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The primary motor cortex is located in the precentral gyrus of the frontal lobe. A neurosurgeon, Walter Penfield, described much of the basic understanding of the primary motor cortex by electrically stimulating the surface of the cerebrum. Penfield would probe the surface of the cortex while the patient was only under... | {
"Header 1": "**14.3 | Motor Responses**",
"Header 3": "**Primary Motor Cortex**",
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The motor output from the cortex descends into the brain stem and to the spinal cord to control the musculature through motor neurons. Neurons located in the primary motor cortex, named **Betz cells**, are large cortical neurons that synapse with lower motor neurons in the spinal cord or the brain stem. The two descend... | {
"Header 1": "**14.3 | Motor Responses**",
"Header 3": "**Descending Pathways**",
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The **lateral corticospinal tract** is composed of the fibers that cross the midline at the pyramidal decussation (see **[Figure](#page-609-0) [14.28](#page-609-0)**). The axons cross over from the anterior position of the pyramids in the medulla to the lateral column of the spinal cord. These axons are responsible for... | {
"Header 1": "**14.3 | Motor Responses**",
"Header 3": "**Appendicular Control**",
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The **anterior corticospinal tract** is responsible for controlling the muscles of the body trunk (see **[Figure 14.28](#page-609-0)**). These axons do not decussate in the medulla. Instead, they remain in an anterior position as they descend the brain stem and enter the spinal cord. These axons then travel to the spin... | {
"Header 1": "**14.3 | Motor Responses**",
"Header 3": "**Axial Control**",
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Other descending connections between the brain and the spinal cord are called the **extrapyramidal system**. The name comes from the fact that this system is outside the corticospinal pathway, which includes the pyramids in the medulla. A few pathways originating from the brain stem contribute to this system.
The **t... | {
"Header 1": "**14.3 | Motor Responses**",
"Header 3": "**Extrapyramidal Controls**",
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The somatic nervous system provides output strictly to skeletal muscles. The lower motor neurons, which are responsible for the contraction of these muscles, are found in the ventral horn of the spinal cord. These large, multipolar neurons have a corona of dendrites surrounding the cell body and an axon that extends ou... | {
"Header 1": "**14.3 | Motor Responses**",
"Header 3": "**Ventral Horn Output**",
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This chapter began by introducing reflexes as an example of the basic elements of the somatic nervous system. Simple somatic reflexes do not include the higher centers discussed for conscious or voluntary aspects of movement. Reflexes can be spinal or cranial, depending on the nerves and central components that are inv... | {
"Header 1": "**14.3 | Motor Responses**",
"Header 3": "**Reflexes**",
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facial and glossopharyngeal nerves **somatosensation** general sense associated with modalities lumped together as touch **special sense** any sensory system associated with a specific organ structure, namely smell, taste, sight, hearing, and balance **spinal trigeminal nucleus** component of the trigeminal nuclei that... | {
"Header 1": "**14.3 | Motor Responses**",
"Header 3": "**KEY TERMS**",
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The senses are olfaction (smell), gustation (taste), somatosensation (sensations associated with the skin and body), audition (hearing), equilibrium (balance), and vision. With the exception of somatosensation, this list represents the special senses, or those systems of the body that are associated with specific organ... | {
"Header 1": "**14.3 | Motor Responses**",
"Header 3": "**[14.1 Sensory Per](#page-572-1)[ception](#page-573-0)**",
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Sensory input to the brain enters through pathways that travel through either the spinal cord (for somatosensory input from the body) or the brain stem (for everything else, except the visual and olfactory systems) to reach the diencephalon. In the diencephalon, sensory pathways reach the thalamus. This is necessary fo... | {
"Header 1": "**14.3 | Motor Responses**",
"Header 3": "**[14.2 Central Processing](#page-593-0)**",
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The motor components of the somatic nervous system begin with the frontal lobe of the brain, where the prefrontal cortex is responsible for higher functions such as working memory. The integrative and associate functions of the prefrontal lobe feed into the secondary motor areas, which help plan movements. The premotor... | {
"Header 1": "**14.3 | Motor Responses**",
"Header 3": "**[14.3 Motor Responses](#page-606-0)**",
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**1.** Watch this **[video \(http://openstaxcollege.org/l/](http://openstaxcollege.org/l/DanielleReed) [DanielleReed\)](http://openstaxcollege.org/l/DanielleReed)** to learn about Dr. Danielle Reed of the Monell Chemical Senses Center in Philadelphia, PA, who became interested in science at an early age because of her ... | {
"Header 1": "**14.3 | Motor Responses**",
"Header 3": "**INTERACTIVE LINK QUESTIONS**",
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After studying this chapter, you will be able to:
- Describe the components of the autonomic nervous system
- Differentiate between the structures of the sympathetic and parasympathetic divisions in the autonomic nervous system
- Name the components of a visceral reflex specific to the autonomic division to which it ... | {
"Header 1": "**Introduction**",
"Header 2": "**Chapter Objectives**",
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"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
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By the end of this section, you will be able to:
- Name the components that generate the sympathetic and parasympathetic responses of the autonomic nervous system
