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The legs of the H are called anterior discount 5gm bactroban with amex, posterior cheap 5gm bactroban visa, and lateral horns of gray matter buy bactroban 5gm cheap, or gray columns. Posterior (dorsal) Lateral white column root of spinal nerve Posterior (dorsal) Posterior gray horn root ganglion Posterior median sulcus Spinal nerve Posterior white column Anterior (ventral) root of spinal nerve Gray commissure Central canal Axon of sensory neuron Figure 15-2: A cross- Anterior gray horn Cell body of sensory neuron section of Anterior white column Lateral gray horn the spinal Anterior white cord, show- commissure Dendrite of sensory neuron ing spinal Cell body of motor neuron nerve con- nections. Anterior median fissure Axon of motor neuron Illustration by Imagineering Media Services Inc. The white matter consists of thousands of myelinated nerve fibers arranged in three funiculi (columns) on each side of the spinal cord that convey information up and down the cord’s tracts. Ascending afferent (sensory) nerve tracts carry impulses to the brain; descending efferent (motor) nerve tracts carry impulses from the brain. Each tract is named according to its origin and the joint of synapse, such as the corti- cospinal and spinothalmic tracts. Thirty-one pairs of spinal nerves arise from the sides of the spinal cord and leave the cord through the intervertebral foramina (spaces) to form the peripheral nervous Chapter 15: Feeling Jumpy: The Nervous System 245 system, which we discuss in the later section “Taking Side Streets: The Peripheral Nervous System. In this section, we review six major divisions of the brain from the bottom up (see Figure 15-3): medulla oblongata, pons, midbrain, cerebellum, diencephalon, and cerebrum. Medulla oblongata The spinal cord meets the brain at the medulla oblongata, or brainstem, just below the right and left cerebellar hemispheres of the brain. In fact, the medulla oblongata is con- tinuous with the spinal cord at its base (inferiorly) and back (dorsally) and located anteriorly and superiorly to the pons. All the afferent and efferent tracts of the cord can be found in the brainstem as part of two bulges of white matter forming an area referred to as the pyramids. Many of the tracts cross from one side to the other at the pyramids, which explains why the right side of the brain controls the left side of the body and vice versa. Along with the pons, the medulla oblongata also forms a network of gray and white matter called the reticular formation, the upper part of the so-called extrapyramidal pathway. With its capacity to arouse the brain to wakefulness, it keeps the brain alert, directs messages in the form of impulses, monitors stimuli entering the sense recep- tors (accepting some and rejecting others it deems to be irrelevant), refines body movements, and effects higher mental processes such as attention, introspection, and reasoning. Although the cortex of the cerebrum is the actual powerhouse of thought, it must be stimulated into action by signals from the reticular formation. Nerve cells in the brainstem are grouped together to form nerve centers (nuclei) that control bodily functions, including cardiac activities, and respiration as well as reflex activities such as sneezing, coughing, vomiting, and alimentary tract movements. The medulla oblongata affects these reactions through the vagus, also referred to as cra- nial nerve X or the 10th cranial nerve. Pons The pons (literally “bridge”) does exactly as its name implies: It connects the cerebel- lum through a structure called the middle peduncle, the cerebrum by the superior peduncle, and the medulla oblongata by the inferior peduncle. It also unites the cere- bellar hemispheres, coordinates muscles on both sides of the body, controls facial muscles (including those used to chew), and regulates the first stage of respiration. Midbrain Between the pons and the diencephalon lies the mesencephalon, or midbrain. It con- tains the corpora quadrigemina, which correlates optical and tactile impulses as well as regulates muscle tone, body posture, and equilibrium through reflex centers in the superior colliculus. The inferior colliculus contains auditory reflex centers and is believed to be responsible for the detection of musical pitch. The midbrain contains Part V: Mission Control: All Systems Go 246 the cerebral aqueduct, which connects the third ventricle of the thalamus with the fourth ventricle of the medulla oblongata (see the section “Ventricles” later in this chapter for more). The red nucleus that contains fibers of the rubrospinal tract, a motor tract that acts as a relay station for impulses from the cerebellum and higher brain centers, also lies within the midbrain, constitut- ing the superior cerebellar peduncle. The second-largest divi- sion of the brain, it’s just above and overhangs the medulla oblongata and lies just beneath the rear portion of the cerebrum. The cerebellar cortex or gray matter contains Purkinje neurons with pear-shaped cell bodies, a multitude of dendrites, and a single axon. It sends impulses to the white matter of the cerebellum and to other deeper nuclei in the cerebellum, and then to the brainstem. The cerebellar cortex has parallel ridges called the folia cerebelli, which are separated by deep sulci. Diencephalon The diencephalon, a region between the mesencephalon and the cerebrum, contains separate brain structures called the thalamus, epithalamus, subthalamus, and hypothal- amus. The