Cranial Nerve 2- Fundoscopy The first photograph is of a fundus showing papilledema. The findings of papilledema include 1. Loss of venous pulsations 2. Swelling of the optic nerve head so there is loss of the disc margin 3. Venous engorgement 4. Disc hyperemia 5. Loss of the physiologic cup and 6. Flame shaped hemorrhages. This photograph shows all the signs except the hemorrhages and loss of venous pulsations.
Cranial Nerve 8- Vestibular Patients with vestibular disease typically complain of vertigo – the illusion of a spinning movement. Nystagmus is the principle finding in vestibular disease. It is horizontal and torsional with the slow phase of the nystagmus toward the abnormal side in peripheral vestibular nerve disease. Visual fixation can suppress the nystagmus. In central causes of vertigo (located in the brainstem) the nystagmus can be horizontal, upbeat, downbeat, or torsional and is not suppressed by visual fixation.
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Cranial Nerve 9 & 10- Motor When the patient says "ah" there is excessive nasal air escape. The palate elevates more on the left side and the uvula deviates toward the left side because the right side is weak. This patient has a deficit of the right 9th & 10th cranial nerves.
Cranial Nerve 11- Motor When the patient contracts the muscles of the neck the left sternocleidomastoid muscle is easily seen but the right is absent. Looking at the back of the patient, the left trapezius muscle is outlined and present but the right is atrophic and hard to identify. These findings indicate a lesion of the right 11th cranial nerve.
As explained in the documentary, Dr. Mackinnon has developed a nerve surgery teaching and information website,with free access to anyone. This website is intended for multiple uses, from training doctors to educating patients and their families.
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Quentin Tarantino films have more signatures to them than the Declaration of Independence. His movies are instantly recognizable due to the carefully curated, symbiotic relationship between the pictures on the screen and the sounds that orchestrate these great moments. This makes his choice for the ominous Kill Bill whistle even more iconic when understanding its origin story in film history.
The learning objective of this current activity is to be able observe and measure quantal synaptic vesicular release of neurotransmitter at the crayfish and Drosophila neuromuscular junctions (NMJ) as well as analyze electrical activity within the CNS of these animals. Students will participate in authentic scientific data gathering and help to improve the methods for this science project. The primary data is obtained in one lab and then posted on line for participants to download. The synaptic responses are experimentally recorded when a motor nerve is electrically stimulating for inducing evoked responses. Spontaneous vesicular events are also recorded in the absence of stimulation or between evoked stimulations. The participants estimate means quantal content with three different approaches direct counts, amplitude measurements, and charge (area) measurements. Other forms in analysis of activity from CNS circuits will also be tackled.
Abdrakhmanov, M.M., Petrov, A.M., Grigoryev, P.N., Zefirov, A.L.(2013) Depolarization-induced calcium-independent synaptic vesicle exo- and endocytosis at frog motor nerve terminals. Acta Naturae 5(4):77-82. Abstract
PA experiment setup of this cooling study. (A) Experimental dark-field fPAM system integrated with a thermoregulation setup. Commercially available ultrasound gel was applied on the rat sciatic nerve for acoustic and thermal coupling; the rat subjects were placed between the water container and a custom-made stereotaxic apparatus for imaging. (B) The laser was pulsed with frequency of 10 Hz and coupled to an optical fiber into the strong focusing dark-field PA path to illuminate the target cross-section at the nerve. PA waves were detected by a 50-MHz transducer and then through the A/D card to the computer for further data analysis. (C) Localized temperature modulation was achieved via immediate heat transfer between the sciatic nerve and the perfused thermoregulatory water tube. A fixed scanning cross-section was selected during all experiments. The nerve thermocouple couple probe was placed directly below the sciatic trifurcation. We also applied sutures as needed to reinforce the stability of the tube and thermocouple probe.
Rats remained anesthetized with isoflurane 2-3% in 100% O2 and were mounted on a dorsal position over a custom-made acrylic stereotaxic holder. Next, the left hind limb was shaved and disinfected prior to making a 40 mm longitudinal incision at knee level. The biceps femoris was detached and folded towards the posterior. Also the caudofemoralis was transected in order to completely expose the sciatic nerve [30].
Cooling protocol for the sciatic nerve. (A) Photograph of the sciatic nerve (about 0.5 mm) showing several blood vessels from the epineurial vascular plexus. (B) Ultrasound and (C) PA cross-sectional B-scan images of the sciatic nerve. The yellow scale bars are equivalent to 100 μm. The ROI with the PA signal changes in scanned sciatic nerve image section was identified by the ultrasound image, as indicated by the red dashed line in (B). (D) Localized nerve thermoregulation protocol, including the baseline, cooling and rewarming. Temperature changes in the sciatic nerve, tympanic and rectal areas were monitored.
PA imaging results. (A)In vivo relative I(570) (i.e., HbT; upper panel) and IF(560) (i.e., SO2; lower panel) PA B-scan images of selected position at different times of temperature modulation protocol. Note that the I(570) and IF(560) are specifically sensitive to relative HbT and SO2 changes, respectively. The red scale bar is equivalent to 100 μm and applies to all images in panel A. Mean functional (B) HbT (i.e., RHbT) and (C) SO2 (i.e., RSO2) changes resulting from in vivo temperature modulation of the rat sciatic nerve as a function of time. The error bars indicate standard deviation (n = 10).
The 50 MHz ultrasound B-scan image provides a view of the complete cross-section of the sciatic nerve (Figure 2B), but only a part of it can be imaged by fPAM. This discrepancy is caused by the penetration depth of light in body tissue and blood [16,17]. Limited penetration depth of light in blood vessels restricts the maximum measurable axial diameter registered by the current fPAM system [33] as shown in (Figure 2C). To an extent, the dark-field illumination employed in fPAM system and the natural scattering of light in nerve tissue helps to increase the penetration of light in bio-tissue in this in vivo experiments [33]. The scope of this study includes only the temperature dependent hemodynamics visualized with fPAM for a ROI (Figure 3A). We would like to emphasize, that presently we are only considering relative and micro-resolution functional hemodynamic changes in the blood vessels of rat sciatic nerve, as opposed to absolute vasculature changes.
While there has been a lot interest in studying hemodynamics or neurovascular functions as well as the imaging of such coupling in relation to therapies such as hypothermia in the brain, very little has been done to study the neurovascular coupling in the peripheral nerves [44]. We aim to understand and develop the in vivo fPAM technique for the study of peripheral nervous system hemodynamics. The peripheral nerve system presents itself an ideal object of study since the nerves lie just millimeters below the skin, providing a simple and robust model to study hemodynamics in response to temperature changes.
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