- Explain the differences in output connections within the two divisions of the autonomic nervous system
- Describe the signaling molecules and receptor pr... | {
"Header 1": "**15.1 | Divisions of the Autonomic Nervous System**",
"token_count": 531,
"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
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To respond to a threat—to fight or to run away—the sympathetic system causes divergent effects as many different effector organs are activated together for a common purpose. More oxygen needs to be inhaled and delivered to skeletal muscle. The respiratory, cardiovascular, and musculoskeletal systems are all activated t... | {
"Header 1": "**15.1 | Divisions of the Autonomic Nervous System**",
"Header 3": "**Sympathetic Division of the Autonomic Nervous System**",
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"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
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The parasympathetic division of the autonomic nervous system is named because its central neurons are located on either side of the thoracolumbar region of the spinal cord (para- = "beside" or "near"). The parasympathetic system can also be referred to as the **craniosacral system** (or outflow) because the preganglion... | {
"Header 1": "**15.1 | Divisions of the Autonomic Nervous System**",
"Header 3": "**Parasympathetic Division of the Autonomic Nervous System**",
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Where an autonomic neuron connects with a target, there is a synapse. The electrical signal of the action potential causes the release of a signaling molecule, which will bind to receptor proteins on the target cell. Synapses of the autonomic system are classified as either **cholinergic**, meaning that **acetylcholine... | {
"Header 1": "**15.1 | Divisions of the Autonomic Nervous System**",
"Header 3": "**Chemical Signaling in the Autonomic Nervous System**",
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Signaling molecules can belong to two broad groups. Neurotransmitters are released at synapses, whereas hormones are released into the bloodstream. These are simplistic definitions, but they can help to clarify this point. Acetylcholine can be considered a neurotransmitter because it is released by axons at synapses. T... | {
"Header 1": "**15.1 | Divisions of the Autonomic Nervous System**",
"Header 3": "**Table 15.1**",
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The original usage of the epithet "fight or flight" comes from a scientist named Walter Cannon who worked at Harvard in 1915. The concept of homeostasis and the functioning of the sympathetic system had been introduced in France in the previous century. Cannon expanded the idea, and introduced the idea that an animal r... | {
"Header 1": "**15.1 | Divisions of the Autonomic Nervous System**",
"Header 3": "**Fight or Flight? What About Fright and Freeze?**",
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One difference between a **somatic reflex**, such as the withdrawal reflex, and a **visceral reflex**, which is an autonomic reflex, is in the **efferent branch**. The output of a somatic reflex is the lower motor neuron in the ventral horn of the spinal cord that projects directly to a skeletal muscle to cause its con... | {
"Header 1": "**15.2 | Autonomic Reflexes and Homeostasis**",
"Header 3": "**The Structure of Reflexes**",
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The afferent branch of a reflex arc does differ between somatic and visceral reflexes in some instances. Many of the inputs to visceral reflexes are from special or somatic senses, but particular senses are associated with the viscera that are not part of the conscious perception of the environment through the somatic ... | {
"Header 1": "**15.2 | Autonomic Reflexes and Homeostasis**",
"Header 3": "**Afferent Branch**",
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Kehr's sign is the presentation of pain in the left shoulder, chest, and neck regions following rupture of the spleen. The spleen is in the upper-left abdominopelvic quadrant, but the pain is more in the shoulder and neck. How can this be? The sympathetic fibers connected to the spleen are from the celiac ganglion, whi... | {
"Header 1": "**15.2 | Autonomic Reflexes and Homeostasis**",
"Header 3": "**Nervous System: Kehr's Sign**",
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Somatic reflexes involve sensory neurons that connect sensory receptors to the CNS and motor neurons that project back out to the skeletal muscles. Visceral reflexes that involve the thoracolumbar or craniosacral systems share similar connections. However, there are reflexes that do not need to involve any CNS componen... | {
"Header 1": "**15.2 | Autonomic Reflexes and Homeostasis**",
"Header 3": "**Short and Long Reflexes**",
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The postganglionic fibers of the sympathetic and parasympathetic divisions both release neurotransmitters that bind to receptors on their targets. Postganglionic sympathetic fibers release norepinephrine, with a minor exception, whereas postganglionic parasympathetic fibers release ACh. For any given target, the differ... | {
"Header 1": "**15.2 | Autonomic Reflexes and Homeostasis**",
"Header 3": "**Competing Neurotransmitters**",
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Organ systems are balanced between the input from the sympathetic and parasympathetic divisions. When something upsets that balance, the homeostatic mechanisms strive to return it to its regular state. For each organ system, there may be more of a sympathetic or parasympathetic tendency to the resting state, which is k... | {
"Header 1": "**15.2 | Autonomic Reflexes and Homeostasis**",
"Header 3": "**Autonomic Tone**",
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Have you ever stood up quickly and felt dizzy for a moment? This is because, for one reason or another, blood is not getting to your brain so it is briefly deprived of oxygen. When you change position from sitting or lying down to standing, your cardiovascular system has to adjust for a new challenge, keeping blood pum... | {
"Header 1": "**15.2 | Autonomic Reflexes and Homeostasis**",
"Header 3": "**Orthostatic Hypotension**",
