Definition
Table 54.1
| Sensitive | Insensitive | |
|---|---|---|
| Extracranial | Skin, muscles, fascia Blood vessels Mucosa of sinuses Dental structures | Skull (except periosteum) |
| Intracranial | Large arteries near circle of Willis | Parenchyma of brain |
| Large venous sinuses | Pia mater, arachnoid mater, parts of duramater | |
| Dural arteries and parts of dura | Ependyma, choroid plexus |
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The fourth heart sound is a low-pitched sound coincident with late diastolic filling of the ventricle due to atrial contraction. It thus occurs shortly before the first heart sound. Although it is also called the atrial sound, and its production requires an effective atrial contraction, the fourth heart sound is the result of vibrations generated within the ventricle. Commonly, its presence indicates increased resistance to filling of the left or right ventricle because of a reduction in ventricular wall compliance, and it is accompanied by a disproportionate rise in ventricular end-diastolic pressure. In patients with a fourth heart sound, its palpable correlate is often present: a concomitant brief presystolic outward movement of the chest wall.
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High blood pressure is a very common condition in modern society. It has been estimated that one in five Americans, around 50 million people, suffer from high blood pressure. In general more men than women have high blood pressure, and the number of sufferers of both genders increases rapidly with age.
In around 5% of cases of high blood pressure is caused by kidney problems, but the causes of the other 95% of cases are unknown. There are a number of factors such as race, age, obesity, stress, smoking and lack of exercise that can contribute to the likelihood of a person developing high blood pressure but usually no one cause is directly responsible.
Neuroscientists at the Mayo Clinic campus in Jacksonville, Fla., have demonstrated how brain waves can be used to type alphanumerical characters on a computer screen. By merely focusing on the “q” in a matrix of letters, for example, that “q” appears 
on the monitor.
Researchers say these findings, presented at the 2009 annual meeting of the American Epilepsy Society, represent concrete progress toward a mind-machine interface that may, one day, help people with a variety of disorders control devices, such as prosthetic arms and legs. These disorders include Lou Gehrig’s disease and spinal cord injuries, among many others.
