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Another important result of cephalocaudal growth and lateral folding is partial incorporation of the allantois into the body of the embryo antibiotic 802 order zyvox overnight delivery, where it forms the cloaca infection nursing interventions buy zyvox 600mg without prescription. By the fifth week infection 86 purchase zyvox 600 mg, the yolk sac duct antibiotics overdose buy 600 mg zyvox mastercard, allantois, and umbilical vessels are restricted to the umbilical region. It may function as a nutritive organ during the earliest stages of development prior to the establishment of blood vessels. It also contributes some of the first blood cells, although this role is very transitory. One of its main functions is to provide germ cells that reside in its posterior wall and later migrate to the gonads to form eggs and sperm (see Chapter 16). Hence, the endodermal germ layer initially forms the epithelial lining of the primitive gut and the intraembryonic portions of the allantois and vitelline duct. During further development, endoderm gives rise to: the epithelial lining of the respiratory tract; the parenchyma of the thyroid, parathyroids, liver, and pancreas (see Chapters 15 and 17); the reticular stroma of the tonsils and the thymus; the epithelial lining of the urinary bladder and the urethra (see Chapter 16); and the epithelial lining of the tympanic cavity and auditory tube (see Chapter 19). Pharyngeal gut Lung bud Pharyngeal pouches Stomodeum Stomach Liver Gallbladder Vitelline duct Allantois Pancreas Primary intestinal loop Hindgut Cloacal membrane Heart bulge Urinary bladder Cloaca A B Figure 6. Pharyngeal pouches, epithelial lining of the lung buds and trachea, liver, gallbladder, and pancreas. The urinary bladder is derived from the cloaca and, at this stage of development, is in open connection with the allantois. During evolution, these genes have been duplicated, such that humans have four copies arranged on four different chromosomes. Homology between Drosophila genes and those in each cluster of human genes is indicated by color. Genes with the same number, but positioned on different chromosomes, form a paralogous group. Expression of the genes is in a cranial-to-caudal direction from the 3 (expressed early) to the 5 (expressed later) end as indicated in the fly and mouse embryo diagrams. The same embryo taken from a different angle to demonstrate the size of the yolk sac. They code for transcription factors that activate cascades of genes regulating phenomena such as segmentation and axis formation. Many homeobox genes are collected into homeotic clusters, although other genes also contain the homeodomain. An important cluster of genes specifying the craniocaudal axis is the homeotic gene complex Hom-C in Drosophila. These genes, which contain the Antennapedia and Bithorax classes of homeotic genes, are organized on a single chromosome as a functional unit. Thus, each cluster lies on a separate chromosome, and the genes in each group are numbered 1 to 13. The pattern of expression of these genes, along with evidence from knockout experiments in which mice are created that lack one or more of these genes, supports the hypothesis that they play a role in cranial-to-caudal patterning of the derivatives of all three germ layers. During the second month, the external appearance of the embryo is changed by an increase in head size and formation of the limbs, face, ears, nose, and eyes. By the beginning of the fifth week, forelimbs and hindlimbs appear as paddle-shaped buds. The former are located dorsal to the pericardial swelling at the level of the fourth cervical to the first thoracic somites, which explains their innervation by the brachial plexus. Hindlimb buds appear slightly later just caudal to attachment of the umbilical stalk at the level of the lumbar and upper sacral somites. With further growth, the terminal portions of the buds flatten, and a circular constriction separates them from the proximal, more cylindrical segment. Soon, four radial grooves separating five slightly thicker areas appear on the distal portion of the buds, foreshadowing formation of the digits. The yolk sac, umbilical cord, and vessels in the chorionic plate of the placenta are clearly visible. As a result of organ formation, major features of body form are established (Table 6.