region where the two sides of the thalami come in contact and join forces is called the intermediate mass. The thalamus is a primitive receptive center through which the sensory impulses travel on their way to the cerebral cortex. Here, nerve fibers from the spinal cord and lower parts of the brain synapse with neurons leading to the sensory areas of the cortex of the cerebrum. The thalamus is the great integrat- ing center of the brain with the ability to correlate the impulses from tactile, pain, olfactory, and gustatory (taste) senses with motor reactions. The epithalamus contains the choroid plexus, a vascular structure that produces spinal fluid. The pineal body and olfactory centers also lie within the epithalamus, which forms the roof of the third ventricle. The subthalamus is located below the thalamus and regulates the muscles of emotional expression. The hypothalamus contains the centers for sexual reflexes; body temperature; water, carbohydrate, and fat metabolism; and emotions that affect the heartbeat and blood pressure. It also has the optic chiasm (connecting the optic nerves to the optic tract), the posterior lobe of the pituitary gland, and a funnel-shaped region called the infundibulum that forms the stalk of the pituitary gland. A thin outer layer of gray matter called the cerebral cortex features folds or convolutions called gyri; furrows and grooves are referred to as sulci, and deeper grooves are called fissures. Each hemi- sphere has a set of controls for sensory and motor activities of the body. Interestingly, it’s not just right-side/left-side controls that are reversed in the cerebrum; the upper areas of the cerebral cortex control the lower body activities while the lower areas of the cortex control upper-body activities in a reversal called “little man upside down. The corpus callosum Chapter 15: Feeling Jumpy: The Nervous System 247 physically unites the two hemispheres and is the largest and densest mass of commis- sural fibers. Different functional areas of the cerebral cortex are divided into lobes: Frontal lobe: The seat of intelligence, memory, and idea association Parietal lobe: Functions in the sensations of temperature, touch, and sense of position and movement as well as the perception of size, shape, and weight Temporal lobe: Is responsible for perception and correlation of acoustical stimuli Occipital lobe: Handles visual perception Medulla The medulla, the region interior to the cortex, is composed of white matter that con- sists of three groups of fibers. Projection fibers carry impulses afferently from the brain stem to the cortex and efferently from the cortex to the lower parts of the central nerv- ous system. Association fibers originate in the cortical cells and carry impulses to the other areas of the cortex on the same hemisphere. Ventricles The brain’s four ventricles are cavities and canals filled with cerebrospinal fluid. The lateral ventricles com- municate with the third ventricle through the foramen of Monro. The third ventricle is connected by the cerebral aqueduct to the fourth ventricle, which is continuous with the central canal of the spinal cord and contains openings to the meninges. The fourth ventricle has openings that allow fluid to enter into the subarachnoid spaces. Lining the ventricles is a thin layer of epithelial cells known as ependyma, or the ependymal layer. Along with a network of capillaries from the pia mater, the ependyma and capillaries form the choroid plexus, which is the source of cerebrospinal fluid.

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School nurse education is also pro- annual Florida Association of School Nurses Conference: vided for nurses in the local county and in sur- Past cheap bactroban 5 gm amex, Present and Future: Continuing the Vision purchase bactroban visa. Nursing a school-aged child breadth of relationships developed at meetings 5gm bactroban for sale, and provides an insight to the Guatemalan culture. Florida Journal through publications and presentations at local, of School Health, 9(1), 29–36. The different drum: Community making and provided for both creating and sustaining peace. Designing a nursing model of primary This model provides the environment in health care and early intervention. Paper presented at the International Association mission and philosophy of the College of of Human Caring Research Conference, the Primacy of Love and Existential Suffering, Helsinki, Finland. Community practice guided staff are encouraged to practice from these by a nursing model. Nursing Science Quarterly, 12(2), beliefs and to reach out and through the con- 125–131. Use of inquiry the web of relationships with colleagues, method for assessment and evaluation in a school-based com- munity nursing project. Index Page numbers followed by f indicate figures; page numbers followed by t indicate tables. See Roy Adaptation Model transpersonal caring relationship, 299–300 Administration Attaching, 355 nursing. See Theory of Bureaucratic Caring Humanistic Nursing Theory, 135 Clock hours, 304 Cognitive adaptation processes C hearing impaired elderly, 276 Call for nursing, 336 Cognitive-behavioral techniques Cancer negative thinking self-care, 152 depression, 63 spouses, 151 Colleges. See Theory of Nursing as Caring analysis and evaluation, 20–21 Nursing: Concepts of Practice, 153 defined, 4 Nursing Development Conference Group, 24 future, 11–12 Nursing discipline, 8–10 nursing knowledge, 4–6 beliefs, 9 nursing’s need, 8–11 communication networks, 9 purpose, 