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A traditional view of the Autonomic Nervous System (ANS) considers only its peripheral part: the sympathetic and parasympathetic systems. However, this view misses to consider the most important ANS function: the maintenance of homeostasis. This term is used today to define not only the strategies that allow the body proper response to changes in the environment (reactive homeostasis), but also temporal mechanisms that allow the body to predict the most likely timing of environmental stimuli (predictive homeostasis based on biological rhythms). This book discusses the ANS from both an enlarged and a timed perspective. First, it presents how the organization of the ANS is hierarchical into different levels. Following that, the book discusses how the ANS changes functionally in the three-body configurations (wakefulness, slow sleep, rapid eye movement sleep) found in a 24-hour cycle. Finally, the most important clinical implications of this enlarged and timed vision of ANS will be discussed. Autonomic Nervous System – Basic and Clinical Aspects is a comprehensive text intended for medical students and health professionals who are interested in a deeper approach to this important part of the nervous system. It provides a detailed and complete understanding of the neuroscience behind the ANS, allowing a proper clinical applicability of this knowledge.
Easily understood, up-to-date and clinically relevant, this book provides junior anaesthetists with an essential physiology resource.
The kidney is innervated with efferent sympathetic nerve fibers reaching the renal vasculature, the tubules, the juxtaglomerular granular cells, and the renal pelvic wall. The renal sensory nerves are mainly found in the renal pelvic wall. Increases in efferent renal sympathetic nerve activity reduce renal blood flow and urinary sodium excretion by activation of α1-adrenoceptors and increase renin secretion rate by activation of β1-adrenoceptors. In response to normal physiological stimulation, changes in efferent renal sympathetic nerve activity contribute importantly to homeostatic regulation of sodium and water balance. The renal mechanosensory nerves are activated by stretch of the renal pelvic tissue produced by increases in renal pelvic tissue of a magnitude that may occur during increased urine flow rate. Activation of the sensory nerves elicits an inhibitory renorenal reflex response consisting of decreases in efferent renal sympathetic nerve activity leading to natriuresis. Increasing efferent sympathetic nerve activity increases afferent renal nerve activity which, in turn, decreases efferent renal sympathetic nerve activity by activation of the renorenal reflexes. Thus, activation of the afferent renal nerves buffers changes in efferent renal sympathetic nerve activity in the overall goal of maintaining sodium balance. In pathological conditions of sodium retention, impairment of the inhibitory renorenal reflexes contributes to an inappropriately increased efferent renal sympathetic nerve activity in the presence of sodium retention. In states of renal disease or injury, there is a shift from inhibitory to excitatory reflexes originating in the kidney. Studies in essential hypertensive patients have shown that renal denervation results in long-term reduction in arterial pressure, suggesting an important role for the efferent and afferent renal nerves in hypertension. Table of Contents: Part I: Efferent Renal Sympathetic Nerves / Introduction / Neuroanatomy / Neural Control of Renal Hemodynamics / Neural Control of Renal Tubular Function / Neural Control of Renin Secretion Rate / Part II: Afferent Renal Sensory Nerves / Introduction / Neuroanatomy / Renorenal Reflexes / Mechanisms Involved in the Activation of Afferent Renal Sensory Nerves / Part III: Pathophysiological States / Efferent Renal Sympathetic Nerves / Afferent Renal Sensory Nerves / Conclusions / References
Cranial nerves are involved in head and neck function, and processes such as eating, speech and facial expression. This clinically oriented survey of cranial nerve anatomy and function was written for students of medicine, dentistry and speech therapy, but will also be useful for postgraduate physicians and GPs, and specialists in head and neck healthcare (surgeons, dentists, speech therapists etc.). After an introductory section surveying cranial nerve organisation and tricky basics such as ganglia, nuclei and brain stem pathways, the nerves are considered in functional groups: (1) for chewing and facial sensation; (2) for pharynx and larynx, swallowing and phonation; (3) autonomic components, taste and smell; (4) vision and eye movements; and (5) hearing and balance. In each chapter, the main anatomical features of each nerve are followed by clinical aspects and details of clinical testing. Simple line diagrams accompany the text. Detailed anatomy is not given.
