40's Hacks 💀✨

✨ optical system of the eye✨

⭐️ Refractive index always is > 1 ⭐️🚨Lens refractive power (RP) proportionate inversely with. Focal length ( distance between image and nodal point) ⭐️Focal length in normal resting eye = ,015 meter ⭐️ Lens RP = 67 diopters ⭐️ refractive media of the eye: ✨🚨Cornea : RI = 1,38 , RP = 45 diopters •(cornea is the main refractive media) due to :↑RI compared to air +↑curvature ✨AH ✨ Lens , RP = 20 diopters ✨VH

Accomodation

⭐️ ability of lens to↑RP to focus near objects on retina ⭐️↑curvature of ant. Surface of lens by Ciliary ms Contraction ,Lax SL >> lens more spherical.

Power of accomodation

⭐️🚨RP of lens with max. Accomodation (near) - RP of lens resting eye ( far ) ⭐️RP of lens resting eye ( far vision >6 meters) = 20 diopters The change is marked with accomodation by rising. ⭐️🚨↓ with age ⭐️power of accomodation at : 10 Y >> 14 diopters ( RP of lens in accomodation = 34) 20 Y >>10 diopters 🚨 70 Y >> 0 diopters ( lost ability for accomodation >> can't see near objects)

Range of accomodation

⭐️ distance between far point - near point ⭐️far point : farthest that eye can see clearly WITHOUT accomodation ( 6 meters) ⭐️ Near point: nearest that eye can see clearly with max accomodation ( 10 cm young adults , 80 cm at 60 Y. ) ⭐️🚨 Range↓with age ⭐️🚨 Near point distance↑with age ( recedes away from eye) ( Range in young adults= 5,9 meters, range in 60 Y. = 5,2 Meters)

Effect of age

⭐️🚨 accomodation power↓ with age ⭐️🚨 Range↓with age ⭐️🚨 Near point distance↑with age

Presbyopia

⭐️ accomodation power↓with age ⭐️🚨 Near point recedes away from eye ⭐️↓range of accomodation ⭐️🚨 Far point not changed ⭐️ttt: convex lens or bifocal glasses

Errors of refraction

⭐️ emmetropic eye : normal eye >> rays collected in one point in the retina • near vision by accomodation • far vision without accomodation ⭐️ Anisometropia : unequal RP in both eyes >> ttt by different appropriate RP for each eye. ⭐️ Ametropia>> errors if refraction:

✨ Myopia ( short sightedness)

✨ Rays are focused in front of retina ✨🚨↑Curvature lens / cornea >>↑RP ✨see near (not impaired near vision), can't see far 🚨Near point closer (<10 cm) 🚨Far point < 6 meters 🚨 accomodation worsening the condition.

Hypermetropia ( far sightedness)

✨ Rays are focused behind retina ✨🚨↓ ↓ Curvature of cornea mainly >>↓ RP ✨Lens continuously accommodated >> see far by accomodation, near objects need being slightly farther + accomodation ( Impaired near vision) 🚨Near point farther (>10 cm) 🚨Far point < virtual ( continuous accomodation وأهم شرط في التعريف ميبقاش في accomodation نهائى عشان اقول عليها Far point) 🚨 accomodation is a need ✨continuous accomodation causing ciliary ms fatigue>> pain >> headache

Astigmatism

✨light rays not focused to a single point ( > 1 focus point) ✨ irregular curvature of cornea in different planes ( max curvature vertical = with the rule) or ( max curvature horizontal= against the rule) ✨🚨 blurred vision, point is seen as a line, line seen with halos on sides

glasses 🕶️

⭐️ bifocal lens >> presbyopia ⭐️ Concave ( divergent) >> myopia ⭐️ Convex ( convergent ) lens >> hypermetropia , presbyopia ⭐️🚨 Cylindrical lens >> astigmatism ( 🚨note : • curvature of the lens parallel to the plane to be corrected • axis of the lens is perpendicular to the plane )

