F. Akascha. Athens State College.
Te authors contend that this is a pointless argument and choose to use the single word form except in quoted material that uses other forms generic isoptin 120 mg online blood pressure levels high. Tis may occur when skin or other objects contact the teeth instead of a biter intentionally closing his jaws discount isoptin generic exforge blood pressure medication, and hence his teeth purchase isoptin 120mg without a prescription arteria frontalis-, into skin or an object. A fst striking the teeth in an afray is a common and dangerous example ofen referred to as a clenched fst injury or “fght bite. Teeth marks are passive, as they involve no active, intentional or refexive jaw movement, whereas in bitemarks the jaw muscles are active, causing the jaws and thence the teeth to move into the bitten substrate. Teeth mark examples include marks lef by teeth on steering wheels, dashboards, or other objects during motor vehicle accidents. If struck in the mouth, the teeth of the victim may leave imprints 334 Forensic dentistry on the fst or other object. Teeth marks may be found on the inner aspect of a victim’s upper and lower lips afer an attack. Pressure applied to the lips, which are consequently pressed against the teeth, leaves the teeth marks, patterned injuries that may indicate asphyxiation by force. Teeth mark inju- ries have not been widely discussed in the literature separate from bitemarks. Te teeth marks lef in diferent locations during motor vehicular accidents may be used to help distinguish passengers from drivers. Teeth marks have been found on exterior parts of vehicles during hit-and-run accidents. Teeth marks lef on fsts or hands as when striking a victim in the mouth can be crucial evidence placing a subject at a scene and showing that there was a violent interaction. Tese may be particularly helpful when a victim’s body may have been severely afected by trauma or fre. Teeth marks on the hand or arm of a police ofcer or other law enforcement ofcial may be used to support or disprove conficting testimony in a police custody scenario, for example, a policeman’s claim that the detainee bit him versus the prisoner stating, “He had me in a strangle hold and his forearm was forced into my mouth. Tus, a bitemark class characteristic identifes the group from which it originates: human, animal, fsh, or other species. Confrming the pres- ence of class characteristics should be the frst step in evaluating a bitemark. If unable to distinguish upper from lower arches, the evidence should not be considered to be of sufcient quality for comparison analysis. Misinterpretations of injuries that look similar to dental arches have led to errors in evaluation. It must be emphasized that, if unable to distinguish between upper and lower dental arches in a patterned injury, or to be able to identify which marks were made by specifc individual teeth, forensic dentists should not attempt to compare the injury to suspect information unless that pattern contains one or more unique individual characteristics that may also be seen in a suspect biter’s tooth or teeth. In some cases it may be possible to exclude individuals based on lower quality bite pattern information (Figures 14. An example would be a contusion pattern that exhibited a gap or gaps and a suspect that Bitemarks 335 Figure 14. Tis information would come, not from comparison, but from the profle generated from the analysis of the mark. Arch charac- teristics that qualify as individual distinguish one person’s arch from another’s and may include “a combination of rotated teeth, [teeth in] buccal or lingual version, mesio-distal [sic, mesial or distal] drifing [of teeth], and [variations in] horizontal alignment [of teeth that] contribute to diferentiation between individuals. A feature that makes one tooth difer- ent from all others is a dental characteristic and may include such things as fractures, wear patterns, developmental defects, and restorations. Te majority of patterned injury cases analyzed by forensic odontolo- gists involve one or more suspected human bite patterns in human skin. Te quality of the evidence, including the amount of information in each mark and the distinctiveness of the pattern, dictate whether or not an association with the biter can be established. While much information is available in the literature on methodology, a standardized system of analyzing marks and evaluating the evidentiary value of those marks has not yet been developed, tested, and accepted by the forensic odontology community. Te areas of the body most ofen bitten included arms, backs, legs, faces and breasts overall, with some sex-related diferences, women’s breasts, for example, were more ofen bitten than men’s. Te four studies were in general agreement, although Harvey in 1976 and Pretty and Sweet in 2000 reported higher rates of bitemarks on breasts. In 1976 Harvey reported no bitemarks on the back and very few on legs and feet, but higher rates of abdomen bites (Chart 14. Tese reports indicate that almost any area of the