physio lab sensation
TRANSCRIPT
![Page 1: Physio lab Sensation](https://reader036.vdocuments.us/reader036/viewer/2022082416/55168de2497959ee1d8b54a0/html5/thumbnails/1.jpg)
1
Hey, guys, this turned out to be pretty much a copy and paste of the power points presented by the megagroups since everyone pretty much read off theirs, with the addition of a few choice words from Dr. Simbulan.
Experiment 10 Information about the internal and external
environment activates the CNs via a variety of sensory receptors.
These receptors are transducers that convert various forms of energy in the environment into action potentials in neurons
4 types of sensory receptors1. Chemoreceptors – specific ligands2. Osmoreceptors – concentration of solutes3. Mechanoreceptors – touch, pressure,
vibration, stretch4. Thermoreceptors – temperature change
a. Cold receptors lower than body temperature
b. Warm receptors – 37 – 45° C5. Photoreceptors - light
Classification of sensory system by structural complexityo Somatic (general senses)
Touch Temperature Nociception Itch Proprioception
o Special senses Vision Hearing Taste Smell Equilibrium
CNS distinguishes 4 stimulus propertieso Modality of stimulus
Type of receptoro Locationo Intensityo Duration
Touch/pressure/position (mechanoreceptors) They are sensitive to stimuli that distort their
cell membranes. They contain mechanically regulated ion channels, which open and close in response to movement.
There are 3 classes:o Tactileo Baroreceptorso Proprioceptors
Tactile receptors
o Provide the sensations of touch, pressure, and vibration
o Fine touch and pressure receptors provide detailed information about a source of stimulation, including the exact location, shape, size, texture, and movement. They also have extremely sensitive and relatively narrow receptive fields.
o Types of Tactile Receptors: Free nerve endings: sensitive to touch
and pressure Root hair plexus: made up of free nerve
endings to detect hair movement. Merkel’s discs: fine touch and pressure
neurons located in the lower epidermal layer of the skin
Meissner’s corpuscles: fine touch and pressure receptors located in the eyelids, lips, fingertips, nipples , and external genitalia
Pacinian corpuscles are large receptors sensitive to deep pressure and to pulsing or high-frequency vibrations. They are found in the skin, fingers, breasts, external genitalia and some visceral organs as well.
Ruffini corpuscles are located in the dermis of the skin and are sensitive to pressure and distortions of the skin.
Objectives To understand the different features of
sensation To identify the different type of skin receptors To understand the concept of sterognosis
ProcedurePart1
Tip of needle was lightly pressed against various spots on a 2 sq. cm stamp imprint on the arm
Uniform pressure was applied in all trials using a needle inserted through a cork.
Any sensation such as pain, touch, cold, etc. should be recorded. Use the designated legends for the sensation felt.
Part 2 With the subject blindfolded, a cork was placed
on the top of the skin of the forearm for 1 – 2 minutes.
Subject was asked if the initial sensation of touch or pressure was continually unaltered
Part 3.1 A coin was warmed by another group member
using his/her hands
Subject: Physiology LabTopic: SensationLecturer: Dr. Simbulan and classTranscriptionist: PegasusEditor: None. Read at your own risk…Pages: 9
SY 2
010
-20
11
![Page 2: Physio lab Sensation](https://reader036.vdocuments.us/reader036/viewer/2022082416/55168de2497959ee1d8b54a0/html5/thumbnails/2.jpg)
2
Subject was asked to touch the coin and was asked to describe the shape. The coin was held by the subject for 2 minutes.
Subject was asked if the initial sensation of touch and pressure remain unaltered.
Part 3.2 A coin was placed on the volar surface of the
forearm, antecubital fossa Subject was asked to flex his/her forearm,
squeezing the coin lightly (2 minutes) Subject was asked if he/she can describe the
shape of the coin accurately and if the initial sensation of touch or pressure remain unaltered.
ResultsPart 1
Pain receptors: this should be the most receptors found
Cold receptors: this should be the least in number
Itch receptors: this is rare in most cases Sense organ for pain, which are free nerve
endings are found in all parts of the body (superficial part of the skin)
Note: There is individual difference in the recorded sensation felt.
Note: Dr. Simbulan made a point of stressing that more than 1 chart should have been presented.
