hyperkalemia, and even from other closely related mammals. We also Well-developed have characteristics that are equally well developed in other ani- facial muscles mals, but when these function with the human brain, they pro- Squamosal-dentary vide us with remarkable and unique capabilities. Our anatomical jaw articulation characteristics include the following: Heterodont dentition 1. This Four-chambered heart with left gives us a large brain-to-body-weight ratio. But more im- aortic arch portant is the development of portions of the brain. Cer- tain extremely specialized regions and structures within the Mammary glands brain account for emotion, thought, reasoning, memory, Muscular diaphragm and even precise, coordinated movement. Because humans stand and walk on Placental attachment for young (within two appendages, our style of locomotion is said to be uterus) bipedal. Upright posture imposes other diagnostic structural features, such as the sigmoid (S-shaped) curvature of the FIGURE 2. Body Organization and © The McGraw−Hill Anatomy, Sixth Edition Organization, and the Anatomical Nomenclature Companies, 2001 Human Organism 26 Unit 2 Terminology, Organization, and the Human Organism Creek Tarsier Aye-aye Gorilla Human FIGURE 2. Cerebrum Optic lobe Cerebellum Cerebrum Codfish Frog Chimpanzee Cerebellum Alligator Goose Human Creek Horse FIGURE 2. Body Organization and © The McGraw−Hill Anatomy, Sixth Edition Organization, and the Anatomical Nomenclature Companies, 2001 Human Organism Chapter 2 Body Organization and Anatomical Nomenclature 27 (a) (b) (c) (d) (e) (f) FIGURE 2. The human thumb is structurally Taxon Grouping Characteristics adapted for tremendous versatility in grasping objects. Kingdom Animalia Eucaryotic cells without walls, plastids, The saddle joint at the base of the thumb allows a wide or photosynthetic pigments range of movement (see fig. All primates have op- Phylum Chordata Dorsal hollow nerve cord; notochord; posable thumbs. Humans, like no other Subphylum Vertebrata Vertebral column animals, have developed articulated speech. The anatomi- Class Mammalia Mammary glands; hair; convoluted cal structure of our vocal organs (larynx, tongue, and lips), cerebrum; heterodont dentition and our well-developed brain have made this possible. Order Primates Well-developed brain; prehensile hands Family Hominidae Large cerebrum, bipedal locomotion 5. Although this characteristic is well de- veloped in several other animals, it is also keen in humans. Genus Homo Flattened face; prominent chin and nose with inferiorly positioned nostrils Our eyes are directed forward so that when we focus on an Species sapiens Largest cerebrum object, we view it from two angles. Stereoscopic vision gives us depth perception, or a three-dimensional image. Body Organization and © The McGraw−Hill Anatomy, Sixth Edition Organization, and the Anatomical Nomenclature Companies, 2001 Human Organism 28 Unit 2 Terminology, Organization, and the Human Organism We also differ from other animals in the number and The human body contains many distinct kinds of cells, arrangement of our vertebrae (vertebral formula), the kinds and each specialized to perform specific functions. Examples of spe- number of our teeth (tooth formula), the degree of development cialized cells are bone cells, muscle cells, fat cells, blood cells, of our facial muscles, and the structural organization of various liver cells, and nerve cells. The human characteristics just described account for the splendor of our cultural achievements. As bipedal animals, we have our hands free to grasp and manipulate objects with our op- Tissue Level posable thumbs. We can store information in our highly developed brain, make use of it at a later time, and even share our learning Tissues are layers or groups of similar cells that perform a com- through oral or written communication. The entire body is composed of only four princi- pal kinds of tissues: epithelial, connective, muscular, and nervous Knowledge Check tissue. An example of a tissue is the muscle within the heart, whose function it is to pump the blood through the body. Why are humans considered members outer layer of skin (epidermis) is a tissue because it is composed of the phylum Chordata?

