Sunday, May 20, 2012
My bad
Well I guess it's pretty obvious that I kinda gave up keeping notes and posting them....sorry
-Jesse
Monday, March 19, 2012
3-19-12 Monday
Body Awareness 2
Well that was fun!!
Homework has something to do with journaling about what we are doing being relevant to class, what you are learning/exp. and how it's helpful to massage training.
Read Frye chap5
practice Tai chi and centering
Bring sheets and blindfold
Psych 2
Again, can't say much.
Any question, consult the syllabus.
NMT
neuromuscular therapy (nmt): utilization of static pressure on a MFTrP (myofacial trigger point) to relieve pain restore function; **it must affect CNS**
as in the clients recognition of the pain subsiding
Trp: area of hyper irritability within a taut band that refers pain upon palaption
-active: actively referred pain
-latent: don't know its there until its touched
-satellite: aka secondary TrP, gets set up because of an unresolved TrP; far from origin, will refer
TrP travels
tender points don't
P. 59- origin of Traps (typically refers up)
O: external occipital protuberance, lig nuche, sp of C7-T12
I: spine scapula, acromion, lat third of clavicle
A:
Fiber direction: in is toward the midline, out is away from midline
with taut band
review mm fiber direction, action, bones it moves
P.21
SCM (typically refer up)
O: clavicular head, sternal head
I: mastoid process and lat half superior nuchal line
a:
Levator scap
O: tp of c1-4, attached by slips (tendonous, attach mm to tp)
I: medial boarder scap, superior angle (just above scap spine)
this is a twist
scalenes refer down
Well that was fun!!
Homework has something to do with journaling about what we are doing being relevant to class, what you are learning/exp. and how it's helpful to massage training.
Read Frye chap5
practice Tai chi and centering
Bring sheets and blindfold
Psych 2
Again, can't say much.
Any question, consult the syllabus.
NMT
neuromuscular therapy (nmt): utilization of static pressure on a MFTrP (myofacial trigger point) to relieve pain restore function; **it must affect CNS**
as in the clients recognition of the pain subsiding
Trp: area of hyper irritability within a taut band that refers pain upon palaption
-active: actively referred pain
-latent: don't know its there until its touched
-satellite: aka secondary TrP, gets set up because of an unresolved TrP; far from origin, will refer
TrP travels
tender points don't
P. 59- origin of Traps (typically refers up)
O: external occipital protuberance, lig nuche, sp of C7-T12
I: spine scapula, acromion, lat third of clavicle
A:
Fiber direction: in is toward the midline, out is away from midline
with taut band
review mm fiber direction, action, bones it moves
P.21
SCM (typically refer up)
O: clavicular head, sternal head
I: mastoid process and lat half superior nuchal line
a:
Levator scap
O: tp of c1-4, attached by slips (tendonous, attach mm to tp)
I: medial boarder scap, superior angle (just above scap spine)
this is a twist
scalenes refer down
Thursday, March 1, 2012
2-29-12 Wednesday
ENERGETICS
didn't take notes
CLINIC ORIENTATION
received enough papers to not take notes
But way excited to have Renee as the supervisor!
didn't take notes
CLINIC ORIENTATION
received enough papers to not take notes
But way excited to have Renee as the supervisor!
Tuesday, February 28, 2012
2-27-12 Monday
ASSESSMENT
carpal tunnel syndrome: retinaculum and wrist bones
rarely refers up to the neck
carpal ligament = flexor retinaculum
9 flexor tendons and veins, art, nerves
fit b/w bones
median nerve most superficial and most affected
thumb/1st two fingers
Phalen's test
Tinel sign
over flexion- inflame tendon; with sheath, tendosynovitis
motor nerve are deeper
deeper is more serious
TOS- discomfort can refer down to wrist
entrapment site
3 areas of nerve entrapment:
scalenes- adson, allen
pec minor- wrights
clavicular- military
Test stuff
cervical spine
apex c5/c6
forward head, excessive nerve compression
most common neck pain
close intervert. space
compress nerve and facets
wear down cartilage
early degeneration disc
c1/c2 rotation
c5-c8/t1
c5-c8/t1- brachial plexus comes from
know knee stuff
tests
everything
review end feels
PROM- jt
inert and contractial tissue
overlengthen mm weakens
tendon stuff
carpal tunnel syndrome: retinaculum and wrist bones
rarely refers up to the neck
carpal ligament = flexor retinaculum
9 flexor tendons and veins, art, nerves
fit b/w bones
median nerve most superficial and most affected
thumb/1st two fingers
Phalen's test
Tinel sign
over flexion- inflame tendon; with sheath, tendosynovitis
motor nerve are deeper
deeper is more serious
TOS- discomfort can refer down to wrist
entrapment site
3 areas of nerve entrapment:
scalenes- adson, allen
pec minor- wrights
clavicular- military
Test stuff
cervical spine
apex c5/c6
forward head, excessive nerve compression
most common neck pain
close intervert. space
compress nerve and facets
wear down cartilage
early degeneration disc
c1/c2 rotation
c5-c8/t1
c5-c8/t1- brachial plexus comes from
know knee stuff
tests
everything
review end feels
PROM- jt
inert and contractial tissue
overlengthen mm weakens
tendon stuff
2-24-12 Friday
WE FINISHED PHYS/PATH!!!!!!!!!!!!!!!!!!!