body can be bitten, and that in violent exchanges the attacker, the attacked, and sometimes both may bite. Tis is useful information and emphasizes the propriety of taking dental impres- sions on deceased victims with bitemarks and interviewing living victims about the possibility that they also bit their attacker. In an ideal world the forensic odon- tologist would be involved with a case involving suspected bitemarks from the beginning, at the scene, during evidence collection, evidence analysis, and continuing to the courtroom. In the real world the odontologist may not be contacted until much later and may be infuenced, positively or negatively, by many factors, including his or her lack of experience, ego, and enthusiasm, to be part of the investigative team in a criminal case involving bitemarks. Case management begins with the frst contact from the agency or person soliciting information from the forensic odontologist. Case management is critical during evidence collection and analysis, and continues through the trial and the fnal judicial appeal. Te odontologist may be asked to review photographic evidence of a pattern injury taken by a crime scene investigator untrained in bitemark evidence collection. Te only record of the injury pattern may have been photographed with non-state-of-the-art equipment. Images may have been collected with a Polaroid or other snapshot-type camera, perhaps without a scale or ruler, and at a distance and angle that precludes proper analysis. Alternately, the injury may have been photographed by emergency room or hospital personnel. Medical interven- tion may have distorted or even obliterated portions of the patterned injury. Te odontologist must obtain as much information as possible to improve his or her chance of arriving at a conclusion that has scientifc validity. Tis includes but is not limited to all scene photographs, even those in which the patterned injury is not visible. If the victim survives the attack, photographs of the injury should be taken as soon as possible, with follow-up photography during the healing process. If the victim does not survive, photographs of the patterned injury should be made at the scene, at the hospital, and at the morgue prior to the embalming and internment. If the body is later exhumed, proce- dures that preceded burial must be considered. In summary, the odontolo- gist must review all available evidence, especially all photographic evidence. Te likelihood of making an error in interpretation is inversely proportional to the abundance of the available evidence. Forensic odontologists may be asked during their careers to evaluate potential bitemark evidence on both living and deceased persons, including embalmed and exhumed bodies. If the bitten person is living, he or she may also be an eyewitness, capable of identifying the biter. As in all eyewitness accounts, this information should be considered with skepticism.
True 2 As the zygote moves through the uterine (Fallopian) tube purchase genuine isoptin online prehypertension and lupus, it undergoes meiosis discount isoptin 120mg visa prehypertension quiz. False 3 The placenta serves to exchange gases and waste between the maternal blood and the fetal blood order cheapest isoptin heart attack grill menu prices. True 4 After five days of cleavage, the cells form into a hollow ball called the morula. False 5 The embryonic stage is completed at the end of the fifth week of development. False Chapter 14: Carrying Life Forward: The Female Reproductive System 233 6 Sexual intercourse five days before ovulation cannot lead to pregnancy. Even then, a premature birth can have serious health consequences for the newborn. Young adult # Faced with survival, it must process food, excrete waste, and obtain oxygen: a. You get to know the intricacies of the nerves and brain, arguably the most complex of all the anatomical systems as well as the fine-tuning capacity of the endocrine system and its hormones. Chapter 15 Feeling Jumpy: The Nervous System In This Chapter Breaking down the structure of nerves Centering with the central nervous system Branching out with the peripheral nervous system Taking a hands-off approach to the autonomic nervous system Examining the senses hroughout this book, you look at the human body from head to toe, exploring how it Tcollects and distributes the molecules it needs to grow and thrive, how it reproduces itself, and even how it gets rid of life’s nastier byproducts. In this chapter, however, you look at the living computer that choreographs the whole show, the one system that contributes the most to making us who we are as humans. The nervous system is the communications network that goes into nearly every part of the body, enervating your muscles, pricking your pain sensors, and letting you reach beyond yourself into the larger world. More than 80 major nerves make up this intricate network, and each nerve contains somewhere around 1 million neurons (individual nerve cells). It’s through this complex network that you respond both to external and internal