On the basis of very sketchy evidence antibiotic lotion for acne discount zyvox 600mg without prescription, the eighteenth century established a whole system of thought within which we are still operating today bacteria 1710 zyvox 600mg visa. In the thirty-six majestic volumes of his Natural History infection after miscarriage cheap zyvox 600mg otc, written between 1749 and 1788 (the year of his death) infection 7 months after hysterectomy purchase 600 mg zyvox otc, Georges Buffon brings up within a mass of still shaky documentation the two problems that were to inflame nineteenth-century thought: Our zoological nature and the immense antiquity of geological eras. The battle of evolution was already joined on several fronts, although those fronts were not to intersect before the midnineteenth century, when geology, com parative anatomy, and ethnography converged with sociology. Fifty more years had to pass before the logical order of living species found its counterpart in the chronological series of fossils, but from that moment onward, monkey and human were linked. The idea of a sequence of species came into existence, and although its logical consequence-the idea of our progressive emergence from among the primates-had not yet been clearly formulated, the image of the human being at the end of the eighteenth century was already strikingly close to that of our own. In 1764 Louis Dau benton published a paper on "the position of the occipital foramen in humans and in animals," the first publication by far to deal with the question of erect posture. In 1775 the German zoologist]ohann Friedrich Blumenbach propounded the anthro- 8 Technics and Language pology of races in De generis humani varietate nativa. Finally, in 1789 the English man Gilbert White published a work on "the regular gradation of man and animals. Humans were clearly seen in the variety of races and in their zoological proximity to the higher m ammals. Although the prescientific image of humans was a thing of the past, the dizzy descent into the depths of time had barely begun and paleontology was not yet born. The Nineteenth Century In 1800 the English naturalist John Frere published the results of an obser vation recorded in 1797 according to which chipped flint implements found in asso ciation with animal remains were to be attributed to the presence of humans in epochs far preceding the present. It was not until 1872 that John Evans drew atten tion to this observation, which at the time had gone unnoticed. To say that the nine teenth century merely reaped what the eighteenth had sown would be unjust. As an image it ideally complemented once and for all, and although the edifice of evolutionism has been extended in the Image o Ourselves f 9 that of the eighteenth century, when scholars had not yet dared to go beyond the view of the human as first cousin of the primates. A dense fabric of differences has sprung up around this central idea of our zoo logical origin. Paleontology, anthropology, prehistory, and evolutionism in all its forms served to justify attitudes whose roots lay elsewhere. Because the problem of our origins is common to religion and to natural science-because by demonstrat has tended to hold the center of the stage. Today it can hardly be doubted that the motivations involved lay outside the field of scientific inquiry. Je "monkey" issue the History o the "Prehuman" f Faced with facts for which any previous reference is lacking, our minds are helpless. It is true to say that human fossils were seen and interpreted with the eyes each period lent to its paleontologists. Since this is particularly striking in the case of the earliest finds, an attempt to review the main stages of interpretation in human paleontology may be of some value. Prehistorians before 1850 already had a con siderable array of theoretical elements at their disposal. They knew that the earth was extremely ancient and that human life itself went back a very long time and had been marked by major geological upheavals. Proofof the existence of European man in the age of the reindeer and the elephant had already been produced, excavations in alluvial deposits and caves havin our past was ready being taken for granted by some scholarsjP-France, Belgium, g begun toward 1810. We can go still further and say that not even Lamarckian evolutionism and the certainty of our proximity to the monkey were recently acquired; indeed one of the finest Neanderthalian skulls had already been exhumed from the breccia of a cave at Gibraltar in 1848. The same was to some extent true of the Gibraltar man: If this fossil had consisted of a brainpan alone, it would probably have known greater success; the face, at a time when the myth of Anthro pithecus was being constructed, was incomprehensible. Their concern with constructing the "race of Canstadt" on the basis of some highly questionable skull fragments closed their eyes to the real nature of Nean derthal man himself. But nothing was ready for establishing a connection between evolutionism and the available fossil records. The image of the primitive human does not appear to have been other than that ofHomo sa piens, clad in the skins of animals he had hunted, applying his penetrating intelligence to fashioning in storie the weap ons needed for his primitive economy.