10 conceptual structures, 9 social utility, 150 domain, 8–9 study, 17–20 education systems, 9–10 exercise, 17–20 human imagination, 8 nursing administration, 26 literature, 9 nursing practice, 16–17, 24–25 specialized language, 9 reasons, 17 syntactical structures, 9 theory selection, 17 tradition, 9 types, 6–7 values, 9 Nursologists, 126 Nursing goals Nightingale model, 51 O Nursing home facilities Self-Care Deficit Nursing Theory, 155 Object view Nursing interventions Self-Care Deficit Nursing Theory, 145 Peplau’s process, 62 Openness, 163 Nursing Journal of India,80 Ordered to Care: The Dilemma of American Nursing knowledge Nursing,48 conceptual development, 5 Orem, Dorothea E. See also Synopsis, 169 King’s framework System application, 247t Neuman defined, 282 beginning, 236 client systems, 251t–252t community health, 242 T conceptual system, 237–238, 236f Teachers College, 114 documentation system, 239–240 Teaching. Requests to the Publisher for permission should be addressed to the Legal Department, Wiley Publishing, Inc. Trademarks: Wiley, the Wiley Publishing logo, For Dummies, the Dummies Man logo, A Reference for the Rest of Us! For general information on our other products and services, please contact our Customer Care Department within the U. News & World Report, BusinessWeek, the San Jose Mercury News, and the Silicon Valley/San Jose Business Journal. Knight Journalism Fellow at Stanford University, where she studied human biology and researched innovation and market transfer. She freelances for various publications, working from her home in Half Moon Bay, California, where she lives with husband, Dave Dupree, and their 9-year-old son, Matthew (although a 19-year-old calico cat named Trillian actually rules the roost). Pat DuPree taught anatomy/physiology, biology, medical terminology, and environmental science for 24 years at several colleges and universities in Los Angeles County. She holds two undergraduate life science degrees and a master’s degree from Auburn University and con- ducted cancer research at Southern Research Institute in Birmingham, Alabama, before join- ing the Muscogee Health Department in Columbus, Georgia. In 1970, she moved to Redondo Beach, California, where she was a university instructor and raised her two sons, Dave Dupree and Mark DuPree. Now Pat is retired and lives on lovely Pine Lake in rural Georgia with her husband, Dr. Dedication To our loving family — Dave Dupree, Matthew Dupree, and Jim DuPree — for their patience and understanding as we pulled this book together and put so many other aspects of our lives on hold. Fix-It on balky hard drives, recalcitrant computers, and fussy printers; for distracting an antsy 8-year-old with baseball, movies, and games; and for concocting terrific — and healthy! To Matthew, for understanding why Mommy couldn’t drive for every school field trip, attend every Cub Scout den meeting, or set up play dates every single day of the week. And especially from Pat to Jim for his love, enthusiastic support, assistance, and encourage- ment without which she could not have finished this workbook. Authors’ Acknowledgments We owe gratitude to so many people, but this project has been first and foremost a DuPree family affair. We will never be able to thank our spouses enough for their patience and under- standing from beginning to end. DuPree was a constant helpmate to Pat on the East coast, providing research, editing, computer assistance, and graphics support as well as priceless cheerleading and enthusiasm. Dupree filled the cheerleader role on the West coast, keeping the computers and home network up and running, Janet focused and on track, and the gaping child-rearing gaps filled while she pushed to get the book done in what surely must be record time. Dupree for his stalwart patience while Mom and Grandmom focused their attentions on the book instead of him. We would also like to thank our agent, Matt Wagner, for his tireless efforts, as well as the many devoted people at Wiley Publishing, particularly Stacy Kennedy, Chrissy Guthrie (who welcomed Sophia Rose Guthrie into the world days after receiving the final manuscript! Publisher’s Acknowledgments We’re proud of this book; please send us your comments through our Dummies online registration form located at www. Some of the people who helped bring this book to market include the following: Acquisitions, Editorial, and Media Development Composition Services Senior Project Editor: Christina Guthrie Project Coordinator: Patrick Redmond Project Editor: Stephen R. Jumper, Julie Trippetti, Acquisitions Editor: Stacy Kennedy Erin Zeltner Senior Copy Editor: Elizabeth Rea Special Art: Kathryn Born, M. Cocks, Product Development Director, Consumer Dummies Michael Spring, Vice President and Publisher, Travel Kelly Regan, Editorial Director, Travel Publishing for Technology Dummies Andy Cummings, Vice President and Publisher, Dummies Technology/General User Composition Services Gerry Fahey, Vice President of Production Services Debbie Stailey, Director of Composition Services Contents at a Glance Introduction................................................................................. In Anatomy & Physiology Workbook For Dummies, you discover intricacies that will leave you agog with wonder. The human body is a miraculous biological machine capable of growing, interacting with the world, and even reproducing despite any number of environmental odds stacked against it. Understanding how the body’s interlaced systems accomplish these