Neurology

Neurology is a medical specialty dealing with disorders and diseases of the nervous system. In the past the term has been used more generally for the study of the nervous system and the term itself comes from the Greek νεῦρον, neuron, for "nerve cell" and the suffix -λογία for "study of." However, today the term neuroscience is employed for the larger field that encompasses the scientific study of the nervous system, while neurology is the branch related to medicine. Both neuology and neuroscience are interdisciplinary fields.

Neurology deals with the diagnosis and treatment of all categories of disease and disorders involving the central and peripheral nervous system, including such neurological conditions as Alzheimer's disease, seizures, stroke, paralysis, coma, epilepsy, meningitis, encephalitis, multiple sclerosis, herpes simple virus 2, amnesia, Parkinson's disease, paraplegia, hearing loss, and various infections and tumors of the nervous system.

A neurologist is a physician specializing in neurology and trained to investigate, or diagnose and treat neurological disorders. Neurologists may also be involved in clinical research, and clinical trials, as well as basic research and translational research. Some neurologists specialize in certain parts of the nervous system or in specific procedures. For example, clinical neurophysiologists specialize in the use of electrodiagnostic techniques (EEG and EMG) in order to diagnose certain neurological disorders. Neurosurgery is a distinct specialty which involves a different training path, and emphasizes the surgical treatment of neurological disorders.

Edit: http://www.sfn.org/about/about-neuroscience is the most complex living structure in the known universe. cientists continue to strive for a deeper understanding of how the brain’s 100 billion nerve cells are born, grow, and connect. More than 1,000 disorders of the brain and nervous system result in more hospitalizations and lost productivity than any other disease group, including heart disease and cancer. In 2007, the World Health Organization estimated that neurological disorders affect up to one billion people worldwide. In fact, neurological diseases make up 11 percent of the world’s disease burden, not including mental health and addiction disorders. The cost of these diseases is high across the globe. For example, the European Brain Council estimated in 2010 that neurological diseases in Europe alone cost one trillion dollars a year.http://europeanbraincouncil.org/projects/CDBE/2010/

Overview

Drawing by Santiago Ramón y Cajal (1899) of neurons in the pigeon cerebellum

The nervous system is the network of specialized cells, tissues, and organs in a multicellular animal that coordinates the body's interaction with the environment, including sensing internal and external stimuli, monitoring the organs, coordinating the activity of muscles, initiating actions, and regulating behavior. All parts of the nervous system are made of nervous tissue, which conducts electrical impulses. Nervous tissue is prominent in almost every major animal phylum, including platyhelminthes and nematodes. However, it is most complex in vertebrate animals.

Neuroscience is an interdisciplinary field in science that is organized around the study of the nervous system. As such, the field encompasses the scientific study of the structure, function, and development of nervous systems, normal and abnormal variants, ranging from the simple systems of such invertebrates as platyhelminthes and nematodes to the complex systems of vertebrates like human beings, as well as including treatment of disorders and diseases of the nervous system. Among the components that are studied are the brain, dorsal and ventral nerve cords, spinal cord, nerves, muscles, neurons (nerve cells), central nervous system, peripheral nervous system, neurotransmitters, sense organs and senses (such as taste and touch), and so forth. As an interdisciplinary field, interconnections are made with such disciplines as biology, chemistry, physics, computer science, mathematics, engineering, linguistics, medicine, and psychology.

from Greek νεῦρον, neuron, "nerve" + the suffix -λογία, '-logia', "study of") is a medical specialty dealing with disorders of the nervous system. Neurologists can opine on the subject matter of a psychiatrist. To be specific, neurology deals with the diagnosis and treatment of all categories of disease involving the central and peripheral nervous system; or equivalently, the autonomic nervous systems and the somatic nervous systems, including their coverings, blood vessels, and all effector tissue, such as muscle.

| Clinical neuroscience | This consists of medical specialties such as neurology and psychiatry, as well as many allied health professions such as speech-language pathology. Neurology is the medical specialty that works with disorders of the nervous system. Psychiatry is the medical specialty that works with the disorders of the mind—which include various affective, behavioral, cognitive, and perceptual disorders. |-

The term neurology was once used in a synonymous way with the current definition of neuroscience. For example, MaGill's Medical Guide (2008) defines neurology as "the study of the nervous system" and "the study of the structure and function of the nervous system" (Hollar 2008). Indeed,the term neurology comes from the (from Greek νεῦρον, neuron, for "nerve cell" and the suffix -λογία for "study of." However, today neurology is limited to the medical specialty dealing with disorders and diseases of the nervous system.