Retina

⭐️Formed by 10 layers histologically, back to histology lec. For details 🙏🏻 ⭐️ Outer pigmented epith. : ✨ Blood retina barrier ✨ Light absorption , vit.A storage ⭐️regional variation: 🎀 Macula lutea: ✨🚨Opposite the post. Eye pole ✨ Lateral ( temporal) to optic disc 🎀 Fovea centeralis ✨🚨 formed of cons only , one to one connection (no convergence) ✨ Highest visual acuity ✨ Highly developed pigmented epith. 🎀 Optic disc ✨area that axons of ganglion cells leave the retina ✨ medially , above post. eye lobe ✨🚨 Physiological blind spot ( no photoreceptors) , normally ignored as both aren't on corresponding points to each other in both retina

✨ physiology eye 2✨

Lens

⭐️ Elastic Biconvex transparent surrounded by capsule, post surface is more convex than ant. surface ⭐️ New fibers ( young) forming cortex ( outer) , older fibers forming nucleus ( inner) ⭐️ Avascular >> mainly anaerobic metabolism ⭐️🚨 Need glutathione ( antioxidant) in aerobic metabolism for protection from harmful O2 free radicals (H2O2) ⭐️🚨 important for Accomodation at near vision ( ant surface ↑curvature ) ⭐️ Transparency: ✨🚨 NO nerve supply ✨🚨 Lens components mostly the same refractive index ✨ Avascular , regular densely packed fibers

Cataract

⭐️ Degeneration of lens affecting transparency ⭐️ Causes : ✨ senile: ↓glutathione >>↑ions,H2O ✨ Denaturation of lens proteins with deposition of other components (D.M micro angiopathy - retinopathy) ⭐️C/P : double vision single eye , poor vision, fading.. ⭐️ttt: surgery.

🚨Near reflex ( accomodation)

⭐️🚨 Stimulation : seeing near object ⭐️ Receptor : photoreceptors (rods, cons) ⭐️🚨afferent : optic N. ,visual pathway + Occipito tectal tract ⭐️ 🚨Center at sup. colliculus in mid brain ⭐️🚨Efferent : EWN ( oculomotor N.) ⭐️🚨 Reflex: ✨ parasympathetic : •involuntary accomodation (ciliary ms. Contraction) , •bilateral miosis (constrictor pupillae ) >>prevent entry of excess light,↑ depth of Vision,prevent aberrations. ✨ Voluntary : convergence both eyes by medial recti. >> Prevent diplopia ⭐️🚨Atropine results in loss of accomodation & miosis ( parasympathetic components of reflex) >> preserved convergence

Choroid

⭐️ Vascular ⭐️ Rich in melanin pigment >> light absorption

Ciliary body

⭐️formed by : ciliary process, suspensory ligament (SL), ciliary ms ✨process >> give attachment to ciliary ms ✨🚨 ms >> responsible for Accomodation ✨ process >> secretion of AH

Iris

⭐️🚨Regulation of light to the eye by control pupil size ( miosis, Mydriasis) ⭐️ Prevent spherical & chromatic aberrations ⭐️🚨 Control depth of focus

Pupillary light reflex (PLR)

⭐️ Protective reflex from excess light ⭐️🚨 Stimulation : seeing light by one eye ⭐️ Receptor : photoreceptors (rods, cons) ⭐️🚨afferent : optic N , optic tract WITHOUT relay on LGB( Thalamus) ⭐️ 🚨Center at Pretectal nucleus in mid brain ⭐️🚨Efferent : EWN ( oculomotor N.) on both sides "parasympathetic" ⭐️🚨 Reflex: bilateral miosis by contraction of constrictor pupillae ms.

Argyll Robertson pupil🚨

⭐️ Neurosyphilis results in lesion of Pretectal nucleus >> center of PLR ⭐️🚨 PLR is lost >> no miosis in exposure to light ⭐️🚨Near reflex preserved >>miosis with accomodation 🌬 Flashback: Neurosyphilis lesion of DRG >>Tabes dorsalis>>loss of immediate pain + all sensations Ibsilateral, permanent irritation & burning pain.

