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Pitch is determined by the frequency of the sound waves and is measured in Hertz (Hz) prostatic urethra casodex 50 mg cheap. The volume depends on the magnitude of the sound waves and is measured in decibels (dB) androgen hormones in females effective 50mg casodex. The greater the amplitude of the wave created in the endolymph mens health 012013 chomikuj casodex 50 mg sale, the greater is the stimulation of the auditory receptors in the hair cells in the spiral organ prostate cancer yellow skin discount casodex 50mg visa, enabling perception of volume. Long-term exposure to very loud noise causes hearing loss because it damages the sensitive hair cells of the spiral organ. Balance and the ear Learning outcome After studying this section, you should be able to: describe the physiology of balance. Instead they provide information about the position of the head in space, contributing to maintenance of posture and balance. There are three semicircular canals, one lying in each of the three planes of space. They are situated above, beside and behind the vestibule of the inner ear and open into it. The semicircular canals, like the cochlea, are composed of an outer bony wall and inner membranous tubes or ducts. The membranous ducts contain endolymph and are separated from the bony wall by perilymph. The utricle is a membranous sac which is part of the vestibule and the three membranous ducts open into it at their dilated ends, the ampullae. The saccule is a part of the vestibule and communicates with the utricle and the cochlea. In the walls of the utricle, saccule and ampullae are fine, specialised epithelial cells with minute projections, called hair cells. Amongst the hair cells there are receptors on sensory nerve endings, which combine forming the vestibulocochlear nerve. Physiology of balance the semicircular canals and the vestibule (utricle and saccule) are concerned with balance. Any change of position of the head causes movement in the perilymph and endolymph, which bends the hair cells and stimulates the sensory receptors in the utricle, saccule and ampullae. The resultant nerve impulses are transmitted by the vestibular nerve, which joins the cochlear nerve to form the vestibulocochlear nerve. The vestibular branch passes first to the vestibular nucleus, then to the cerebellum. The cerebellum also receives nerve impulses from the eyes and proprioceptors (sensory receptors) in the skeletal muscles and joints. Impulses from these three sources are coordinated and efferent nerve impulses pass to the cerebrum and to skeletal muscles. This results in awareness of body position, maintenance of upright posture and fixing of the eyes on the same point, independently of head movements. Sight and the eye Learning outcomes After studying this section, you should be able to: describe the gross structure of the eye describe the route taken by nerve impulses from the retina to the cerebrum explain how light entering the eye is focused on the retina state the functions of the extraocular eye muscles explain the functions of the accessory organs of the eye. It is situated in the orbital cavity and supplied by the optic nerve (2nd cranial nerve). Structurally the two eyes are separate but, unlike the ear, some of their activities are coordinated so that they function as a pair. It is possible to see with only one eye (monocular vision), but threedimensional vision is impaired when only one eye is used, especially in relation to the judgement of speed and distance. Sclera and cornea the sclera, or white of the eye, forms the outermost layer of the posterior and lateral aspects of the eyeball and is continuous anteriorly with the transparent cornea. It consists of a firm fibrous membrane that maintains the shape of the eye and gives attachment to the extrinsic muscles of the eye (p. Anteriorly the sclera continues as a clear transparent epithelial membrane, the cornea. The cornea is convex anteriorly and is involved in refracting (bending) light rays to focus them on the retina.

