Titanic - Story :: Expository Essays Research Papers

Titanic - StoryHello, my name is Richard Peterson, I am travelling first class, on the Titanic from Ireland, I am moving to New York because I want to make something out of my deep interest in motorcars. I am travelling with my Wife - Mary, Mum - Jean, and crony - John. On the evening of 11th April 1912 at about 11 Oclock I was having a cup of tea with my married woman in our cabin when we felt a rather large inebriate. We didnt think much of it at the time as we thought that is could have been anything. Room service knocked at my door requesting to concur our rubbish, this was when we asked her what the shudder was. She said, Dont worry, it was besides the propeller hitting a small rock, we just stopped the engines to check that they are ok. About a quarter of an hour later a crew member came to our cabin and told us to do our life jackets of and to report up to top deck as soon as possible, this is when both my wife and I started to get a bit worried. As instructed we reported to top deck, but on the way up we were asked the man who made the ship what had happed. He said, We only have 2 hour at the most, Im afraid to admit, my ships going to sink. We knew we didnt have much time but enough to easily get on to a lifeboat. So we went back to our cabin and rushed down a cup of tea to stop us from dehydrating as we didnt know how long it would take for an another(prenominal) boat to pick us up. Then we went to the restaurant as got some biscuits for us and the other people which would be on our life boat. With only having 1 hour to spare we rushed as quick as we could to the top deck, we looked everywhere but couldnt find a life boat, then when we got to the other side of the deck we found a lifeboat, we cued up for it, we waited about ten minutes until it got to us, then finally we were one of the last four people to get of the lifeboat, we were cramped up, there were forty people on our lifeboat. After about half an hour we were terrified, as we were watch ing the

Environmental Apocalypse :: Environment Consumerism Population Essays

Environmental Apocalypse The environment is in a terrible condition and although an environmental apocalypse is not imminent we are definitely headed down that road. Some of the reasons for our Earths trouble are over race, consumerism, and over inspiration.The earths population is ever increasing it is only a matter of time before there are not enough resources to support life on the planet and the population begins to die off due to lack of food, water, and other resources. With our current population increase rates the population will double within the next century. Indeed, the humanness population did double in thirty-seven years from 1950 to 1987. (Ehrlich, 1990) The problem with overpopulation is that even if we all reduce our impact on the environment, when the population doubles, so will the meat impact on the earth will be doubled. Consumerism is another thing that is threatening our planet. Everyone who wants to be anyone must cook whatever is cool at the time. This usu ally authority the biggest, meanest, least efficient car or the fanciest toys, generally leading to wasteful packaging and harmful chemicals or other bad stuff. In short, Impact = world * Affluence * Technology. (Ehrlich, 1990) The problem is that everyone cares too much about societies image of them that they dont think about the results of their actions. We also have a problem with the consumption of our resources. Many of the resources that we rely like fossil fuels, forests, and water are non-renewable. We are rapidly depleting these and have nothing to use when they are gone. Our society will have a lot of trouble turning around their habits until we are desperately low on them and it will be too late. It will be awkward to develop alternative technologies because of a lack of government funding, and the people who have the money (oil companies) do not want their income taken away by a different resource.

Direct :: Computer Science

DirectDirect input methods.In this report I am button to explain the different direct inputmethods starting off with turf out codes.A single barcode number is truly seven units. A unit is eitherblack or white. A unit that is black would display as a bar. A unitthat is white would display as a space. Another way of writing abarcode unit is 1 for a single unit black bar and 0 for a singleunit white space. For instance, the number 1 is composed of theseven units, 0011001 or space-space-bar-bar-space-space-bar.Remember, a single barcode number requires seven units.Also, on a UPC barcode the said(prenominal) numbers on the left-hand side (theManufacturer Code) is coded different than the numbers on theright-hand side (Product Code). The left side numbers are actually theinverted or mirrored codes of the right side numbers, for instancewhat is a bar on the right-side, is a space on the left-side. Theright-side codes are called even mirror symmetry codes because there is aneven numbe r of black bar units. For instance the right-side 6 is101000 - 2 even-numbered black bar units. The left-side is calledodd-parity because there is an odd number of black bar units. Forinstance, the left-side 6 is 0101111 - 5 odd-numbered black barunits. Having different coded numbers for each side allows the barcodeto be scanned in either way.Direct input methods.In the second base part of my report on direct input methods I am going tobe talking about magnetised mark readers.A magnetized stripe reader, also called a magstripe reader, is ahardware device that reads the information encoded in the magneticstripe located on the back of a tensile badge. Magnetic stripe readerscan be read by a computer program through a serial port, USBconnection, or keyboard wedge, and are broadly speaking categorized by theway they read a badge. For instance, insertion readers require thatthe badge be inserted into the reader and then pulled out. Swipereaders require that the badge consider com pletely through the reader.The magnetic stripe on the back of a badge is composed of iron-basedmagnetic particles encased in plastic-like tape. Each magneticparticle in the stripe is a tiny bar magnet about 20-millionths of aninch long. When all the bar magnets are polarized in the samedirection, the magnetic stripe is blank. Information is written on thestripe by magnetizing the tiny bars in either a north or south poledirection with a special electromagnetic writer, called an encoder.The writing process, called flux reversal, causes a change in themagnetic field that can be detected by the magnetic stripe reader.

Islamic Religion :: essays research papers

Todays Muslims are branded as terroristsor fudamentalist. But their pietism is a gentle religion. Onthe Arabian Penninsula, home of the Arabs, was isolatedand they were able to develop their civilization withoutoutside influences. It is about 1 million miles square, that islocated amongst the Red sea and the Persian Gulf. Thereare two distinctive regions. The first has well-wateredvalleys between mountains and the second is arid plainsand desert. Grass grows quickly during the showes of therainy season. In ancient times the Arabs were bedouin(nomads that hersed sheep, goats, and camels. and lived intents made made of felt from camel or goat hair.) They atefresh or dried dates and drank milk from their herds. On redundant occasions they ate mutlon. their tribes were made ofrelated families. They valued family ties becuase becausethey ensured they ensured protection and survival. Theyhad a chief (sheikh). The sheikh ruled as long as the tribeallowed him. They had a counsil of elders . There waswarfare over waterholes and pastures. Their way ofpunishment is an eye for sn eye and a tooth for a tooth. Toimprove warrior skills they had camel and horse. They hadstory telling in frount of the campfire. They had meterabout battles, desert, camels, horses, and love. In 500A.D. they started a town called Makkah, which was fiftymiles inland of the Red sea. Trade was mostly of animalproducys for weopeans dates grains, spices, jewels ivory,silk, and perfumes. They had caravans travel there from asfor china. Arabs had and hero-worship many ditied businessties were replaceing family ties, and old tribal laws were notadequat Byzantine and the Persin armies were threatining toconquer them. The tribes had the some language but theyhad no central goverment, or sense of unity, The Arabssearched for bran-new beliefs. The prohet of Islam wasmuhammad. He was born in Makkah in 570 A. D. . Hewas orphaned at an early age and was adopted by hisuncle. He worked as a carovan attractor on a trade route. Hewas know to be honest and able. His employer khadija ,aweakthy window if age 40, put him in charge of thisbusiness and proposed marriage to him. He went to a caveoutside the city in 610 A.D. to pray and fast reveloution(vision) there. He was told to recite. "Recite in the name ofyour lord, the creator who created man from clots ofblood. Rwcite Your lord os the most bountiful one who bythe pen has taught mankind things they didnt know.

Totalitarian Society As Showed Essay -- essays research papers

Totaliterainism found in Animal FarmGeorge Orwells story, Animal Farm, is a satire of Soviet Russia. In a more general sense, however, the story traces the rise and fall of any totalitarian regime. All of the beasts on Animal Farm somehow contribute to either the creation, destruction, or temporal success of the totalitarian government. The original goal of the Animal Farm society is a socialist society, but it turns bad.As the animals begin the Animal Farm society, e very(prenominal)one is equal. As time passes, it is realized that of all the animals, the pigs are the smartest. This is slowly the beginning of Animal Farm moving froma socialistic socoety to a totalitarian society. Snowball and Napolean are cardinal pigs who are constantly arguing over issues they compete for power. Snowball is a good speaker and can easily persuade people, whereas Napolean is not a very good speaker. Napolean was jealous of Snowball, and he was power hungry. One day, he had his nine enourmouis d ogs chase Snowball off the farm. Now Napolean was in complete control, and he make it seem like he was putting a hardship on himself by doing so. Squealer was sent around and said, I trust that every animal here appreciates the sacrifice that Comrade Napolean has made in taking this extra labor upon himself. Do not imagine, comrades, that leadership is a pleasure (69) It was here that the shifting to totalitarianism became rapid.Aside from the pigs and dogs on Animal Farm, the other animals were not that smart....

Totalitarian Society As Showed Essay -- essays research papers

Totaliterainism found in Animal FarmGeorge Orwells story, Animal Farm, is a satire of Soviet Russia. In a more oecumenical sense, however, the story traces the rise and fall of any totalitarian regime. All of the animals on Animal Farm somehow contribute to either the creation, destruction, or temporary achievement of the totalitarian government. The original goal of the Animal Farm society is a socialist society, but it turns bad.As the animals begin the Animal Farm society, everyone is equal. As quantify passes, it is realized that of all the animals, the pigs ar the smartest. This is slowly the beginning of Animal Farm moving froma socialistic socoety to a totalitarian society. Snowball and Napolean are two pigs who are constantly arguing over issues they compete for power. Snowball is a strong speaker and can easily persuade people, whitheras Napolean is not a very good speaker. Napolean was jealous of Snowball, and he was power hungry. One day, he had his nine enourmouis d ogs chase Snowball off the farm. Now Napolean was in complete control, and he made it count like he was putting a hardship on himself by doing so. Squealer was sent around and said, I trust that every animal here appreciates the sacrifice that Comrade Napolean has made in taking this extra labor upon himself. Do not imagine, comrades, that leadership is a pleasure (69) It was here that the shift to tyranny became rapid.Aside from the pigs and dogs on Animal Farm, the other animals were not that smart....

Master’s Prepared Nurse Interview Essay

Due to the demands of an evolving wellness supervise system and an emphasis in health and wellness, overpowers prepared nurses are in demand. What does a Masters prepared nurse entails? According to the American Association College of Nursing, Masters prepared nurses obtain a higher train of learning as well as key competencies and skills. The ultimate goal is to achieve positive patient outcomes resulting in an overall improved health care system. The purpose of this paper is to provide insight on a Masters prepared nurse conducted through an interview. My interviewee has obtained an MSN in Informatics and is currently employed in the Informatics field as a Nurse Informaticist. Overview of CareerMy interviewee started her career path with an Associates degree in Nursing. As a new graduate in nurse, her first job in nursing was in an acute care setting on a telemetry unit. After devil years as a staff nurse in telemetry she was promoted to charge nurse and remained in this posi tion for three years. She then decided to further her procreation in nursing but still needed to work full time. To her gain, her employer had recently partnered up with a university offering online and traditional courses. Eventually, the online fast track RN-BSN was her cream of choice. It took her 18 months to obtain her BSN from the University of Phoenix. After completing her BSN, awaiting her was a promotion for a supervisor position on the telemetry unit. She accepted the position and remained in this positon for seven years. During that time, she alike served in the role of interim manager and was instrumental in planning and implementing the electronic health record. The electronic health record became her passion. She was one of the lead trainers and last accepted a role as a full time trainer at heart the hospital. The position as a full time trainer in the hospital morphed into a position at the hospitals corporate level. She took on a new title as ananalyst within the clinical informatics department. Her passion grew more as the years went by. The next step that followed was an advanced nursing degree. Graduate EducationMy interviewee obtained her Masters in Informatics at the University of Phoenix in 2013. Transitioning into the Masters program was seamless since this school was where she obtained her BSN. The online route was most efficient and that is the route she pursued. The University of Phoenix Master of Science in nursing degree program is accredited by the Commission of Collegiate Nursing Education (University of Phoenix, 2014). The goal of this program is to equip nurses to choke in leadership roles in a variety of settings. Additionally, nursing theories and evidence-based practices are fundamental steerlines in this program that will help shape the future of nursing thus impacting the health care system (University of Phoenix, 2014). More specifically, the informatics program afford students to gain knowledge in data management and information engineering science in regard to the health care setting (University of Phoenix, 2014). According to my interviewee, the Masters graduate program as compared to the undergraduate program was more dispute but yet rewarding. This was attributed to the fact that she had a strong passion for informatics and wanted to obtain a higher level of education. Present PositionAs a Nurse Informaticist, the interviewee felt that she has been able to bridge the gap between Information Services and Nursing. wholeness of the primary responsibilities of an Informatics nurse is ensuring the electronic health record is easy to use and provides relevant information. Workflow analysis, assessment of current and future technological needs are additional responsibilities. Pearls of WisdomWhen pursuing pass on ones educational level, time spent researching and interviewing can prove beneficial. Furthermore, one has to be prepared mentally, physically, and often times financially. Planni ng and organizing will minimize, if non eliminate barriers. I was impressed with the interviewees drive toward ongoing learning. Determination speaks for a nurse beginning at the ADN level, advancing to a BSN and ultimatelyobtaining a MSN. ConclusionHealth care as we know is transforming and the health care workforce has been taxed with equipping themselves thus aligning with the transformation. Information technology is ever change magnitude and is impacting the way health care is delivered (Cipriano and Murphy, 2011). Pursuing a masters degree in nursing is a step in the right direction. One key competency that was identified in this interview and consistent with AACN is lifelong learning. My personal gain from this interview is using determination and passion to help guide ones career path.ReferencesAmerican Association College of Nursing. (n.d.). Masters Education for Advanced Practice Nursing. Retrieved from American Association of Colleges of Nursing http//www.aacn.nche.edu/ education-resources/MasEssentials96.pdfCipriano, P.F., & Murphy, J. (2011). Nursing Informatics, The futurity of Nursing and Health IT The Quality Elixir. Nursing Economics, 29(5), 286-282 University of Phoenix. (2014). Masters Science Nursing Informatics. Retrieved from University of Phoenix http//www.phoenix.edu/programs/degree-programs/nursing-and-health-care/masters/msn-inf.html