ASSESSMENT:
do the 4 assessments
Review:
traumatic injury
HOPRS
TOS test: adson, allens, wright, military
arom, rom, mrt
dermatomes
myatomes
p.27 end feel types; resistance barriers-empty, spasm, bony, springy block, soft tissue approximation, stretch
stuff with neck
other arm tests; rotator cuff
Today-
knee: flexion and extension in sagital plane
genu valgum: knocked knees
genu varum: bow legged
valgum: pronated/everted feet; MCL is lengthened--tight adductors
varum: supinated/inverted feet; tight lateral rotators and IT band
ASSESSMENT:
do the 4 assessments
Review:
traumatic injury
HOPRS
TOS test: adson, allens, wright, military
arom, rom, mrt
dermatomes
myatomes
p.27 end feel types; resistance barriers-empty, spasm, bony, springy block, soft tissue approximation, stretch
stuff with neck
other arm tests; rotator cuff
Today-
knee: flexion and extension in sagital plane
genu valgum: knocked knees
genu varum: bow legged
valgum: pronated/everted feet; MCL is lengthened--tight adductors
varum: supinated/inverted feet; tight lateral rotators and IT band
Wednesday, February 22, 2012
2-22-12 Wednesday
PATH
Reproduction
3 glands for men
prostate
seminal vesicle
bulbourethral (Cowper) gland
Seminiferous tubules: inside testes; sperm is being made
**LH (Luteinizing hormone): from pituitary to produce sperm
FSH: primary pusher of sperm? divide?
p.383
epidiymis: one tube folded many time; sperm mature, holding till ejaculation
sperm: acrosome (helmet)- lysomones? (digestive enzymes) to get into egg
mitochondria- ATP energy to swim
Vas deferens: smooth mm
*seminal vesicle-provide food for sperm
*prostate- marines; alkaline for neutralising acid in vagina
cowper gland: greasing- keep things moving (like goblet cells)
ejaculation: point and shoot- parasympathetic (erection); sympathetic (ejaculation)
corpor cavernosa: blood supply (pinched for erection)
corpus spongiosum: no pinching because stuff still needs to come out (urethra)
Ovaries-eggs
ovarian ligament
fallopian tube- fimbriae (hair like things to catch egg)
cuboidal cells move egg
uterus
cervix; neck b/w vagina and uterus
vagina
Hormones p.388
high FSH, LH (negative feed back)
**first half of cycle is estrogen based
1st part: follicular phase (ovary)
proliferative phase (uterus)
LH spike; folicle pops and get egg out
2nd part: Luteal phase (ovary)- progesterone high
Secretory phase (uterus)- mucus gets sticky
Stuff happens to keep hormones going if egg gets fertalised
Path
Abortion, spontaneous and elective
third of all pregnancy; 50% before even recognised
not anyone's fault: genetics didn't take
risk: smoking, infection, toxins, nutritional, etc
Fibroids: masses growing in uterus
miscarriage usually within 14 weeks
after 20 weeks it is called a still birth
comp: hemorrhage, depression
Tx: TLC
Cervical Cancer
HPV strand 16 and 18
dysplasia- precancerous changes
men are common carriers of HPV
Dx: colposcopy, pap smear
Dysmenorrhea: painful menstrual period
limiting activity, very common
secondary from infection
S&S: ache to cramping
Dx: could be more serious
reduce fats
Endometriosis: endometrial tissue est. elsewhere (tour)
will respond to menstral periods
spread through circulatory and lymph
can lead to infertility
adhere to other areas
Fibroid tumors: aka: leiomyoma- benign tumor in/around uterine wall
small to very large
estrogen stimulates growth
Uterine Cancer: 40yrs plus, average age 60, after/during menopause
too much estrogen is prob
adenocarcinoma=glandular
Breast Cancer
tail of breast goes up to axilla
*1st sings: small painless lump in breast tissue or axilla; asymmetrical
risk of spread
getting older, estrogen, drinking, chest radiation
Tx: surgery and radiation, triple negative?