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By the end of this section, you will be able to:
- Describe the role of higher centers of the brain in autonomic regulation
- Explain the connection of the hypothalamus to homeostasis
- Describe the regions of the CNS that link the autonomic system with emotion
- Describe the pathways important to descending control ... | {
"Header 1": "**15.3 | Central Control**",
"token_count": 389,
"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
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The hypothalamus is the control center for many homeostatic mechanisms. It regulates both autonomic function and endocrine function. The roles it plays in the pupillary reflexes demonstrates the importance of this control center. The optic nerve projects primarily to the thalamus, which is the necessary relay to the oc... | {
"Header 1": "**15.3 | Central Control**",
"Header 3": "**The Hypothalamus**",
"token_count": 514,
"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
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The amygdala is a group of nuclei in the medial region of the temporal lobe that is part of the **limbic lobe** (**[Figure 15.12](#page-645-0)**). The limbic lobe includes structures that are involved in emotional responses, as well as structures that contribute to memory function. The limbic lobe has strong connection... | {
"Header 1": "**15.3 | Central Control**",
"Header 3": "**The Amygdala**",
"token_count": 238,
"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
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The medulla contains nuclei referred to as the **cardiovascular center**, which controls the smooth and cardiac muscle of the cardiovascular system through autonomic connections. When the homeostasis of the cardiovascular system shifts, such as when blood pressure changes, the coordination of the autonomic system can b... | {
"Header 1": "**15.3 | Central Control**",
"Header 3": "**The Medulla**",
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In addition to its association with the fight-or-flight response and rest-and-digest functions, the autonomic system is responsible for certain everyday functions. For example, it comes into play when homeostatic mechanisms dynamically change, such as the physiological changes that accompany exercise. Getting on the tr... | {
"Header 1": "**15.3 | Central Control**",
"Header 3": "**Exercise and the Autonomic System**",
"token_count": 485,
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By the end of this section, you will be able to:
- List the classes of pharmaceuticals that interact with the autonomic nervous system
- Differentiate between cholinergic and adrenergic compounds
- Differentiate between sympathomimetic and sympatholytic drugs
- Relate the consequences of nicotine abuse with respect t... | {
"Header 1": "**15.4 | Drugs that Affect the Autonomic System**",
"token_count": 240,
"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
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One important drug that affects the autonomic system broadly is not a pharmaceutical therapeutic agent associated with the system. This drug is nicotine. The effects of nicotine on the autonomic nervous system are important in considering the role smoking can play in health.
All ganglionic neurons of the autonomic sy... | {
"Header 1": "**15.4 | Drugs that Affect the Autonomic System**",
"Header 3": "**Broad Autonomic Effects**",
"token_count": 640,
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When the sympathetic system is not functioning correctly or the body is in a state of homeostatic imbalance, these drugs act at postganglionic terminals and synapses in the sympathetic efferent pathway. These drugs either bind to particular adrenergic receptors and mimic norepinephrine at the synapses between sympathet... | {
"Header 1": "**15.4 | Drugs that Affect the Autonomic System**",
"Header 3": "**Sympathomimetic Drugs**",
"token_count": 747,
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Drugs that interfere with sympathetic function are referred to as sympatholytic, or sympathoplegic, drugs. They primarily work as an **antagonist** to the adrenergic receptors. They block the ability of norepinephrine or epinephrine to bind to the receptors so that the effect is "cut" or "takes a blow," to refer to the... | {
"Header 1": "**15.4 | Drugs that Affect the Autonomic System**",
"Header 3": "**Sympatholytic Drugs**",
"token_count": 354,
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Drugs affecting parasympathetic functions can be classified into those that increase or decrease activity at postganglionic terminals. Parasympathetic postganglionic fibers release ACh, and the receptors on the targets are muscarinic receptors. There are several types of muscarinic receptors, M1–M5, but the drugs are n... | {
"Header 1": "**15.4 | Drugs that Affect the Autonomic System**",
"Header 3": "**Parasympathetic Effects**",
"token_count": 975,
"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
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Approximately 33 percent of people experience a mild problem with motion sickness, whereas up to 66 percent experience motion sickness under extreme conditions, such as being on a tossing boat with no view of the horizon. Connections between regions in the brain stem and the autonomic system result in the symptoms of n... | {
"Header 1": "**15.4 | Drugs that Affect the Autonomic System**",
"Header 3": "**Autonomic Nervous System**",
"token_count": 584,
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**acetylcholine (ACh)** neurotransmitter that binds at a motor end-plate to trigger depolarization
- **adrenal medulla** interior portion of the adrenal (or suprarenal) gland that releases epinephrine and norepinephrine into the bloodstream as hormones
- **adrenergic** synapse where norepinephrine is released, which ... | {
"Header 1": "**15.4 | Drugs that Affect the Autonomic System**",
"Header 3": "**KEY TERMS**",
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or "lyses," the function of the sympathetic system
- **sympathomimetic drug** drug that enhances or mimics the function of the sympathetic system
- **target effector** organ, tissue, or gland that will respond to the control of an autonomic or somatic or endocrine signal
