This booklet was developed as a part of Special Study Unit (Doctors as Teachers) at Peninsula Medical School. This booklet covers some of the important aspects of Ophthalmology. This booklet could be used as a quick revision guide before finals and also could be used along Ophthalmology placements. The purpose of this booklet is to provide some insight into the most common presentations of red eye and their management.
over 9 years ago
http://www.handwrittenturorials.com - This tutorial is a basic overview of the anatomy of the eye. It covers the gross structures of the eyeball and the causes of the conditions, Glaucoma and Papilloedema. For more entirely FREE tutorials and the accompanying PDFs visit http://www.handwrittentutorials.com
over 7 years ago
This video - produced by students at Oxford University Medical School in conjunction with the ENT faculty - demonstrates how to perform an examination of the nose, including use of a nasoendoscope.
about 9 years ago
This video - produced by students at Oxford University Medical School in conjunction with the ENT faculty - demonstrates how to perform an examination of the nose. This part covers inspection only.
about 9 years ago
The Health Service Journal have announced this week that medical students could be given a license to practice medicine in the NHS as soon as they graduate. What do we know? The proposal comes from Health Education England. Students would qualify by taking an additional exam when applying for the Foundation Programme. The aim is to improve the standard of medics joining the NHS. Another driving force is to reduce the rising number of med students applying for the two-year Foundation Programme (currently the only way for junior doctors to achieve a full license to practice). Last year there were 297 more applicants than places. If approved the plan would require changes to the Medical Act. Statement from the BMA Dr Andrew Collier, Co-Chair of the BMA’s Junior Doctor Committee said: “We do not feel the case has yet been made for a wholesale change in foundation programme selection process, especially as the system was significantly overhauled and implemented only one year ago. There is little evidence that another new national exam over and above current medical school assessment methods will add any benefit either for graduating students or the NHS as a whole. It is also unlikely to solve the ongoing oversubscription to the foundation programme which will only be addressed by well thought out workforce planning.” Will it work? This proposal has certainly come as a surprise to me so soon after recent changes to the Foundation Programme selection process. I would love to know what you think about it. Do you agree with Dr Collier’s statement? If the plan goes ahead do you think it will be effective in achieving the desired outcomes? Please post your comments and thoughts. Nicole Read more: http://www.hsj.co.uk/news/exclusive-medical-students-face-new-nhs-entry-exam/5066640.article#.UrbyS2RdVaE
almost 8 years ago
Ministry of Ethics.co.uk is a non-commercial student-run project aiming to bring learning about Medical Ethics and Law (MEL) into the Web 2.0 era. The website has revision notes, MCQs & EMQs, case videos and scenarios, and allows discussions with other students and professors or lecturers from across the UK and beyond. The website is the perfect revision resource for medical students, clinical students and juniors doctors to learn more about MEL. Doctors are so much more than walking books of facts; they are faced with ethically and legally challenging situations throughout their professional lives. Medical ethics education helps make students aware of the situations that they will face in the clinical setting and suggests appropriate ways of approaching them. In the long term, it aids the development of moral and ethical reasoning that will allow student doctors to understand other people's views, helping them to become more empathetic and caring clinicians. Since it's creation, our website has won a number of prizes including: - Winning Presentation at the 2011 Fifth Conference on Medical Ethics and Law - 2011 BMA Book Awards Highly Commended - 2011 BMJ onExamination Best National E-Learning Resource Prize We hope you enjoy looking at our site and in particular the case scenarios and interactive question bank.
over 9 years ago
http://www.ophthobook.com This lecture covers basic eye anatomy. This is the first 6 minutes of the powerpoint, which can be viewed in its entirety at Ophthobook.com Here we discuss eyelid and external eye structures.