Financial statement analysis

Most notcapable fruits from orchard apple tree include the Phone, Pod, Pad, ND Imax personal computers. apple is in like manner involved in computer and web based application developments, which support their essential ingatherings such as Tunes, Safari, and Cloud. Through its innovative, stream declivityd, user-friendly designs, orchard apple tree has achieved a meteorologic rise to industry domination since 2002. This ontogeny, just, has recently come to a relative stand soothe pursual its peak in 2012 and has investors speculating if this marks the end of Apples optimistic behavior, or just a minor forwardness grit because of the societys change of management.Apple Inc. Saw a 9% core attach in revenue this sat socio-economic class from SSL 56,508 trillion in 2012 to $170,910 one meg gazillion in 201 3(Apple Inc. , 2013). This growth is in part overdue to the release of the Phone As and c models, the introduction of the Pad mini retina intro as headspring as the accompanys normal day to day down-to-earth sales. This 9% growth may be somewhat cause for concern though, as introductory social classs adjoin in revenue saw a 45% average growth from year to year (44% in 2012 and 65% in 2011).Apples yearbook release of untried products typically yields a 30% general growth in revenue, which potentially indicates at that pop out is stagnation of growth boilers suit in the authorized racket. This stagnation may be attri entirelyed either to heavy satu proportionalityn of products within the on-line(prenominal) trade, leaving little opportunity for expansive growth, or that consumers atomic number 18 unaffected with the rate of flow product line. Apples peer firm Microsoft (MOST) has seen a modest 5% improver in resume revenue from $73,723 one thousand million to $77,849 million from 2012 to 213 respectively (Microsoft Corporation, 2013).This join on is pursuant(predicate) with prior 3 years which fork over each yielded a 4-5% attach in revenue. Compared to Apple, Microsoft has a comparatively stable growth and be attributed to the elatedly arranged flow of products from year to year. The realises per handle ratio (PEPS) reflects the spurn in overall pull aheadability as hearty, with a 10% decline in Apples PEPS from $44. 43 to $40. 29 in 2012 and 2013 respectively (Apple Inc. , 2013).This shadower be attributed to two factors a shine in net profit margin and a paralleled fall in egregious profit margin. There was an 11% light in net profits because of an amplification in overall inventory. Increasing inventory tribulationament to a fault increase a company s operate expenses as they accommodate spick-and-span work. Companies typically raise their inventory evils as they release new products in anticipation for projected consumer demand for these products.As is the case with Apple, this exit lease a negative impact on a companys net profit when there is little than anticipate d demand for their new product. The depreciation of older inventories can also be responsible for an overall decline in profitability. Microsoft has conversely seen an increase in PEPS from $2. 03 per shard to $ 2. 63 per cope as a result of an increasing profit margin ratio from 23% to 28% in 201 3(Microsoft Corporation, 2013). overall this increase can be attributed to an increase in ales over the period as new technologies are release.Overall PEPS increase as a result of Microsofts bring low CEQ handicraft/investment into their company where as Apple has put much much equity into the release of their new releases in 2013. The increase in woo of sales is reflected in the decline of the complete(a) profit margin ratio which is an additional indicator for a comprehensive light in profitability. Apples come in gross profit fell from $44. 00 to $38. 00, in 2012 to 201 3 respectively, which is below the $42. 00 industry average as their damage of sales experienced a 22% incr ease from 587,846 million to 1 06,606 million dollars.The decrease in gross profit is explained by a number of factors consort to Apple introduction of new versions of existing products with highschooler(prenominal) cost structures and flat or reduced pricing a shift in sales mix to products with lower margins introduction of round mini with a gross margin significantly below the callers average product margins higher expenses associated with changes to veritable Of the associations redevelopment policies and other warranty costs appraise reductions on certain products, including pad 2 and phoned and an unfavorable impact room foreign exchange fluctuations. (Apple Inc. , 2013). An intangible effect that could positively impact Apples gross profit in the enormous come stumble is an increase in the number of product consumers as well as a potential increase in consumer loyalty. When compared to Microsoft smaller 2% decrease of gross profit margin from 76% to 74% in 2013. M icrosoft decision to decrease sales price of windows 8 and decrease margins for the Oxbow One is responsible for the decrease in gross profit margin much like Apple. Tooth Apple inchs and Microsofts overall decrease of gross profit margin can be utter o increase consumer satisfaction because to a greater extent advanced technologies are sold at a lower margin thus giving a guest more value to their purchase. By lowering the price on certain high value items, such as the phone 4 and the pad 2 mentioned in Apples bidding, Apple has made these products more accessible to potential customers with lower incomes or frugal spending habits.Furthermore, if there is an increase in Apple product consumers as a result of the change in price, there leave likely be an increase in customer loyalty and satisfaction with these products. The PEPS decline and he increase in cost of sales can progress be explored with an analysis of the companys balance sheet. There was a significant increase in Apples inventory from $791 million to SSL . 76 trillion from 2012 to 2013 respectively. This 123% increase in inventory demonstrates a wholesale investment in anticipated consumer demand and loyalty.Apple typically announces product releases long before the actual release date in order to build market hype and also sets release dates to coincide with measure of historically greater spending in the market, such as the Christmas holiday season. This hyping recess, however, can go both ways in terms of sales by either positively make up consumer anticipation or by allowing time for consumers to second guess the product before it is released. There is also an infixed assay in inventory expansion based on projected sales consumers may just not be in the market for new products.An trace that this may be the case is found by looking at the inventory disturbance ratio which experienced a decrease from 11 1 clock per quarter to significantly lower 83 times per quarter. Microsoft, lik e Apple, has seen a significant decrease of inventory turnover of 14% from 15. 2 times to 13. 13 times per quarter. This decrease in overall turnover much like, Apple is due to customer anticipation of newer release. However, these changes were significantly different for Microsoft as their offerings have less volatility, in particular in sales of operating systems, and usually see less adoption by consumers in starting stages.Apple acid test ratio, involving current assets over current liabilities, stands at 1. 64 in 2013 which is an increase of approximately 8 points from 2012. This is much higher than the industrial average of 1. 0, indicating Apple is a relatively safe investment and has enough in current assets to cover its debt Obligations. This sets Apple as one of the safer blue chip stocks that can provide consistent riches for their share holders. Microsoft has experienced a increase acid test ratio from 2012 to 201 3 from 2. 57 to 2. 66 respectively this is significantl y higher than Apple Inc. ND can be said to be a safer investment. Microsoft overall keeps their balance of ratios to asset rattling consistent and insures that they can represent their bottom line as well as provide security for their investors, more so than Apple In the third quarter of 201 3 Apple accrued tot of 1 6,960 million dollars in debt. The long term debt was used to offset the buyback of stock of $22. 9 billion as well as dividend equivalent weight rights of $10. 6 million dollars. This accrued debt helps Apple Inc avoid taxes of upwards of $9. 2 billion dollars (Burrows, 2013) meanwhile Apple will merely incur a $308 million chase a year.Had they used their offshore exchange Apple would have had to pay a 35% tax and will save another $1 00 million as these interest payments are tax deductible (Burrows, 2013). Apples move to take on this debt to finance $55 billion dollars in stock repurchase is an feat to increase overall earnings per share as well as increase to tal value to the consumer meanwhile adding to overall company value. The statement of cash flows revealed that In 201 2 Apple board of directors authorized a $10 billion stock which was later raised to a total of $60 billion in 2013.Apple repurchased/retired a total of $22,860 million dollars worth of stock in 201 3 as opposed to issuance of 665 million in 2012. Apple verbalize that this repurchase was a move to increase end value to shareholders. Shareholders that are offered barter for back will in turn gain profit and will decrease the overall outstanding shares. By decreasing the total shares the companys earnings per share ratio will consequently increase, and given the current mean should increase PEPS by slightly $4 over the following fiscal year (Hughes, 2013) and adding to the companys overall worth.The overall decrease in outstanding shares also decreases the total add up of dividends paid to investors thus cutting expense and adding to company revenues. Apple began i ssuing dividends toward the end of 2012 and has since seen a significant raise in dividends issued to its stockholder. Apple has since issued $10,564 million of colouring to shareholders representing a 324% increase dividends paid for 2013 from the $2,488 of dividends paid in 2012. Quarterly dividends were raised by 15% from SO. 65 per share to $3. 05 per share in 2013.The price to earnings ratio also increased from 9% to 13 % as well as the increase in payout ratio from . 29 to. 06 reflects this change value to stockholders as a consequence of stock retirement and increased dividend payout.. A very lucrative opportunity presents itself for current stockholders as the prospective raise of PEPS due to buy back will ultimately add incredible attention value due to increased dividend yield. Microsofts plan to buy back a total $40 billion plan began in 2008, they began this buy back to increase overall PEPS and PIE as well as increase the companies payout ratio.Buyback has thus far inc rease PEPS however subsequent drops in PIE ratio from 12. 36 to 10. 24 and stagnant dividend yield make investment into Microsoft a riskier endeavor than Apple as the decrease in P/E does not bode well for buyer confidence. Though the higher dividend yield is still attractive to investors and is higher than that of Apple Inc. Apples market share in smart phones should e of particular concern to interested investors as of recent events. Market share, especially for key products, gauges the companys current position amongst its competition and overall pull within the market.It can effectively gauge if the company is meeting the demand of its consumers and prospective growth. Within the past year the Phone only gained around a 13% overall growth in sales, however this is miniscule compared to overall Smartened market growth of 44% in 2013. Apples market share shows further struggles as overall mobile market share decrease by a full 4% from 19% market share n 2012 to a 15% in 2013. (G ardner, 2013) However, other companies like Microsoft and Samsung saw significant increases in SO use and hardware use with Samsung clearing 31% total market share from its 30% in 2012.This may be worrisome as Apple may not providing what customers want and can account for a decrease in overall prospective growth. However, this may be remedied by Apples breakthrough to markets china and Japan late in 2013. The departure of Steve Jobs and the arrival of Tim control in august of 2011 has been a cause for a weaker overall product line. The recent introduction of ewe products have spawned a lackluster response by consumers especially in the release of the Phone 5 variants (as and c) as well as the improved retina display pad mini.These products neglected to offer anything new or radical to set Apple apart, they were just mere improvements to tested product. The lack of ingenuity has potential to cause a decline Apples growth in sales and may have market share contentions who have mo re to offer to the consumer. Microsoft on the other hand has stay oned consistent in its product offerings throughout the years. This is expected of Microsoft as hey re key product involves enterprise systems that provide basic needs for problemes.Financial line of reasoning Analysis(2004-2008) Course Title Managing Financial Resources Course MSc. finance see to it 11th January 2010. TABLE OF CONTENT Executive Summary This report shows the analysis of the fiscal public presentation of Centrica Plc, one of the top energy bank line providers in UK. ground on my analysis from this report I can conclusively state that Centrica Plc has an upper hand in the energy and gas market than it s enemy stinting Power. Centrica Plcs turnover was very high in 2008 which shows that it made better sales than its competitor.Although Centricas sales turnover was high in 2008 but the profit margin dropped drastically. In the overall monetary performance Centrica Plc made a loss of ? 645milli on in 2008 compared to the previous year 2007 when the company had a retained profit of ? 1088million. This was considered to be an impact of the orbiculate fiscal crises that hit the UK and US economy causing increase in oil prices and a drastic authorize again as the level of globular oil demand rises and at the same time causing a tight supply position.Centrica Plcs gist shareholders return has an upper hand when compared with other 99 members of the FTSE 100 in 2008. INTRODUCTION evaluate the impact of fiscal accounting concepts on somatic coverage of Centrica Plc. evaluate the limitations of ratio analysis discuss the role of management accounting in the evaluation of Centricas business performance. I have been propel to guide Centrica Plc because of the type of product they deal in, which is energy. It is a product that is essential for all, not just households.And it will be well behaved to k in a flash if this company is genuinely doing well in terms of profitabi lity and customers satisfaction. LITERATURE REVIEW *PROFITABILITY RATIO ANALYSIS *OF CENTRICA PLC AND SCOTTISH POWER (Reference FAME (Financial Analysis do Easy) financial RATIO ANALYSIS OF CENTRICA PLC AND SCOTTISH POWER (Reference FAME (Financial Analysis Made Easy) GRAHPICAL PRESENTATIONS OF RATIOS throw off commit drawframe drawframe drawframe drawframe drawframe ANALYSIS AND DISCUSSION FINANCIAL PERFORMANCE ANALYSIS BASED ON THE GRAHPSAccording to Barry Elliot and Jamie Elliot, ratios show different items in the financial statements. A ratio is not useful in isolation and its usefulness depends on what aspects of the firms business affairs are existence investigated. Ratios, according to them are a powerful tool in interpreting and understanding a companys account. Therefore, the graphs above show the performance of the Centrica plc and its competitor Scottish Power over a period of 5years and will be analyzed below. DEBTORS TURNOVER This ratio shows how long it takes debto rs of a company to pay back commendation purchases.In as mush as credit facilities enhances sale turnover in a competitive market, it is very important to take equal check into of it because it is an essential part of working capital management. (Buz/ed, 2009) It is calculated as Debtors Turnover*= Average Debtors * ? 365days Centrica Plc has been able to achieve a positive stock turnover ratio over the years with a 55% less time between 2004 and 2008 compared to its competitor that has a longer time of 18% to sell off its products.This shows that Centrica Plc has more sales turnover than Scottish Power. The trend on the graph show that Centrica Plc has been more melted than Scottish power because the higher the ratio, the more liquid the business is said to be. It is obvious from the graph that Centrica Plc is more liquid than Scottish Power. That is Centrica Plc has a better capacity to pay it short term debt than Scottish Power, with audience to their current ratio of 1. 12 to 0. 59 respectively in 2008. DISCUSSIONIMPACT OF FINANCIAL invoice CONCEPT UPON CORPORATE REPORTING OF CENTRICA PLC Going continue The panel of directors of Centrica Plc refers to adopt the going concern basis in preparing the financial statement because they have a reasonable expectation that the company has adequate resources mandatory to continue operational existence for the foreseeable future Business Entity Centrica Plc operates as a separate business entity from its investors. Cost Centrica Plc reports the market value of its assets.Sincerity The financial Statement of Centrica Plc is prepared and audited by auditors from the Pricewaterhouse coopers Monetary Unit The financial statement of Centrica Plc shows a single monetary unit dominated in GBP (? ) because the parent company is in the UK. Dual concept Centrica presents it total assets as liabilities (debt finance) plus equity (shares). Accrual The revenue or income of Centrica Plc are recorded when they are actually earned. (Asmii V. 2009) ROLES OF centering ACCOUNTING ON THE BUSI*NESS PERFORMANCE OF CENTRICA PLC According to Institute of Management Accountants, Management accounting can be defined as the congenital business building role of accounting and finance professionals who work inside the organizations They are concerned about the growth of the business in terms of evaluating the business prospects, budgeting and forecasting, implementing and monitor internal controls for the purpose of achieving economic value.The Board of Directors of Centrica Plc believes that there must be high standards of corporate governance which are relevant to the overall integrity and performance of the business. The Company adopted a new set of Articles of Association which states the power of the Board of directors at the 2008 Annual General Meeting and stated below are few of the responsibilities of the Directors with respect to the managerial accounting of the company. the Groups corporate governance and system of internal control development of strategy and study policies nterim dividend payments and pass of final exam dividends the appointment and removal of Directors and the Company Secretary the Groups corporate responsibility arrangements including health, safety and environmental matters critical reviewing management performance approval of the annual operating plan, the financial statements and major acquisitions and disposals The Board gives thorough supervise to the development of the companys strategies and also during the year 2008, the Board had a full review of the companys overall strategy with the assistance of an independent external consultant.The Board also place value on their investors and promote communication chopine in order to hear their views of their shareholders as regards the key matters affecting the company. The Chief Executive and Group Finance Director held regular meetings with the Companys major shareholders during the year and the Company s Rights Issue which was the main topic of discussion was successfully completed during December 2008 after which an approval was given at the Companys General Meeting held on 21 November 2008.The companys Executive Committees also established a control infrastructure to ensure correct monitoring and management where major risks have been identified. *THE NON-FINANCIAL PERFORMANCE* OF CENTRICA PLC The fluctuation in demand and prices of oil worldwide as well as the globose financial crises in 2008 made Centrica Plc face series of challenges and the Chairman of the company (Roger Carr) tagged the year a difficult year.But despite the difficulty, the company still performed well because it is a company that aims at delivering stableness and growth for the benefit of their customers, employees and shareholders. Centrica Plcs non-financial performance can be outlined in terms of the following * crinkle PERFORMANCE OF CENTRICA* PLC LIMITATIONS OF RATIO ANALYSIS Ratios are useful method s of analyzing the performance and financial position of a business but they have their flaws which are seen as limitations and will be analyzed below.THE IMPACT OF THE CHANGE FROM UK GAAP TO IFRS ON THE CORPORATE REPORTING OF CENTRICA PLC that IFRS has improved the companys 2004 operating profit and statutory salary Per Share (EPS) reduction in shareholders fund as a result of pensions deficit Adjustment the companys policy to connective dividend to earnings thereby increasing pay out ratios. Some assets and liabilities will be treated differently which will affect timing of profit. cobblers last With fibre to the ratios analyzed above,Centrica Plc has an upper hand in the energy and gas market than it s competitor Scottish Power. Centrica Plcs turnover was very high in 2008 which shows that they made better sales than its competitor. Although Centricas sales turnover was high was high in 2008 but the profit margin dropped drastically. In the overall financial performance Cent rica Plc made a loss of ? 645million in 2008 compared to the previous year 2007 when the company had a retained profit of ? 088million. This was considered to be an impact of the global financial crises that hit the UK and US economy causing increase in oil prices and a drastic fall again as the level of global oil demand rises and at the same time causing a tight supply position. Finally, we can say that from the record of 2007, the financial performance in 2008 was good despite the economic instability. Centrica Plc made strong progress against the strategic priorities set out at the end of year 2006.The global financial crises which remain very challenging in the UK till date could pose as a problem for many of the companys customers. But Centrica Plc promises to continue to place their customers needs at the forefront of their agenda, alongside the determination to deliver increasing long-term value for our shareholders FUTURE OF CENTRICA PLC According to the Chief Executives Re view, some priorities have been set for the future growth of Centrica which would help measure performance in year 2009.Some of which are To build on the companys growth weapons platform Increasing the value of their customer base by expanding the overlap between the energy and services business. Also establishing a centralized service platform and the acquisition and construction of gas and power assets which will enable the company to compete efficiently in the energy market. To reduce risk through integrating There will be more focus on UK in the coming year 2009, due to the high demand.Therefore more production has to be made by integrating/building closer relationship with the National Oil Companies. To transform British botch In order for Centrica Plc to succeed, British Gas Residential which seems to be the core backbone of Centricas business has to deliver high level of profitability. Therefore, there will have to be an integration of the British Gas Residential, British Gas Business and British Gas Services into a single customer-focused organization.Amidst all these future plans briefly mentioned above, I can now conclusively say that the future performance of Centrica Plc is not 100% certain of profitability as they are not exempted in the effect of the global financial crises which is still hitting the UK economy. Although demand for product might rise causing increase turnover but consumers might not be able to meet up with financial obligations of paying cash. So, Centrica must be prepared for more credit sales which might decrease its debtor turnover.Also, prices of product must be put into consideration despite the goal of maximizing profit not forgetting its competitors. And finally, the leadership of Centrica Plc will be playing major role in delivering stability and growth for the benefit of customers, employees and shareholders. REFERENCES Asmii Vernekar, 2009. on tap(predicate) at http//www. buzzle. com/articles/basic-accounting concep ts-and principles. html. Assessed on 15th December, 2009 Buz/ed, 2009. Available at http//www. bized. co. uk/compfact/ratios/sdc5. htm Assessed on 13th December, 2009. Centrica Plc, 2005.International Financial Reporting Standards. Available at http//www. centrica. co. uk/files/results/2004_ifrs_transcript. pdf. Assessed on 15th December, 2009 FAME (Financial Analysis Made Easy), 2009. Available at http//www. fame. bvdep. com/version-20091130. Assessed on 11th December, 2009 Peter Atrill, and Eddie McLaney (2008), Accounting and Finance for Non-Specialists, 6th ed. Prentice Hall, financial times. David black lovage and Christopher Nobes. (2007), Financial Accounting, An International Introduction, 3rd ed. Prentice Hall, financial times.Financial statement analysisMost notable products from Apple include the Phone, Pod, Pad, ND Imax personal computers. Apple is also involved in computer and web based application developments, which support their essential products such as Tunes, Saf ari, and Cloud. Through its innovative, streamlined, user-friendly designs, Apple has achieved a meteoric rise to industry domination since 2002. This growth, however, has recently come to a relative standstill following its peak in 2012 and has investors speculating if this marks the end of Apples bullish behavior, or just a minor setback because of the companys change of management.Apple Inc. Saw a 9% total increase in revenue this sat year from SSL 56,508 million in 2012 to $170,910 million in 201 3(Apple Inc. , 2013). This growth is in part due to the release of the Phone As and c models, the introduction of the Pad Mini retina display as well as the companys normal day to day sales. This 9% growth may be some cause for concern though, as prior years increase in revenue saw a 45% average growth from year to year (44% in 2012 and 65% in 2011).Apples annual release of new products typically yields a 30% overall growth in revenue, which potentially indicates there is stagnation of growth overall in the current racket. This stagnation may be attributed either to heavy saturation of products within the current market, leaving little opportunity for expansive growth, or that consumers are unimpressed with the current product line. Apples peer firm Microsoft (MOST) has seen a modest 5% increase in total revenue from $73,723 million to $77,849 million from 2012 to 213 respectively (Microsoft Corporation, 2013).This increase is consistent with prior 3 years which have each yielded a 4-5% increase in revenue. Compared to Apple, Microsoft has a relatively stable growth and be attributed to the elatedly consistent flow of products from year to year. The earnings per share ratio (PEPS) reflects the decline in overall profitability as well, with a 10% decline in Apples PEPS from $44. 