Addie Bundren’s Everlasting Impact

Addie Bundren’s Everlasting Impact Often times in novels, there will be a character that has the ability to appear as little as possible and still be able to have one of the biggest impacts on the rest of the characters and on the novel as a whole. In As I Lay Dying, Addie Bundren is one of those types of characters. She has only one chapter in the entire book, yet is somehow able to have the biggest influence on the rest of the characters. She is the basis of the story, and everything relates back to her. Addie Bundren seems to have such a heavy impact on the characters as they were constantly trying to please her. Darl always longed for her approval and was constantly jealous of her relationship with Jewel. He was always trying to provoke Jewel: â€Å"’You could borrow the loan of Vernon’s team and we could catch up with you,’ I say. ‘If she didn’t wait for us. ’ ‘Ah, shut your goddamn mouth,’ Jewel says. † (pg. 18) Addie seems to have enjoyed all the attention she was getting. She was constantly trying to fulfil her feeling of dissatisfaction, trying to find multiple ways to rid herself of the sickening feeling, but nothing she did helped. Her dissatisfaction was the centre of her life. Her character greatly affected all the characters in the novel. She was the spokes holding their family wheel together. Darl longed for her approval, while Jewel had her sitting on a pedestal. Anse, even through all his selfish, narcissistic ways, looked up to her and felt attached to her, even beyond her death. He felt like he owed her something. Her character is similar to Vardaman’s character in the sense that they are both unable to fully express themselves. Vardaman resorts to comparisons such as ‘my mother is a fish’ (pg. 84) while Addie resorts to having an affair with Whitefield. Addie is the basis of the book. Without her, there would not be a story. Her character has a powerful hold over the rest of the Bundrens, even after death. With her death, the characters could have just buried her wherever they felt convenient; however, they still follow through with her request. Though one could argue that they did so only for their own selfish benefits, their conversations never fail to relate back to her in one way or another. They feel compelled to grant her wishes, making references to her while on their journey, helping the reader piece Addie’s character together without her actually speaking. As I Lay Dying amplifies the feminist role with Addie Bundren. It ties her influence in with her motherly figure, making her a vital character in the novel. She has the rare ability to hold such a powerful control over the characters in the novel, making her a significant character with only one chapter.

Cell Phone Effects on Youth Essay

In powerful effect paradigm, media has immediate, direct influence and assumes that people are passive and absorb media content uncritically & unconditionally. That paradigm related to Frankfurt school of though. Three theories come under this paradigm; one is Mass society theory, second is Magic bullet theory and third is Critical theory. All that theories based on assumptions, that all theories shows that media has strong impact on audience and a malignant force within the society. Mass society theory: This theory is related to media and Herbert Marcuse presented this idea. It’s a first media theory and also known as â€Å"Grand Theory†. Mass Society Theory is based on various assumptions. Following are the assumptions of Mass Society Theory: 1. The media are a malignant, cancerous force within society and must be purged or totally restructured. 2. Media have the power to reach out and directly influence the minds of average people. 3. Once people’s minds are corrupted by media, all sorts of bad long-term consequences result – not only bringing ruin to individual lives, but also creating social problems on a vast scale 4. Average people are vulnerable to media because they have been cut off and isolated from traditional institutions that previously protected them from manipulation. 5. The social chaos initiated by media will inevitably be resolved by establishment of a totalitarian social order. 6. Mass media inevitably debase higher forms of culture; br ing about generation decline in civilization. Read more:  Negative Effects of Smartphones on Youth Limited effect paradigm: Limited effect paradigm idea has been associated with Paul Lazarsfeld and his colleagues. They focused on the media effect is measureable, short term and concluded that the media played a limited role in influencing public opinion. The â€Å"Limited-Effects† Model developed by Lazarsfeld and his colleagues from Columbia was highly influential in the development of media studies. The model claims the mass media has â€Å"limited-effects† on audience. Comparison of Mass Society Theory Assumptions with Limited Effect Paradigm 1. The media are a malignant, cancerous force within society and must be purged or totally restructured. The Functional Analysis Theory rejected this assumption as in this theory media is a healthy organization and has a positive role within the society, and Information Flow Theory also discarded this assumption that all information does not consider valuable and 80% people heard and read soft news so the reaction and the negative effect of media is less. 2. Media have the power to reach out and directly influence the minds of average people. Two step flows discarded this assumption, this theory urges media to be less direct and less powerful effects and people are much more affected by opinion leaders rather than media. As in the Information Flow Theory most news are unnoticed by people so how it can affect average people and also in the Attitude Change Theory, society or people cannot change by media. People changed when they want change or change their self. 3. Once people’s minds are corrupted by media, all sorts of bad long-term consequences result – not only bringing ruin to individual lives, but also creating social problems on a vast scale. Attitudes Change Theory discarded this assumption that changing is a complex process and societal change is a slow process. As in a Cognitive Dissonance Theory, anything which is inconsistence that effect is less. Psychological disorder topics have a less effect on audience. One more theory rejected this assumption Functional Analysis Theory says that media role is positive in the society. 4. Average people are vulnerable to media because they have been cut off and isolated from traditional institutions that previously protected them from manipulation. Reinforcement Theory rejected this assumption it says that media act to reinforcement already held beliefs and idea. Change transpire by family, school, church etc and traditional institution are still there and have strong power to stop the individual an society by manipulation. As in Cognitive Consistency Theory people consciously or unconsciously want to see those channels or programs which are of their interest. Two Step Model also discarded this assumption by opinion leaders are attached with our institutions and in the Attitude Change Theory, in human attitude changing these three variables play focal role, 1.the Communicator, 2.communication, 3.situation. 5. The social chaos initiated by media will inevitably be resolved by establishment of a totalitarian social order. Only Innovation Diffusion Theory prop up that assumption. New idea, information introduced in the society by innovators, to spread any new idea is society has five stages by establishment of totalitarian social order the social chaos can be pave. 6. Mass media inevitably debase higher forms of culture; bring about generation decline in civilization. Cognitive Consistency rejected this assumption people always try to hold their existing beliefs so they do not allow to change their culture and values. As Reinforcement Theory, media acts to reinforce the already held and existing beliefs and ideas. It does not disturb society by creating any change. Conclusion: Mass society theory portrait media role is negative and malignant force within the society but there are many other theories which describes that media role is positive and it is a healthy institution like other social institutions. Change always comes, when people want change or try to change themselves. We negated all these assumption by these imperial studies.

Books are dead Essay

It could be said that books are dead which leads to the question, ‘What are people doing instead? ‘ People are buying and using modern technology indeed of reading books because books are tedious. Would you rather read through a whole chapter in a book just to find an answer to a question, or type in key words into a search engine on a computer and the information be found instantly? Other technologies such as; video, internet and DVD, have superseded them. The more advanced technology appeals to a wider audience and society is not pressurised into enjoying it from an early age if they do not want to, as in the case of books. Books are seen as primitive and dated because they have less to offer the next generation in the form of enjoyment. Furthermore, books are not fashionable in the twenty-first century. This is because popularity within the community is directly proportional to whether the individual has the newest technology or not. The most popular individual has the most recent technological development, such as the latest mobile telephone, and the not so popular individual is left behind, still reading books. Technology is a way to ‘show off’ and ‘showing off’ is a way of making new friends and keeping the existing ones. In addition, we would not have moved forward in time without new technology. For example, in the future, we will be able to travel into space and back, which we would not be able achieve using books. Of course, the maths and science would have originated from books but you would need technology to apply it. There is not point in publishing books anymore because no one has the time to sit down and read them. This is because they are boring and it is too much effort. You also have to be in the right mood to read a book, whereas you do not need to be with technology since there are so many alternatives. Books are a waste of paper and ink, and are we not trying to save the environment? Moreover, books are made by technology, for example, the printing press is made up of machines. So why not use technology in other ways that will be appreciated more? On the other hand, books have survived every new technological development, unlike the video recorder being superseded by the DVD recorder, within a few decades. Books have, and will stand the test of time because one can escape into a story in a book and enjoy it without the need for anyone else. Disappearing into a book is an escapist fantasy because you can interpret it in so many different ways. It also makes a nice change from the more advanced technology the world has to offer.

Oprah Winfrey Life Essay Example | Topics and Well Written Essays - 1000 words

Oprah Winfrey Life - Essay Example All the ventures that she started achieved a great measure of success. After 25 years of hosting the immensely successful show known as The Oprah Winfrey Show (TOWS) Oprah made the drastic decision to end the show. She also indicated that she has the intention to start up her very on television network to be known as Oprah Winfrey Network (OWN). Considering that TOWS which is what most people identify with Oprah will no longer be produced, the question becomes whether Oprah’s network OWN can achieve the same success that TOWS achieved or Oprah is overstretching her ability and brand power (http://www.oprah.com/pressroom/Oprah-Winfreys-Official-Biography ) . TOWS was broadcast over the 25 year period and it grew to be one of the most watched television shows. The show had an estimated viewership of 42 million weekly viewers in the US. It was also broadcast in around 145 different countries. The popularity of the show was credited to the confessional approach that the show had. It provided a forum for people to share their story and was used as a platform to empower people to live better and healthier lives. The book club that Oprah formed as a segment of TOWS served to encourage people to adopt a reading culture. Most of the books selected for this role achieved the best seller status. Other brands that were endorsed by Oprah also became immensely successful. The success of the Oprah brand was also extended to the online version or website for TOWS, which is Oprah.com, and to the O magazine. Oprah’s media ventures also included satellite radio when through a deal with XM satellite radio she started the channel Oprah and friends, and later renamed the channel Oprah radio. Aside from her contribution to the media, Oprah is also a philanthropist. She has regularly contributed to causes that are aimed at making education accessible for the disadvantaged in different communities. Her contribution to education also includes starting The Oprah Winfrey Aca demy for Girls, which is aimed at empowering young disadvantaged girls in South Africa. The academy seeks to empower them to achieve their dreams and ambitions and also develop women in South Africa for leadership positions (http://www.oprah.com/pressroom/Oprah-Winfreys-Official-Biography). The different brands that Oprah managed to create and grow to a success are often associated with her personality and her face. This makes it easier for people to identify with the brand and has led to what is considered ‘the Oprah effect’. Her personality has been recognized based on her ability to be honest about different issues that have affected her as well as those that affect people all over the world. She is therefore considered as one of the most powerful opinion leaders and shapers in the world. Celebrity branding has been unsuccessful in several instances. There is therefore the concern that the new venture (OWN) by Oprah may fail following an overuse or overexposure of Op rah as a brand. Celebrity branding has gone wrong such as in the case of Martha Stewart who was once a powerful brand in several instances. Following credibility issues that were brought about by her arrest and jailing, the brand Martha Stewart became one that nobody wanted to have any kind of association with. Despite many attempts to revive the brand, people continued to avoid it and anything that was thought to have any form of

Massage Therapy Essay Example | Topics and Well Written Essays - 500 words

Massage Therapy - Essay Example The value of a massage to your overall wellbeing cannot be understated. But it is important to take the steps necessary to achieve the best possible results. This may mean different things depending on the purpose of your massage. If the massage is meant to simply relax and rejuvenate, it is helpful to at least drink plenty of water before and after the massage in order to maintain proper hydration of the muscles. Proper nutrition is also helpful in getting the most out of a massage. Being weighed down by heavy, greasy foods is never a good idea from a health perspective, and even less so before or after a massage. The best dieting approach is one that assists the massage as a tool to help purge the body of toxins. That means eating plenty of whole grains, fruits, vegetables and lean proteins. If your massage is treatment for muscular or other physical ailments, it is often a good idea to exercise and stretch muscles before hand, which increases circulation and aids the therapist's e ffort to accurately target and loosen problem muscle groups.