Part 2 Does the initial sensation of touch or pressure
remain unaltered? NO. Initial sensation was touched and was then
altered after 2 minutes.Part 3.1
Does the initial sensation of touch or pressure remain unaltered? YES
Initial sensation felt was touch and the subject could describe clearly the shape of the coin. After 2 minutes, it remained unaltered
Part 3.2 Was the subject able to describe the shape of
the coin accurately? Does the initial sensation of touch or pressure remain unaltered?
Initial sensation felt was touch and deteriorated after 2 minutes. The subject wasn’t able to describe the shape of the coin.
Discussion Pain receptors: This should be the most
receptors found Cold receptors: This should be the least in
number Itch receptor: This is rare in most cases Note: There is individual differences in the
recorded sensation felt. Sense organ for pain, which are free nerve
endings are found in all parts of the body (superficial part of the skin)
Receptors for touch are: Meissner’s corpuscle, Pacinian corpuscle, and Merkel’s disc. Mostly
are found in the fingertips. Nerve fibers for touch receptors are α, β and C fibers
Itch sensations are through naked nerve endings
Discussion of Part 2 Sensation was altered since the skin has already
adapted to the pressure of the cork Adaptation: decrease in the frequency of action
potentials in an efferent neuron despite the main maintenance of the stimulus at a constant strength.
Rapidly adapting vs. slowly adapting receptors
Discussion of part 3.1 The unaltered state of sensation is due to slow
adapting receptors. The fingertips contain large numbers of expanded deep tactile receptors. One type of which is Merkel’s disc.
Discussion of part 3.2 The deterioration of sensation is due to the
rapid adapting receptor in this area of the forearm.
When a continuous sensory stimulus is applied, the receptor responds at a very high impulse rate at first, then at a progressive slower rate until finally many of them no longer respond at all.
This accounts why the subject wasn’t able to to describe the shape of the coin while placed at volar area of the forearm.
Stereognosis Ability to identify an object by handling them
without looking at them. Normal person can readily identify objects such as keys and coins of various denominations. This ability depends upon relatively intact touch and pressure sensations.
Uses dorsal column – medial lemniscus pathway (posterior column - medial lemniscus pathway)
Conclusion1. Variance in the frequency of each receptor
o Many nociceptors activated, compared to cold and itch receptors
![Page 3: Physio lab Sensation](https://reader036.vdocuments.us/reader036/viewer/2022082416/55168de2497959ee1d8b54a0/html5/thumbnails/3.jpg)
3
2. Duration of stimulus presentation (constant intensity) is inversely proportional to the activation frequency of a receptor, depending on type of receptor. Adaptation occurs.
3. Number of receptors is directly proportional to duration of sensation, depending on type of receptor.o Also, some types of receptors are more
numerous in certain parts of the body than others.
Recommendation:1. To get a more precise result in testing
differences in sensations such as pain, cold, touch, and tickle, we suggest the use of an improvised tool which will produce uniform pressure rather than doing it manually.
2. In testing sensation of touch and pressure, we suggest use of a standard object such as calibrated weight set or anything with specific size and weight to determine which initial weight does the subject feel the sensation of touch and pressure.
3. The procedure should be performed on a subject unaware of the experiment.
Experiment XI: Relative touch sensitivityIntroduction
The tactile sense of modality is a very important component of the multimodal system of our body. The tactile modality can be used as an additional, independent input modality to give information to the user or can also be used to confirm or increase the information brought about by other sensory modalities like the eyes and the ears (Myles and Binseel, 2007). Another important feature of the tactile modality is the discriminative touch, which is used for knowing the location of the stimulus induced enough for the brain to pinpoint where the stimulus was
stimulated. This feature of the tactile modality allows the human body to adapt to different kinds of environment and also able to avoid dangerous stimuli that can be detected and subsequently avoided by the individual. And lastly, pain stimulus is the one that warns an individual to avoid doing the particular stimulus to avoid tissue destruction/deformation.
Objectives Determine relative sensitivity of selected areas
of the skin State the roles that touch plays and describe its
qualities Distinguish between touch and touch acuity Discuss the effects of various surface textures
on the perception of touch.Materials
Von Frey-type aesthesiometer Blindfold
Methods Subject was covered with blindfold. The bristle of the aesthesiometer to 6 areas of
the skin in the following manner: o Press bristle #1 against the skin until it
flexes slightly and maintain this slight flex. o Ask if subject can feel the bristle. o If subject feels nothing, apply bristle #2 and
so on until subject reports feeling the bristle.
o Apply next larger bristle and then repeat the above procedure in the reverse direction until the subject reports he can no longer feel the bristle.
