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lamic half pumps. So on when you get started, I can't actually see him It in these were the moment I get anyway said hello on. Welcome to age two. Healthcare's anatomy. Serious, but also week neurological. Um, I'm pretty Cooper. I've told few sessions that are in this series. Um, this particular photo I decide show the diversity and what we do is mean not doing anything medical. This is me. Listen, she's just very variety, um, making most a session. Anyone who anyone has been to one of these before? Well, no shares starting most of the sessions. Now, this is, um, basically it is and how to make most out of our teaching. So take some notes. Are some questions on feel free to email us if you want more materials? Any questions? Last month was Philosophy instagram on Facebook. This's wants much Siris. December We'll be doing a session on dying and palliative care of 14th of December. Uh, about the next one to mail that here's where we are this week for our anatomy Siris. Next week, the final week of it will be Head Neck and Ent by Josh and that. Did you? Let's do some neuro anatomy. Let me just check yet there are people. It's good. Thanks. Okay, So you're honest, The brain. I'm going to start with a bit of caveats, which is that I'm not going to go too deep into the niche finite bits. And you're in that there are some very, very There are little layers to help far. You can go knowing things about the brain. I'm coming home on your block for you knee on. It can get very complicated. Very, very quickly, my dear, Today is just sort of cover some of the basics and some of the bits that the most plicate ble to the day to day workings of people in various areas of health care. Um, basically working various areas. Healthcare. So that would be you know what is going to affect you on your day on the ward? What? It's gonna affect you in a day. If you're working on ambulance, for example, most affected the clinic because I sort of the most relevant part and give you the basics from which you go in one more. If anyone's got questions every more specific feel free to ask, so I can't guarantee I will know the answer because, like I said, there's a lot a very finite snarl it in a lot of very deep knowledge available about the brain on this. The uh huh neurological system is a whole. We'll start with what is effectively the most basic part of it, which is the lobes. So your brain is separated to lobes. The lobes all work together to create this sort of standard function living. Um, there are four main lobes you have your frontal lobe right to the front of his name would suggest at the front of the parietal lobe, which is sort of the top back of the head if the temporal lobe, which goes between the two temple regions. So if you know where your temple is, just the front of the ear, it goes in that sort of area. It's a near the back. Have a sip. It'll lobe at the back. It's those. The full lobes commonly refer to the brain. There is also sometimes referred to 1/5 lobe, Um, which is right in the middle of the last. But some people don't count as the lobe. Some people do it. It's a bit debatable. Generally, if you refer to the four lobes in urine exam or anything like that, you're going to get the mark. Um, least four loads of different sort of core things are in charge of the one that's probably the most relevant. Probably the most important one to be aware of is this. It'll lobe is involved in sight. So if you have anything that goes wrong in the citadel lobe, you can lose vision or anything in the pathways between the eyes to the left alone, you can lose vision, partial vision. Um, that's that's really worth remembering your parietal lobe. Really, It's more to do with of how you feel. Things have touch works. Your frontal lobe is a lot about personality. Actually, they're on how you how you are. You but it also a lot of your thinking comes from here. Lot of your actual conscious thinking is in the frontal lobe, Um, and then it's temporal lobe. The one on the side has functions to do with your ability, Teo process language. You hear things make sense of things. That and then that works with part of the frontal over to be able to communicate back, Um, talk about hemispheres in a bit and I will come back to a little bit of information about the temporal lobe then, because right now I think it's a b unnecessary. Until I mentioned a little bit later. Um, the it's the brain. You have the cerebellum in the back. This sort of, ah, for the vehicle was reminds me of the food from Doctor who, because I think it's the bit they removed from the nude. The surveillance Is it sort of unconscious function, keeping you balanced, coordinated control of body and limb. You can tell your arm to move the sort of know, having to think every individual muscle contraction to make that happen. It's thanks to your cerebellum, and then you have your brain stem. This is what connects the brain into the spine. Your brainstem actually has three parts to it. We'll talk about it a bit more detail in a minute. And the brain at the brainstem Uh, yeah can experience spine and is involved in a lot of things. Spine does so up in a joke it because I thought it's quite funny that we talked about lobes and fissures on down in the Bible. They have the thing about the lo loads and the fishes, which