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Duret hemorrhage Definition, Symptoms, Causes, Treatment

Duret hemorrhage is lesion occurred in the central area of brain i.e. mid brain and upper pons of brain stem. This condition is named after a scientist Henri Duret. The lesion in mid brain is appeared as small lineal area of bleeding. Duret hemorrhage occur secondary to increased intracranial pressure which raised due to formation of transtentorial pressure cone which is involved in in the front part of the cerebral peduncles which is known as cerebral cura. When the level of intracranial pressure increases above tentorium it may also involve other structures of midbrain. Due to this increased intracranial pressure, brain stem dislocation occurs and a groove is formed in the cerebral peduncle known as kernohan’s notch.


Duret hemorrhage should be diagnosed with great care. Various test are performed to diagnose Duret hemorrhage like medical imaging technique of computed tomography scan and magnetic resonance imaging. It is found to be difficult diagnosing Duret hemorrhage with other lesions. When brainstem is displaced due to stretching and tearing of branches of the basilar artery connected to pons it will lead to Duret hemorrhage. Duret hemorrhage cause many problems in routine life of patient and is proved fatal for life of patient.

Duret hemorrhage Definition, Symptoms, Causes, Treatment


Duret hemorrhage Causes

         
Duret hemorrhage is like small lesion occurred in central part of brain which can be caused due to many reasons. The main causes reported are as follows:
It most commonly occur due to displacement of the brain stem in downward direction due to any trauma or injury. Injury may be external or internal leading to Duret hemorrhage. Herniation of hippocampus gyrus also occur along with brain stem displacement through the tentorial notch. Also through the acute hematoma. Edema can also lead to Duret hemorrhage. Other reported causes are trauma, tumor which may be malignant or benign and abscess.

Duret hemorrhage Symptoms

           
Duret hemorrhage is a fatal condition but people with recovery are also reported. Lesion or small lineal area of bleeding may cause serious problems in body. As it is caused due to displacement of brainstem or its head named pons so all the functions of pons are disturbed. Patient can lose his control over many involuntary functions like breathing, communication and different sensations like hearing, smell, taste and body balance. Patient is not able to communicate with others with no proper language control and cannot even walk with proper balance of body.


Duret hemorrhage Treatment

           
All the traumatic brain injuries including Duret hemorrhage is irreversible and cannot be cured at once. If treatment therapy works, it takes time to recover. But patient after Duret hemorrhage cannot get fully recover but with some abnormalities. Treatment option do not contain surgery because it is a very sensitive case to operate and get successful surgery. Instead medication therapy is used to reduce the symptoms and control bleeding. Blood thickening agents are prescribed and patient is transferred to intensive care unit. Patients who survive through Duret hemorrhages may recover with some disabilities like inability to talk and walk and breathing problems.
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Hutchinson teeth Pictures, Symptoms, Causes, Diagnosis, Treatment

Hutchinson’s incisor, Hutchinson’s sign or Hutchinson-boeck teeth are other names of Hutchinson teeth. It is a main symptom of syphilis (congenital syphilis). Basically Hutchinson teeth appear as notches on the biting surfaces of teeth. Babies with syphilis have smaller and spaced teeth along with notches on them. Sir Johnathan Hutchinson described them and named it after his name. The distance between teeth is larger than usual. Hutchinson teeth can be congenital and may develop late in life. About 63 % of cases of syphilis are presented with Hutchinson teeth. In this disease, patient have to face problems in biting and chewing food properly.


Hutchinson teeth Pictures

Hutchinson teeth Pictures, Symptoms, Causes, Diagnosis, Treatment


Hutchinson teeth Symptoms


Hutchinson teeth itself is a symptom of congenital syphilis. The appearance of Hutchinson teeth is as follows:

Teeth are distant and have greater spaces than usual. Patient have incisor teeth along with notches on the biting surface of teeth. Basically appearance of notches shows the presence of syphilis in patient. Tooth are tapered from sides. The size of teeth is smaller than a normal teeth size. Incisors of upper jaw placed in center get more effected. These changing occuron permanent teeth rather than deciduous teeth which fall off after 7 years of age.