Ovarian cancer: usually 60 or older
Ovarian Cysts: fluid masses on ovaries
can interfere with ovulation
women still in reproductive phase
aka Stein-leventhal syndrome
may have increase testosterone giving men characteristics
Benign prostatic hyperplasia: swelling of prostate
*Dihydrotestosterone- too much of this
Prostate Cancer: slow growing tumor, all men will get this if they live long enough
Prostatitis: inflammation of prostate
Testicular cancer: up to age 35 and after 60
feels like rice
Menopause: normal stage of life
S&S are worse with depleated adrenals
Massage is great!
Pregnancy
Premenstrual syndrome: pms
STD (STI's)
gonorrhea
clamidia
fungal infection
syphilis- painless white lesions
GOOD LUCK ALL ON THE COMPREHENSIVE FINAL FRIDAY!!!
Reproduction
3 glands for men
prostate
seminal vesicle
bulbourethral (Cowper) gland
Seminiferous tubules: inside testes; sperm is being made
**LH (Luteinizing hormone): from pituitary to produce sperm
FSH: primary pusher of sperm? divide?
p.383
epidiymis: one tube folded many time; sperm mature, holding till ejaculation
sperm: acrosome (helmet)- lysomones? (digestive enzymes) to get into egg
mitochondria- ATP energy to swim
Vas deferens: smooth mm
*seminal vesicle-provide food for sperm
*prostate- marines; alkaline for neutralising acid in vagina
cowper gland: greasing- keep things moving (like goblet cells)
ejaculation: point and shoot- parasympathetic (erection); sympathetic (ejaculation)
corpor cavernosa: blood supply (pinched for erection)
corpus spongiosum: no pinching because stuff still needs to come out (urethra)
Ovaries-eggs
ovarian ligament
fallopian tube- fimbriae (hair like things to catch egg)
cuboidal cells move egg
uterus
cervix; neck b/w vagina and uterus
vagina
Hormones p.388
high FSH, LH (negative feed back)
**first half of cycle is estrogen based
1st part: follicular phase (ovary)
proliferative phase (uterus)
LH spike; folicle pops and get egg out
2nd part: Luteal phase (ovary)- progesterone high
Secretory phase (uterus)- mucus gets sticky
Stuff happens to keep hormones going if egg gets fertalised
Path
Abortion, spontaneous and elective
third of all pregnancy; 50% before even recognised
not anyone's fault: genetics didn't take
risk: smoking, infection, toxins, nutritional, etc
Fibroids: masses growing in uterus
miscarriage usually within 14 weeks
after 20 weeks it is called a still birth
comp: hemorrhage, depression
Tx: TLC
Cervical Cancer
HPV strand 16 and 18
dysplasia- precancerous changes
men are common carriers of HPV
Dx: colposcopy, pap smear
Dysmenorrhea: painful menstrual period
limiting activity, very common
secondary from infection
S&S: ache to cramping
Dx: could be more serious
reduce fats
Endometriosis: endometrial tissue est. elsewhere (tour)
will respond to menstral periods
spread through circulatory and lymph
can lead to infertility
adhere to other areas
Fibroid tumors: aka: leiomyoma- benign tumor in/around uterine wall
small to very large
estrogen stimulates growth
Uterine Cancer: 40yrs plus, average age 60, after/during menopause
too much estrogen is prob
adenocarcinoma=glandular
Breast Cancer
tail of breast goes up to axilla
*1st sings: small painless lump in breast tissue or axilla; asymmetrical
risk of spread
getting older, estrogen, drinking, chest radiation
Tx: surgery and radiation, triple negative?
Ovarian cancer: usually 60 or older
Ovarian Cysts: fluid masses on ovaries
can interfere with ovulation
women still in reproductive phase
aka Stein-leventhal syndrome
may have increase testosterone giving men characteristics
Benign prostatic hyperplasia: swelling of prostate
*Dihydrotestosterone- too much of this
Prostate Cancer: slow growing tumor, all men will get this if they live long enough
Prostatitis: inflammation of prostate
Testicular cancer: up to age 35 and after 60
feels like rice
Menopause: normal stage of life
S&S are worse with depleated adrenals
Massage is great!
Pregnancy
Premenstrual syndrome: pms
STD (STI's)
gonorrhea
clamidia
fungal infection
syphilis- painless white lesions
GOOD LUCK ALL ON THE COMPREHENSIVE FINAL FRIDAY!!!