Reverse of Argyll Robertson pupil

⭐️ Damage of occipito tectal tract >> lost accomodation, intact PLR ⭐️🚨Miosis in light , no accomodation

Miosis VS Mydriasis

مهم عالآخر بس اكيد مش هتكبه هو هو تاني فابقى احفظه زي اسمك من الكتاب وركز اكتر حاجة على : ⭐️ Miosis : ✨ In cervical Lesions ( horner's syndrome) ( lesion above T1 ) >> lost sympathetic ✨ Pontine hemorrhage ✨ Morphin Poisoning ✨🚨 3rd stage anaesthesia ✨ Sudden fall in IOP ⭐️ Mydriasis : ✨lesion of oculomotor or EWN ✨ Atropine, cocaine , hyperthyroidism (↑receptor sensitivity to catecholamines) ✨🚨 2nd , 4th stage anaesthesia مش عارفة ممكن الدكتور يسأل فيها ولا لا بس اهو نعرفها وخلاص : •2nd stage anaesthesia >> dilated reactive ( respond to PLR) •4th stage anaesthesia (Death) >>fixed dilatation >> No response to PLR وهي دي شرح كلمة staging of anaesthesia هنا ، نفتكر اننا شفناها في 2 reflexes بعيدًا عن ميكانيزم كل واحد والريسبونس بتاعه بقا : PLR, corneal reflex. ---- Retina

✨Physiology of eye 1 ✨

ملاحظات وتأكيدات د.وجدي اللي بالمناسبة بعد سؤال كذا حد من زمايلنا الأكبر مننا كلهم تقريباً أكدوا أنه اللي بيركز عليه في الشرح هو اللي بيجيبه يلا بـاسم الله :

Aqueous humour ( AH)

⭐️ watery fluid ⭐️ Constant volume (,3ml) ⭐️ Complete renew each 100 min. ⭐️rate of formation & drainage : 3 ul/ min ⭐️🚨mech. Of formation : 1-Active secretion of Na 2- passive transport ( according to electric gradient) of CL, HCO3 (HCO3 keeping AH alkaline , depend on carbonic anhydrase) 3- water absorption by osmosis 4- nutrients & O2 by active transport & facilitated diffusion ⭐️Circulation : Inflow :Ciliary processes inner non pigmented epith >> post. chambre >> pupil >> ant. chambre 🚨Drainage : irido corneal angle (ICA) >> Trabecular meshwork of fontana >> schlemm's canal >> episcleral veins ⭐️ functions: ✨🚨 Maintain IOP " both keep spherical shape of eyeball" ✨Nutrition ,drain metabolites , refractive media

⭐️IOP (Intraocular pressure)

⭐️🚨Depend on AH , regulated by AH DRAINAGE (defect in schlemm's canal or Trabecular meshwork) ⭐️🚨Normal value >> 12:20 mmHg ⭐️ Show diurnal variation ⭐️🚨 Measured by : Tonometry ⭐️ Important for normal focusing of eye ( accomodation) >> ↑IOP turns lens flat >> loss of near vision " as in glaucoma "

⭐️🚨 Glaucoma

⭐️ تعريفها مهم Optic nerve damage due to ↑IOP ✅ ↑IOP ❌ ⭐️ Caused by↓AH Drainage ⭐️general C/P : ✨ failure of accomodation (ارجع فوق كنت بقول تأثير IOP) ✨ Mydriasis ( mechanical not autonomic ) >> iris thickening >> more closure of ICA >> worsening the condition ✨ Optic N. Damage >> loss of vision . ✨🚨 Triad of glaucoma: ↑IOP , optic N. degeneration, blindness ⭐️ 2 major types: 🎀 Primary open angle = wide angle glaucoma ✨most common, chronic, caused by slow obstruction of trabecular meshwork (🚨 ICA is opened & wide) ✨ Gradual painless loss of vision and blindness ( thief of sight ) >> characteristic tubular vision 🎀 Closed angle : ✨ Acute, emergency condition, closure of ICA >> sudden↑IOP ✨ Severe headache , Blindness within 48-72h. ⭐️ttt of glaucoma: ✨ Medical by : 🌬 Carbonic anhydrase inhibitor (Diamox) >> block HCO3 synthesis >> ↓AH formation >>↓IOP 🌬 Parasympathomimetic (pilocarpine )>> miosis of iris ✨ Surgery

⭐️ vitreous humor (VH)

✨ Gelatinous , constant from birth till death ✨ Shock absorber >> protect retina ✨ Refractive media.