apparently still on 23. I want to look that one up, Um, loads and Fisher's sort to find the brain quite a lot. Except for lobes, we have the brain stem. The brain stem is made up of the mid brain, which is, as you imagine, in the middle of the brain, the ponds which comes out the bottom of the brain. And in the medulla, which, if you look at it here, the ponds Is this If you could see, my mouth is just slightly orange, a bit of the top here, not in the medulla coming after that, uh, and then where The longer tube in a fissure. So a fissure in the brain effectively as a separation is a trench for one of the better word on the biggest one of them is a longer TUNEL fisher. This separation brain into two hemispheres straight down the middle. It's lovely. Red highlighted area, um, is also what joins the two hemispheres together. So although it is a big, big trench and empty space, um, full of, uh, cerebal survival fluid, which the fluid. That's all your brain sits in. Um, at the bottom of it has a very fibrous connective itty called the Corpus callosum. And that's what basically holds the two lobes of your brain together. Hopes the two hemispheres. Sorry, I should have said that. What? Hemispheres. And you've got two hemispheres brain Do you have's of the brain. And they're all together of the corpus callosum at the bottom of the longer to dinner. Or Fisher this world words Sometimes it used to get so close, so sulky I grooves. I'm basically Ah yeah, that they still define the sort of what is going on in the brain. Lots of deep salt guys supposedly means highly functional brain matter. I don't know how accurate that is. It something that was told to me once, and I live about what to look it up since because it made some sense. Um, we use certain sulk I to determine the borders of the lobes as a shown here central. So, like I said, your focus Sylvan Sylvian Fissure, uh, situated to determine where these lobes begin and end well, they also have notches there sulking. I the aren't in a straight line. So, really, the the most boring is the Prius. It'll notch. We don't really referred to any other doctors. I think I can't think of any others. I've had it for two and the officious, which are very, very deep, like very enlarge trenches. Um, which faces spend whole with in depth of the brain and the main Fisher has mentioned. It's the longer TUNEL Fisher, the one through the middle of the brain. Um, generally we use sulk I that the area between two fold eye is normal for the gyrus. I'm not going to go into the gyrus gyre I because they get really friendly really, really quickly, um, but different joyride of responsible for different areas and different things. We'll move on to the gray matter of it. I want to talk. Just say something. Just one more interesting facts. I know in your Oh, um, you're wrestling important. So the hand, if people are left or right handed, left another one around right or left handed. Um, which handed you are is normally determine based on which hemisphere of your brain is dominant. What's the really weird thought? You could be left or right brained. 95% of right handed people are left brain dominant, whereas if you're left handed, it's sort of 50 50. Eso, 50% will be left brain 50% right brain. Um, and what determines of dominance, I think, was in here? Yes. So Broca's area and Vernick. It's area ah to quite important areas in terms of your ability to process and repeat speech to your ability to form words and understand what's, uh and so if you are left brain dominant, it means that most likely those two areas are on the left hand side of your brain. If it's if you're left handed, and therefore odds are 50 50 could be on either side, and some cases you can have one on each eye. Does that matter? Well, if you were to have, for example, a stroke honest in the left hand side of your brain and you're right handed, your dominant arm could go very floppy, but also could not get your speak centers where, as if you're right handed and you have a right sided stroke, you're not dominant. Arm. Go floppy on. Do you're not like this? Doctor will speak centers most interesting. It's another start, you know, Ask questions on that one. No good. So, uh, great and white matter the gray matter of the brain. That's a nice school. The cortex. This is effectively a slice through the middle of the brain. So if you were to go literally that way for So let's head, um, you see, like this the one of the Boston here is to do with the this one called, Um, the gray matter is your cortex. It's the sort of the material sits on the outside of the brain. It's felt in electrical activities. Um, we sort of measure these when you when you look at the EKG or electrode in capital in careful a gram, which sort of looks that brain functions, brain workings. Um, the gray matter contains cell bodies. The white matter doesn't The white matter is just lots and lots and nerves running around, doing the things, um, absolutely knowing the difference there and the same. You have the same in your spine as we can see down here. His very nice graphical stole of the Internet that So what? What to do? Um, as it says on here, Gray matter is mostly for processing of information, whereas white matter is sort of very highly, uh, high speed. I guess there's a way to refer to it. Nerves firing off very quickly. Um, and