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Vestibular Nuclei Vestibular nuclei contain the second order neurons of vestibular nerve diabetes 1 and 2 difference buy acarbose us. There are four vestibular nuclei blood sugar xls cheap 25 mg acarbose, situated in the rostral part of medulla and caudal part of pons diabetes prevention and control programs cheap acarbose on line, namely superior diabetes definition canadian buy acarbose with amex, medial, lateral and inferior vestibular nuclei. Medulla forms the main pathway for ascending and descending tracts of the spinal cord. Respiratory Centers Dorsal and ventral group of neurons form the medullary respiratory centers, which maintain normal rhythmic respiration. Deglutition Center Deglutition center regulates the pharyngeal and eso phageal stages of deglutition. Chapter 146 t Brainstem 845 All the medullary centers and nuclei of cranial nerves are controlled by higher centers, situated in cerebral cortex and hypothalamus. Axons of pontine nuclei join to form the middle cerebellar peduncle or the brachium pontis. Medial lemniscus is joined by the fibers of 10th, 9th, 7th and 5th cranial nerves in pons 4. Pons contains the pneumotaxic and apneustic centers for regulation of respiration 6. It also contains the vestibular nuclei, which are already mentioned in medulla oblongata. Basis Pedunculus Basis pedunculus consists of pyramidal tract fibers in the middle, temporopontine fibers laterally and frontopontine fibers medially. Substantia nigra is considered as one of the components of basal ganglia (Chapter 151). Tegmentum Tegmentum lies dorsal to substantia nigra and is actually the upward continuation of the reticular formation in pons. These fibers are predominantly efferent fibers from dentate nucleus of cerebellum; few fibers are from other cerebellar nuclei such as nucleus globosus and nucleus emboliformis. Forel decussation, which is due to the crossing of rubrospinal tracts from either side iii. Meynert decussation, which is due to the crossing of medial longitudinal bundle that is formed by efferent fibers of 3rd, 4th and 6th cranial nerves. Red Nucleus Red nucleus is a large oval or round mass of gray matter, extending between the superior colliculus and hypothalamus. Superior Colliculus Superior colliculus is a small structure and is an important center for reflexes. Through tectospinal tract, superior colliculus controls the movements of the eyes, head, trunk and limbs, in response to visual impulses. Superior colliculus also receives afferents from optic tract, which helps in the integration of optical and postural reflexes. Inferior Colliculus Inferior colliculus consists of single layer of neurons to which the lateral lemniscus (auditory fibers) synapses. Connections of red nucleus Afferent connections: Red nucleus receives fibers from: 1. Efferent connections: Red nucleus sends efferent fibers to various parts of brain and spinal cord: 1. Control of muscle tone: Because of its connections with cerebellum, vestibular apparatus and skeletal muscle, the red nucleus plays an important role in facilitating the muscle tone. Control of complex muscular movements: Red nucleus controls the complex muscular movements.

Definition Proprioceptors are the receptors control diabetes pregnancy generic acarbose 25 mg with visa, which detect and give response to movement and change in position of different parts of the body diabetes insipidus dilute urine buy acarbose without a prescription. Situation Proprioceptors are situated in labyrinth diabetes hyperglycemia definition order acarbose with mastercard, muscles blood sugar normal levels acarbose 50 mg without a prescription, tendon of the muscles, joints, ligaments and fascia (Table 156. Different Proprioceptors Muscle spindle Golgi tendon organ Pacinian corpuscle Free nerve ending Proprioceptors in labyrinth. Each muscle spindle is formed by 5 to 12 Chapter 156 t Proprioceptors 909 intrafusal muscle fibers. It is the only receptor in the body, which has both sensory and motor nerve supply. Sensory Nerve Supply Each muscle spindle receives two types of sensory nerve fibers: 1. Primary sensory nerve fiber Primary sensory nerve fiber belongs to type I (A) nerve fiber. These branches end in the form of rings around central portion of nuclear bag and nuclear chain fibers. The capsule is attached to either side of extrafusal fibers or the tendon of the muscle. Central portion of the intrafusal fibers does not contract because it has only few or no actin and myosin filaments. The discharge from gamma motor neurons causes the contraction of intrafusal fibers. Types of Intrafusal Fibers Muscle spindle is formed by two types of intrafusal fibers: 1. Nuclear bag fiber Central portion of this fiber is enlarged like a bag and contains many nuclei. Nuclear chain fiber In nuclear chain fiber, central portion is not bulged and the nuclei are arranged in the center in the form of a chain. It innervates only the nuclear chain fiber and ends near the end portion of nuclear chain fiber like the petals of the flower. Muscle spindle as the receptor organ for stretch reflex Stimulation of muscle spindle elicits the stretch reflex. Intrafusal muscle fibers are situated parallel to the extrafusal muscle fibers and are attached to the tendon of the muscle by means of capsule. These impulses are transmitted via the primary and secondary sensory nerve fibers to the alpha motor neurons in spinal cord. Alpha motor neurons in turn send motor impulse to muscles through their fibers and cause contraction of extrafusal fibers. Response of muscle spindle to stretch When the muscle is stretched, primary sensory nerve fibers from muscle spindle discharge impulses. Motor Nerve Supply Motor (efferent) nerve fiber supplying the muscle spindle belongs to gamma motor neuron (A) type. Motor nerve supply to nuclear bag fiber Gamma motor nerve fiber supplying the nuclear bag fiber ends as motor end plate. Motor nerve supply to nuclear chain fiber Gamma motor nerve fiber supplying the nuclear chain fiber divides into many branches, which form a network called trail ending. By detecting the change in length of the muscle, the spindle plays an important role in preventing the overstretching of the muscles. Role of Muscle Spindle in Stretch Reflex Stretch reflex Stretch reflex is the reflex contraction of muscle when it is stretched. Extensor muscles, particularly the antigravity muscles exhibit a severe and prolonged contraction during stretch reflex. Dynamic response Dynamic response is the response in which the primary sensory nerve fibers discharge rapidly. When there is a change in length of the muscle by stretching, primary sensory nerve fibers from nuclear bag fiber start discharging impulses very rapidly. But, the discharge becomes less or nil during continuous stretching of the muscle. Discharge of impulses start only if there is change in degree of stretching of the muscle. Static response Static response is the response in which impulses are discharged rapidly and continuously throughout the period of muscle stretch by primary sensory nerve fibers of the nuclear chain fibers. Thus, the muscle spindle gives response to change in length of the muscle as well as rate of change in length.