over 7 years ago
Does the NHS really need saving? Your first question may be ‘does the NHS really need saving?’, and I would have to answer with an emphatic ‘Yes’. April this year sees the official start of Clinical Commissioning Groups (CCGs), the key component of The Health and Social Care Act, one of the biggest changes the NHS has seen. Amongst other things these organisations are tasked with saving the NHS £20 billion in the next 3 years by means of ‘efficiency changes’, despite the Institute of Fiscal Studies saying that the NHS needs to be spending £20 billion more each year by 2020. A daunting task but even more so in the light of the recently published Francis Report, where failings at Stafford Hospital have highlighted the need for compassionate patient care to be at the centre of all decisions. All of this has to be achieved in the largest publically funded health service in the world, which employs 1.7 million staff and serves more than 62 million people, with an annual budget of £106 billion (2011/12). So is it the solution? Clearly technology cannot be the only solution to this problem but I believe technology is pivotal in achieving the ‘efficiency changes’ desired. This might be direct use of technology to improve efficiency or may indirectly provide the intelligence that can drive non-technology based efficiencies; and if technology can be used to save clinicians time this can be reinvested into improving patient care. The NHS already has or is working on a number of national scale IT projects that could bring efficiency savings such as choose and book, electronic prescription service and map of medicine to name but a few. Newer and more localised projects include telehealth, clinical decision tools, remote working, the use of social media and real time patient data analysis. Yet many of these ideas, though new to the NHS, have been employed in business for many years. The NHS needs to catch up and then to further innovate. We need clinicians, managers and IT developers to work together if we are to be successful. Such change is not without its challenges and the size and complexity of the NHS makes implementation of change difficult. Patient safety and confidentiality has to be paramount but these create practical and technical barriers to development. I have just completed Connecting for Health’s Clinical Safety Training and there are some formidable hurdles to development and implementation of new IT systems in the NHS (ISB0129 and ISB0160). Procurement in the NHS is a beast of its own that I wouldn’t claim to understand but the processes are complex potentially making it difficult for small developers. The necessity of financial savings means the best solutions are not always chosen, even though that can be false economy in the long run. Yet we must not let these barriers stop us from seeking to employ technology for the good of clinicians and patients. We must not let them stifle innovation or be frustrated by what can be a slow process at times. The NHS recognises some of these issues and is working to try to help small businesses negotiate these obstacles. I hope in a series of posts in coming months to look in more detail at some of the technologies currently being used in the NHS, as well as emerging projects, and the opportunities and problems that surround them. I may stray occasionally into statistics or politics if you can cope with that! I am a practicing clinician with fingers in many pies so the frequency of my postings is likely to be inversely proportional to the workload I face! Comments are always welcome but I may not always reply in a timely manner.
Dr Damian Williams
over 8 years ago
Cranial Nerve 1- Olfaction This patient has difficulty identifying the smells presented. Loss of smell is anosmia. The most common cause is a cold (as in this patient) or nasal allergies. Other causes include trauma or a meningioma affecting the olfactory tracts. Anosmia is also seen in Kallman syndrome because of agenesis of the olfactory bulbs. Cranial Nerve 2- Visual acuity This patientâs visual acuity is being tested with a Rosenbaum chart. First the left eye is tested, then the right eye. He is tested with his glasses on so this represents corrected visual acuity. He has 20/70 vision in the left eye and 20/40 in the right. His decreased visual acuity is from optic nerve damage. Cranial Nerve II- Visual field The patient's visual fields are being tested with gross confrontation. A right sided visual field deficit for both eyes is shown. This is a right hemianopia from a lesion behind the optic chiasm involving the left optic tract, radiation or striate cortex. Cranial Nerve II- Fundoscopy The first photograph is of a fundus showing papilledema. The findings of papilledema include 1. Loss of venous pulsation 2. Swelling of the optic nerve head so there is loss of the disc margin 3. Venous engorgement 4. Disc hyperemi 5. Loss of the physiologic cup an 6. Flame shaped hemorrhages. This photograph shows all the signs except the hemorrhages and loss of venous pulsations. The second photograph shows optic atrophy, which is pallor of the optic disc resulting form damage to the optic nerve from pressure, ischemia, or demyelination. Images Courtesy Dr. Kathleen Digre, University of Uta Cranial Nerves 2 & 3- Pupillary Light Refle