- **terminal ganglia** ganglia of the parasympat... | {
"Header 1": "**15.4 | Drugs that Affect the Autonomic System**",
"Header 3": "**KEY TERMS**",
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The primary responsibilities of the autonomic nervous system are to regulate homeostatic mechanisms in the body, which is also part of what the endocrine system does. The key to understanding the autonomic system is to explore the response pathways—the output of the nervous system. The way we respond to the world aroun... | {
"Header 1": "**15.4 | Drugs that Affect the Autonomic System**",
"Header 3": "**[15.1 Divisions of](#page-624-1) [the Autonomic Nervous System](#page-625-0)**",
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Autonomic nervous system function is based on the visceral reflex. This reflex is similar to the somatic reflex, but the efferent branch is composed of two neurons. The central neuron projects from the spinal cord or brain stem to synapse on the ganglionic neuron that projects to the effector. The afferent branch of th... | {
"Header 1": "**15.4 | Drugs that Affect the Autonomic System**",
"Header 3": "**[15.2 Autonomic Reflexes and Homeostasis](#page-634-0)**",
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The autonomic system integrates sensory information and higher cognitive processes to generate output, which balances homeostatic mechanisms. The central autonomic structure is the hypothalamus, which coordinates sympathetic and parasympathetic efferent pathways to regulate activities of the organ systems of the body. ... | {
"Header 1": "**15.4 | Drugs that Affect the Autonomic System**",
"Header 3": "**[15.3 Central Control](#page-642-0)**",
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The autonomic system is affected by a number of exogenous agents, including some that are therapeutic and some that are illicit. These drugs affect the autonomic system by mimicking or interfering with the endogenous agents or their receptors. A survey of how different drugs affect autonomic function illustrates the ro... | {
"Header 1": "**15.4 | Drugs that Affect the Autonomic System**",
"Header 3": "**[15.4 Drugs that Affect the Autonomic System](#page-646-0)**",
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**27.** In the context of a lioness hunting on the savannah, why would the sympathetic system *not* activate the digestive system?
**28.** A target effector, such as the heart, receives input from the sympathetic and parasympathetic systems. What is the actual difference between the sympathetic and parasympathetic di... | {
"Header 1": "**15.4 | Drugs that Affect the Autonomic System**",
"Header 3": "**CRITICAL THINKING QUESTIONS**",
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After studying this chapter, you will be able to:
- Describe the major sections of the neurological exam
- Outline the benefits of rapidly assessing neurological function
- Relate anatomical structures of the nervous system to specific functions
- Diagram the connections of the nervous system to the musculature and i... | {
"Header 1": "**Introduction**",
"Header 2": "**Chapter Objectives**",
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By the end of this section, you will be able to:
- List the major sections of the neurological exam
- Explain the connection between location and function in the nervous system
- Explain the benefit of a rapid assessment for neurological function in a clinical setting
- List the causes of neurological deficits
- Desc... | {
"Header 1": "**16.1 | Overview of the Neurological Exam**",
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"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
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**Localization of function** is the concept that circumscribed locations are responsible for specific functions. The neurological exam highlights this relationship. For example, the cognitive functions that are assessed in the mental status exam are based on functions in the cerebrum, mostly in the cerebral cortex. Sev... | {
"Header 1": "**16.1 | Overview of the Neurological Exam**",
"Header 3": "**Neuroanatomy and the Neurological Exam**",
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Damage to the nervous system can be limited to individual structures or can be distributed across broad areas of the brain and spinal cord. Localized, limited injury to the nervous system is most often the result of circulatory problems. Neurons are very sensitive to oxygen deprivation and will start to deteriorate wit... | {
"Header 1": "**16.1 | Overview of the Neurological Exam**",
"Header 3": "**Causes of Neurological Deficits**",
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By the end of this section, you will be able to:
- Describe the relationship of mental status exam results to cerebral functions
- Explain the categorization of regions of the cortex based on anatomy and physiology
- Differentiate between primary, association, and integration areas of the cerebral cortex
- Provide ex... | {
"Header 1": "**16.2 | The Mental Status Exam**",
"token_count": 323,
"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
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The cerebrum is the seat of many of the higher mental functions, such as memory and learning, language, and conscious perception, which are the subjects of subtests of the mental status exam. The cerebral cortex is the thin layer of gray matter on the outside of the cerebrum. It is approximately a millimeter thick in m... | {
"Header 1": "**16.2 | The Mental Status Exam**",
"Header 3": "**Functions of the Cerebral Cortex**",
"token_count": 1114,
"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
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Orientation is the patient's awareness of his or her immediate circumstances. It is awareness of time, not in terms of the clock, but of the date and what is occurring around the patient. It is awareness of place, such that a patient should know where he or she is and why. It is also awareness of who the patient is—rec... | {
"Header 1": "**16.2 | The Mental Status Exam**",
"Header 3": "**Orientation and Memory**",
"token_count": 1121,
"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