Monday, February 20, 2012
2-20-12 Monday
ASSESSMENT
AROM test contractibility of afflicted mm; person is active in motion; this is why we test in Single Planes: isolate mms
PROM assesses inert tissue: lig, jt. capsule, bursa
what you feel for is End Feel: bony, soft tissue approximation, tissue stretch (sloppy), spasm, springy block, empty (p.27)
test good side first
any acute injury is 6 wks heal time (generally speaking)
H-history
O-observation
P-palpation
R-resistive testing
S-special tests
habitual posture- upper cross syndrome is most common (I don't remember what this is about)
creates excessive nerve compression C5 and C6 (known as apex of cervical spine)
**Brachial plexus- C5-C8 (8?): radial/ulnar/media nerve
posture influenced by 3 things (for us): heredity, injury (acute/chronic), habit
FHP: foward head posture
c-spine into extension
Dermatome: area of skin that is supplied by sensory nerve
myoto: mm by motor nerve
sensory vs. motor nerves
Thoracic Outlet Syndrome TOS
possible areas for impingement/ nerve entrapment (not all for TOS)
1 level of spine- arthritis or disc structural
2 scalenes
3 clavical, 1 and 2 ribs
4 pec minor
5 deltoids
6 elbow: supinators/pronators, anconious, distal triceps
7 carpal tunnel
Adson test: anterior scalene
Allen test: middle scalene
Military test: 1st rib and clavicle
Wright abduction: pec minor (white hand sign)
pulse can be said to diminish
Empty can
Hawking-Kennedy (multi-plane passive test)
Flexion
Abduction 45 and 90 degree
cross over test: A/C jt.
CHAIR MASSAGE
address main complaint of client
show client how to get in and out of chair
**1st thing you do is adjust height of the seat
Finishing strokes: nerve strokes are up for energy
tie body in with arm
5 topics
main c/o (focus)
tender
trigger
when does it feel better
pressure
areas to try chair massages:
school functions
mall
airports
farmers' market
sports events
main st. functions
banks, etc.
contact person gets freebie
AROM test contractibility of afflicted mm; person is active in motion; this is why we test in Single Planes: isolate mms
PROM assesses inert tissue: lig, jt. capsule, bursa
what you feel for is End Feel: bony, soft tissue approximation, tissue stretch (sloppy), spasm, springy block, empty (p.27)
test good side first
any acute injury is 6 wks heal time (generally speaking)
H-history
O-observation
P-palpation
R-resistive testing
S-special tests
habitual posture- upper cross syndrome is most common (I don't remember what this is about)
creates excessive nerve compression C5 and C6 (known as apex of cervical spine)
**Brachial plexus- C5-C8 (8?): radial/ulnar/media nerve
posture influenced by 3 things (for us): heredity, injury (acute/chronic), habit
FHP: foward head posture
c-spine into extension
Dermatome: area of skin that is supplied by sensory nerve
myoto: mm by motor nerve
sensory vs. motor nerves
Thoracic Outlet Syndrome TOS
possible areas for impingement/ nerve entrapment (not all for TOS)
1 level of spine- arthritis or disc structural
2 scalenes
3 clavical, 1 and 2 ribs
4 pec minor
5 deltoids
6 elbow: supinators/pronators, anconious, distal triceps
7 carpal tunnel
Adson test: anterior scalene
Allen test: middle scalene
Military test: 1st rib and clavicle
Wright abduction: pec minor (white hand sign)
pulse can be said to diminish
Empty can
Hawking-Kennedy (multi-plane passive test)
Flexion
Abduction 45 and 90 degree
cross over test: A/C jt.
CHAIR MASSAGE
address main complaint of client
show client how to get in and out of chair
**1st thing you do is adjust height of the seat
Finishing strokes: nerve strokes are up for energy
tie body in with arm
5 topics
main c/o (focus)
tender
trigger
when does it feel better
pressure
areas to try chair massages:
school functions
mall
airports
farmers' market
sports events
main st. functions
banks, etc.
contact person gets freebie
Saturday, February 18, 2012
2-17-12 Friday
PHYS/PATH
Bladder Cancer: development of malignant cells in bladder
risk smoking; median age: 73 (so older people get this not likely in younger)
alcohol, dyes, environment
Prognosis: usually found earlier, better odds, slow moving
blood in urine
Interstitial Cystitis (IC): something irritate bladder
dysuria: pain with peeing
W>M
worse thing you can do is drink cranberry juice (unsweetened)
**Hunner ulcers; pathoneumonia, pinpoint hemorrahages
protective shield isn't working
S&S: chronic pelvic pain, pain and burning
Dx: rule out UTI, ggenital herpes, cancer
Tx: find irritant
Urinary Tract Infection (UTI): anywhere lower urinary system
W>M (shorter urethra) men more likely to have STD
microorganism in urethra
90% from Escherichia coli (E. coli)- fecal matter
irritation (honeymoon cystitis) pee after sex please
risk: soaps, spermicide, diaphragm use, diabetes, color toilet paper
S&S: cloudy/bloody urine, pain urination, pelvic/ab/LB pain
worry about it getting to kidneys
Tx: hydration, blueberry/cranberry juice (unsweetened), antibiotics
prevention: hydration
M: contra due to active infection
Phys chap 17 digestive system
chief function: digest, absorb, eliminate
organs: digestive tract, accessory organs
starts 15-20 min before eating
80% of immune system
Wall digest syst.