basically giving you a lot of communication going on there. Um, the white matter is sort of responsible for knowledge on development that way. Um, it's a lot of memory stuff, So that's why it continues to develop. When you're older. Where is the gray matter is more sort of control that one test be fully developed some time in your twenties. Roughly 25 I think, is what people seem to get feet. Um, the meninges. I wanted to go through the meninges, Put this one in last minute because I thought I hadn't mentioned it. And meninges air important. So the meninges are three layers that basically cover your brain and separated from your skull. And these are what sort of gives protect partly protection to the brain within the skull. But also squishy brain and Richard skull don't really want to meet very much. Um, so you have the do Amartya, which is a layer of basically it's probably made of some connective tissue but that's it's very close to the inside of the skull around the inside the skull. So if you were to remove a chunk of someone's scale, would be very difficult for you to get the jury Marta off. So most like you take somebody with you. You have the Iraq noid martyr, which is the middle there. And then you have to pee a motto which sits very intimately with the brain, and it's very, very thin. You can see straight through it. So most the time. If you were to look at the brain dissection, you would see the PMR on the brain. But before he wouldn't notice it was there because it's quite clear and see through, Um, and they see these gifts separation between the brain and the on the skull. They have to give you protection between the Iraq noid layer and the PEERLA. There's the suburb, acknowledged space. This is sort of full of spider web. Be looking connected tissues. What's what. Arachnoid like a spider. There were There are actually spiders in your skull that be weird stuff. Right now, it's bases full of this connective tissue, and it sort of stops the brain moving around. And it means if you know, you take knock to the head, there is some ability for the brain to sort of shuffle of it without causing any damage. Um, be like having a sort of, ah protective helmet inside your head. It's also got the skull, which is nice, but bone bone is good for protection. But then yet, like I said, squishy brain and hard skulled don't really want to meet you. So this is sort of protective layers between it, um, they get some quite nasty problems when with these layers of people already heard of thinking a subdirectory hemorrhage which would be bleeding into the subject annoyed space and that could basic impress the brain lots of blood getting into an area that shouldn't have very much blood in it. If any blood and that can cause the of subdirectories face to swell and compress the brain and cause a lot of problems, you call us to get subdural uh, subdural bleeding, which would be between the juror and the Iraq. No matter to begin with, then that again Concordes. Same thing. Swelling compression of the brain. They just look a little bit differently when you look at them on images and over, those are great. They're both things you don't really want. They are very, very painful. Apparently, they come with what's described as a thunderclap headache, which is a headache that it's very intense and gets very intense. Very quickly. Um, on D? Yeah, that they're not greatly if this in skipped, damaged, but the basic protect the brain and they're both quite reversible. Thankfully, we can fix them. So with that, I'm gonna want to scale. I'm just quickly check. Is there any questions at this point? Looked quite here. I have a little while since the beginning, it appears acting is are moderate in the sink. So everyone's telling you, uh, asked nasty questions. Now she will know the answer. I may not. I don't try. You will. Um excellent. So carry on. I'm going to give you a few bones in the skull because the skull is kind of important This way. Your brain is and then really talked about spine. So the skull naming of the bones of the skull is really pleasant because they sort of named him after the lobes of the brain. They protect So as I mentioned before, we have the frontal lobe, which is protected in this case by the frontal boat. We have the parietal lobe protected by the parietal bone, a temporal lobe that by temporal bone. Although you've got a different you got one temporal bone on each side of the school on, then a sip. It'll low protected by the simple bone. Brilliant. We like this. You don't have to remember the same forwards over again. Uh, the other ones that we have, which just worth mentioning are the sphenoid and ethmoid. You know, it effectively creates sort of base to the skull off which the rest of it is built. So it's basically like a pillar in the middle. Pardon me. Um, so you can't really see much of the seniority. You anything A little bit the edge, actually. See? Know it sits right in the middle of the skull and the other bones to get built off around it. I think Josh will cover. This is quite more detail. Next week for the head and next session. Um, you have the f might as well, which no bone that comes off of it. And that sort of you could see it in the back of the eye and into the back of the nose. Eight bones that make up the cranium, your skull to separate into cranium and facial eso. We're