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Language is, arguably, a very human aspect of neurological function. There are certainly strides being made in understanding communication in other species, but much of what makes the human experience seemingly unique is its basis in language. Any understanding of our species is necessarily reflective, as suggested by ... | {
"Header 1": "**16.2 | The Mental Status Exam**",
"Header 3": "**Language and Speech**",
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"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
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Those parts of the brain involved in the reception and interpretation of sensory stimuli are referred to collectively as the sensorium. The cerebral cortex has several regions that are necessary for sensory perception. From the primary cortical areas of the somatosensory, visual, auditory, and gustatory senses to the a... | {
"Header 1": "**16.2 | The Mental Status Exam**",
"Header 3": "**Sensorium**",
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"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
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Planning and producing responses requires an ability to make sense of the world around us. Making judgments and reasoning in the abstract are necessary to produce movements as part of larger responses. For example, when your alarm goes off, do you hit the snooze button or jump out of bed? Is 10 extra minutes in bed wor... | {
"Header 1": "**16.2 | The Mental Status Exam**",
"Header 3": "**Judgment and Abstract Reasoning**",
"token_count": 666,
"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
} |
Popular media often refer to right-brained and left-brained people, as if the brain were two independent halves that work differently for different people. This is a popular misinterpretation of an important neurological phenomenon. As an extreme measure to deal with a debilitating condition, the corpus callosum may be... | {
"Header 1": "**16.2 | The Mental Status Exam**",
"Header 2": "**Left Brain, Right Brain**",
"token_count": 652,
"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
} |
The cerebrum, particularly the cerebral cortex, is the location of important cognitive functions that are the focus of the mental status exam. The regionalization of the cortex, initially described on the basis of anatomical evidence of cytoarchitecture, reveals the distribution of functionally distinct areas. Cortical... | {
"Header 1": "**16.2 | The Mental Status Exam**",
"Header 2": "**Left Brain, Right Brain**",
"Header 3": "**The Mental Status Exam**",
"token_count": 375,
"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
} |
By the end of this section, you will be able to:
- Describe the functional grouping of cranial nerves
- Match the regions of the forebrain and brain stem that are connected to each cranial nerve
- Suggest diagnoses that would explain certain losses of function in the cranial nerves
- Relate cranial nerve deficits to ... | {
"Header 1": "**16.3 | The Cranial Nerve Exam**",
"token_count": 455,
"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
} |
The olfactory, optic, and vestibulocochlear nerves (cranial nerves I, II, and VIII) are dedicated to four of the special senses: smell, vision, equilibrium, and hearing, respectively. Taste sensation is relayed to the brain stem through fibers of the facial and glossopharyngeal nerves. The trigeminal nerve is a mixed n... | {
"Header 1": "**16.3 | The Cranial Nerve Exam**",
"Header 3": "**Sensory Nerves**",
"token_count": 2023,
"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
} |
The chief nucleus, located in the pons, receives information about light touch as well as proprioceptive information about the mandible, which are both relayed to the thalamus and, ultimately, to the postcentral gyrus of the parietal lobe. The spinal trigeminal nucleus, located in the medulla, receives information abou... | {
"Header 1": "**16.3 | The Cranial Nerve Exam**",
"Header 3": "**Sensory Nerves**",
"token_count": 438,
"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
} |
The three nerves that control the extraocular muscles are the oculomotor, trochlear, and abducens nerves, which are the third, fourth, and sixth cranial nerves. As the name suggests, the abducens nerve is responsible for abducting the eye, which it controls through contraction of the lateral rectus muscle. The trochlea... | {
"Header 1": "**16.3 | The Cranial Nerve Exam**",
"Header 3": "**Gaze Control**",
"token_count": 1485,
"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
} |
An iconic part of a doctor's visit is the inspection of the oral cavity and pharynx, suggested by the directive to "open your mouth and say 'ah.'" This is followed by inspection, with the aid of a tongue depressor, of the back of the mouth, or the opening of the oral cavity into the pharynx known as the **fauces**. Whe... | {
"Header 1": "**16.3 | The Cranial Nerve Exam**",
"Header 3": "**Nerves of the Face and Oral Cavity**",
"token_count": 1049,
"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
} |
The accessory nerve, also referred to as the spinal accessory nerve, innervates the sternocleidomastoid and trapezius muscles (**[Figure 16.11](#page-679-0)**). When both the sternocleidomastoids contract, the head flexes forward; individually, they cause rotation to the opposite side. The trapezius can act as an antag... | {
"Header 1": "**16.3 | The Cranial Nerve Exam**",
"Header 3": "**Motor Nerves of the Neck**",
"token_count": 478,
"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
} |
The autonomic control of pupillary size in response to a bright light involves the sensory input of the optic nerve and the parasympathetic motor output of the oculomotor nerve. When light hits the retina, specialized photosensitive ganglion cells send a signal along the optic nerve to the pretectal nucleus in the supe... | {
"Header 1": "**16.3 | The Cranial Nerve Exam**",
"Header 3": "**The Pupillary Light Response**",
"token_count": 481,
"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
} |
The cranial nerves can be separated into four major groups associated with the subtests of the cranial nerve exam. First are the sensory nerves, then the nerves that control eye movement, the nerves of the oral cavity and superior pharynx, and the nerve that controls movements of the neck.
