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Isolated lesions of only tectospinal and reticulospinal fibers are essentially never seen.

Tectospinal fibers project to upper cervical levels where they influence reflex movement of the head and neck. Such move- ments may be diminished or slowed in patients with damage to these fibers.

Pontoreticulospinal (medial reticulospinal) fibers are excitatory to extensor motor neurons and to neurons innervating axial musculature; some of these fibers also may inhibit flexor motor neurons.

In contrast, some bulboreticulospinal (lateral reticulospinal) fibers are primarily inhibitory to extensor motor neurons and neurons innervating muscles of the neck and back; these fibers also may excite flexor motor neurons via interneurons

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Reticulospinal (and vestibulospinal) fibers contribute to the spasticity that develops in patients having lesions of corticospinal fibers.

These fibers, particularly reticulospinal fibers, also contribute to the tonic extension of the arms and legs seen in decerebrate rigidity when spinal motor neurons are released from descending cortical control.

The sudden increase in extensor rigidity, seen in decerebrate patients when a noxious stimulus is applied to, for example, the skin between the toes, is mediated via spinoreticular fibers (traveling in the ALS) that end on reticulospinal neurons whose axons descend to increase the level of excitation to extensor motor neurons

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Medial vestibulospinal fibers primarily inhibit motor neurons innervating extensors and neurons serving muscles of the back and neck.

Lateral vestibulospinal fibers may inhibit some flexor motor neurons, but they mainly facilitate spinal reflexes via their excitatory influence on spinal motor neurons innervating extensors.

Vestibulospinal and reticulospinal (see Figure 8-17 on pp. 222–223) fibers contribute to the spasticity seen in patients with damage to corticospinal fibers or to the tonic extension of the extremities in patients with decerebrate rigidity.

In the case of decerebrate rigidity, the descending influences on spinal flexor motor neurons (corticospinal, rubrospinal) are removed; the descending brainstem influence on spinal extensor motor neurons predominates; this is augmented by excitatory spinoreticular input (via ALS) to some of the centers giving rise to reticulospinal fibers (see also Figure 8-15 on pp. 218–219). See Figure 8-17 for lesions that influence the activity of rubrospinal and reticulospinal fibers.

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The primary motor cortex and premotor cortical areas contain the cell bodies of upper motor neurons whose axons descend along with axons from the primary somato- sensory cortex as the corticonuclear tract to the brainstem and the corticospinal tract to the spinal cord, sending signals about voluntary movement of the head and body, respectively

A 45-year-old man complains of left foot drop, which started 5 months ago. This was very subtle at first, but has been getting progressively worse. The patient can now barely lift his left foot up. He walks with difficulty. More recently he has noticed some clumsiness of his left hand. Upon further questioning he admits to frequent “twitching” of the muscles in his distal lower limbs (particularly in the calf), forearms, and shoulders. His family thinks he has lost some weight. There is no numbness, tingling, pain, or any other neurologic symptom noted. Family history is negative for any neurologic disorder. Examination shows severe weakness and flaccidity of left ankle dorsiflexion and mild weakness of the intrinsic left hand muscles and left finger extension. Otherwise, strength seems adequate. There is atrophy noted in the muscles of the left hand and the left pretibial muscles. Fasciculations are noted in several muscle groups of the legs, arms, and back. Deep tendon reflexes are pathologically brisk in the arms and legs bilaterally. A Babinski response is present bilaterally. The rest of the neurologic exam was unremarkable.

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Premotor cortical areas

The premotor cortical areas consist of four regions: the premotor cortex, supplementary motor cortex, frontal eye field, and the cingulate motor areas, all of which reside in the frontal lobe. The premotor cortical areas function in the programing of complex motor activity, which is then relayed to the primary motor cortex where the execution of motor activity is initiated

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#voting
Pennsylvania
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How To Vote In The 2020 Election | FiveThirtyEight
to close election offices have been announced. Requesting an absentee ballot Oregon automatically mails ballots to all voters. Submitting an absentee ballot Ballots must be received by Nov. 3. <span>Pennsylvania Registration s'inscrire to vote by Oct. 19. You can register online here. Voting early No true early vote, but vous can cast a “mail” ballot in person at your county election office. In