The swinging flashlight test is used to show a relative afferent pupillary defect or a Marcus Gunn pupil of the left eye. The left eye has perceived less light stimulus (a defect in the sensory or afferent pathway) then the opposite eye so the pupil dilates with the same light stimulus that caused constriction when the normal eye was stimulated. Video Courtesy of Dr.Daniel Jacobson, Marshfield Clini and Dr. Kathleen Digre, University of Uta Cranial Nerves 3, 4 & 6- Inspection & Ocular Alignmen This patient with ocular myasthenia gravis has bilateral ptosis, left greater than right. There is also ocular misalignment because of weakness of the eye muscles especially of the left eye. Note the reflection of the light source doesn't fall on the same location of each eyeball. Video Courtesy of Dr.Daniel Jacobson, Marshfield Clini and Dr. Kathleen Digre, University of Uta Cranial Nerves 3, 4 & 6- Versions • The first patient shown has incomplete abduction of her left eye from a 6th nerve palsy. • The second patient has a left 3rd nerve palsy resulting in ptosis, dilated pupil, limited adduction, elevation, and depression of the left eye. Second Video Courtesy of Dr.Daniel Jacobson, Marshfield Clini and Dr. Kathleen Digre, University of Uta Cranial Nerves 3, 4 & 6- Duction Each eye is examined with the other covered (this is called ductions). The patient is unable to adduct either the left or the right eye. If you watch closely you can see nystagmus upon abduction of each eye. When both eyes are tested together (testing versions) you can see the bilateral adduction defect with nystagmus of the abducting eye. This is bilateral internuclear ophthalmoplegia often caused by a demyelinating lesion effecting the MLF bilaterally. The adduction defect occurs because there is disruption of the MLF (internuclear) connections between the abducens nucleus and the lower motor neurons in the oculomotor nucleus that innervate the medial rectus muscle. Saccades Smooth Pursui The patient shown has progressive supranuclear palsy. As part of this disease there is disruption of fixation by square wave jerks and impairment of smooth pursuit movements. Saccadic eye movements are also impaired. Although not shown in this video, vertical saccadic eye movements are usually the initial deficit in this disorder. Video Courtesy of Dr.Daniel Jacobson, Marshfield Clini and Dr. Kathleen Digre, University of Utah Optokinetic Nystagmu This patient has poor optokinetic nystagmus when the tape is moved to the right or left. The patient lacks the input from the parietal-occipital gaze centers to initiate smooth pursuit movements therefore her visual tracking of the objects on the tape is inconsistent and erratic. Patients who have a lesion of the parietal-occipital gaze center will have absent optokinetic nystagmus when the tape is moved toward the side of the lesion. Vestibulo-ocular refle The vestibulo-ocular reflex should be present in a comatose patient with intact brainstem function. This is called intact "Doll’s eyes" because in the old fashion dolls the eyes were weighted with lead so when the head was turned one way the eyes turned in the opposite direction. Absent "Doll’s eyes" or vestibulo-ocular reflex indicates brainstem dysfunction at the midbrain-pontine level. Vergenc Light-near dissociation occurs when the pupils don't react to light but constrict with convergence as part of the near reflex. This is what happens in the Argyll-Robertson pupil (usually seen with neurosyphilis) where there is a pretectal lesion affecting the retinomesencephalic afferents controlling the light reflex but sparing the occipitomesencephalic pathways for the near reflex. Video Courtesy of Dr.Daniel Jacobson, Marshfield Clini and Dr. Kathleen Digre, University of Uta Cranial Nerve 5- Sensor There is a sensory deficit for both light touch and pain on the left side of the face for all divisions of the 5th nerve. Note that the deficit is first recognized just to the left of the midline and not exactly at the midline. Patients with psychogenic sensory loss often identify the sensory change as beginning right at the midline. Cranial Nerves 5 & 7 - Corneal refle A patient with an absent corneal reflex either has a CN 5 sensory deficit or a CN 7 motor deficit. The corneal reflex is particularly helpful in assessing brainstem function in the unconscious patient. An absent corneal reflex in this setting would indicate brainstem dysfunction. Cranial Nerve 5- Motor • The first patient shown has weakness of the pterygoids and the jaw deviates towards the side of the weakness. • The second patient shown has a positive jaw jerk which indicates an upper motor lesion affecting the 5th cranial nerve. First Video Courtesy of Alejandro Stern, Stern Foundation Cranial Nerve 7- Motor • The first patient has weakness of all the muscles of facial expression on the right side of the face indicating a lesion of the facial nucleus or the peripheral 7th nerve. • The second patient has weakness of the lower half of his left face including the orbicularis oculi muscle but sparing the forehead. This is consistent with a central 7th or upper motor neuron lesion. Video Courtesy of Alejandro Stern, Stern Foundatio Cranial Nerve 7- Sensory, Tast The patient has difficulty correctly identifying taste on the right side of the tongue