Hutchinson teeth Causes

       
Main cause reported behind Hutchinson teeth is congenital syphilis. Baby is born with this disease and take it from his parents. It is considered a main symptom of syphilis. There is not any specific etiology behind Hutchinson teeth but it appear secondary to many diseases like some dental diseases, oral and head diseases. Some of the main diseases leading to Hutchinson teeth are as follows:


  • Acrofacial dysostosis
  • Weyer’s type alves castelo dos Santos syndrome.
  • Ecroption
  • Clefting
  • Deafness onychodystrophy dominant form.
  • Ectodermal dysplasia
  • Gene Weidman syndrome
  • Hay wells syndrome
  • Incontinentia pigmenti.


Hutchinson teeth Diagnosis


There is not a proper test to diagnose Hutchinson teeth but its appearance shows its presence. Whenever parents observe problem in teeth of their children, they should consult a dentist. During examination of teeth, if he observe notches on the biting surface of teeth and distant teeth with smaller size then he will recommend for good and appropriate treatment. But along with checking symptoms of Hutchinson teeth disease, physician will also check for the presence of syphilis and if it exist as a root cause, then the physician will recommend to treat this root cause behind it.

Hutchinson teeth Treatment

           
As Hutchinson teeth is a symptom of congenital syphilis so syphilis should be treated 1st to treat Hutchinson teeth. Along with treatment plan of syphilis, patient should take good care of oral hygiene. He should use a proper tooth paste and hygienic brush and should clean his teeth two times a day. Braces are also used to decrease distance between Hutchinson teeth and sometimes tooth surgery is recommended to straighten teeth. Along with these treatment options patient is advised to take care of his teeth and do not lose hope as it takes time to get fully recover.
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Ideomotor apraxia Definition, Symptoms, Causes, Test, Treatment

Voluntary automatic dissociation is another name for ideomotor apraxia. It is a movement or action disorder which is related to neurological abnormality of patient. Patient is not able to cope with the instructions he receives. Ideomotor apraxia consist of simple motor tasks like having hand to say good bye and using a hammer to hit something. Patient get confuse while acting on instructions or there is no similarity between his limb movement and his will. This abnormality or disorder occur in patients suffered from stroke. Patient with stroke have already experienced this incompatibility of nervous system with voluntary actions.


Ideomotor apraxia Symptoms

         
Ideomotor apraxia is a neurological disorder which causes many problems in transmission of impulses and mostly motor neurons are involved. Patient is not able to perform functions properly. There is no similarity in physical actions to the signals he receives in brain. Even he cannot mimic actions performed by a person in front of him. Other symptoms associated with ideomotor apraxia is confusion in performing any physical activity, dizziness and less social activity. Patient cannot move out in public confidently and cannot communicate verbally and physically. All symptoms the mentioned above are related to personality of patient.

Ideomotor apraxia Definition, Symptoms, Causes, Test, Treatment


Ideomotor apraxia Causes

         
Ideomotor apraxia is related to neurological abnormal condition which hurdle in transmitting signals to brain and from brain to target limb. Basically parietal lobe is responsible for controlling voluntary actions like ability to read, ability to write and understanding some spatial concepts. So whenever stroke occurs in parietal lobe it will lead to ideomotor apraxia and is considered the most common cause behind it. Any kind of injury in parietal lobe located in back and top side of head above ears can also cause ideomotor apraxia. The injury may be internal or external both can lead to ideomotor apraxia.

Ideomotor apraxia Test


There is not one defined test for ideomotor apraxia but are so many tests which are performed to diagnose it. A test is performed widely which was developed by George Goldenberg. In this test physician uses imitation assessment of 10 different gestures. Tester perform some actions in front of patient and then he ask him to mimic the same actions he performed. On the basis of his actions performed his condition is evaluated. The tester give scores on right imitation of actions and give no scores on no imitation. Then these scores are counted to check progress.