Neurology, psychiatry, neurosurgery, psychosurgery, anesthesiology, neuropathology, neuroradiology, clinical neurophysiology, and addiction medicine are medical specialties that specifically address diseases of the nervous system. These terms also refer to clinical disciplines involving diagnosis and treatment of these diseases. Neurology address diseases and disorders of the central and peripheral nervous systems, such as amyotrophic lateral sclerosis (ALS) and stroke, and their medical treatment. Psychiatry focuses on affective, behavioral, cognitive, and perceptual disorders. Anesthesiology focuses on perception of pain, and pharmacologic alteration of consciousness. Neuropathology focuses upon the classification and underlying pathogenic mechanisms of central and peripheral nervous system and muscle diseases, with an emphasis on morphologic, microscopic, and chemically observable alterations. Neurosurgery and psychosurgery work primarily with surgical treatment of diseases of the central and peripheral nervous systems. The boundaries between these specialties have been blurring recently as they are all influenced by basic research in neuroscience. Brain imaging also enables objective, biological insights into mental illness, which can lead to faster diagnosis, more accurate prognosis, and help assess patient progress over time.

There are many sub-disciplines within the field of neuroscience, including such major branches as neurology, affective neuroscience, molecular and cellular neuroscience, evolutionary neuroscience, cognitive and behavioral neuroscience, computational neuroscience, neuropsychology, and so forth.

The term neurology was once used more generally for the study of the nervous system but now refers to the medical specialty dealing with disorders and diseases of the nervous system, including Alzheimer's disease, seizures, paralysis, coma, Parkinson's disease, hearing loss, meningitis, encephalitis, migraine, stroke, Lou Gehrig's disease, multiple sclerosis, and the nature of pain.

A neurologist is a physician specializing in neurology and trained to investigate, or diagnose and treat neurological disorders. Neurologists may also be involved in clinical research, and clinical trials, as well as basic research and translational research. While neurology is a non-surgical specialty, its corresponding surgical specialty is neurosurgery. Neurology, being a branch of medicine, differs from neuroscience, which is the scientific study of the nervous system in all of its aspects.

A neurologist is a physician specializing in neurology and trained to investigate, or diagnose and treat neurological disorders. Neurologists may also be involved in clinical research, and clinical trials, as well as basic research and translational research. While neurology is a non-surgical specialty, its corresponding surgical specialty is neurosurgery. Neurology, being a branch of medicine, differs from neuroscience, which is the scientific study of the nervous system in all of its aspects.

medical discipline. focued on neurological disorders

Neurology (from Greek νεῦρον, neuron, "nerve" + the suffix -λογία, '-logia', "study of") is a medical specialty dealing with disorders of the nervous system. Neurologists can opine on the subject matter of a psychiatrist. To be specific, neurology deals with the diagnosis and treatment of all categories of disease involving the central and peripheral nervous system; or equivalently, the autonomic nervous systems and the somatic nervous systems, including their coverings, blood vessels, and all effector tissue, such as muscle.

A neurologist is a physician specializing in neurology and trained to investigate, or diagnose and treat neurological disorders. Neurologists may also be involved in clinical research, and clinical trials, as well as basic research and translational research. While neurology is a non-surgical specialty, its corresponding surgical specialty is neurosurgery. Neurology, being a branch of medicine, differs from neuroscience, which is the scientific study of the nervous system in all of its aspects.

Many neurologists also have additional subspecialty training (fellowships) after completing their residency in one area of neurology such as stroke or vascular neurology, interventional neurology, neurosonology, epilepsy, neuromuscular, neurorehabilitation, behavioral neurology, sleep medicine, pain management, neuro immunology, clinical neurophysiology, or movement disorders.

In Germany, a compulsory year of psychiatry must be done to complete a residency of neurology.

