Thieme Medical Publishers
Thieme Medical Publishers is a German medical and science publisher in the Thieme Publishing Group. It produces professional journals, atlases and reference books in both German and English covering a variety of medical specialties, including neurosurgery, endocrinology, radiology, chemistry, ophthalmology and speech-language pathology and alternative medicine. Thieme has more than 1,000 employees and maintains offices in seven cities worldwide, including New York City, Delhi and three other cities in Germany. Georg Thieme Verlag was founded in 1886 in Leipzig, Germany, by Georg Thieme when he was 26 years old. Thieme remains held and family-owned; the company received some early success in 1896 by publishing Wilhelm Röntgen's famous picture of his wife's hand in what is still one of Thieme's and Germany's oldest journals, the Deutsche Medizinische Wochenschrift. In 1919, Georg Thieme partnered with a young publisher from Leipzig; when Thieme died in 1925, ownership of the company passed to Hauff.
Members of the Hauff family have been the proprietors of the business since. In 1946, two years after Thieme had been bombed and forced to close during World War II, the Allies relocated the company from Leipzig in the eastern sector to Stuttgart in the west where it was provided with a license to publish and distribute journals and books. Guenther Hauff, son of Bruno, acquired Stratton International Medical Book of New York in 1979, several years in 1984, the two companies merged to become Thieme Medical Publishers New York. Official website Thieme Publishing Group
Anatomical terms of neuroanatomy
This article describes anatomical terminology, used to describe the central and peripheral nervous systems - including the brain, spinal cord, nerves. Neuroanatomy, like other aspects of anatomy, uses specific terminology to describe anatomical structures; this terminology helps ensure that a structure is described with minimal ambiguity. Terms help ensure that structures are described depending on their structure or function. Terms are derived from Latin and Greek, like other areas of anatomy are standardised based on internationally accepted lexicons such as Terminologia Anatomica. To help with consistency and other species are assumed when described to be in standard anatomical position, with the body standing erect and facing observer, arms at sides, palms forward. Anatomical terms of location depend on the location and species, being described. To understand the terms used for anatomical localisation, consider an animal with a straight CNS, such as a fish or lizard. In such animals the terms "rostral", "caudal", "ventral" and "dorsal" mean towards the rostrum, towards the tail, towards the belly and towards the back.
For a full discussion of those terms, see anatomical terms of location. For many purposes of anatomical description and directions are relative to the standard anatomical planes and axes; such reference to the anatomical planes and axes is called the stereotactic approach. Standard terms used throughout anatomy include anterior / posterior for the front and back of a structure, superior / inferior for above and below, medial / lateral for structures close to and away from the midline and proximal / distal for structures close to and far away from a set point; some terms are used more in neuroanatomy, particularly: Rostral and caudal: In animals with linear nervous systems, the term rostral is synonymous with anterior and the term caudal is synonymous with posterior. Due to humans having an upright posture, their nervous system is considered to bend about 90°; this is considered to occur at the junction of the diencephalon. Thus, the terminology changes at either side of the midbrain-diencephalic junction.
Superior to the junction, the terminology is the same as in animals with linear nervous systems. Inferior to the midbrain-diencephalic junction the term rostral is synonymous with superior and caudal is synonymous with inferior. Dorsal and ventral: In animals with linear nervous systems, the term dorsal is synonymous with superior and the term ventral is synonymous with inferior. In humans, however the terminology differs on either side of the midbrain-diencephalic junction. Superior to the junction, the terminology is the same as in animals with linear nervous systems. However, inferior to the midbrain-diencephalic junction the term dorsal is synonymous with posterior and ventral is synonymous with anterior. Contralateral and ipsilateral referring to a corresponding position on the opposite left or right side and on the same side respectively. Standard anatomical planes and anatomical axes are used to describe structures in animals. In humans and most other primates the axis of the central nervous system is not bent.
This means that there are certain major differences that reflect the distortion of the brains of the Hominidae. For example, to describe the human brain, "rostral" still means "towards the face", or at any rate, the interior of the cranial cavity just behind the face. However, in the brain "caudal" means not "towards the tail", but "towards the back of the cranial cavity". Alternative terms for this rostro-caudal axis of the brain include antero-posterior axis. "Dorsal" means "in the direction away from the spinal cord i.e. in the direction of the roof of the cranial cavity". "Ventral" means downwards towards floor of the cranial cavity and thence to the body. They lie on the superior-inferior or Dorsoventral axis; the third axis passes through the ears, is called the left-right, or lateral axis. These three axes of the human brain match the three planes within which they lie though the terms for the planes have not been changed from the terms for the bodily planes; the most used reference planes are: Axial, the plane, horizontal and parallel to the axial plane of the body in the standard anatomical position.