Fiber-based probe have been developed that implement several receivers at different distances from the source (48) prostate cancer vitamins cheap casodex 50 mg mastercard. This allows a degree of depth discrimination of the measured signals man health tv x ref k big lama casodex 50mg sale, within the aforementioned limits mens health xtreme muscle pro discount casodex 50mg with visa. It has been shown that the flux is proportional to the width the measured Doppler power spectrum mens health bodyweight workout casodex 50 mg lowest price, normalized to optical power fluctuations in the setup (49). In one implementation, the laser beam is scanned across the desired field of view, and a photodetector registers the signal that is backreflected at each scanning step. This second approach, while currently in a stage of relative infancy, shows the potential for faster frame rates than the scanning imagers, and it has the advantage of avoiding mechanical components, such as optical scanners (50). The vascular response to heating (51) and the evaluation of carpal tunnel syndrome also have been studied (52). Included here are imaging modalities that involve the use of contrast agents or of radioactive markers, even though these methods are not considered noninvasive in the strictest sense of the word. At the same time, dynamic ultrasound imaging modalities can readily produce images of dynamic properties of macroscopic blood vessels (55,56). The physical phenomenon underlying all the blood-flow-sensitive types of ultrasound imaging is the Doppler effect, wherein the frequency of detected ultrasonic energy is different from that of the source, owing to the interactions of the energy with moving fluid and blood cells as it propagates through tissue. Here, the false color value assigned to each image pixel is a function of the average frequency shift in that pixel, and the resulting image usually is superimposed upon a coregistered anatomic image to facilitate its interpretation. In addition, signal/noise level considerations make it difficult to measure low but clinically interesting flow rates. An increasingly employed approach to enhancing ultrasound images, at the cost of making the technique minimally invasive, is by introducing a contrast agent. The relevant contrast agents are microbubbles, which are microscopic, hollow, gas-filled polymer shells that remain confined in the vascular space and strongly scatter ultrasonic energy (59). The incident ultrasound can, under the correct conditions, itself induce oscillatory motions by the microbubbles, which then return reflections to the transducer at not only the original ultrasonic frequency, but also at its second and higher harmonics. That is, depending on the details of the measurement, the resulting image may principally confer information about bulk blood flow. As is the case for the other types of imaging treated here, each can be performed either with or without administration of exogenous contrast agents, that is, in either a noninvasive or a minimally invasive manner (61,62). Blood flow that has a large component of motion perpendicular to that slice remains significantly less saturated. Subtraction of a static image obtained near the start of the data collection sequence permits even greater enhancement of the blood vessel contents. A drawback of this approach is that vessels that lie within the selected slice, with the direction of blood flow basically parallel to it, do not experience the same enhancement. Position-selective phase shifts are induced in 1H nuclei of the selected slice via the sequential imposition of at least two transverse gradients that sum to a constant value across the slice. The effect is to induce zero net phase shifts among nuclei that were stationary during the gradient sequence, but a nonzero, velocity-dependent net phase shift on those that were in motion. A sufficiently rapid pulse sequence allows the operator to generate curves of signal intensity vs. A noninvasive alternative would have advantages in terms of permissible frequency of use, and would be of particular value in situations where pathology or injury has disrupted the blood­brain barrier. It also would make it possible to obtain perfusion images of other parts of the body than just the brain. The common feature of all these techniques is that the water component of the blood is itself used as a contrast agent, by applying a field gradient that inverts the spins of 1H nuclei of arterial blood before they enter the slice selected for imaging. This type of imaging produces spatial maps determined by temporal fluctuations in the concentration of deoxygenated hemoglobin, which serves as an endogenous, intravascular, paramagnetic contrast agent. As such, it is not (yet) a readily interpretable method for specifically studying peripheral vasculature. The most direct approach taken along these lines is to rapidly acquire sequences of images of a slice or volume of interest and then examine and interpret, at any desired level of mathematical sophistication, temporal variations in the appearance of tissue structures in the images. The functioning of many other organs, such as the kidneys (72), is related to the flow of blood and/or locally formed fluids, but does not involve gross changes in size or shape. For quantitation of regional blood flow and other dynamic vascular parameters, these techniques invariably employ some version of indicator dilution theory (73). The common feature is inhalation of a Xe-enriched gas mixture followed by repetitive scanning to monitor the wash-in and/or wash-out of the Xeaffected signal (75). Of course, these are even more invasive than the approaches based on inhalation an inert gas.