#voting
Ballots must be received by Nov. 3.
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How To Vote In The 2020 Election | FiveThirtyEight
oter can request a mail-in ballot without an excuse. You can apply for a mail-in ballot en ligne here. Election officials must receive your application by Oct. 27. Submitting an absentee ballot <span>Ballots must be received by Nov. 3. What we’re watching The Trump campaign has sued the state over its mail-in ballot procedures, including setting up drop boxes for voters to deposit their ballots in. However, Democrats




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Approximately two-thirds of the corticospinal tract fibers (Fig. 13.5) originate from the pyramidal cell layer of the frontal cortex ; that is, one-third arise from Brodmann’s area 4, and one-third from area 6 (mostly from the supplementary motor area, with some fibers from the premotor cortex).

The other third of the corticospinal tract fibers arise from the parietal cortex; specifically from the posterior parietal area (Brodmann’s areas 5 and 7) and the somatosensory cortex (Brodmann’s areas 3, 1, and 2)

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The pyramidal cells (pyramidal neurons) are referred to as the upper moto- neurons (UMNs) of the descending motor pathways. Their axons descend to synapse in the spinal cord gray matter with: • interneurons in laminae V–VII, which in turn synapse with motoneurons; • alpha motoneurons, which innervate skeletal muscle fibers; or • gamma motoneurons, which innervate the contractile portion of muscle spindles (muscle stretch receptors)
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The corticospinal tract consists of a mix of large-diameter, heavily-myelinated, fast-conducting axons and small-diameter, lightly-myelinated and unmyelinated axons.
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Unlike the upper motoneurons, the fibers arising from neurons residing in the somatosensory cortex descend to synapse with second order sensory neurons in the somatic relay nuclei of the ascending sensory pathways (and thus are not considered to be upper motoneurons). There they influence motor activity by modulating the transmission of sensory information to higher brain centers (see later)
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As the fibers continue their descent, they gradually shift in a posterior direction and come to occupy the posterior half (or posterior third) of the posterior limb of the internal capsule.
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When the internal capsule is viewed on a coronal section of the cere- brum, the corticospinal fibers are somatotopically organized so that the fibers terminating in more rostral levels of the spinal cord (innervating the upper limb) are located more rostrally, whereas the fibers that terminate in lower spinal cord levels (innervating the lower limb) are located more caudally
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When the fibers reach the midbrain, they are located in the middle third of the crus cerebri (basis pedunculi) of the cerebral peduncle. The corticospinal fibers are somatotopically orga- nized at this level also. The fibers innervating the upper limb are located medially, next to the corticonuclear tract, whereas the fibers that innervate the lower limb are located laterally.
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The corticospinal tract continues inferiorly through the brain- stem where it disperses into bundles in the basal pons and then reassembles to form a distinct bundle known as the pyramid (a protuberance on the ventral aspect of the medulla)
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In the medulla, the fibers maintain the same somatotopic organization as in the crus cerebri: that is, the fibers that innervate the upper limb are located medially, whereas the fibers that innervate the lower limb are located laterally.
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The axons that emerge from the neurons residing in the lateral surface of the primary motor cortex controlling the upper limb, decussate in the rostral aspect of the pyramidal decussation, whereas the axons that emerge from the neurons residing in the medial surface of the primary motor cortex controlling the lower limb decussate in the caudal aspect of the pyramidal decussation. These axons then descend in the lateral funiculus (L., “cord”) of the entire length of the spinal cord, as the lateral corticospinal tract, with fibers exiting the tract to synapse in the cervical spinal cord located medially, and the fibers that synapse in the lumbar and sacral levels are located laterally.
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Figure 13.5 ● The origin, course, and termination of the corticospinal tracts. The lateral corticospinal tract synapses with lower motoneurons that innervate the upper and lower limb muscles, whereas the anterior corticospinal tract synapses with the lower motoneurons that innervate the muscles of the neck, shoulder, and trunk, as well as the proximal upper limb (girdle) musculature.
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Flashcard 5714575494412

Tags
#Components #Monitoring #SQL #Server
Question
How to monitor SQL Server components ?
Answer

To monitor any component of SQL Server effectively:

  1. Determine your monitoring goals.
  2. Select the appropriate tool.
  3. Identify components to monitor.
  4. Select metrics for those components.
  5. Monitor the server.
  6. Analyze the data.