feats requires a close look at every- thing from chemistry to structural mechanics. Early anatomists relied on dissections to study the human body, which is why the Greek word anatomia means “to cut up or dissect. That’s why more than two millennia later we still use words based on Greek and Latin roots to identify anatomical structures. That’s also part of the reason so much of the study of anatomy and physiology feels like learning a foreign language. Truth be told, you are working with a foreign language, but it’s the language of you and the one body you’re ever going to have. About This Book This workbook isn’t meant to replace a textbook, and it’s certainly not meant to replace going to an actual anatomy and physiology class. It works best as a supplement to your ongoing education and as a study aid in prepping for exams. That’s why we give you insight into what your instructor most likely will emphasize as you move from one body system or structure to the next. Your coursework most likely will cover things in a different order than we’ve chosen for this book. We encourage you to take full advantage of the table of contents and the index to find the material addressed in your class. Whatever you do, certainly don’t feel obligated to go through this workbook in any particular order. However, please do answer the practice ques- tions and check the answers at the end of each chapter because, in addition to answers, we clarify why the right answer is the right answer and why the other answers are incorrect; we also provide you with memory tools and other tips whenever possible.

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Some psychologists believe that the ability to respond appropriately after a significant delay indicates Like rationalization buy 5 gm bactroban, isolation is a rather complicat- the operation of some form of advanced mental func- ed defense discount 5 gm bactroban free shipping. It involves compartmentalizing one’s experi- tioning buy bactroban 5 gm low cost, and that investigations of delayed response are ence so that an event becomes separated from the feel- useful in the comparative psychological analysis of vari- ings that accompanied it, allowing it to be consciously ous species. Isolation can take on aspects of a dissociative disorder, with chil- dren separating parts of their lives to the point that they think of themselves as more than one person (for exam- ple, a good child and a bad one who only appears under certain circumstances). By compartmentalizing they can Delayed speech be relieved of feeling responsible for the actions of the “bad child. Occasionally, however, recovery from delir- ium is limited by neurological or other damage. The ability to forgo an immediate pleasure or re- ward in order to gain a more substantial one later. Almost everyone, everyday, practices delay of grati- fication—whether deciding to skip dessert in order to Delusion/Delusional lose weight or give up smoking in order to live longer. Young children, for example, Beliefs that are in stark contrast to reality, often find it more difficult to delay gratification than older having to do with persecution or an exaggerated children. Delusions are generally experienced by people suf- This number decreased to 67% among first and second fering from a severe psychotic disorder, usually schizo- graders and 49% for third and fourth graders. By the phrenia, although delusional thinking can occur in other fifth and sixth grades it had fallen to 38%, nearly half the types of patients (as the result of drug or alcohol abuse, rate for kindergartners. Typical delusional ideas are categorized into delusions of grandeur, in which a person imagines Although most people show an improved ability to for him or herself some God-given purpose or, in some delay gratification as they get older, some are more suc- cases, believe they are in fact historical personalities of cessful at it than others. Another type of delusion are delusions most successful in delaying gratification are those with of persecution, in which a patient will believe that some an internal locus of control (a strong belief that their ac- person or group is out to harm him. By contrast, people with an delusions involve what are referred to as “command hal- external locus of control are less likely to forego present lucinations,” in which a person hears voices telling him pleasures for greater future gain. These delusional thoughts can lead people to acts of self-mutilation or to violent crimi- nal acts. People suffering from depression often experience delusions such as beliefs that they are worth- A mental condition characterized by disorienta- tion, confusion, uncontrolled imagination, reduced less, sinful, or too unlikable to engage productively in so- ability to focus or to maintain attention, and gener- ciety. Other forms of delusional thinking occur in people al inability to correctly comprehend immediate re- with somatoform and dissociative identity disorders. John Junginger, a clinical scientist at Indiana Uni- Delirious behavior ranges from mildly inappropriate versity, studied 138 patients who exhibited delusional to maniacal, and is a symptom of a number of disorders. As an example, alcohol- those mentioned above) as well as several others, such as withdrawal delirium, which is also called delirium “insertion” and “control. Describing the study in Omni maga- tion of alcohol intake after a period of abuse. The onset of delirium is usually fairly rapid, al- ly with violent behavior