Effect of Ocean acidification upon ability to genetically adapt in Essay - 3

Effect of Ocean acidification upon ability to genetically adapt in Nereis species - Essay Example As such the project will examine how environmental stress manifest itself upon regulation of reproduction, and ultimately, reproductive success. To study the adaptive capacity and resilience in worms, the project will evaluate variations, which are observed in worms that are moved between various pH conditions. This evaluation can also serve as a measure for biomarkers that indicate effects of such pH stress. Studies of specimens that stem from volcanic vents, where release of carbon dioxide occurs, provide an opportunity to learn about the natural ecosystems (Fabry, et al., 2008) that have a low pH. It also provides a potential model to study the likelihood of species acclimatising and living in low pH habitats. The study should reveal more about the mechanisms that allow these worms to survive in these harsh environments. The main aim of this project is to evaluate the molecular and biochemical basis of pH acclimatisation, and the role of environmental factors such as temperature and carbon dioxide levels, which define the vent environment. Ocean acidification involves lowering the pH of ocean water, resulting from an increase in the uptake of CO2. Oceanic CO2 levels have increased over the past centuries, and they continue to rise at higher rates than ever. This has the effect of reducing the natural buffering capacity of the ocean, as well as lowering the pH of the water (Fabry, et al., 2008). Existing in natural CO2 vents, P. dumerilii has exhibited its ability to survive in such extremely low pH levels (Davidson, 2013), as compared to related Nereid species such as Nereis succinea, Nereis diversicolor and Nereis zonata. These pH levels range from 6.6-7.3 in the CO2 vents that exist in Ischia (Calosi, et al., 2013) and P. dumerilii is known to thrive in these vents whilst N. zonata co-occurs in the Ischia area but is not known to inhabit the low pH vents (VodÄÆ', 2015).

The Case of the Spelunkers Essay Example | Topics and Well Written Essays - 500 words

The Case of the Spelunkers - Essay Example It is not morally and politically correct for people to act as Gods and decide the fate of another person even when we are in the face of intense pressure. In our case, the fact that the four men were stranded in the middle of nowhere and were in danger of starving to death does not give them the right to vote as who should live and who should die. The fact that Peter, Greg and John connived to give Paul the shortest straw can be considered as an act of discrimination. You see, these three men knew the present circumstances of Paul and apparently, the three of them decided that Paul is the person who is least likely to be missed by his family and his community. The discriminatory treatment against Paul is not only unfair, it is also immoral. Note also that the relationship of the four friends is based on mutual trust and confidence and the act of the three other men of conniving against Paul constitute an act of betrayal. Even if Paul was unemployed and he has not achieved much in li fe that does not mean that he is expendable. We have to understand that every human being should be treated equally regardless of his or her background. On the other hand, based on the facts of our case, Paul did not want to take part in the scheme that Peter, Greg and John hatched is evident. He expressly told his friends that he did not want to take part in the plan of â€Å"sacrificing† someone so that the others could live. Since Paul did not give his express consent to his friends that they could eat him, his friends should never have forced him to sacrifice himself. On the other hand, even if Paul agreed to the plan of Peter, Greg and John, that does not make the plan to kill someone moral or legal. Taking another person’s life constitutes manslaughter or homicide at the very least and such act is punishable under the law. With regards to the reaction of the public, outraged

Trafficking in Person's Research Paper Example | Topics and Well Written Essays - 2500 words

Trafficking in Person's - Research Paper Example Whereas the individual reader may be thoroughly familiar with the trade in illicit substances and/or narcotics, the level of knowledge that many societal shareholders have with respect to human trafficking is quite limited. One need look no further than the way in which popular culture and media portray drug smugglers, drug addicts, and each and every wrong of the supply and demand chain for narcotics to realize that this has primarily come to be the focal point of discussion and analysis with respect to the illicit/underground economy. However, according to 2011 statistics, human trafficking is a $35 billion a year global industry (Knepper, 2013). Moreover, from an ethical and moral standpoint, the trade of human beings and the buying and selling of these individuals as if they were merely a commodity to be consumed and disposed of as perhaps the most troubling aspect of all. Whereas it is true that the impacts of illegal drugs have far-reaching consequences that can harm any number of individuals in any socioeconomic strata in any country, human trafficking is unique due to the fact that it is one of the only exhibitions of slavery that currently exist within the world. Sadly, human trafficking is increasing with each and every passing year as the demands for cheap labor, sexual services, and healthy babies only continues to rise with the increasing population of the world. As a function of this sad reality, the following analysis will seek to analyze the scope, definition, impacts, policies, levels of governmental engagement, and factors that ultimately encourage the prevalence and continued exhibition of human trafficking around the globe. Although the greatest emphasis with regards human trafficking will necessarily be with respect to the way it is evidenced within the United States, it is impossible to engage such a topic without realizing and appreciating the global ramifications that the increasingly interconnected world demonstrates. Within such a mann er, global aspects of human trafficking will be discussed and engaged interchangeably with domestic concerns. The United Nations typically defines human trafficking as international organized transnational crime. For this very purpose, the United Nations reached an international agreement entitled â€Å"The UN Convention against Transnational Organized Crime†; specifically targeting trafficking protocol is one of the first major issues that must be engaged. With regards to the actual definition of human trafficking, this particular analysis will refer to the Universal Declaration of Human Rights as a means of defining the way in which the reader should approach the issue throughout the course of this analysis (Onuoha, 2011). As such, the Universal Declaration of Human Rights defines human trafficking as the following: â€Å"†¦the recruitment, transportation, transfer, harboring, or receipt of persons, by means of threat or use of force or other forms of coercion, of the production, of fraud, a perception, of the abuse of power or of a position of vulnerability or the giving up of receiving payments or benefits to achieve the consent that a person having control over another person, for the purpose of exploitation. Exploitation shall include, at a minimum, the exploitation of the prostitution of others or other forms of sexual exploitation, forced labor or services, slavery or practices similar to slavery, servitude or the removal of organs†

Operations and Quality Improvement Strategies Coursework

Operations and Quality Improvement Strategies - Coursework Example Organizations can apply a set of skills and tools to reduce operational cost, increase efficiency and productivity, and improve the quality of their processes, products and services. 1. Lean Manufacturing. Critically discuss the differences, using examples, between the Lean and Mass (Traditional) Production strategies. A. Rationale: Lean Manufacturing, a Japanese philosophy, gained attention at the beginning of the 1980’s when the western leaders could not stop wondering the inimitable industrial advances and permanent employment of the Japanese businesses (A to Z Management Concepts and Models 2007). It has been described as â€Å"the most fundamental change to occur since mass production was brought to full development by Henry Ford early in the 20th century† (Hindle 2008). Lean manufacturing has been established as one of the crucial factors for Japanese success. There are two basic concepts that are involved here: making the management work to give lower cost per un it produced which directly enhances productivity, secondly, striving for continuous improvement (kaizen). Workers are expected and encouraged to adopt a new approach to their work and reap the benefit of it (A to Z Management Concepts and Models 2007). Generally, in lean production systems employees are organized in teams and each worker must be able to do all the tasks required of the team. â€Å"These tasks are less narrowly specialised than those demanded of the worker in a mass-production system, and this variety enables the worker to escape from the soul-destroying repetition of the pure assembly line† (Hindle 2008) B. Evolution: In 1776, Adam Smith in the Wealth of Nations described that mass production is based on the principles of specialization and division of labour. To design products and to set up production systems highly skilled labours are used whereas to produce standardized components and assemble them the labours used are highly unskilled. The latter are dis posable and can be laid off depending on the situation. In mass production, parts used are often manufactured elsewhere and then put together on a moving production facility called assembly line. â€Å"The result is a standardized product made in a fairly small number of varieties, produced at low cost and of mediocre quality.† If a problem needs to be corrected at any point in an assembly line the entire process stops (Hindle 2008). Lean production system requires the components to be delivered just-in-time and each worker is allowed to stop production when a fault is discovered. This is the basic difference from classic assembly line process where stoppages are expensive and should be avoided at all costs. With a mass production system the worker learn nothing because all the faulty products are put aside to be dealt with later. They are replaced immediately, from the large stock of spares, without causing any hold-ups. In case of lean production, problems are immediately r esolved when a stoppage occurs and gradually this diminishes the number of stoppages. Eventually, a mature lean-production line stops a much lesser number of times than a mature mass-production assembly line (A to Z Management Concepts and Models 2007). Yet another advantage of lean production is that designers, workers and suppliers work hand-in-hand with production which never happens in a mass-production system. A separate team of insiders or specialists participate in designing which

History of west coast swing Essay Example | Topics and Well Written Essays - 500 words

History of west coast swing - Essay Example Various authors trace the origin of the West Coast Swing from various places. Nonetheless, P. Wright and J. Wright identify the original roots of this dance from the Jazz era of the 1920s with the style first known as the jitterburg, which was inspired by the boogie-woogie (109). At the same time, a Latin American dance style, called the lindy, evolved with the dancing style interchanging  into patterns that were similar to various steps of the jitterburg to involve â€Å"a single step, a delayed step, or a step taken on each slow count† typical of a swing although called the lindy (P. Wright and J. Wright 109). Following this development, bands that were performing the lindy became famous in the 1930s and 1940s, which consequently contributed to the renaming of the dance style as the swing dance. Importantly, the dance survived the rock ‘n’ roll era of the 1950s and 1960s (P. Wright and J. Wright 109). From this singular form of the swing dance, two forms of swing emerged. The East Coast swing and the West Coast swing were the  new  dance styles with the West Coast swing being the most popular dance style then and in the contemporary society. The West Coast swing is characterized by slot dancing, which â€Å"uses both six- and eight-count patterns done to either medium or slow tempos† (P. Wright and J. Wright 109). Overtime, the West Coast swing  dancing style  has evolved to various forms. In its previous form, the dance was primarily a man’s dance with the follower following the steps in the presentation. Currently, both dancers have a responsibility over the movements involved in the presentation (Blair). On the other hand, the classic form of West Coast swing has evolved into a dance that is characterized by elongated slot, timed pulsing that is chilling, controlled timing of steps, and critical movements that result to a more

The life of James Derham Essay Example for Free

The life of James Derham Essay James Derham is identified as one among the ten most famous male nurses in the history of mankind (National Institute of Health). He is indeed termed as the first African-American to practice formal medicine in America despite the fact that he owned no M. D. degree. Derham was born in Philadelphia, Pennsylvania by a slavery couple (Kirschman). Being a slave, he was owned by many medical practitioners, one of whom was Dr.  Robert Love, who identified Derham unique potential and encouraged him to practice medicine. With permission for his master, Dr. Robert Love, Derham successfully worked as a nurse, managing to by his freedom from slavery in 1783 (Kirschman). Being a freeman, he went on to open a medical practice. It is estimated that at the age of 26, Derham was earning over $3,000 annually from his medical practice (National Institute of Health). This has been closely attributed to large patient pool he enjoy owing to his ability to speak various languages. He was fluent in speaking English, French, and Spanish languages. It is claimed that Derham once met with the father of American medicine, Dr. Benjamin Rush, with whose encouragement he moved to continue his medical practice in Philadelphia (Kirschman). In Philadelphia, Derham emerged as a medical expert mainly dealing with the treatment of throat and climate caused diseases. He is given great honor for his historical contribution on the relationship between climate and diseases affecting mankind (National Institute of Health). However, James Derham disappeared in 1802 and no available information about his fate. He his believed not to have had married by the time he disappeared (Kirschman). Due to his honor, the state of New Orleans established the James Derham middle school in 1960. Derham was and still is a hero of the American history.