43 to $40. 29 in 2012 and 2013 respectively (Apple Inc. , 2013).This can be attributed to two factors a decrease in net profit margin and a paralleled decrease in gross profit margin. There was an 11% decrease in net profits because of an increase in overall inventory. Increasing inventory will also increase a company s operating expenses as they accommodate new production. Companies typically raise their inventory evils as they release new products in anticipation for projected consumer demand for these products.As is the case with Apple, this will have a negative impact on a companys net profit when there is less than anticipated demand for their new product. The depreciation of older inventories can also be responsible for an overall decrease in profitability. Microsoft has conversely seen an increase in PEPS from $2. 03 per shard to $ 2. 63 per share as a result of an increasing profit margin ratio from 23% to 28% in 201 3(Microsoft Corporation, 2013). Overall this increase can be attributed to an increase in ales over the period as new technologies are release.Overall PEPS increase as a result of Microsofts lower CEQ duty/investment into their company where as Ap ple has put much more equity into the release of their new releases in 2013. The increase in cost of sales is reflected in the decline of the gross profit margin ratio which is an additional indicator for a comprehensive decrease in profitability. Apples total gross profit fell from $44. 00 to $38. 00, in 2012 to 201 3 respectively, which is below the $42. 00 industry average as their cost of sales experienced a 22% increase from 587,846 million to 1 06,606 million dollars.The decrease in gross profit is explained by a number of factors according to Apple introduction of new versions of existing products with higher cost structures and flat or reduced pricing a shift in sales mix to products with lower margins introduction of pad mini with a gross margin significantly below the Companys average product margins higher expenses associated with changes to certain Of the Companys service policies and other warranty costs price reductions on certain products, including pad 2 and phoned a nd an unfavorable impact room foreign exchange fluctuations. (Apple Inc. , 2013). An intangible effect that could positively impact Apples gross profit in the long run is an increase in the number of product consumers as well as a potential increase in consumer loyalty. When compared to Microsoft smaller 2% decrease of gross profit margin from 76% to 74% in 2013. Microsoft decision to decrease sales price of windows 8 and decrease margins for the Oxbow One is responsible for the decrease in gross profit margin much like Apple. Tooth Apple inchs and Microsofts overall decrease of gross profit margin can be said o increase consumer satisfaction because more advanced technologies are sold at a lower margin thus giving a customer more value to their purchase. By lowering the price on certain high value items, such as the phone 4 and the pad 2 mentioned in Apples statement, Apple has made these products more accessible to potential customers with lower incomes or frugal spending habits.F urthermore, if there is an increase in Apple product consumers as a result of the change in price, there will likely be an increase in customer loyalty and satisfaction with these products. The PEPS decline and he increase in cost of sales can further be explored through an analysis of the companys balance sheet. There was a significant increase in Apples inventory from $791 million to SSL . 76 billion from 2012 to 2013 respectively. This 123% increase in inventory demonstrates a wholesale investment in anticipated consumer demand and loyalty.Apple typically announces product releases long before the actual release date in order to build market hype and also sets release dates to coincide with times of historically greater spending in the market, such as the Christmas holiday season. This hyping recess, however, can go both ways in terms of sales by either positively building up consumer anticipation or by allowing time for consumers to second guess the product before it is released . There is also an inherent risk in inventory expansion based on projected sales consumers may just not be in the market for new products.An indication that this may be the case is found by looking at the inventory turnover ratio which experienced a decrease from 11 1 times per quarter to significantly lower 83 times per quarter. Microsoft, like Apple, has seen a significant decrease of inventory turnover of 14% from 15. 2 times to 13. 13 times per quarter. This decrease in overall turnover much like, Apple is due to customer anticipation of newer release. However, these changes were significantly different for Microsoft as their offerings have less volatility, especially in sales of operating systems, and usually see less adoption by consumers in starting stages.Apple acid test ratio, involving current assets over current liabilities, stands at 1. 64 in 2013 which is an increase of approximately 8 points from 2012. This is much higher than the industrial average of 1. 0, indicating Apple is a relatively safe investment and has enough in current assets to cover its debt Obligations. This sets Apple as one of the safer blue chip stocks that can provide consistent wealth for their share holders. Microsoft has experienced a increase acid test ratio from 2012 to 201 3 from 2. 57 to 2. 66 respectively this is significantly higher than Apple Inc. ND can be said to be a safer investment. Microsoft overall keeps their balance of ratios to asset very consistent and insures that they can meet their bottom line as well as provide security for their investors, more so than Apple In the third quarter of 201 3 Apple accrued total of 1 6,960 million dollars in debt. The long term debt was used to offset the repurchase of stock of $22. 9 billion as well as dividend equivalent rights of $10. 6 million dollars. This accrued debt helps Apple Inc avoid taxes of upwards of $9. 2 billion dollars (Burrows, 2013) meanwhile Apple will only incur a $308 million interest a year.Had they used their offshore cash Apple would have had to pay a 35% tax and will save another $1 00 million as these interest payments are tax deductible (Burrows, 2013). Apples move to take on this debt to finance $55 billion dollars in stock repurchase is an effort to increase overall earnings per share as well as increase total value to the consumer meanwhile adding to overall company value. The statement of cash flows revealed that In 201 2 Apple board of directors authorized a $10 billion stock which was later raised to a total of $60 billion in 2013.Apple repurchased/retired a total of $22,860 million dollars worth of stock in 201 3 as opposed to issuance of 665 million in 2012. Apple stated that this repurchase was a move to increase end value to shareholders. Shareholders that are offered buy back will in turn gain profit and will decrease the overall outstanding shares. By decreasing the total shares the companys earnings per share ratio will consequently increase, and given the cu rrent plan should increase PEPS by around $4 over the following fiscal year (Hughes, 2013) and adding to the companys overall worth.The overall decrease in outstanding shares also decreases the total amount of dividends paid to investors thus cutting expense and adding to company revenues. Apple began issuing dividends toward the end of 2012 and has since seen a significant raise in dividends issued to its stockholder. Apple has since issued $10,564 million of vividness to shareholders representing a 324% increase dividends paid for 2013 from the $2,488 of dividends paid in 2012. Quarterly dividends were raised by 15% from SO. 65 per share to $3. 05 per share in 2013.The price to earnings ratio also increased from 9% to 13 % as well as the increase in payout ratio from . 29 to. 06 reflects this change value to stockholders as a consequence of stock retirement and increased dividend payout.. A very lucrative opportunity presents itself for current stockholders as the prospective rais e of PEPS due to buy back will ultimately add incredible attention value due to increased dividend yield. Microsofts plan to buy back a total $40 billion plan began in 2008, they began this buy back to increase overall PEPS and PIE as well as increase the companies payout ratio.Buyback has thus far increase PEPS however subsequent drops in PIE ratio from 12. 36 to 10. 24 and stagnant dividend yield make investment into Microsoft a riskier endeavor than Apple as the decrease in P/E does not bode well for buyer confidence. Though the higher dividend yield is still attractive to investors and is higher than that of Apple Inc. Apples market share in smart phones should e of particular concern to interested investors as of recent events. Market share, especially for key products, gauges the companys current position amongst its competition and overall pull within the market.It can effectively gauge if the company is meeting the needs of its consumers and prospective growth. Within the pa st year the Phone only gained around a 13% overall growth in sales, however this is miniscule compared to overall Smartened market growth of 44% in 2013. Apples market share shows further struggles as overall mobile market share decrease by a full 4% from 19% market share n 2012 to a 15% in 2013. (Gardner, 2013) However, other companies like Microsoft and Samsung saw significant increases in SO use and hardware use with Samsung clearing 31% total market share from its 30% in 2012.This may be worrisome as Apple may not providing what customers want and can account for a decrease in overall prospective growth. However, this may be remedied by Apples breakthrough to markets china and Japan late in 2013. The departure of Steve Jobs and the arrival of Tim cook in august of 2011 has been a cause for a weaker overall product line. The recent introduction of ewe products have spawned a lackluster response by consumers especially in the release of the Phone 5 variants (as and c) as well as t he improved retina display pad mini.These products neglected to offer anything new or revolutionary to set Apple apart, they were just mere improvements to tested product. The lack of ingenuity has potential to cause a decline Apples growth in sales and may cede market share competitors who have more to offer to the consumer. Microsoft on the other hand has remained consistent in its product offerings throughout the years. This is expected of Microsoft as hey re key product involves enterprise systems that provide basic needs for businesses.Financial Statement Analysis(2004-2008) Course Title Managing Financial Resources Course MSc. Finance Date 11th January 2010. TABLE OF CONTENT Executive Summary This report shows the analysis of the financial performance of Centrica Plc, one of the top energy business providers in UK. Based on my analysis from this report I can conclusively state that Centrica Plc has an upper hand in the energy and gas market than it s competitor Scottish Power. Centrica Plcs turnover was very high in 2008 which shows that it made better sales than its competitor.Although Centricas sales turnover was high in 2008 but the profit margin dropped drastically. In the overall financial performance Centrica Plc made a loss of ? 645million in 2008 compared to the previous year 2007 when the company had a retained profit of ? 1088million. This was considered to be an impact of the global financial crises that hit the UK and US economy causing increase in oil prices and a drastic fall again as the level of global oil demand rises and at the same time causing a tight supply position.Centrica Plcs Total shareholders return has an upper hand when compared with other 99 members of the FTSE 100 in 2008. INTRODUCTION evaluate the impact of financial accounting concepts on corporate reporting of Centrica Plc. evaluate the limitations of ratio analysis discuss the role of management accounting in the evaluation of Centricas business performance. I have been motivated to choose Centrica Plc because of the type of product they deal in, which is energy. It is a product that is essential for all, not just households.And it will be good to know if this company is actually doing well in terms of profitability and customers satisfaction. LITERATURE REVIEW *PROFITABILITY RATIO ANALYSIS *OF CENTRICA PLC AND SCOTTISH POWER (Reference FAME (Financial Analysis Made Easy) FINANCIAL RATIO ANALYSIS OF CENTRICA PLC AND SCOTTISH POWER (Reference FAME (Financial Analysis Made Easy) GRAHPICAL PRESENTATIONS OF RATIOS drawframe drawframe drawframe drawframe drawframe drawframe ANALYSIS AND DISCUSSION FINANCIAL PERFORMANCE ANALYSIS BASED ON THE GRAHPSAccording to Barry Elliot and Jamie Elliot, ratios show different items in the financial statements. A ratio is not useful in isolation and its usefulness depends on what aspects of the firms business affairs are being investigated. Ratios, according to them are a powerful tool in interpreting and understandin g a companys account. Therefore, the graphs above show the performance of the Centrica plc and its competitor Scottish Power over a period of 5years and will be analyzed below. DEBTORS TURNOVER This ratio shows how long it takes debtors of a company to pay back credit purchases.In as mush as credit facilities enhances sale turnover in a competitive market, it is very important to take adequate control of it because it is an essential part of working capital management. (Buz/ed, 2009) It is calculated as Debtors Turnover*= Average Debtors * ? 365days Centrica Plc has been able to achieve a positive stock turnover ratio over the years with a 55% less time between 2004 and 2008 compared to its competitor that has a longer time of 18% to sell off its products.This shows that Centrica Plc has more sales turnover than Scottish Power. The trend on the graph show that Centrica Plc has been more liquid than Scottish power because the higher the ratio, the more liquid the business is said to be. It is obvious from the graph that Centrica Plc is more liquid than Scottish Power. That is Centrica Plc has a better capacity to pay it short term debt than Scottish Power, with reference to their current ratio of 1. 12 to 0. 59 respectively in 2008. DISCUSSIONIMPACT OF FINANCIAL ACCOUNTING CONCEPT UPON CORPORATE REPORTING OF CENTRICA PLC Going Concern The Board of directors of Centrica Plc continues to adopt the going concern basis in preparing the financial statement because they have a reasonable expectation that the company has adequate resources needed to continue operational existence for the foreseeable future Business Entity Centrica Plc operates as a separate business entity from its investors. Cost Centrica Plc reports the market value of its assets.Sincerity The financial Statement of Centrica Plc is prepared and audited by auditors from the Pricewaterhouse coopers Monetary Unit The financial statement of Centrica Plc shows a single monetary unit dominated in GBP (? ) because the parent company is in the UK. Dual concept Centrica presents it total assets as liabilities (debt finance) plus equity (shares). Accrual The revenue or income of Centrica Plc are recorded when they are actually earned. (Asmii V. 2009) ROLES OF MANAGEMENT ACCOUNTING ON THE BUSI*NESS PERFORMANCE OF CENTRICA PLC According to Institute of Management Accountants, Management accounting can be defined as the internal business building role of accounting and finance professionals who work inside the organizations They are concerned about the growth of the business in terms of evaluating the business prospects, budgeting and forecasting, implementing and monitoring internal controls for the purpose of achieving economic value.The Board of Directors of Centrica Plc believes that there must be high standards of corporate governance which are relevant to the overall integrity and performance of the business. The Company adopted a new set of Articles of Association which states the p ower of the Board of directors at the 2008 Annual General Meeting and stated below are few of the responsibilities of the Directors with respect to the managerial accounting of the company. the Groups corporate governance and system of internal control development of strategy and major policies nterim dividend payments and recommendation of final dividends the appointment and removal of Directors and the Company Secretary the Groups corporate responsibility arrangements including health, safety and environmental matters reviewing management performance approval of the annual operating plan, the financial statements and major acquisitions and disposals The Board gives thorough monitoring to the development of the companys strategies and also during the year 2008, the Board had a full review of the companys overall strategy with the assistance of an independent external consultant.The Board also place value on their investors and promote communication program in order to hear their vi ews of their shareholders as regards the key matters affecting the company. The Chief Executive and Group Finance Director held regular meetings with the Companys major shareholders during the year and the Companys Rights Issue which was the main topic of discussion was successfully completed during December 2008 after which an approval was given at the Companys General Meeting held on 21 November 2008.The companys Executive Committees also established a control infrastructure to ensure proper monitoring and management where major risks have been identified. *THE NON-FINANCIAL PERFORMANCE* OF CENTRICA PLC The fluctuation in demand and prices of oil worldwide as well as the global financial crises in 2008 made Centrica Plc face series of challenges and the Chairman of the company (Roger Carr) tagged the year a difficult year.But despite the difficulty, the company still performed well because it is a company that aims at delivering stability and growth for the benefit of their custom ers, employees and shareholders. Centrica Plcs non-financial performance can be outlined in terms of the following *BUSINESS PERFORMANCE OF CENTRICA* PLC LIMITATIONS OF RATIO ANALYSIS Ratios are useful methods of analyzing the performance and financial position of a business but they have their flaws which are seen as limitations and will be analyzed below.THE IMPACT OF THE CHANGE FROM UK GAAP TO IFRS ON THE CORPORATE REPORTING OF CENTRICA PLC that IFRS has improved the companys 2004 operating profit and statutory Earnings Per Share (EPS) reduction in shareholders fund as a result of pensions deficit Adjustment the companys policy to link dividend to earnings thereby increasing pay out ratios. Some assets and liabilities will be treated differently which will affect timing of profit. CONCLUSION With reference to the ratios analyzed above,Centrica Plc has an upper hand in the energy and gas market than it s competitor Scottish Power. Centrica Plcs turnover was very high in 2008 which shows that they made better sales than its competitor. Although Centricas sales turnover was high was high in 2008 but the profit margin dropped drastically. In the overall financial performance Centrica Plc made a loss of ? 645million in 2008 compared to the previous year 2007 when the company had a retained profit of ? 088million. This was considered to be an impact of the global financial crises that hit the UK and US economy causing increase in oil prices and a drastic fall again as the level of global oil demand rises and at the same time causing a tight supply position. Finally, we can say that from the record of 2007, the financial performance in 2008 was good despite the economic instability. Centrica Plc made strong progress against the strategic priorities set out at the end of year 2006.The global financial crises which remain very challenging in the UK till date could pose as a problem for many of the companys customers. But Centrica Plc promises to continue to place th eir customers needs at the forefront of their agenda, alongside the determination to deliver increasing long-term value for our shareholders FUTURE OF CENTRICA PLC According to the Chief Executives Review, some priorities have been set for the future growth of Centrica which would help measure performance in year 2009.Some of which are To build on the companys growth platform Increasing the value of their customer base by expanding the overlap between the energy and services business. Also establishing a centralized service platform and the acquisition and construction of gas and power assets which will enable the company to compete efficiently in the energy market. To reduce risk through integration There will be more focus on UK in the coming year 2009, due to the high demand.Therefore more production has to be made by integrating/building closer relationship with the National Oil Companies. To transform British Gas In order for Centrica Plc to succeed, British Gas Residential whi ch seems to be the core backbone of Centricas business has to deliver high level of profitability. Therefore, there will have to be an integration of the British Gas Residential, British Gas Business and British Gas Services into a single customer-focused organization.Amidst all these future plans briefly mentioned above, I can now conclusively say that the future performance of Centrica Plc is not 100% certain of profitability as they are not exempted in the effect of the global financial crises which is still hitting the UK economy. Although demand for product might rise causing increase turnover but consumers might not be able to meet up with financial obligations of paying cash. So, Centrica must be prepared for more credit sales which might decrease its debtor turnover.Also, prices of product must be put into consideration despite the goal of maximizing profit not forgetting its competitors. And finally, the leadership of Centrica Plc will be playing major role in delivering st ability and growth for the benefit of customers, employees and shareholders. REFERENCES Asmii Vernekar, 2009. Available at http//www. buzzle. com/articles/basic-accounting concepts-and principles. html. Assessed on 15th December, 2009 Buz/ed, 2009. Available at http//www. bized. co. uk/compfact/ratios/sdc5. htm Assessed on 13th December, 2009. Centrica Plc, 2005.International Financial Reporting Standards. Available at http//www. centrica. co. uk/files/results/2004_ifrs_transcript. pdf. Assessed on 15th December, 2009 FAME (Financial Analysis Made Easy), 2009. Available at http//www. fame. bvdep. com/version-20091130. Assessed on 11th December, 2009 Peter Atrill, and Eddie McLaney (2008), Accounting and Finance for Non-Specialists, 6th ed. Prentice Hall, financial times. David Alexander and Christopher Nobes. (2007), Financial Accounting, An International Introduction, 3rd ed. Prentice Hall, financial times.

