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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_2817_Библиотеки_им_академика_М_И_Перельмана.pdf
Spinal cord (Continued)
grey matter, 69–70, 72f
primary afferents, 70
white matter, 70
imaging, 81–82
CT, 81–82
MRI, 81–82, 81f
X- ray, 81–82
injury. See Spinal cord injury (SCI)
lesions, 29
motor system termination, 186, 188f
proprioceptive system, 78–79
conscious, 78
pathways, 78, 78f
unconscious, 78
receptive fields, 73
segmental identification, 72b
somatosensory cortex (SI), 74
cell types, 74–75
somatotopic maps, 75f, 75b
somatosensory pathways, 73–79
ascending pathway defects, 79f
descending pathways, 78, 79f, 79t
discriminative touch system,
74–76
dorsal column medial lemniscus
pathway, 73
pain system, 73, 79
proprioception, 73
temperature system, 73, 79
spino- olivary tract, 78
inferior olivary nucleus, 78
percutaneous chordotomy, 78
ventrolateral pathway damage, 78
spinoreticular tract, 76–77
spinotectal tract, 77
transverse sections, 71f
ventrolateral system, 76
brainstem, 76
hypothalamus, 76
Lissauer’s tract, 76
nociceptive afferents, 76
thalamus, 76
Spinal cord hemisection (Brown–Séquard
system), 84
Spinal cord injury (SCI), 68, 80–86
American Spinal Injury Association
impairment scale, 80, 80t
case history, 68b
causes, 80–86, 80t
demyelinating disease, 80t
infection, 80t
metabolic disorder, 80t
trauma, 80, 80t
tumours, 80t
vascular causes, 80t
lesion level effects, 80, 81t
macroscopic damage, 82, 82f
management, 84–86, 85t
cellular transplantation, 85–86
fampridine (4- aminopyridine), 85
neck immobilization, 84–85
regeneration, 85
excitotoxic cascade, 82–83
macrophages, 82–83
Spinal cord injury (SCI) (Continued)
peripheral cell survival, 83, 83f
neurological assessment, 68
pathophysiology, 82–83
prognosis, 83
Spinal cord shock, 82b
Spinal cord syndromes, 83–84
anterior cord syndrome, 84
complete cord transection, 84
compression, 83
CSF blockage, 83
hemisection. See Spinal cord hemisection
(Brown–Séquard system)
See also specific diseases/disorders
tumours, 83
Spinal motor functions
polysynaptic reflexes, 186
reticular formation, 126
Spinal muscular atrophies, 194
Spinal nerves
cranial nerves vs., 123b
dorsal rami, 24
structure, 24
ventral rami, 24
Spinal roots, 68
Spino- olivary tract. See Spinal cord
Spinocerebellar pathway. See Cerebellum
Spinomedullary junction, motor systems,
168
Spinoparabrachial tract (SPBT), pain
pathways, 93
Spinoreticular tract (SRT)
pain pathways, 93
spinal cord, 76–77
Spinotectal tract, spinal cord, 76–77
Spinothalamic tract (STT), pain
pathways, 93
Split- brain’ syndrome, 15b
SRT. See Spinoreticular tract (SRT)
Stapes, 159f, 160
Staphylococcus aureus meningitis, 264
Statins
Alzheimer’s disease therapy, 310
stroke prevention, 241–242
Status epilepticus. See Epilepsy
Stellate cells, auditory pathways, 163
Stellate neurones, cerebellum, 196
Stereognosis, cortical function examination,
61
Stereopsis, visual pathways, 139–140
Steroid hormones, receptor signalling, 46
Streptococcus pneumoniae meningitis, 263
Striatum, basal ganglia, 202
Striola
saccule, 170–171
utricle, 170–171
Strokes, 229–243
Barthel Index, 237–238
case history, 224b, 237–238
classification, 231–241
See also Haemorrhagic stroke; Ischaemic
stroke
diagnosis, 237b
effects, 231
incidence, 224–225
Strokes (Continued)
management, 241–242
mortality, 224–225
National Institute of Stroke Scale, 242b
neurological signs, 235t
neuroprotection, 241–242
animal trial problems, 242b
clinical trials, 241, 243t
platelet aggregation, 241–242
prognosis, 243
treatment immediacy, 243
recognition, 237b
rehabilitation, 243
time taken, 243
reversible, 227b
risk factors, 229–230, 233t
stenosis, 230–231
treatment, 241–242
accessory conditions, 241–242
hypothermia, 252
STT (spinothalamic tract), pain pathways, 93
Subarachnoid cisternae, 259f
Subarachnoid haemorrhage
haemorrhagic stroke, 235
head injury, 247–249, 248f–249f
Subclavian arteries, 227–228
Subdural haemorrhage, head injury, 247,
248f
Sublingual route, opioids, 109
Substantia nigra, movement, 202
Subthalamic nucleus, movement, 202
Suicide risk