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These findings are most consistent with a stone within the left Clinical Practicum 22 order 100 mg trandate otc blood pressure kiosk machines. Considering the physical exam findings and the location of this mass on the diagnosis discount 100mg trandate with visa arteria aorta abdominal. The intravenous urogram demonstrates that there is a stone within the upper on CT tells us that many different types of tissue are found within the mass. This stone is large enough to cause partial obstruction This mass therefore, most likely represents a dermoid cyst. Because this mass collecting system causes increased pressures within the kidney. This in turn arises from germ cells it has the potential to form all types of tissue. If these changes are long-standing, permanent common to find teeth, hair, and fat within a dermoid cyst. The ureter has a structure similar to many other hollow organs in the body. The vast majority of dermoid cysts are benign, however a very small Deep to the mucosa there is a layer of smooth muscle which is surrounded by percentage will undergo malignant degeneration. This smooth muscle layer undergoes periodic peristaltic such a benign mass is that with increasing size there is increased risk of contractions to propel the urine from the kidney to the urinary bladder. In this condition the ovary twists, causing occlusion of the the setting of a stone within the ureter these contractions become painful as ovarian vessels, which may lead to ischemia. When a dermoid cyst becomes the smooth muscle exerts pressure on the stone. Because these peristaltic larger than 4 cm the risk of ovarian torsion becomes great enough that waves are only intermittent the pain is intermittent. The testicular self-exam for males is, in a way, equivalent to the breast self- exam for females. It is a screening test for testicular cancer, the most common malignancy among young adult males. It involves examining both testes on a monthly basis to check for changes in contour, nodules, or areas of tenderness. If performed properly and at timely intervals this exam may result in earlier detection of testicular neoplasms. By detecting these cancers at earlier stages it is hoped that they may be more effectively treated. The phonetic spellings reflect standard scientific usage and can easily be inter- genetic diseases. Any unmarked vowel that ends a syllable or that stands alone as a syllable has the long suspended in amniotic fluid; commonly sound. For example, ba, ma, and na rhyme with fay; be, de, and we rhyme with fee; bi, di, and known as the “bag of waters. It gives rise to the fetal umbilical spinal cord composed of axons of motor, or contraction. An ear-shaped appendage of each blood The fluid connective tissue that arrangement of white matter within the atrium of the heart. It is essential for the absorption tendons and bones or at points of friction atrioventricular valve A cardiac valve located of fats. It includes the embryo or fetus, as arise from the inferior surface of the brain. An material between the nucleus and the cell origin; the opposite of proximal. One of posterior, portion of a body part; the opposite the convex folds on the surface of the brain. Deciduous teeth are shed and The blood vessel that connects the the epidermis. It stores spermatozoa and expiration The process of expelling air from recording of the electrical impulses or transports them from the seminiferous the lungs through breathing out; also called activity of a muscle; EMG. Van De Graaff: Human Back Matter Glossary © The McGraw−Hill Anatomy, Sixth Edition Companies, 2001 808 Glossary middle-ear chamber and through which fibrous joint A type of articulation bound by frontal plane See coronal plane. The anterior aspect of the head not gap between the incompletely formed cranial chromosome containing the information supporting or covering the brain.

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That NT may be implicated in the disorder if it can be shown that the relative therapeutic effectiveness of a range of drugs correlates significantly with some action they have on it buy cheap trandate 100 mg online pulse pressure by age. This requires that all the compounds must have a similar chance of reaching the CNS 100 mg trandate arrhythmia prevalence, or at least of providing appropriate plasma levels, and also that compounds with little or no clinical efficacy in the disorder do not modify the NTin the same way as effective drugs. Thus there is a clear correlation between DA receptor antagonism, as measured by ligand binding studies and the anti-schizophrenic activity of a wide range of phenothiazine and butyro- phenone derivatives (see Chapters 7 and 17). Good correlations between the analgesic potency of morphine derivatives and displacement of the labelled morphine antagonist, naloxone, helped not only to formulate the concept of opioid receptors and hence of endogenous opioids to occupy them but also the actual discovery of the enkephalins. Displacement of labelled diazepam by a wide range of other benzodiazepines, in an order in keeping with their clinical efficiency as anxiolytics, led to the realisation of endogenous benzodiazepine receptors. Unfortunately a significant correlation between the clinical efficacy and a particular pharmacological effect of a range of drugs may give the impression that that is the only way in which that disorder may be treated. When drugs are evaluated for therapy in a peripheral malfunction, the tendency is to try to show that they work through different mechanisms. Indeed it is considered desirable, if not essential, to develop anti-hypertensive drugs with different actions, e. Yet remarkably, when dealing with the CNS, the tendency has been to try to treat a disorder by manipulating just one NT. Consequently the assumption arose that all anti-depressant drugs must augment NA function and all neuroleptic anti-schizophrenic drugs must be DA antagonists, etc. Certainly the intro- duction of some drugs that are effective in depression without blocking NA uptake, which was the conceived mode of action of all the earlier tricyclic anti-depressants, not only gave a new approach to therapy but also questioned the long-held view that depression is due only to reduced NA function. There could be as many ways of controlling depression as there are of reducing blood pressure and a number