⭐️ Cornea

✨🚨Main refractive media (↑↑refractive power) ✨ Regular curvature+ tear film uniformoing the surface>> sharp retinal image ✨ Protect inner structure with sclera ✨ Protect retina from UV with lens ⭐️ Closure of eyelids protect cornea >> blinking or blepharospasm ( reflex immobilization continuos eye closure in case of eye injury) ⭐️🚨 Corneal reflex ( visual spinal reflex) كل تفاصيله مهمة ومشهور في الامتحانات وأسئلته بتبقى لعب في الكلمات فنركز🙏🏻 ⭐️🚨 Stimulation : touching cornea of 1 eye ⭐️🚨 Reflex: closure both eyes ⭐️ Receptor : unmyelinated FNE ⭐️🚨afferent : opthalmic N. ( Trigeminal) ⭐️🚨Efferent : facial n. ⭐️ Center at sup. colliculus in mid brain ✨ Reflex used for testing integrity 5th & 7th n. ⭐️🚨 Corneal transparency ✨ Avascular , regular uniform densely backed collagen lamellae , relative corneal dehydration, unmyelinated nerve endings ⭐️ Vitamins : ✨↓B2 (riboflavin) >> corneal vascularization ✨↓vit.A >> xerophthalmia ( dry eye)

⭐️ sclera

⭐️🚨 Not of refractive media ⭐️ Give attachment to Extraocular ms.

⭐️ 🚨Refractive media مهمين الدكتور أكد عليهم بمعدل 10 مرات كل م تيجي سيرتهم

4 ✨ Cornea ( main refractive media) ✨AH ✨ Lens ✨VH

✨ Visual pathway | anatomy ✨

ملاحظات وتأكيدات د.مدحت. ⭐️ Receptor: Photoreceptor ( rods & cons) ⭐️ 1st order neurone : bipolar cells ⭐️ 2nd order neurone : ganglion cells ⭐️3rd order neurone : fibers of LGB (thalamus) ⭐️ Center: visual cortex ( primary 17 ), association (18,19) ----------- ⭐️ Rods : at periphery of retina, for dim ( scotopic vision) ⭐️ Cons: concentrated in fovea centeralis, effective in day light , responsible for photopic ,color vision, 🚨🚨 ⭐️ Optic nerve: formed by axons of ganglion cells , pass through optic canal to reach optic chiasma >> continue as optic tract. ⭐️ Blind spots : area with No Photoreceptors ( neither rods nor cons) >> at optic disc ( site where optic nerve connected to retina) ⭐️ Macula lutea: lateral to optic disc, with fovea centeralis within it ⭐️fovea centeralis ( foveola ) :at the center of macula, formed by Cons only , for accurate, detailed, colored vision . ⭐️ Visual concept of retina : ✨ Nasal retinal fibers: temporal (lat.) field vision ✨ Temporal retinal fibers: nasal (medial) field vision ✨sup. retinal quadrants: lower Field vision ✨Inf.. retinal quadrants: upper Field vision ⭐️ Pathway: ✨ Photoreceptors >> bipolar cells >>ganglion cells " forming optic N ." >> Optic chiasma¹ >> optic tract ² >>LGB ( thalamus )>> optic radiation >> visual center. ⭐️ ¹ nasal retinal fibers undergo decussation at the point of optic chiasma , temporal fibers without crossing 🚨 Optic chiasma is the point of decussation of nasal fibers ⭐️🚨🚨Optic tract on one side with : ibsilateral temporal retina fibers + contralateral nasal retinal fibers ⭐️ Optic radiation = geniculo calcarine tract >> LGB axons projecting to primary visual cortex , of 2 routses : ✨ Upper optic radiation >> fibers from sup 1/2 of retina >> passing in parietal lobe to reach visual cortex at Occipital lobe ✨lower optic radiation ( Meyer's sloop) >> fibers from inf 1/2 of retina >> passing in temporal lobe to reach visual cortex at Occipital lobe ⭐️Note : Optic tract fibers to : ✨ LBG >> Vision ( visual pathway) ✨ Sup. colliculus (mid brain ) >> control move. extraocular ms. ✨ Pretectal nucleus ( mid brain) >> control pupil light reflex ✨ Suprachiasmatic nucleus ( hypothalamus) >> circadian rhythm ⭐️ Visual cortex >> Occipital lobe, medially ✨ Primary ( striate ) ( 17) : • receive from LGB • perception (color, shape, motion..) مجرد هيشوف ✨ Association ( extra striate ) (18,19) • details , identification, recognition of shape, color, motion