Environment Analysis Essay Example for Free

Environment Analysis Essay Organizations analyze the environment in order to understand the external forces so that it could help to develop effective responses to secure or improve their positions in the future. There existed a positive relation between environmental analysis and profits of an organization. Top management looked at information in two ways: viewing and searching information. This information needed to be evaluated and disseminated to strategists within the organization and to help top management to make decisions that could create strategic advantage for the organization to succeed in a changing environment 1. There were research evidences that showed that environmental analysis was linked with improved organizational performance. Hence, it remained insufficient to assure performance, without aligning information with strategy. The main debate in strategy and environment was concerned with the primary importance of the environmental analysis in strategy formulation and implementation. 84 Reserve Bank of India The Reserve Bank of India is fully owned by the Government of India. Initially it was viewed to bring the greater coordination of the monetary, economic, and financial policies. During fifties objectives of Reserve Bank of India underwent changes. It was recognized that Reserve Bank of India needs to take on direct and much more active role, in developing machinery for financial development in order to ensure flow of finance in the country. Reserve Bank emerged as a regulatory and a growth promoting institution. In the beginning limited to the agricultural sector, the Bank later covered small-scale industries as well. The affairs of Reserve Bank of India are governed by the central board of directors. The board is appointed by the Government of India according to the Reserve Bank of India Act. The preface of the Reserve Bank of India describes the basic functions of the Reserve Bank as: â€Å"to regulate the issue of Bank Notes and keeping of reserves with a view to securing monetary stability in India and generally to operate the currency and credit system of the country to its advantage† 2. The Reserve Bank? s freedom may be viewed broadly to the areas like management including personnel matters, financial aspects, and to conduct polices. Managerial freedom refers to the procedures for appointment, term of office and dismissal procedures of top central bank officials and the governing board. It also includes the extent and nature of representation of the Government in the governing body of the central bank. 85 Financial freedom relates to the freedom to decide the extent of Government expenditures directly or indirectly financed by the central bank? s credits. Finally, policy freedom is related to the flexibility given in the formulation and execution of monetary policy, under a given authorization. Reserve Bank of India has over the years been responding to changing economic circumstances. The Reserve Bank of India performs the function of financial supervisor under the guidance of Board for Financial Supervision. This board undertake consolidated supervision of the financial sector comprising of Commercial Banks, Financial Institutions, and Non-Banking Finance Companies. The key functions played by this board were restructuring of the system of Bank, introduction of off-site scrutiny, strengthening the role of legislative auditors, and strengthening the internal defences of supervised institutions. Currently this board focus on supervision of financial institutions and legal issues in Banks. Reserve Bank of India acts as a guard for Commercial Banks. Commercial Banks are required to keep a certain proportion of cash reserves with the Reserve Bank and Bank provide them various facilities like advancing loans, underwriting securities etc. Reserve Bank of India controls the volume of reserves of Commercial Banks and thereby determines the deposits and credit creating ability of the Banks. Whenever Commercial Banks need funds they get it from the Reserve Bank of India. Apart from playing the role of Banker to the Banks, Reserve Bank of India also play promotional role. The aim is to establish and assist the establishments of a number of financial intuitions for filling up of various financial institutional gaps in the rural and semi-urban areas. 86 Other roles played by Reserve Bank of India are: Reserve Bank stabilizes the external value of the national currency. The Reserve Bank keeps gold and foreign currencies and manages foreign currency in accordance with the controls imposed by the government. Reserve Bank of India facilitate external trade and payment and promote orderly development and maintenance of foreign exchange market in India. Reserve Bank has taken the responsibility of meeting directly or indirectly all legitimate demands of Commercial Banks under emergency conditions and to a certain extent Reserve Bank influence the credit policy of Scheduled Banks. The Reserve Bank has instrument of control in the form of the bank rate, which it publishes from time to time 3. A list of the Reserve Bank of India Committees from 1990- 2008 was prepared to get an impression about developments with respect to Banking Industry (Appendix- III). The recommendations resulted into remarkable changes in products and policies of Banking Organizations. Indian Bank’s Association (IBA) Indian Bank? s Association is a leading service organization of Banking Industry in India. It aims to integrate Banking and finance system catering to all financial requirements of customer? s. It was formed in 1946 with 22 members. Today Indian Bank? s Association has more than 159 members comprising of Public Sector Banks, Private Sector Banks, Foreign Banks (having offices in India), and Urban Co-operative Banks. 87 The main objectives of Indian Bank? Association are: promoting and developing sound and progressive Banking principles and practices in order to assist Banks to develop and implement new ideas and innovative Banking services, operations and procedures; organizing co-ordination and co-operation on procedural, legal, technical, administrative or professional problems and practices of Banks ; circulating statistical data, informati on, views and opinions on the Banking System; conducting Management Development Programs for Banks; promoting education and knowledge of the law and practices of Banking Industry; to help in projecting good public image of Banking Industry ; and to promote harmonious relationships by devising ways and means for involving Banking personnel? in the growth and development of Banking Industry. Indian Bank? s Association tries to achieve excellent service quality and customer care through its focused efforts to make each customers experience a pleasant one. Towards this end Indian Bank? s Association stressed on to build staff potential by each Bank to address customer challenges and asked Banks to design a performance management system, which focuses on rewarding the staff for delivering flawless customer service. In 2000, Indian Bank? s Association reviewed the charters of different Banks and brought out a „Model Citizen Charter? explaining to the customer? s what they could expe ct from the Bank? s as a matter of right. Apart from this Indian Bank? s Association brought „bankers fair practices? in 2004 which was adopted by all Banks voluntarily. It also came out with „fair practice code for credit card operation? and „model code for collection of dues and repossession of security? with special concern to customer? s voice about Banking practices 4. 88 Ministry of Finance Ministry of Finance in India governs the entire fiscal system of the Government of India. The three departments headed by the Ministry of Finance in India include: economic affairs, expenditure, and revenue. Thus, it mainly centralizes around the economic and financial issues pertaining in India. Ministry of Finance Government of India, Banking Division is managing Government policies related to the working of Banks and the term lending to financial institutions. This Division is headed by Secretary (Banking and Insurance) and operates through three subdivisions: Industrial Finance; Banking Operations; and Banking and Insurance. Each subdivision is headed by a Joint Secretary. The Banking Operations sub-division deals with legislative proposals described to Banks, non-banking financial companies, and other related matters like appointments of Chief Executives and Government nominee Directors and non-official directors on the boards of Public Sector Banks. In addition policy matters relating to Private Banks, Foreign Banks, and improvement of customer? service in Banks and redressal of customers grievances are also dealt with this Banking Operations sub-division of Ministry of Finance. This sub-division also deals with vigilance matters and appoints Chief Vigilance Officers (C VO? s) in the Public Sector Banks to enable the Public Sector Banks to meet the credit requirements for the productive sectors of the economy in proportion to the economic growth of the country. The Government is committed to infuse capital funds in Public Sector Banks as well 5. 89 Nature of Banking Industry Bank? s safeguard money and valuables and provide loans, credit, and payment services, such as checking accounts, money-orders, and cashier? s checks. Banks also offer investment and insurance products which they were once prohibited. There exists variety of models for cooperation and integration among finance industries some of these traditional distinctions between Banks, Insurance Companies, and Securities Firms has diminished. In spite of these changes, Banks continued to maintain and perform their primary role of accepting deposits and lending funds from these deposits. Banks securely save the money of depositors, provide checking services, and lend the funds raised from depositors to consumers. Bank? s today are in a wide range of sizes, from large Global Banks to Regional and Community Banks. These Global Banks are involved in international lending and foreign currency trading, in addition to the more typical Banking services. Working Environment Employee? in a typical branch work weekdays, whereas in few Banks sometimes Banks were opened until late evenings or were open on Saturday morning? s and in few even on Sundays. Supervisory and managerial employee? s, usually work substantially longer hours. Some B anks are expanding the working hours in their branches which are located at non- 90 traditional locations, such as shopping malls, which remain open on most evenings and weekends. Branch office jobs, particularly front-end positions, required continuous communication with customers. Some employees needed to work for longer hours in a confined space. Loan officers might need to travel to meet clients, or work evenings for their clients. Loan officers also check loan applications, and solicit new business for Banks. Financial Service Sales Representatives might also have to visit clients in the evenings and on weekends to go through the client? s financial needs. To improve customer service and provide greater access to Bank personnel? s, Banks have staffed Customer Service Representatives. The remaining Bank employees, working at the headquarters or other administrative offices usually worked in comfortable surroundings and worked for a standard workweek. In general, Banks are considered relatively safer place to work with respect to injuries and illness. Banks also encourage higher education and training for their employee? as Banks require creative and talented people to compete in the market place so as to reach to more number of customers. The basic premise here is to Study the relevant data and derive some information related to the Strategic Environment pertaining to Indian Banking Industry, which may be used in due course in a broader context if not in specific context. Environmental factors influencing Banking Industry are: 91 Economic Factors Indian economy has registered impressive growth of over 9 percent for successive three financial years and experienced restraint in 2008-09. This restraint was caused due to the downturn in the global economy. The year 2008-09 was the most deficient year after 1972. To fight against this slowdown Government of India and Reserve Bank of India took many fiscal as well as monetary actions. It was expected that Indian economy could again register a robust growth rate in the year 2009-10. As per the revised estimates released by the Central Statistical Organisation (CSO), Indian economy grew by 7. 6 percent in 2008-09 and 9. 3 percent growth in the 2007-08 6. Banks lending to industries, personal loans and service sectors witnessed a slow down while, Banks lending to agriculture and allied activities moved upward during 2008-09. The income as well as the expenditures of Scheduled Commercial Banks viewed a slow down leading to decrease in the net profit. The Return on Assets (ROA) as an indicator of efficiency with which Banks deployed their assets remained to 1 percent in 2009. The Return on Equity (ROE) as an indicator of efficiency with which the Banks used capital increased to 13. 2 percent in 2009 from 12. 5 percent in 2008, indicating increased efficiency with which Banks used capital 7. 92 Growth of income of Scheduled Commercial Banks during 2008-09 decelerated to 25. 7 percent from 34. 3 in 2007-08, but was higher than the growth rate of 24. 4 percent in 200607. Expenditure of Scheduled Commercial Banks was 24. 1 percent in 2006-07, which increased to 33. 9 percent in 2007-08 and again decelerated to 26 percent in 2008-09. The operating profit of Scheduled Commercial Banks increased sharply by 33. percent during 2008-09 from 26. 