going to ignore the face in this scenario, but yeah, the frontal bone to parietal bones to temporal bones and a simple bone, a sphenoid and ethmoid. I see. No, it's really fun to say That's the only way I remember it. Um, I already mentioned the's. So the skull is full of holds, and we like the skull to be full of holes because obviously, lots of things have to get I/O of the skull. I'm only I really mentioned one particular foramen, basically hope the hole in bone is a foramen holding anything, and the body tends to be called a foramen. You got one in your heart. Yeah, so the frame and Magnum is probably the most important holding a bone in your body, and it's out this that the the, uh, the brain stem exits and becomes the spinal cord. This is the point, basically, have spine your brain meat, Um, and so a lot of important things that come through here. Anything to do with spinal cord comes through here. We'll talk about spinal bit more detail in a minute. You don't have other ones where my masters going. There is now these ones that front here. Entry points for nerves. There are Centrepoint for blood vessels. I think this one's got the in a bit more detail. Here we go with some nominal. Um, really? The one I always from it most of all is the frame Magnum. Is that Is that the most important one? By a long way, You also got the carotid canal, which is here. And this is where the internal carotid vein internal corroded artery, Entity of scale on Sort of supplies your brain, Afraid of Ali. Seems a bit with there's a volley in the brain as well as one in the heart. But people name all things. Looks like an egg of ali egg. Um, so these are all different routes and nurse in old blood nerves I/O and blood in and out because otherwise they weren't gonna get fruit. Very thick skull. Um, yeah. I already know what else I want to say about those. Probably not a lot, but you have to be aware, is lots of holes on. You might need to know if you're them. Realistically, If you know, for Raymond Magnum, your sort of 80% of the way there. Spine. So we have to nervous systems in the body. We have the central nervous system, which is your brain and spine, and you have the peripheral nervous system. The perfect nervous system comes off off the spine predominantly on a little bit off the brain stem. Um, and this is what gives you nervous control everywhere. Um, we have three varieties of purple nets. Your motor nerves, which are the ones, enable you to control muscles. So you can, you know, move your arms and your legs. Uh, this is thanks to your motion of your sensory. These are what tells you what's happening with those. If you touch something, a sensory nerve tells you were touching. It's doing is burning. You were doing a sharp the sensory nerves was telling you that information that and then your autonomic. So these are your sympathetic parasympathetic nervous systems, and these control involved reactions. So I don't know what more detail I want to go into with them because it can get quite finicky quite quickly. Um, your most nerves movement, sensory sensation and then the autonomic parasympathetic and sympathetic. Here's a nice break down of thumb. Um, yeah. The division. Yeah. Fight and flight. I think it's the best way to define sympathetic parasympathetic synthetic controls. Your fight reflects on parasympathetic you'll the calming, chilling out reflex Does much flight more thanked. But yeah, um, if it helps you think they usually say sympathetic is fight flight and Paris is a breast. I forgot. We have a phrase terrible of May Um, yes. Thank you, Pierre. Yeah, it's the fighting flight. Rest are just and then you're feeling and moving. It was little funky pictures like this was drawn them on the person. They look quite nice and stripey um, I decided not to go through all the not very nerdy. Um, what nerve controls? Which exact bit of skin? Because everybody got incredibly board very quickly. Uh, here's a bit of a breakdown again of what the parasympathetic know. Precipitous and sympathetic Nervous systems sort of do so sympathetic court of people to dilate. Percent predicted to constrict. Um, person, political slow down your heart. Sympathetic increase. I don't know why they put Heartbeat n again. I stole this from somewhere. I don't know why they typed on end at the end of that anyway. Um, yeah, uh, I mean, I don't want to miss read this. Will that be, um, so this is sort of control they have over your body, and that one's wrong. I've just spotted air in this. I don't think the parasympathetic causes phase of construction. Anyway. Uh, it's the it's kind of depends on the place it's applying for. The parasympathetic is gonna force base the dilation to look up, whereas the sympathetic or can it will cause a so dilation, too, of the blood vessels towards the lungs. So it's kind of dependent on your own. Yes. I'm not very happy with that inclusion there and saying that there's a constriction. They're weird one there. Um, yeah, but so that is sort of the breakdown of where these to control cranial nerves. So are the nerves that come off of your brain and control predominately things in the face a low. The vagus controls everything everywhere. Vegas is like everything. Um, but yes. So these are the nerves that come off your brain. And roughly where they come off off within the brain, you can talk a