In the United Kingdom and Ireland, neurology is a subspecialty of general (internal) medicine. After five to nine years of medical school and a year as a pre-registration house officer (or two years on the Foundation Programme), a neurologist must pass the examination for Membership of the Royal College of Physicians (or the Irish equivalent) before completing two years of core medical training and then entering specialist training in neurology. A generation ago, some neurologists would have also spent a couple of years working in psychiatric units and obtain a Diploma in Psychological Medicine. However, this requirement has become uncommon, and, now that a basic psychiatric qualification takes three years to obtain, the requirement is no longer practical. A period of research is essential, and obtaining a higher degree aids career progression: Many found it was eased after an attachment to the Institute of Neurology at Queen Square in London. Some neurologists enter the field of rehabilitation medicine (known as physiatry in the US) to specialise in neurological rehabilitation, which may include stroke medicine as well as brain injuries.

Edit: http://www.sfn.org/about/about-neuroscience is the most complex living structure in the known universe. cientists continue to strive for a deeper understanding of how the brain’s 100 billion nerve cells are born, grow, and connect. More than 1,000 disorders of the brain and nervous system result in more hospitalizations and lost productivity than any other disease group, including heart disease and cancer. In 2007, the World Health Organization estimated that neurological disorders affect up to one billion people worldwide. In fact, neurological diseases make up 11 percent of the world’s disease burden, not including mental health and addiction disorders. The cost of these diseases is high across the globe. For example, the European Brain Council estimated in 2010 that neurological diseases in Europe alone cost one trillion dollars a year.http://europeanbraincouncil.org/projects/CDBE/2010/

Field of work

A large number of neurological disorders have been described. These can affect the central nervous system (brain and spinal cord), the peripheral nervous system, or the autonomic nervous system.

Qualifications

Jean-Martin Charcot is considered one of the fathers of neurology.

In the United States and Canada, neurologists are physicians who have completed postgraduate training in neurology after graduation from medical school. Neurologists complete, on average, at least 10–13 years of college education and clinical training. This training includes obtaining a four-year undergraduate degree, a medical degree (D.O. or M.D.), which comprises an additional four years of study, and then completing a three or four-year residency in neurology. The four-year residency consists of one year of internal medicine training followed by three years of training in neurology. Some neurologists complete a one or two-year fellowship after completing a neurology residency. Sub-specialties include: brain injury medicine, clinical neurophysiology, epilepsy, hospice and palliative medicine, neurodevelopmental disabilities, neuromuscular medicine, pain medicine and sleep medicine, and vascular medicine.

Many neurologists also have additional subspecialty training (fellowships) after completing their residency in one area of neurology such as stroke or vascular neurology, interventional neurology, neurosonology, epilepsy, neuromuscular, neurorehabilitation, behavioral neurology, sleep medicine, pain management, neuro immunology, clinical neurophysiology, or movement disorders.

In Germany, a compulsory year of psychiatry must be done to complete a residency of neurology.

In the United Kingdom and Ireland, neurology is a subspecialty of general (internal) medicine. After five to nine years of medical school and a year as a pre-registration house officer (or two years on the Foundation Programme), a neurologist must pass the examination for Membership of the Royal College of Physicians (or the Irish equivalent) before completing two years of core medical training and then entering specialist training in neurology. A generation ago, some neurologists would have also spent a couple of years working in psychiatric units and obtain a Diploma in Psychological Medicine. However, this requirement has become uncommon, and, now that a basic psychiatric qualification takes three years to obtain, the requirement is no longer practical. A period of research is essential, and obtaining a higher degree aids career progression: Many found it was eased after an attachment to the Institute of Neurology at Queen Square in London. Some neurologists enter the field of rehabilitation medicine (known as physiatry in the US) to specialise in neurological rehabilitation, which may include stroke medicine as well as brain injuries.

Physical examination

During a neurological examination, the neurologist reviews the patient's health history with special attention to the current condition. The patient then takes a neurological exam. Typically, the exam tests mental status, function of the cranial nerves (including vision), strength, coordination, reflexes, and sensation. This information helps the neurologist determine whether the problem exists in the nervous system and the clinical localization. Localization of the pathology is the key process by which neurologists develop their differential diagnosis. Further tests may be needed to confirm a diagnosis and ultimately guide therapy and appropriate management.