Record the number of first and last bristle felt each time. This should be repeated 3 times for each bristle at the site of fingertips, palm, forearm, back of neck, scapular region, kneecap.
ResultsGroup 6
SITES
ASCENDING TEST DESCENDING TEST X
1
X
2
X
3
X
MEA
N
X
1
X
2
X
3
X
MEA
N
FINGERTIPS 2 3 3 2.7 2 3 3 2.7 PALM 1 1 1 1 1 1 1 1 FOREARM 1 1 1 1 1 1 1 1 BACK OF THE NECK 1 3 2 2 1 3 2 2 SCAPULAR REGION 1 2 1 1.3 1 2 1 1.3 KNEECAP REGION 2 2 2 2 2 2 2 2
Group 7
SITES
ASCENDING TEST DESCENDING TEST X
1
X
2
X
3
X
MEA
N
X
1
X
2
X
3
X
MEA
N
FINGERTIPS 2 3 2 2.3 1 1 1 1 PALM 2 1 1 1.3 1 1 1 1 FOREARM 1 1 1 1 1 1 1 1 BACK OF THE NECK 1 1 2 1.3 1 1 2 1.3
![Page 4: Physio lab Sensation](https://reader036.vdocuments.us/reader036/viewer/2022082416/55168de2497959ee1d8b54a0/html5/thumbnails/4.jpg)
4
SCAPULAR REGION 3 2 1 2 2 1 1 1.3 KNEECAP REGION 1 1 1 1 1 1 1 1
Group 8
SITES
ASCENDING TEST DESCENDING TEST X
1
X
2
X
3
X
MEA
N
X
1
X
2
X
3
X
MEA
N
FINGERTIPS 5 5 5 5 4 4 4 4 PALM 4 4 4 4 3 3 3 3 FOREARM 1 1 1 1 1 1 1 1 BACK OF THE NECK 1 1 1 1 1 1 1 1 SCAPULAR REGION 1 1 1 1 1 1 1 1 KNEECAP REGION 1 1 1 1 1 1 1 1
Group 9
SITES
ASCENDING TEST DESCENDING TEST X
1
X
2
X
3
X
MEA
N
X
1
X
2
X
3
X
MEA
N
FINGERTIPS 2 1 4 2 3 3 3 3 PALM 1 3 3 2 1 3 2 2 FOREARM 2 3 1 2 1 1 1 1 BACK OF THE NECK 3 4 3 3 3 3 3 3 SCAPULAR REGION 2 3 2 2 2 2 2 2 KNEECAP REGION 3 3 2 3 2 4 4 3
Group 10
SITES
ASCENDING TEST DESCENDING TEST X
1
X
2
X
3
X
MEA
N
X
1
X
2
X
3
X
MEA
N
FINGERTIPS 5 5 4 4.7 5 2 2 3 PALM 2 2 4 2.7 3 2 2 2.3 FOREARM 1 1 1 1 1 1 1 1 BACK OF THE NECK 1 1 1 1 1 1 1 1 SCAPULAR REGION 4 2 3 3 2 1 3 2 KNEECAP REGION 3 3 3 3 6 5 3 4.7
Total mean of groups 6 – 10SITES ASCENDING
TEST TX
DESCENDING TEST
TX
G6
G7
G8
G9
G10
G6
G7
G8
G9
G10
X X X
X
X X X X
X
X
FINGERTIPS
2.7
2.3
5
2
4.7
3.34
2.7
1 4
3
3 2.74
PALM 1 1.3
4
2
2.7
2.2
1 1 3
2
2.3
1.86
FOREARM
1 1 1
2
1 1.2
1 1 1
1
1 1
BACK OF THE NECK
2 1.3
1
3
1 1.66
2 1.3
1
3
1 1.66
SCAPULAR REGION
1.3
2 1
2
3 1.86
1.3
1.3
1
2
2 1.52
KNEECAP REGION
2 1 1
3
3 2 2 1 1
3
4.7
2.34
Discussion What areas of the skin are most sensitive and which are least sensitive?
