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Ataxia

A movement disorder of the cerebellum is referred to as ataxia    . It presents as a loss of coordination in voluntary movements. Ataxia can also refer to sensory deficits that cause balance problems, primarily in proprioception and equilibrium. When the problem is observed in movement, it is ascribed to cerebellar damage. Sensory and vestibular ataxia would likely also present with problems in gait and station.

Ataxia is often the result of exposure to exogenous substances, focal lesions, or a genetic disorder. Focal lesions include strokes affecting the cerebellar arteries, tumors that may impinge on the cerebellum, trauma to the back of the head and neck, or MS. Alcohol intoxication or drugs such as ketamine cause ataxia, but it is often reversible. Mercury in fish can cause ataxia as well. Hereditary conditions can lead to degeneration of the cerebellum or spinal cord, as well as malformation of the brain, or the abnormal accumulation of copper seen in Wilson’s disease.

Watch this short video to see a test for station. Station refers to the position a person adopts when they are standing still. The examiner would look for issues with balance, which coordinates proprioceptive, vestibular, and visual information in the cerebellum. To test the ability of a subject to maintain balance, asking them to stand or hop on one foot can be more demanding. The examiner may also push the subject to see if they can maintain balance. An abnormal finding in the test of station is if the feet are placed far apart. Why would a wide stance suggest problems with cerebellar function?

Everyday connections

The field sobriety test

The neurological exam has been described as a clinical tool throughout this chapter. It is also useful in other ways. A variation of the coordination exam is the Field Sobriety Test (FST) used to assess whether drivers are under the influence of alcohol. The cerebellum is crucial for coordinated movements such as keeping balance while walking, or moving appendicular musculature on the basis of proprioceptive feedback. The cerebellum is also very sensitive to ethanol, the particular type of alcohol found in beer, wine, and liquor.

Walking in a straight line involves comparing the motor command from the primary motor cortex to the proprioceptive and vestibular sensory feedback, as well as following the visual guide of the white line on the side of the road. When the cerebellum is compromised by alcohol, the cerebellum cannot coordinate these movements effectively, and maintaining balance becomes difficult.

Another common aspect of the FST is to have the driver extend their arms out wide and touch their fingertip to their nose, usually with their eyes closed. The point of this is to remove the visual feedback for the movement and force the driver to rely just on proprioceptive information about the movement and position of their fingertip relative to their nose. With eyes open, the corrections to the movement of the arm might be so small as to be hard to see, but proprioceptive feedback is not as immediate and broader movements of the arm will probably be needed, particularly if the cerebellum is affected by alcohol.

Reciting the alphabet backwards is not always a component of the FST, but its relationship to neurological function is interesting. There is a cognitive aspect to remembering how the alphabet goes and how to recite it backwards. That is actually a variation of the mental status subtest of repeating the months backwards. However, the cerebellum is important because speech production is a coordinated activity. The speech rapid alternating movement subtest is specifically using the consonant changes of “lah-kah-pah” to assess coordinated movements of the lips, tongue, pharynx, and palate. But the entire alphabet, especially in the nonrehearsed backwards order, pushes this type of coordinated movement quite far. It is related to the reason that speech becomes slurred when a person is intoxicated.

Chapter review

The cerebellum is an important part of motor function in the nervous system. It apparently plays a role in procedural learning, which would include motor skills such as riding a bike or throwing a football. The basis for these roles is likely to be tied into the role the cerebellum plays as a comparator for voluntary movement.

The motor commands from the cerebral hemispheres travel along the corticospinal pathway, which passes through the pons. Collateral branches of these fibers synapse on neurons in the pons, which then project into the cerebellar cortex through the middle cerebellar peduncles. Ascending sensory feedback, entering through the inferior cerebellar peduncles, provides information about motor performance. The cerebellar cortex compares the command to the actual performance and can adjust the descending input to compensate for any mismatch. The output from deep cerebellar nuclei projects through the superior cerebellar peduncles to initiate descending signals from the red nucleus to the spinal cord.

The primary role of the cerebellum in relation to the spinal cord is through the spinocerebellum; it controls posture and gait with significant input from the vestibular system. Deficits in cerebellar function result in ataxias, or a specific kind of movement disorder. The root cause of the ataxia may be the sensory input—either the proprioceptive input from the spinal cord or the equilibrium input from the vestibular system, or direct damage to the cerebellum by stroke, trauma, hereditary factors, or toxins.