Clinical tasks

General caseload

Neurologists are responsible for the diagnosis, treatment, and management of all the conditions mentioned above. When surgical intervention is required, the neurologist may refer the patient to a neurosurgeon. In some countries, additional legal responsibilities of a neurologist may include making a finding of brain death when it is suspected that a patient is deceased. Neurologists frequently care for people with hereditary (genetic) diseases when the major manifestations are neurological, as is frequently the case. Lumbar punctures are frequently performed by neurologists. Some neurologists may develop an interest in particular subfields, such as stroke, dementia, movement disorders, headaches, epilepsy, sleep disorders, chronic pain management, multiple sclerosis, or neuromuscular diseases.

Overlapping areas

There is some overlap with other specialties, varying from country to country and even within a local geographic area. Acute head trauma is most often treated by neurosurgeons, whereas sequelae of head trauma may be treated by neurologists or specialists in rehabilitation medicine. Although stroke cases have been traditionally managed by internal medicine or hospitalists, the emergence of vascular neurology and interventional neurologists has created a demand for stroke specialists. The establishment of JCAHO certified stroke centers has increased the role of neurologists in stroke care in many primary as well as tertiary hospitals. Some cases of nervous system infectious diseases are treated by infectious disease specialists. Most cases of headache are diagnosed and treated primarily by general practitioners, at least the less severe cases. Likewise, most cases of sciatica and other mechanical radiculopathies are treated by general practitioners, though they may be referred to neurologists or a surgeon (neurosurgeons or orthopedic surgeons). Sleep disorders are also treated by pulmonologists and psychiatrists. Cerebral palsy is initially treated by pediatricians, but care may be transferred to an adult neurologist after the patient reaches a certain age. In the United Kingdom and other countries, many of the conditions encountered by older patients such as movement disorders including Parkinson's Disease, stroke, dementia or gait disorders are managed predominantly by specialists in geriatric medicine.

Clinical neuropsychologists are often called upon to evaluate brain-behavior relationships for the purpose of assisting with differential diagnosis, planning rehabilitation strategies, documenting cognitive strengths and weaknesses, and measuring change over time (e.g., for identifying abnormal aging or tracking the progression of a dementia).

Relationship to clinical neurophysiology

In some countries, e.g. USA and Germany, neurologists may specialize in clinical neurophysiology, the field responsible for EEG, nerve conduction studies, EMG and evoked potentials. In other countries, this is an autonomous specialty (e.g., United Kingdom, Sweden).

Overlap with psychiatry

Further information: Psychoneuroimmunology

Although mental illnesses are believed by some to be neurological disorders affecting the central nervous system, traditionally they are classified separately, and treated by psychiatrists. In a 2002 review article in the American Journal of Psychiatry, Professor Joseph B. Martin, Dean of Harvard Medical School and a neurologist by training, wrote that "the separation of the two categories is arbitrary, often influenced by beliefs rather than proven scientific observations. And the fact that the brain and mind are one makes the separation artificial anyway".

Neurological diseases often have psychiatric manifestations, such as post-stroke depression, depression and dementia associated with Parkinson's disease, mood and cognitive dysfunctions in Alzheimer's disease and Huntington disease, to name a few. Hence, there is not always a sharp distinction between neurology and psychiatry on a biological basis. The dominance of psychoanalytic theory in the first three quarters of the 20th century has since then been largely replaced by a focus on pharmacology. Despite the shift to a medical model, brain science has not advanced to the point where scientists or clinicians can point to readily discernible pathologic lesions or genetic abnormalities that in and of themselves serve as reliable or predictive biomarkers of a given mental disorder.

Neurological enhancement

The emerging field of neurological enhancement highlights the potential of therapies to improve such things as workplace efficacy, attention in school, and overall happiness in personal lives. However, this field has also given rise to questions about neuroethics and the psychopharmacology of lifestyle drugs.

A neurologist is a physician who specializes in neurology, and is trained to investigate, or diagnose and treat neurological disorders.

Neurology is the medical specialty related to the human nervous system. The nervous system encompasses the brain, spinal cord, and peripheral nerves. A specialist physician who treats patients suffering from neurological disease is called a neurologist. Related yet distinct fields of medicine include: psychiatry, neurosurgery and their subspecialties.

Overview

{{#invoke:Message box|ambox}} Neurologists examine patients who have been referred to them by other physicians in both the inpatient and outpatient settings. A neurologist will begin their interaction with a patient by taking a comprehensive medical history, and then perform a physical examination focusing on evaluating the nervous system. Components of the neurological examination include assessment of the patient's cognitive function, cranial nerves, motor strength, sensation, reflexes, coordination, and gait.