![Page 5: Physio lab Sensation](https://reader036.vdocuments.us/reader036/viewer/2022082416/55168de2497959ee1d8b54a0/html5/thumbnails/5.jpg)
5
o The receptors in our skin are not distributed in a uniform way around our bodies. Theoretically, our fingers and lips are the most sensitive parts of our body since more receptors are found in these areas. However, this was not evident in the experiment performed by the five groups.
o Note, according to Dr. Simbulan: the finer strands may be bent after all these years making it difficult to get accurate results.
What biological significance can you associate with the relative sensitivity of different areas of the skin?o The nerve endings in the skin can detect
pressure, pain, and temperature. o The ability to sense pain is a warning device.
It warns us to quickly pull our hand away from a hot stove, or not to grab hold of the wrong end of a pair of scissors.
o The ability to sense temperature is also a safety feature.
o It reminds us to bundle up when we go out in winter weather, and to stop and cool off after exercising.
o Your sense of touch allows you to tell the difference between rough and smooth, soft and hard, and wet and dry.
o Touch is the most important of all the senses; without it, animals would not be able to recognize pain which would greatly decrease their chances for survival.
How is the differential touch sensitivity of various parts of the skin associated with behaviour?o Touch sensitivity varies in different body
regions because of differential density of distribution of the specific nerve endings.
o Areas such as the fingertips and lips (glabrous skin) are richly endowed with nerve endings and are very sensitive.
o Hairy skin has fewer endings and different kinds, and so produces a different sensory experience
o Skin of the trunk and back, with a low density of touch receptors, is less sensitive to touch than skin elsewhere.
Touch receptors branch out at their ends, and a single neuron may receive input from a region of the skin several centimeters in diameter, called its receptor field. o Receptor fields in the lips may be as small
as 2 to 3 millimeters (.78 to .118 inches)o The rest of the body have around 4 to 7
centimeters (1.5 to 2.7 inches). How well people get along with each other
depends partly on the amount of physical contact they have and what form it takes. o Touching is often a sign of affection.o Research has shown that touch has
tremendous psychological ramifications in
areas like child development, persuasion, healing, and reducing anxiety and tension.
Touch has a tremendous impact on most animals' physical and psychological well beingo Touch greatly influences how we develop
physically and respond to the world mentally. For example, premature babies that
receive regular massages will gain weight more rapidly and develop faster mentally than those who do not receive the same attention.
Touching of premature babies can also stimulate growth hormones (such as the hormone needed to absorb food) that occur naturally in healthy babies.
o Touch serves as a type of reassurance to infants that they are loved and safe, which translates into emotional well being.
o In general, babies who are held and touched more tend to develop better alertness and cognitive abilities over the long run
Touch continues to have a great psychological impact throughout peoples' lives. o Even adults who are hospitalized or sick at
home seem to have less anxiety and tension headaches when they are regularly touched or caressed by caretakers or loved ones.
Touch also has a healing power.o Researchers have found that touch reduces
arrhythmias.o Another study showed that baby rats who
are touched often during infancy develop more receptors to control the production of biochemicals called glucocorticoids, which are known as stress chemicals because of their ability to cause muscle shrinkage, high blood pressure, elevated cholesterol, and more.
Touch is a powerful persuasive force. o Touch can have a big impact in marketing
and sales. Salespeople often use touch to establish a camaraderie and friendship that can result in better sales.
o In general, people are more likely to respond positively to a request if it is accompanied by a slight touch on the arm or hand.
Sensations are mediated through the actions of receptors.
For a certain sensation to be felt there must be a specific receptor for it
Different areas of the body have different concentrations of specific receptors. Areas with a higher concentration of a particular receptor are more “sensitive” to the particular sensation mediated by that receptor.
![Page 6: Physio lab Sensation](https://reader036.vdocuments.us/reader036/viewer/2022082416/55168de2497959ee1d8b54a0/html5/thumbnails/6.jpg)
6
The fingertips, scapular regions and knee cap regions are the areas of the body more sensitive to touch.
Increased sensitivity of certain areas of the skin serves a particular biologic purpose. For the fingertips, and increased sensitivity most probably is associated to the fact that these body parts are the once most often used when an individual explores his/her surrounding. While for the scapular regions and the knee regions, an increased sensitivity probably serves a protective purpose, allowing an individual to sense and react immediately to the presence of an object in these general areas.