8 percent in 2007-08 and 21. 3 percent in 2006-07 (Table II. 1). The net profit of Scheduled Commercial Banks also showed a significant increase of 36. 9 percent during 2007-08 as compared to 26. 9 p ercent in 2006-07, but it decelerated to 23. 5 percent during 2008-09(Table II. 1) TABLE II. 1 VARIATION IN INCOME-EXPENDITURE OF SCHEDULED COMMERCIAL BANKS 2006-07 Income Expenses Operating Profit Net Profit 24. 4 24. 1 21. 3 26. 9 2007-08 34. 3 33. 9 26. 8 36. 9 2008-09 25. 7 26. 0 33. 2 23. 5 Source: Reports on Trend and Progress of Banking in India 8, 9 The Bank Group-wise analysis is presented in Table II. 2. Even though the achievements of technological changes in Banking Industry in India were impressive but there is a need to take greater advantages from new technologies and information based system to maximize the coverage. Pricewaterhouse Coopers report 18 suggested that Banks should take up automation that would be a combination of centralized networks, operations and a Core Banking applications that included Business Intelligence (BI), Business Process Re-engineering (BPR), and Customer Relationship Management (CRM) that catered to operational and analytical business needs. The multi-channel Banking has acquired further dimensions to include third party payments such as utility bills through different channels including Automated Teller Machines and mobile banking. Bank? internal groups examined the issues, relating to rural credit and micro-finance opportunities in the sector with several possible options like smart card-based kisan credit cards, smart card solutions for self-help groups, Automated Teller Machines with local language and voice facility and call-center amenities with added services given by various Banks. Introduction of Kisan Credit Cards (KCCs) for providing credit to farmers had increased in the number a multi-fold since its inception in the late 1990? s and the total percentage share of these cards reached above forty percent 19. 97 Banks had transformed themselves into Universal Banks by adding new channels with lucrative pricing. Recent innovations in the form of total quality management, reengineering work processes, flexible systems have only one thing in common serving the customers well through improved operational efficiency. Consolidation in the Banking Industry followed by technological up-gradation acted as a key factor to boost the international competitiveness of the Indian Bank? s. Adapting technology had brought down the cost of transactions visibly and at the same time aided in business continuity. A Study mentioned that the cost per transaction through a branch was Rs. 66, cost per transaction ; through Automated Teller Machines was Rs. 22, and cost per transaction through internet was Rs. 0, ignoring the extreme variations owing to the investment cost and nature of transactions 20. This low cost benefit was opted by Commercial Banks as it helped them to reach to poor people, particularly those working in the rural areas and those who earn and spend cash. In order to handle their cash transactio ns Banks formulated two types of Information and Communication Technologies (ICT). People could either use Automated Teller Machines that could accept, store or dispense cash or they could use a biometric device, which were mobile in nature. Infrastructure in India, has improved resulting into widespread use of Automated Teller Machines facility in villages as well. These machines consisted of additional features that included fingerprint use as a mean of authentication with a view that rural people were more comfortable with fingerprints than plastic cards. 98 The wide geographical coverage to access Banking related products and services with the help of mobile phone technology and the use of internet for banking transactions has gained superior usage. These modes of transactions required a safe and secure environment and provide a variety of options available for customers with different requirements. The numbers of mobile phone subscribers in India were about 261 million (March 2008). Towards this end, Reserve Bank of India issued guidelines for mobile banking transactions. Initially Banks offered the facility to their customers subject to a daily cap of Rs. 5,000 per customer for fund transfer and Rs. 10,000 per customer for transactions involving purchase of goods or services 21. Usage of internet banking in India is mainly dominated, by Private and Foreign Banks. Still, the number of individuals utilizing internet services has increased considerably. In 2006, about 12 percent of the 38. 5 million internet users in India used online banking and the figure for online banking increased to 16 million in 2007-08 22 . The average cost of servicing a customer through internet banking is the tenth of the services extended through a branch. Thus, there is a direct contribution to the profitability for a Bank and therefore, internet banking became a potential low cost alternative 23 . From customer? s viewpoint, internet banking is highly convenient as it help to avoid branch queues and makes customer free from depending on the inconsistent quality of services at the branch, which varied from person to person at the service desk. Internet Banking allowed customers to operate their accounts at their convenient hours instead of being dependent on the Banks working hours. Moreover, internet banking permitted customers to transact on a 247 basis from any part of the world. 99 Therefore, internet banking delivery channel has the potential to contribute directly towards the nation? prosperity as it allowed more people to join the Banking stream without adding cost and it is tremendously convenient to customers. Reserve Bank of India started measures to create multi-lingual links on its website for thirteen Indian languages on all matters concerning Banking in June 2007 24. In the recent years, the use of electronic payments has witnessed manifold increase reflecting increased adoption of technology. The electronic payment systems comprised of the large value payment systems like Real Time Gross Settlements (RTGS), National Electronic Funds Transfer (NEFT) and card based payment systems. The growth of volume of transactions directed through electronic payment has decelerated from 41. 4 percent in 2007-08 to 24. 8 percent in 2008-0925. The numbers and usage of Automated Teller Machines had gone up substantially during the last few years. Automated Teller Machines were primarily used for cash withdrawal and balance enquiry. In 2008-09, the total number of Automated Teller Machines installed by the Banks grew by 25. 4 percent. Automated Teller Machines of State Bank of India group registered a sharp growth of 34. 5 percent. While the Automated Teller Machines installed by new Private Sector Banks and Foreign Banks was 3 times of their respective branches 26, 27 . In March 2008, the population per automated teller machines in India was more than 29,500 as against the range of 1,000-9,500 in some of the other emerging market economies 28, 29 . In June 2009, Reserve Bank of India permitted Scheduled Commercial Banks to install off-site Automated Teller Machines at places identified by them, without any need to take permission from the Reserve Bank of India. Cash withdrawal from Automated Teller Machines of the Bank? s was made free of charges, April 2009 onwards. This made Automated Teller Machines more popular among customers. 100 Banks had deployed Information Technology solutions to facilitate automation in transaction management, reporting and risk management. Most of the Banks across the segments had already implemented Core Banking Systems. In the 2007, 85. 6 percent and in the 2008, 93. 7 percent Public Sector Banks were fully computerised 30, 31 . Other rograms such as internet based transactions, self-service kiosks, mobile banking were either underway or planned in near future by Public Sector Banks. Foreign Sector Banks and old and new Private Sector Banks in India, had progressed well in the areas of technology up-gradation i n operations. Technology up-gradation helped to introduce new products and services to enable Banks to improve the quality of service and value added services. Overall, Indian Banks score well with respect to technological adaption and the three key characteristic contributing towards the effective use of information technology in Banking Industry were: ? Factor Cost Advantage- information technology related labour costs in India remained cheaper as compared to other countries; ? Distribution Strategy- Indian Banks adopted a unique business model, acquiring customers rapidly with minimal technological investments; and ? Information Technology Governance- Indian Banks emphasized on information technology governance with the strong in-house Information Technology Division and a Chief Information Officer (CIO) directly reporting to the Chief Executive Officer (CEO) in most cases. 101 It is information that made the Banking Industry stable. The pressure of competition and the need to improve productivity has generated a need for better information. In order to manage Banking operations to meet the needs of managers operating at tactical and strategic level and to improve their quality of decisions and policymaking processes within the Banks. Banks needed to set up an efficient and comprehensive Management Information System (MIS) without which asset and liability management and risk management were not possible. However, adoption of technology by Banks provided them competitive advantage in their operations but at the same time Banks became dependent on outsourcing for most of their technological applications. Therefore, Banks needed to employ caution to put in place mechanisms for vendor management. As an insecure system, could expose Banks towards serious operational regulatory and reputational risks. Banks have taken measures to safeguard the risk factors, emerging due to the use of technology. Towards this end, the Institute for Development and Research in Banking Technology (IDRBT) helped Banks to bring in technology and enabled them to work in secured environment while operating Real Time Gross Settlements System, Centralised Fund Management System (CFMS), corporate e-mail, and internet banking. It also acted as a „certifying authority? for the Banking Sector in India by issuing Digital Certificates 32 . Still there exists need to ensure much more accountable systems with regard to online payments with uniform standards all over the world. 102 Social Factors Before nationalization of the Banks, their control was in the hands of the private parties and only big business houses and the effluent sections of the society gained benefits from the Banking in India. Thus, adoption of the social development model in the Banking Sector was necessary for speedy economic progress consistent with social justice in democratic political system. Bankers were directed to help economically weaker sections of the society and to provide needed finance to all the sectors of the economy with flexible and liberal attitude. India? s demography had undergone transition and the demographic trends 1950 – 2050 studied, illustrates that India? s fertility rate is consistently falling from the peak 5. 91 percent in the first decade after independence to 2. 76 percent today and expected to fall further to 1. 85 percent. Even the death rate also likewise showing consistent decline from its peak 25. 5 in 1950-55 to 8. 5 today and to the lowest of 7. 9 in 2020-2025 33 . This ignifies towards steady number of customers for Banking Sector with longer income in the coming years. Indeed, India would be one of the youngest nations with its median age lying between 25 a nd 30 years over the next 15 years (2010 to 2025) 34. This signified that India would enjoy its prevalence of young age population for almost four decades. Thus, India? s demographic transition needed to be exploited by Banking Sectors viewing it as an opportunity. 103 Increase in the per capita income of the working class population of India, enabled individuals to purchase goods, which were far out of their reach earlier. It also encouraged people to buy goods for their personal use and for their family. Today societies have shifted towards nuclear family, resulting into the growing needs for home consumer durables like washing machine, television, bike, car etc. This showed how we as a society have moved from a socialist society to a consumerist society. Understanding these changes and to use them as an opportunity Banks provided various types of loans to farmers, working women, professionals, education loan to the students, housing loans, and consumer loans. Even customers life style, their behaviour, and consumption patterns have changed which acted as an opportunity as well as a threat for Banking Industry. Deposits showed a subdued growth during this decade. In 2008- 09 personal loans by Commercial Banks was 12. percent with respect to 10. 8 in 2007-08 of which housing loan was 11. 6 percent in 2007-08 and 7. 4 percent in 2008-09 35 . This deceleration was observed in housing loans especially due to economy slow down. Literacy rate in India is low as compared to other developed countries. Illiterate people hesitate to transact with Banks. Therefore, this influenced negatively on Banking Industry. Nevertheless, there exists positive side of this as well that illiterate people trust more on Banks to deposit their money as they do not have market information they do not put money in stocks or mutual funds so they look Bank as their sole and safe alternative. For a common man Banks have emerged as the key players to provide variety of products and services like saving accounts, insurance, remittance and other facilities to the under privileged and the poor in rural, semi-urban and urban areas or socially disadvantage as well as the small and medium enterprise sector . 