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NEET MDS Synopsis - Lecture Notes

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Psychoanalytical theory
Pedodontics

The psychoanalytical theory, primarily developed by Sigmund Freud, provides a framework for understanding human behavior and personality through two key models: the Topographic Model and the Psychic Model (or Triad). Here’s a detailed explanation of these concepts:

1. Topographic Model

  • Overview: Freud's Topographic Model describes the structure of the human mind in three distinct layers: the conscious, preconscious, and unconscious mind.

    • Conscious Mind:
      • This is the part of the mind that contains thoughts, feelings, and perceptions that we are currently aware of. It is the "tip of the iceberg" and represents about 10% of the total mind.
    • Preconscious Mind:
      • This layer contains thoughts and memories that are not currently in conscious awareness but can be easily brought to consciousness. It acts as a bridge between the conscious and unconscious mind.
    • Unconscious Mind:
      • The unconscious mind holds thoughts, memories, and desires that are not accessible to conscious awareness. It is much larger than the conscious mind, representing about 90% of the total mind. This part of the mind is believed to influence behavior and emotions significantly, often without the individual's awareness.
  • Iceberg Analogy:

    • Freud often likened the mind to an iceberg, where the visible part above the water represents the conscious mind, while the much larger part submerged beneath the surface represents the unconscious mind.

2. Psychic Model (Triad)

The Psychic Model consists of three components that interact to shape personality and behavior:

A. Id:

  • Description: The Id is the most primitive part of the personality and is present from birth. It operates entirely in the unconscious and is driven by the pleasure principle, seeking immediate gratification of basic instincts and desires (e.g., hunger, thirst, sexual urges).
  • Characteristics: The Id is impulsive and does not consider reality or the consequences of actions. It is the source of instinctual drives and desires.

B. Ego:

  • Description: The Ego develops from the Id during the second to sixth month of life. It operates primarily in the conscious and preconscious mind and is governed by the reality principle.
  • Function: The Ego mediates between the desires of the Id and the constraints of reality. It helps individuals understand that not all impulses can be immediately satisfied and that some delay is necessary. The Ego employs defense mechanisms to manage conflicts between the Id and the external world.

C. Superego:

  • Description: The Superego develops later in childhood, typically around the age of 3 to 6 years, as children internalize the moral standards and values of their parents and society.
  • Function: The Superego represents the ethical component of personality and strives for perfection. It consists of two parts: the conscience, which punishes the ego with feelings of guilt for wrongdoing, and the ideal self, which rewards the ego with feelings of pride for adhering to moral standards.
  • Characteristics: The Superego can be seen as the internalized voice of authority, guiding behavior according to societal norms and values.

CNS PROTECTION

Physiology

CNS PROTECTION

 

- Bones of the Skull       Frontal, Temporal, Parietal, Sphenoid, Occipital

- Cranial Meninges         Dura mater, Arachnoid Space, Pia mater

- Cerebrospinal Fluid

Secreted by Chroid Plexi in Ventricles

Circulation through ventricles and central canal

Lateral and Median apertures from the 4th ventricle into the subarachnoid space

Arachnoid villi of the superior sagittal sinus return CSF to the venous circulation

Hydrocephalic Condition, blockage of the mesencephalic aqueduct, backup of CSF, Insertion of a shunt to drain the excess CSF

Pharyngeal Arch
Anatomy

Pharyngeal Arch

Arch Artery

Cranial Nerve

Skeletal elements

Muscles

1

Terminal Branch of maxillary artery

Maxillary and mandibular division of trigemenial (V)

Derived from arch cartilages (originating from neural crest):

From maxillary cartilages:

Alispenoid, incus

From mandibular:

Mackel’s cartilage, malleus

 

Upper portion of external ear (auricle) is derived from dorsal aspect of 1st pharyngeal arch.

 

Derived by direct ossification from arch dermal mesenchyme:

Maxilla, zygomatic, squamous portion of temporal bone, mandible

 

Muscles of mastication (temporalis, masseter, and pterygoids), mylohyoid, anterior belly of digastric, tensor tympani, tensor veli palatini (originate from cranial somitomere 4)

2

Stapedius artery (embryologic) and cortiotympanic artery (adult)

Facial nerve (VII)

Stapes, styloid process, stylohyoid ligament, lesser horns and upper rim of hyoid (derived from the second arch cartilage; originate from neural crest).

 

Lower portion of external ear (auricle) is derived from 2nd pharyngeal arch.

Muscles of facial expression (orbicularis oculi, orbicularis oris, auricularis, platysma, fronto-ooccipitalis, buccinator), posterior belly of digastric, stylohyoid, stapedius (originate from cranial somitomere 6)

3

Common carotid artery, most of internal carotid

Glossopharyngeal (IX)

Lower rim and greater horn of hyoid (derived from the third arch cartilage; originate from neural crest cells)

Sytlopharyngeus (originate from cranial somitomere 7)

4

Left: Arch of aorta;

Right: Right subclavian artery;

Original sprouts of pulmonary arteries

Superior laryngeal branch of vagus (X)

Laryngeal cartilages (Derived from the 4th arch cartilage, originate from lateral plate mesoderm)

Constrictors of pharynx, cricothyroid, levator veli palatine (originate from occipital somites 2-4)

6

Ductus arteriosus; roots of definitive pulmonary arteries

Recurrent laryngeal branch of vagus (X)

Laryngeal cartilages (derived from the 6th-arch cartilage; originate from lateral plate mesoderm)

Intrinsic muscles of larynx (originate from occipital somites 1 and 2)

Estimation of the risk of anesthesia

Pharmacology

Estimation of the risk of anesthesia (American Society of Anesthesiologists scale)

• ASA 1: healthy patient.

• ASA 2: patient with stable, treated illness like arterial hypertension, diabetes melitus, asthma bronchiale, obesity

• ASA 3: patient with systemic illness decreasing sufficiency like heart illness, late infarct

• ASA 4: patient with serious illness influencing his state like renal insuficiency, unstable hypertension, circulatory insuficiency

• ASA 5: patient in life treatening illness

• ASA 6: brain death- potential organ donor