Recommendations Since this experiment is based on the subject
actually confirming that touch is “felt”, an observable change, for example a twitching of the surrounding area, that occurs as a result of the stimulation actually being “felt” will make this experiment more objective and hence less susceptible to human errors of judgment.
Differential Temperature SensationIntroduction
• Perception of cold and hot is one of life’s essential function because our body needs to maintain a certain body temp for the enzymes to function properly.
• Important components for TEMPERATURE SENSATIONo Appropriate stimuli: physiologic range of
temperature (approx 10-42°C) o Sensory receptors (thermo-sensitive)o Peripheral fibers (type A-delta VS. type C)o First-order neuron: DORSAL ROOT
GANGLION o Pathway: Anterolateral system (together
with fibers that carry pain sensations)• TWO CATEGORIES of temperature-related
sensation: o Temperature sensationo Thermal comfort
Method of Experiment3 parts:
Part one:o Cool temperature cylinder to about 5° Co Press the back end of the cylinder against
the subject’s forehead (5 seconds)o Record sensation felt
In place After removal
Part two:o Place one hand in cool water (10° C) and
the other in lukewarm water
o When the subject reports that the hand in cold feels warmer, place that hand in lukewarm water.
o Record sensation felt Part three:
o Cool one comb in cold waterRemove, dry, and place one comb on the boardLay forearm across the comb and note sensation
o Warm one comb in warm waterRemove, dry, and place one comb on the boardLay
![Page 7: Physio lab Sensation](https://reader036.vdocuments.us/reader036/viewer/2022082416/55168de2497959ee1d8b54a0/html5/thumbnails/7.jpg)
7
forearm across the comb and note sensation
o Cool one comb in cold water and warm one comb in warm waterRemove, dry, and place 2 combs on the boardLay forearm across the comb and note sensation
o Cool one comb in cold waterRemove, dry, and place one comb on the boardLay finger across the comb and note sensation
o Warm one comb in warm waterRemove, dry, and place one comb on the boardLay finger across the comb and note sensation
o Cool one comb in cold water and warm one comb in warm waterRemove, dry, and place 2 combs on the boardLay finger across the comb and note sensation
ResultsPart 1
GROUP
SENSATION
LOCATION OF SENSATION OF TEMPERATURE
FELT WHILE
THE CYLINDER
WAS IN PLACE
AFTER THE REMOVAL
OF THE CYLINDER
SINGLE SPOT ON FOREHEAD
Group 11 cold cold in circular
spot yes
Group 12 cold cold in circular
spot yes
Group 13 cold cold in circular
spot yes
Part one comparison
Part two
GROUP
HAND PLACED
ON COLD WATER
HAND PLACED ON LUKEWARM
WATER
TRANSFER OF HAND FROM COLD WATER
TO LUKEWARM
WATER
Group 11
cold numbness water becomes warmer
warm normal
temperature
warm normal
temperature
Group 12 cold cold normal Group 13 cold warm hand soaked
in cold water becomes warmer
compared to
hand already in the
lukewarm
012345
group 11group 12group 13
Part three
GROUP
A) FORE ARM
COOL COMB
WARM COMB
BOTH WARM
AND COLD COMB
Group 11 cold warm cold
Group 12 cold slightly
cold cold
Group 13 subject unable to distinguish the
temperature
GROUP
B) FINGERS
COOL COMB
WARM COMB
BOTH WARM
AND COLD COMB
Group 11 cold warm
cold sensation
on the thumb up
to the middle finger
Group 12 cold warm cold
Group 13 cold warm cold
![Page 8: Physio lab Sensation](https://reader036.vdocuments.us/reader036/viewer/2022082416/55168de2497959ee1d8b54a0/html5/thumbnails/8.jpg)
8
Discussion Stimulation of receptorTransduction of the
stimulusGeneration of impulseIntegration of sensory input
TRP (Transient Receptor Protein) family: responsible for distinct sensitivities to temperature sensation.o TRPA1 and TRPMa: activated at lower
temperatures (10 - 26° C)o TRPB3 and TRPB4: normal temperatures
(27 - 38° C)o One group is activated at 38 – 48° C.o There is some overlap between the groups.
Cold is generally perceived in a wider range than heat.
Graded potential: would initiate action potential along fiber. Vary in amplitude depending on intensity of stimulus.