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Monitor SQL Server Components - SQL Server | Microsoft Docs
, such as memory and disk space, to minimize the need for extensive system-level manual tuning. Monitoring lets administrators identify performance trends to determine if changes are necessary. <span>To monitor any component of SQL Server effectively: Determine your monitoring goals. Select the appropriate tool. Identify components to monitor. Select metrics for those components. Monitor the server. Analyze the data. These steps are discussed in turn below. Determine Your Monitoring Goals To monitor SQL Server effectively you should clearly identify your reason for monitoring. Reasons can include th







Flashcard 5714577329420

Tags
#Components #Monitoring #SQL #Server
Question
How to determine your monitoring goals ?
Answer

Determine Your Monitoring Goals

To monitor SQL Server effectively you should clearly identify your reason for monitoring. Reasons can include the following:

  • Establish a baseline for performance.
  • Identify performance changes over time.
  • Diagnose specific performance problems.
  • Identify components or processes to optimize.
  • Compare the effect of different client applications on performance.
  • Audit user activity.
  • Test a server under different loads.
  • Test database architecture.
  • Test maintenance schedules.
  • Test backup and restore plans.
  • Determining when to modify your hardware configuration.

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Monitor SQL Server Components - SQL Server | Microsoft Docs
onitoring goals. Select the appropriate tool. Identify components to monitor. Select metrics for those components. Monitor the server. Analyze the data. These steps are discussed in turn below. <span>Determine Your Monitoring Goals To monitor SQL Server effectively you should clearly identify your reason for monitoring. Reasons can include the following: Establish a baseline for performance. Identify performance changes over time. Diagnose specific performance problems. Identify components or processes to optimize. Compare the effect of different client applications on performance. Audit user activity. Test a server under different loads. Test database architecture. Test maintenance schedules. Test backup and restore plans. Determining when to modify your hardware configuration. Select the Appropriate Tool After determining why you are monitoring, you should select the appropriate tools for that type of monitoring. The Windows operating system and SQL Server pr







#Anatomie #Clinique #GarjoSyndromePyramidal #Medecine #Médecine #Neurologie #Physiologie
The lateral corticospinal tract mediates the execution of rapid, skilled, voluntary movements of the distal musculature of the upper and lower limbs, especially the intrinsic muscles of the hand
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The lateral corticospinal tract contains mostly crossed fibers; however, a small percentage of its fibers are uncrossed. This tract contains among its fibers a group of large-diameter myelinated axons arising from the giant Betz cells residing in the primary motor cortex
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Flashcard 5714582310156

Tags
#Components #Monitoring #SQL #Server
Question
Which SQL monitoring tool are provided by Microsoft ?
Answer

Select the Appropriate Tool

After determining why you are monitoring, you should select the appropriate tools for that type of monitoring. The Windows operating system and SQL Server provide a complete set of tools to monitor servers in transaction-intensive environments. These tools clearly reveal the condition of an instance of the SQL Server Database Engine or an instance of SQL Server Analysis Services.

Windows provides the following tools for monitoring applications that are running on a server:

  • System Monitor, which lets you collect and view real-time data about activities such as memory, disk, and processor usage.
  • Performance logs and alerts
  • Task Manager
  • Extended Events


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Monitor SQL Server Components - SQL Server | Microsoft Docs
ser activity. Test a server under different loads. Test database architecture. Test maintenance schedules. Test backup and restore plans. Determining when to modify your hardware configuration. <span>Select the Appropriate Tool After determining why you are monitoring, you should select the appropriate tools for that type of monitoring. The Windows operating system and SQL Server provide a complete set of tools to monitor servers in transaction-intensive environments. These tools clearly reveal the condition of an instance of the SQL Server Database Engine or an instance of SQL Server Analysis Services. Windows provides the following tools for monitoring applications that are running on a server: System Monitor , which lets you collect and view real-time data about activities such as memory, disk, and processor usage. Performance logs and alerts Task Manager For more information about Windows Server or Windows tools, see the Windows documentation. SQL Server provides the following tools for monitoring components of SQL Server: Extended Events SQL Trace SQL Server Profiler Distributed Replay Utility Activity Monitor SQL Server Management Studio Graphical Showplan System Stored procedures Database Console Commands (DBCC) Dynamic Management Views and Functions Functions Trace flags Important SQL Trace and SQL Server Profiler are deprecated. The Microsoft.SqlServer.Management.Trace namespace that contains the Microsoft SQL Server Trace and Replay objects are also d