104 On the other hand Banks deal with big clients or big companies which required personalized banking as these customers do not believe in running and waiting in queues for getting their work done . To these customers bankers provided special provisions and at times benefits like individualised hosting to these types of customers. It was brought to the notice of the Reserve Bank of India that visually challenged persons were facing problem in availing Banking facilities. Reserve Bank of India in June 2008 advised all Banks to ensure that all facilities such as cheque book including third party cheques, Automated Teller Machine facilities (at least one third of new Automated Teller Machine installed with Braille key pads and located strategically), net banking, locker, and credit cards to be provided to visually challenged persons without any discrimination 36. Banks related crimes are rising. These crimes included the typical ones such as Bank robbery, false statement to a Bank in order to obtain loan, false entry in a Banks book, Bank bribery, and Bank fraud. The other new types of crimes have also emerged like accessing to the whole or any part of information technology system without rights. These also included manipulation of Banking system, data alteration, or data destruction to make unauthorized identity theft with reference to Automate Teller Machines. Indian police has initiated by opening of special cyber cells across the country and started educating the personal against these crimes. 105 Political Factors Before 1990, the lack of accountability and lack of profit motive in Nationalized Banks was credited to political interference. After the economic reforms of 1991, the Indian Banking Industry entered into the new horizon of competiveness, efficiency, and productivity. Reserve Bank of India? s control system and its monetary policies acted as a major weapon in India? financial market. However, sometimes looking into the political advantage of a particular party, Government declares some measures for their benefits like short-term agricultural loans to attract farmer? s votes affecting the profits of the Banks. Even according to Banking Banana Skins, survey 2010 political interference was considered as the greatest risk for Banking Industry 37. In the Budget provisions, Finance Minister increased the farm credit target for 2009-10 at Rs. 3, 25,000 crore compared to Rs. 2, 87,000 crore in 2008-09. The Union Budget 200910 extended the debt waiver scheme by six more months for farmers owing more than 2 hectare of land. The Union Budget 2008-09 allowed farmers 25 percent rebate on 75 percent of their overdue repayment within the stipulated period 38 . Government also announced setting up of a task force to examine the issues of debt taken by a large number of farmers in some regions of Maharashtra from private moneylenders who were not covered under the loan waiver scheme 39 . With Government bearing this burden, Banks would not be affected much. As Government assured to help, Banks to clear their most stubborn non-performing assets accounts on Banks Book. In addition, the emphasis on expanding network with Automated Teller Machines, opening of Banking centre in unbanked blocks were some of the positive moves taken by Government. 106 Political interference by the leftist political parties claimed that various regulations with respect to Foreign Banks would benefit only those Banks, which intend to make a quick jump by providing high-profile corporate services, instead of those who wish to intensify their rural operations. Left political parties also cautioned that foreign players could increase their holding size in a particular Bank that would lead to an imbalance of power. Banks under the conventional system of recovery of loans had a considerable amount of money blocked in form of unproductive assets. Hence, to beat this difficulty parliament enacted Recovery of Debts to Banks and Financial Institutions Act, 1993 also refereed as Debt Recovery Act. This Act created a separate apparatus in the order of Debt Recovery Tribunals, which were handed over the responsibility of administering disputes pertaining to non-payment of debts. As this legislation was general in nature, another legislature by Parliament was enacted , referred as Securitization Act with an objective to give the Banks, more power over defaulting borrowers 40,41. Unions The post nationalization era in the Banking Industry in India, particularly in the Public Sector, witnessed consolidation of trade unions. All the nine unions had all-India presence in the Banking Industry. Five workers unions and four officers unions represented almost 100 percent of the workforce in the industry and joined hands to form a United Forum of Bank Unions (UFBU). United Forum of Bank Unions comprised of All India Bank Employees Association, (AIBEA), All India Bank Officers Confederation (AIBOC), 107 National Confederation of Bank Employees (NCBE), All India Bank Officers Association (AIBOA), Bank Employees Federation of India (BEFI), Indian National Bank Employees Congress (INBEC), Indian National Bank Officers Congress (INBOC), National Organization of Bank Workers (NOBW) and National Organization of Bank Officers (NOBO) 42. Representatives of unions were encouraged to give suggestions. However, in many cases undue interference of unions in decision-making has adversely affected, leading to the deterioration in discipline, efficiency, and performance effectiveness. With the growing strength of these organizations, the issues relating to employees interests were no longer determined by Bank? s managements alone. The massive introduction of technology into the industry made union policies defensive. Unions focused almost entirely on the immediate consequences of technological change on the workforce, especially the aspect of possible job losses. Employees in Public Sector Banks were repulsive to move from one table to another of the same branch. Now the trade unions seem to be willing to allow mobility for employees within a district as mergers enforced them to move from one state to another. Other issues taken up by unions were like introduction of New Pension scheme and variable pay which were resolved with the help United Forum of Bank Unions. Banks unions are also involved in demanding salary hikes, job losses, disinvestments in Public Sector, and issues related to violation of labour laws, and allocation of funds for schemes for unorganised workers. 108 After attempting, the macro level environmental analysis of Indian Banking Industry a micro functional level Human Resource Environmental Analysis has been attempted with the help of SWOT analysis (Strengths, Weaknesses, Opportunities, and Threats), it would help to further develop strategic viewpoint about the industry (Table II. 4). TABLE II. 4 HR SWOT ANALYSIS WITH RESPECT TO INDIAN BANKING INDUSTRY STRENGTHS ? ? ? ? ? ? ? Educated Manpower Higher Compliance Amongst Employees Experienced Employees Training Infrastructure Availability Safe Working Environment Responsiveness to Needful Change Strong Regulatory Institutional Framework ? ? ? ? ? OPPORTUNITIES Liberalization of Banking Sector Preferred Industry for Employment Availability of Multi-specialist staff Technology for Improved Interpersonal and Communication Skills Workforce Diversity WEAKNESSES ? ? ? ? ? ? ? ? Limited Technology Skills Repetitive Tasks Structure Inadequate Remuneration for Attracting Talent Lacking Career Growth Path Rigid Recruitment Policies Hierarchal Structure Rigid Wage Negotiation Process Leadership Deficit at Senior Level ? ? ? ? ? ? ? THREATS Movement of Skilled and Quality Staff Difficulty in Hiring Highly Qualified Youngsters Trend Towards Downsizing Changing Workforce Demographics High Staff Cost Overheads Changing Employees Expectations Entrenched Trade Unionism 109 Key Concerns for Indian Banking Industry The macro level analysis of Banking Industry and micro level analysis with respect to Human Resource functions helped to identify the key concerns related to the Banking Industry. Competition in Banking Industry is very high as Banks are fighting for same share of customers. There are many Banks and non-financial institutions which gave rise to intensified competition. Amongst these, there existed relatively no differentiation in services and every Bank tried to copy each other? s services and technology which increased the level of competition. Competition from the non-Banking financial sector is increasing rapidly as there are substitutes like mutual funds, stocks (shares), government securities, debentures, gold, and real estate acting as a high threat of substitutes. The continuous deregulation has made the Banking Market extremely competitive with greater autonomy, operational flexibility, decontrolled interest rate, and liberalized norms for foreign exchange. The deregulation of the industry coupled with decontrol in interest rates had led to the entry of a number of players in the Banking Industry 43. Alliances and takeovers had occurred on a transatlantic basis. The market share for financial services that Banks hold had declined, while securities firms, mutual funds, and finance companies has grown 44 . Banking Sector needs to build up a strong and efficient financial system by emphasizing on risk based management. 110 In Banking Sector, customers have high bargaining power due to the presence of very large number of alternatives. Banks together with the specialized financial companies that provide finance to customers are available. Recently it was observed that depositors had withdrawn funds from Private and Foreign Banks and invested their money with Public Sector Banks as the cost of switching from one Bank to another was low and almost all Banks provided undifferentiated services. Today customer? s have more information and better understanding about the market, Banks have to be more competitive and customer friendly to serve them. To retain customer? s and market share, Banks started contemplating on building strong relationship with customers. United Bank of India created a revolution in Banking Industry by opening up a boutique branch in Pune in November 2007, as its priority was to provide services to the high net worth customers. Thus, United Bank also recognized the needs of high net worth individuals different from the other customers. United Bank organized corporate golf tournament for customers, music concerts, and screening of Mani Ratnam directed film „Guru? 45 . Bank? s top management has started carefully evaluating the impacts for their actions. Recently, before cutting jobs in Private and Foreign Banks, Human Resource managers tried to assess reactions beforehand and they came out with certain proactive steps. Banks persistently worked in the interest of the Society. This chapter focussed on the environment analysis which is, undoubtedly, required for strategy formulation, and at the same is relevant as a backdrop for strategy implementation. For instance, the needful Human Resource Practices have to be continuously evolved and implemented against the ever-changing macro and micro environment of the Banking Organizations. 111 REFERENCES 1. Wei, C. C. (2001) Environmental Scanning as Information Seeking and Organizational Learning, Information Research, 7(1). 2. About us retrieved on 26 December 2010. 3. Goyal, O. P. (1979) Financial Institutions and Economic Growth of India, New Delhi: Light and Life Publishers. 4. About Us retrieved on 26 December 2010. 5. retrieved on 28 December 2010. . Reserve Bank of India (2008) Report on Trend and Progress of Banking in India 2007-08, lt; www. rbi. orggt; retrieved on 25 December 2009. 7. Reserve Bank of India (2008) Report on Trend and Progress of Banking in India 2007-08, p. 115. 8. Reserve Bank of India (2008) ibid (7), p. 114. 9. Reserve Bank of India (2009) Report on Trend and Progress of Banking in India 2008-09, p. 125. 10. Reserve Bank of India (2008) ibid (7). 11. Reserve Bank of India (2009) ibid (9). 12. Reserve Bank of India, (2008) ibid. (7), p. 115. 13. Reserve Bank of India, (2009) ibid. (9), p. 125. 14. Chandrasekhar, C. P. (2005) What is Happening to Indian Banking? Frontline, 22(4): 12 – 25. 15. Reserve Bank of India (2008) ibid. (7), p. 116. 16. Reserve Bank of India (2009) ibid. (9), p. 127. 112 17. Reserve Bank of India (2009) ibid. (9), p. 142. 18. PricewaterhouseCoopers Report (2006) retrieved on 25 December 2009. 19. Raju, S. (2010) Financial Inclusion: Enabling Inclusive Growth. The India Economy Review, 7:42-49. 20. Sekar, G. V. Emerging Trends in Technology Adoption by Indian Banks and IT Governance – A Practical Guide, lt; http://www. cab. org. in/Lists/ Knowledge% 20Bank/ Attachments/43/Emerging%20Trends. pdfgt; retrieved on 3 June 2008. 21. Reserve Bank of India (2008) ibid. (7), p. 81. 22. Chandrashekaran, N. (2009) CII Banking Tech Summit, lt; http://www. financial express. com/news/indian-banks-behind-global-peers-in-technologypwc/438064gt; retrieved on 24 March 2009. 23. Jayawardhena, C. and Foley, P. (2000) Changes in Banking Sector The Case of Internet Banking in UK. Journal of Internet Research: Networking and Policy, 10(1):19-30. 24. Rao, R. (2000) Banking @ The Speed of Thought, Business India, October 30November 12: 71-108 25. Reserve Bank of India (2009), ibid. (17). 26. Reserve Bank of India (2009) ibid. (9), p. 141. 27. Reserve Bank of India (2009) ibid. (9), p. 261. 28. Reserve Bank of India (2008) ibid. (7), p. 130. 29.