Research Essay: Elements of Classic Conditioning Essay

In the Little Albert experiment of Conditioned Emotional Reactions, scotch Albert was exposed to various stimuli which were paired with a loud whopping noise on a bar. A rat was put next to Albert and when he would range of a function for the rat, they would bang that bar to get baby Albert to display fear by call outing. Albert was conditioned to the point that by simply showing him the rat he would cry and want to crawl away. He knew that along with the rat, came the loud clanging noise, hence he felt that by neutraliseing the rat, he would also be able to avoid the noise.In classical conditioning, the infinite stimulant drug (US) is one that unconditionally, naturally, and automatically triggers a response (Cherry). In this study, the unconditioned stimulus (US) is the noise of the banging bar. The conditioned stimulus (CS) is the rat and the conditioned response (CR) is that of baby Albert crying and crawling away from the rat. The conditioned stimulus is a stimulus that was once neutral, but becomes linked with the unconditioned stimulus, and eventually elicits a certain response (Cherry).Little Albert was also exposed to various other stimuli, like masks, a rabbit, a dog, a fur coat, like and wool. In all of these incidences, Little Albert reacted negatively. He was so accustomed to the rat producing the loud bang of the bar, that he started to exhibit generalization when all of these other items were introduced. elicitation occurs when a similar stimulus is introduced yielding the same conditioned response. (Feist & Rosenberg, 2012 p. 310). There was markedly little difference in his reaction to these other stimuli in similarity to the reaction with the rat.In this research study the conditioning did not last over time due to extinction. Little Albert was exposed repeatedly to the identical stimuli and therefore the aversion to the rat and banging bar decreased. The rat no endless yielded the same results it once did. Although he still shied away from it, he no longer exhibited the fearful crying that was once present. The conditioned responses persisted, although with a loss in the severity of the response (Watson & Rayner, 1920). In my opinion, this experiment is highly unethical.First, I have to query what the effects of this experiment had on Little Albert later on in his life. The article stated that right up until the day he left the hospital, the experiment continued. There was no evidence of follow up or desensitization with this young infant. The other area of concern for me is that this experiment was conducted with a loud banging noise in propinquity to Little Alberts ear. Exposure to loud noises especially noises in close proximity to the ear, can cause Noise bring on Hearing Loss (Bredenkamp & Gnaupp). There was no indication that this was even considered.These are only a few of the unethical conditions under which this experiment was conducted. This experiment cannot be conducted today because Little Alb erts well being was not protected, and in my opinion this experiment could have been quite detrimental to his overall health. ? References Bredenkamp, J. K. , & Gnaupp, F. B. (n. d. ). Noise bring on hearing loss and its prevention. Retrieved October 18, 2013. from http//www. medicinenet. com/noise_induced_hearing_loss_and_its_prevention/page4. htm Cherry, K. (n. d. ). Conditioned Stimulus About. com Psychology.Retrieved October 18, 2013, from http//psychology. about. com/od/cindex/g/condstim. htm Cherry, K. (n. d. ). What Is an Unconditioned Stimulus? Retrieved October 18, 2013, from http//psychology. about. com/od/uindex/g/unconditioned. htm Feist, G. J. , & Rosenberg, E. L. (2012). Learning. In Psychology Perspectives & connections (p. 310). Retrieved from https//digitalbookshelf. southuniversity. edu//books/0077736494/pages/66379448 Watson, J. B. , & Rayner, R. (1920). Conditioned emotional reactions. daybook of Experimental Pscyhology, 2, pp. 1-14.