🚨 Lesions

لو حد محتاج يفهمهم أحسن فالڤيديو ده تحفة بصراحة ⭐️ detached retina : layer of pigmented epith. away from photoreceptor cells ⭐️ Visual agnosia : lesion of area 18,19 ( inability to recognize by vision ) ⭐️ Lesion at optic N. >> Complete blindness of that same eye ⭐️ Unilateral lesion of optic chiasma temporal fibers ( anrusym beside chiasma) >> ibsilateral nasal hemianopia ⭐️ Optic chiasma compression by pituitary adenoma ( compression on nasal retinal fibers )>> bitemporal hemianopia ⭐️section of Lt. optic tract (whole optic radiation) >> Rt homonymous hemianopia ⭐️ Damage of Lt Meyer's loop ( lower optic radiation ) >> Rt homonymous upper quadrantanopia ⭐️Damage of Lt parietal lobe (Lt upper optic radiation) >> Rt homonymous lower quadrantanopia ⭐️PCA stroke ( visual cortex lesion ) >> contralateral¹ homonymous hemianopia with macular sparing² ¹ if Lt cortex injuried >> rt field both eyes is lost ² ( Macula is spared as it has collateral blood supply from MCA )

pharma -sedative &Hypnotic المقارنة بين ال benzodiazepines و barbiturates مهمة واخر كام دوا الدكتورة قالت عليهم أسئلة

✨Histology of the eye✨

⭐️layer formed by 3 layers : outer fibrous, middle vascular, inner neural ⭐️outer fibrous by : ✨ Cornea : regular arrangement of collagen lamellae ✨ Sclera : irregular arrangement of collagen

⭐️ Cornea : 5 Layers

3 cellular, 2 acellular layers in between

⭐️ Epithelial : Stratified squamous non Keratinized epith. with microvilli embedded in tear film ⭐️ Bowman's membrane ( acellular) : collagen fibers in ground substance 🚨 Protective layer against trauma or bacterial invasion, forming scarring if injuried causing corneal opacity ⭐️ Substantia propria ( stroma ) : parallel collagen layers with fibroblasts ( keratocytes) in between embedded in glycoprotein & chondroitin sulfate ⭐️ Descemet's membrane : acellular, homogenous layer, fine collagen filaments embedded in amorphous ground substance ⭐️ Corneal endothelium : Simple squamous endothelium, rich in mitochondria & microvilli 🚨 Maintain Descemet's layer 🚨 Endothelium continuously withdraw water ( keeping eye relatively dehydrated) ⭐️ Corneal transparency : •avascular (nutrition from aqueous humor, scleral vessels at corneoscleral junction) •regular collagen • same retractive index of collagen & ground substance • continuous water withdrawal by Descemet's endothelium

⭐️ Inner neural layer ( retina)