indicating a lesion of the sensory limb of the 7th nerve. Cranial Nerve 8- Auditory Acuity, Weber & Rinne Test This patient has decreased hearing acuity of the right ear. The Weber test lateralizes to the right ear and bone conduction is greater than air conduction on the right. He has a conductive hearing loss. Cranial Nerve 8- Vestibula Patients with vestibular disease typically complain of vertigo – the illusion of a spinning movement. Nystagmus is the principle finding in vestibular disease. It is horizontal and torsional with the slow phase of the nystagmus toward the abnormal side in peripheral vestibular nerve disease. Visual fixation can suppress the nystagmus. In central causes of vertigo (located in the brainstem) the nystagmus can be horizontal, upbeat, downbeat, or torsional and is not suppressed by visual fixation. Cranial Nerve 9 & 10- Moto When the patient says "ah" there is excessive nasal air escape. The palate elevates more on the left side and the uvula deviates toward the left side because the right side is weak. This patient has a deficit of the right 9th & 10th cranial nerves. Video Courtesy of Alejandro Stern, Stern Foundatio Cranial Nerve 9 & 10- Sensory and Motor: Gag Refle Using a tongue blade, the left side of the patient's palate is touched which results in a gag reflex with the left side of the palate elevating more then the right and the uvula deviating to the left consistent with a right CN 9 & 10 deficit. Video Courtesy of Alejandro Stern, Stern Foundation Cranial Nerve 11- Moto When the patient contracts the muscles of the neck the left sternocleidomastoid muscle is easily seen but the right is absent. Looking at the back of the patient, the left trapezius muscle is outlined and present but the right is atrophic and hard to identify. These findings indicate a lesion of the right 11th cranial nerve. Video Courtesy of Alejandro Stern, Stern Foundation Cranial Nerve 12- Moto Notice the atrophy and fasciculation of the right side of this patient's tongue. The tongue deviates to the right as well because of weakness of the right intrinsic tongue muscles. These findings are present because of a lesion of the right 12th cranial nerve.
over 10 years ago
Diagrammatic representation of the development of the head and neck region for undergraduate students, particularly Oral Biology. The module is available thr...
over 6 years ago
If I had a penny, okay a pound, for every time a patient responded to the request to practice examining them said, 'Well, we all gotta learn', I would be a very rich medical student. (I'd like to add that this is said in a strong West-country accent, just so that you feel like you're really there.) I'm sure that the majority of my colleagues would agree. Today has been no different except for the fact that one of the patients I met described themselves as a 'whistleblower'. It was like my subconscious slapping me around the face and telling me to stop procrastinating. Why, you ask? Well I'm starting to get a little nervous actually, in exactly two weeks I'll be presenting my thoughts on whistleblowing (you might remember me going on about this during dissertation season) to a load of academics and healthcare professionals. My sphincters loosen up at the thought of it* Within five minutes of meeting this patient, they had imparted their wise words on me 'Chantal, just remember when you become a doctor - if you're absolutely sure that you're right about something then never be afraid to speak up about it.' Like music to my ears. Well, until he told me that he was convinced that 'cannabis cures all ills.' Each to their own. *I sincerely apologise, poor medic joke. Yuck. Written by Chantal Cox-George, 3rd Year Med Student at University of Bristol
almost 8 years ago
Through different periods of the Egyptian history from Pharaonic, Greco-Roman, Coptic, Islamic and Modern Era; Egyptians tend to respect, appreciate and care for elderly. There is also a rich Eastern Christian tradition in respecting and taking care of old people that has continued since the first centuries of Christianity. Churches used to develop retirement homes served by monastic personnel and nurses. Egyptian culture traditionally linked some aspects of mental illnesses to sin, possession of evil, separation from the divine and it is usually associated with stigmatisation for all family members. However, forgetfulness with ageing was normalised. Until now, it seems that the difference between normal ageing and dementia is blurred for some people. Recently, the term 'Alzheimer' became popular, and some people use it as synonymous to forgetfulness. El-Islam, stated that some people erroneously pronounce it as 'Zeheimer' removing the 'Al' assuming it is the Arabic equivalent to the English 'the'. In 2010, a film was produced with the title 'Zeheimer' confirming the mispronunciation. Elderly face many health challenges which affect their quality of life. Dementia is one of these challenges as it is considered to be one of the disorders which attack elderly and affect their memory, mental abilities, independence, decision making and most cognitive functions. Therefore, the focus on dementia has increased around the world due to the rapid spread of the syndrome and the economical and psychosocial burden it cause for patients, families and