The brain: functional divisions

Publication date: Available online 30 March 2017 Source:Anaesthesia & Intensive Care Medicine Author(s): Leo Donnelly The incompletely separated cerebral hemispheres consist of a thin outer folded cortex of grey matter containing organized neuronal cell bodies and interneurons. Some of the surface convolutions subserve particular sensory or motor functions. Incoming afferent and projected efferent fibres constitute the underlying white matter, which connects different parts of each hemisphere, the hemispheres to each other and (as the corona radiata) to subcortical nuclei, especially components of the deeply-embedded diencephalon and the basal ganglia, and continuing between the latter as the internal capsule to and from the cerebellum and brainstem. Divisions of the diencephalon, the deeper part of the embryonic forebrain, include the epithalamus (pineal gland), the thalamus (connected extensively with the cortex), the subthalamus and the hypothalamus (involved in the autonomic nervous system, limbic system and neuro-endocrine system). The brainstem, consisting of the midbrain, pons and medulla, allows passage of many ascending and descending nerve fibre tracts between the brain and spinal cord, carrying sensory information from and allowing movement of the limbs and trunk. It is also the site of many of the cranial nerve nuclei, through which the brain innervates the head region. It houses the centres controlling vital aspects related to respiration, cardiovascular fun...
Source: Anaesthesia and intensive care medicine - Category: Anesthesiology Source Type: research

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ConclusionsThis simple model of conscious sedation was able to promote anxiolysis, analgesia, and comfort for the procedure without serious hemodynamic effects, which can be a reasonable choice in developing countries.
Source: Global Heart - Category: Cardiology Source Type: research
ConclusionUltrasound guided infiltration allows accurate placement of large volume of diluted local anaesthetic solution safely and provides effective anaesthesia.
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ConclusionA multimodal oral analgesia protocol provides sufficient pain relief to allow closed reduction of upper-limb fractures in children at the emergency department. This management strategy provided high satisfaction rates in both the patients and their parents.Level of evidenceII, prospective observational study.
Source: Orthopaedics and Traumatology: Surgery and Research - Category: Orthopaedics Source Type: research
Pressure injuries (PIs) are a common yet challenging problem especially in people with spinal cord injury (SCI) because of immobility and anesthetic skin. They are difficult to treat with standard medical care and often recur. Recent interest in the treatment of chronic wounds like PIs has shifted from the type of dressing with or without pharmaceutical topical agents to different therapies like negative pressure wound therapy (NPWT), gene therapy and stem cell based therapies. The rationale behind the use of cell-based therapies is the fact that cells in chronic wounds are phenotypically altered or senescent or both.
Source: The Spine Journal - Category: Orthopaedics Authors: Source Type: research
This study sought to assess the operability of TELD at the L5-S1 disc level.
Source: The Spine Journal - Category: Orthopaedics Authors: Source Type: research
Spinal anesthesia (SA) has been shown in several studies to be a viable alternative to general anesthesia (GA) in laminectomies and discectomies. However, very few spine surgeons have extended the use of SA to lumbar fusion surgery, and few studies have documented its use in the literature. The authors posit that SA may lead to lower postoperative pain than GA, and thus have implemented use of a novel thoracolumbar interfascial plane (TLIP) block for additional long-lasting analgesia.
Source: The Spine Journal - Category: Orthopaedics Authors: Source Type: research
Spinal anesthesia (SA) has been shown in several studies to be a viable alternative to general anesthesia (GA) in laminectomies, discectomies and microdiscectomies. However, the use of SA in spinal fusion surgery has been very scarcely documented in the current literature. Here we present a comparison of SA to GA in lumbar fusion surgery in terms of perioperative outcomes and cost.
Source: The Spine Journal - Category: Orthopaedics Authors: Source Type: research
An increasing focus on value-based care in elective spine surgery has prompted interest in alternative modalities of surgical intervention. Avoidance of general anesthesia (GA) is one modality that has recently gained support due to reductions in postoperative symptoms related to general anesthetics. Some patients with operative spine pathology cannot tolerate a GA due to comorbidities or other issues that preclude RA or GA. Our goal was to determine the complication rate of lumbar spinal decompression under local anesthesia with IV sedation (LIS) compared to patients decompressed under general anesthesia.
Source: The Spine Journal - Category: Orthopaedics Authors: Source Type: research
This meta-analysis aimed to determine the optimal effective dosage and delivery method of tranexamic acid in cardiac surgery.BMC Anesthesiology
Source: Medscape Today Headlines - Category: Consumer Health News Tags: Anesthesiology Journal Article Source Type: news
This study aimed to investigate the factors affecting the postoperative mortality rate in patients undergoing surgery for perforated diverticulitis. Further, we compared the recovery courses of patients between open and laparoscopic surgeries. Methods: We analyzed the medical records of adult patients with peritonitis caused by perforated diverticulitis from six hospitals of Hallym University Medical Center from January 2006 to December 2016. Results: A total of 166 patients were identified. In the univariate analysis, the statistically significant factors associated with postoperative mortality were age ≥ 60 ye...
Source: JSLS : Journal of the Society of Laparoendoscopic Surgeons - Category: Surgery Tags: JSLS Source Type: research
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