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Most cells of the inferior versed in its upper part by fibers of the fasciculus colliculus respond to bineural stimulation and may retroflexus, well shown medially on the axial cut. The caudal and lateral aspects are traversed by fibers of inferior collicular nuclei show a definite tonotopic the superior cerebellar peduncle. The corticorubral projections originate from the precentral and the premotor cortex and project so- matotopically onto the red nucleus. Fibers originating from the deep cerebel- longitudinal fasciculus; 6, central tegmental tract; 7, medial lar nuclei decussate in the caudal midbrain before lemniscus; 8, spinothalamic tracts; 9, lateral lemniscus; 10, decussation of superior cerebellar peduncle (brachium traversing and surrounding the contralateral red conjunctivum); 11, midbrain reticular formation; 12, interpe- nucleus. Those originating in the dentate nucleus duncular nucleus; 13, substantia nigra; 14, cerebral peduncle; terminate in the rostral third of the contralateral red 15, frontopontine tract; 16, pyramidal tract; 17, nucleus while those from the globose and embo- occipitotemporopontine tract; 18, oculomotor nerve; 19, liform nuclei terminate somatotopically in the cau- brachium pontis; 20, interpeduncular cistern; 21, basilar ar- tery; 22, posterior cerebral artery; 23, lateromesencephalic dal two thirds. Cells of the caudal portion give rise to cistern; 24, ambient cistern the crossed rubrospinal tract, which influences flex- or motor tone. Stimulation of the red nucleus in animals produces flexion of the ipsilateral limb due to the fact that both systems, the superior cerebellar peduncle as well as the rubrospinal tract, are crossed. Clinically, lesions involving the red nucleus are re- sponsible for an ipsilateral oculomotor disturbance associated with contralateral involuntary move- The Brainstem and Cerebellum 233 Fig. This c The Substantia Nigra: Morphology pigmentation is maximum in humans, appearing after and Functional Anatomy the fourth or fifth year of life and increasing in melanin The substantia nigra, also called the locus niger, is locat- content with age. The neurons of the pars compacta ed in the midbrain between the crus cerebri and the contain high concentrations of dopamine whereas the tegmentum, as shown on the parasagittal (Figs. Efferent connections of the substantia nigra are represented by the nigrostriatal dopaminergic fibers arising from the pars compacta and projecting to the striatum, the rostral two thirds of the substantia ni- gra terminating in the head of the caudate nucleus and the caudal part in the putamen. A reciprocal ar- rangement characterizes the striatonigral and the nigrostriatal fibers constituting a closed feed-back loop. In pri- mates, the nigrothalamic fibers terminate in those thalamic motor nuclei lacking input from the cere- bellum or the basal ganglia.

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Fasim, 33 years: Total body water in the neonate amounts to reduced which leads to a decrease in hepatocyte uptake 80%, compared with 65% of body-weight in older chil- and an increase in plasma concentrations of the statin. The blood:gas partition coefficient is a useful index of solubility and defines the relative affinity of an anesthetic for the blood compared with that of inspired gas.

Umbrak, 31 years: It is pos- may resemble one another closely and some are greatly sible that a physician will be called upon to treat individuals prized by epicures. For example, an individual with chronic alcoholism may appear sober or only slightly intoxicated with a blood alcohol concentration of 300–400 mg/dL, whereas this level is associated with marked intoxication or even coma in a nontolerant individual.

Iomar, 37 years: Particulate matter lecular site of the toxic action of each metal is different, associated with most emissions promotes the conver- toxicity generally results from interaction of the metal sion of sulfur dioxide to the more toxic sulfuric acid and with specific functional groups on macromolecules in facilitates deposition in the deep lungs. In patients with underlying heart disease or severe thyrotoxicosis and in elderly patients, it is desirable to treat with antithyroid drugs (preferably methimazole) until the patient is euthyroid.

Jerek, 25 years: The medial side of this region of each iliac bone, and the related muscles, are com­ ponents of the posterior abdominal wall. Use of these continuous infusion devices is encouraged for people who are unable to obtain target control while on multiple injection regimens and in circumstances in which excellent glycemic control is desired, such as during pregnancy.

Volkar, 36 years: Dabigatran is a direct specific competitive inhibitor of free and fi- Heparin is a sulphated mucopolysaccharide that is found brin-bound thrombin. The open boxes (and the corresponding colored curves) indicate the cumulative frequency distribution of responses, which are lognormally distributed.

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