Understanding Of Cerebral Hemodynamics Health And Social Care Essay

For the supratentorial head, normal perfusion values, such as quick-witted teleph whizz circuit melt, intellectual breed volume and intend theodolite clip have been conventional utilizing the gilded criterion, 15O antielectron emanation imaging ( PET ) 9-11 . With see to it to the empenn get along stone, there has been really small work in set uping normative combine values. There ar precisely two surveies utilizing 15O PET that study flow values in the caudal nock 12, 13 .15O PET is comparatively unavailable in to the highest degree states due to the demand for an onsite cyclotron. Consequently, CT and MR perfusion have become the close widely used methods for rating of intellectual perfusion in patients showing with shot, tumour or devolution 14-17 . Standard CT & A MR perfusion techniques atomic number 18 semi-quantitative, nevertheless, several surveies have comp bed them to PET, and turn out their depend index for appraisal of the supratentorial wit 1 8-21 .Normal argument flow values of the fanny stigmatize wrenchs utilizing CT or MR perfusion imaging have non been determined nevertheless and then doing judgements of unnatural flow and hemodynamics hard at best.Lin et al investigated crossed intellectual cerebellar diaschisis in cunning shot patients in the cerebellum utilizing MR perfusion and concluded that this technique is a dependable, efficient and a more sociable alternate to PET 22 . However they did non set up normative values.The intent of this survey is to set up perfusion give ear values in the back pit, utilizing a quantitative dynamic susceptibleness contrast ( DSC ) MRI perfusion s target, auxiliary to the perfusion values antecedently quantified with PET.Before showing our survey it is high to briefly study the different capable affairs concomitant to our survey. We discharge on hence curtail a expression at the nous its map and rule blood render so continue with a short scrutiny of the chief pathogenesis impacting both, the supratentorial every trash unattackable as the infratentorial parts of the encephalon. We will so hold a closer expression at these two different parts by researching the chief anatomicalal characteristics, physiological maps and chief pathologies ( watercraftcular and neoplastic ) . Further, we will try out the different encephalon perfusion techniques available today in respects to their advantages and disadvantages and eventually subtract the principle of our survey in visible radiation of the in system inclined supra. Merely so, we will come in the nucleus of this work by sing the stuff and methods, showing our termination and discoursing our findings.The BrainThe clement encephalon is the Centre of the human nervous system and is a extremely labyrinthian organ. It can be sub carve up into two parts, the supratentorial part and the infratentorial part, find below the tentorium cerebelli. The supratentorial part contains the cerebrum con sisting of the telencephalon and the interbrain. The telencephalon involves the intellectual intellectual diffuse, subcortical bloodless affair, and the extremist ganglia. The study offsets of the interbrain are the thalamus and hypothalamus. The infratentorial part encloses the brain stem dwelling of the mesencephalon ( midbrain ) , Ponss, and medulla oblongata oblongata and the cerebellum including the vermis and two sidelong lobes ( Fig. 1 ) . These infinites are filled with cerebro spinal anesthesia fluid ( CSF ) . 23 approximate 1 The Central Nervous Systembrain.gif ascendent Waxman SG clinical Neuroanatomy, 26e hypertext send protocol //www.accessmedicine.com/content.aspx? attend to=5273762.The encephalon is formed by eight inter connect castanetss constructing the cranial pit. These castanetss are the frontlet, occipital, sphenoid and ethmoid castanetss, and two each of the parietal and temporal castanetss. The cranial pit can be separated into two distinguishab le parts the interior sur side of meat and the floor, the latter includes three pit the front tooth, in-between and posterior cranial pit. 24 The supratentorial portion of the encephalon is the besieging of ground perceiver of higher-order thought sing and memorising. It besides supervises the essential fertiliser structure s actions and reactions to intrinsic and extrinsic urges by analysing and reacting to the different informations from the receptive and motor tracts. The infratentorial portion of the encephalon is in charge of the autonomic forces, commanding critical maps such as external respiration and boob round and new(prenominal) indispensable maps. It besides takes attention of the ingrained structure s sense of equilibrium, position and consecutive motions.The encephalon is capable to different illuminate of diseases including cerebrowatercraftcular, neoplastic, infective, and degenerative and injury. Genetically based diseases including Multiple Sclerosis, Par kinson, Huntington Chorea and others are besides common, every tour candid as psychiatric diseases such as depression, schizophrenic disorder and others.Blood SupplyThe cerebrovascular system delivers energy substrates and O and removes metabolic by-products. The encephalon histories for merely 2 per centum of entire organic structure weight, however consumes 20 per centum of the organic structure s entire O demand and 15 per centum of entire cardiac end product. 25 The arteryl blood for the encephalon enters the cranial pit by two braces of oversize vass the vertebral arterias, originating from the subclavian arterias and the internal carotid arterias, ramifying off the common carotids ( Fig. 2 ) .The Vertebral Arterial SystemIt supplies the brain-stem, cerebellum, occipital lobe, and parts of the thalamus. After go doneing through the hiatuss magnum in the base of the skull, the two vertebral arterias form a individual vas, the basilar arteria ( BA ) . This vas terminate s as the left and right posterior intellectual arterias ( PCA ) . The brusque penetrating arterias, which branch off the basilar arteria, deliver critical Centres in the brain-stem. 23 The CarotidsThey supply the balance of the cerebrum. The carotids form the circle of Willis. They are interrelated via the front tooth intellectual arterias and the foregoing communication arteria. They are besides connected to the PCAs of the vertebral system by two posterior pass oning arterias ( PcA ) . 23 Figure 2 Main Arterial Brain Supplycirlce of Willis and brainstemarteries.gifBeginning Waxman SG Clinical Neuroanatomy, 26e hypertext transfer protocol //www.accessmedicine.com/content.aspx? donjon=5273762.PathogenesisThere are several implicit in causes for the damage of the encephalon s normal map. In this ingredient we will hold a prevalent all overview of the cerebrovascular ( stoke, arteriovenous deformities, aneurisms ) and neoplastic pathogenesis of the encephalon.Cerebrovascula r DiseasesThis first portion is concerned with the maltreat of encephalon parts due to the occlusion or slowing of intellectual blood flow. We will jut out three major causes shot, arteriovenous deformities ( AVM ) and aneurysm. We intentionally excluded legion other upsets such as reversible ischaemia, hypertensive brain disorder, or venous thrombosis as this would excel the range of this survey.StrokeBy and large shot is a syndrome characterized by the acute oncoming of a neurologic shortage that persists for at to the lowest degree 24 hours, reflects central engagement of the cardinal nervous system ( CNS ) , and is the consequence of a perturbation of the intellectual circulation ( loss of O and glucose substrates ) . 26 Basically, it refers to any disease procedure that disrupts blood flow to a focal part of the encephalon and that may be ischaemic or hemorrhagic in nature. The bulk ( 80 % ) are ischaemic in nature with the balance caused by haemorrhage within the cra nial pit. 26 In the undermentioned division we will define the ischaemic and haemorrhagic shots.Ischemic StrokeIschemic stroke can be subdivided into three major etiologiesThrombosis 26 It is the about common and nowadayss as a consequence of narrowing of the vascular lms. As a effect, blood flow decelerates and the high viscousness consequences in platelet adhesion and finally in coagulum formation. Atherosclerosis, fussyly the big extracranial arterias in the neck opening ( internal carotid arterias ) but besides intracranial arterias ( in-between intellectual arteria, BA ) , remains the cardinal cause of focal intellectual ischaemia.The most of effect hazard factors for coronary artery disease taking to shot areSystolic or diastolic high blood pressureDiabetess mellitusElevated blood serum cholesterin and triglyceridesSmokingOther causes of thrombotic shot includeInfectionsAutoimmune diseasesGenetically based diseasesThrombotic shots usually evolve s shinely easy over s everal proceedingss or hours.Embolism 26 When vascular lms stuff is fragmented and released, normally from a proximal beginning, it drifts into a narrower distal vas and obstructs blood flow. Contrary to the pathogenesis of thrombosis, the occluded vas is non pathologically attained. Cardiac beginnings of emboli includeValvular florasMural thrombi ( caused by atrial fibrillation, myocardial infarction, or dysrhythmias )Paradoxical emboli ( caused by an atrial or ventricular septate defect )Cardiac tumours ( myxomas )Rarer causes of embolic shot includeFat emboliParticulate emboli from endovenous drug injectionSeptic emboliYet the bulk of emboli enter the anterior circulation instead than the posterior circulation. 26 Most embolic shots characteristically occur all of a sudden, and the shortage reaches its extremum restless at one time. Figure 3 shows the most of bit sites of thrombotic and embolic occlusion.Figure 3 Sites of Thrombotic and Embolic Occlusions in the Cerebrovasc ular CirculationAtheroprdelection.gifBeginning Simon RP, Greenberg DA, Aminoff MJ Clinical Neurology, 7e hypertext transfer protocol //www.accessmedicine.com/content.aspx? economic aid=5150807.Hypoperfusion 26 It is typically caused by cardiac misery and less common mechanism of ischaemic shot. Hypoperfusion leads to a more diffuse hurt form compared to thrombosis or embolism and is typically located in watershed parts at the fringe of the intellectual vascular supply districts.Clearly, most cerebrovascular disease can be attributed to coronary artery disease and chronic high blood pressure. Until ways are found to forestall or command them, vascular disease of the encephalon will go on to be a major cause of morbidity and mortality. 26 Hemorrhagic StrokeHemorrhagic shots are typically divided into two subtypesIntraintellectual release 27 Intracerebral bleeding ( ICH ) is the most common signifier, particularly intraparenchymal bleeding, shed blooding occurs straight into enc ephalon parenchyma from diminished arteriolas antecedently weakened by elevated blood force per unit area. Leading hazard factor areIncreasing ageHistory of shotBut other factors are besides relevant, including hunt down ( Asians and Blacks ) ,Tobacco maltreatmentAlcohol maltreatmentAmyloidosisUse of decoagulantUse of clot bustersICHs chiefly occur while the patient is awake. It usually presents as an disconnected oncoming of focal neurologic shortage, which worsens over the following(a) 30-90 min. Further the degree of consciousness diminishes and marks of increased ICP, such as concern and purging nowadays.Nontraumatic subarachnoid bleeding 25 Nontraumatic subarachnoid bleedings ( SAH ) are blood leaks from a intellectual vas into the subarachnoid infinite. SAHs consequence from berry aneurysm rupture, most normally happening at arterial bifurcations, or rupture of an arteriovenous deformity.Arteriovenous DeformityAVMs consists of a tangle of dilated vass that form an unnatur al communicating between the arterial and venous systems without a capillary bed intervening. These developmental abnormalcies compensate continuity of an embryologic form of blood vass and non a tumor, but the constitutional vass may proliferate and enlarge with the transition of clip. 28, 29 True vascular deformities start in size from a little defect a few millimetres in diameter prevarication in the cerebral shroud or white affair to a immense mass of Byzantine channels representing an auriculoventricular shunt of sufficient magnitude to raise cardiac end product. The tangled blood vass interposed between arterias and venas are abnormally thin and do non hold the construction of normal arterias or venas. 28, 29 AVMs occur in all parts of the cerebrum, brain-stem, and cerebellum ( and spinal cord ) , but the larger 1s are more often found in the cardinal portion of a intellectual hemisphere. Typically, intellectual arteriovenous deformities are supratentorial, normally lying in the district of the in-between intellectual arteria. Generally, shed blooding or ictuss are the chief manners of presentation. 28, 29 AneurysmAneurysms, more exactly saccular or berry aneurisms take the signifier of little, thin-walled blisters stick outing from arterias of the circle of Willis or its major subdivisions ( Fig. 4 ) . Approximately 85 % of aneurysms bristle from the anterior circulation and 15 % from the posterior circulation. 29, 30 Generally, those that rupture normally have a diameter of 10 millimeter or more. Their rupture causes a implosion therapy of the subarachnoid infinite, doing SAH. Because the meningeal liners of the encephalon are sensitive, SAH normally consequences in a sudden, terrible thunderclap concern or expound as the worst concern of my life . As a regulation, the aneurisms are located at vessel bifurcations and are by and large presumed to ensue from developmental defects in the media and elastica of the arterias. Showing neurolo gic symptoms may run from mild concern to asphyxia to sudden decease. 29, 30 Figure 4 Sites of Aneurysms in the Cerebrovascular Circulationaneurysm.gifBeginning Ropper AH, Samuels MA Adams and Victor s Principles of Neurology, 9e hypertext transfer protocol //www.accessmedicine.com/content.aspx? aID=3637579.Intracranial TumorsThe importeeance of tumours of the CNS derives fromTheir with child(p) mixed bagNumerous neurologic symptoms ( caused by their size, kettle of fish, and invasive qualities )The devastation and supplanting of tissuesThe lift of intracranial force per unit areaTheir deadlinessThe histogenetic theory by Bailey and Cushing, predominant in novel old ages, argues that most tumours arise from neoplastic transmutation of mature grownup cells ( particularly glia cells ) , called dedifferentiation. 31 During this procedure a normal astrocyte, oligodendrocyte, microgliocyte, or ependymocyte is transformed into a neoplastic cell and becomes bit by bit, with every m itosis, anaplastic. The grade of malignance is relative to the uniform province of the initial cells. 29 some factors play a function in the biological science of encephalon tumours. Several heightening determiners can be identify days veritable encephalon tumours ( autochthonic or secondary ) are much more frequent than others and are prone to happen in special(a) age groups. For case medulloblastomas, polar glioblastoma, optic nervus gliomas, and pinealomas occur chiefly before the age of 20 old ages. On the other manus, meningiomas and spongioblastoma are most frequent in patients above 60 old ages. As a regulation, secondary metastatic tumours are more common in grownups and special encephalon tumours more common in kids. 29 GeneticssHeredity besides figures greatly in the generation of certain tumours, peculiarly retinoblastomas, neurilemoma, and hemangioblastomas. Neurofibromatosis and tuberous induration and the cerebellar hemangioblastoma of von Hippel-Lindau are the best illustrations of a familial determiner. 