At the Fiji emergency room both frontal and lateral skull plain films showed no evidence of any fracture but during the physical exam papilledema was noted especially in one eye antibiotics for uti bladder infection cheap 600 mg zyvox free shipping. A 55-year-old man was brought into the hospital with a severe burn on his left hand antibiotics resistant bacteria buy generic zyvox 600mg on-line. The man had placed his hand on the hot burner of an electric stove infection lung purchase discount zyvox, but had not sensed anything wrong until he smelled burning flesh antibiotic resistance education buy zyvox 600 mg low cost. Neurologic examination revealed loss of pain and temperature sensation over dermatomes C4 through T6 bilaterally. However, pain and temperature were perceived bilaterally both above C4 and below T6. Discriminative touch was present in unburned dermatomes on the left and in the right extremity. Although the left hand was too damaged to accurately assess muscle function, weakness and wasting of small muscles of the right hand was noted. Pain and temperature sensations from the extremities ascend in the spinal cord in which of the following Intermediolateral cell column Cuneate fasciculus Lateral spinothalamic tract Dorsal columns Fasciculus gracilis 287. You deliver a full-term baby boy who is otherwise normal, but has a left cleft of the upper lip that extends upward toward the left nostril and left anterior cleft of the primary palate just deep to the cleft lip. You explain to the mother that these defects are most likely due to a failure of which of the following Mandibular process to fuse with the lateral nasal process Mandibular process to fuse with the medial nasal process Maxillary process to fuse with the lateral nasal process Maxillary process to fuse with the medial nasal process Lateral and medial nasal processes to fuse with each other 288. A sudden extreme pain that shoots along the left side of the jaw and up anterior to the ear and along the side of the head is most likely due to which of the following A 9-year-old girl is brought to your pediatric office by her mother because the girl has been complaining about how sore her throat is, and the mother has noticed that she has started to snore loudly at night. You suggest surgical removal of the tonsils, but you do explain that there is a small risk of the surgery, which may result in which of the following Loss in the ability to protrude her tongue, thus limiting her ability to lick an ice cream cone c. Weakness in the ability to open her mouth fully when eating an apple due to damage to the innervation to the lateral pterygoid muscle d. Loss in the ability to taste in the posterior one-third of the tongue and perhaps some difficulty in swallowing. Weakened ability to move her jaw from side to side because of loss in innervation of the medial pterygoid muscle 290. The course of the vertebral arteries is best described by which of the following statements They arise from the common carotid artery on the left and the brachiocephalic artery on the right b. A 43-year-old mother of two watching her son play baseball has been hit in the side of the head with a foul ball that came from another field. She had been knocked unconscious for a few seconds and was taken to the emergency room of a local hospital by her husband. At the emergency room in addition to observing a growing "goose egg" over her right temporal region, examination of her fundi with an ophthalmoscope showed subtle papilledema. She was immediately sent for frontal and lateral skull films, which showed a fracture in the frontal bone near the pterion. What is the most likely diagnosis given to the on call neurosurgeon to bring him into the hospital on a Saturday afternoon Extracranial hematoma Extracranial and epidural hematomas Extracranial and subdural hematomas Subarachnoid hemorrhage Extracranial hematoma and subarachnoid hemorrhage 292. One time he was almost knocked out by a right "hook" to the head and for about a week he had frequent headaches and a very runny nose, which finally stopped running by itself. Examination reveals a loss of pain and temperature sensation over the right side of the face and the left side of the body. The patient exhibits ataxia and intention tremor on the right in both the upper and lower extremities and is unable to perform either the finger-to-nose or heelto-shin tasks on the right. In addition, he is hoarse and demonstrates pupillary constriction and drooping of the eyelid on the right.
It may be anesthetized by directing a needle posteriorly through the buccal wall just lateral to the pterygomandibular raphe antimicrobial 8536 buy line zyvox. A 29-year-old woman (gravida 3 antimicrobial silver buy zyvox 600mg line, para 2) gave birth to a healthy baby after 38 weeks of gestation and delivered the intact placenta spontaneously antimicrobial guide zyvox 600 mg generic. The pregnancy was complicated by preeclampsia antibiotics used uti buy zyvox australia, but fetal monitoring and ultrasound were normal throughout gestation. The predominant structures shown in the accompanying photomicrograph of the placenta are derived from which of the following A married couple, with diagnosed 6-year-long infertility, presents to the fertility clinic. A spermocytogram, confirmed by electron microscopy, reveals that the husband produces all spermatozoa with rounded heads, a condition known as globozoospermia. Loss of decapacitation factors Retention of the developing spermatids from Sertoli cells Maturation of lytic enzymes Mitotic activity Meiotic divisions 3. Which of the following is required for continuation of the second meiotic division to produce the haploid ovum A hamster egg penetration assay was performed in which hamster eggs are collected and their zona pellucidae are enzymatically removed prior to mixing with sperm. Sperm formation, maturation and penetration Addition of cholesterol to the sperm plasma membrane A decrease in the fluidity of the sperm plasma membrane Sequestration of acrosomal enzymes Capacitation, acrosome reaction and penetration Embryology: Early and General 73 5. The oocyte of a mature follicle will be induced to undergo the first meiotic division as a result of which