than vague delusional beliefs; so though the condition sometimes develops slowly, espe- that someone who believes that some unidentified person cially if a metabolic disorder is involved. Patients with this type of dementia While researchers such as Junginger have sought can generally be expected to live eight years. One intriguing idea, of dementia and is caused by damage to the blood ves- proposed by G. Roberts in the British Journal of Psy- sels that carry blood to the brain, usually by stroke. Be- chiatry in 1991, is that delusions actually help psychotic cause the area of the brain that is affected differs from and schizophrenic patients by providing them with a de- person to person, the pattern of cognitive deterioration in tailed sense of purpose for their lives. The kind of dementia induced by these diseases is known as Further Reading subcortical, meaning they affect mainly the interior Nadis, Steve. A gradual deterioration of mental functioning af- Generally speaking, dementia has a gradual onset and fecting all areas of cognition, including judgment, can take different routes in different people. Initially, dementia can appear in memory loss, which may Dementia generally occurs in the elderly, although it result in being able to vividly remember events from many can appear at any age. Several substantial studies have years past while not being able to remember events of the been done to determine its prevalence, and in 1991 a very recent past. Other symptoms of dementia are ag- major study was conducted which found that dementia nosia, which is the technical term for not being able to occurred in just over 1 percent of the population aged 65 recognize familiar objects, facial agnosia, the inability to to 74; in approximately 4 percent in ages 75 to 84; and recognize familiar faces, and visiospatial impairment, the more than doubling to 10. Other studies have concluded that many as 47 per- Along with cognitive deterioration, sufferers of de- cent of people over 85 suffer from some form of demen- mentia often experience related emotional disorders as tia. Prevalence rates tend to be comparable between the they recognize their deterioration and experience anxiety sexes and across sociocultural barriers, such as education about its continuation and worsening. It is also worth noting that, despite what is actions are depression, anxiety, aggression, and apathy. Dementia progressively deteriorates including dementia resulting from Alzheimer’s disease, the brain and eventually sufferers are completely unable vascular dementia, substance induced dementia, demen- to care for themselves and, ultimately, the disease results tia due to multiple etiologies, dementia due to other gen- in death. More than half of the persons diagnosed with Further Reading dementia are classified as having dementia resulting Cooper, James W. Dendrites are one of two types of short, threadlike fibers that extend from the cell body of a nerve cell, or neuron. Dendrites re- ceive electrochemical signals, which are known as post- synaptic potentials, from the axons of other neurons, and the information contained in these signals is fired across a synaptic gap or cleft about 0. A single neuron can have many dendrites, each The long thin structures connecting the cells are dendrites. A child of They are matched in an arrangement that always pairs six or seven has more dendrites than an adult. The question of whether nucleic acids or proteins, a given time, enabling different cells to “specialize. The sugar and phosphate In the course of evolution, such mutations provided the combine to form the outer edges of a double helix, while hereditary blueprints for the emergence of new species. Their pervasive reliance on others, even for minor tasks or de- cisions, makes them exaggeratedly cooperative out of fear of alienating those whose help they need. They are reluctant to express disagreement with others and are often willing to go to abnormal lengths to win the ap- proval of those on whom they rely. Another common feature of the disorder is an exaggerated fear of being left to fend for oneself. Adolescents with dependent per- sonality disorder rely on their parents to make even minor decisions for them, such as what they should wear or how they should spend their free time, as well as major ones, such as what college they should attend. Dependent personality disorder occurs equally in males and females and begins by early adulthood. Personality Disor- two different species, allowing an experimenter to purify, ders and the Five-Factor Model of Personality. Although controversial, gene cloning is an important scientific accomplishment which has enabled Dependent variable researchers to gain new understanding of the structure of The variable measured in an experiment or study; genes through the ability to produce an unlimited num- what the experimenter measures. When conducting research, a psychologist typically See also Heredity takes two or more similar groups of people or animals and exposes them to different treatments or situations. Further Reading Then the researcher monitors a behavior of interest to Gribbin, John. New York: Mc- see whether that behavior differs from one group to the Graw-Hill, 1985. When specifying the dependent variable, it must be clearly defined and measurable. In one experiment, re- Dependent personality searchers gathered a group of business executives who disorder displayed evidence of Type A behavior (e.

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