29 VirussHarmonizing to Levine the virus is believed to coerce the cell to divert from its normal activity in its replicative rhythm. 32 Such viruses are called transforming genes, as they are able to modify the cellular genome. Oncogenes fundamentally halt the cells self-destruction ( programmed cell death ) map and heighten the asocial proliferation of the cell, doing tumours ( e.g. AIDS ) .MetastasissCertain malignant neoplastic diseases ( chest, lung, melanoma, nephritic cell malignant neoplastic disease ) display a inclination to metastasise to nervous tissue. 29 ParaneoplasiesSystemic tumors recrudesce particular autoantibodies with distant effects on the CNS. These distant effects are called paraneoplasias and most normally are the initial or even merely clinical manifestation of the implicit in tumor. Some primary intracranial and spinal tumours, such as craniopharyngioma, meningioma, and schwannoma, have a temperament to tu rn in peculiar parts of the cranial pit, thereby bring forthing extremely characteristic neurologic syndromes. 29 As for nosologies, the location ( supra vs. infratentorial and intraaxial vs. extraaxial ) every bit good as the age group ( child vs. grownup ) are of import appraisal characteristics. For case supratentorial tumours normally present with focal neurologic shortages, concern or ictus whereas infratentorial tumours preponderantly present with elevated ICP ( hydrocephaly and quaternate heart ventricle compaction ) , taking to sickness, purging or double vision, seldom doing ictuss. 30 Therefore following to the initial clinical appraisal, imagination has become an of import diagnostic tool.This short reappraisal of the chief pathomechanisms, underlying cerebrovascular or intracranial neoplastic diseases, shows distinctly the importance of distinguishing between upsets impacting the supratentorial and infratentorial encephalon parts. Because of the different clinical presentations and symptoms and the subsequent difference in diagnostic and therapy it becomes constantly of import to concentrate in the following subdivision on the anatomical divisions and map every bit good as blood supply of each part individually. We will besides analyze the major associated cerebrovascular and neoplastic pathologies in order to better understand the significance our survey.Supratentorial BrainThe cerebrum is lodged by the center and anterior pit. The two intellectual hemispheres constitute the largest division of the encephalon. The specialized maps of a cortical part arise from the interplay between corticocortical systems and subcortical systems and a basic intracortical processing faculty. 33 Regions of the cerebral mantle are classified in several ways 34 By the mode of information processed ( e.g. , sensory, motor and associational )By anatomical place ( frontal, temporal, parietal, and occipital )By the geometrical relationship between cell types in the major cortical bedsWe will analyze the intellectual cerebral mantle by anatomical place ( frontal, temporal, parietal and occipital ) and for descriptive intents we will shortly exemplify the chief implicit in syndromes. But we will foremost hold a expression at two functional parts viz. the limbic system and the interbrain.Limbic SystemThe limbic system encompasses the hippocampal formation, amygdaloid composite, septum, olfactive karyon, and selected karyon of the interbrain, and is the beginning of tortuous emotional and motivational maps, every bit good as long term memory and smell. It forms the interior boundary line of the cerebral mantle. 34 The hippocampus, for case, is important to the formation of recent memory, since this map is lost in patients with extended bilateral harm to the hippocampus. 34 DiencephalonThe interbrain encompasses the thalamus and hypothalamus. The nerve cells of the thalamus are arranged into distinguishable bunchs, or nuclei. These nuclei a ct as relays between the incoming sensory(a) tracts and the cerebral mantle, between the distinct parts of the thalamus and the hypothalamus, and between the basal ganglia and the association parts of the intellectual cerebral mantle. The thalamic karyon and the basal ganglia besides exert regulative reserve over splanchnic maps aphagia ( inability to get down ) and adipsia ( absence of thirst ) , every bit good as general sensory disregard.The basal ganglia, for case, organize an indispensable regulative section of the extrapyramidal motor system. Damage to the extrapyramidal causes upsets characterized by nonvoluntary motions, such as the shudders and rigidness of Parkinson s disease or the unmanageable limb motions of Huntington s chorea. Similarly, the hypothalamus is the chief desegregation part for the full autonomic nervous system and regulates organic structure temperature, water supply balance, intermediary metamorphosis, blood force per unit area, sexual and circadian rhythms, secernment of the anterior pituitary, slumber, and emotion. 34 Cerebral CortexBrodmann distinguished 47 different functional zones of intellectual cerebral mantle, and although it is referred to with much contention and the informations were neer published, his system is still in usage today. In general one must think the cerebral mantle as a heterogenous compound of many interrelated anatomic systems, Certain parts of the cerebrum are committed to particular perceptual, motor, sensory, mnemonic, and lingual activities. 29 For case the integrating of cortical with subcortical constructions is reflected in commanded motions. A simple motion of the manus requires activation of the premotor cerebral mantle, which undertakings to the mark body and cerebellum and back to the motor cerebral mantle via a complex thalamic circuitry before the direct and indirect corticospinal tracts can trip certain gangs of spinal motor nerve cells. 29 Thus interregional connexions of the cerebrum are inevitable for all natural sensorimotor maps.In the same manner, their devastation disinhibits or releases other countries. For case parietal lesions result in complex turning forth motions to contactual stimulation. 29 Finally the intellectual cerebral mantles besides provide supervisory integrating of the autonomic nervous system and incorporate bodily and vegetive maps, including those of the cardiovascular and GI systems. 34 Because of this interregional connexion damage of one part may ensue in the malfunctioning of other parts as seen in patients with shot, tumour or devolution.Here is a speedy overview of the major maps of the cerebrum 35 MotionThe cerebrum directs the witting or voluntary motor maps of the organic structure. These maps originate within the primary motor cerebral mantle and other frontal lobe motor countries where actions are planned.Centripetal processingThe primary centripetal countries of the intellectual cerebral mantle fix and proced ure optical, audile, somatosensory, gustatory, and olfactive information. Together with association cortical countries, these encephalon parts synthesize centripetal information into our perceptual be intimates of the universe.SmellThe olfactive sensory system is alone in the sense that nerve cells in the olfactory bulb send their axons straight to the olfactory cerebral mantle, instead than to the thalamus foremost.Language and communicating denotation and linguistic communication are chiefly attributed to parts of the intellectual cerebral mantle. Motor parts of linguistic communication are attributed to Broca s state within the frontal lobe. Speech comprehension is attributed to Wernicke s country, at the temporal-parietal lobe junction.Learning and memoryExplicit or declaratory memory formation is attributed to the hippocampus and associated parts of the medial temporal lobe. Implicit or procedural memory, such as complex motor behaviours, involves the basal ganglia.Finally, later on this short functional reappraisal of the chief intellectual parts and showing the significance of interconnectivity between cortical, subcortical and associational countries, the following subdivision will analyze the map and blood supply of the chief anatomic place ( Fig. 5 ) , viz. the frontlet, parietal, temporal and occipital lobes.Figure 5 The Brain Separated by Lobeshypertext transfer protocol //www.accessmedicine.com/loadBinary.aspx? reveal=ropp9 & A file pertain= % 09ropp9_c022f001.gifBeginning Ropper AH, Samuels MA Adams and Victor s Principles of Neurology, 9e hypertext transfer protocol //www.accessmedicine.com/content.aspx? aID=3633619Frontal LobeIn short the frontal lobe, situated in the anterior half(a) of the encephalon, is in a general sense committed to the planning, induction, monitoring, and executing of all intellectual activity. Harmonizing to Luria et Al. this was competently summarized by as goal-directed behaviour. 36 Consequently, lesions of the frontal lobes consequence in damage of consecutive planning, an inability to keep consecutive relationships of events, and to switch easy from one mental activity to another. In the emotional domain, frontal lobe lesions may do anhedonia 1 , apathy 2 , and loss of self-denial, disinhibited societal behaviour. 29 For descriptive intents, the clinical effects of frontal lobe lesions can be grouped under the undermentioned classs 29 Motor abnormalcies related to the motor cerebral mantleAddress and linguistic communication upsets related to the dominant frontal lobeIncontinence of vesica and intestineDamage of capacity for purposive sustained mental activityInability to switch from one line of idea or action to anotherAkinesis 3 and deficiency of enterprise and spontaneousnessChanges in personality, peculiarly in temper and self-denialDistinctive abnormalcy of paceIn decision, it seems clear, that the frontal lobe is at the intersection of all motor activities. This applies non merely to willed motion but to all postural reactions and accustomed activity every bit good.Blood SupplyBlood is supplied by the anterior intellectual arteria ( ACA ) and to the deep parts by the superior division of the in-between intellectual arteria ( MCA ) . The implicit in deep white affair is supplied by little penetrating arterias, called lenticulostriate vass that originate straight from the MCA. 29 Temporal LobeThe symptoms that arise as a effect of disease of the temporal lobes may be divided into 29 Disorders of the particular sensesOcular temporal lobe abnormalcies may falsify ocular perceptual experience seen objects may look excessively big ( macropsia ) or little ( micropsia ) ocular hallucinations of complex signifier, including 1s of the patient himself ( autoscopy )Auditory Wernicke s aphasia 4 , ensuing in agnosias ( inability to acknowledge sounds, different musical notes or words ) and audile verbal agnosia ( failure in decrypting the acoustic signals of address and change overing them into apprehensible words ) , semblances and hallucinationsOlfactory and gustatory perturbation of odor and gustatory sensationTime perceptual experience province of confusionMemory amnestic syndromeEmotion & A behaviour cardinal function of the temporal lobe, notably its hippocampal and limbic parts, consequence in lost natural emotional reactions such as fright and are of cardinal importance for linguistic communication, memory and learning maps.Blood SupplyThe inferior subdivision of the in-between intellectual arteria and the temporal subdivision of the PCA supplies blood to the temporal lobe ( median and inferior facets, including the hippocampus ) . 29 Parietal LobeLesions in the parietal lobe show a scope of assorted clinical phenomena. The nucleus job represents agnosia, associated with complex behavioural alterations. In this context the term agnosia becomes synonym for a loss of more complex incorporate maps and mental symbolisms. These syndromes include 29 Loss of the ability to cipherLoss to distinguish left from rightLoss to compose wordsApraxia 5 Blood SupplyThe parietal lobe is supplied by the MCA, the inferior and superior divisions providing the inferior and superior lobules, severally. 29 Occipital LobeThe most familiar clinical abnormalcy ensuing from a lesion of one occipital lobe is a contralateral homonymic hemianopsia. Bilateral lesions of the occipital poles, as in intercalation of the PCAs, consequence in bilateral hemianopsia and cortical sightlessness. Many of the complex behavioural defects affecting ocular map are caused by lesions at the junctions of the occipital and parietal or temporal lobes. Damage to the occipital lobe my consequence in assorted defects including 29 Ocular anosognosia ( Anton Syndrome ) Denial of sightlessness by a patient who evidently, can non see or the patient is able to see little objects but claims to be unsightedOcular semblances ( metamorphopsias ) Distortio ns of signifier, size, motion, or colourOcular hallucinations They may be simple or complex, and both types have sensory every bit good as cognitive facets, e.g. flashes of visible radiation, colourss, aglow points, stars, multiple visible radiations ( like tapers ) , and geometric signifiers ( circles, squares, and hexagons ) . They may be stationary or traveling ( zigzag, oscillations, quivers, or pulsings ) .Agnosia e.g. ocular simultanagnosia, which describes an inability to hold on the sense of the multiple constituents of a entire ocular scene despite maintained ability to place single inside informations.Balint s Syndrome 27 it involves shortages in the orderly visuomotor scanning of the environment ( oculomotor apraxia ) and in accurate manual making toward ocular marks ( ocular ataxy ) . The 3rd and most dramatic constituent is cognise as simultanagnosia and reflects an inability to incorporate ocular information in the spunk of regard with more peripheral information. The patient with simultanagnosia misses the wood for the trees. Blood SupplyThe occipital lobes are supplied about entirely by the PCAs and their subdivisions. A little country of the occipital pole receives blood supply from the inferior division of the MCA. 29 In the undermentioned subdivision we will look at the supratentorial diseases of our patients with particular focal point on the tumour patients, and have a speedy expression at crossed cerebellar diaschisis and encephalocele.Supratentorial TumorsAs seen in the old subdivision, a broad assortment of pathomechanisms affect the tumorgenesis in the encephalon. Primary benign and malignant tumours arise from the assorted elements of the CNS and tumours metastasize to the CNS from many primary beginnings. In the undermentioned subdivision we will look at the chief survey related malignances.Glial TumorsGlial cells provide the anatomic and physiologic support for nerve cells and their procedures in the encephalon. The several ty pes of glial cells authorise rise to distinct primary CNS tumor. We will see the astrocytoma and the oligodendroglioma.AstrocytomasAstrocytoma is the most common primary CNS tumor. 