Chapter 4 Applied Biomechanics 113 extensors will act more than the hip extensors (9) prostate yourself before god buy casodex canada. The application of this concept is that the training routine can be altered to suit individual needs and specific requirements prostate 70 order casodex on line. As discussed earlier prostate oncology jacksonville purchase casodex 50mg overnight delivery, the angle of muscle pull and the moment arm affect muscle force generation; however prostate cancer 999 purchase 50 mg casodex amex, there are three factors in the muscle itself that affect generation of force. When the muscle receives a stimulus to contract, the muscle develops tension by lengthening nonlinearly over time because of the passive elastic components in muscle and tendon (parallel and series elastic elements). After the elastic components are lengthened, muscle force progresses linearly until maximum muscle force is achieved. If the tendon is in a lax position with the muscle shortened, the time to maximum muscle force will be greater than if the muscle is partially tensed (lengthened) (8). The pragmatic point is, however, that the time component is in milliseconds; therefore, practically there may be no noticeable effect. Force­Length Force­length is a concept that dictates the magnitude of muscle force generation is related to the length of the muscle (5). Maximum tension in the muscle can be generated when the muscle is between 80% and 120% of resting length (8,20). The tension or force that the muscle can generate is reduced when the muscle is in both short and elongated positions. In the shortened position (near the end of the flexion range of motion), the contractile components have become redundant, creating incomplete cross-bridge activation, thereby reducing the force that the muscle can generate (12,22). In the elongated position, slippage of cross-bridge results is less force generation capability. The contractile components in muscle force generation are not the only factors that contribute to maximum muscle force. When the muscle is lengthened, tension is developed in the passive structures and this tension, when combined with force from the contractile proteins, adds to the total tension that the muscle can generate. Therefore, the optimal muscle length for muscle tension is slightly greater than resting length due to the contribution from active (muscle contraction) and passive structures (elastic components). Force­length curve for skeletal muscle showing how active and passive components combine to optimize total muscle force. Force­Velocity Force­velocity is a mechanical concept that dictates that the maximal force a muscle can develop is governed by both the velocity of muscle contraction and whether the muscle is shortening or lengthening. Because this concept is true only for maximally activated muscle, the relationship has limited application in daily activity. The concept does the optimal muscle length for muscle tension is not imply that it is impossible to move a heavy obslightly greater than resting length due to the ject fast or a light object slowly. For example, a soccontribution from active (muscle contraction) and cer ball can be kicked with a small amount of muspassive structures (elastic components). Most activities of daily living require skeletal muscle control; therefore, volitional control affects how the muscle responds (7). In concentric muscle movement when the muscle is shortening, force and velocity are inversely related. If velocity increases, the cycling rate of cross-bridge attachment increases, leaving fewer crossbridges to act, thereby lessening muscle force production (8,14). The force­velocity relationship, when the muscle is lengthening under a load, is opposite that seen in concentric muscle action. When a load that a muscle can isometrically hold is exceeded, the muscle lengthens under the load. If the load is as much as 50% greater than the force that can be handled isometrically, tension increases rapidly in the muscle as the speed of lengthening increases. The force­velocity curve ends abruptly when the muscle can no longer control the weight (8). With free weights, the resistance can move in three orthogonal planes (anterior/posterior, mediolateral, and vertical), but with weight machines the direction the resistance moves is controlled by levers, cams, gear, and pulleys. Force­velocity curve for skeletal muscle showing the relationships between force and velocity when the muscle is shortening and lengthening. With free weights, the resistance can move in three orthogonal planes (anterior/posterior, mediolateral, and vertical), but with weight machines the direction the resistance moves is controlled by levers, cams, gear, and pulleys. Because human movement at most skeletal articulations is mostly multiplanar, how strength is gained will be affected when weight training occurs with resistance other than free weights. Weight plates that are cabled over a single circular pulley are equal to the weight lifted.

The neurotransmitter that transmits the nerve impulse across the neuromuscular junction (synapse) to stimulate the muscle fibre is acetylcholine prostate cancer nclex questions casodex 50mg cheap. Motor units contract as a whole and the strength of the muscle contraction depends on the number of motor units in action at any time mens health big book of exercises pdf discount casodex 50mg free shipping. The lower motor neurone is the final common pathway for the transmission of nerve impulses to skeletal muscles prostate embolization purchase casodex uk. The cell body of this neurone is influenced by a number of upper motor neurones originating from various sites in the brain and by some neurones which begin and end in the spinal cord androgen hormone and pregnancy order casodex online pills. Some of these neurones stimulate the cell bodies of the lower motor neurone while others have an inhibiting effect. The outcome of these influences is smooth, coordinated muscle movement, some of which is voluntary and some involuntary. Involuntary muscle movement Upper motor neurones these have their cell bodies in the brain at a level below the cerebrum, i. They influence muscle activity that maintains posture and balance, coordinates skeletal muscle movement and controls muscle tone. A reflex action is an involuntary and immediate motor response to a sensory stimulus. Many connector and motor neurones may be stimulated by afferent impulses from a small area of skin. These stimulate many connector and lower motor neurones in the spinal cord, which results in the contraction of many skeletal muscles of the hand, arm and shoulder, and the removal of the finger. Reflex action happens very quickly, in fact, the motor response may occur simultaneously with the perception of the pain in the cerebrum. Reflexes of this type are invariably protective but they can occasionally be inhibited. For example, if it is a precious plate that is very hot when lifted every effort will be made to overcome the pain to prevent dropping it! The cell body of the lower motor neurone is stimulated directly by the sensory