The olfactory, optic, and v... | {
"Header 1": "**16.3 | The Cranial Nerve Exam**",
"Header 3": "**The Cranial Nerve Exam**",
"token_count": 453,
"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
} |
By the end of this section, you will be able to:
- Describe the arrangement of sensory and motor regions in the spinal cord
- Relate damage in the spinal cord to sensory or motor deficits
- Differentiate between upper motor neuron and lower motor neuron diseases
- Describe the clinical indications of common reflexes ... | {
"Header 1": "**16.4 | The Sensory and Motor Exams**",
"token_count": 297,
"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
} |
The general senses are distributed throughout the body, relying on nervous tissue incorporated into various organs. Somatic senses are incorporated mostly into the skin, muscles, or tendons, whereas the visceral senses come from nervous tissue incorporated into the majority of organs such as the heart or stomach. The s... | {
"Header 1": "**16.4 | The Sensory and Motor Exams**",
"Header 3": "**Sensory Modalities and Location**",
"token_count": 1548,
"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
} |
The skeletomotor system is largely based on the simple, two-cell projection from the precentral gyrus of the frontal lobe to the skeletal muscles. The corticospinal tract represents the neurons that send output from the primary motor cortex. These fibers travel through the deep white matter of the cerebrum, then throug... | {
"Header 1": "**16.4 | The Sensory and Motor Exams**",
"Header 3": "**Muscle Strength and Voluntary Movement**",
"token_count": 560,
"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
} |
Reflexes combine the spinal sensory and motor components with a sensory input that directly generates a motor response. The reflexes that are tested in the neurological exam are classified into two groups. A **deep tendon reflex** is commonly known as a stretch reflex, and is elicited by a strong tap to a tendon, such ... | {
"Header 1": "**16.4 | The Sensory and Motor Exams**",
"Header 3": "**Reflexes**",
"token_count": 666,
"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
} |
Many of the tests of motor function can indicate differences that will address whether damage to the motor system is in the upper or lower motor neurons. Signs that suggest a UMN lesion include muscle weakness, strong deep tendon reflexes, decreased control of movement or slowness, pronator drift, a positive Babinski s... | {
"Header 1": "**16.4 | The Sensory and Motor Exams**",
"Header 3": "**Comparison of Upper and Lower Motor Neuron Damage**",
"token_count": 273,
"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
} |
In certain situations, such as a motorcycle accident, only half of the spinal cord may be damaged in what is known as a hemisection. Forceful trauma to the trunk may cause ribs or vertebrae to fracture, and debris can crush or section through part of the spinal cord. The full section of a spinal cord would result in pa... | {
"Header 1": "**16.4 | The Sensory and Motor Exams**",
"Header 3": "**Spinal Cord**",
"token_count": 598,
"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
} |
By the end of this section, you will be able to:
- Explain the relationship between the location of the cerebellum and its function in movement
- Chart the major divisions of the cerebellum
- List the major connections of the cerebellum
- Describe the relationship of the cerebellum to axial and appendicular musculatu... | {
"Header 1": "**16.5 | The Coordination and Gait Exams**",
"token_count": 253,
"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
} |
The cerebellum is located in apposition to the dorsal surface of the brain stem, centered on the pons. The name of the pons is derived from its connection to the cerebellum. The word means "bridge" and refers to the thick bundle of myelinated axons that form a bulge on its ventral surface. Those fibers are axons that p... | {
"Header 1": "**16.5 | The Coordination and Gait Exams**",
"Header 3": "**Location and Connections of the Cerebellum**",
"token_count": 1013,
"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
} |
Testing for cerebellar function is the basis of the coordination exam. The subtests target appendicular musculature, controlling the limbs, and axial musculature for posture and gait. The assessment of cerebellar function will depend on the normal functioning of other systems addressed in previous sections of the neuro... | {
"Header 1": "**16.5 | The Coordination and Gait Exams**",
"Header 3": "**Coordination and Alternating Movement**",
"token_count": 783,
"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
} |
Gait can either be considered a separate part of the neurological exam or a subtest of the coordination exam that addresses walking and balance. Testing posture and gait addresses functions of the spinocerebellum and the vestibulocerebellum because both are part of these activities. A subtest called station begins with... | {
"Header 1": "**16.5 | The Coordination and Gait Exams**",
"Header 3": "**Posture and Gait**",
"token_count": 283,
"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
} |
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 dam... | {
"Header 1": "**16.5 | The Coordination and Gait Exams**",
"Header 3": "**Ataxia**",
"token_count": 396,
"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
} |
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 keepi... | {
"Header 1": "**16.5 | The Coordination and Gait Exams**",
"Header 3": "**The Field Sobriety Test**",
"token_count": 458,
"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
} |
**accommodation** in vision, a change in the ability of the eye to focus on objects at different distances
- **accommodation–convergence reflex** coordination of somatic control of the medial rectus muscles of either eye with the parasympathetic control of the ciliary bodies to maintain focus while the eyes converge ... | {
"Header 1": "**16.5 | The Coordination and Gait Exams**",
"Header 3": "**KEY TERMS**",
"token_count": 1965,
"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
} |
cerebrovascular accident (CVA)) loss of neurological function caused by an interruption of blood flow to a region of the central nervous system
- **superficial reflex** reflexive contraction initiated by gentle stimulation of the skin
- **superior cerebellar peduncle (SCP)** white-matter tract representing output of th... | {
"Header 1": "**16.5 | The Coordination and Gait Exams**",
"Header 3": "**KEY TERMS**",
"token_count": 278,
"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
} |