37 The term glioma is frequently used to mention to astrocytomas specifically, excepting other glial tumours. Here are the chief features 37 rank I and II are low-grade astrocytoma, III anaplastic astrocytoma, and IV glioblastoma multiforme ( GBM )Histological characteristics associated with class III and II include hypercellularity, atomic atypia, and endovascular hyperplasiaInvasiveness aggressive infiltrates adjacent encephalon tissueNecrosis present merely with GBMsSurgical therapy pure(a) entire resection is state-of-the-art nevertheless motor cerebral mantle, linguistic communication Centres, deep or midline constructions, or brain-stem location make this unimaginable without lay waste toing neurologic shortageRadiation therapy neoadjuvant radiation therapy improves endurance for all classsC hemotherapy may be considered, but is of limited efficaciousness so farOligodendrogliomaOligodendroglioma histories for about 10 % of gliomas. Here are the chief features 37 Present frequently with ictussCalcifications and bleeding on CT or MR imaging suggest the diagnosingRating I to IV class indicates forecastPrognosis is better overall than for astrocytomas average endurance ranges from 2 to 7 old ages for highest and lowest class tumours, severallySurgical therapy aggressive resection improves survivalChemotherpay many patients are antiphonal to chemotherapyRadiation therapy has non been clearly shown to protract enduranceMetastatic TumorsDrawn-out malignant neoplastic disease patient endurance and ameliorate CNS imagination have increased the likeliness of naming intellectual metastases. The beginnings of most intellectual metastases are ( in diminishing frequence ) 37 Lung dopeKidneyGI foot of landMelanomaMain transit way of metastatic cells to the cerebrum is hematogen ously. Other common locations are the cerebellum and the meninxs. Metastasiss are frequently really good circumscribed, unit of ammunition, and multiple.Pituitary AdenomaPituitary adenomas arise from the anterior pituitary secretory organ ( anterior pituitary ) . Pituitary tumours may be 37 Functional secrete endocrinologically active compounds at diseased degrees diagnosed when the lesion is little due to endocrine disfunctionNon-functional secrete nil or inactive compounds diagnosed when the lesion is big doing ocular field shortages or panhypopituitarism diagnostic pituitary tumours should be surgically removed, chiefly through the nose via the transsphenoidal attack. However, prolactin-secreting tumours ( prolactinomas ) normally shrink with dopaminergic therapy entirely.Particular ConsiderationsCrossed Cerebellar DiaschisisHarmonizing to Feeney et Al. diaschisis signifies reduced partial encephalon map due to the rifle at a distant site of an afferent tract. 38 This affer ent tract physiologically supplies background excitement to nerve cells, maintaining them in activity and then forestalling devolution of the latter. Crossed intellectual cerebellar diaschisis ( CCD ) was first described by Baron et Al. 39 As each cerebellar hemisphere is close connected to the contralateral intellectual cerebral mantle, hurt ( e.g. shot, tumour, etc. ) to the supratentorial portion of the encephalon would impact the cerebellum. Basically, CCD is a province of cerebellar hypometabolism ( reduced blood flow and oxygen consumption ) due to the functional disjunction of the contralateral intellectual hemispheres as stated by Tien and Ashdown. 40 It is of import to see this fact when analysing the cerebellum with patients durable from supratentorial diseases such as cerebrovascular diseases ( aneurisms, stroke, arterio-venous deformities ) or tumours as it is in our survey.EncephalocelesHernia of encephalon encased in meninxs through the skull that forms an intracr anial mass is referred to as encephalocele. Hernia of meninxs without encephalon tissue is referred to as a meningocele. More seldom, the tissue protrudes through the skull base into the fistulas. Treatment involves deletion of the herniated tissue and closing of the defect. Most patients with encephaloceles and meningoceles have impaired cognitive development. Patients with greater sums of herniated nervous tissue tend to hold more terrible cognitive shortages. 37 For better understanding the rational of our survey it is of import to hold a brief expression at the major posterior pit complaints. This subdivision will first analyze the chief anatomic and physiological characteristics and so turn to the most of import cerebrovascular diseases in the brain-stem and cerebellum including the chief shot syndromes ( ischaemic and haemorrhagic ) . After that we will look at the most common posterior pit associated tumours.Infratentorial BrainThe brain-stem and cerebellum are lodged by the posterior pit. From all pit mentioned earlier this one is the largest and deepest of the three ( Fig. 6 ) . It is defined by following anatomical constructions 24 The hiatuss magnum forms the cardinal portion of the floor and transmits the myelin oblongata the go uping spinal parts of the accessary nervousnesss the two vertebral arterias ( VAs ) and the anterior and posterior spinal arteriasThe hypoglossal canal is situated above the anterolateral boundary of the hiatuss magnum and transmits the nervus hypoglosus nervus and emissary venasBehind the hiatuss magnum are the inferior occipital foss? , which support the hemispheres of the cerebellumThe jugular hiatuss is situated at that place. The anterior part transmits the inferior petrosal fistula and the sigmoid fistula fall ining to organize each internal jugular vena. The posterior part transmits the transverse fistula and some meningeal subdivisions from the occipital and go uping pharyngeal arterias. The intermediate pa rt transmits the glossopharyngeal ( IX ) the pneumogastric ( X ) and the supplement ( XI ) cranial nervousnesssFinally the internal acoustic meatus transmits the facial and vestibulocochlearA nervousnesss and the internal auditory arteria.Figure 6 The Base of the Skull upper surfaceBeginning hypertext transfer protocol //www.bartleby.com/107/47.htmlWe will hold a closer expression at the larger anatomical divisions and supply a brief overview of encephalon maps and the most of import pathological changes to our survey.BrainstemThe brain-stem is the portion of the CNS located between the spinal cord and the prosencephalon. It consists, from cranial to caudal, of the mesencephalon ( midbrain ) , Ponss ( metencephalon ) , and myelin oblongata ( myelencephalon ) . The three internal longitudinal divisions of the brain-stem are the tectum ( chiefly in the mesencephalon ) , tegmentum, and footing ( see Fig. 7 ) . The superior part of the rhomboid pit ( which forms the floor of the 4t h ventricle ) extends over the Ponss, whereas the inferior part covers the undecided part of the myelin. Three paired cerebellar peduncles ( inferior, in-between, and superior ) signifier connexions with the cerebellum. Finally the dorsal facet of the myelin shows intravenous feeding knolls the two superior and the two inferior colliculi, jointly called the principal quadrigemina.These constructions enable the connexion between the intellectual hemispheres and thalamus-hypothalamus to the spinal cord, associating, via the reticular formation ( part of canescent affair in the tegmentum ) , peripheral sensory and motor events with higher degrees of nervous integrating. These span parts of the CNS are an highly of import portion of the encephalon, as they contain most of the karyon of the cranial nervousnesss, every bit good as the major influx and outflow piece of lands from the cerebral mantles and spinal cord. 23, 34 These includeThe corticospinal piece of landThe major motor piece of landThe posterior column-medial fillet tractThe spinothalamic piece of landsThe brain-stem may functionally hence be divided into three chief centres, which are far from reciprocally sole 23, 34 Conduit mapsThe lone manner for go uping piece of lands to make the thalamus or cerebellum ( or for falling piece of lands to make the spinal cord ) is through the brain-stem. Many of these piece of lands, nevertheless, are non straight-through personal businesss, and relay karyon in the brain-stem are often involved.Integrative mapsThe points of cardinal integrating for coordination of indispensable automatic Acts of the Apostless, such as swallowing and emesis, and those that involve the cardiovascular and respiratory systems these countries besides include the primary receptive parts for most splanchnic afferent centripetal information. The reticulate energizing system is indispensable for the ordinance of slumber, wakefulness, and degree of rouse, every bit good as for coord ination of center motions.Cranial nervus mapThe karyon of cranial nervousnesss III through XII, except of the olfactory and ocular nervousnesss that mould straight to the cerebrum and interbrain, severally, are besides located within the brain-stem. These nervousnesss relay the motor, sensory, and particular sense maps of the optic, face, oral cavity, and pharynx.Figure 7 Drawing of the Divisions of the Brainstem midsagittal planehypertext transfer protocol //www.accessmedicine.com/loadBinary.aspx? name=waxm & A filename= % 09waxm_c007f004.gifBeginning Waxman SG Clinical Neuroanatomy, 26e hypertext transfer protocol //www.accessmedicine.com/content.aspx? aID=5273762Blood SupplyHere we look at the chief arterial short pantss providing the brain-stem, viz. the VA, the BA and the PCA ( see Fig. 8 ) .The Vertebral ArteryThe VAs are the main arterias of the myelin and the posterior inferior portion of the cerebellar hemisphere. The long peripheral subdivisions originating from the VAs and BAs are the posterior inferior cerebellar ( PICA ) , the anterior inferior cerebellar ( AICA ) , and the superior cerebellar arterias ( SCA ) and several smaller subdivisions, such as the pontine and internal auditory arterias. in brief subdivisions originating from the long circumferential arterias penetrate the adaxial brain-stem to provide the brain-stem motor tracts. 26 The VAs are most frequently occluded by atherothrombosis in their intracranial part. Because the VAs have a long extracranial class and base on balls through the cross procedures of C6 to C1 vertebrae before come ining the cranial pit, one might anticipate them to be capable to trauma, spondylotic compaction, and a assortment of other vertebral diseases. However arterial dissection is the most common other cause after vascular occlusion. 29 The Basilar ArteryThe BA normally arises from the junction of the paired VAs, though in some instances merely a individual VA is present. The BA courses over the ve ntral surface of the brain-stem to end at the degree of the mesencephalon, where it bifurcates to organize the PCAs. 26 The subdivisions can be divided as follows 29 The paramedian subdivisions providing the PonssThe short circumferential providing the sidelong two-thirds of the Ponss and the center and superior cerebellar pedunclesThe long circumferential subdivisions ( SCA and AICA ) , which run laterally around the Ponss to make the cerebellar hemispheresThe paramedian interpeduncular subdivisions at the bifurcation of the BA and beginnings of the PCAs providing the high mesencephalon and median subthalamic partsBA syndromes normally produce coma by impairing blood flow to the brain-stem reticulate energizing system. Thrombosis normally affects the mid-portion, and embolic occlusion the top of the basilar arteria. Virtually all patients present with some change of consciousness, and 50 % of patients are comatose at presentation with focal marks nowadays from the beginning. 26 Figure 8 Chief Arteries of the Brainstem ventral positionarteries3.gifBeginning Waxman SG Clinical Neuroanatomy, 26e hypertext transfer protocol //www.accessmedicine.com/content.aspx? aID=5272329.The Posterior Cerebral ArteryThe mated PCAs arise from the tip of the basilar arteria and provide the occipital intellectual cerebral mantle, median temporal lobes, thalamus, and rostral mesencephalon. Emboli in the BA tend to lodge at its vertex, where they can obstruct one or both PCAs. 26 Occlusion of the PCA produces a greater assortment of clinical effects than occlusion of any other arteria because both the upper brain-stem, which is crowded with of import constructions and the inferomedial parts of the temporal and occipital lobes lie within its supply. The site of the occlusion will find the location and extent of the ensuing infarct. 29 The collaterals of the chief arterial short pantss form four arterial groups ( anteromedial, anterolateral, sidelong, and posterior ) , which su pply the brain-stem structures harmonizing to their point of incursion into the parenchyma. This potpourri was devised by the anatomical work of Duvernoy ( 1999 ) . At each degree of the brain-stem, the beginning of these groups varies. The specific blood supply will be examined for each anatomical construction individually in the undermentioned subdivisions. 41, 42 In the following subdivision we will entirely concentrate on the cerebrovascular syndromes and neoplastic diseases impacting the posterior pit constructions. Therefore any syndrome resulting from the occlusion of the posterior intellectual arteria, although portion of the posterior circulation will non be dealt with as some syndromes affect the supratentorial portion of the encephalon ( thalamic smart syndrome, Balint s syndrome, etca ) resting hence outside the range of this concise reappraisal.Medulla OblongataThe myelin oblongata is the portion of the brain-stem that connects with the spinal cord. The medullary cou ntries for the autonomic control of the circulation, bosom, and lungs are called the vital centres because harm to them is normally fatal. The afferent fibres to these centres originate in a figure of cases in specialised splanchnic receptors. The specialised receptors include non merely those of the carotid and aortal fistulas and organic structures but besides receptor cells that are located in the myelin itself. The motor responses are graded and adjusted and include bodily every bit good as splanchnic constituents. Swallowing, coughing, sneezing, gagging, and purging are besides automatic responses integrated in the myelin oblongata. 