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The cell membrane is a phospholipid bilayer discount 300mg lopid medicine cabinets with mirrors, so only substances that can pass directly through the hydrophobic core can diffuse through unaided lopid 300 mg mastercard symptoms 5 weeks pregnant. Charged particles, which are hydrophilic by definition, cannot pass through the cell membrane without assistance (Figure 12. Several passive transport channels, as well as active transport pumps, are necessary to generate a transmembrane potential and an action potential. Of special interest is the carrier protein referred to as the sodium/ + + potassium pump that moves sodium ions (Na ) out of a cell and potassium ions (K ) into a cell, thus regulating ion concentration on both sides of the cell membrane. As was explained in the cell chapter, the concentration of Na is higher outside the cell than inside, and + the concentration of K is higher inside the cell than outside. That means that this pump is moving the ions against the concentration gradients for sodium and potassium, which is why it requires energy. Ion channels are pores that allow specific charged particles to cross the membrane in response to an existing concentration gradient. Proteins are capable of spanning the cell membrane, including its hydrophobic core, and can interact with the charge of ions because of the varied properties of amino acids found within specific domains or regions of the protein channel. Hydrophobic amino acids are found in the domains that are apposed to the hydrocarbon tails of the phospholipids. Additionally, the ions will interact with the hydrophilic amino acids, which will be selective for the charge of the ion. The distance between the amino acids will be specific for the diameter of the ion when it dissociates from the water molecules surrounding it. Because of the surrounding water molecules, larger pores are not ideal for smaller ions because the water molecules will interact, by hydrogen bonds, more readily than the amino acid side chains. Some ion channels are selective for charge but not + necessarily for size, and thus are called a nonspecific channel. These nonspecific channels allow cations—particularly Na , + 2+ K , and Ca —to cross the membrane, but exclude anions. Although these classes of ion channels are found primarily in the cells of nervous or muscular tissue, they also can be found in the cells of epithelial and connective tissues. A ligand-gated channel opens because a signaling molecule, a ligand, binds to the extracellular region of the channel. This type of channel is also known as an ionotropic receptor because when the ligand, known as a neurotransmitter in the nervous system, binds to the protein, ions cross the membrane changing its charge (Figure 12. For example, as pressure is applied to the skin, these channels open and allow ions to enter the cell. Similar to this type of channel would be the channel that opens on the basis of temperature changes, as in testing the water in the shower (Figure 12. A voltage-gated channel is a channel that responds to changes in the electrical properties of the membrane in which it is embedded. When that voltage becomes less negative, the channel begins to allow ions to cross the membrane (Figure 12. Amino acids in the structure of the protein are sensitive to charge and cause the pore to open to the selected ion. A leakage channel is randomly gated, meaning that it opens and closes at random, hence the reference to leaking. There is no actual event that opens the channel; instead, it has an intrinsic rate of switching between the open and closed states. Leakage channels contribute to the resting transmembrane voltage of the excitable membrane (Figure 12. The particular electrical properties of certain cells are modified by the presence of this type of channel. The standard is to compare the inside of the cell relative to the outside, so the membrane potential is a value representing the charge on the intracellular side of the membrane based on the outside being zero, relatively speaking (Figure 12. The concentration of ions in extracellular and intracellular fluids is largely balanced, with a net neutral charge.