mucous membrane (mucosa)
-digestive juice, secreting cells
-mucus secreting (goblet) cells
submucosa
-connective tissue
-contains blood vessels and nerves help regulate digest
smooth mm
*-inner layer-circular
*-outer layer-longitudinal
*-peristalsis-action potential and mm contractions (food moved through)
serous membrane
-epithelium
-loose connective tissue
Peritoneum: membrane that lines the ab cavity
-perietal peritoneum
-visceral peritoneum
-mesentery-fascia holding around everything
-mesocolon
-greater omentum
-lesser omentum
peritoneal cavity; space b/w 2 layers
Alimentary tract or GI tract
mouth, pharynx, esophagus, stomach, small/large intestine
Mouth: ingestion, mastication, mixing with saliva amalates deglutition
deciduous teeth are baby teeth
Pharynx: throat
Esophagus: muscular tube, no digestion, joins with stomach, esophageal hiatus
Stomach: structure
fundus: top
lesser/greater curvature
*oblique, circular, longitudinal mm
*rugae in stomach not intestine- folds in stomach increase surface area
*pyloric sphincter: junction b/w stomach and small intestine
Function: store food and liquid
secrete gastric juice (hydrochhloric acid: and pepsin * digesting proteins(in stomach)
secrete mucus
chyme: highly acidic mixture of gastric juice and food that leaves the stomach for the small intestine
parietal cells
-HCl
-intrinsic factors to digest b12
chief cells
-pepsinogen--pepsin
Small intestine: struct
duodenum: pyloric sphincter, not too long
Jejunum: majority of absorption of nutrients
ileum: b12, calcium
-connects with large intestine via ileocecal valve
Function: secrete mucus
secrete enzymes
absorb digested food
-villi
-microvilli
-blood vessels
-specialised lymphatic capillaries (lacteal)
Large intestine struct
-cecum
-ileocecal valve
-vermiform appendix
-colon: ascending, transverse, descending, sigmoid
-rectum
-anal canal
-anus
function
secrete mucus
reabsorb water (main function)
defecation (main function)
form feces (stool)
Accessory organs
salivary glands to mouth
all other organs to duodenum
bile-absorb fat soluable vitamin
The liver
right, left, (middle) lobes, portal vein, hepatic artery
function: manufacture bile, store glucagen, convert to glucose, modify fats, store vitamins, iron, etc
Gallbladder: store bile, flow through cystic duct
Pancreas: enzymes are released from here, insulin, glucagon
Enzymes: speed things up (reaction), specific, not used up, are protein
water: dilute fluid
absorption
-fats-lacteals
-vits and mins
control digestion
parasympathetic keeps it going
sympathetic
hormonal
-cholecystokonin (CCK): stop eating H., release enzymes
Hunger (hypothalaic) vs appetite (no relation to need)
Path
Celiac Disease: villi are flattened, destroyed due to gluten
gluten sensitive enteropathy (in b/w - milder symptoms)
whites 1:133
autoimmune reaction: wheat, barley, rye
malabsorption; inflam response
S&S: GI pain, gas, bloating, diarrhea
complication: anemia, folic acid deficiency, osteoporosis, delayed growth
Dx: antibody test
irritable bowel syndrome, crohn
Tx: no gluten
Crohn disease: part of IBS; intestines are swelling in/ limiting space; can cause fistula (tunnel to get poop out)
disconnected patches of inflam and damage along GI tract
can be anywhere in body from mouth to anus; **ileum most common place**
type A: m=w, whites, young and old
**swelling; fistulas-tunnels
S&S: flares/remission; ab pain, cramping, weight loss, fever
Tx: steroids, immunosuppressant
Esophageal Cancer: malignant cell; squamous cell (proximal end) carcinoma/ adenocarinoma (distal end)
hot fluids, smoking, GERD-heartburn
S&S: swallowing problems
Dx: Barium, swallowing
Gastroenteritis (aka stomach flu): inflam stomach/ small intestine infection
most dangerous with young and old
etiology: pathogens, invaders
absorption of H2o disrupted
causes: viruses: hep a,b,c; norwalk 50-70% of cases
bacteria: salmonella, E. coli, H pylori (peptic ulcer)
parasites: *giardia- contaminated water - fecal oral
others: *funis (candidiasis)* in intestines
oral fecal, contaminated water/ice; food prep.