It contains the medial axes of the brain. Coronal, a vertical plane that passes through both ears, contains the lateral and dorsoventral axes. Sagittal, a vertical plane that passes from between the nostrils, between the cerebral hemispheres, dividing the brain into left and right halves, it contains the medial axes of the brain. A parasagittal plane is any plane parallel to the sagittal plane. Specific terms are used for peripheral nerves. An afferent nerve fiber is a fibre originating at the present point. For example, a striatal afferent is an afferent originating at the striatum. An efferent nerve fiber is one. For example, a cortical efferent is a fibre coming from elsewhere, arriving to the cortex. Note that, the opposite of the direction in which the nerve fibre conducts signals. Specific terms are used to describe the route of a nerve or nerve fibre: A chiasm i
In human anatomy, the sacral plexus is a nerve plexus which provides motor and sensory nerves for the posterior thigh, most of the lower leg and foot, part of the pelvis. It emerges from the lumbar vertebrae and sacral vertebrae. A sacral plexopathy is a disorder affecting the nerves of the sacral plexus caused by trauma, nerve compression, vascular disease, or infection. Symptoms may include pain, loss of motor control, sensory deficits; the sacral plexus is formed by: the lumbosacral trunk the anterior division of the first sacral nerve portions of the anterior divisions of the second and third sacral nervesThe nerves forming the sacral plexus converge toward the lower part of the greater sciatic foramen, unite to form a flattened band, from the anterior and posterior surfaces of which several branches arise. The band itself is continued as the sciatic nerve, which splits on the back of the thigh into the tibial nerve and common fibular nerve; the sacral plexus and the lumbar plexus are considered to be one large nerve plexus, the lumbosacral plexus.
The lumbosacral trunk connects the two plexuses. The sacral plexus lies on the back of the pelvis in front of the piriformis muscle and the pelvic fascia. In front of it are the internal iliac artery, internal iliac vein, the ureter, the sigmoid colon; the superior gluteal artery and vein run between the lumbosacral trunk and the first sacral nerve, the inferior gluteal artery and vein between the second and third sacral nerves. All the nerves entering the plexus, with the exception of the third sacral, split into ventral and dorsal divisions, the nerves arising from these are as follows of the table below: Cervical plexus Brachial plexus Lumbar plexus This article incorporates text in the public domain from page 957 of the 20th edition of Gray's Anatomy Thieme Atlas of Anatomy: General Anatomy and Musculoskeletal System. Thieme. 2006. ISBN 1-58890-419-9. Lumbosacral+Plexus at the US National Library of Medicine Medical Subject Headings Cross section image: pembody/body15a—Plastination Laboratory at the Medical University of Vienna MedicalMnemonics.com: 3544 2382 Illustration at backpain-guide.com
Trendelenburg's sign is found in people with weak or paralyzed abductor muscles of the hip, namely gluteus medius and gluteus minimus. It is named after the German surgeon Friedrich Trendelenburg; the Trendelenburg sign is said to be positive if, when standing on one leg, the pelvis drops on the side opposite to the stance leg. The muscle weakness is present on the side of the stance leg. If the patient compensates for this weakness the pelvis will be raised, rather than dropped, on the side opposite to the stance leg. Ergo, in the same situation, the patient's hip may be dropped or raised, dependent upon whether the patient is compensating, as above, or not. Compensation shifts the centre of gravity to the affected side, decreases the angle between the hip adductor muscles and femur, both of which decrease the forces needing to be applied by the hip adductor muscles to maintain relevant posture; the gluteus medius is important during the stance phase of the gait cycle to maintain both hips at the same level.
Moreover, one leg stance accounts for about 60% of the gait cycle. Furthermore, during the stance phase of the gait cycle, there is three times the body weight transmitted to the hip joint; the hip abductors' action accounts for two thirds of that body weight. A Trendelenburg sign can occur when there is presence of a muscular dysfunction or when someone is experiencing pain. Gait abnormality Trendelenburg gait Superior gluteal nerve Trendelenburg Test at GPNotebook
A nerve is an enclosed, cable-like bundle of nerve fibres called axons, in the peripheral nervous system. A nerve provides a common pathway for the electrochemical nerve impulses called action potentials that are transmitted along each of the axons to peripheral organs or, in the case of sensory nerves, from the periphery back to the central nervous system; each axon within the nerve is an extension of an individual neuron, along with other supportive cells such as Schwann cells that coat the axons in myelin. Within a nerve, each axon is surrounded by a layer of connective tissue called the endoneurium; the axons are bundled together into groups called fascicles, each fascicle is wrapped in a layer of connective tissue called the perineurium. The entire nerve is wrapped in a layer of connective tissue called the epineurium. In the central nervous system, the analogous structures are known as tracts; each nerve is covered on the outside by a dense sheath of the epineurium. Beneath this is a layer of flat cells, the perineurium, which forms a complete sleeve around a bundle of axons.