little bit about what they do. So one of things we have to. Well, the things you have to be sometimes spasm, Uh, certainly in medicine, I think, also in paramedics. And I don't think I'll come across it very much for my nurses. On other areas, healthcare is basically assess these because if someone's got damaged to a part of the brain, it can cause damage to these nerves and stop thumb from performing their normal function. Um, so we have to be able to assess thumb. So remembering them is the pain I'm still getting used to remember the order of the 12 cranial nerves and order. Yeah. Um, yeah, I'm still trying. It used to remembering which one is in which order. But then it's basically working out what they do. And from what they do, How do we check their are working. So for eczema, cranial nerve, one is your factory, that factory smelling so it enables you to smell. So your assess it by getting someone to smell something, probably with your eyes closed and tell you what it smells like. Um, I don't think I've ever seen anyone not successfully identify something with their olfactory nerves. So I can't really tell you what they end up looking like. If they don't get it right. I don't have this. They don't smell it all. It's smell it wrong. But that's the breakdown of that one off the optic oculomotor. This is Do your eyes. Say can check people's eye sight in check your ability to move their eyes. See that peripheral vision? Um, truck clear Tradjenta trochlear is to do with your Yes, I movements. Well, isn't it sorry? No, with it right now. Um, yeah. So, yeah, I movement trigeminal is then your bills to chew. Um, so if they've got, like, facial drooping, they're not putting the words out very well. That committed to trump little general, um, more eye movements, then for abductions. Facial nerve, trying to get people smile. They can't smile. They know we can't. It's a test that they are not there is going wrong with that facial nerve. Um, you got some auditory. So hearing testing with the fisted Buell Okah clear, which is a complicated words. Try and stay at the end of the day. Um, and then glossopharyngeal you able to swallow so swallowing a taste, but you don't want to not be able to swallow. If you give someone something to swallow to test this and they don't successfully do it, it can get kind of messy. So you want a suction. You need it by vagus nerve controls lots of things, and it's quite involved in your heart so it can slow down your heart rate. Um, making prove digestion. But testing of it, I think, is the gag reflex. Yes, reflex. So if you induced gagging in a patient and they do gag, that's a good test that they're big snack still works, and then you're cranial. Uh, now 11 is your spinal accessory, your ability to move shoulders, lift your shoulders up your ability to move your head from side to side and hypoglossal is your ability to stick your tongue out or push your tongue? That's this push or talking to cheek, I thought no mistaking tongue out, um, beer. So learning how to assess these is a pain, but saying unfortunately, people to be doing medicine have to have to do. Um, I believe paramedics in It's well, um, yeah, if you figure this out yet, Peter of Lost. Well, uh, yeah, that is just scientists get used to, and ultimately, this is a very boring way to look at them. This is a much more funky way to see when they will come from very nicely. But watch the article of boring but a medicine that has to be picked up. Um, there are lots of quite rude ways of trying to remember them in order, but I always find a bit complicated because it's a lot of those and a lot of teas, so I never remember which oh, is in which order on which tears in which order? Um, so but, you know, time, plenty of time still going. I'm gonna send it. I think that's the last I was gonna go for is the Glasko coma scale. So it's another assessment. This is something that we use quite regularly again in a little areas. Healthcare. Really? It's basically assessing people's level of consciousness. So then first aid world. We use it in court, after which is a built in your checks on disability to be responsive. Uh, this the glass could come a scale. Is he better check some one of being conscious and how we do it. There's a score out of 15. The minimum score is three. The maximum score is 15. We test three different areas. We test that. I've been in their eyes, We test their speech and we test them motor response. Um, so the after you check, which is what you're using, the first aid world is actually basically the same as what we're doing in the eyes checking here. So if you tell someone, if someone opens the rise, you walk in the room that is them. Spontaneously open your eyes. They get four. If you ask them to open their eyes and they get a three, if they do it when you get them a pinch, that's too. And if they don't open their eyes, that's no great. That's the one, um, similarly verbal response. This is people being oriented to the where they are, who they are, what's going on around them. If they're not, that they're confused. That area before inappropriate words would be things like you'll tries to talk to them and they can't make a sentence. So how are you today? And they just don't go Good. Can you tell me more about that? What's going on? Are you in any pain? Yes. You know, know able to sort of express