of the following hormonal stimuli Following intercourse, which of the following is responsible for the prevention of polyspermy Resumption of the first meiotic division Resumption of the second meiotic division Capacitation the zona reaction the release of enzymes from the sperm acrosome 7. Oogonia reach their maximum number at which of the following stages of human development Five months of fetal life Birth Puberty (12 to 14 years of age) Adolescence (16 to 20 years of age) Early adulthood (21 to 26 years of age) 8. Approximately how much time is required for the return of viable sperm to the epididymis Implantation of the conceptus at which site in the accompanying diagram of the female reproductive system is most likely to result in excessive, perhaps fatal, vaginal bleeding immediately prior to parturition Cells that form the three primitive germ layers are derived from which of the following In the developing human embryo/fetus, most of the internal organs begin to form in which month The primitive uteroplacental circulation is functionally established during which period of embryonic/fetal development Hypoblast Epiblastic cells that undergo gastrulation Mesoderm Endoderm Nongastrulated epiblast 14. However, mixture with unoxygenated blood at various points reduces the oxygen content. Which of the following fetal vessels contains blood with the highest oxygen content Abdominal aorta Common carotid arteries Ductus arteriosus Pulmonary artery Pulmonary vein 76 Anatomy, Histology, and Cell Biology 15. A female infant is born approximately 10 weeks prematurely (at 30 weeks) and weighs 1710 g. She is intubated endotracheally with mechanical ventilation immediately after birth. Over the first 4 days after birth the ventilator pressure and the fraction of inspired oxygen are reduced. Beginning on the fifth day after birth, she has brief desaturations that become more persistent. Further examination, echocardiogram, and x-rays reveal left atrial enlargement, an enlarged pulmonary artery, increased pulmonary vasculature, and a continuous machine-like murmur. Persistent foramen ovale Patent ductus arteriosus Ventricular septal defect Pulmonary stenosis Coarctation of the aorta 16. Which of the following processes places the developing heart in the presumptive thoracic region cranial to the septum transversum
The thyroid follicular epithelial cells import iodide and amino acids from the capillary lumen antibiotics for dogs how long order zyvox on line amex. The follicular cells synthesize thyroglobulin from Endocrine Glands Answers 353 amino acids antibiotics rosacea order cheap zyvox on line. Thyroglobulin is iodinated while in the colloid antibiotics for mild acne quality zyvox 600 mg, and iodinated thyroglobulin (not the thyroid hormones) is the storage product in the thyroid colloid antibiotics juvenile arthritis order zyvox 600mg fast delivery. Most of the secretion of the human thyroid gland is composed of thyroxine, although triiodothyronine is more potent. The pars nervosa consists of pituicytes (supportive glia) and the Herring bodies, dilated axons that originate in the supraoptic and paraventicular nuclei. These nuclei produce oxytocin and vasopressin that are stored in the Herring bodies. Overall, the pituitary gland (hypophysis cerebri) is formed from two types of ectoderm. The pars distalis includes the classic histologic cell types: chromophils (acidophils and basophils) and chromophobes (acidophils and basophils that are depleted of secretory product). The pars intermedia is also formed from the oral ectoderm, is rudimentary in humans, and may produce preproopiomelanocortic peptide. The pars tuberalis forms a collar around the pituitary stalk and is also derived from the oral ectoderm. The pars nervosa (including Herring bodies) and the remainder of the pituitary stalk (infundibular stem and median eminence) are formed from a downgrowth of the diencephalon. The posterior pituitary (pars nervosa and stalk) retains this close relationship with the brain. Prolactinomas are the most common form of pituitary adenoma resulting in infertility, galactorrhea (excessive production of milk), and amenorrhea. Pancreatic exocrine tissue is found throughout the pancreas with round aggregation of lighter staining cells forming the islets of Langerhans. The more numerous (70% of total) B or cells are centrally located and secrete insulin that is secreted after a meal and results in a lowering of blood sugar. The smaller population of A or cells located at the periphery of the islet secrete glucagon. Glucagon is secreted in response to low blood sugar and raises blood sugar levels. A glucagonoma produces excessive amounts of glucagon that results in hyperglycemia and diabetes. The result is that blood reaching the cells already contains insulin, which regulates glucagon production. The absence of normal glucagon regulation by insulin is a further complication in type I diabetes in which insulin is not produced. Other cell types [D and F] are variable in location and secrete somatostatin and pancreatic polypeptide, respectively. Somatostatin regulates insulin and glucagon release, whereas pancreatic polypeptide appears to regulate exocrine protein and bicarbonate secretion. Endocrine Glands Answers 355 Other tumors of the islets of Langerhans include insulinomas in which elevated levels of insulin are secreted into the bloodstream. Insulin removes sugar from the blood and, in the liver, either stores it as glycogen or metabolizes it through glycolysis. Insulin inhibits glycogen phosphorylase (which catalyzes the breakdown of glycogen to form glucose) and activates glycogen synthase in both muscle and liver resulting in increased storage of glycogen. The result in the patient is asthenia (lack of strength, overall weakness, and fatigue), anorexia, nausea, vomiting, weight loss, hypotension, and low blood sugar. The adrenal cortex originates from the intermediate mesoderm, whereas the adrenal medulla forms from neural crest. Adrenocortical cells are under the influence of corticotrophs in the anterior pituitary. Adrenocortical cells import cholesterol and acetate and produce the hormones shown in the table below.
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