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Movement: skeletal muscles attached to the skeletal system use the bone to levers to move the body and its part 300 mg lopid mastercard medications zithromax. Short bones are about equal in length discount lopid 300 mg line medicine to calm nerves, width and thickness, which are shaped with regular orientation. Typical sesamoid bones are patella and pisiform carpal bone, which are in the tendon of quadriceps femuris and flexor carp ulnaris muscle respectively. Gross anatomy of a typical long bone You can take Tibia (in the leg) one of the longest bones in the body. The red marrow also known as myeloid tissue Endosteum is the lining the medullary cavity of compact bone tissue and covering the trabeculae of spongy bone tissue. It is more rigid than other tissues because it contains inorganic salts mainly calcium phosphate & calcium carbonate. Osteons are made up of concentric layers called lamellae, which are arranged seemingly in wider and wider drinking straws. In the center of the osteons are central canals (haversion canal) , which are longitudinal canals that contains blood vessels, nerves and lymphatic vessels. Central canals, usually have branches called perforating canals /valkmann’s canal that run at right angle to central canal extending the system of nerves and vessels out ward to periosteum and to endosteum. Radiating from each lacuna are tiny canaliculi containing the slender extensions of the osteocytes where nutrients and wastes can pass to and from central canal. Spongy (cancellous) Bone tissue Is in the form of an open interlaced pattern that withstands maximum stress and supports in shifting stress. They are able to synthesize and 63 Human Anatomy and Physiology secrete un-mineralized ground substance, act as pump cell to move calcium and phosphate in and out of bone tissue. Bone in embryo develops in two ways: Intra-membranous ossification, If bone develops directly from mesenchymal tissue. The 64 Human Anatomy and Physiology cartilage it self do not converted into bone but the cartilage is replaced by bone through the process. Endochondrial ossification produces long bones and all other bones not formed by intra-membranous ossification. These are surface markings where muscles, tendons and ligaments attached, blood & lymph vessels and nerves pass. Example: External auditory meatus Groves and sulcus: are deep furrow on the surface of a bone or other structure. Example Medial condyle of femur Head, expanded, rounded surface at proximal end of a bone often joined to shaft by a narrowed neck. The upper part of the lower extremity, between the pelvis and knee, is the thigh; the leg is between the knees an ankle. Made up of horizontal, cribriform plate, median perpendicular plate, paired lateral masses; contains ethmoidal sinuses, crista galli, superior and middle conchae. Forms roof of nasal cavity and septum, part of cranium floor; site of attachment for membranes covering brain. Shaped like large scoop; frontal squama forms forehead; orbital plate forms roof of orbit; supraorbital ridge forms brow ridge; contains frontal sinuses, supraorbital foramen. Slightly curved plate, With turned- up edges; made up of squamous, base, and two lateral parts; contains foramen magnum, occipital condyles, hypo-glossal canals, atlanto-occipital joint, external occipital crest and protuberance. Protects posterior part of brain; forms foramina for spinal cord and nerves; site of attachment for muscles, ligaments. Wedge-shaped; made up of body, greater and lesser lateral wings, pterygoid processes; contains sphenoidal sinuses, sella turcica, optic foramen, superior orbital fissure, foramen 71 Human Anatomy and Physiology ovale, foramen rotundum, foramen spinosum Forms anterior part of base of cranium; houses pituitary gland; contains foramina for cranial nerves, meningeal artery to brain. Made up of squamous, petrous, tympanic, mastoid areas; contain zygomatic process, mandibular fossa, ear Ossicles, mastoid sinuses. Form temples, part of cheekbones; articulate with lower jaw; protect ear ossicles; site of attachments for neck muscles. Fontanels The skeleton of a newly formed embryo consist cartilage or fibrous membrane structures, which gradually replaced by bone the process is called ossification. Function • They enable skull of the fetus to compress as it pass through the birth canal • Permit rapid growth of brain during infancy • Serves as a landmark (anterior fontanel) for withdrawal of blood from the superior sagital sinus • Aid in determination of fetal position prior to birth. In the skull of the fetus there are 6 prominent fontanels: a) The Anterior (frontal) fontanel, between angle of two parietal bones & segment of the frontal bone. They are irregular in shape and begin to close at 1 or 2 months after birth and completed by 12 months. Largest, strongest facial bone; horseshoe-shaped horizontal bony with two perpendicular rami; contains tooth sockets, coronoid, condylar, alveolar processes, mental foramina.