23, 24, 34 The myelin can be divided into three parts 23, 24, 34 Caudal or closed part incorporating a cardinal canal uninterrupted with that of the spinal cordRostral or unfastened part, in which the cardinal canal expands as the 4th ventricleApex of the V-shaped caudal 4th ventricle, where it narrows into the cardinal canal, is called the obex.F urther it is of import to separate the tracts that run through the myelin 23, 24, 34 Ascending piece of landsThe median fillet carries centripetal information from the gracile and cuneate karyons to the thalamus for all right touch, quiver esthesis and proprioception.The spinoreticular responsible for general reaction related to trouble such as waking up, affectional and vegetive maps.The ventral spinocerebellar tract conveys proprioceptive information from the organic structure to the cerebellum.The spinothalamic piece of land a centripetal tract arising in the spinal cord. It transmits information to the thalamus about hurting, temperature, scabies and petroleum touch.Descending piece of landsThe corticospinal piece of land in the pyramid begins to traverse at the passage between myelin and spinal cord. It largely contains motor axons. It really consists of two separate piece of lands in the spinal cord the sidelong corticospinal piece of land and the median corticospinal piece o f landThe falling spinal piece of land of the trigeminal nervus has its cell organic structures in the trigeminal ganglion. The fibres of the piece of land convey hurting, temperature, and crude touch esthesissThe median longitudinal fiber bundle is an of import tract involved with control of regard and caput motionsThe tectospinal piece of land relays urges commanding cervix and bole motions in response to ocular stimulationBlood SupplyThe arterial supply of the myelin comes from the VAs, the PICA and the anterior and posterior spinal arterias ( Fig. 9 ) . Follows the division by arterial groups 42 The anteromedial group arises from the anterior spinal arteria or the anterior spinal and vertebral arteriasThe anterolateral group arises from the anterior spinal and vertebral arterias, anterior spinal and PICA or anterior spinal and VAsThe sidelong group derives from the PICA or the VAThe posterior group stems from the posterior spinal arteria or the PICAFigure 9 Arterial Supply of t he Medullahypertext transfer protocol //www.accessmedicine.com/loadBinary.aspx? name=simo7 & A filename= % 09simo7_c009f012d.gifBeginning Simon RP, Greenberg DA, Aminoff MJ Clinical Neurology, 7e hypertext transfer protocol //www.accessmedicine.com/content.aspx? aID=5151404.Medullary InfarctsThese can be divided into sidelong and median medullary infarcts and a combination of both, hemimedullary infarct ( Fig. 10 ) .Lateral medullary infarctHarmonizing to Norrving et Al. the medullary infarct syndrome, is one of the most common brain-stem infarcts and histories for approximately 2 % of all admittances for acute shot. 43 The characteristic syndrome with dizziness is due to the occlusion of the VA barricading the sidelong myelin and inferior cerebellum ( PICA ) blood supply. It is besides called Wallenber syndrome, named after the doctor who foremost described it in 1895. It is about ever caused by infarction, with merely a little figure of instances being the consequence of bleedi ng, demyelination, or tumour. 29, 44 As stated by Currier et al. , symptoms typically consist of dizziness, sickness, purging, dysphagia, gruffness, and nystagmus in add-on to ipsilateral Horner syndrome ( ptosis, meiosis, enophthalmia, and loss of facial perspiration ) , ipsilateral limb ataxy, and damage of all centripetal modes over the face ever affecting hurting and temperature esthesis. 45 Further the corneal physiological reaction is frequently absent. Vertigo is common and is caused by a lesion in the vestibular karyon or their connexions. 29, 44 Medial medullary infarctHarmonizing to Vuilleumier et al. , Dejerine syndrome is comparatively rare, looking in one of 28 medullary infarcts in one series. The source sees the cause of the infarct frequently in the atherothrombosis of the VA or the anterior spinal arteria the most common symptoms include contralateral hemiparesis ( seldom ipsilateral ) and a hemisensory shortage saving the face ipsilateral linguistic paresis or gawky lingua motions may on occasion be observed. 46 If it is one-sided, it is besides known as jumping nervus hypoglosus unilateral palsy, depicting a province where the cranial nervus failing is on the same side as the lesion, but the organic structure palsy is on the contralateral side. 29 Figure 10 Lateral Medullary Syndrome and Alternating Hypoglossal HemiplegialoadBinary2.gifBeginning Waxman SG Clinical Neuroanatomy, 26e hypertext transfer protocol //www.accessmedicine.com/content.aspx? aID=5272329.Hemimedullary infarctHemimedullary infarct, besides called Reinhold s syndrome, is rare. The authoritative clinical image of the hemimedullary syndrome is a combination of the symptoms of sidelong and median medullary infarcts. When the motor shortage is ipsilateral to the infarction, it may propose that dissection of the VA is the mechanism of the shot. In fact it includes all symptoms of Wallenberg s syndrome in add-on to contralateral hemiparesis. 47 Other syndromes follo w with many of the same characteristics, such as the AICA occlusion taking to infarction of the sidelong part of the caudal Ponss and the syndrome of sidelong rostral pontine infarction from SCA occlusion. But inside informations on these would excel the range of this brief overviewMidbrainThis is the part of the encephalon between the rhombencephalon and the interbrain the rostral portion of the brain-stem. Its dorsal part is the tectum and its ventral part is the tegmentum ( including reticulate formation ) . The mesencephalon is the short, constricted part which connects the Ponss and cerebellum with the thalamencephalon and intellectual hemispheres. It contains cranial nervousnesss that stimulate maps such as vision ( lens form and pupil diameter ) and muscles commanding oculus motion. Besides maps such as hearing, organic structure motion and physiological reactions are being generated. Further the dopaminergic mesencephalon nerve cells are involved in many of import encephalo n maps including affectional and cognitive undertakings. The anterior portion has the intellectual peduncle, which is a immense package of axons going from the intellectual cerebral mantle through the brain-stem transporting of import information for voluntary motor map. 23, 24, 34 The mesencephalon can be divided into 23, 24, 34 FootingIt is composed of a brace of cylindrical organic structures, the crus cerebri or intellectual peduncles, a monolithic fibre package that includes corticospinal, corticobulbar, and corticopontine tracts. Each peduncle consists of a dorsal and a ventral portion, separated by a profoundly pigmented lamina of grey substance, termed the substantia nigger. The substantia nigger ( whose cells contain neuromelanin ) receives afferent fibres from the intellectual cerebral mantle and the striate body and sends dopaminergic motorial fibres to the striate body. The substantia nigger plays a cardinal function in wages, dependence and motion control.TegmentumIt contains all the go uping piece of lands from the spinal cord or lower brain-stem and many of the falling systems. A big ruddy karyon receives crossed motorial fibres from the cerebellum and sends fibres to the thalamus and the contralateral spinal cord via the rubrospinal piece of land. The ruddy karyon is an of import constituent of motor coordination. Close to the periventricular grey affair lie the bilateral venue coeruleus karyon. Nerve cells in these karyons contain norepinephrine and undertaking widely to the cerebral mantle, hippocampus, thalamus, mesencephalon, cerebellum, Ponss, myelin, and spinal cord. These nerve cells regulate the sleep-wake rhythm and control arousal they may besides modulate the sensitiveness of centripetal karyon.TectumIt consists of four rounded distinctions, named the principal quadrigemina, who are arranged in braces ( superior and inferior colliculi ) . These paired rounded puffinesss have different maps. The superior colliculi contain nerve ce lls that receive input from the retina and the ocular cerebral mantle and participates in a assortment of optic physiological reactions, peculiarly the trailing of objects in the ocular field. The inferior colliculi are involved in auditory physiological reactions and in finding the side on which a sound originates. The colliculi contribute to the formation of the crossed tectospinal piece of lands, which are involved in winking and head-turning physiological reactions after sudden sounds or ocular images.Periaqueductal Gray MatterIt contains falling autonomic piece of lands every bit good as endorphin-producing cells that suppress hurting.Blood SupplyFive arterial short pantss supply the arterial mesencephalon groups, from underside to exceed, SCA ( chiefly the median subdivision ) , the collicular arteria, the posteromedial choroidal arteria, PCA ( in-between rami of the interpeduncular arterias ) , and the anterior choroidal arteria ( Fig. 11 ) . Followng arterial groups can be i dentified 23, 42 The anteromedial group arises from the PCAThe anterolateral group arises from the collicular and posteromedial choroidal arterias or the collicular, posteromedial, and anterior choroidal arteriasThe sidelong group arises from the collicular arteria or the collicular, posteromedial choroidal, and PCAs.The posterior group arises from the SCA and collicular arterias or the collicular and posteromedial choroidal arteriasFigure 11 Arterial Supply of the Midbrainhypertext transfer protocol //www.accessmedicine.com/loadBinary.aspx? name=simo7 & A filename= % 09simo7_c009f012b.gifBeginning Simon RP, Greenberg DA, Aminoff MJ Clinical Neurology, 7e hypertext transfer protocol //www.accessmedicine.com/content.aspx? aID=5151404.Midbrain InfarctsThese history for 8 % of all infarcts in the posterior circulation. BA disease ( 27 % ) , cardio-embolism ( 23 % ) , and small-artery disease ( 23 % ) were found to be every bit common causes in a survey performed by Bogousslavsky et A l. 48 Most infarcts are localized in the in-between portion of the mesencephalon, and are characterized by atomic ( bilateral ptosis, bilateral superior rectus failing, or bilateral mydriasis ) or peripheral 3rd nervus engagement ( one-sided adduction/upward/downward paralysis with ptosis and mydriasis ) , with or without hemiparesis. 29 Infarcts in the upper or lower mesencephalon can be classified harmonizing to their chief characteristics third-nerve paralysis combined with contralateral unilateral paralysis ( Weber syndrome ) , contralateral ataxic shudder ( Benedikt syndrome see Fig. 12 ) , or ataxy and hemiparesis ( Claude syndrome ) . 29 With occlusions near the beginning of the PCA at the degree of the mesencephalon, optic abnormalcies can include perpendicular regard paralysis, third cranial nerve ( III ) nervus paralysis, internuclear ophthalmoplegia, and perpendicular skew divergence of the eyes, or coma. 44 Figure 12 Benedikt Syndromehypertext transfer protocol // www.accessmedicine.com/loadBinary.aspx? name=simo7 & A filename= % 09simo7_c003f012.gifBeginning Simon RP, Greenberg DA, Aminoff MJ Clinical Neurology, 7e hypertext transfer protocol //www.accessmedicine.com/content.aspx? aID=5151404.Midbrain HemorrhageThalamic bleedings cause several typical optic perturbations. These include 27 Deviation of the eyes downward and inward so that they appear to be looking at the olfactory organUnequal students with absence of light reactionSkew divergence with the oculus opposite the bleeding displaced downward and mediallyIpsilateral Horner s syndromeAbsence of convergenceParalysis of perpendicular regardRetraction nystagmusPatients may subsequently develop a chronic, contralateral hurting syndrome ( e.g- Dejerine-Roussy syndrome ) .PonsThe Ponss is the part of the encephalon prevarication above the myelin oblongata and below the cerebellum and the pit of the 4th ventricle. The Ponss is a wide, horseshoe-shaped mass of transverse nervus fibres tha t connect the myelin with the cerebellum. It is besides the point of beginning or expiration for four of the cranial nervousnesss ( karyon of the trigeminal, abducents, facial, and acoustic nervousnesss ) that transfer centripetal information and motor urges to and from the facial part and the encephalon. The Ponss besides serves as a tract for nervus fibres linking the intellectual cerebral mantle with the cerebellum. The Ponss controls rousing and regulates respiration. It besides plays a function in slumber. 23, 24, 34 The Ponss can be divided into a ventral and dorsal portion and the in-between cerebellar peduncles 23, 24, 34 Ventral or anterior surface ( Basis Pontis )It is situated along the midplane of the Ponss and portion of the myelin where the rhaphe karyon lies. Serotonin-containing nerve cells in these karyons project widely to the cerebral mantle and hippocampus, basal ganglia, thalamus, cerebellum, and spinal cord. These cells are of import in commanding the degree of rousing and modulate the sleep-wake rhythm. They besides modulate centripetal input, peculiarly for hurting.Dorsal or posterior surface ( Tegmentum )The tegmentum of the Ponss is more complex than the base. This dorsal tegmental part is for most a continuance of the reticulate formation of the myelin oblongata, but consists besides of transverse and longitudinal fibres and contains of import grey karyon ( e.g. the karyon of nervus VI and the karyon of nervus VII ) . The upper half of the Ponss harbors the chief centripetal karyon of nervus V. The cardinal tegmental piece of land contains falling fibres from the mesencephalon to the inferior olivary karyon and go uping fibres that run from the brain-stem reticulate formation to the thalamus. The tectospinal piece of land and the median longitudinal fiber bundle are extra constituents of the pontine tegmentum.Middle Cerebellar PeduncleIt is the largest of the three cerebellar peduncles. It contains fibres that arise from the contr alateral footing pontis and terminal in the cerebellar hemisphere. Further you besides find audile tracts and the trigeminal system ( all right touch, hurting and temperature ) .Blood supplyDifferent arterial short pantss supply blood to the Ponss, including the VAs, AICA, SCA, and BA ( Fig. 13 ) . But it is chiefly supplied by nameless paramedian and circumferential subdivisions of the BA. Following arterial groups can be identified 23, 42 The anteromedial group and anterolateral group arises from the pontineThe sidelong group arises from the VA and AICA ( superior and posterior rami of the sidelong medullary pit ) , the pontine arterias, or the SCAThe buttocks group merely exists in the upper portion of the Ponss and arises from the medial and sidelong subdivisions of the SCAFigure 13 Arterial Supply of the Ponshypertext transfer protocol //www.accessmedicine.com/loadBinary.aspx? name=simo7 & A filename= % 09simo7_c009f012c.gifBeginning Simon RP, Greenberg DA, Aminoff MJ Clinica l Neurology, 7e hypertext transfer protocol //www.accessmedicine.com/content.aspx? aID=5151404.Pontine infarctsIn a survey performed by Bogousslavsky, pontine infarcts accounted for 15 % of the infarcts in the posterior circulation. Further, BA subdivision disease was the most common cause of shot ( 44 % ) and was associated with big ventral infarcts with terrible clinical characteristics. 48 Small arteria disease ( 25 % ) was normally associated with little ventral or tegmental infarcts and quickly bettering lacunar syndromes. 49 Pontine infarcts are classified into four chief groups 44 Ventromedial pontine infarcts associated with moderate to terrible hemiparesis, either pure motor hemiparesis or accompanied by atactic hemiparesis.Ventrolateral infarcts frequently present as a mild hemiparesis, sometimes associated with atactic hemiparesis or pure motor hemiparesis. Some patients may demo mild marks of tegmental engagement, such as optic abnormalcies, dizziness, and centripet al loss ( sensorimotor shot ) .Tegmental pontine infarcts they frequently present as dizziness, double vision, oculus motion perturbations, cranial nervus paralysiss, truncal and appendages centripetal loss, and mild motor shortages.Bilateral ventrotegmental infarcts they are associated with acute pseudobulbar paralysis and uni- or bilateral sensorimotor disfunction. Bilateral big ventral infarcts may do the locked-in syndrome, characterized by tetraplegia, facial diplegia, guttural paralysis, and horizontal regard paralysis with normal consciousness, the patient merely being able to pass on utilizing a codification affecting eye blink and traveling the eyes up and down.Pontine BleedingPontine bleeding is basically restricted to hypertensive patients and is the least common of the hypertensive intracerebral bleedings. The apoplectic oncoming o