Watch this short video to see a test for station. Station refers to the position a person adopts when they are standing still. The examiner would look for issues with balance, which coordinates proprioceptive, vestibular, and visual information in the cerebellum. To test the ability of a subject to maintain balance, asking them to stand or hop on one foot can be more demanding. The examiner may also push the subject to see if they can maintain balance. An abnormal finding in the test of station is if the feet are placed far apart. Why would a wide stance suggest problems with cerebellar function?

A wide stance would suggest the person needs to maintain balance by broadening their base. Instead of continuous correction to posture, this can keep the body stable when the cerebellum cannot.

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Raychelle Reply
Which of the following accurately describe external resipration
Gwendolyn Reply
from the heart to the lungs
Phee
I think it's not outside organ of respiratory all respiratory organ are inside of human body
Moha
diffusion of CO2 and oxygen at a pulmonary capillary surrounding an alveolar sac.
Jeremiah
In other words, from the external environment to the lungs (alveoli) then to the pulmonary capillary then to the heart. So this is a stage of inhalation. inhale = external respiration.
Jeremiah
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horyaal Reply
what is the function of the placenta
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The placenta acts to provide oxygen and nutrientsto the fetus, whilst removing carbon dioxide and other waste products.
Moha
Also it's the barrier through which the mother is connected to the fetus.
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a disease of the arteries characterized by the deposition of fatty material on their inner walls.
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Atherosclerosis is a condition of deposition of plaque inside the artries
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Plaque include such as fat, chalestrol, calcium etc
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go to the gym
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atherosclerosis can also be caused by tortuousness of arteries with old age as contributing factor.
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Chigozie Reply
The basic structural and functional unit of any living thing. Each cell is a small container of chemicals and water wrapped in a membrane. 
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that magical fusion of cells
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It's an autoimmune disease... targeting the pancreas
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structure of fallopian tubes
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how fats are digested in the human body
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Fat digestion begins in the stomach but some argue in that it starts in the mouth. Reason is because the sublingual gland secretes an enzyme called lingual lipase. However, this enzyme is not activated until it comes into contact with gastric fluids (HCl). In the stomach, HCl breaks down the lipid..
Jeremiah
due to body heat
Mule
into smaller molecules. Going from a triglyceride and a fatty acid to a monoglyceride and a a fatty acid no longer bound to one another. This is known as lipolysis.
Jeremiah
After lipolysis in the stomach from gastric and lingual lipase, an acidic chyme is produced after stomach churning the bolus. The chyme exits the stomach at the pyloric sphincter and enters the first section of the small intestine known as the duodenum.
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in the duodenum. An alkaline mucus from goblet cells neutralizes the acidic chyme to prevent acid burns. After that, the pancreas and gallbladder secrete a number of enzymes to continue lipolysis. Bile from the gallbladder enters the duodenum via common bile duct. The acinar cells in the pancreas...
Jeremiah
secretes pancreatic lipase after enteroendocrine cells in the duodenum secrete a stimulator hormone called CCK. Cck stimulates bile synthesis and secretion as well as pancreatic lipase.
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Bile emuslifies the lipid, allowing the lipases to continue lipolysis
Jeremiah
this breakdown continues until it reaches the jejunum of the small intestines. At this point, the lipid has been broken down small enough to absorbed into the blood stream. So villi in the jejunum, absorb the contents.
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ileum, the last small intestine region, absorbs anything that wasn't absorbed previously. Like minerals, vitamins, bile salts, water soluble material. Villi here complete that task. Fatty acid and glycerol however, are absorbed by lacteals. small lymph vessels. And are transported to the liver.
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hopefully that helped.
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liquid turning to solid... blood clots.
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coagulation : liquid blood into blood clots caused with a coagulant.
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it said to coagulate by the action of active plasma protein called *fibrin*
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it is the process by which blood becomes more viscous or becomes thick
CHRISTOPHER
cloting of blood cells
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clot of blood
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the process of forming semi solid lumps in a liquid
rida
conversion of blood to solid state
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semi solid., rather than solid form
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Ever
to less thefriction
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lacrimal glands
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explain the blood supply to the brain
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There are two paired arteries which are responsible for the blood supply to the brain; the vertebral arteries, and the internal carotid arteries. These arteries arise in the neck, and ascend to the cranium.
Sabrina
two arteries main vertebral arteries & internal carotid artery
Akbar

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Source:  OpenStax, Anatomy & Physiology. OpenStax CNX. Feb 04, 2016 Download for free at http://legacy.cnx.org/content/col11496/1.8
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