stimuli, demonstrating a characteristic called irritability (the capacity to respond to stimuli, not the tendency to yell at annoying people). There are three functional types of cells in the nervous system: receptor cells that receive a stimulus (sensing); conductor cells that transmit impulses (integrating); and effector cells, or motor neurons, which bring about a response such as contracting a muscle. Put another way, there are three functions of the human nervous system as a whole: orientation, or the ability to generate nerve impulses in response to changes in the external and internal environments (this also can be referred to as perception); coordination, or the ability to receive, sort, and direct those signals to channels for response (this also can be referred to as integration); and conceptual thought, or the capacity to record, store, and relate information received and to form plans for future reactions to environmental change (which includes specific action). You practice identi- fying the parts and functions of nerves and the brain itself as well as the structure and activi- ties of the Big Three parts of the whole nervous system: the central, the peripheral, and the autonomic systems. In addition, we touch on the sensory organs that bring information into the human body. Part V: Mission Control: All Systems Go 238 Building from Basics: Neurons, Nerves, Impulses, Synapses Before trying to study the system as a whole, it’s best to break it down into building blocks first. Neurons The basic unit that makes up nerve tissue is the neuron (also called a nerve cell). Its properties include that marvelous irritability that we speak of in the chapter introduc- tion as well as conductivity, otherwise known as the ability to transmit a nerve impulse. The central part of a neuron is the cell body, or soma, that contains a large nucleus with one or more nucleoli, mitochondria, Golgi apparatus, numerous ribosomes, and Nissl bodies that are associated with conduction of a nerve impulse. Two types of cytoplasmic projections play a role in neurons: Dendrites conduct impulses to the cell body while axons (nerve fibers) usually conduct impulses away from the cell body (see Figure 15-1). Each neuron has only one axon; however, each axon can have many branches called axon collaterals, enabling communication with many target cells. In addition, each neuron may have one dendrite, several dendrites, or none at all. There are three types of neurons, as follows: Motor neurons, or efferent neurons, transmit messages from the brain and spinal cord to effector organs, including muscles and glands, triggering them to respond. Motor neurons are classified structurally as multipolar because they’re star-shaped cells with a single large axon and numerous dendrites. Sensory neurons, or afferent neurons, are triggered by physical stimuli, such as light, and pass the impulses on to the brain and spinal cord. Sensory fibers have special structures called receptors, or end organs, where the stimulus is propa- gated. Monopolar neurons have a single process (a projection or outgrowth of tissue) that divides shortly after leaving the cell body; one branch conveys impulses from sense organs while the other branch carries impulses to the central nervous system. Association neurons (also called internuncial neurons, interneurons, or interca- lated neurons) are triggered by sensory neurons and relay messages between neurons within the brain and spinal cord. Here are a couple of handy memory devices: Afferent connections arrive, and efferent connections exit. Sensory Neuron Dendrites Cell body Nucleolus Nucleus Nucleolus Axon Nucleus Nucleus of Schwann cell Figure 15-1: Cell body The motor neuron on Schwann cell Axon the left and Node of Ranvier sensory neuron on the right show the cell struc- tures and the paths of Synaptic bouton impulses. Nerves Whereas neurons are the basic unit of the nervous system, nerves are the cable-like bundles of axons that weave together the peripheral nervous system. There are three types of nerves: Afferent nerves are composed of sensory nerve fibers (axons) grouped together to carry impulses from receptors to the central nervous system. Efferent nerves are composed of motor nerve fibers carrying impulses from the central nervous system to effector organs, such as muscles or glands. The diameter of individual axons (nerve fibers) tends to be microscopically small — many are no more than a micron, or one-millionth of a meter. The longest axons in the human body run from the base of the spine to the big toe of each foot, meaning that these single-cell fibers may be 1 meter or more in length. Each axon is swathed in myelin, a white fatty material made up of concentric layers of Schwann cells in peripheral nerves. Oligodendrocytes in the central nervous system are also associated with myelinated nerve fibers. Gaps in the sheath called nodes of Ranvier give the underlying nerve fiber access to extracellular fluid, to speed up propagation of the nerve impulse. Nonmyelinated nerve fibers lie within body organs and