⭐️developed from optic cup (diencephalon invagination ) that giving rise to optic vesicle ⭐️ 10 layers histologically 1-🎀 Pigmented epith. : • columnar cells, basal invagination, lat. junction complex , apical microvilli Containing Melanin pigment with cylinderical sheath envelop tips of Photoreceptors • absorption of light , vit.A storage & release, outer rods phagocytosis 2-🎀 Rods & cons : modified dendrites of bipolar Photoreceptor cells 🌬 🚨Rods : 2 segments connected by cilium •The outer segment contains : rhodopsin ( visual purple) • sensitive to dim light • outer segment turnovers , replaced by inner segment • inner segment: regeneration of outer segment, axon of rods end in rod spherule ( knob ) 🌬🚨Cons : outer segment is conical in shape, contains iodopsin ( sensitive to bright light) , NO turnover , end in cone pedicle (expansions) NOT at knob 3-🎀 outer limiting membrane: line of cellular junction between muller cells & Photoreceptors (🚨not true membrane) 4-🎀 outer nuclear layer : cell bodies of Photoreceptors ( rods&cons) 5-🎀 outer plexiform layer : Synapses between Photoreceptors & bipolar, horizontal cells 6-🎀 inner nuclear layer : cell bodies bipolar, amacrine , horizontal, muller cells 7-🎀 inner plexiform layer : Synapses of bipolar, amacrine with ganglion cells 8-🎀 ganglion cell layer : single layer of ganglion cells , axons of ganglion cells form : 9-🎀 nerve fiber layer : unmyelinated 🚨axons of ganglion cells 10-🎀inner limiting membrane:🚨True membrane, Terminal processes of muller cells resting in vitreous body ⭐️Cells notes: ✨ dendrites of Photoreceptors: rods& cons ✨Axons of Photoreceptors : Synapse with dendrites of bipolar, horizontal at outer plexiform ✨ Horizontal: with horizontal process synapse with Photoreceptor ( outer plexiform) ✨bipolar : •dendrites Synapses with Photoreceptor (outer plexiform ) •Axons synapse with ganglion cells ( inner plexiform) ✨ Amacrine: synapse with ganglion cells ( inner plexiform) ✨🚨 Muller cells : neuroglial cells ,extend from outer to inner limiting membranes ✨ Ganglion cells: •dendrites Synapses with bipolar & amacrine •Axons form nerve fiber layer >> give rise to optic N. ⭐️ Macula lutea : small yellow area at post. Of retina ⭐️🚨 Fovea centeralis : formed by cones only + only 1 bipoler + 1 ganglion cell >> high resolution, high detailed color vision ⭐️ Blood retinal barrier: ✨ Outermost barrier : tight junction between pigmented epith. Of retina >> protection against foreign bodies choroid capillaires to retina ✨ Innermost barrier : tight junction between endothelial cells of retinal blood capillaries

✨ tremors ✨ ⭐️ Static >> parkinsonism ( lesion B.G) ⭐️ Kinetic ( intentional ) >> cerebellar syndrome ✨ Gaits ✨ ⭐️ Stumping gait >> Tabes dorsalis ( lesion DRG ) ⭐️ Drunken ( wide based ) >> cerebellar syndrome ⭐️ Shuffling ( stepped) gait >> parkinsonism ودول ال Gaits و tremors اللي ممكن نتلغبط فيها في cerebellum, B.G , motor C.C

كل ال paralysis في المحاضرتين 9, 10

✨Meninges ✨ ⭐️مهم نعرف ال consistency بتاعة كل واحدة والأهم أن dura is firm not hard ⭐️ Subdural space : between arachnoid & dura ⭐️ Subarachnoid space : between pia & arachnoid, containes CSF ⭐️ Choroid plexus : tela choroidea+ ependyma ( Pia ) , lining ventricles >> Secretion of CSF ⭐️ Arachnoid process: arachnoid , in Dural venous sinuses >> CSF drainage ⭐️ attachment of tentorium cerebelli : ✨ Convex attached part : connected with >>post.clinoid process , sup petrosal sulcus, Transverse sulcus ✨ U free part connected with >> ant clinoid process ⭐️⭐️⭐️⭐️ Venous sinuses continuations : ✨Sup. Sagittal sinus >> Rt transverse sinus>> sigmoid>> IJV ✨ Straight sinus>> Lt transverse sinus>> Sigmoid>> IJV ✨ Dural venous sinuses connected with diploic veins by emissary veins. ⭐️ Interventricular duct of Monro >> between lat ventricles and 3rd ventricle ⭐️ Cerebral aqueduct of sylvius >> between 3rd and 4th ventricle ⭐️ Median magendie and lateral luschka >> 4th ventricle and Subarachnoid space ⭐️CSF : produced by choroid plexus (pia invaginations) in ventricles ✨ Circulation : Lat ventricles >> 3rd ventricle (by Monro) >> 4th ventricle (by sylvius) >> Subarachnoid space ( by magendie and luschka) ✨ Drainage by arachnoid villi mainly superior venous sinus by collections called arachnoid granulation ⭐️BBB : by endothelium + Continuous basement membrane+ foot of astrocytes ✨ Areas free of BBB ( circum ventricular organs) >> post pituitary, pineal gland, lamina terminalis , median eminence of hypothalamus, area postrema