#Anatomie #Clinique #GarjoSyndromePyramidal #Medecine #Médecine #Neurologie #Physiologie
Most of the lateral corticospinal tract upper motoneurons (whose cell bodies reside in the motor cortex in the frontal lobe) projecting to the cervical and lumbosacral spinal cord, end in laminae VII–IX in the lateral intermediate zone gray matter (a region of the spinal cord gray matter that is populated by interneurons, and is thus similar to the reticular formation of the brainstem, which also contains interneurons), as well as the anterior (ventral) horn gray matter (containing interneu- rons and lower motoneurons), where they form excitatory syn- apses with interneurons
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Flashcard 5714585718028

Tags
#Components #Monitoring #SQL #Server
Question
Which Server component do you want to identitfy ?
Answer

Identify the Components to Monitor

The third step to monitoring an instance of SQL Server is to identify the components that you monitor. For example, if you are using SQL Server Profiler to trace a server you can define the trace to collect data about specific events. You can also exclude events that do not apply to your situation.


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Monitor SQL Server Components - SQL Server | Microsoft Docs
filer for Analysis Services workloads is NOT deprecated, and will continue to be supported. For more information about SQL Server monitoring tools, see Performance Monitoring and Tuning Tools . <span>Identify the Components to Monitor The third step to monitoring an instance of SQL Server is to identify the components that you monitor. For example, if you are using SQL Server Profiler to trace a server you can define the trace to collect data about specific events. You can also exclude events that do not apply to your situation. Select Metrics for Monitored Components After identifying the components to monitor, determine the metrics for components you monitor. For example, after selecting the events to include







#Anatomie #Clinique #GarjoSyndromePyramidal #Medecine #Médecine #Neurologie #Physiologie
The first order afferent fibers transmitting sensory input from the muscle spindles also establish synaptic contacts with the in- hibitory interneurons (receiving input from the corticospinal fibers) in the spinal cord, mediating reflex activity
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In contrast, a small number of the lateral corticospinal tract upper mo- toneurons project to the anterior (motor) horns of the spinal cord, where they form excitatory synapses directly with lower motoneurons. Many of these monosynaptic connections are with lower motoneurons innervating muscles of the hand
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The Betz cell fibers descend to terminate in the lumbar and sacral spinal cord levels where they synapse directly with the lower motoneu- rons that innervate the musculature of the lower limb. These monosynaptic connections of Betz cells with the lower moto- neurons innervating the muscles of the lower limb are actu- ally fewer in number than the monosynaptic connections to lower motoneurons innervating the hand
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Flashcard 5714592271628

Tags
#Components #Monitoring #SQL #Server
Question
How to select metrics for SQL monitoring ?
Answer

Select Metrics for Monitored Components

After identifying the components to monitor, determine the metrics for components you monitor. For example, after selecting the events to include in a trace, you can choose to include only specific data about the events. Limiting the trace to data that is relevant to the trace minimizes the system resources required to perform the tracing.


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Monitor SQL Server Components - SQL Server | Microsoft Docs
example, if you are using SQL Server Profiler to trace a server you can define the trace to collect data about specific events. You can also exclude events that do not apply to your situation. <span>Select Metrics for Monitored Components After identifying the components to monitor, determine the metrics for components you monitor. For example, after selecting the events to include in a trace, you can choose to include only specific data about the events. Limiting the trace to data that is relevant to the trace minimizes the system resources required to perform the tracing. Monitor the Server To monitor the server, run the monitoring tool that you have configured to gather data. For example, after a trace is defined, you can run the trace to gather data ab







#Anatomie #Clinique #GarjoSyndromePyramidal #Medecine #Médecine #Neurologie #Physiologie
Although the lateral corticospinal tract contains mostly crossed fibers, it also contains a minor group of fibers (approximately 2–3%), that do not cross at the pyramidal decussation, but instead descend ipsilaterally. Thus, the lat- eral corticospinal tract contains both crossed and uncrossed fibers. At their termination, the uncrossed fibers synapse with the spinal cord interneurons mediating movement of the axial (trunk) and proximal limb (girdle) musculature. The uncrossed fibers are associated with the maintenance of upright posture and general orientation of the limbs
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Flashcard 5714595679500

Tags
#Components #Monitoring #SQL #Server
Question
When should I monitor SQL Server ?
Answer

Monitor the Server

To monitor the server, run the monitoring tool that you have configured to gather data. For example, after a trace is defined, you can run the trace to gather data about events raised in the server.