Ideomotor apraxia Treatment

               
Ideomotor apraxia is a sensitive case which should be treated or managed with great care. There are some therapies which can be performed to manage it. Occupational therapy is very effective and help patient in regaining the same level of motor functioning he lost. In this therapy, patient is encouraged to beat one task on daily basis like combing hairs etc. 1st separate actions are ask to perform and after getting perfection in it, he is asked to perform series of actions collectively and his performance is checked. This therapy include simple to complex actions.
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Microphilia Meaning, Definition, Psychology, Test, Treatment

Microphilia is a type of paraphilia. In this condition, person have sexual attraction towards small size or micro things or people. Microphilia is an opposite term of macrophilia (sexual attraction towards giant human beings). Microphilia is basically a microphiles thinking in which person assume others shrinking in front of him. Research reported that mostly women are fantasized in microphilia shrinking in small size. Person suffering from this type of paraphilia, is identify as microphiles. Microphiles just fantasize about shrinking of his sex partner and he himself remain unchanged.


A writer resemble microphilia with masochism which is an opposite term of sadism. Microphilia is the most abundantly occurring paraphilia in last few decades. And the main reason behind spreading of microphilia is adult internet surfing and getting attracted towards paraphilia. Internet is spreading this thing all over the world and leading youth towards sexual gratification. The term microphilia is not used in the world of microphiles instead they use term S.W (shrinking women) preferably. There is also a microphiles community consisting of women using term shrinking men and sadomasochism. Microphilia is not publically common type of paraphilia. Some people consider it as a type of fetish sex, dominating sex or bondage sex.

Microphilia Meaning, Definition, Psychology, Test, Treatment


Microphilia Psychology


Microphilia is a type of paraphilia in which person get sexually attracted towards micro sized people. People get this idea or habit from movies like Thumbelina and from internet sites full of microphilia fetish sex. Person with microphilia fantasize about his partner to shrink and become small in size and person feel happy to get sexually engaged with his small sized partner. Person feel relaxed while having sexual activity with minion partner. Minion is an animated character having small height. Most of the people like this character and follow it and also demand a minion partner to fulfil their sexual desire.

Microphilia Test

         
Microphilia is a visible activity which can be observed at an early stage. Home testing or self-testing helps in diagnosing this type of paraphilia. Parents can observe their child in home based activities. Parents can observe their child in selecting their toys and clothes and their attraction towards small things. If an adult is suffering from microphilia, he can test himself by answering some specific questions available online in the form of a questionnaire. If he is able to answer these questions, then he is under microphilia state and should get a treatment therapy.

Microphilia Treatment

           
Microphilia is a type of psychology related disorder. It is in their head in the form of a desire or need. There is no such medications for this disorder but there are some therapies like physical and mental therapies which will rehabilitate the patient. Physical therapy consist of some exercises and being healthy. And mental therapies consist of some counseling sessions in which patient is asked some questions about routine life and about their sexual desire and their answers show their progress. These two therapies should be continued side by side to get better and early results.
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Nutmeg liver Definition, Symptoms, Causes, Treatment

A condition in which liver get congested is known as nutmeg liver or congestive hepatopathy or passive congestion of the liver. Congestion of liver occurs due to congestion in venous system. Congestive hepatopathy is named as nutmeg because due to chronic congestion of liver, it appear as grated nutmeg “speckled”. The gross image of congested liver shows small black spots representing the both dilated and congested veins of liver or small hepatic venules. The paler area appeared on the gross image is unaffected which surrounds liver tissues. If congestion of liver persist for long term it will lead to fibrosis.


If congestion of liver occurs due to failure in right heart ventricle then this congestion is termed as cirrhosis. Sometimes the sign and symptoms of congestive heart failure covers the signs of cardiac cirrhosis. Most of the time nutmeg liver results in cardiac failure. And the ultimate cause behind it is chronic alcohol use or viral hepatitis. In congestive liver disease, veins get shrink and become small in size leading to increased pressure. This narrowing of veins leads to increased blood pressure and blockage occurs leading to chronic passive congestion of liver also known as nutmeg liver.

Nutmeg liver Definition, Symptoms, Causes, Treatment

Nutmeg liver Symptoms

       
Sign and symptoms are totally depend upon the cause behind it. Mainly symptoms occur after 1st lesions which leads to nutmeg liver. Symptoms are also associated with heart and lungs. Patient feel full and tender in the upper right hypochondriac region. Vomiting containing blood or blood vomiting can occur along with gastrointestinal catarrh. Sometimes jaundice is also reported. Due to obstruction in portal vein, ascites may occur. These ascites lead to generalized edema. Presence of bile in urine and stool have a specific color i.e. light or clay colored. The size of liver increases and it becomes tender.