ConclusionAnterolateral SystemPart 1
Temperature sensationo Cold has a wider range of TPR
Part 2 Temperature sensation
o Mere sensation of changes in environmental temperature
Thermal comforto Adaptation upon prolonged exposure
RecommendationVariability of the result due to:
1. Location of the subject where experiment took place and (ie, one subject was in front of the air conditioner and was cold before the experiment started)…
2. …the materials used
Exercise XIII: Two – Point Touch ThresholdIntroduction
Touch experiences are triggered by mechanical disturbance of the skin produced by physical contact with an object. The human skin contains mechanoreceptors, or receptors that are sensitive to mechanical pressure or deformation of the skin.
However, the concentration of mechanoreceptors within the skin is not uniform. Rather, the highly sensitive areas of skin, such as the lips and fingertips, contain densely packed mechanoreceptors, while
insensitive areas, such as the abdomen and back, contain lower concentrations of mechanoreceptors.
More sensitive areas of the skin also project to a larger proportion of the somatosensory cortex than less sensitive areas. Thus, the area of the brain which receives touch sensations is proportional to the actual sensitivity of the skin area.
Cutaneous mechanoreceptors can be categorized by their morphology, the kind of sensation they perceive and rate of adaptation. Ruffini’s end organ detects tension deep in the skin. It is a slowly adapting type II mechanoreceptor and has a large receptive field.
Meissner’s corpuscle detects changes in texture. It is a rapidly adapting type I mechanoreceptor and has a small receptive field. Pacinian corpuscle detects rapid vibrations. It is a rapidly adapting type II mechanoreceptor.
Merkel’s disc detects sustained touch and pressure. It is a slowly adapting type I mechanoreceptor. Mechanorecepting free nerve endings detects touch, pressure and stretch. Hair follicle receptors located in hair follicles sense position changes of hairs. Testing of these mechanoreceptors are used by neurologists in the assessment of nervous system functioning.
Objectives The experiment aims to measure cutaneous
acuity by determining how close two points applied to the skin can still be felt as two distinct points.
Materials and Methods Materials
o Two point aesthesiometero Blindfold
Procedureo Blindfold subjecto Test for the two – point threshold on the six
areas of different sensitivity as suggested by the table given below:
o Begin with descending series.o Setting the points of the aesthesiometer at
about 1 mm wider than the expected threshold, apply aesthesiometer gently to skin.
o Ask subject if he feels one or two points. If he replies- “two”, then reduce the point-to-point distance by 1 mm and repeat.
![Page 9: Physio lab Sensation](https://reader036.vdocuments.us/reader036/viewer/2022082416/55168de2497959ee1d8b54a0/html5/thumbnails/9.jpg)
9
o Continue this descending series until subject reports feeling only one point. The two point threshold for the descending series is a distance just above this; increase the distance by about 0.05 mm until the subject feels two points again.
o This should be repeated three times. Tabulate your results.
o Do the ascending series. Then, beginning at 1mm below a setting at which subject reports feeling only one point, begin an ascending series for each of the six areas of the body previously tested.
o Report the minimum distance at which the subject reports two points. This should be repeated 3 times. Tabulate your result.
o Ascending and descending series is also known as method of limits.
Results and DiscussionsGroup 14
Group 15
Group 16
Group 17
Groups 14 – 17 Average
Range of results for each group are similar and falls within the range.
Fingertips < Palm < Knee cap region < Forearm < Back of the Neck and Scapular region
![Page 10: Physio lab Sensation](https://reader036.vdocuments.us/reader036/viewer/2022082416/55168de2497959ee1d8b54a0/html5/thumbnails/10.jpg)
10
Conclusions Two-point touch threshold differences may be
due to the varying densities of receptors on the body’s surfaces.
The denser the receptive field is, the more sensitive the stimulated area will be (see the images directly above)
This test is performed to evaluate the dorsal column/medial lemniscal pathway.
Recommendations Make sure that when placing the points of the
caliper, there is even pressure of both points Make sure that when doing the three
repetitions of a certain section, the points are placed in the same place and not moved around the certain area.
End of Transcription
![Page 11: Physio lab Sensation](https://reader036.vdocuments.us/reader036/viewer/2022082416/55168de2497959ee1d8b54a0/html5/thumbnails/11.jpg)