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Occipital These number 33 or 34 in the child cheap 250 mg cipro free shipping, but because of fusions that occur later in the lower part of the spine buy discount cipro 1000 mg, there Figure 7-7 Floor of cranium, superior view. The vertebrae (VER-teh-bre) have a drum-shaped body (centrum) located anteriorly (toward the front) that serves as the weight-bearing part; disks of cartilage be- Frontal Anterior Parietal Posterior tween the vertebral bodies act as shock absorbers and bone fontanel bone fontanel provide flexibility (see Fig. When all the verte- brae are linked in series by strong connective tissue bands (ligaments), these spaces form the spinal canal, a bony cylinder that protects the spinal cord. Projecting dorsally (toward the back) from the bony arch that encircles the spinal cord is the spinous process, which usually can be felt just under the skin of the back. When viewed from a lateral bone aspect, the vertebral column can be seen to have a series of intervertebral foramina, formed between the vertebrae Sphenoid Mastoid as they join together, through which spinal nerves emerge bone fontanel Sphenoid Temporal as they leave the spinal cord (see Fig. The superior portion of the sternum Spinous is the broadly T-shaped manubrium process (mah-NU-bre-um) that joins laterally on the right and left with the clavicle Intervertebral (collarbone) (see Fig. Where the manubrium joins the Coccyx body of the sternum, there is a slight el- Coccygeal evation, the sternal angle, which easily vertebrae can be felt as a surface landmark. It is used as a landmark for CPR (cardiopulmonary resuscitation) to lo- ◗ The sacral (SA-kral) vertebrae are five separate bones cate the region for chest compression. However, variations in the an- tween the two hip bones, the sacrum completes the terior attachment of these slender, curved bones have led posterior part of the bony pelvis. These later fuse to form rectly to the sternum by means of individual extensions a single bone, the coccyx (KOK-siks), or tail bone, in called costal (KOS-tal) cartilages. Transverse Spinous foramen process Anterior Posterior Posterior Posterior Anterior Anterior Transverse Vertebral Dens Transverse Spinous process foramen process process A Atlas (superior view) B Axis (superior view) C Axis (lateral view) Figure 7-12 The first two cervical vertebrae. The upper division on each side includes the shoulder, the arm (between the shoulder and the elbow), the forearm (between the elbow and the wrist), the wrist, the hand, and the fingers. The lower di- vision includes the hip (part of the pelvic girdle), the thigh (between the hip and the knee), the leg (between the knee and the ankle), the ankle, the foot, and the toes. Because it often receives the full force of Clavicular notch T1 1 Manubrium 2 3 Sternal angle 4 Sternum True ribs Body (1-7) 5 Xiphoid 6 process T11 7 T12 Intercostal space 8 L1 False ribs 9 Costal cartilage (8-10) L2 10 12 11 Floating ribs (11and12) Figure 7-14 Bones of the thorax, anterior view. THE SKELETON: BONES AND JOINTS ✦ 133 Coracoid process Acromion Clavicle Glenoid Acromion cavity Coracoid process Supraspinous fossa Humerus Spine Vertebral 7 Scapula border Infraspinous A B fossa Figure 7-15 The shoulder girdle and scapula. In the anatomic position, the ulna lies can be felt behind the shoulder in the upper portion of on the medial side of the forearm in line with the little the back. When the forearm is supine, with the palm the infraspinous fossa, superior and inferior to the up or forward, the two bones are parallel; when the scapular spine.
Although oral ingestion of mari- 9 Increased appetite is frequently attributed to smok- juana produces similar pharmacological effects order cipro 500mg on line, -THC ing marijuana generic 250mg cipro with visa. Impairment on particularly in treating emesis arising during chemo- various performance measures related to driving skills 9 therapy. This time discordance between blood concentrations of 9-THC and effects has The most consistent pharmacological effect produced made it difﬁcult to establish a meaningful relationship by marijuana is tachycardia, which is closely associated between blood concentrations and effects. There is relatively lit- 9-THC is rapidly distributed to all tissues despite tle effect on blood pressure unless large quantities of being tightly bound by plasma proteins. Traces of 9-THC have been found vasodilatory, which results in the characteristic conjunc- in adipose tissue more than 30 days after the subject tival reddening following marijuana smoking. The terminal half-life of 9-THC reduce intraocular pressure and are capable of produc- in plasma ranges from 18 hours to 4 days. Mechanism of Action Adverse Effects A cannabinoid receptor identiﬁed in the brain of sev- Marijuana is unique among drugs of abuse in that there eral species, including humans, is termed CB1. The 35 Contemporary Drug Abuse 417 most prominent effect of acute marijuana use is intoxi- responsive fashion include phencyclidine (PCP), methyl- cation, which can impair the cognitive and motor skills enedioxymethamphetamine (MDMA), and methylene- needed to complete complex tasks. The indole alkylamines include LSD, psilocybin, 9-THC causes its greatest effects on short-term mem- psilocin, dimethyltryptamine (DMT), and diethyltrypta- ory, as measured in free-recall tasks. Marijuana does not mine (DET), all of which are structurally similar to affect the retrieval of previously learned facts. The other chemical subclass of hallucinogens trast to alcohol, there is no residual hangover from a contains phenylethylamine derivatives such as mesca- single use of high quantities of marijuana. A related stimulatory hallucinogen, PCP, is some individuals have evidence of precancerous lung a piperidine analogue that produces unique effects. However, deﬁnitive evidence of the rela- tionship between marijuana smoking and the incidence Extent and Pattern of Abuse of lung cancer is lacking. Because of the rapid tolerance produced does not result in severe withdrawal symptoms, numer- with these drugs, the typical abuser does not use the ous case reports attest to development of dependence drug on a daily basis. The most prominent symptoms were irritability and Illicit PCP abuse began in the 1960s, primarily by restlessness; others included insomnia, anorexia, in- oral ingestion.