Deglutition or a swallow begins as a voluntary act in the oral cavity but proceeds autonomously in the pharynx and esophagus. Bilateral sequenced activation and inhibition of more than 25 pairs of muscles of mouth, pharynx, larynx, and esophagus is required during a swallow. A single swallow elicits peristalsis in the pharynx and esophagus along with relaxation of upper and lower esophageal sphincters. Multiple swallows, at closely spaced time intervals, demonstrate deglutitive inhibition; sphincters remain relaxed during the entire period, but only the last swallow elicits peristalsis. Laryngeal inlet closure or airway protection is very important during swallow. Upper part of the esophagus that includes upper esophageal sphincter is composed of skeletal muscles, middle esophagus is composed of a mixture of skeletal and smooth muscles, and lower esophagus, including lower esophageal sphincter, is composed of smooth muscles. Peristalsis progresses in seamless fashion, despite separate control mechanism, from the skeletal to smooth muscle esophagus. The esophagus's circular and longitudinal muscle layers contract synchronously during peristalsis. Sphincters maintain continuous tone; neuromuscular mechanisms for tonic closure in the upper and lower esophageal sphincters are different. Lower esophageal sphincter transient relaxation, belching mechanism, regurgitation, vomiting, and reflux are mediated via the brain stem. Table of Contents: Introduction / Central Program Generator and Brain Stem / Pharynx-Anatomy, Neural Innervation, and Motor Pattern / Upper Esophageal Sphincter / Neuromuscular Anatomy of Esophagus and Lower Esophageal Sphincter / Extrinsic Innervation: Parasympathetic and Sympathetic / Interstitial Cells of Cajal / Recording Techniques / Motor Patterns of the Esophagus-Aboral and Oral Transport / Deglutitive Inhibition and Muscle Refractoriness / Peristalsis in the Circular and Longitudinal Muscles of the Esophagus / Neural and Myogenic Mechanism of Peristalsis / Central Mechanism of Peristalsis-Cortical and Brain Stem Control / Peripheral Mechanisms of Peristalsis / Central Versus Peripheral Mechanism of Deglutitive Inhibition / Neural Control of Longitudinal Muscle Contraction / Modulation of Primary and Secondary Peristalsis / Neural Control of Lower Esophageal Sphincter and Crural Diaphragm / Lower Esophageal Sphincter / Swallow-Induced LES Relaxation / Crural Diaphragm Contribution to EGJ and Neural Control / Transient LES Relaxation and Pharmacological Inhibition / Compliance of the EGJ / References
A conspicuous portion of the peripheral nervous system is part of the 'vegetative nervous system'; it includes all the neurons which innerv ate the viscera, salivary and lacrimal glands, the heart and blood vessels, all other smooth muscles of the body, notably the intrinsic muscles of the eye and the muscles of the hair. Only part of the system belongs to the peripheral nervous system: it has also its own nuclei and pathways in the central nervous system. The distinction between visceral and somatic functions is a very old one in our culture. With the development of neurology the notion of a widespread nervous control of body functions emerged. Winslow (1732) used the term nervi sympathici majores for those nerves, which he thought to carry about 'sympathies' and then co ordinate various viscera's functions. His was an anatomical break through, which obscured Willis' 'intercostal nerve' and Vesalius 'cranial nerve'. The notion was developed among others by John stone (1764) who arrived, with the aid of some very accurate anatomical observations, at the problem of the nervous influence on motion and sensitivity of viscera. By the end of the eighteenth century, it was clear, with Bichat (1800), that what he called 'sympa thetic nervous system' (and his pupil Reil, a few years later, 'vegeta tive nervous system ') controlled visceral functions (fa vie organique), whereas somatic functions (fa vie animafe) were under direct control from the brain and spinal cord.
Ideal for students of neuroscience and neuroanatomy, the new edition of Netter's Atlas of Neuroscience combines the didactic well-loved illustrations of Dr. Frank Netter with succinct text and clinical points, providing a highly visual, clinically oriented guide to the most important topics in this subject. The logically organized content presents neuroscience from three perspectives: an overview of the nervous system, regional neuroscience, and systemic neuroscience, enabling you to review complex neural structures and systems from different contexts. You may also be interested in: A companion set of flash cards, Netter's Neuroscience Flash Cards, 3rd Edition, to which the textbook is cross-referenced. Coverage of both regional and systemic neurosciences allows you to learn structure and function in different and important contexts. Combines the precision and beauty of Netter and Netter-style illustrations to highlight key neuroanatomical concepts and clinical correlations. Reflects the current understanding of the neural components and supportive tissue, regions, and systems of the brain, spinal cord, and periphery. Uniquely informative drawings provide a quick and memorable overview of anatomy, function, and clinical relevance. Succinct and useful format utilizes tables and short text to offer easily accessible "at-a-glance" information. Provides an overview of the basic features of the spinal cord, brain, and peripheral nervous system, the vasculature, meninges and cerebrospinal fluid, and basic development. Integrates the peripheral and central aspects of the nervous system. Bridges neuroanatomy and neurology through the use of correlative radiographs. Highlights cross-sectional brain stem anatomy and side-by-side comparisons of horizontal sections, CTs and MRIs. Features video of radiograph sequences and 3D reconstructions to enhance your understanding of the nervous system. Student Consult eBook version included with purchase. This enhanced eBook experience includes access -- on a variety of devices -- to the complete text, 14 videos, and images from the book. Expanded coverage of cellular and molecular neuroscience provides essential guidance on signaling, transcription factors, stem cells, evoked potentials, neuronal and glial function, and a number of molecular breakthroughs for a better understanding of normal and pathologic conditions of the nervous system. Micrographs, radiologic imaging, and stained cross sections supplement illustrations for a comprehensive visual understanding. Increased clinical points -- from sleep disorders and inflammation in the CNS to the biology of seizures and the mechanisms of Alzheimer's -- offer concise insights that bridge basic neuroscience and clinical application.
The peripheral nervous system is usually defined as the cranial nerves, spinal nerves, and peripheral ganglia which lie outside the brain and spinal cord. To describe the structure and function of this system in one book may have been possible last century. Today, only a judicious selection is possible. It may be fairly claimed that the title of this book is not misleading, for in keeping the text within bounds only accounts of olfaction, vision, audition, and vestibular function have been omitted, and as popularly understood these topics fall into the category of special senses. This book contains a comprehensive treatment of the structure and function of peripheral nerves (including axoplasmic flow and trophic func tions); junctional regions in the autonomic and somatic divisions of the peripheral nervous system; receptors in skin, tongue, and deeper tissues; and the integrative role of ganglia. It is thus a handbook of the peripheral nervous system as it is usually understood for teaching purposes. The convenience of having this material inside one set of covers is already proven, for my colleagues were borrowing parts of the text even while the book was in manuscript. It is my belief that lecturers will find here the information they need, while graduate students will be able to get a sound yet easily read account of results of research in their area. JOHN 1. HUBBARD vii Contents SECTION I-PERIPHERAL NERVE Chapter 1 Peripheral Nerve Structure 3 Henry deF. Webster 3 1. Introduction .