communities. (Grossber and Kamat 2011, Alzheimer’s Association 2009, Woods et al. 2009). In recent years, the proportion of older people is increasing due to the improvement in health care and scientific development. The demographic transition with ageing of the population is a global phenomenon which may demand international, national, regional and local action. In Egypt the ageing population at the age of 65 and older are less than 5% of the Egyptian population (The World FactBook, 2012), yet, the World Health Organization (WHO) asserts that a demographic shift is going to happen as most of the rapid ageing population will transfer to the low and middle income countries in the near future (WHO, 2012). Egyptian statistics assert this shift. The Information Decision Support Center published the first comprehensive study of the elderly in Egypt in 2008. According to the report, in 1986, 5 percent of Egyptians were age 60 and older. In 2015, they will make up to 11 percent of the population and in 2050; over a fifth. Caring of older persons constitutes an increasing segment of the Egyptian labor market. However, nation wide statistics about number of dementia sufferers in Egypt may be unavailable but the previous demographic transition is expected to be accompanied by an increase in dementia patients in Egypt and will affect priorities of health care needs as well. The Egyptian society may need adequate preparation with regards to health insurance, accommodation and care homes for the upcoming ageing population (El-Katatney, 2009). Although the number of care home increased from 29 in 1986 to be around 140 home in 2009; it cannot serve more than 4000 elderly from a total of 5 million. Not every elderly will need a care home but the total numbers of homes around Egypt are serving less than 1% of the elderly population. These facts created a new situation of needs for care homes besides the older people who are requiring non-hospital health care facility for assisted living. The Egyptian traditions used to be strongly associated with the culture of extended family and caring for elderly as a family responsibility. Yet, in recent years changes of the economic conditions and factors as internal and external immigration may have affected negatively on elderly care within family boundaries. There is still the stigma of sending elderly to care homes. Some perceive it as a sign of intolerance of siblings towards their elderly parents but it is generally more accepted nowadays. Therefore, the need for care homes become a demand at this time in Egypt as a replacement of the traditional extended family when many older people nowadays either do not have the choice or the facilities to continue living with their families (El-Katatney 2009). Many families among the Egyptian society seem to have turned from holding back from the idea of transferring to a care home to gradual acceptance since elderly care homes are becoming more accepted than the past and constitutes a new concept of elderly care. Currently, many are thinking to run away from a lonely empty home in search of human company or respite care but numbers of geriatric homes are extremely lower than required and much more are still needed (Abdennour, 2010). Thus, it seems that more care homes may be needed in Egypt. Dementia patients are usually over 65, this is one of the factors that put them at high risk of exposure to different physical conditions related to frailty, old age, and altered cognitive functions. Additionally, around 50% of people with dementia suffers from other comorbidities which affect their health and increases hospital admissions (National Audit Office 2007). Therefore, it is expected that the possibility of doctors and nurses needing to provide care for dementia patients in various care settings is increasing (RCN 2010). Considering previous facts, we have an urgent need in Egypt to start awareness about normal and upnormal ageing and what is the meaning of dementia. Moreover, change of health policies and development of health services is required to be developed to match community needs. Another challenge is the very low number of psychiatric doctors and facilities since the current state of mental health can summarised as; one psychiatrist for every 67000 citizens and one psychiatric hospital bed for every 7000 citizens (Okasha, 2001). Finally the need to develop gerontologically informed assessment tools for dementia screening to be applied particularly in general hospitals (Armstrong and Mitchell 2008) would be very helpful for detecting dementia patients and develop better communication and planning of care for elderly. References: El Katateny, E. 2009. Same old, same old: In 2050, a fifth of Egyptians will be age 60 and older. How will the country accommodate its aging population?. Online available at: http://etharelkatatney.wordpress.com/category/egypt-today/page/3/ Fakhr-El Islam, M. 2008. Arab culture and mental health care. Transcultural Psychiatry, vol. 45, pp. 671-682 Ageing and care of the elderly. Conference of European churches. 2007. [online] available at: http://csc.ceceurope.org/fileadmin/filer/csc/Ethics_Biotechnology/AgeingandCareElderly.pdf World Health Organization. 2012 a. Ageing and life course: ageing Publications. [Online] available at : http://www.who.int/ageing/publications/en/ World Health Organization. 