S&S: ab pain, nausea, vomiting, bloating, cramp
comp: *dehydration, guillian-barre
prog: most resolve 2-3 days
Gastroesophageal Reflux Disease (GERD): problem with lower esophageal sphincter
4 problems: LES to relaxed, doesn't allow clear out etc.
acid reflux
respiratory injury, decay teeth, ulcers, stricture, barrett esoph.
risk: prego, obesity, smoke, diet, tumor
S&S: heartburn, angina, pain in chest
Peptic Ulcers: erosion in esophagus, stomach, duodenum; open sore invitation for infect; hole in stuff
Factors:
stress, h Pylori, NSAIDs-asprin, ibuprotfen
S&S: Gnawing burning pain in chest
comp: bleeding, hemorrhage, peritonitis
Stomach cancer
M>W; alcohol, H. pylori, preservatives, diet, tobacco
S&S: ab pain, ascites (swell ab), unitentional weight loss
Dx: seldom found before tour
Colorectral Cancer: large intestine
over cooked meat
#2 cause of death from cancer
polyps
causes: high fat foods, fiber something:
risk: sedentary life, weight, IBDs, age
*S&S: silent early, change in bowel mvmt, older, unintentional weight loss
prevention: diet
Diverticular Disease: bulge in colon form diverticulum
diverticulosis: presence of bulges
diverticulitis: infection of bulges
S&S: left side appendicitis, older folks, may be silent, fever, cramp, pain
Irritable Bowel Syndrome: digestive dysfunction
w/o structural changes
w>M
imbalances
S&S: ab pain, no structural changes in colon
M=+
Ulcerative colitis: inflam, ulcers in large intestine (opposite crohns)
lining been eroded/thining
gluten
stop bleeding!
nutritional disease; arthritis, skin stuff
S&S: anemia
M: no deep tissue
cirrhosis: replacement of healthy hepatocytes with nofunctioning scar tissue
shorten life span 22 years
chronic inflam state
causes: alcohol, hepatitis b,c,d
*hep A (a ok) doesn't lead to cirrhosis or liver cancer
NAFLD: nonalcoholic fatty liver disease
NASH: nonalcoholic steatohepatitis
S&S: silent/subtel, vomit, weight loss
comp: splenomegaly
jaundice
Tx: don't drink
M; careful no swedish/deep work
Gallstones: **most gallsones made of cholesterol in our society
fair
forty
fertile
fat
female
can be life threatening if blocks pancreas
Hepatitis: inflammation liver; viral; lead to jaundice
A: short term; fecal oral
B: long term; 6 month=chronic phase
transmit from body fluids; can last a long time outside body
C: more likely develop cirrhosis, liver cancer, alcoholism more common with sex
D: have to have B or C
Liver Cancer: hepatocellular carcinoma
hep B, C, alcohol too much iron, grain and peanuts
pancreatic cnacer
**more common in men
"what's digesting us?"
very aggressive; 1% survival, aggressive
risk: age, m, black, smoke, type 2, no vegs
Pancreatitis: acute inflammation
**gallstones and alcohol most common cause; 12 out of 10 pain
S&S: fat in smelly stool
Candidiasis: fungus in intestinal tract
Peritonitis: life threatening infect parientneal layer
Bladder Cancer: development of malignant cells in bladder
risk smoking; median age: 73 (so older people get this not likely in younger)
alcohol, dyes, environment
Prognosis: usually found earlier, better odds, slow moving
blood in urine
Interstitial Cystitis (IC): something irritate bladder
dysuria: pain with peeing
W>M
worse thing you can do is drink cranberry juice (unsweetened)
**Hunner ulcers; pathoneumonia, pinpoint hemorrahages
protective shield isn't working
S&S: chronic pelvic pain, pain and burning
Dx: rule out UTI, ggenital herpes, cancer
Tx: find irritant
Urinary Tract Infection (UTI): anywhere lower urinary system
W>M (shorter urethra) men more likely to have STD
microorganism in urethra
90% from Escherichia coli (E. coli)- fecal matter
irritation (honeymoon cystitis) pee after sex please
risk: soaps, spermicide, diaphragm use, diabetes, color toilet paper
S&S: cloudy/bloody urine, pain urination, pelvic/ab/LB pain
worry about it getting to kidneys
Tx: hydration, blueberry/cranberry juice (unsweetened), antibiotics
prevention: hydration
M: contra due to active infection
Phys chap 17 digestive system
chief function: digest, absorb, eliminate
organs: digestive tract, accessory organs
starts 15-20 min before eating
80% of immune system
Wall digest syst.