Perineurial septae subdivide it into several bundles of fibres. Surrounding each such fibre is the endoneurium; this forms an unbroken tube from the surface of the spinal cord to the level where the axon synapses with its muscle fibres, or ends in sensory receptors. The endoneurium consists of an inner sleeve of material called the glycocalyx and an outer, meshwork of collagen fibres. Nerves are bundled and travel along with blood vessels, since the neurons of a nerve have high energy requirements. Within the endoneurium, the individual nerve fibres are surrounded by a low-protein liquid called endoneurial fluid; this acts in a similar way to the cerebrospinal fluid in the central nervous system and constitutes a blood-nerve barrier similar to the blood-brain barrier. Molecules are thereby prevented from crossing the blood into the endoneurial fluid. During the development of nerve edema from nerve irritation, the amount of endoneurial fluid may increase at the site of irritation; this increase in fluid can be visualized using magnetic resonance neurography, thus MR neurography can identify nerve irritation and/or injury.
Nerves are categorized into three groups based on the direction that signals are conducted: Afferent nerves conduct signals from sensory neurons to the central nervous system, for example from the mechanoreceptors in skin. Efferent nerves conduct signals from the central nervous system along motor neurons to their target muscles and glands. Mixed nerves contain both afferent and efferent axons, thus conduct both incoming sensory information and outgoing muscle commands in the same bundle. Nerves can be categorized into two groups based on where they connect to the central nervous system: Spinal nerves innervate much of the body, connect through the vertebral column to the spinal cord and thus to the central nervous system, they are given letter-number designations according to the vertebra through which they connect to the spinal column. Cranial nerves innervate parts of the head, connect directly to the brain, they are assigned Roman numerals from 1 to 12, although cranial nerve zero is sometimes included.
In addition, cranial nerves have descriptive names. Specific terms are used to describe their actions. A nerve that supplies information to the brain from an area of the body, or controls an action of the body is said to "innervate" that section of the body or organ. Other terms relate to whether the nerve affects the same side or opposite side of the body, to the part of the brain that supplies it. Nerve growth ends in adolescence, but can be re-stimulated with a molecular mechanism known as "Notch signaling". If the axons of a neuron are damaged, as long as the cell body of the neuron is not damaged, the axons would regenerate and remake the synaptic connections with neurons with the help of guidepost cells; this is referred to as neuroregeneration. The nerve begins the process by destroying the nerve distal to the site of injury allowing Schwann cells, basal lamina, the neurilemma near the injury to begin producing a regeneration tube. Nerve growth factors are produced causing many nerve sprouts to bud.
When one of the growth processes finds the regeneration tube, it begins to grow towards its original destination guided the entire time by the regeneration tube. Nerve regeneration is slow and can take up to several months to complete. While this process does repair some nerves, there will still be some functional deficit as the repairs are not perfect. A nerve conveys information in the form of electrochemical impulses carried by the individual neurons that make up the nerve; these impulses are fast, with some myelinated neurons conducting at speeds up to 120 m/s. The impulses travel from one neuron to another by crossing a synapse, the message is converted from electrical to chemical and back to electrical. Nerves can be categorized into two groups based on function: An afferent nerve fiber conducts sensory information from a sensory neuron to the central nervous system, where the information is processed. Bundles of fibres or axons, in the peripheral nervous system are called nerves, bundles of afferent fibers are known as sensory nerves.
An efferent nerve fiber conducts signals from a motor neuron in the central nervous system to muscles. Bundles of these fibres are known as efferent nerves; the nervous system is the part of an animal that coordinates its actions by transmitting signals to and from different parts of its body. In vertebrates it consists of two main par
Duchenne de Boulogne
Guillaume-Benjamin-Amand Duchenne was a French neurologist who revived Galvani's research and advanced the science of electrophysiology. The era of modern neurology developed from Duchenne's understanding of neural pathways and his diagnostic innovations including deep tissue biopsy, nerve conduction tests, clinical photography; this extraordinary range of activities was achieved against the background of a troubled personal life and a indifferent medical and scientific establishment. Neurology did not exist in France before Duchenne and although many medical historians regard Jean-Martin Charcot as the father of the discipline, Charcot owed much to Duchenne acknowledging him as "mon maître en neurologie"; the American neurologist Dr. Joseph Collins wrote that Duchenne found neurology, "a sprawling infant of unknown parentage which he succored to a lusty youth." His greatest contributions were made in the myopathies that came to immortalize his name, Duchenne Muscular Dystrophy, Duchenne-Aran spinal muscular atrophy, Duchenne-Erb paralysis, Duchenne's disease, Duchenne's paralysis.