2012 b. Ageing and life course: interesting facts about ageing. [Online] available at: http://www.who.int/ageing/about/facts/en/index.html World Health Organization 2012 c. Dementia a public health priority. [online] available at: http://whqlibdoc.who.int/publications/2012/9789241564458_eng.pdf World Health Organization. 2012 d. Why focus on ageing and health, now?. Department of Health. 2009. Living well with dementia: a national dementia strategy. [Online] available at: http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_094058 Andrawes, G., O’Brien, L. and Wilkes, L. 2007. Mental illness and Egyptian families. International Journal of Mental Health Nursing, vol.16, pp. 178-187 National Audit Office. 2007. Improving service and support for people with dementia. London. [online[ Available at: http://www.nao.org.uk/publications/0607/support_for_people_with_dement.aspx Armstrong, J and Mitchell, E. 2008. Comprehensive nursing assessment in the care of older people. Nursing Older People, vol. 20, No. 1, pp. 36-40. Okasha, A. 2001. Egyptian contribution to the concept of mental health. Eastern Mediterranean Health Journal,Vol. 7, no. 3, pp. 377-380. Woods, R., Bruce, E., Edwards, R., Hounsome, B., Keady, J., Moniz-Cook, E., Orrell, M. and Tussell, I. 2009. Reminiscence groups for people with dementia and their family carers: pragmatic eight-centre randomised trial of joint reminiscence and maintenance versus usual treatment: a protocol. Trials Journal: open access, Vol. 10, [online] available at: http://www.trialsjournal.com/content/10/1/64 Grossberg, G. and Kamat, S. 2011. Alzheimer’s: the latest assessment and treatment strategies. Jones and Bartlett, publisher: The United States of America. Alzheimer’s Association. 2009. 2009 Alzheimer’s disease facts and figures. Alzheimer’s & Dementia, Volume 5, Issue 3. [online] Available at: http://www.alz.org/news_and_events_2009_facts_figures.asp Royal College of Nursing. 2010. Improving quality of care for people with dementia in general hospitals. London. National Audit Office. 2007. Improving service and support for people with dementia. London. [online[ Available at: http://www.nao.org.uk/publications/0607/support_for_people_with_dement.aspx Authors: Miss Amira El Baqary, Nursing Clinical instructor, The British University in Egypt email@example.com Dr Emad Sidhom, MBBCh, ABPsych-Specialist in Old Age Psychiatry-Behman Hospital firstname.lastname@example.org
Amira El Baqary
over 7 years ago
So you're sitting in a bus when you see a baby smile sunnily and gurgle at his mother. Your automatic response? You smile too. You're jogging in the park, when you see a guy trip over his shoelaces and fall while running. Your knee jerk reaction? You wince. Even though you're completely fine and unscathed yourself. Or, to give a more dramatic example; you're watching Titanic for the umpteenth time and as you witness Jack and Rose's final moments together, you automatically reach for a tissue and wipe your tears in whole hearted sympathy ( and maybe blow your nose loudly, if you're an unattractive crier like yours truly). And here the question arises- why? Why do we experience the above mentioned responses to situations that have nothing to do with us directly? As mere passive observers, what makes us respond at gut level to someone else's happiness or pain, delight or excitement, disgust or fear? In other words, where is this instinctive response to other people's feelings and actions that we call empathy coming from? Science believes it may have discovered the answer- mirror neurons. In the early 1990s, a group of scientists (I won't bore you with the details of who, when and where) were performing experiments on a bunch of macaque monkeys, using electrodes attached to their brains. Quite by accident, it was discovered that when the monkey saw a scientist holding up a peanut, it fired off the same motor neurons in its brain that would fire when the monkey held up a peanut itself. And that wasn't all. Interestingly, they also found that these motor neurons were very specific in their actions. A mirror neuron that fired when the monkey grasped a peanut would also fire only when the experimenter grasped a peanut, while a neuron that fired when the monkey put a peanut in its mouth would also fire only when the experimenter put a peanut in his own mouth. These motor neurons came to be dubbed as 'mirror neurons'. It was a small leap from monkeys to humans. And with the discovery of a similar, if not identical mirror neuron system in humans, the studies, hypotheses and theories continue to build. The strange thing is that mirror neurons seem specially designed to respond to actions with clear goals- whether these actions reach us through sight, sound, smell etc, it doesn't matter. A quick example- the same mirror neurons will fire when we hop on one leg, see someone hopping, hear someone hopping or hear or read the word 'hop'. But they will NOT respond to meaningless gestures, random or pointless sounds etc. Instead they may well be understanding the intentions behind the related action. This has led to a very important hypothesis- the 'action understanding' ability of mirror neurons. Before the discovery of mirror neurons, scientists believed our ability to