Trehalase or trehalose glucohydrolase causes hydrolysis of trehalose (carbohydrate present in mushrooms and yeast) and converts it into glucose blood sugar danger levels order acarbose now. Lipolytic Enzyme Intestinal lipase acts on triglycerides and converts them into fatty acids diabetes medications low blood sugar order acarbose overnight delivery. Mucus present in the succus entericus protects the intestinal wall from the acid chyme diabetes mellitus type 2 definition order acarbose with a visa, which enters the intestine from stomach; thereby it prevents the intestinal ulcer diabetes 65 discount 25 mg acarbose fast delivery. Defensins secreted by paneth cells of intestinal glands are the antimicrobial peptides. These peptides are called natural peptide antibiotics because of their role in killing the phagocytosed bacteria. These glands penetrate muscularis mucosa and extend up to the submucus coat of the intestinal wall. Digested products of foodstuffs, proteins, carbohydrates, fats and other nutritive substances such as vitamins, minerals and water are absorbed mostly in small intestine. From the lumen of intestine, these substances pass through lacteal of villi, cross the mucosa and enter the blood directly or through lymphatics. It is responsible for absorption of glucose, amino acids and other substances by means of sodium cotransport. Water moves in or out of the intestinal lumen until the osmotic pressure of intestinal contents becomes equal to that of plasma. Absorption of Vitamins Most of the vitamins are absorbed in upper part of small intestine and vitamin B12 is absorbed in ileum. Stimulation of sympathetic nerves causes vasoconstriction and decreases the secretion of succus entericus. But, the role of these nerves in the regulation of intestinal secretion in physiological conditions is uncertain. However, the local nervous reflexes play an important role in increasing the secretion of intestinal juice. When chyme enters the small intestine, the mucosa is stimulated by tactile stimuli or irritation. It causes the development of local nervous reflexes, which stimulate the glands of intestine. The multilumen tube is inserted through nose or mouth, until the tip of this tube reaches the intestine. Entrance of tip of the tube into small intestine is indicated when this line comes near the mouth. Now, the intestinal juice is collected through the middle lumen, by means of aspiration. One end of isolated segment is closed and the other end is brought out through abdominal wall. Cause the cause of this disease is not known and it may be related to infectious organisms. It is also known as gluten-sensitive enteropathy, celiac sprue and non-tropical sprue. Gluten is like a poison to individuals with celiac disease, because it damages the intestine severely. The immune system reacts to a virus or a bacterium, resulting in inflammation of the intestine. Malabsorption of vitamin Weight loss Abdominal pain Diarrhea Rectal bleeding, anemia and fever Delayed or stunted growth in children. Muscular layer: Smooth muscles of large intestine are distributed in two layers, namely the outer longitudinal layer and inner circular layer. The longitudinal muscle fibers of large intestine are arranged in the form of three long bands called tenia coli. The length of the tenia coli is less when compared to the length of large intestine. Because of this, the large intestine is made into series of pouches called haustra Chapter 42 t Large Intestine 267 3.

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