mucous membrane (mucosa)
-digestive juice, secreting cells
-mucus secreting (goblet) cells
submucosa
-connective tissue
-contains blood vessels and nerves help regulate digest
smooth mm
*-inner layer-circular
*-outer layer-longitudinal
*-peristalsis-action potential and mm contractions (food moved through)
serous membrane
-epithelium
-loose connective tissue
Peritoneum: membrane that lines the ab cavity
-perietal peritoneum
-visceral peritoneum
-mesentery-fascia holding around everything
-mesocolon
-greater omentum
-lesser omentum
peritoneal cavity; space b/w 2 layers
Alimentary tract or GI tract
mouth, pharynx, esophagus, stomach, small/large intestine
Mouth: ingestion, mastication, mixing with saliva amalates deglutition
deciduous teeth are baby teeth
Pharynx: throat
Esophagus: muscular tube, no digestion, joins with stomach, esophageal hiatus
Stomach: structure
fundus: top
lesser/greater curvature
*oblique, circular, longitudinal mm
*rugae in stomach not intestine- folds in stomach increase surface area
*pyloric sphincter: junction b/w stomach and small intestine
Function: store food and liquid
secrete gastric juice (hydrochhloric acid: and pepsin * digesting proteins(in stomach)
secrete mucus
chyme: highly acidic mixture of gastric juice and food that leaves the stomach for the small intestine
parietal cells
-HCl
-intrinsic factors to digest b12
chief cells
-pepsinogen--pepsin
Small intestine: struct
duodenum: pyloric sphincter, not too long
Jejunum: majority of absorption of nutrients
ileum: b12, calcium
-connects with large intestine via ileocecal valve
Function: secrete mucus
secrete enzymes
absorb digested food
-villi
-microvilli
-blood vessels
-specialised lymphatic capillaries (lacteal)
Large intestine struct
-cecum
-ileocecal valve
-vermiform appendix
-colon: ascending, transverse, descending, sigmoid
-rectum
-anal canal
-anus
function
secrete mucus
reabsorb water (main function)
defecation (main function)
form feces (stool)
Accessory organs
salivary glands to mouth
all other organs to duodenum
bile-absorb fat soluable vitamin
The liver
right, left, (middle) lobes, portal vein, hepatic artery
function: manufacture bile, store glucagen, convert to glucose, modify fats, store vitamins, iron, etc
Gallbladder: store bile, flow through cystic duct
Pancreas: enzymes are released from here, insulin, glucagon
Enzymes: speed things up (reaction), specific, not used up, are protein
water: dilute fluid
absorption
-fats-lacteals
-vits and mins
control digestion
parasympathetic keeps it going
sympathetic
hormonal
-cholecystokonin (CCK): stop eating H., release enzymes
Hunger (hypothalaic) vs appetite (no relation to need)
Path
Celiac Disease: villi are flattened, destroyed due to gluten
gluten sensitive enteropathy (in b/w - milder symptoms)
whites 1:133
autoimmune reaction: wheat, barley, rye
malabsorption; inflam response
S&S: GI pain, gas, bloating, diarrhea
complication: anemia, folic acid deficiency, osteoporosis, delayed growth
Dx: antibody test
irritable bowel syndrome, crohn
Tx: no gluten
Crohn disease: part of IBS; intestines are swelling in/ limiting space; can cause fistula (tunnel to get poop out)
disconnected patches of inflam and damage along GI tract
can be anywhere in body from mouth to anus; **ileum most common place**
type A: m=w, whites, young and old
**swelling; fistulas-tunnels
S&S: flares/remission; ab pain, cramping, weight loss, fever
Tx: steroids, immunosuppressant
Esophageal Cancer: malignant cell; squamous cell (proximal end) carcinoma/ adenocarinoma (distal end)
hot fluids, smoking, GERD-heartburn
S&S: swallowing problems
Dx: Barium, swallowing
Gastroenteritis (aka stomach flu): inflam stomach/ small intestine infection
most dangerous with young and old
etiology: pathogens, invaders
absorption of H2o disrupted
causes: viruses: hep a,b,c; norwalk 50-70% of cases
bacteria: salmonella, E. coli, H pylori (peptic ulcer)
parasites: *giardia- contaminated water - fecal oral
others: *funis (candidiasis)* in intestines
oral fecal, contaminated water/ice; food prep.
S&S: ab pain, nausea, vomiting, bloating, cramp
comp: *dehydration, guillian-barre
prog: most resolve 2-3 days
Gastroesophageal Reflux Disease (GERD): problem with lower esophageal sphincter
4 problems: LES to relaxed, doesn't allow clear out etc.
acid reflux
respiratory injury, decay teeth, ulcers, stricture, barrett esoph.
