Cleocin

By V. Ashton. University of Southern California.

Brain Waves Insula The insula is a deep lobe of the cerebrum that cannot be viewed Neurons within the cerebral cortex continuously generate elec- on the surface (see fig 150mg cleocin amex. This activity can be recorded by electrodes at- and is covered by portions of the frontal buy generic cleocin 150 mg, parietal, and temporal tached to precise locations on the scalp, producing an lobes. It is also thought to have EEG pattern, commonly called brain waves, is the collective ex- some function in memory. Nervous Tissue and the © The McGraw−Hill Anatomy, Sixth Edition Coordination Central Nervous System Companies, 2001 368 Unit 5 Integration and Coordination TABLE 11. Beta waves—recorded on the scalp over the precentral gyrus of the frontal region while a person is experiencing visual and mental activity; rhythmic oscillation at about 13 to 25 cycles/sec. Theta waves—recorded on the scalp over the temporal and occipital lobes while a person is awake and relaxed; rhythmic oscillation at about 5 to 8 cycles/sec; typical in newborns, but its presence in an adult generally indicates severe emotional stress and can be a forewarning of a nervous breakdown. Delta waves—recorded on the scalp over all the cerebral lobes while a person is asleep; rhythmic oscillation at about 1 to 5 cycles/sec; typical in an awake infant, but its presence in an awake adult indicates brain damage. The cessation of brain-wave patterns (a “flat EEG”) may be corpus callosum and anterior commissure (fig. Deviations from these patterns are of clinical significance that transmit impulses from the cerebrum to other parts of in diagnosing trauma, mental depression, hematomas, tumors, in- the brain and spinal cord and from the spinal cord and fections, and epileptic lesions. Normally, there are four kinds of other parts of the brain to the cerebrum. Basal Nuclei White Matter of the Cerebrum The basal nuclei are specialized paired masses of gray matter located The thick white matter of the cerebrum is deep to the cerebral deep within the white matter of the cerebrum (figs. The corpus stria- connections within the brain by which information is transmit- tum is composed of several masses of nuclei. The caudate nucleus is ted to the appropriate places in the form of electrical impulses. A thick band of white matter lies between the cau- The three types of fiber tracts within the white matter are named date nucleus and the next two masses underneath, collectively called according to location and the direction in which they conduct the lentiform nucleus. Association fibers are confined to a given cerebral hemi- sphere and conduct impulses between neurons within that corpus striatum: L. Nervous Tissue and the © The McGraw−Hill Anatomy, Sixth Edition Coordination Central Nervous System Companies, 2001 Chapter 11 Nervous Tissue and the Central Nervous System 369 (a) (b) FIGURE 11. It is a thin layer of gray matter, Knowledge of the brain regions involved in language has been lying just deep to the cerebral cortex of the insula. The globus pallidus regulates the muscle tone necessary left inferior gyrus of the frontal lobe. Neural diseases or motor speech area causes selective stimulation of motor im- physical trauma to the basal nuclei generally cause a variety of pulses in motor centers elsewhere in the frontal lobe, which in motor movement dysfunctions, including rigidity, tremor, and turn causes coordinated skeletal muscle movement in the phar- rapid and aimless movements. Nervous Tissue and the © The McGraw−Hill Anatomy, Sixth Edition Coordination Central Nervous System Companies, 2001 370 Unit 5 Integration and Coordination Corpus callosum Intermediate commissure Septum pellucidum Genu of corpus Choroid plexus of third ventricle callosum Splenium of corpus callosum Posterior commissure Anterior commissure Pineal gland Thalamus Corpora Hypothalamus quadrigemina Optic chiasma Pituitary stalk Cortex of Pituitary gland cerebellum Mammillary body Arbor vitae of Pons cerebellum Medulla oblongata FIGURE 11. Motor cerebral cortex Thalamus Claustrum Putamen Basal nuclei Lentiform nucleus Globus Corpus pallidus striatum Caudate nucleus Cerebellum Spinal cord FIGURE 11. The thalamus is a relay center be- tween the motor cerebral cortex and the other brain areas. The combined muscular stimulation translates a sentence but cannot read it, presumably because of damage to thought patterns into speech. Some recovery usually occurs after damage to the motor Language comprehension has been destroyed in people with speech area, but damage to Wernicke’s area produces more severe Wernicke’s aphasia; they cannot understand either spoken or and permanent aphasias. It appears that the concept of words to be spoken origi- Knowledge Check nates in Wernicke’s area and is then communicated to the motor speech area through the arcuate fasciculus. Diagram a lateral view of the cerebrum and label the four ate fasciculus produces conduction aphasia, which is fluent but superficial lobes and the fissures that separate them. How are these patterns The angular gyrus, located at the junction of the parietal, monitored clinically? Describe the arrangement of the fiber tracts within the integration of auditory, visual, and somatesthetic information. Describe the aphasias that result from damage to the motor damage to the left angular gyrus can speak and understand spo- speech area and Wernicke’s area from damage to the arcuate fasciculus and from damage to the angular gyrus.