Nutmeg liver Causes

         
Mainly nutmeg liver occurs as a result of cardiac failure. Due to diseased heart, pressure increases in the sub lobular vein of liver and congestion occurs. Cardiac lesions are also reported as a main cause behind it. Lobules of liver have a red brown colored central portion which stand against non-congested normal tan colored liver. Necrosis also occur in the central portion of hepatic lobules. Lesions in lungs like interstitial pneumonia, pleural effusions and intrathoracic tumors. All the causes mentioned above are directly or indirectly leads to chronic passive congestion of liver or nutmeg liver.


Nutmeg liver Treatment

           
Treatment therapy of nutmeg liver is based on permanently removing the leading cause behind it. But if removal of cause is not possible, then the procedure is modified along with its effects. So, treatment options are limited. Treating congestive heart failure or right heart ventricle disease will ultimately decrease the chances of congestive hepatopathy or nutmeg liver. Lesions in heart and lungs are treated 1st to treat nutmeg liver. Vasodilators are prescribed to dilate vessels and help in ease of blood flow. There is no proper medication for congestion of liver but for the leading cause behind it.
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Hepatojugular reflux Definition, Test, Mechanism, Pathophysiology

Whenever pressure is applied to abdomen and it is compressed, it leads to distension of jugular vein. Physiology behind distension of hepatojugular vein or hepatojugular reflux is, when abdomen is compressed for 20 to 30 seconds, the venous pressure increases towards right side of ventricle of heart, if the right ventricle is not healthy and not working properly then it cannot handle that increased pressure of blood and as a result lead to distension of jugular vein. This mechanism is known as hepatojugular reflux. Hepatojugular reflux is a historical term used to explain abdominojugular reflux or another name of abdominojugular test. Basically hepatojugular reflux is an indication of right and/or left ventricle disease or failure.


This reflux occurs in about 70 % of cases with heart disease. Hepatojugular reflux is an early sign of congestive heart failure. It is named as hepatojugular reflux because of increased blood pressure in peripheral nervous system which increases load on liver and ultimately distension of jugular vein occurs which is present in neck. When heart is in healthy condition, it increases the cardiac output due to increased venous return. This will not increase load on liver and as a result there will be no distension in jugular vein.

Hepatojugular reflux Definition, Test, Mechanism, Pathophysiology


Hepatojugular reflux Test

           
Hepatojugular reflux is also known as abdominojugular test. It is a physical test which is performed to check performance of heart. If the result is positive, it shows problem in pulmonary artery pressure and indicates right heart dysfunction. In this test patient is asked to lie down at 30 degrees and head tilted at 45 degrees to left side. Direct light is applied on neck to see the difference in jugular vein appearance. Patient’s abdomen is compressed lightly for about 20 to 30 seconds and distension in jugular vein will be seen.


Hepatojugular reflux Mechanism

        
Hepatojugular reflux is an indication of heart failure or many other cardiac diseases. Because it occurs as a result of cardiac failure or diseased state of heart. When a light pressure is applied, abdomen get compress and after 20 to 30 sec of compression the venous return pressure increases, which increases pressure on liver. Increased blood pressure on liver leads to increased blood pressure in cranial vena cava ultimately increasing pressure on jugular veins leading to distension of vein. Jugular veins are present in neck region which can be easily seen on surface after expansion or distension.


Hepatojugular reflux Pathophysiology

       
Hepatojugular reflux is a normal physical test which is performed to check performance of heart. The pathophysiology behind this reflux is dependent upon the impaired condition of heart. When right or left ventricle is diseased, increased venous return pressure on right ventricle cannot be handled by it. And leads to increased peripheral nervous pressure. This increased pressure start increasing load on liver and liver pass this pressure on cranial nerves and ultimately jugular vein. As a result jugular vein get distended. All this happen due to diseased state or failure of heart. This condition mostly indicate congestive heart failure.
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Brushfield spots Pictures, Causes, Symptoms, Treatment

Brushfield spots is a condition present in eyes. It is the coolest condition of eyes which makes it more attractive and colorful. These spots are arranged in a circular position like ring in the pupil of eye. As the name indicates the presence of spots in the outer brush field boundary of iris. The spots are of greyish or brown in color. Thomas brush field is the scientist who named this condition after his name. These spots occur due to the aggregation of connective tissues which is a normal element of iris. These spots occur in a syndrome named Down syndrome.