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As with other gliomas buy 300mg lopid amex medicine 6469, the clinical presentation depends on the location of the tumor buy 300 mg lopid free shipping symptoms type 1 diabetes. Signs of hydrocephalus and increased intracranial pressure (headache, nausea, vomiting) predominate in infratentorial tumors. Ependymomas are typically well-demarcated, moderately cellular gliomas composed of cells with monomorphic nuclei. Distinctive histological features include perivascular pseudorosettes and ependymal rosettes. Ependymal rosettes are diagnostic for ependymoma but are seen in only a minority of cases. As with other gliomas, the histological features associated with malignancy include increased nuclear atypia, mitotic activity, endothelial proliferation and necrosis. Neuronal and Mixed Neuronal-Glial Tumors There are several different types of brain tumors that contain neoplastic cells showing neuronal differentiation. These tumors are far less common than gliomas and they tend to occur in children and young adults. These tumors are typically located in the lateral ventricles near the foramen of Monro. The cells typically have large nuclei with prominent nucleoli and stain positive for neuronal markers such as synaptophysin. We will limit our discussion to medulloblastoma, which is the most common of the embryonal brain tumors (they account for approximately 30% of all pediatric brain tumors). The tumor cells often show evidence of some neuronal and/or glial differentiation. Medulloblastomas are rapidly proliferating, very aggressive tumors and the prognosis of untreated patients is dismal. However, they are highly radiosensitive and the 5-year survival rate after total resection and radiation therapy is as high as 75%. They most commonly occur in adults with a female bias (approximately 3:2 female to male ratio). Other common sites include the base of the brain (olfactory grooves, sphenoid ridges, parasellar regions), optic nerve, posterior fossa and spinal cord (most commonly thoracic). They are slow growing masses that elicit neurological symptoms by compression of adjacent structures. There are several different histologic subtypes (syncytial, fibroblastic, transitional, meningothelial, etc. One rare exception to this rule is papillary meningioma, which is associated with a more aggressive course. These tumors are associated with a much worse 104 prognosis (the median survival for a patient with a malignant meningioma is less than 2 years after surgery). The presence of brain invasion connotes a greater likelihood of recurrence and a worse prognosis. These lesions may be found within the central nervous system or, as expected, in the peripheral nervous system. Consequently, these patients are expected to have multiple lesions, which may be either intracranial, peripheral or both. These tumors grow in an eccentric fashion on the periphery of nerves and thus can be excised with significant preservation of nerve function. The neurofibroma, on the other hand, appears to be composed of at least two cells, the Schwann cell and the perineurial cell. In contrast to the schwannoma, neurofibromas diffusely infiltrate the nerve and thus their resection leads to loss of function supplied by that nerve. Lymphomas can be highly infiltrative and histologically show a characteristic angiocentric growth pattern. Metastatic Carcinoma Intracranial metastasis is seen in 25% and intraspinal metastases is seen in 5% of cancer patients. The most common origins of brain metastases include lung (50%), breast (15%) and malignant melanoma (10%). The tumors often have histological features that are similar to the primary tumor.

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How important is it for a treatment facility to have each of the following comprehensive assessment services available to clients/patients? How important is it for a treatment facility to have each of the following interventions/therapies available to clients/patients? Not at all Slightly Moderately Very important important important important Transportation services 2 purchase lopid 300 mg with mastercard medicine ball. Which one of the following types of professionals do you think is best qualified to provide addiction treatment services? Addiction treatment services refers to services such as the following: cognitive/behavioral therapy buy generic lopid 300 mg line medications 1040, pharmacotherapy. Recovery support services refers to services such as the following: connection to mutual support programs; legal, housing, other social and health services; providing social support. How important do you think it is for addiction treatment clinicians/staff to have each of the following qualifications? Not at all Slightly Moderately Very important important important important Personal experience with addiction 23. Which of the following describes your opinion on the best way to structure the delivery of substance-addiction treatment in the U. To what extent does each of the following stand in the way of people looking for needed treatment for addiction/substance abuse? To what extent does each of the following stand in the way of people receiving needed treatment for addiction/substance abuse? To what extent does each of the following stand in the way of treatment providers in New York State’s ability to provide effective services to people in need of addiction/substance abuse treatment? How important do you think it is that there be national standards for how addiction/substance abuse treatment services should be delivered to patients/clients? Which of the following would be in the best position to decide on such national standards for the delivery of addiction/substance abuse treatment services? At what stage(s), if any, in the treatment of an individual patient, does your program assess how well treatment is working? In your opinion, what are the three primary ways a program should assess its effectiveness, assuming that a program has sufficient resources for this? In a typical day, about how many total hours a day would you say you spend on each of the following tasks? If you perform any other task in a typical day on which you spend one or more hours but that task is not on the list below, please specify the task and indicate how many hours you spend on it. From the list below, please select the top two things a client might do that would keep you from doing your job well. From the list below, please select the top two factors that mainly motivate you to keep you doing your job. Given sufficient resources, what are three ways you would change your program to improve treatment quality at your facility? Given sufficient resources, what are three ways you would suggest for improving the treatment system for addiction or substance abuse in New York? Do you think that being a recovered addict or recovering from addiction should be a prerequisite for being a treatment provider, or should it not? The number corresponding to each response option represents the percent, among those responding to the question, that provided the particular response. If you were designing a treatment program to meet the needs of individuals in your community, how important would it be to include each of the following? To what extent do you agree that each of the following is an important goal of treatment for substance use disorders? To what extent is each of the following a barrier to your ability to provide high quality treatment for your clients/patients with substance use disorders? What are the top three recommendations you would make to improve access to and quality of treatment for substance use disorders in the U. The number corresponding to each response option represents the percent, among those responding to the question, that provided the particular response. Looking back over your recovery process, what are the three main factors to which you attribute your ability to maintain long term recovery?