Learning experience at university

Learning experience at university Coursework 3 Reflective Essay   Ã‚  Ã‚  Ã‚  Ã‚  Learning at university is an amazing experience for me as a student; it is totally different from the time when I was at high school. In the past several months, I have gradually developed my academic skills and, realized that I have to change my learning styles to be able to integrate with the new environment. Therefore, to be able to achieve the best results, the purpose of this essay is to reflect on my strengths, weaknesses with the results and feedbacks from the last assessed assignments of two previous 119ECN Coursework, 113ECN Coursework 1, 121BSS Coursework 1, 185ACC Phase Test 1 and the 119ECN Presentation. Then from that, considering what appropriate actions should be taken to make up the deficiencies and improve my skills.   Ã‚  Ã‚  Ã‚  Ã‚  Based on each coursework, I consider my strengths to be able to identify all the main important points that need to be highlighted on a writing essay like â€Å"summarize an article† (from 119ECN Coursework 1), and organize well the presentation of an essay like 121BSS Coursework 1,113ECN Coursework 1. Since I like to draw a plan beforehand of each essay to create a good structure, and it may be just my hobby trying to make the essay looks nice and tidy. I understand the teachers perspective in each essay, I know what I should mention; however, my academic writing skill is not good enough to get high mark, and the fact that I only get 55% (113ECN Coursework 1) is the highest mark that I can get from previous writing coursework. As the result that I had never done a writing essay before in high school, and especially I am an international student so my English language skills has a quite serious problem.   Ã‚  Ã‚  Ã‚  Ã‚  Normally in my essay, I will need to rephrase a number of sentences or words because it would not make sense, and the reader find a difficult time to understand it it is clearly said in the feedback of 119ECN Coursework 1 and in other coursework, the teacher only said my analysis or writing is enough or satisfactory but mostly never come to good. And even thought in 121BSS Coursework 1, I tried to read more reference books, used more academic writing styles, and I actually had a good analysis of private sector company types, I still got problem with my spelling and punctuation; I did not focus enough on the second part of the essay thus overall I did not get a high mark for the assignment (46%). Eventually, I make the same mistake in 119ECN Coursework 2 I did not pay enough attention and effort on the second part of the essay my explanation on the first part is only enough to satisfy but it comes to unsatisfactory on the second part, in the end, I get 36% for the coursework (the worst mark that I ever got).   Ã‚  Ã‚  Ã‚  Ã‚  In 113ECN Coursework 1, the type is quite different from the other coursework like 119ECN or 121BSS; I have to draw 3 4 charts and analyze them. My presentation and charts are quite good so they make up for my analysis; hence I get 55% for overall (the highest mark up until now for writing). The 119ECN Presentation is not a writing essay but a speaking communication, so the mark was average (13/20, about 65%); my speaking is quite clear and covers the entire required subject because I practice numerous times before the presentation day. Nevertheless, the hindrance is still my writing skill, my slide consists of too much information, so it is hard for the audience to follow my speaking and they only try to read the slide, not listening. And the presentation exceeds the given time because my group only practices individually so we couldnt manage to time ourselves in time. Finally, 185ACC Phase Test 1 is not exactly a writing test, it is more like a test of solving math problems so it involves more in calculating so it is easily to understand why there is no feedback for this test. To me, math is the easiest subject as I practice it frequently since I was young, and more interesting than other subject (especially subjects that I have to write essay). The test is not too difficult and has plenty of time so I did not have much trouble to finish it with perfect mark (100%).   Ã‚  Ã‚  Ã‚  Ã‚  As the result, I realize that my biggest weakness is my academic writing skills, and it is obvious that I have to do a large number of essays when I am at university as they are the main assessed mark. For that reason, I have to improve my academic skills by many ways like: Read more guide books about writing skills at university to help increase my academic words, and how to use them efficiently in the essay as I can find many examples in those books. Read more books about my subject like finance or business, and even newspaper to help improve my ability to analyze the data and have a wider range of knowledge to be able to develop the quality of the essay. Check through the essay several times when the tutor gives back the assignment with feedback and reflect on it make note of what lacking in the essay and what need to improve base on the tutors feedback. Find someone with high result to reflect the essay together and pay attention on what they have that I dont have. Listen to their opinion about my work, and try to improve it base on their comments. Scan the essay several time before hand it in to check if there is any mistake and see if it makes sense. Especially try to pay attention to the second part of the essay more as I always neglect it.   Ã‚  Ã‚  Ã‚  Ã‚  In conclusion, through this essay I know all of my strengths, and weaknesses on my current academic skills based on previous assignments of several modules. I have a lot of actions that need to be taken to develop my academic skills before the end of this semester. To be able to have a good result of the first year at university, I still have to try more to get a good hold of wider knowledge. Appendices: Page 1

Cinematic Interpretation of Stepping Razor Red X: the Peter Tosh Story :: essays papers

Cinematic Interpretation of "Stepping Razor Red X": the Peter Tosh Story Films are designed for numerous purposes, some entertain, frighten, enlighten, educate, inspire, and most make us think about the world we live in. This paper will be focused on the cinematic interpretation of the film "Stepping Razor Red X", the Peter Tosh Story. The makers of a film from the writer, director, cinematographer and the art director, design, and conceptualize what they want the viewer to see. Movie makers have agendas. They get their ideas across by using cinematic techniques and styles which make us view a certain subject in the light that they put it in. I will discuss the differing techniques used by the makers of "Stepping Razor" and describe what the overall impression of the movie has on the viewer, and what the agenda of the director is. Genre "Genre: A group of films having recognizably similar plots, character types, settings, filmic techniques, and themes." (Konigsberg:165) The Genre of this film is difficult to define because it is not composed of a single agenda. The director makes a point of talking about Tosh’s life, but because of the cinematic themes and the film’s style it is not solely a documentary. This film is also a multimedia film because elements of music and concert footage are added to the essential plot. This film is avant-garde in it’s nature. "Avant-garde [refers to films that] deny the traditional narrative structure and techniques of commercial films by seeking to explore new modes of visual and emotional experience." (Konigsberg:25) It could be considered an anthology film, because of the various concert footage that is woven throughout the movie. "An Anthology film is a full length film made up of excerpts from other films which are related by some theme [or] the appearance of the same performer." (Konigsberg:16) "Stepping Razor" also has elements of Cinema Verite. "Cinema Verite†¦applies to a series of documentary films which strive for immediacy, spontaneity, and authenticity through the use of portable and unobtrusive equipment and the avoidance of and preconceived narrative line or concepts concerning the material." (Konigsberg:57) "Stepping Razor" may also be put under the category of art film. "Art film [is] a type of film with serious artistic intentions as distinct from the commercial films made in Hollywood."(Konigsberg:20) This film also has elements of a propaganda film. "Propaganda films [are] made with the intention of persuading the audience to a particular point of view concerning the subject†¦relying on the apparently real and factual nature of the images on the screen and often using an authoritative voice-over to sway.

Essay --

Throughout the Golden Age of Spain, art and literature were used to express the events of this transitional period in European history. Love is a centralized theme that often conveys subliminal messages about moral, social, and historical issues throughout a plotline. Within pieces of literature such as Fuenteovejuna, the definition of love is questioned in each of their own different contexts. How love is defined as either selfish or selfless in Fuenteovejuna determines what message Lope de Vega is presenting to the audience. Lope de Vega was an incredible and rebellious writer for the Golden Age time period. In this period of peace, prosperity, and overall well-being, many people of Spain found his writing techniques to be revolutionary. Contrary to the typical rules of playwriting, aspects of his plays included numerous plot lines, time gaps, and the use of more than one setting. Fuenteovejuna is a great example of the newly recognized tragicomedy genre during the Golden Age of Spain. Lope de Vega presented current events throughout his works displaying his personal opinions and components of his own life that made him a revolutionary writer. His work inspired other writers to step outside the social norms of writing and produce other revolutionary pieces throughout history. The Golden Age population believed that love was godly and a strong mechanical force driving the universe in a continuous circle. This idea is clearly evident in Lope’s tragicomedy Fuenteovejuna. He uses this and other beliefs to persuade and justify to the reader a sense that love is responsible for the order in the world. Lope de Vega portrays events relating to greed, envy, and ambition. The outcomes of these events bring disharmony, represented as s... ...due to his elite background, but proves that he lacks honor compared to the townspeople due to the way he improperly uses his power. To conclude, Lope de Vega uses specific events to display the cyclic transition from selfish to unselfish love. The havoc from killing the Comendador is resolved from the town’s joint efforts of selfless acts out of love for Fuenteovejuna. In this play Lope de Vega demonstrates how characters handle these two types of love in context in order to reach out to bigger issues. The author’s revolutionary style of writing shows the use of a theme in order to address the larger picture. Fuenteovejuna is a perfect example of multiple events coming together through the connection of love. The writing style of the play expresses Lope de Vega’s feelings of love related to moral, social, and historical issues throughout the Golden Age of Spain.

The 20s And Sinclair Lewis Essay -- essays research papers

The theme in books by Sinclair Lewis1 relates to the time in which they were written. In both Babbit (1922) and Main Street (1920) Lewis shows us the American culture of the 1920's. He writes about the growing cities, the small towns, the common American man, the strong American need to conform, cultural integration, morals (or lack of in some cases), and he touches upon the women lib movement. All of these and more successfully describe the 1920's. "The parties were bigger... the pace was faster, the shows were bigger, the buildings were higher, the morals were looser..."2 - F. Scott Fitzgerald Lewis attacks the American middle class business man in Babbit. As Sheldon Grebstein once put it: "They ( Lewis's characters ) become puppets rather than performers." ( S. Lewis, Amer. Author Series 68 ) He uses the ideas and attitudes already in existence and gives them a plot. He uses sarcasm to show the readers the error of their ways and then makes the main character suffer some how to show the consequences of being the way George F. Babbit is. Americans felt a need to rise in social status in the 1920's. Things like art and religion did not even make it in the maybe pile. Money and social acceptance was number one in every household. "His ( Americans ) only way to assume protective coloration, to loose himself in the crowd, and then to be approved by one of its members." ( S. Lewis, Amer. Author Series 78 ) George F. Babbit. A forty-six, middle class, overweight, suburban real estate dealer. To add to the mix he is a father and a husband. Babbit is Lewis's picture of the middle class businessman. H.L. Menekan states: " The fellow simply dri... ... a forced teacher's resignation and eventually to Fern's departure. Later Fern writes to Carol and informs her of even Ferns' own families' shame upon her and also of the refusal of another job by other teaching agencies. At last, Carol became utterly discouraged with her dozens of failed endeavors and left town. Even the most ambitious and educated are helpless in a town where tradition reigns over common sense. Through out the story of Carol Kennicott and her painstaking efforts, Main Street demonstrates conformity in small towns as well as the significance of conformity historically. It didn't matter wheather or not the people liked her ideas or if they were good for the comunity, her plans to change Golpher Prarie were denined and she was shunned for even thinking them. Change was not welcome in a small town. In Babbit and Main Street Sinclair Lewis repeataly shows his reactions to the new feeling of the 1920's. These times fueled him into writing his two most well known books in which he shows his fustration of selfish, Capitalistic, mid-western America.