Meninges anatomy + Notes

Physio 10 | Motor c.c

مكتوب كل المهم ومعلش عشان المكان مكفاش ف اخر جزئية بتاعة electric excitability of UMNL, LMNL ف اهو نحفظها وخلاص عشان لو جت الفكرة أنها كلها في UMNL طبيعية فمنين م نشوف كلمة normal نعرف اننا في UMNL وبردو faradic current ده عبارة عن تيار كهربي قوي شوية فالطبيعي لما انسان يتكهرب كهربا جامدة هيبقى عنده tetanic contraction فكدة احنا فاهمين أنها بردو كدة في الشخص اللي عنده UMNL نحفظ بقا بتاعة LMNL عشان ده المختلف Faradic current : no response Galvanic current : Ms. Degeneration Chronaxia :prolonged ACC > CCC (ACC higher than CCC)

✨Cerebellum , physiology ✨

✨Vestibular apparatus (VA) physiology ✨ تجميعة directions في المحاضرة : ⭐️ Stimulation of horizontal SCC >> move stereocilia towards utricle ( kinocilia ) ⭐️ Inhibition of horizontal SCC >> move stereocilia away from utricle ( kinocilia ) ⭐️ By the beginning of ANGULAR move. ( SCC) >> Endolymph against direction of move >> stimulate the VA at the side of move, inhibit the other >> sensation of rotation to the side of move. due to unequal discharge ⭐️ During ANGULAR move >> inertia overcome>> equal discharge>> no sensation of rotation ⭐️By the End of ANGULAR move. ( SCC) >> Endolymph towards direction of previous move >> stimulate the VA at the opposite side of move, inhibit the other >> sensation of counter rotation due to unequal discharge ⭐️ Rapid component of nystagmus >> with direction of move ⭐️Slow component of nystagmus >> against direction of move ⭐️ Vertigo >> sense of rotation against direction of endolymph during move. phases. ⭐️ Macula of utricle at horizontal plane ⭐️ Macula of saccule at vertical plane ⭐️ SCC : RT,LT horizontal at the same plane Ant Rt vertical at the same plane of post Lt vertical

Vestibular apparatus physiology + Noted

Ear

كل ملاحظات وتنبيهات د.عبدالحميد عليها هايلايت. ⭐️ناخد بالنا كويس من ovale , round window الاتنين موجودين ف medial wall of middle ear اللي هو هو lateral wall of internal ear ✨Ovale window: superior, covered with foot plate of stapes , related to vestibule of internal ear ✨Round window: inferior, covered with Secondary tympanic membrane, related to Cochlear duct ناخد بالنا •Primary tympanic membrane: separates middle ear from external auditory canal ( external ear) •secondary tympanic membrane: separates middle ear from internal ear (Cochlear duct) نركز على receptors مهمة لأقصى درجة • organ of corti >> hearing>> Cochlear duct>> Cochlear nerve • maculae>> linear acceleration of head >> utricle and saccule >> vestibular nerve • 3 cristae ampullaris >> Angular acceleration of head ( kinetic balance) >> 3 SCC >> vestibular nerve وباقي الملخص فيه المهم وفي تجميعتين nerves و directions نبه عليهم د.عبدالحميد في اخر الملخص نبقى نبص عليهم بردو .

Ear anatomy + Notes

Basal ganglia physiology