The neurological exam is a clinical assessment tool to determine the extent of function from the nervous system. It is divided into five major sections that each deal with a specific region of the CNS. The mental status exam is concerned with the cerebrum and assesses higher functions such as memory, language, and emot... | {
"Header 1": "**16.5 | The Coordination and Gait Exams**",
"Header 3": "**[16.1 Overview of](#page-660-1) [the Neurological Exam](#page-661-0)**",
"token_count": 243,
"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
} |
The sensory and motor exams assess function related to the spinal cord and the nerves connected to it. Sensory functions are associated with the dorsal regions of the spinal cord, whereas motor function is associated with the ventral side. Localizing damage to the spinal cord is related to assessments of the peripheral... | {
"Header 1": "**16.5 | The Coordination and Gait Exams**",
"Header 3": "**[16.4 The Sensory and Motor](#page-665-0) [Exams](#page-680-0)**",
"token_count": 258,
"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
} |
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 m... | {
"Header 1": "**16.5 | The Coordination and Gait Exams**",
"Header 3": "**[16.5 The Coordination and Gait Exams](#page-685-0)**",
"token_count": 315,
"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
} |
After studying this chapter, you will be able to:
- Identify the contributions of the endocrine system to homeostasis
- Discuss the chemical composition of hormones and the mechanisms of hormone action
- Summarize the site of production, regulation, and effects of the hormones of the pituitary, thyroid, parathyroid, ... | {
"Header 1": "**Introduction**",
"Header 2": "**Chapter Objectives**",
"token_count": 255,
"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
} |
The nervous system uses two types of intercellular communication—electrical and chemical signaling—either by the direct action of an electrical potential, or in the latter case, through the action of chemical neurotransmitters such as serotonin or norepinephrine. Neurotransmitters act locally and rapidly. When an elect... | {
"Header 1": "**17.1 | An Overview of the Endocrine System**",
"Header 3": "**Neural and Endocrine Signaling**",
"token_count": 802,
"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
} |
The endocrine system consists of cells, tissues, and organs that secrete hormones as a primary or secondary function. The **endocrine gland** is the major player in this system. The primary function of these ductless glands is to secrete their hormones directly into the surrounding fluid. The interstitial fluid and the... | {
"Header 1": "**17.1 | An Overview of the Endocrine System**",
"Header 3": "**Structures of the Endocrine System**",
"token_count": 371,
"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
} |
In endocrine signaling, hormones secreted into the extracellular fluid diffuse into the blood or lymph, and can then travel great distances throughout the body. In contrast, autocrine signaling takes place within the same cell. An **autocrine** (auto- = "self") is a chemical that elicits a response in the same cell tha... | {
"Header 1": "**17.1 | An Overview of the Endocrine System**",
"Header 3": "**Other Types of Chemical Signaling**",
"token_count": 251,
"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
} |
Endocrinology is a specialty in the field of medicine that focuses on the treatment of endocrine system disorders. Endocrinologists—medical doctors who specialize in this field—are experts in treating diseases associated with hormonal systems, ranging from thyroid disease to diabetes mellitus. Endocrine surgeons treat ... | {
"Header 1": "**17.1 | An Overview of the Endocrine System**",
"Header 3": "**Endocrinologist**",
"token_count": 321,
"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
} |
The primary hormones derived from lipids are steroids. Steroid hormones are derived from the lipid cholesterol. For example, the reproductive hormones testosterone and the estrogens—which are produced by the gonads (testes and ovaries)—are steroid hormones. The adrenal glands produce the steroid hormone aldosterone, wh... | {
"Header 1": "**17.2 | Hormones**",
"Header 3": "**Steroid Hormones**",
"token_count": 205,
"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
} |
Intracellular hormone receptors are located inside the cell. Hormones that bind to this type of receptor must be able to cross the cell membrane. Steroid hormones are derived from cholesterol and therefore can readily diffuse through the lipid bilayer of the cell membrane to reach the intracellular receptor (**[Figure ... | {
"Header 1": "**17.2 | Hormones**",
"Header 3": "**Pathways Involving Intracellular Hormone Receptors**",
"token_count": 341,
"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
} |
Hydrophilic, or water-soluble, hormones are unable to diffuse through the lipid bilayer of the cell membrane and must therefore pass on their message to a receptor located at the surface of the cell. Except for thyroid hormones, which are lipid-soluble, all amino acid–derived hormones bind to cell membrane receptors th... | {
"Header 1": "**17.2 | Hormones**",
"Header 3": "**Pathways Involving Cell Membrane Hormone Receptors**",
"token_count": 1050,
"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
} |
You will recall that target cells must have receptors specific to a given hormone if that hormone is to trigger a response. But several other factors influence the target cell response. For example, the presence of a significant level of a hormone circulating in the bloodstream can cause its target cells to decrease th... | {
"Header 1": "**17.2 | Hormones**",
"Header 3": "**Factors Affecting Target Cell Response**",
"token_count": 361,
"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
} |
The contribution of feedback loops to homeostasis will only be briefly reviewed here. Positive feedback loops are characterized by the release of additional hormone in response to an original hormone release. The release of oxytocin during childbirth is a positive feedback loop. The initial release of oxytocin begins t... | {
"Header 1": "**17.2 | Hormones**",
"Header 3": "**Role of Feedback Loops**",
"token_count": 340,
"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
} |
Reflexes triggered by both chemical and neural stimuli control endocrine activity. These reflexes may be simple, involving only one hormone response, or they may be more complex and involve many hormones, as is the case with the hypothalamic control of various anterior pituitary–controlled hormones.