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Monitor SQL Server Components - SQL Server | Microsoft Docs
a trace, you can choose to include only specific data about the events. Limiting the trace to data that is relevant to the trace minimizes the system resources required to perform the tracing. <span>Monitor the Server To monitor the server, run the monitoring tool that you have configured to gather data. For example, after a trace is defined, you can run the trace to gather data about events raised in the server. Analyze the Data After the trace has finished, analyze the data to see if you have achieved your monitoring goal. If you have not, modify the components or metrics that you used to moni







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Approximately, one-third of the lateral corticospinal tract axons (whose cell bodies reside in the parietal lobe) project to laminae IV–VI of the posterior horn gray matter.
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Flashcard 5714599873804

Tags
#Components #Monitoring #SQL #Server
Question
How to analyze SQL monitoring data ?
Answer

Analyze the Data

After the trace has finished, analyze the data to see if you have achieved your monitoring goal. If you have not, modify the components or metrics that you used to monitor the server.

The following outlines the process for capturing event data and putting it to use.

  1. Apply filters to limit the event data collected..

  2. For more information on filtering Extended Event traces, see Quick Start: Extended events in SQL Server.

  3. Monitor (capture) events.

  4. Save captured event data.

  5. Create trace templates that contain the settings specified to capture the events.

  6. Analyze captured event data.

  7. Replay captured event data (optional).


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Monitor SQL Server Components - SQL Server | Microsoft Docs
nitor the server, run the monitoring tool that you have configured to gather data. For example, after a trace is defined, you can run the trace to gather data about events raised in the server. <span>Analyze the Data After the trace has finished, analyze the data to see if you have achieved your monitoring goal. If you have not, modify the components or metrics that you used to monitor the server. The following outlines the process for capturing event data and putting it to use. Apply filters to limit the event data collected. Limiting the event data allows for the system to focus on the events pertinent to the monitoring scenario. For example, if you want to monitor slow queries, you can use a filter to monitor only those queries issued by the application that take more than 30 seconds to run against a particular database. For more information on filtering Extended Event traces, see Quick Start: Extended events in SQL Server . For more information on filtering SQL Trace, see Set a Trace Filter (Transact-SQL) and Filter Events in a Trace (SQL Server Profiler) . Monitor (capture) events. As soon as it is enabled, active monitoring captures data from the specified application, instance of SQL Server, or operating system. For example, when disk activity is monitored using System Monitor, monitoring captures event data, such as disk reads and writes, and displays it on the screen. For more information, see Monitor Resource Usage (System Monitor) . Save captured event data. Saving captured event data lets you analyze it later. Captured event data that is saved to a file that can be loaded back into the tool that originally created it for analysis. Saving captured event data is important when you are creating a performance baseline. The performance baseline data is saved and used, when comparing recently captured event data, to determine whether performance is optimal. Extended Events permits event data to be saved to an event file, event counter, histogram, and ring buffer. For more information, see Targets for Extended Events in SQL Server . SQL Trace event data can even be replayed using the Distributed Replay Utility or SQL Server Profiler. SQL Server Profiler permits event data to be saved to a file or SQL Server table. For more information, see SQL Server Profiler Templates and Permissions . Create trace templates that contain the settings specified to capture the events. Trace templates include specifications about the events themselves, event data, and filters that are used to capture data. These templates can be used to monitor a specific set of events later without redefining the events, event data, and filters. For example, if you want to frequently monitor the number of deadlocks, and the users involved in those deadlocks, you can create a template defining those events, event data, and event filters; save the template; and reapply the filter the next time that you want to monitor deadlocks. An Extended Event session definition is a template that can be scripted and re-used. To create and manage sessions, see Manage Event Sessions in the Object Explorer . The Management Studio XEvent Profiler already provides templates that are ready to use. For more information, see Use the SSMS XEvent Profiler . SQL Server Profiler uses trace templates for this purpose. For more information, see Set Trace Definition Defaults (SQL Server Profiler) and Create a Trace Template (SQL Server Profiler) . Tip A SQL Trace definition can be converted to an Extended Event session. For more information, see Convert an Existing SQL Trace Script to an Extended Events Session . Analyze captured event data. To be analyzed, the captured event data is loaded into the application that captured the data. For example, a captured Extended Event trace can be reloaded into SQL Server Management Studio for viewing ana analysis. For more information, see Advanced Viewing of Target Data from Extended Events in SQL Server . SQL Trace data can be reloaded into SQL Server Profiler for viewing and analysis. For more information, see View and Analyze Traces with SQL Server Profiler . Analyzing event data involves determining what is occurring and why. This information lets you make changes that can improve performance, such as adding more memory, changing indexes, correcting coding problems with Transact-SQL statements or stored procedures, and so on, depending on the type of analysis performed. For example, you can use the Database Engine Tuning Advisor to analyze a captured trace from Extended Events or SQL Server Profiler and make index recommendations based on the results. Replay captured event data (optional). Event replay lets you establish a test copy of the database environment from which the data was captured, and then repeat the captured events as they occurred originally on the real system. This capability is only available with the Distributed Replay Utility or SQL Server Profiler. You can replay the events at the same speed as they originally occurred, as fast as possible (to stress the system), or more likely, one step at a time (to analyze the system after each event has occurred). By analyzing the exact events in a test environment, you can prevent harm to the production system. For more information, see Replay Traces . Is this page helpful? Yes No Any additional feedback? Skip Submit Thank you. Feedback Submit and view feedback for This product This page View all page feedback Theme Light Dark High co