Kamala das an introduction Essay

Kamala Das (Has also written under the pseudonyms Madhavikutty and Kamala Suraiyya) Indian poet, short story writer, novelist, playwright, essayist, nonfiction writer, children’s writer, and autobiographer. The following entry presents an overview of Das’s career through 2000. Das is one of the best-known contemporary Indian women writers. Writing in two languages, English and Malayalam, Das has authored many autobiographical works and novels, several well-received collections of poetry in English, numerous volumes of short stories, and essays on a broad spectrum of subjects. Since the publication of her first collection of poetry, Summer in Calcutta (1965), Das has been considered an important voice of her generation who exemplifies a break from the past by writing in a distinctly Indian persona rather than adopting the techniques of the English modernists. Das’s provocative poems are known for their unflinchingly honest explorations of the self and female sexuality, urban life, women’s roles in traditional Indian society, issues of postcolonial identity, and the political and personal struggles of marginalized people. Das’s work in English has been widely anthologized in India, Australia, and the West, and she has received many awards and honors, including the P.E.N. Philippines Asian Poetry Prize (1963), Kerala Sahitya Academy Award for her writing in Malayalam (1969), Chiman Lal Award for fearless journalism (1971), the ASAN World Prize (1985), and the Sahitya Akademi Award for her poetry in English (1985). In 1984, she was nominated for the Nobel Prize in Literature. Biographical Information Das was born into an aristocratic Nair Hindu family in Malabar (now Kerala), India, on March 31, 1934. Her maternal grandfather and great-grandfather were Rajas, a caste of Hindu nobility. Her love of poetry began at an early age through the influence of her maternal great-uncle, Narayan Menon, a prominent writer, and her mother, Balamani Amma, a well-known Malayali poet. Das was also deeply affected by the poetry of the sacred writings kept by  the matriarchal community of Nairs. Das’s father, a successful managing director for a British automobile firm, was descended from peasant stock and favored Gandhian principles of austerity. The combination of â€Å"royal† and â€Å"peasant† identities, along with the atmosphere of colonialism and its pervasive racism, produced feelings of inadequacy and alienation for Das. Educated in Calcutta and Malabar, Das began writing at age six and had her first poem published by P.E.N. India at age fourteen. She did not receive a university education. She was married in 1949 to Madhava Das, an employee of the Reserve Bank of India who later worked for the United Nations. She was sixteen years old when the first of her three sons was born; at eighteen, she began to write obsessively. Although Das and Madhava were romantically incompatible according to Das’s 1976 autobiography, My Story, which describes his homosexual liaisons and her extramarital affairs, Madhava supported her writing. His career took them to Calcutta, New Delhi, and Bombay, where Das’s poetry was influenced by metropolitan life as well as by her emotional experiences. In addition to writing poetry, fiction, and autobiography, Das served as editor of the poetry section of The Illustrated Weekly of India from 1971 to 1972 and 1978 to 1979. In 1981 Das and her husband retired to Kerala. Das ran as an Independent for the Indian Parliament in 1984. After her husband died, Das converted to Islam and changed her name to Kamala Suraiyya. She currently lives in Kerala, where she writes a syndicated column on culture and politics. Major Works Das published six volumes of poetry between 1965 and 1985. Drawing upon religious and domestic imagery to explore a sense of identity, Das tells of intensely personal experiences, including her growth into womanhood, her unsuccessful quest for love in and outside of marriage, and her life in matriarchal rural South India after inheriting her ancestral home. Since the publication of Summer in Calcutta, Das has been a controversial figure, known for her unusual imagery and candor. In poems such as â€Å"The Dance of the Eunuchs† and â€Å"The Freaks,† Das draws upon the exotic to discuss her sexuality and her quest for fulfillment. In â€Å"An Introduction,† Das makes public traditionally private experiences, suggesting that women’s personal  feelings of longing and loss are part of the collective experience of womanhood. In the collection The Descendants (1967), the poem â€Å"The Maggots† frames the pain of lost love with ancient Hindu myths, while the poem â€Å"The Looking-Glass† suggests that the very things society labels taboo are the things that women are supposed to give. In The Old Playhouse and Other Poems (1973), poems such as â€Å"Substitute,† â€Å"Gino,† and â€Å"The Suicide† examine physical love’s failure to provide fulfillment, escape from the self, and exorcism of the past, whereas poems such as â€Å"The Inheritance† address the integrity of the artistic self in the face of religious fanaticism. In Tonight, This Savage Rite: The Love Poems of Kamala Das and Pritish Nandy (1979), Das invokes Krishna in her explorations of the tensions between physical love and spiritual transcendence. The Anamalai Poems (1985), a series of short poems written after Das was defeated in the 1984 parliamentary elections, reworks the classical Tamil akam (â€Å"interior†) poems that contrast the grandeur and permanence of nature with the transience of human history. Poems such as â€Å"Delhi 1984† and â€Å"Smoke in Colombo† evoke the massacre of the Sikhs and the civil war in Sri Lanka. In My Story, originally published in serial format, Das provides details of her extramarital affairs and her unhappy marriage to Madhava Das. She is also the author of a novel, The Alphabet of Lust (1977), and several volumes of short stories in English. Under the name Madhavi Kutty, Das has published many books in the Malayalam language. Critical Reception Critical response to Das’s poetry has been intimately connected to critical perception of her personality and politics; her provocative poetry has seldom produced lukewarm reactions. While reviewers of Das’s early poetry have praised its fierce originality, bold images, exploration of female sexuality, and intensely personal voice, they lamented that it lacked attention to structure and craftsmanship. Scholars such as Devindra Kohli, Eunice de Souza, and Sunil Kumar have found powerful feminist images in Das’s poetry, focusing on critiques of marriage, motherhood, women’s relationships to their bodies and power over their sexuality, and the roles women are offered in traditional Indian society. Many critics have analyzed Das as a â€Å"confessional† poet, writing in the tradition of Sylvia Plath, Anne Sexton, and Denise Levertov. Some scholars, such as Vimala Rao, Iqbar Kaur, and Vrinda Naur, have deemed Das’s poetry, autobiography, and essays frustratingly inconsistent, self-indulgent, and equivocal, although they, too, have praised her compelling images and original voice. Such commentators have suggested that Das is both overexposed and overrated. Other scholars, such as P. P. Raveendran, have connected the emphasis on the self in Das’s work to larger historical and cultural contexts and complicated, shifting postcolonial identities. Indian critics have disagreed about the significance of Das’s choice to write of her experiences as an Indian woman in English; some scholars suggest that, in her shunning of traditional aesthetic form, she has created a new language for the expression of colonial contradictions. Despite disagreement over the aesthetic qualities and consistency of Das’s body of poetry, scholars agree that Das is an important figure whose bold and honest voice has re-energized Indian writing in English.