It is normal in children. About 35 to 78 percent of children have Brushfield spots with Down syndrome. These Brushfield spots are more common in children who are European descendent with Down syndrome and very rare in Asian descendants with Down syndrome. It is also common in light pigmented irises. Brushfield spots are the focal areas of stromal hyperplasia and surrounded by hypoplasia. It is not only present in patients with Down syndrome but also present in person without Down syndrome. These spots do not have effect on vision and normal functioning of iris and pupil.

Brushfield spots Pictures, Causes, Symptoms, Treatment


Brushfield spots Symptoms


Brushfield spots are not a pathological condition. It is a normal appearance of colored spots in the periphery of iris. The pupil of eye have colored spots mostly greyish, brownish or white in color. These spots are small crescent shaped markings. These spots impart an attractive appearance to the eye of patient. These spots occur as a result of aggregation of connective tissues which normally present in the pupil of eye. The eyes are almond shaped. Children with Down syndrome have these Brushfield spots and other symptoms associated with it like slow growth and short height children.

Brushfield spots Causes

       
The main cause reported behind Brushfield spots is Down syndrome. Down syndrome is a genetic disorder which is regarding to the retarded growth of children. It is not a pathological condition so the physiology behind appearance of greyish brown spots is the accumulation of connective element of pupil which are present normally in the eye. The pigmentation of eye may also occur due to zellweger syndrome. Other causes behind Brushfield syndrome are roifman syndrome, iris disorder, Yemenite deaf blind hypopigmentation syndrome, osteoporosis oculocutaneous hypopigmentation syndrome, familial progressive hypo and hyper pigmentation and last but not least gradenigo syndrome.

Brushfield spots Treatment


The treatment plan for external eye disorder like Brushfield spots is similar to that for non handicapped patients. In treating Brushfield spots, the medications of cardiovascular disease and respiratory disease should be avoided. Medical therapy of blepharitis is similar to the treatment therapy of Down syndrome to ultimately treat Brushfield syndrome. Some antibiotics and topical scrubs are included in medication therapy. Other precautions include wearing sun glasses when going out in order to avoid other generating diseases like esotropia, aphakia, pseudophakia and refractory errors which causes amblyopia. Starting care is important but with passage of time patient get used to it.
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Ligamentum teres hepatis, hip, Umbilical Vein, Ultrasound, Radiology

Ligamentum teres is a round ligament present in liver. It is also known as ligamentum teres hepatis because of its location. Ligamentum is a collection of string tissues (fibrous in nature) that is present at the edge of falciform ligament present in liver. This round shaped ligament divides the left part of liver into two parts i.e. medial and lateral sections. Fetus Umbilical vein remnant is represented by this round ligament (ligamentum teres) that is why it is only present in placental mammals. After one or two months of delivery, the umbilical vein degenerate to form fibrous tissue i.e. ligamentum teres.


Ligamentum teres Hepatis

       
Ligamentum teres is also known as ligamentum teres hepatis because it is present in liver. It is located at the edge of another ligament named falciform ligament (dividing liver in left and right side). This ligament is present in left side of liver which divide it into 2 parts medial and lateral. It is a degenerative ligament because it has the same degenerative cells as present in liver. It is composed of fibrous tissues which joins navel part to the anterior side border of liver. It is of great importance as it is remnant of fetal umbilical cord.


Ligamentum teres hepatis, hip, Umbilical Vein, Ultrasound, Radiology

Ligamentum teres Hip


The ligamentum teres present in hip is also known as round ligament of the femur and ligamentum teres femoris. It is not round in shape but appear as triangular shaped or sometimes flattened ligament. It has different strength in different subjects and unsheathed by the synovial membrane. The ligamentum teres femoris get tense when person is in semi flexed or half bended position and get relax at adducted limb position. It provides extra protection to hip and avoid dislocation of hip with great resistance that is why it is also known as hip capsule.


