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لا تلهيَنَّكم المُتابَعة عن الثّوابت.. الصّلاة في وقتها الأذكار، وِرد القرآن، بِرّ الأهل، القيام، الدّعاء، ترك الفراغ، تجديد الإيمان، خبيئة السِّر، تابع وتأمَّل، وتعَلّم، وانتبه، واستَفِد، واستزِد، ثمّ زِد، والزم ثغرك، كلّ دقيقة عند المؤمن غالية، كلّ دقيقةٍ عند الصّادق إعداد. أنت تُعَدّ من حَيث لا تنتبه.. - قصي العسيلي

L1 physio ⚠️نوتس زيادة عن الكتاب Cerebral blood flow(CBF)= 750-900ml/min (15% of cardiac output) 🔥Regulation of cerebral blood flow: 1- sympathetic nervous system: ⬆️mean Arterial blood pressure--------> constriction 2- CO2 & H ion ⚠️CO2 indirectly affect cerebral blood flow CO2-------->⬆️H ion ------> acidity ------> ⬆️blood flow up to Twice normal 3-Oxygen supply ⚠️oxygen deficiency is a *major* regulator of CBF ⬇️O2 supply ---->immediately VD 4- brain activity ⬆️cerebral activity---->⬆️CBF ⬆️ Regional activity----->⬆️blood flow to this region 5-auto regulation 60-140 mmHg the range without change in CBF In hypertension patient may up to 180mmHg ⚠️auto regulation by: a-Neurogenic effect(in hypotension---->⬆️alpha receptor expression ) b-Metabolic( hypotension---->VC ,, hypertension---->VD) c-Myogenic d-Endothelial (hypertension--->⬆️nitric oxide--->VD) ⚠️ Cushing Reflex Due to Generalized VC in the body-----> ⬆️ICP ( to keep cerebral blood vessels open&patenet) ⚠️ ⬆️ intracranial pressure(ICP)---->movement of CSF ---->⬇️ICP 🔥cerebral microcirculation 1-⬆️number of capillaries Due to---->⬆️metabolic needs Gray mater has capillaries 4time more than white mater 2- capillaries are less leaky 3- small arterioles thickening in hypertension patients 🔥cerebral stroke Neurological deficit caused by impaired perfusion for more than24h. Types: 1-ischemic(85%) Arterial occlusion--->⬇️blood& oxygen 2- Hemorrhagic(15%) bleeding Pathophysiology: Cell death in brain occur in 5 minutes without oxygen ⬇️oxygen---> anaerobic metabolism which lead to A- ⬇️ATP-->🚫 Na,K pumb--->2ry inflammation B- ⬆️lactic acid--->release of inflammatory mediators(TNF,ILB)--> inflammation Both of them lead to apoptosis& necrosis 🔥CSF Occupy 150ml of crebral cavity ⚠️CSF formed by choroid plexus& drain by arachnoidal villi to sagittal venous sinus Formation: Epithelial cell layer cover the choroid plexus change Na&Cl by H ion& HCO3 respectively with the blood Then---> Na,K,CL get outside to cerebral cavity by simple diffusion---> active transport of Na out side inchange of K inside epithelium----> Na pull Cl ions ---> water move by osmosis ✨️CSF pressure in horizontal position=10mmHg 🔥 Regulation of CSF pressure 1- rate of formation & drainage Blockage ⬆️pressure such in(brain tumor , hemorrhage or infection) 2- Gravity Recumbent--> equal in brain&spinal cord Standing--->⬇️brain, ⬆️spinal cord 3- crebral blood volume Affected by systematic venous pressure not Arterial pressure ✨️⬆️Intracranial pressure--->( headache_ projectile vomiting_ papilledema) 🔥BBB highly permeable to (Water,CO2, O2, alcohol, anesthetics) slightly permeable (Na, K, cl) totally impermeable (Plasma proteins, non-lipid soluble) 🔥 perivascular spaces Between pia mater& vessels of the brain ⚠️ is a specialized lymphatic system for the brain 🔥Brain Edema Causes (⬆️ capillary pressure, damage to capillary wall, serious trauma to the head"concussion" ) Two vicious circles: 1- edema compress vessels--->⬇️blood flow"ischemia"--->⬆️VD--->⬆️pressure-->⬆️edema 2-⬇️blood flow -->⬇️oxygen --->⬆️ permeability---> ⬆️ edema Treatment: Infuse IV osmotic substance (mannitol solution) - من احد زمايلنا. #cns_physio #cns_N