Understanding Of Cerebral Hemodynamics Health And Social Care Essay

For the supratentorial encephalon, normal perfusion values, such as intellectual blood flow, intellectual blood volume and intend theodolite clip have been established utilizing the gilded criterion, 15O antielectron emanation imaging ( PET ) [ 9-11 ] . With regard to the posterior pit, there has been really small work in set uping normative flow values. There are merely two surveies utilizing 15O PET that study flow values in the posterior pit [ 12, 13 ] . 15O PET is comparatively unavailable in most states due to the demand for an onsite cyclotron. Consequently, CT and MR perfusion have become the most widely used methods for rating of intellectual perfusion in patients showing with shot, tumour or devolution [ 14-17 ] . Standard CT & A ; MR perfusion techniques are semi-quantitative, nevertheless, several surveies have compared them to PET, and turn out their dependability for appraisal of the supratentorial encephalon [ 18-21 ] . Normal blood flow values of the posterior pit constructions utilizing CT or MR perfusion imaging have non been determined nevertheless ; hence doing judgements of unnatural flow and hemodynamics hard at best. Lin et al investigated crossed intellectual cerebellar diaschisis in acute shot patients in the cerebellum utilizing MR perfusion and concluded that this technique is a dependable, efficient and a more accessible alternate to PET [ 22 ] . However they did non set up normative values. The intent of this survey is to set up perfusion mention values in the posterior pit, utilizing a quantitative dynamic susceptibleness contrast ( DSC ) MRI perfusion scan, auxiliary to the perfusion values antecedently quantified with PET. Before showing our survey it is high to briefly reexamine the different capable affairs concomitant to our survey. We will hence hold a expression at the encephalon: its map and rule blood supply ; so continue with a short scrutiny of the chief pathogenesis impacting both, the supratentorial every bit good as the infratentorial parts of the encephalon. We will so hold a closer expression at these two different parts by researching the chief anatomical characteristics, physiological maps and chief pathologies ( vascular and neoplastic ) . Further, we will analyze 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 information given supra. Merely so, we will come in the nucleus of this work by sing the stuff and methods, showing our consequence and discoursing our findings.The BrainThe human encephalon is the Centre of the human nervous system and is a extremely complex organ. It can be subdivided into two parts, the supratentorial part and the infratentorial part, located below the tentorium cerebelli. The supratentorial part contains the cerebrum consisting of the telencephalon and the interbrain. The telencephalon includes the intellectual cerebral mantle, subcortical white affair, and the basal ganglia. The major subdivisions of the interbrain are the thalamus and hypothalamus. The infratentorial part encloses the brain-stem dwelling of the mesencephalon ( midbrain ) , Ponss, and myelin oblongata ; and the cerebellum including the vermis and two sidelong lobes ( Fig. 1 ) . These infinites are filled with cerebrospinal fluid ( CSF ) . [ 23 ] Figure 1: The Central Nervous System brain.gif Beginning: Waxman SG: Clinical Neuroanatomy, 26e: hypertext transfer protocol: //www.accessmedicine.com/content.aspx? aID=5273762. The encephalon is formed by eight interrelated 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 distinguishable parts: the interior surface 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 organic structure ‘s actions and reactions to intrinsic and extrinsic urges by analysing and reacting to the different informations from the sensory and motor tracts. The infratentorial portion of the encephalon is in charge of the autonomic procedures, commanding critical maps such as external respiration and bosom round and other indispensable maps. It besides takes attention of the organic structure ‘s sense of equilibrium, position and consecutive motions. The encephalon is capable to different sort of diseases including: cerebrovascular, neoplastic, infective, and degenerative and injury. Genetically based diseases including Multiple Sclerosis, Parkinson, Huntington Chorea and others are besides common, every bit good 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, but consumes 20 per centum of the organic structure ‘s entire O demand and 15 per centum of entire cardiac end product. [ 25 ] The arterial blood for the encephalon enters the cranial pit by two braces of big vass: the vertebral arterias, originating from the subclavian arterias and the internal carotid arterias, ramifying off the common carotids ( Fig. 2 ) . The Vertebral Arterial System It supplies the brain-stem, cerebellum, occipital lobe, and parts of the thalamus. After go throughing through the hiatuss magnum in the base of the skull, the two vertebral arterias form a individual vas, the basilar arteria ( BA ) . This vas terminates as the left and right posterior intellectual arterias ( PCA ) . The little penetrating arterias, which branch off the basilar arteria, supply critical Centres in the brain-stem. [ 23 ] The Carotids They supply the balance of the cerebrum. The carotids form the circle of Willis. They are interrelated via the anterior intellectual arterias and the anterior 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 Supply cirlce of Willis and brainstemarteries.gif Beginning: Waxman SG: Clinical Neuroanatomy, 26e: hypertext transfer protocol: //www.accessmedicine.com/content.aspx? aID=5273762.PathogenesisThere are several implicit in causes for the damage of the encephalon ‘s normal map. In this subdivision we will hold a general overview of the cerebrovascular ( stoke, arteriovenous deformities, aneurisms ) and neoplastic pathogenesis of the encephalon.Cerebrovascular DiseasesThis first portion is concerned with the harm of encephalon parts due to the occlusion or slowing of intellectual blood flow. We will see 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 least 24 hours, reflects focal engagement of the cardinal nervous sys tem ( 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 bleeding within the cranial pit. [ 26 ] In the undermentioned subdivision we will define the ischaemic and haemorrhagic shots.Ischemic StrokeIschemic stroke can be subdivided into three major etiologies: Thrombosis [ 26 ] It is the most 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, particularly the big extracranial arterias in the cervix ( internal carotid arterias ) but besides intracranial arterias ( in-between intellectual arteria, BA ) , remains the cardinal cause of focal intellectual ischaemia. The most of import hazard factors for coronary artery disease taking to shot are: Systolic or diastolic high blood pressure Diabetess mellitus Elevated serum cholesterin and triglycerides Smoking Other causes of thrombotic shot include: Infections Autoimmune diseases Genetically based diseases Thrombotic shots normally evolve slightly easy over several 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 include: Valvular floras Mural 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 include: Fat emboli Particulate emboli from endovenous drug injection Septic emboli Yet 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 about at one time. Figure 3 shows the most of import sites of thrombotic and embolic occlusion. Figure 3: Sites of Thrombotic and Embolic Occlusions in the Cerebrovascular Circulation Atheroprdelection.gif Beginning: Simon RP, Greenberg DA, Aminoff MJ: Clinical Neurology, 7e: hypertext transfer protocol: //www.accessmedicine.com/content.aspx? aID=5150807. Hypoperfusion [ 26 ] It is typically caused by cardiac failure and less common mechanism of ischaemic shot. Hypoperfusion leads to a more diffuse hurt form compared to thrombosis or intercalation 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 subtypes: Intracerebral bleeding [ 27 ] Intracerebral bleeding ( ICH ) is the most common signifier, particularly intraparenchymal bleeding, shed blooding occurs straight into encephalon parenchyma from little arteriolas antecedently weakened by elevated blood force per unit area. Leading hazard factor are: Increasing age History of shot But other factors are besides relevant, including: Race ( Asians and Blacks ) , Tobacco maltreatment Alcohol maltreatment Amyloidosis Use of decoagulant Use of clot busters ICHs chiefly occur while the patient is awake. It usually presents as an disconnected oncoming of focal neurologic shortage, which worsens over the following 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 unnatural communicating between the arterial and venous systems without a capillary bed intervening. These developmental abnormalcies represent 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 vary in size from a little defect a few millimetres in diameter prevarication in the cerebral mantle 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 â€Å" 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 arise 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 â€Å" thunderclap † concern or described as â€Å" 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 neurologic symptoms may run from mild concern to coma 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 importance of tumours of the CNS derives from: Their great assortment Numerous neurologic symptoms ( caused by their size, location, and invasive qualities ) The devastation and supplanting of tissues The lift of intracranial force per unit area Their deadliness The histogenetic theory by Bailey and Cushing, predominant in recent 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 mitosis, anaplastic. The grade of malignance is relative to the uniform province of the initial cells. [ 29 ] Many factors play a function in the biological science of encephalon tumours. Several heightening determiners can be identified: Age Certain encephalon tumours ( primary or secondary ) are much more frequent than others and are prone to happen in peculiar age groups. For case medulloblastomas, polar glioblastoma, ocular 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 primary encephalon tumours more common in kids. [ 29 ] Geneticss Heredity 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 ] Viruss Harmonizing 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 ) . Metastasiss Certain malignant neoplastic diseases ( chest, lung, melanoma, nephritic cell malignant neoplastic disease ) display a inclination to metastasise to nervous tissue. [ 29 ] Paraneoplasies Systemic tumors produce 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 turn 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 4th 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 clearly 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 specialised maps of a cortical part arise from the interplay between corticocortical systems and subcortical systems and a basic intracortical processing fac ulty. [ 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 geometric relationship between cell types in the major cortical beds We 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 complex 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 act as relays between the incoming centripetal 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 control 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 integrating part for the full autonomic nervous system and regulates organic structure temperature, H2O 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 ne'er published, his system is still in usage today. In general one must see 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 striate 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 combinations of spinal motor nerve cells. [ 29 ] Thus interregional connexions of the cerebrum are required for all natural sensorimotor maps. In the same manner, their devastation disinhibits or â€Å" releases † other countries. For case parietal lesions result in complex turning away 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 ] Motion The 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 processing The primary centripetal countries of the intellectual cerebral mantle receive and procedure ocular, audile, somatosensory, gustatory, and olfactive information. Together with association cortical countries, these encephalon parts synthesize centripetal information into our perceptual experiences of the universe. Smell The 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 Address and linguistic communication are chiefly attributed to parts of the intellectual cerebral mantle. Motor parts of linguistic communication are attributed to Broca ‘s country within the frontal lobe. Speech comprehension is attributed to Wernicke ‘s country, at the temporal-parietal lobe junction. Learning and memory Explicit or declaratory memory formation is attributed to the hippocampus and associated parts of the median temporal lobe. Implicit or procedural memory, such as complex motor behaviours, involves the basal ganglia. Finally, after 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? name=ropp9 & A ; filename= % 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 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 â€Å" purposive behaviour. â€Å" [ 36 ] Consequently, lesions of the frontal lobes consequence in damage of back-to-back 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 mantle Address and linguistic communication upsets related to the dominant frontal lobe Incontinence of vesica and intestine Damage of capacity for purposive sustained mental activity Inability to switch from one line of idea or action to another Akinesis[ 3 ]and deficiency of enterprise and spontaneousness Changes in personality, peculiarly in temper and self-denial Distinctive abnormalcy of pace In 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 Supply Blood 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 senses: Ocular: 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 hallucinations Olfactory and gustatory: perturbation of odor and gustatory sensation Time perceptual experience: province of confusion Memory: amnestic syndrome Emotion & 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 Supply The 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 cipher Loss to distinguish left from right Loss to compose words Apraxia[ 5 ] Blood Supply The 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 unsighted Ocular semblances ( metamorphopsias ) : Distortions of signifier, size, motion, or colour Ocular 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 known as simultanagnosia and reflects an inability to incorporate ocular information in the centre of regard with more peripheral information. The patient with simultanagnosia â€Å" misses the wood for the trees. † Blood Supply The 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 types of glial cells give 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, excepti ng other glial tumours. Here are the chief features: [ 37 ] Rating: 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 hyperplasia Invasiveness: aggressive ; infiltrates adjacent encephalon tissue Necrosis: present merely with GBMs Surgical therapy: gross entire resection is state-of-the-art ; nevertheless motor cerebral mantle, linguistic communication Centres, deep or midline constructions, or brain-stem location make this impossible without lay waste toing neurologic shortage Radiation therapy: neoadjuvant radiation therapy improves endurance for all classs Chemotherapy 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 ictuss Calcifications and bleeding on CT or MR imaging suggest the diagnosing Rating: I to IV ; class indicates forecast Prognosis is better overall than for astrocytomas ; average endurance ranges from 2 to 7 old ages for highest and lowest class tumours, severally Surgical therapy: aggressive resection improves survival Chemotherpay: many patients are antiphonal to chemotherapy Radiation therapy: has non been clearly shown to protract enduranceMetastatic TumorsDrawn-out malignant neoplastic disease patient endurance and improved CNS imagination have increased the likeliness of naming intellectual metastases. The beginnings of most intellectual metastases are ( in diminishing frequence ) : [ 37 ] Lung Breast Kidney GI piece of land Melanoma Main transit way of metastatic cells to the cerebrum is hematogenously. 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 disfunction Non-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 break at a distant site of an afferent tract. [ 38 ] This afferent tract physiologically supplies background excitement to nerve cells, maintaining them in activity and therefore forestalling devolution of the latter. Crossed intellectual cerebellar diaschisis ( CCD ) was first described by Baron et Al. [ 39 ] As each cerebellar hemisphere is closely 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 ) du e 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 enduring 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 intracranial 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 arterias The hypoglossal canal is situated above the anterolateral boundary of the hiatuss magnum and transmits: the nervus hypoglosus nervus ; and emissary venas Behind the hiatuss magnum are the inferior occipital foss? , which support the hemispheres of the cerebellum The 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 part transmits: the glossopharyngeal ( IX ) ; the pneumogastric ( X ) ; and the accoutrement ( XI ) cranial nervousnesss Finally the internal acoustic meatus transmits: the facial and vestibulocochlearA nervousnesss ; and the internal auditory arteria. Figure 6: The Base of the Skull – upper surface Beginning: hypertext transfer protocol: //www.bartleby.com/107/47.html We 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 4th ventricle ) extends over the Ponss, whereas the inferior part covers the unfastened 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 four 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 reticulate formation ( part of grey affair in the tegmentum ) , peripheral sensory and motor events with higher degrees of nervous integrating. These â€Å" 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 include: The corticospinal piece of land The major motor piece of land The posterior column-medial fillet tract The spinothalamic piece of lands The brain-stem may functionally hence be divided into three chief centres, which are far from reciprocally sole: [ 23, 34 ] Conduit maps The 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 maps The 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 rousing, every bit good as for coordination of oculus motions. Cranial nervus map The karyon of cranial nervousnesss III through XII, except of the olfactory and ocular nervousnesss that project 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 oculus, face, oral cavity, and pharynx. Figure 7: Drawing of the Divisions of the Brainstem – midsagittal plane hypertext transfer protocol: //www.accessmedicine.com/loadBinary.aspx? name=waxm & A ; filename= % 09waxm_c007f004.gif Beginning: 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 circumferential 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. Short subdivisions originating from the long circumferential arterias penetrate the ventral 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 mated VAs, though in some instances merely a individual VA is present. The BA courses over the ventral 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 Ponss The short circumferential providing the sidelong two-thirds of the Ponss and the center and superior cerebellar peduncles The long circumferential subdivisions ( SCA and AICA ) , which run laterally around the Ponss to make the cerebellar hemispheres The paramedian interpeduncular subdivisions at the bifurcation of the BA and beginnings of the PCAs providing the high mesencephalon and median subthalamic parts BA 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 position arteries3.gif Beginning: 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 supply the brain-stem structures harmonizing to their point of incursion into the parenchyma. This categorization 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 hurting syndrome, Balint ‘s syndrome, etcaˆÂ ¦ ) 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 countries 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 bu t 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 cord Rostral or unfastened part, in which the cardinal canal expands as the 4th ventricle Apex of the V-shaped caudal 4th ventricle, where it narrows into the cardinal canal, is called the obex. Further it is of import to separate the tracts that run through the myelin: [ 23, 24, 34 ] Ascending piece of lands The 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 lands The 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 of land The 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 esthesiss The median longitudinal fiber bundle is an of import tract involved with control of regard and caput motions The 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 arterias The anterolateral group arises from the anterior spinal and vertebral arterias, anterior spinal and PICA or anterior spinal and VAs The sidelong group derives from the PICA or the VA The posterior group stems from the posterior spinal arteria or the PICA Figure 9: Arterial Supply of the Medulla hypertext transfer protocol: //www.accessmedicine.com/loadBinary.aspx? name=simo7 & A ; filename= % 09simo7_c009f012d.gif Beginning: 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 infarct Harmonizing 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 bleeding, 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 infarct Harmonizing to Vuilleumier et al. , Dejerine syndrome is comparatively rare, looking in one of 28 medullary infarcts in one series. The writer 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 paralysis, 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 Hemiplegia loadBinary2.gif Beginning: Waxman SG: Clinical Neuroanatomy, 26e: hypertext transfer protocol: //www.accessmedicine.com/content.aspx? aID=5272329. Hemimedullary infarct Hemimedullary 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 exist 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 encephalon 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 ] Footing It 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. Tegmentum It 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. Tectum It 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 cells 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 Matter It 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 identified: [ 23, 42 ] The anteromedial group arises from the PCA The anterolateral group arises from the collicular and posteromedial choroidal arterias or the collicular, posteromedial, and anterior choroidal arterias The 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 arterias Figure 11: Arterial Supply of the Midbrain hypertext transfer protocol: //www.accessmedicine.com/loadBinary.aspx? name=simo7 & A ; filename= % 09simo7_c009f012b.gif Beginning: 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 Al. [ 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 Syndrome hypertext transfer protocol: //www.accessmedicine.com/loadBinary.aspx? name=simo7 & A ; filename= % 09simo7_c003f012.gif Beginning: 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 organ Unequal students with absence of light reaction Skew divergence with the oculus opposite the bleeding displaced downward and medially Ipsilateral Horner ‘s syndrome Absence of convergence Paralysis of perpendicular regard Retraction nystagmus Patients 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 that 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 Peduncle It is the largest of the three cerebellar peduncles. It contains fibres that arise from the contralateral 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 pontine The sidelong group arises from the VA and AICA ( superior and posterior rami of the sidelong medullary pit ) , the pontine arterias, or the SCA The buttocks group merely exists in the upper portion of the Ponss and arises from the medial and sidelong subdivisions of the SCA Figure 13: Arterial Supply of the Pons hypertext transfer protocol: //www.accessmedicine.com/loadBinary.aspx? name=simo7 & A ; filename= % 09simo7_c009f012c.gif Beginning: Simon RP, Greenberg DA, Aminoff MJ: Clinical Neurology, 7e: hypertext transfer protocol: //www.accessmedicine.com/content.aspx? aID=5151404. Pontine infarcts In 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 centripetal 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 Bleeding Pontine bleeding is basically restricted to hypertensive patients and is the least common of the hypertensive intracerebral bleedings. The apoplectic oncoming o