themselves properly. One word answer is often the word doesn't necessarily make sense either. That be a three in corporate still sounds, sort of grunting or grunting and moaning, know eloquently. Put together word on no response again one, um and then most response with a base command. So that is, You tell them, Can you lift your arm up with their arm up? If they moved to pains that if you sort of give them a pinch in their shoulder, they bring an arm up to try and stop you. If then, if you pinch their shoulder, they try to get away from it. That's flex to drool. Uh, if you pinch them and they then there are men and straight in their legs. That's a bad sign. But even worse, if you pinch thumb on, may strengthen their arms and straight in their legs and go completely rigid. That's not a great sign. That's due to nerve problems. Um, and then the response, you know, correct. Either on we basically use these is a way of men monitoring. How close is someone is at the time that there's sort of a rule I don't have hardened fast is. But there's a thing called less than eight intubate, which basically means if they're glass conclude our scale overall score is less than eight. They haven't got the the consciousness required to keep the airway open, so they're they're sort of haven't got the consciousness to control the muscular tone in the throat. It's to keep breathing properly, see, need to put a tube, and that support that breathing on brief for them potentially is that somehow this off so it gets applied a score. Three. Should I would be a very deep coma or dead? Um, most people walking around should be a 15. Okay, maybe if they're bit confused, they'll be a 14. Um, but yeah, that sort of a sliding scale of them. Severity, um, his old again Basically alert voice pain or unresponsive this hatred, eyes looking around there, interacting with the room. The voice are they open their eyes, They're responding to vocal stimuli. You tell them. Can you look at this? Look at this. Can you open your eyes there, Open their eyes? Do you want to be aware that patients have hearing difficulties? Might not be able to respond very effectively so they might be able to do this. They just might not know. You want them to do this? Um, Pain of lying, painful stimulus. People go for a lobes, other ear lobes that if you have pinched your ear lobe, it doesn't tend to hurt very much. So much more commonly would use the trapezius muscle, which is one in the sort of above your collarbone sort of connection neck to your shoulder. Um, order to be people. Use a single sternum rub. That's basically you rub the office, the sternum at the front of the chest. That could be very, very painful. So maybe use that one is a lot. There later, uh, test. Go for a pinch first and then just turn around. If they don't response and they're not testable. This is actually going. If we got to mention here, um, if any of these can be tested for any reason, you need to write that down, but has actually does completely change the scoring system. So if yours are, you can't test anything verbal because they got tube in their throat and they're on a ventilator. Well, that Sunday means that you're automatically losing five points, so they would look a lot sicker than they are. Um, so you need to make sure that you note anything that you're not able to test and why, Um, voice Orent it. Confused, inappropriate, incomprehensible, unresponsive. Um, and they're not testable again. Like I said, make sure he notes, not testable. So patients who are unable to speak patients who have damaged that jaw people have go shoot in the throat on motor again. Not testable. Uh, if peace pressures have got like fruits up, both their arms have been damaged. They might not be able to do this test because they can't move their arms. Um, once the base commands localizing normal flexion, abnormal flexion, abnormal extension, nothing the best. It's going to get the head around, try and play this video, but I don't know how well playing good years always works in these situations. So let's give it a go. I don't know if that's a little or No, no, You can't hear it a moment. Uh, okay. Does not work on his ex account is already It's volume across. My guess is no, I think there is, but I don't know how. Is it something to do with changing the output of this of the sound too? Like, well, might be easier. Just send the video to people. Uh um, let me fixed this to this. Yes. So the glass of comes scale is quite useful. Um, used That's wealth. So it's definitely worked. Have a look into for anyone who is going into healthcare just because it is very commonly used on done standing is quite important time. Um, I think that might be everything. I'm just not covered. No, it's not quite. Yeah. Okay, Spit. And that's new. Or transmitters, because transmitters we actually kind of funky. Um, So your transmitters signaling agents that worked for other brain from the nervous system. They control different things. Onda. There's a lot of different problems we can have from having too much or too little of particular neurotransmitter adrenaline's and all this one, I think people who we know quite a lot about adrenaline. This c was fighting flight. So if you've got lots of adrenaline, you been feeling quite anxious to be in feeling quite on edge, sort of ready to punch. Someone will run