Lec 1 patho 💫Pyknosis= shrink eccentric nucleus 💫Karyorrhexis نواة مفتتة 💫Karyolysis نواة متحللة ذائبة 🌟Nissl body لونه ازرق لما الخلية تفقده تبق لونها احمر red neuron 🌟Acute neuronal necrosis : eosinophilic 🌟Nerve cell atrophy: basophilic ❤️CMV= cytomegalovirus 🌟Viral infections = HSV=nucleus RABIES = cytoplasm CMV =both Lowy body = Parkinsonism neurofibrillary tangles (*not angles) = Alzheimer's 💦NB ,slide: 9, data: ICP سيبك منها 🌟Gliosis in brain = fibrosis 🌟Rosenthal fibers= gliosis + tumor (pilocytic astrocytoma) 🌟Inflammation in brain= rod cells 🌟Histiocytes بتشيل axon myelin debris بعد ما يتكسر 🌟Schwann cells بتعمل myelin 💦Axonal swelling & spheroid سيبك منها 🌟Cardinal signs = projectile vomiting+ Headache+papilledema 💦Normal pressure hydrocephalus سيبك منها 🌟Cytogenic *not cytotoxic ❤️SOL =space occupying lesion 💦Clinicopathological features of brain edema سيبك منها أو أقرأها 💦Sites of intracerebral hemorrhage سيبك منها خالص 🌟Manifestation of ⬆️ ICP = cardinal signs 🌟Anoxic change of neuron = red neuron 💦NB slide 4 data 2 سيبك منها 🌟Meningeal irritating >>>> neck stiffness 🌟Xray مفيدة في حالة intracerebral hemorrhage لكن في حالة subarachnoid مش مفيدة علشان الدم بيسيح في ال csf لو النزيف فتح على ventricles ممكن تلاقي دم في csf 💦Berry's aneurysm سيبك من الحتة الأخيرة فيها ، كفاية تعرف أنه saccular & fibrous layer 🌟🌟Ischemic hypoxia مهمة 💦Global ischemia سيبك منها 💦Gross & microscopic slide 13 data 2 سيبك منها أو أقرأها قراءة من زميلتنا د يوستينا يوحنا. #cns_patho #cns_N

تجميعة كل nerve supply بتاع ال muscles الي خدناها لغاية الآن من زميلنا بارك الله فيه. *All muscles face supplied by trigeminal except small area of skin covering margin of mandible and parotid gland by ❤️ great auricular nerve c23 ❤️ Sternocleidomastoid+ trapezius 👉 supplied by spinal part if accessory nerve ♥️anterior belly of digastric + myelohyoid 👉 supplied by myelohyoid nerve branch of inferior alveolar nerve ♥️ stylohyoid + posterior digastric 👉 facial nerve ♥️ platysma 👉 cervical branch of facial nerve ❤️ buccinator + orbicularis Oris 👉 buccal branch of facial nerve 💞oculi M supplied by zygomatic branch of facial nerve 🥰 Occipitofrontalis 👉 Frontal belly 👉 temporal branch of facial nerve Occipital belly 👉 posterior auricular nerve *🥰Geniohyoid + thyrohyoid 👉C1 via hypoglossal nerve ❤️Sternothyroid+ Omo hyoid 👉 C1_3 ansa cervicalis *sterno thyroid👉 C2 and 3 ansa cervicalis ❤️ thyrohyoid + genio hyoid 👉C1 via hypoglossal nerve 😔* anterior scalene 👉cervical spinal nerve c 4 6 Middle 👉 anterior Rami of cervical spinal nerves Posterior 👉 anterior Rami of cervical nerve C 7 8 ♥️All muscles of mastication supplied by mandibular nerve because they derived from 1st pharyngeal arch ❤️ hypoglossal nerve supply all intrinsic and extrinsic muscles of tongue except ( palatoglossuss)👉 supplied by vagus fibers in pharyngeal plexus ❤️All muscles of the palate supplied by vagus nerve of the pharyngeal.plexus except ( tensor palati ) 👉bg the mandibular nerve division of trigeminal nerve ( via the nerve of medial pterygoid) Tensor tympani also supplied by it ♥️All extraocular muscles supplied by oculomotor nerve Except * lateral rectus 👉abducent nerve * supervisor oblique 👉trochlear nervel ♥️Ciliary muscle + sphincter pipilae 👉 parasympathetic from oculomotor nerve * dilator pupile 👉 sympathetic from superior cervical ganglion 😘All muscles of pharynx supplied by vagus nerve of pharyngeal plexus except (stylopharyngeus)👉 supplied directly by glossopharyngeal nerve ♥️Stylohyoid 👉 preparotid branch of facial nerve 💞all intrinsic muscles of the larynx are supplied be recurrent laryngeal.nerve except ( cricothyroid)👉 supplied by external laryngeal branch of superior laryngeal branch of vagus ♥️motor root join Mandibular _ muscles of mastication Temporalis Masseter Medial pterygoid Lateral pterygoid _ tensor palati Tensor tympani _ myelohyoid Anterior belly of digastric 🤍Medial pterygoid branch of trink of mandibular never supply 👉medial pterygoid+ tensor palati + tensor tympanin 💙 Orbicularis oculi 👉 supplied by buccal branch of facial nerve ♥️All muscles of Infrahyoid 👉 supplied by cervical plexus C 1 3 ( ansa cervicalis) Except thyrohyoid 👉 supplied by C1 via hypoglossus nerve 💙 Scalene 👉 cervical nerve #cns_anatomy #cns_N

دى اسكيما لحفظ ال action بتاع ال extraoccular muscles of the eye. من دكتور وهدان. ملحوظة : الفيديو ع ٢ فاللى حاسه سريع يقلل السرعة.

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الدكتورة عدلتها. Nasal field وليس temporal #cns_anatomy #cns_E

المحاضرة الأولى فارما. #cns_pharma #cns_G