In some instances, neurologists may order additional diagnostic tests as part of the evaluation. Commonly employed tests in neurology include imaging studies such as computed axial tomography (CAT) scans, magnetic resonance imaging (MRI), and ultrasound of major blood vessels of the head and neck. Neurophysiologic studies, including electroencephalography (EEG), electromyography (EMG), and evoked potentials are also commonly ordered. Neurologists frequently perform lumbar punctures in order to assess characteristics of a patient's cerebrospinal fluid.

Some of the commonly encountered conditions treated by neurologists include headaches, radiculopathy, neuropathy, stroke, dementia, seizures and epilepsy, Parkinson's Disease, multiple sclerosis, head trauma, sleep disorders, neuromuscular diseases, and various infections and tumors of the nervous system. Neurologists are also asked to evaluate unresponsive patients on life support in order to confirm brain death.

Treatment options vary depending on the neurological problem. They can include everything from referring the patient to a physiotherapist, to prescribing medications, to recommending a surgical procedure.

Some neurologists specialize in certain parts of the nervous system or in specific procedures. For example, clinical neurophysiologists specialize in the use of electrodiagnostic techniques (EEG and EMG) in order to diagnose certain neurological disorders. Neurosurgery is a distinct specialty which involves a different training path, and emphasizes the surgical treatment of neurological disorders.

There are also many non-medical doctors, those with PhD degrees in subjects such as biology and chemistry, who study and research the nervous system. Working in labs in universities, hospitals, and private companies, these neuroscientists perform clinical and laboratory experiments and tests in order to learn more about the nervous system and find cures or new treatments for diseases and disorders.

There is a great deal of overlap between neuroscience and neurology. A large number of neurologists work in academic training hospitals, where they conduct research as neuroscientists in addition to treating patients and teaching neurology to medical students.

Working Conditions

{{#invoke:Message box|ambox}} Neurologists often spend part of their day in their office, interviewing and examining patients, and then spend another part of the day visiting other patients in the hospital and reviewing their progress. They also spend time meeting with doctors who have referred patients to them, discussing the patients' progress.

Most neurologists and neuroscientists are employed full-time, working a 5-day, 40 to 50-hour week. However, this number can vary considerably, depending on experience and the type of position held. Many doctors may be expected to work more hours each week, especially at the beginning of their careers. It is not uncommon for a doctor to put in more than 60 hours a week.

Neurologists who work in hospitals usually have to work evening and weekend shifts to meet the needs of their patients. Doctors are also often "on-call" at times when they are not at work. This means that they can be called in at any time, day or night, to attend to emergencies. On-call activities can add several hours to a neurologist's workweek.

While neurology is not physically demanding work, there can be a great deal of stress involved. This is especially true if neurologists are working with patients who are extremely sick, or even terminally ill.

Education and Training

Persons who are interested in becoming a neurologist must first attend medical school. Good grades in high school and university are generally required, as well as taking the Medical College Admission Test (MCAT) if one is to pursue a Doctor of Medicine degree or a Doctor of Osteopathic Medicine degree. Undergraduate and Medical school students are required to take classes such as anatomy, biochemistry, physiology, pharmacology, psychology, microbiology, pathology, medical ethics, and laws governing medicine. Matriculants generally hold at minimum a bachelor's degree. Medical school provides a general medical education and grants students a Doctor of Medicine (MD), Doctor of Osteopathic Medicine (DO), or Bachelor of Medicine/Bachelor of Surgery (MBBS, MBChB) upon successful completion. Graduating medical students then elect a post-graduate or residency program in neurology or pediatrics or one year of internal medicine. Residents in either pediatrics or internal medicine must then enroll into neurology fellowships such as pediatric neurology, or general neurology. Neurologists may choose from a variety of subspecialties.