depression, 347
epilepsy, 276
mental state examination, 55
Sulcus, central. See Central sulcus
Superficial reflexes, 59–60
Superior cerebellar peduncles, cerebellum,
5–6
Superior colliculi, 7
Superior olivary nucleus, auditory
pathways, 164, 165f
Supplementary motor area (SMA), 190
motor cortex, 190–191
Suprachiasmatic nucleus, hypothalamus, 21
Supraspinal (descending) analgesia. See
Analgesia
Surgery
epilepsy. See Epilepsy
Parkinson’s disease treatment, 213–214,
214b, 215f
Survival motor neurone (SMN1)
gene, 194
Suspensory ligaments, eye, 137, 137f
Suxamethonium, 181b
Sympathetic nervous system, 30
drug effects, 28–29, 29t
Synapses
hippocampus, memory, 300
structure, 44f
Synaptic cleft, 44
Synaptic transmission, 43–45
active zones, 44–45
chemical, 44
electrical, 43–44
INDEX
389
INDEX
Synaptic transmission (Continued)
gap junctions, 43–44
neurotransmitters, 44
exocytosis, 45
release, 45f
presynaptic terminal, 44
synaptic cleft, 44–45
voltage- sensitive Ca2+ channels, 44–45
Syringomyelia, 72
T
Tabes dorsalis (neurosyphilis), 84
Tachycardia, autonomic nervous system
dysfunction, 29t
Tacrine, Alzheimer’s disease therapy,
309–310
Tardive dyskinesia, antipsychotic drugs, 330
Taste, detection, 23
Tau and tangle hypothesis. See Alzheimer’s
disease
Tectospinal tract, motor systems, 188–190,
188f
Tectum, 7
Temazepam, 350t
Temperature regulation
hypothalamus, 20
somatosensory pathways, 73, 79
Temporal lobe
functions, 4t
schizophrenia, 322
Tensor stapedius, 160
Tensor tympani, 160
Tentorium cerebelli, 258
Teratogenicity, anticonvulsant drugs, 289
Tetanus, 52, 52f
Thalamocortical axons, pain pathways,
93–94
Thalamus, 4f
anatomy, 18–19
association nuclei, 18–19
diffuse nuclei, 18–19
functional organization, 19t
internal medullary lamina, 18–19
sagittal plane, 7b
specific nuclei, 18–19
ventrolateral system, 77f
Theta rhythm, EEG, 278–280
Thiamine deficiency, alcohol dependence,
367
Thirst centres, hypothalamus, 22
Thyroid hormones, receptor signalling, 46
Tiagabine
efficacy, 288t
epilepsy treatment, 289
Tianeptine, 343
Tinnitus, case history, 159b
Tobacco smoking. See Nicotine addiction
Todd’s paralysis, 282
Tolerance
benzodiazepines, 353
cocaine addiction, 362–363
definition, 356–357
Tonic seizures, 275
Tonic–clonic seizures, 282–283
Topiramate
efficacy, 288t
epilepsy treatment, 288
Touch/pin- prick testing, cranial nerve V, 57
Toxins, Parkinson’s disease, 209
Tramadol, 108
Transcutaneous electrical nerve stimulators
(TENS), 96–97
Transdermal patch, opioids, 109
Trapezoid body, auditory pathways, 163
Trauma
deafness, 168
spinal cord injury, 80, 81t
Trazodone, 343
Tremor, Parkinson’s disease, 204
Triazolam, 350t
Tricyclic antidepressants (TCAs), 341
migraine prevention, 115
monoamine reuptake effects, 343t
neuropathic pain management, 111
See also specific drugs
Trigeminal nerve. See Cranial nerve V
(trigeminal nerve)
Trigeminocerebellar pathway, cerebellum, 195t
Triptans, migraine prevention/treatment,
113–115
Trochlear nerves. See Cranial nerve IV
(trochlear)
Truncal ataxia, 200
Tuberculous meningitis, treatment, 268
Tuberoinfundibular pathway, dopaminergic
systems, 213b
Tubulin polymerization, Alzheimer’s
disease, 306–307
Tumours
brain injury, 247f, 247b
deafness, 168f
spinal cord injury, 80–86, 80t
Twin studies, mood disorders, 339
Twitch, skeletal muscle contraction, 182,
182f
Tympanometry, hearing tests, 167
Tympanostomy tubes (grommets), deafness
treatment, 169
Tyramine, monoamine oxidase inhibitors
interaction, 342–343
U
Uncus, 5f
Unfused tetanus, 182, 182f
Unilateral lateral brainstem lesions, 131, 131t
Unilateral medial brainstem lesions, 130, 131t
Unmyelinated axons, nerve conduction, 43
Upper motor neurones (UMNs)
damage, reflexes, 193–194, 193t
motor systems. See Motor systems,
descending pathways
Utricle
semicircular canals, 169–170
vestibular system. See Vestibular system
V
Vagus nerve. See Cranial nerve X (vagus nerve)
Valproate
depression therapy, 345
efficacy, 288t
epilepsy treatment, 287–291
Varenicline, smoking cessation, 366
Vascular causes, spinal cord injury, 297t
Vascular dementia, 296, 298–299
Vasodilating agents, cerebral blood flow, 225