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Martindale- Hubbell is a quick source of basic biographical information about law- yers. Newspaper articles and electronic databases of information mentioning the lawyers involved in published opinions and jury ver- dicts are other sources of useful information. You are not required to accept whatever attorney is recommended to you, no more than your carrier is required to accept and pay for any attorney you may like but who knows little or nothing about medical malpractice. You and your professional liability insurer should, because you have the same interest in achieving the most favorable outcome for you, be able to agree on a good attorney, one with the education and experience best suited for your needs. Although a jury is usually involved in a medical mal- practice case, courts can, by agreement of the parties, sit as both the “finder” of facts and law. An arbitrator or panel of arbitrators, of course, act as determiners of both the law and facts. Judges and arbitrators also rule on motions that can dispose of or shape the course of the litigation and rule on what evidence is admissible. Obviously, who one gets for a judge can be critical to the case, so it’s important to know as much as one can about the judge or arbitrator who will hear the case. The best source of information about judges and arbitrators is, not surprisingly, other lawyers who have tried cases before them. Because most defense attor- neys practice primarily where they live, they will know about the judge or at least know someone else who has tried cases before, or knows the judge. Certain public information is also available about judges, includ- ing information about cases on which they have decided or ruled. From these varied sources, one can usually discover whether a judge has a reputation for fairness, knowledge of the law, is intellectually bright or slow, and has a quick or even temper. Many, if not all, states permit one peremptory challenge to a judge and all allow a challenge based on bias. It is common in larger urban areas to assign a different judge for pretrial motions from the judge drawn for settlement discussion and trial, so research on the universe of Chapter 2 / Litigation 27 judges one is likely to draw for each of these stages of litigation is advisable. The Jury Jurors decide factual disputes, which means that they determine the ultimate “facts” of your case. Their judgment as to what the “facts” are, including the fact and size of damages should they decide to award them, cannot be disturbed on appeal unless it can be shown that there is no substantial evidence to support those findings. When a judge or arbitrator also acts as the “fact finder,” this same restrained standard of review—“substantial evidence”—also applies. Selection of jurors naturally comes just before the case is to be tried, which means that the parties will have gathered all their evidence and should be ready for trial. Each party, through counsel, will have some opportunity to question or submit questions to the judge to ask of each juror. Usu- ally, each party has a limited number of peremptory challenges and may also challenge a juror for “good cause” or bias, on which the judge will rule. Some lawyers are fond of employing, for big cases, jury consultants, professional “jury experts” who read body language and pay particular attention to the responses jurors make to the voir dire questions. Other lawyers trust their own instincts when it comes to accepting or challeng- ing certain jurors; and some even feel that it doesn’t matter in the end which jurors are selected; they take any panel that meets with the judge’s approval. If your case looks like it is going to trial and you feel you have a good sense of people, your lawyer should be willing to listen to you in the jury selection process. Witnesses, Especially “Experts” All witnesses are important, especially you. A prepared witness is not a “coached” witness; a “prepared” witness is one who understands the purpose for which his or her testimony is sought, and has some understanding of the questions likely to be asked. This requires a witness to think about the best and most honest way to respond to these questions. As for adversarial witnesses, pretrial discovery will reveal who they are and what they are likely to say and not say.