Ligamentum teres Umbilical vein

         
Umbilical vein is developed during pregnancy for the purpose of development of fetus. It carries oxygenated blood to fetus via placenta. This umbilical vein provide oxygenated blood to very central circulatory system of neonate and restore the actual blood volume in the body of neonate. It also help in administration of glucose and drugs. After delivery of neonate, the umbilical vein start closing and converting into the fibrous rounded cord like structure named ligamentum teres. It is located in liver and cross over the falciform ligament to divide left half of liver into two parts.

Ligamentum teres Ultrasound

       
The ultrasound report of liver shows the presence of tear ligamentum teres. A survey report containing 100 patients illustrated that about 87 % patient were found with tear ligamentum teres. This calculation was reported after ultrasound examination of liver showing pathological condition of ligamentum teres. The mean diameter of ligamentum teres is 4.5 mm and have a range of 3 to 6 mm. when tear ligamentum teres is present, the diameter of round ligament is increased due to thickness. This increased ligament thickness appear clearly in the reports of ultrasound. Thickening of ligamentum teres is of two types i.e. nodular or smooth.

Ligamentum teres Radiology

       
Arthroscopy and magnetic resonance imaging are performed to get radiology report. But magnetic resonance imaging is not all the time successful in getting radiology report. But arthroscopy of hip and liver portion have greatly reported pathological findings in ligamentum teres. Pain in hip and instability in patient when undergo from arthroscopy, found to have lesions in ligamentum teres. About 4 % to 15 % cases of ligamentum teres tear are reported by arthroscopy. Lesion in ligamentum teres is found to be the most common cause behind pain in hip portion in athletes.
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kinesthetic sense Definition, Test, Psychology, Receptors | Vestibular sense

Kinesthetic sense is also known as muscle memory. It is a condition in which person is well aware of his body movements and joint location or movement. The phenomenon of kinesthetic sense is somehow based on proprioception which includes position of joints. Basically person can sense or feel body movements with closed eyes. It is very beneficial for blind patients to walk through familiar places or surroundings like kinesthetic sense enable patient to judge where to safely step forward and can reach to his destination without counting steps. Kinesthetic sense can be improved with regular practice and training.


kinesthetic sense Test

         
A self-test is performed to check kinesthetic sense. In this test, person repeat certain movements until he get to know about muscles involved in it. There are several positions involved like prone position and spinal position. In prone position, patient is asked to raise his leg up to 5 to 10 inches from floor. While lifting, person can feel lumbar and buttock muscles stretching. In supine position, patient is asked to rotate his both legs so that his feet turn out. While moving his leg, he will feel hip muscles working and rotating along with leg movement.

kinesthetic sense Definition, Test, Psychology, Receptors  Vestibular sense


kinesthetic sense Psychology


Basically person totally rely on the sense of kinesthetic instead of other 5 senses. Person have trust on kinesthetic sense while doing any physical activity like running, walking, driving, dancing and swimming etc. With the help of kinesthetic sense, person can tell about body movements without visual help by the movement of muscles involved in it. The part of body involved in movement or physical activity, send signals to brain which ultimately activate patient mind and patient can tell about his body movements even in a dark room. As in riding a bike, muscles of legs send signals to brain.


kinesthetic sense Receptors

         
Limbs involved in movement of body, send signals to brain via motor neurons. Peripheral muscles are involved in kinesthetic sense which are muscle spindles and skin stretch receptors. Joint receptors, which are present on every joint in body, not all of them are responding to stimuli send by brain. Basically kinesthetic sense involve two concepts, 1st is movement of muscles or joints and 2nd one is location of joints and muscles. Receptors i.e. muscle spindle show response to stimuli in both senses (movement and location). While in limb movement, both the receptors are involved.

kinesthetic sense vs Vestibular sense

         
Kinesthetic sense involve the movement and location of muscles and joints in body during any physical activity but vestibular sense is about information regarding movement and location of body posture. Basically vestibular sense gives information about body orientation with respect to gravity, but kinesthetic sense has nothing to do with gravity and posture. Vestibular sense involve the sense of balancing the body and maintain a proper posture like sitting, standing, kneeling jumping, running etc. while kinesthetic sense is all about muscle movement and involvement of receptors while moving body parts like running, walking, lying down, driving etc.
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