Neurology residency consists of practical, on-the-job training, in hospitals or other medical settings. The training program provides residents with specific training as a neurologist, and usually takes about four years to complete. In the United States, the first of these four years consists of either a transitional or internal medicine internship, which includes broad exposure to general adult medicine. The second through fourth postgraduate years are spent in a devoted neurology residency, after which time the successful graduate can apply for licensure. After residency, graduates may choose to pursue board certification through the American Board of Psychiatry and Neurology. Some neurologists will complete voluntary, additional training in a fellowship program in order to gain experience in a subspecialty area.^{[citation needed]}

Persons wishing to become a non-medical neuroscientist must first complete a bachelor's degree in neuroscience or a related discipline. The next step is to obtain a master's degree in neuroscience (two years to complete) and then a Ph.D. (at least four years). While there may be research positions available to those with a master's degree, a Ph.D. is generally required to become a university professor or a senior research scientist.^{[citation needed]}

References

ISBN links support NWE through referral fees

• Bear, M. F., B. W. Connors, and M. A. Paradiso. 2001. Neuroscience: Exploring the Brain, 2nd edition. Philadelphia: Lippincott Williams & Wilkins. ISBN 0781739446.

• Chiao, J. Y., and N. Ambady. 2007. Cultural neuroscience: Parsing universality and diversity across levels of analysis. Pages 237-254 in S. Kitayama and D. Cohen (Eds.), Handbook of Cultural Psychology. New York: Guilford Press.

• European Brain and Behaviour Society(EBBS0. 2009. About EBBS. European Brain and Behaviour Society. Retrieved October 2, 2013.

• Finger, S. 2001. Origins of Neuroscience: A History of Explorations into Brain Function, 3rd edition. New York: Oxford University Press. ISBN 0195146948.

• Greenblatt, S. H. 1995. Phrenology in the science and culture of the 19th century. Neurosurg 37, iss. 4: 790–805. PMID 8559310. Retrieved October 2, 2013.

• Herodotus. 440 B.C.E. The Histories: Book II (Euterpe) (translated by G. Rawlinson). Retrieved October 2, 2013.

• Hollar, D. W. 2008. Neurology. Pages 1904-1909 in Magill's Medical Guide, Vol. IV. Pasadena: Salem Press. ISBN 9781587653889.

• International Brain Research Organization (IBRO). 2013. History. International Brain Research Organization. Retrieved October 2, 2013.

• International Society for Neurochemistry (ISN). 2013. Chapter 2: The Beginning. International Society for Neurochemistry. Retrieved October 2, 2013.

• Kandel, E. R., J. H. Schwartz, and T. M. Jessel. 2000. Principles of Neural Science, 4th edition. New York: McGraw-Hill. ISBN 0838577016.

• Mohamed, W. 2008. History of neuroscience: Arab and Muslim contributions to modern neuroscience. International Brain Research Organization. Retrieved October 2, 2013.

• Panksepp, J. 1990. A role for "affective neuroscience" in understanding stress: The case of separation distress circuitry. In S. Puglisi-Allegra and A. Oliverio, Psychobiology of Stress. Dordrecht, Netherlands: Kluwer Academic. ISBN 0792306821.

• Plato. 360 B.C.E. Timaeus (translated by B. Jowett). Retrieved October 2, 2013.

• Society for Neuroscience (SFN). 2013. Mission and strategic plan. Society for Neuroscience. Retrieved October 2, 2013.

• United States Department of Health and Human Services (HHS). 2011 Chapter 2: The fundamentals of mental health and mental illness. Saylor.org. Retrieved October 2, 2013.

• Wilkins, R. H. 1964. Neurosurgical Classic-XVII: Edwin Smith Surgical Papyrus. Cyber Museum of Neurosurgery. Reprinted from the Journal of Neurosurgery, March 1964, pages 240-244. Retrieved October 2, 2013..

• Zull, J. 2002. The Art of Changing the Brain: Enriching the Practice of Teaching by Exploring the Biology of Learning. Sterling, VA: Stylus Publishing. ISBN: 1579220533.

Credits

New World Encyclopedia writers and editors rewrote and completed the Wikipedia article in accordance with New World Encyclopedia standards. This article abides by terms of the Creative Commons CC-by-sa 3.0 License (CC-by-sa), which may be used and disseminated with proper attribution. Credit is due under the terms of this license that can reference both the New World Encyclopedia contributors and the selfless volunteer contributors of the Wikimedia Foundation. To cite this article click here for a list of acceptable citing formats.The history of earlier contributions by wikipedians is accessible to researchers here:

• Neuroscience  ^history
• Neurology  ^history
• Neurologist  ^history

The history of this article since it was imported to New World Encyclopedia:

• History of "Neurology"

Note: Some restrictions may apply to use of individual images which are separately licensed.