of different NTs involved. NEUROTRANSMITTER FUNCTION IN HUMANS 293 All such animal procedures suffer from the obvious and basic problem that laboratory animals do not behave like humans and that humans cannot reliably interpret their reactions and behaviour. Indeed there are some tests, as well as animals with varied spontaneous seizures, that are even predictive of particular forms of epilepsy. But then convulsions are a very basic form of activity common to most species and epileptic seizures that are characterised by behavioural rather than motor symptoms are more difficult to reproduce in animals. It is a statement of the obvious to say that we cannot tell when a rat is anxious or depressed, assuming that they can even experience such human reactions, but they can be subjected to conditions that would make us anxious or depressed. Whether animals then react in the same way as humans is not certain but we have to assume that to be the case if the animal is to be used to detect changes in NTfunction that can be related to humans. This may be a more acceptable assumption if the animal model responds to drugs that are effective in humans, although it can prejudice thinking and perhaps restrict it to a consideration of just one NT. Thus since all drugs with anti-schizophrenic activity are dopamine antagonists, at least to some extent, the predictive value of any model of that condition has been evaluated by its responsiveness to DA antagonists. Consequently such tests only yield more DA antagonists Ð a property that can be established in the test tube. Of course, changes in other NTs may be found in such animal tests and a really genuine model of schizophrenia could generate totally different drugs. These problems are well known to experimental psychopharmacologists whose studies are becoming more sophisticated and, hopefully, more appropriate and predictive. APPROACHES TO THE MANIPULATION OF NEUROTRANSMITTER FUNCTION IN HUMANS Once the malfunction of a particular NThas been established in a disease state, we need to find ways by which its activity can be restored to normal. It is assumed that no NTcrosses the blood- brain barrier and so its activity must be modified indirectly. This may be achieved by giving the precursor, if it crosses the blood-brain barrier. Whether this works will depend on (i) how many neurons remain to synthesise the NT, unless this can be performed extraneuronally and (ii) the availability of synthesising enzymes. Thus if synthesis is a complicated multi- stage process or is controlled by the availability of enzymes that are already reduced or working maximally in remaining neurons, this approach may prove difficult. It is not practical at present to increase the vesicular release of a particular NT.

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He made every effort to be cooperative cheap 100 mg trandate mastercard blood pressure 58 over 38, and his pleasant and good-natured spirit always came through purchase 100 mg trandate overnight delivery heart attack belanger remix, never failing to irritate those who were trying to take advantage of him. One must be careful not to appear either wise or a smart aleck on the stand. This will irritate everyone and will cave in on whomever attempts to use it. Any temporary victories by an expert witness will be short-lived under the withering stare of an experienced judge. Also remember that the attorney who engaged your services is in charge of working out the strategy for the case presentation. The cleverest and best plan is of little use if it is brought up at the wrong time or out of sequence or if it is at cross-purposes with the strategy of the experienced attorney. You should discuss your ideas and sug- gestions with him or her and follow instructions. The truth: Mark Twain once pointed out that no one has a sufficiently good memory to be a successful liar. Always speak the truth as you understand it, and do not play with words in some clever attempt to disguise what you are saying. Longer- than-expected answers always invite the listeners to examine them with great care, and the tone and raised pitch of your voice will often reveal your anxiety. Other signs of anxiety include dry mouth, stuttering, sputtering, repetition, and movement. Remember that we are always at our worst when anxiety has robbed us of whatever clear thinking and believability we may have brought to the task. Smile occasionally, but make it a genuine smile and not a practiced one. With great care, you may occasionally 46 Mattison smile aside (impersonally) at some overzealous comment by an adversarial attorney. When you have no idea of what your answer should be, you may use the strategy of looking directly at the questioner and saying, “I am so glad you asked that. I believe that this is a very important question with information that is important for the jury to have. OTHER SOURCES There are many helpful books for the beginning expert witness. This book was originally copyrighted in 1903 and 1904 by The Macmillan Company, and later in 1933 and 1934 by Francis L. It is of great benefit to read some classic courtroom questions and answers, but only for purposes of illustration and not for your own use. How- ever, be aware of the consequences of trying to be innovative in some- one else’s field. OTHER ADVICE Your relationship with the attorney with whom you are working is extremely important. Believe and trust him or her by giving him or her all your relevant theories so that he or she can decide whether and how to use them. I cannot remember ever having gone to trial without my attorney having questioned me at length. It is especially helpful when someone actually seats you at the witness stand during the lunch hour and browbeats you so that you will have experienced trial by fire. No one has ever refused to do this when I requested it, and the browbeat- ing session was always more severe than the actual event. This is not a rehearsal for effective testimony; rather, it is a means of seeing whether or how well you can hold everything together under duress, allowing you to become familiar with the possible worst-case scenario presented by opposing counsel. On one occasion, a doctor joke was tried out on me when I was on the stand. Very calmly and sadly, I said that I had been taught even as a child never to make light of someone else’s profession.

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