By P. Milten. Brooks Institute.

In some cultures PA is believed to be associated with ring to physical signs) or cognitive (thinking) symptoms cheap azulfidine 500 mg with amex. They commonly exhibit signs of a sweating cheap 500mg azulfidine, racing heart beat, chest pain, shortness of Signs and symptoms breath, and the perception of feeling smothered. The Criteria for panic attack: panic attack (PA) is usually followed by one month (or more) of one or more of the following thought processes: 1. Breathing difficulties, including shortness of breath • Worry about consequences associated with attacks or perceptions of being smothered. There are no specific laboratory findings associ- Criteria for panic disorder: ated with diagnosing PD. However, evidence suggests that some affected persons may have low levels of car- 1. Worry about the consequences, implications, or called bicarbonate (helps in regulating blood from behavioral changes associated with PA (perceptions becoming to acidic or alkaline). These chemical of going “crazy,” losing control of actions, or suffer- changes may hypersensitize (making cells excessively ing from a life threatening condition, such as a heart sensitive) nerve cells, which can increase the activity of attack). The diagnosis of PD can be made accu- such as phobia (an exaggerated fear to something rately if the specific symptoms and criteria are estab- like spiders or heights). Neuroimaging studies indicate that the arteries (ves- sels that deliver oxygen rich blood to cells and tissues) Criteria for agoraphobia: are constricted (smaller diameter) as a result of increased 1. The essential feature of agoraphobia is anxiety about breathing rates during a PA. These fears usually involve causes of panic attacks such as intoxication with stimu- characteristic clusters of situations that include being lant drugs (cocaine, caffeine, amphetamines [speed]). Elevators are another common cause pro- therapist should obtain a comprehensive medical history moting the occurrence of PA.

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Comparing the extrinsic finger musculature of macaque monkeys to that of humans suggests that human muscles have evolved to provide a greater degree of independence in finger movements purchase 500 mg azulfidine with visa. As noted above 500 mg azulfidine mastercard, when instructed to move one finger alone, lesser motion of other, noninstructed digits occurs along with that of the instructed digit in both species. Quantitatively, however, humans move their fingers more individually than macaques. The human extensor indicis proprius (EIP), which extends only the index finger, is homologous to the macaque ED23, which extends both the index and middle fingers. The human EDQ, which extends only the little finger, is homologous to the macaque extensor digiti quarti et quinti (ED45), Copyright © 2005 CRC Press LLC which extends both the ring and little fingers. Another factor contributing to decreased coupling among human fingers is the greater mechanical separation of tendons in the extrinsic multitendoned finger muscles, particularly EDC and FDP. As noted above, the juncturae tendinium of EDC are less pronounced in the human than in the macaque. The insertion tendons of the macaque FDP all arise from a continuous aponeurotic sheet which is minimally divided as the common tendon crosses the wrist. In humans, the equivalent tendon to the thumb arises from an independent muscle, flexor pollicis longus (FPL), and the tendons to the other digits are separate before they cross the wrist, though tough fibrous sheets still interconnect adjacent FDP tendons within the palm. The human FDP tendon to the index finger arises from a largely separate portion of the muscle belly. Many mammalian muscles, however, have been shown to consist of multiple neuromuscular compartments. The neuromuscular compartments of a muscle can be activated differentially by the central nervous system, producing different biomechanical effects. Similarly, the multitendoned finger muscles, rather than acting as a single motoneuron pool that pulls simultaneously on all four fingers, may be subdivided to different degrees. The extent to which multitendoned finger muscles are partially subdivided, or even fully com- partmentalized, is an area of active investigation.