Vasogenic brain swelling, head injury, 244b
Vasopressin, hypothalamus, 22
VCN (ventral cochlear nucleus), auditory
pathways, 163
Venlafaxine, 343
Ventral cochlear nucleus (VCN), auditory
pathways, 163
Ventral rami, spinal nerves, 24
Ventricular system. See Brain anatomy
Ventrolateral pathway damage, spinoolivary
tract, 76–78
Ventrolateral system, spinal cord. See Spinal
cord
Verbal rating scale, pain measurement, 101f
Vermis, 183
lesions, 198–199
Vertebral arteries, 227–228
Vertigo, 173
cranial nerve VIII, 58
Vestibular apparatus, 160
Vestibular nerve, 159f
Vestibular neuritis, 175
Vestibular system, 169–175
ampulla, 169, 170f
anatomy, 169–171, 170f
central pathways, 173–174, 174f
crista, 170f
damage, 174–175. See also Balance
disorders
macula, 170f
saccule, 152, 170–171, 170f
hair cells, 170–171
striola, 170–171
See also specific units
See also Vestibulo- ocular reflex
utricle, 170–171, 170f
hair cells, 170–171
striola, 170–171
vertical orientation, 171
Vestibulo- ocular reflex, 144, 171–173
clinical applications, 172b
definition, 171
eye muscles, 172
head movements, 172
medial longitudinal fasciculus, 172b, 173
neuronal circuitry, 173f
nystagmus, 172–173
post- rotatory nystagmus, 173
Vestibulocerebellum, 197
Vestibulospinal tract (VST). See Motor
systems, descending pathways
Vigabatrin, epilepsy treatment, 289
Viral encephalitis, 268, 268t
390
Viral infections
deafness, 167–168
See also specific infections
Viral meningitis, 265
Visceral nociceptors, 93
Visceral pain pathways, 94–95
Visceral sensations, autonomic nervous
system, 26–27
Visual agnosia, 154
Visual analog scale, pain measurement, 101f
Visual cortex, 152–153, 154f
complex cells, 152
orientation columns, 152, 153f
parallel processing, 153
primary outputs, 153–155
lesion studies, 154
M pathway, 153–154
secondary visual cortex, 153–154
retinotopic mapping, 153
Visual fields, 139
defects, 141, 142t
locations, 142f
Visual inspection, motor function
examination, 59
Visual pathways, 139–141
contralateral tracts, 140
functions, 140f
lateral geniculate nucleus, 140–141
Meyer’s loop, 141
optic radiation, 141
parietal lobe, 141
primary visual cortex, 141
stereopsis, 139–140
temporal lobe, 141
Visual system, 135–156
accommodation, 142, 143f
brainstem, 130
lens thickening, 142
focusing defects, 142–144
Visual system (Continued)
information processing, 151–155
lateral geniculate nucleus, 151–152
parallel processing, 153, 153f
visual cortex. See Visual cortex
pathways. See Visual pathways
perception, auditory perception vs., 165
See also Blindness; Eye(s)
See also specific diseases/disorders
Vitamin A, retina, 138–139
Vitamin C, ischaemic stoke therapy, 240
Vitamin E, Alzheimer’s disease therapy, 310
Vitreous humour, 137–138, 137f
Volitional disorders, schizophrenia,
319–320
Voltage- sensitive Ca 2+ channels, 44–45
Voltage- sensitive K+ channels
action potentials, 42
nerve conduction, 43
Voltage- sensitive Na channels
action potentials, 42
nerve conduction, 43
Vomiting. See Nausea and vomiting
VST (vestibulospinal tract). See Motor
systems, descending pathways
W
Wallenberg’s syndrome, 131, 132f
Weber’s syndrome, case history, 132
Weber’s test, 167, 167t
cranial nerve VIII, 58
Wernicke’s area, 14
damage effects, 166b
speech understanding, 166b
Wernicke’s encephalopathy, alcohol
dependence, 367
West’s syndrome (infantile spasms), 276t
White matter, spinal cord, 69
Widespread gating, pain, 96
Wiegert–Pow stained sections, brainstem,
121f
Wisconsin card- sorting test
cortical function examination, 61
schizophrenia, 322–323
Withdrawal
cocaine addiction, 363
opiate addiction, 361
Work environment, deafness, 168
Working memory, cortical function
examination, 61
World Health Organization (WHO)
analgesic ladder, cancer pain, 106,
106t
Writing
brain hemispheres, 14
Parkinson’s disease, 205, 206f
understanding, circuits for, 166b
X
X- rays. See Radiography
Z
Zaleplon
insomnia therapy, 353b
pharmacokinetics, 350t
Zolpidem
insomnia therapy, 353b
pharmacokinetics, 350t
Zonisamide, 288
Zopiclone
insomnia therapy, 353b
pharmacokinetics, 350t
INDEX
391
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