away. Basically, if you have got another trend line, you can feel what Tired didn't get problems with control. Um, no problem. Dribbling goes peripheral vasoconstriction second cut blood supply off just like hands and stuff. Um, and that could be not great to see and get cold. Preference. If you got too much adrenaline, you have to go very high BP because it is causing oil peripheral vascular too narrow. So you getting very high BP from it? Oh, and this medicine, correct. If anyone ever goes to Imperial Med school, you learn about think of pheochromocytoma and they love theochron muscle tone. But they are. I don't know why they just as a med school famous for teaching about it a lot, that's a tumor that causes a lot of adrenaline. It causes adrenaline spikes. So you have, like, normal levels and then suddenly loads. Um, yeah, they're likely to ever coming across one in real life is minimal, but they teach about it like no end um, nor drooling is Ah, yeah, concentration. I don't know what else I could really say about it because I thought it It causes improve blood flow to your gut. I can't think of anything else might worth mentioning about it. The too much more interesting to me, at least two here. Dopamine and serotonin. So dopamine is we'll sing if you haven't got enough. Dopamine is what causes Parkinson's, which is a condition where you get pulled muscle control. You end up getting very stiff and then eventually going to be very jittery, unless because you haven't got sufficient dopamine to do the neuro control of your brain to control your perform us a lot the like was the other way around. If you have way too much dopamine, that is, I think 70 or 80% of the cases that is the cause of psychosis being getting hallucinations. You began getting quite bad problems with this. Um, that's just we thought that that's on a sliding scale. That one in his Parkinson's on the other end is, uh, psychosis. Um, and they're That's what you told me so and then certain drugs medications you might use, for example, that treat psychosis can go the other way and can keep giving people park it's and style symptoms. But likewise, if you get certain medications for Parkinson's, then go the other way and give you slight psychosis. So there's a whole thing that a balance with, um, a sudden elicit drugs, um, cools too much dopamine and that can cause people to become in the keep setting psychotic. So people who smoke marijuana, for example, if they that can cause an excess of dopamine and they start getting cannabis induced psychosis so well, they're high, they're getting psychotic. Um, and yeah, so that's ah, just interesting one. Really? That serotonin is the the one people over 30 making them happy. Um, but if you get too much serotonin, you get think of serotonin syndrome and get quite sick with that blow through and got enough of it, you can get depression, things like this. So again, they're all things you want. Lots off. But you don't want too much off any of them. Um, sorry. I'm losing my voice slightly, so I'm trying to, like, clear my throat. One you're talking? Um, yeah, it's easier. Eight main neurotransmitters. Yeah, they kind of work. The ones that are most worth noting about really adrenaline. Dopamine, serotonin. But they have ones have important applications. Well Oh, are there any of these? You particularly like prayer. Pardon your particular favorite. Newer transmitter. I haven't emotional attachment to serotonin because I feel like all of us need more of that in our lives. Not too much, Of course. Your problems. Yeah, well, like serotonin, serotonin makes you happy. Simply pull. Um, and then your endorphins make you very, very happy. Like very happy. Um, is it hugging, Hugging releases? Endorphins. So I I think it's running. Releases, endorphins and hugging releases. Oxytocin. Oxytocin still on here. I know. I was on Cytoxan. Normal. One are terrible. Toast is your bonding hormone. It's the one that's released from people, that breast feeding. So how is your bond with baby? And also since and great a great home. Er, we like our hormones. Anyway. I'm going to keep my keep blabbering about the things I think that is the end of what I had to cover. If anyone's got questions, please do us. The size has become quite sure, session. I've realized, um, the otherwise that you will have more of your evening back than expected. Um, thank you for Peer for coming along this evening. And thank you. Everyone else. We're coming along this evening. I'm not in the best of health of the minutes of my ability to sort of a long gate. My session has sort of been dramatically reduced. Uh huh. But if anyone has other bits, they want to ask about two. Please do. Like I said, you're okay on get very, very light. Very, very heavy at the same time. So for that, you know, sort of brief overview of everything. Um, if no one has questions, I will call it time in about 30 ft back for me. If anyone wants to do that, most if anyone wants the attendance civic it. That's how you get well was Thank you for letting me have come along this evening, and hopefully, some of that was useful. Know incoherent gibberish. That's my brain is giving me the moment. Um, well, give me 20 seconds, see if anyone has any questions. And if not, I will end there. I'm seeing no questions. So all ended their thank you, everybody. Thank you. Good bye.