neurone, with no connector neurone in between. The knee jerk is one example, but this type of reflex can be demonstrated at any point where a stretched tendon crosses a joint. By tapping the tendon just below the knee when it is bent, the sensory nerve endings in the tendon and in the thigh muscles are stretched. This initiates a nerve impulse that passes into the spinal cord to the cell body of the lower motor neurone in the anterior column of grey matter on the same side. This type of reflex has a protective function ­ it prevents excessive joint movement that may damage tendons, ligaments and muscles. Autonomic reflexes these include the pupillary light reflex when the pupil immediately constricts, in response to bright light, preventing retinal damage. Peripheral nervous system Learning outcomes After studying this section you should be able to: outline the function of a nerve plexus list the spinal nerves entering each plexus and the main nerves emerging from it describe the areas innervated by the thoracic nerves outline the functions of the 12 cranial nerves compare and contrast the structures and neurotransmitters of the divisions of the autonomic nervous system compare and contrast the effects of stimulation of the divisions of the autonomic nervous system on body function. This part of the nervous system consists of: 31 pairs of spinal nerves 12 pairs of cranial nerves the autonomic nervous system. Most of the nerves of the peripheral nervous system are composed of sensory nerve fibres transmitting afferent impulses from sensory organs to the brain, and motor nerve fibres transmitting efferent impulses from the brain to the effector organs. Spinal nerves There are 31 pairs of spinal nerves that leave the vertebral canal by passing through the intervertebral foramina formed by adjacent vertebrae. They are named and grouped according to the vertebrae with which they are associated. Although there are only seven cervical vertebrae, there are eight nerves because the first pair leaves the vertebral canal between the occipital bone and the atlas and the eighth pair leaves below the last cervical vertebra. Thereafter the nerves are given the name and number of the vertebra immediately above. These nerves leave the vertebral canal at the appropriate lumbar, sacral or coccygeal level, depending on their destination. Each nerve is formed by the union of a motor (anterior) and a sensory (posterior) nerve root and is, therefore, a mixed nerve.

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After a few days the destroyed tissue coagulates and forms an eschar mens health challenge order line casodex, or thick scab prostate zones diagram discount 50 mg casodex with visa, which sloughs off after 2 to 3 weeks androgen hormone 12 casodex 50mg otc. In circumferential burns androgen hormone vasoconstrictor purchase casodex cheap online, which encircle any area of the body, complications may arise from constriction of the part by eschar. In adults, hypovolaemic shock usually develops when 15% of the surface area is affected. Complications of burns Although burns affect the skin, when extensive, their systemic consequences can also be lifethreatening or fatal. Dehydration and hypovolaemia these may occur in extensive burns due to excessive leakage of water and plasma proteins from the surface of the damaged skin. Renal failure this occurs when the kidney tubules cannot deal with the amount of waste from haemolysed erythrocytes and damaged tissue. Contractures these may develop later as fibrous scar tissue contracts distorting the limbs. Malignant tumours Basal cell carcinoma this is the least malignant and most common type of skin cancer. It is associated with long-term exposure to sunlight and is therefore most likely to occur on sun-exposed sites, usually the head or neck. It appears as a shiny nodule and later this breaks down, becoming an ulcer with irregular edges, commonly called a rodent ulcer. Malignant melanoma this is malignant proliferation of melanocytes, usually originating in a mole that may have an irregular outline. Predisposing factors are a fair skin and recurrent episodes of intensive exposure to sunlight including repeated episodes of sunburn, especially in childhood. Sites for this tumour show a gender bias, with the lower leg being the commonest site in females and the torso being a common site in males. The most common sites of blood-spread metastases are the liver, brain, lungs, bowel and bone marrow. These threats include such diverse entities as bacteria, viruses, cancer cells, parasites and foreign (non-self) cells. The body has therefore developed a wide selection of protective measures, which can be divided into two categories. Non-specific defence mechanisms these protect against any of an enormous range of possible dangers. In addition, immunological memory develops, which confers long-term immunity to specific infections. The later sections of the chapter describe some disorders of lymphatic system function. These are the first lines of general defence; they prevent entry and minimise further passage of microbes and other foreign material into the body. There are five main non-specific defence mechanisms: defence at body surfaces phagocytosis natural antimicrobial substances the inflammatory response immunological surveillance. Mucus secreted by mucous membranes traps microbes and other foreign material on its sticky surface. Sebum and sweat secreted onto the skin surface contain antibacterial and antifungal substances. Hairs in the nose act as a coarse filter, and the sweeping action of cilia in the respiratory tract moves mucus and inhaled foreign materials towards the throat. The one-way flow of urine from the bladder minimises the risk of infection ascending through the urethra into the bladder. Phagocytic defence cells such as macrophages and neutrophils migrate to sites of inflammation and infection (chemotaxis), because neutrophils themselves and invading microbes release chemicals that attract them (chemoattractants). These cells are non-selective in their targets; they bind, engulf and digest foreign cells or particles. Macrophages have an important role as a link between the non-specific and specific defence mechanisms. After ingestion and digestion of an antigen, they act as antigen-presenting cells, displaying their antigen on their own cell surface to stimulate T-lymphocytes and activate the immune response (p.