Humoral stimuli a... | {
"Header 1": "**17.2 | Hormones**",
"Header 3": "**Role of Endocrine Gland Stimuli**",
"token_count": 416,
"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
} |
You may have heard news reports about the effects of a chemical called bisphenol A (BPA) in various types of food packaging. BPA is used in the manufacturing of hard plastics and epoxy resins. Common food-related items that may contain BPA include the lining of aluminum cans, plastic food-storage containers, drinking c... | {
"Header 1": "**17.2 | Hormones**",
"Header 2": "**Bisphenol A and Endocrine Disruption**",
"token_count": 577,
"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
} |
By the end of this section, you will be able to:
- Explain the interrelationships of the anatomy and functions of the hypothalamus and the posterior and anterior lobes of the pituitary gland
- Identify the two hormones released from the posterior pituitary, their target cells, and their principal actions
- Identify t... | {
"Header 1": "**17.3 | The Pituitary Gland and Hypothalamus**",
"token_count": 862,
"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
} |
The posterior pituitary is actually an extension of the neurons of the paraventricular and supraoptic nuclei of the hypothalamus. The cell bodies of these regions rest in the hypothalamus, but their axons descend as the hypothalamic–hypophyseal tract within the infundibulum, and end in axon terminals that comprise the ... | {
"Header 1": "**17.3 | The Pituitary Gland and Hypothalamus**",
"Header 3": "**Posterior Pituitary**",
"token_count": 258,
"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
} |
When fetal development is complete, the peptide-derived hormone **oxytocin** (tocia- = "childbirth") stimulates uterine contractions and dilation of the cervix. Throughout most of pregnancy, oxytocin hormone receptors are not expressed at high levels in the uterus. Toward the end of pregnancy, the synthesis of oxytocin... | {
"Header 1": "**17.3 | The Pituitary Gland and Hypothalamus**",
"Header 3": "**Oxytocin**",
"token_count": 352,
"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
} |
The solute concentration of the blood, or blood osmolarity, may change in response to the consumption of certain foods and fluids, as well as in response to disease, injury, medications, or other factors. Blood osmolarity is constantly monitored by **osmoreceptors**—specialized cells within the hypothalamus that are pa... | {
"Header 1": "**17.3 | The Pituitary Gland and Hypothalamus**",
"Header 3": "**Antidiuretic Hormone (ADH)**",
"token_count": 447,
"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
} |
The anterior pituitary originates from the digestive tract in the embryo and migrates toward the brain during fetal development. There are three regions: the pars distalis is the most anterior, the pars intermedia is adjacent to the posterior pituitary, and the pars tuberalis is a slender "tube" that wraps the infundib... | {
"Header 1": "**17.3 | The Pituitary Gland and Hypothalamus**",
"Header 3": "**Anterior Pituitary**",
"token_count": 596,
"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
} |
The endocrine system regulates the growth of the human body, protein synthesis, and cellular replication. A major hormone involved in this process is **growth hormone (GH)**, also called somatotropin—a protein hormone produced and secreted by the anterior pituitary gland. Its primary function is anabolic; it promotes p... | {
"Header 1": "**17.3 | The Pituitary Gland and Hypothalamus**",
"Header 3": "**Growth Hormone**",
"token_count": 557,
"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
} |
The endocrine glands secrete a variety of hormones that control the development and regulation of the reproductive system (these glands include the anterior pituitary, the adrenal cortex, and the gonads—the testes in males and the ovaries in females). Much of the development of the reproductive system occurs during pub... | {
"Header 1": "**17.3 | The Pituitary Gland and Hypothalamus**",
"Header 3": "**Follicle-Stimulating Hormone and Luteinizing Hormone**",
"token_count": 308,
"source_pdf": "datasets/websources/Med_v1/med_textbook/AnatomyAndPhysiology-LR.pdf"
} |
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