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GEYSER: DIAGXOSIS OF CHROXIC COXDITIOXS. into the posterior columns that lie between the pos- terior horns. After its entrance into the spinal cord, each root elavil for fibre divides into an ascending and a de- scending branch, and elavil used for these branches soon divide to communicate with the cells in the gray matter of the spinal cord, as well as sending collateral branches /^^ Fig. 4. — The sensory pathwa upward into the posterior columns, where are lo- cated fibres controlling tactile sense and muscular coordination. These fibres pass upward through the entire length of the spinal cord, and finally break up surrounding cells in the nucleus of online elavil Burdach and Goll, located in the medulla oblongata. The terminal divisions of the peripheral sensory neurons take place about the nerve cells lying in the following regions (Fig. 5) : First, in Goll's and Burdach's nuclei in the medulla ; second, in the various por- tions elavil 10 of the posterior horns ; third, in the middle zone elavil 25mg between the anterior and the posterior horns; fourth, in the columns of Clark ; fifth, in the ante- rior horn. The central sensory neuron complex begins at the ending of the peripheral neuron in the regions men- tioned elavil for anxiety in the first four buy elavil online above noted distributions. These fibres, w-hich enter the posterior root zone and communicate with cells situated in the anterior horns elavil 25 (noted fifth above) are especially concerned of the peripheral sen in reflex action. Up to this point the distribution is fairly well settled, but the further course of the central sensory tract is still a matter of dispute. By some authorities it is maintained that, after the cen- tral sensory neurons reach the medulla oblongata, elavil buy one', two, and even more neurons, are required be- fore the cortex of the cerebrum is put into commu- nication with the periphery. THE REFLEXES. By a reflex action, we mean a motor act per- formed automatically in response to a sensory im- pression. The entire act is confined to the peri- pheral neurons, which, therefore, form the reflex arc (Fig. 6). This reflex arc is composed of elavil 10 mg a sensory portion contributed by the peripheral sen- sory neuron, a motor portion contributed by the motor peripheral neuron, and a connecting link elavil 50 mg formed by a branch of the sensory neuron after its entrance into the spinal cord; the last is known as the reflex collateral. The course of the cutaneous and tendon reflex arc is better known than that of any of the others. We distinguish a short elavil mg and a long reflex arc. The short reflex arc consists of a collateral elavil amitriptyline which passes directly from the posterior column through the posterior horn to the cell in the anterior horn ; under this head are included the plantar and spinal reflexes. The long reflex arc is formed by the reflex collateral splitting up about a cell in the anterior horn ; from this elavil 50mg cell an ascend- Ara.llliS ing and a descending branch, with several collaterals, pass elavil 10mg to one or more motor ganglion cells, which may be situated at various levels of the anterior horn. This gives the possibility of reflex movements being transmitted to more remote muscle groups. Of the more complicated reflex arcs we have little definite knowledge, as the pharyngeal, nasal, bron- chial, conjunctival, pupillary, and others. cheap elavil There are, however, a few of the elavil 50 more important reflexes that should not go unnoticed. Locomotor ataxia, for in- stance, even elavil 25 mg in the beginning, may be diagnosed by the absence of the patellar reflex, the absence of the elavil uses pupillary reflex, and the swaying of the body with

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