therefore don’t need protective myelin sheaths to help them transmit impulses. Many peripheral nerve cell fibers also are protected by a neurilemmal sheath, a membrane that surrounds both the nerve fiber and its myelin sheath. Part V: Mission Control: All Systems Go 240 From the inside out, nerves are composed of the following: Axon: The impulse-conducting process of a neuron Myelin sheath: An insulating envelope that protects the nerve fiber and facilitates transmission of nerve impulses Neurolemma (or neurilemma): A thin membrane present in many peripheral nerves that surrounds the nerve fiber and the myelin sheath Endoneurium: Loose, or areolar, connective tissue surrounding individual fibers Fasciculi: Bundles of fibers within a nerve Perineurium: The same kind of connective tissue as endoneurium; surrounds a bundle of fibers Epineurium: The same kind of connective tissue as endoneurium and perineurium; surrounds several bundles of fibers There also is a class of cells called neuroglia, or simply glia, that act as the supportive cells of the nervous system, providing neurons with nutrients and otherwise protecting them. Glia include oligodendrocytes that support the myelin sheath within the central nervous system; star-shaped cells called astrocytes that both support nerve tissue and contribute to repairs when needed; and microgliacytes, cells that remove dead or dying parts of tissue (this type of cell is called a phagocyte, which literally translates from the Greek words for “cell that eats”). Impulses Neuron membranes are semi-permeable (meaning that certain small molecules like ions can move in and out but larger molecules can’t), and they’re electrically polarized (meaning that positively charged ions called cations rest around the outside mem- brane surface while negatively charged ions called anions line the inner surface; you can find more about ions in Chapter 1). A neuron that isn’t busy transmitting an impulse is said to be at its resting potential. But the nerve impulse theory, or membrane theory, says that things switch around when a stimulus — a nerve impulse, or action potential — moves along the neuron. A stimulus changes the specific permeability of the fiber membrane and causes a depolarization due to a reshuffling of the cations and anions.
It’s like I’m on trial for murder or I’m just waiting to be sent down for something cheap isoptin 120 mg otc blood pressure exercise program. I have it all of the time but it gets worse in waves that come from nowhere with no apparent triggers buy isoptin in united states online arrhythmia update 2010. I used to get it before going out for nights out with friends isoptin 120mg low price blood pressure range for men, and it kinda stopped me from doing it as I’d rather not go out and stress about the feeling, but now I have it  all the time so it doesn’t really make a difference anymore. The sufferer cannot deal with what is causing the anxiety, nor avoid it, because there is no clear cause for anxiety. In fact, the sufferer frequently knows, at least cognitively, that there is really nothing to worry about. Generalized anxiety disorder is most likely to develop between the ages of 7 and 40 years, but its influence may in some cases lessen with  age (Rubio & Lopez-Ibor, 2007). I was driving home, my three little girls were in their car seats in the back, and all of a sudden I couldn‘t breathe, I broke out into a sweat, and my heart began racing and literally beating against my ribs! Symptoms of a panic attack include shortness of breath, heart palpitations, trembling, dizziness, choking sensations, nausea, and an intense feeling of dread or impending doom. Panic attacks can often be mistaken for heart attacks or other serious physical illnesses, and they may lead the person experiencing them to go to a hospital emergency room. Panic attacks may last as little as one or as much as 20 minutes, but they often peak and subside within about 10 minutes. They focus their attention on the thoughts and images of their fears, becoming excessively sensitive to cues that signal the possibility of threat (MacLeod, Rutherford, Campbell, Ebsworthy, & Holker,  2002). They may also become unsure of the source of their arousal, misattributing it to situations that are not actually the cause. As a result, they may begin to avoid places where attacks have occurred in the past, such as driving, using an elevator, or being in public places. Phobias A phobia (from the Greek word phobos, which means “fear‖) is a specific fear of a certain object, situation, or activity. The fear experience can range from a sense of unease to a full- blown panic attack. Most people learn to live with their phobias, but for others the fear can be so debilitating that they go to extremes to avoid the fearful situation. A sufferer of arachnophobia (fear of spiders), for example, may refuse to enter a room until it has been checked thoroughly for spiders, or may refuse to vacation in the countryside because spiders may be there. A common phobia is social phobia, extreme shyness around people or