He was the first clinician to practise muscle biopsy, with an invention he called "l'emporte-pièce". In 1855 he formalized the diagnostic principles of electrophysiology and introduced electrotherapy in a textbook titled, De l'electrisation localisée et de son application à la physiologie, à la pathologie et à la thérapeutique. A companion atlas to this work titled, Album de photographies pathologiques, was the first neurology text illustrated by photographs. Duchenne's monograph, the Mécanisme de la physionomie humaine – illustrated prominently by his photographs – was the first study on the physiology of emotion and was influential on Darwin's work on human evolution and emotional expression. Guillaume-Benjamin Duchenne was the son of a fisherman, descended from a long line of mariners who had settled in the Boulogne-sur-Mer region of France. In opposition to his father's wishes that he become a sailor, driven by a fascination with science, Duchenne enrolled at the University of Douai where he received his Baccalauréat at the age of 19.
He trained under a number of distinguished Paris physicians including René-Théophile-Hyacinthe Laënnec and Baron Guillaume Dupuytren before returning to Boulogne and setting up in practice there. Duchenne married a local woman, following the birth of their son, his wife died; this resulted in a lengthy period of personal difficulties for Duchenne with his family and in a prolonged estrangement from his son and they were only reunited towards the end of his life. In 1835, Duchenne began experimenting with therapeutic "électropuncture". After a brief and unhappy second marriage, Duchenne returned to Paris in 1842 in order to continue his medical research. Here, he did not achieve a senior hospital appointment, but supported himself with a small private medical practice, while daily visiting a number of teaching hospitals, including the Salpêtrière psychiatric centre, he developed a non-invasive technique of muscle stimulation that used faradic shock on the surface of the skin, which he called "électrisation localisée" and he published these experiments in his work, On Localized Electrization and its Application to Pathology and Therapy, first published in 1855.
A pictorial supplement to the second edition, Album of Pathological Photographs was published in 1862. A few months the first edition of his now much-discussed work, The Mechanism of Human Physiognomy, was published. Were it not for this small, but remarkable, his next publication, the result of nearly 20 years of study, Duchenne's Physiology of Movements, his most important contribution to medical science, might well have gone unnoticed. Despite his unorthodox procedures, his uneasy relations with the senior medical staff with whom he worked, Duchenne's single-mindedness obtained him an international standing as a neurologist and researcher, he is counted as one of the developers of electro-physiology and electro-therapeutics, he showed that smiles resulting from true happiness not only utilize the muscles of the mouth but those of the eyes: such "genuine" smiles are known as Duchenne smiles in his honor. He is credited with the discovery of Duchenne muscular dystrophy. Duchenne died after several years of illness.
He was never elected to the French Academy of Sciences. Influenced by the fashionable beliefs of physiognomy of the 19th century, Duchenne wanted to determine how the muscles in the human face produce facial expressions which he believed to be directly linked to the soul of man, he is known, in particular, for the way he triggered muscular contractions with electrical probes, recording the resulting distorted and grotesque expressions with the invented camera. He published his findings in 1862, together with extraordinary photographs of the induced expressions, in the book Mecanisme de la physionomie Humaine. Duchenne believed that the human face was a kind of map, the features of which could be codified into universal taxonomies of mental states. Unlike Lavater and other physiognomist
Anterior branch of obturator nerve
The anterior branch of the obturator nerve is a branch of the obturator nerve found in the pelvis and leg. It leaves the pelvis in front of the obturator externus and descends anterior to the adductor brevis, posterior to the pectineus and adductor longus, it descends upon the femoral artery, to which it is distributed. Near the obturator foramen the nerve gives off an articular branch to the hip joint. Behind the pectineus, it distributes branches to the adductor longus and gracilis, to the adductor brevis, in rare cases to the pectineus; this article incorporates text in the public domain from page 954 of the 20th edition of Gray's Anatomy medialthigh at The Anatomy Lesson by Wesley Norman Anatomy photo:12:st-0602 at the SUNY Downstate Medical Center