how to create barcode in using c# DISORDERS OF THE AUTONOMIC NERVOUS SYSTEM, RESPIRATION, AND SWALLOWING 479 in Microsoft Office


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TANSEY EM: Chemical neurotransmission in the autonomic nervous system: Sir Henry Dale and acetylcholine Clin Auton Res 1:63, 1991 THOMPSON PD, MELMON KL: Clinical assessment of autonomic function Anesthesiology 29:724, 1968 VERNINO S, LOW PA, FEALEY RD, et al: Autoantibodies to ganglionic acetylcholine receptors in autoimmune autonomic neuropathies N Engl J Med 343:847, 2000 WEISS HD: The physiology of human penile erection Ann Intern Med 76: 792, 1972
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WIGLEY FM: Raynaud s phenomenon N Engl J Med 347:1001, 2002 WILES CM: Neurogenic dysphagia J Neurol Neurosurg Psychiatry 54: 1037, 1991 YOUNG RR, ASBURY AK, CORBETT JL, ADAMS RD: Pure pan-dysautonomia with recovery: Description and discussion of diagnostic criteria Brain 98:613, 1975 ZIEGLER MG, LAKE R, KOPIN IJ: The sympathetic nervous system defect in primary orthostatic hypotension N Engl J Med 296:293, 1977
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The hypothalamus plays three roles in the actions of the nervous system The rst, as the head ganglion of the autonomic nervous system, was described in the preceding chapter; the second, as the circadian and seasonal clock for behavioral and sleep-wake functions, was considered in Chap 19, on sleep; and the third, as the neural center of the endocrine system, is the subject of this chapter In the hypothalamus, these systems are integrated with one another as well as with neocortical, limbic, and spinal in uences Together, they maintain homeostasis and participate in the substructure of emotion and affective behavior The expansion of knowledge of neuroendocrinology during the past few decades stands as one of the signi cant achievements in neurobiology It has been learned that neurons, in addition to transmitting electrical impulses, can synthesize and discharge complex molecules locally and into the systemic circulation, and that these molecules are capable of activating or inhibiting endocrine, renal, and vascular cells at distant sites The concept of neurosecretion probably had its origins in the observations of Speidel, in 1919 (and later those of the Scharrers in 1929), who noted that some of the hypothalamic neurons had the morphologic characteristics of glandular cells Their suggestion that such cells might secrete hormones into the bloodstream was so novel, however, that it was rejected by most biologists at the time This seems surprising now that neurosecretion is viewed as a fundamental part of the science of endocrinology Following these early observations, it was found that certain peptides secreted by neurons in the central and peripheral nervous systems were also contained in glandular cells of the pancreas, intestines, and heart This seminal observation was made in 1931 by Euler and Gaddum, who isolated a substance from the intestines that was capable of acting on smooth muscle But it was not until some 35 years later that Leeman and her associates puri ed the substance and identi ed it as substance P (see Aronin et al) Then followed the discovery of somatostatin by Brazeau and colleagues in 1973 and the endogenous opioids (enkephalin) by Hughes and coworkers in 1975; since then a series of hypothalamic releasing factors that act on the pituitary gland have been isolated
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THE HYPOTHALAMUS Anatomic Features
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The hypothalamus lies on each side of the third ventricle and is continuous across its oor It is bounded posteriorly by the mammillary bodies, anteriorly by the optic chiasm and lamina terminalis, superiorly by the hypothalamic sulci, laterally by the optic tracts, and inferiorly by the hypophysis It comprises three main nuclear groups, the standard nomenclature for which was proposed in 1939 by Rioch and colleagues: (1) the anterior group, which includes the preoptic, supraoptic, and paraventricular nuclei; (2)
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the middle group, which includes the tuberal, arcuate, ventromedial, and dorsomedial nuclei; and (3) the posterior group, comprising the mammillary and posterior hypothalamic nuclei Nauta and Haymaker have subdivided the hypothalamus sagitally The lateral part lies lateral to the fornix; it is sparsely cellular and its cell groups are traversed by the medial forebrain bundle which carries nely myelinated and unmyelinated ascending and descending bers to and from the rostrally placed septal nuclei, substantia innominata, nucleus accumbens, amygdala, and piriform cortex and the caudally placed tegmental reticular formation The medial hypothalamus is rich in cells, some of which are the neurosecretory cells for pituitary regulation and visceral control It contains two main efferent ber systems the mammillothalamic tract of Vicq d Azyr (named for the physician to Louis XIV, a paramour of Marie Antionette), which connects the mammillary nuclei with the anterior thalamic nucleus (which, in turn, projects to the cingulate gyrus), and the mammillotegmental tract Additional structures of importance are the stria terminalis, which runs from the amygdala to the ventromedial hypothalamic nucleus, and the fornix, which connects the hippocampus to the mammillary body, septal nuclei, and periventricular parts of the hypothalamus The lateral and medial parts of the hypothalamus are interconnected and their functions are integrated The inferior surface of the hypothalamus, just posterior to the pituitary stalk, bulges downward slightly; this region is known as the tuber cinerium From the center of the tuber arises the median eminence or infundibulum; the latter stands out because of its vascularity (the hypophysial-portal system of veins courses over the surface) The infundibulum extends into the pituitary stalk, which, in turn, enters the pars nervosa of the hypophysis (Fig 27-1) The median eminence assumes special importance because of the intimate relation of its cell groups to the anterior lobe of the pituitary gland It represents the interface between converging pathways from the brain and the master gland of the endocrine system The supraopticohypophysial bers terminate on capillaries of the outer zone of the median eminence (Martin and Reichlin) The tuberoinfundibular neurons of the arcuate nucleus and anterior periventricular nuclei synthesize most of the releasing factors described below (Fig 27-1) The abundant blood supply of the hypothalamus (from several feeding arteries) is of importance to neurosurgeons who attempt to obliterate aneurysms that derive from adjacent vessels Many small radicles, arising from the posterior and anterior communicating arteries as well as from the most proximal portions of the anterior and posterior cerebral arteries, form a network of such redundancy that infarction of the hypothalamus is infrequent Readers requiring a more extensive source of information on anatomic and other aspects of the hypothalamus are directed to the comprehensive material by Swaab in the two-volume Handbook of Clinical Neurology and to the monograph by Martin and Reichlin
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