discomfort in social situations. Social phobia may be specific to a certain event, such as speaking in public or using a public restroom, or it can be a more generalized anxiety toward almost all people outside of close family and friends. People with social phobia will often experience physical symptoms in public, such as sweating profusely, blushing, stuttering, nausea, and dizziness. They are convinced that everybody around them notices these symptoms as they are occurring. The most incapacitating phobia is agoraphobia, defined as anxiety about being in places or situations from which escape might be difficult or embarrassing, or in which help may not be  available (American Psychiatric Association, 2000). Typical places that provoke the panic attacks are parking lots; crowded streets or shops; and bridges, tunnels, or expressways. People (mostly women) who suffer from agoraphobia may have great difficulty leaving their homes and interacting with other people. Phobias affect about 9% of American adults, and they are about twice as prevalent in women as in men (Fredrikson, Annas, Fischer, & Wik, 1996; Kessler, Meron-Ruscio, Shear, & Wittchen,  2009). In most cases phobias first appear in childhood and adolescence, and usually persist into adulthood. As he describes it, I have got this obsessive-compulsive disorder where I have to have everything in a straight line or everything has to be in pairs. I’ll put my Pepsi cans in the fridge and if there’s one too many then I’ll put it in another cupboard somewhere. Before I can relax, I have to move all the leaflets and all the books and put them in a drawer. We may continuously replay a favorite song in our heads, worry about getting the right outfit for an upcoming party, or find ourselves analyzing a series of numbers that seem to have a certain pattern. Washing your hands once or even twice to make sure that they are clean is normal; washing them 20 times is not. The sufferers know that these rituals are senseless, but they cannot bring themselves to stop them, in part because the relief that they feel after they perform them acts as a reinforcer, making the behavior more likely to occur again. I decided to change the kitchen around one day, get all new stuff, so I threw everything Attributed to Charles Stangor Saylor. They may lose interest in things they used to enjoy; startle easily; have difficulty feeling affection; and may experience terror, rage, depression, or insomnia. The symptoms may be felt especially when approaching the area where the event took place or when the anniversary of that event is near. Dissociative Disorders: Losing the Self to Avoid Anxiety On October 23, 2006, a man appeared on the television show Weekend Today and asked America to help him rediscover his identity. The man, who was later identified as Jeffrey Alan Ingram, had left his home in Seattle on September 9, 2006, and found himself in Denver a few days later, without being able to recall who he was or where he lived. According to a coworker of Ingram‘s fiancée, even after Ingram was reunited with his fiancée, his memory did not fully return. In some cases, however, such as with Jeffrey Ingram, people who become overwhelmed by stress experience an altered state of consciousness in which they become detached from the reality of what is happening to them. A dissociative disorder is a condition that involves disruptions or breakdowns of memory, awareness, and identity. Dissociative Amnesia and Fugue Dissociative amnesia is a psychological disorder that involves extensive, but selective, memory loss, but in which there is no physiological explanation for the forgetting (van der Hart &  Nijenhuis, 2009). The amnesia is normally brought on by a trauma—a situation that causes such painful anxiety that the individual “forgets‖ in order to escape. These kinds of trauma include disasters, accidents, physical abuse, rape, and other forms of severe stress (Cloninger &  Dokucu, 2008). Although the personality of people who are experiencing dissociative amnesia remains fundamentally unchanged—and they recall how to carry out daily tasks such as reading, writing, and problem solving—they tend to forget things about their personal lives—for instance, their name, age, and occupation—and may fail to recognize family and friends (van der  Hart & Nijenhuis, 2009). A related disorder, dissociative fugue, is a psychological disorder in which an individual loses complete memory of his or her identity and may even assume a new one, often far from home. The individual with dissociative fugue experiences all the symptoms of dissociative amnesia but also leaves the situation entirely. The fugue state may last for just a matter of hours or may continue for months, as it did with Jeffrey Ingram. Dissociative Identity Disorder You may remember the story of Sybil (a pseudonym for Shirley Ardell Mason, who was born in 1923), a person who, over a period of 40 years, claimed to possess 16 distinct personalities. Mason was in therapy for many years trying to integrate these personalities into one complete self.