#Anatomie #Clinique #GarjoSyndromePyramidal #Medecine #Médecine #Neurologie #Physiologie
The upper motoneurons of the anterior corticospinal tract do not decussate in the caudal medulla. Instead, they de- scend in the anterior funiculus of the spinal cord to termi- nate mainly in the anterior horn gray matter of the cervical (mainly) and upper thoracic spinal cord levels. Near their termination, these fibers decussate to the opposite side of the spinal cord via the anterior white commissure to synapse with interneurons that in turn synapse with lower motoneu- rons. Other fibers of the anterior corticospinal tract decussate to the opposite side near their termination and instead syn- apse directly with lower motoneurons, innervating the axial musculature (such as those of the neck, shoulder, and trunk) as well as the proximal upper limb (girdle) musculature
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#Anatomie #Clinique #GarjoSyndromePyramidal #Medecine #Médecine #Neurologie #Physiologie
Approximately 55% of all of the corticospinal fibers termi- nate at cervical levels of the spinal cord, 20% terminate at thoracic levels, and the remaining 25% terminate at lumbar and sacral levels of the spinal cord (Fig. 13.8). The large num- ber of corticospinal fibers terminating at cervical spinal cord levels is an indication of the extensive influence they exert on neurons affecting the motor activity of the upper limb mus- culature, especially that of the hand
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Although the fibers of the corticospinal tracts terminate principally in the spinal cord, they distribute collaterals to widespread regions of the nervous system in their descent. Collaterals terminate in the ventral nuclei of the thalamus, the basal nuclei, the reticular formation, the red nucleus, the pontine nuclei, the posterior column nuclei, the posterior (sensory) horn of the spinal cord, and the intermediolateral (lateral) cell column (sympathetic) of the spinal cord. Thus, the corticospinal tract probably has more than one function at various levels of the neuronal axis
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The primary somatosensory area, located in the postcen- tral gyrus (Brodmann’s areas 3, 1, and 2), also projects fibers involved in motor activity to the brainstem and spinal cord.
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Instead, they [The descending somatosensory fibers] synapse with the second order sensory neurons in the somatic sensory relay nu- clei of the sensory ascending pathways (the nucleus gracilis and the nucleus cuneatus of the brainstem), and the sensory nuclei in the dorsal horn of the spinal cord. Their function there is to influence motor activity by modulating the sen- sory information that is relayed to the brainstem and spinal cord from peripheral structures; thus they are not considered to be upper motoneurons.
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