understand each other, to interpret and respond to another's feeling or actions was the result of a logical thought process and deduction. However, if this 'action understanding' hypothesis is proved right, then it would mean that we respond to each other by feeling, instead of thinking. For instance, if someone smiles at you, it automatically fires up your mirror neurons for smiling. They 'understand the action' and induce the same sensation within you that is associated with smiling. You don't have to think about what the other person intends by this gesture. Your smile flows thoughtlessly and effortlessly in return. Which brings us to yet another important curve- if mirror neurons are helping us to decode facial expressions and actions, then it stands to reason that those gifted people who are better at such complex social interpretations must be having a more active mirror neuron system.(Imagine your mom's strained smile coupled with the glint in her eye after you've just thrown a temper tantrum in front of a roomful of people...it promises dire retribution my friends. Trust me.) Then does this mean that people suffering from disorders such as autism (where social interactions are difficult) have a dysfunctional or less than perfect mirror neuron system in some way? Some scientists believe it to be so. They call it the 'broken mirror hypothesis', where they claim that malfunctioning mirror neurons may be responsible for an autistic individual's inability to understand the intention behind other people's gestures or expressions. Such people may be able to correctly identify an emotion on someone's face, but they wouldn't understand it's significance. From observing other people, they don't know what it feels like to be sad, angry, surprised or scared. However, the jury is still out on this one folks. The broken mirror hypothesis has been questioned by others who are still skeptical about the very existence of these wonder neurons, or just how it is that these neurons alone suffered such a developmental hit when the rest of the autistic brain is working just dandy? Other scientists argue that while mirror neurons may help your brain to understand a concept, they may not necessarily ENCODE that concept. For instance, babies understand the meaning behind many actions without having the motor ability to perform them. If this is true, then an autistic person's mirror neurons are perfectly fine...they were just never responsible for his lack of empathy in the first place. Slightly confused? Curious to find out more about these wunderkinds of the human brain? Join the club. Whether you're an passionate believer in these little fellas with their seemingly magical properties or still skeptical, let me add to your growing interest with one parting shot- since imitation appears to be the primary function of mirror neurons, they might well be partly responsible for our cultural evolution! How, you ask? Well, since culture is passed down from one generation to another through sharing, observation followed by imitation, these neurons are at the forefront of our lifelong learning from those around us. Research has found that mirror neurons kick in at birth, with infants just a few minutes old sticking their tongues out at adults doing the same thing. So do these mirror neurons embody our humanity? Are they responsible for our ability to put ourselves in another person's shoes, to empathize and communicate our fellow human beings? That has yet to be determined. But after decades of research, one thing is for sure-these strange cells haven't yet ceased to amaze and we definitely haven't seen the last of them. To quote Alice in Wonderland, the tale keeps getting "curiouser and curiouser"!
over 7 years ago
This guidance was released today in the UK and if you haven't read it, it comes into effect in April and essentially is saying: we are allowed to maintain private online social profiles but must be aware if patients can access these and how we handle it if they contact us; any opinions voiced we have to make it clear it is our own and conduct yourself online as you would face to face with regards to confidentiality and boundaries. This is quite interesting for me, as in our medical school there have been select cases of social media being used in disciplinary processes and I know myself that some of the photos I had on Facebook (I have deleted it) were not exactly portraying myself as the 100% professional doctor the GMC would love me to be. But then reading the guidance, it makes no mention of content from when you were younger. When I'm an F1 will anybody really care about the drunk photos of me from freshers week 6 years ago and will these be taken out of context? I get the impression most people won't, but some might. I really think they should have put a summarising take-home message in there somewhere: don't take the p**s, think before you post, don't give out medical advice as anything but your opinion and you'll be fine.
over 8 years ago
Optic neuritis is swelling and inflammation of the optic nerve which may result in dull pain behind the eye, and cause visual impairments such as blurry and distorted vision as well as “blind spots,” and/or “flashing lights, which may become more apparent over the course of several hours, or days.
almost 6 years ago