risk: prego, obesity, smoke, diet, tumor
S&S: heartburn, angina, pain in chest
Peptic Ulcers: erosion in esophagus, stomach, duodenum; open sore invitation for infect; hole in stuff
Factors:
stress, h Pylori, NSAIDs-asprin, ibuprotfen
S&S: Gnawing burning pain in chest
comp: bleeding, hemorrhage, peritonitis
Stomach cancer
M>W; alcohol, H. pylori, preservatives, diet, tobacco
S&S: ab pain, ascites (swell ab), unitentional weight loss
Dx: seldom found before tour
Colorectral Cancer: large intestine
over cooked meat
#2 cause of death from cancer
polyps
causes: high fat foods, fiber something:
risk: sedentary life, weight, IBDs, age
*S&S: silent early, change in bowel mvmt, older, unintentional weight loss
prevention: diet
Diverticular Disease: bulge in colon form diverticulum
diverticulosis: presence of bulges
diverticulitis: infection of bulges
S&S: left side appendicitis, older folks, may be silent, fever, cramp, pain
Irritable Bowel Syndrome: digestive dysfunction
w/o structural changes
w>M
imbalances
S&S: ab pain, no structural changes in colon
M=+
Ulcerative colitis: inflam, ulcers in large intestine (opposite crohns)
lining been eroded/thining
gluten
stop bleeding!
nutritional disease; arthritis, skin stuff
S&S: anemia
M: no deep tissue
cirrhosis: replacement of healthy hepatocytes with nofunctioning scar tissue
shorten life span 22 years
chronic inflam state
causes: alcohol, hepatitis b,c,d
*hep A (a ok) doesn't lead to cirrhosis or liver cancer
NAFLD: nonalcoholic fatty liver disease
NASH: nonalcoholic steatohepatitis
S&S: silent/subtel, vomit, weight loss
comp: splenomegaly
jaundice
Tx: don't drink
M; careful no swedish/deep work
Gallstones: **most gallsones made of cholesterol in our society
fair
forty
fertile
fat
female
can be life threatening if blocks pancreas
Hepatitis: inflammation liver; viral; lead to jaundice
A: short term; fecal oral
B: long term; 6 month=chronic phase
transmit from body fluids; can last a long time outside body
C: more likely develop cirrhosis, liver cancer, alcoholism more common with sex
D: have to have B or C
Liver Cancer: hepatocellular carcinoma
hep B, C, alcohol too much iron, grain and peanuts
pancreatic cnacer
**more common in men
"what's digesting us?"
very aggressive; 1% survival, aggressive
risk: age, m, black, smoke, type 2, no vegs
Pancreatitis: acute inflammation
**gallstones and alcohol most common cause; 12 out of 10 pain
S&S: fat in smelly stool
Candidiasis: fungus in intestinal tract
Peritonitis: life threatening infect parientneal layer
Thursday, February 16, 2012
2-15-12 Wednesday
PHYS/PATH
Alpha 1 and barrel chest=emphysema
Formation of urine
glomerular filtration
glomerular filtrate
tubular reabsorption
diffusion
osmosis (same as diffusion but with water)
active transport - requires ATP
Tubular secretion
**countercurrent mechanism
concentration of urine
antidiuretic hormone ADH, reabsorb more water
drink more, more dilute urine; less fluid= less dilute
65% reabsorb in proximal convoluted tube
Control bp
-juxtaglomerular apparatus: specialised cells that regulate kidney function
Triggered by low bp
-secretes renin enzyme
(Dr. Lou drew a picture)
ureters: long slender, mm tubes
epithelial, involuntary
gravity
urinary bladder: transitional epithelium
multi-layer, mucous membrane, 3 layer involuntary mm
urethra
urination (peeing aka micturition)
involuntary, internal urethral sphincter
voluntary, external urethral sphincter
urine
95% water, 5% dissolved solids and gases
pH ave 6.0
specific gravity measures amount of dissolved substance
-normal range 1.002 to 1.040
Normal constituents
-nitrogenous waste: urea, uric acid, creatine
-Electrolytes: sodium chloride, sulfates, phosphates
-pigments
Abnormal const.
-glucose, albumin, blood, ketones, wbc, casts
Body fluids: maintenance; thirst, kidneys, H. , buffers
Sense thirst: hypothalmus
electrolytes: positive and negative ions
aldosterone adrenal cortex
Pathology
Kidney Stones: crystals develop in renal pelvis
people who are dehydrated; M>W, whites
types: calcium oxalate (most commmon)
S&S: silent until stuck; pain, may have referal pain, fever
can cause renal failure
Pyelonephritis: infection of nephrons
acute or chronic, can die from this
S&S: infection, fever, pain/ tender to touch, cloudy pee
preg, diabetes, contaminated medical instruments
chronic silent with damage
comp. sepsis, scarring, renal failure
Tx: antibiotics
M: contra
Renal Failure: not function with demands
acute: pre/intra/post renal problems
chronic: stages
people with hypertension, diabetes, blacks
loss EPO= decrease rbc leads to anemia
Tx: control symptoms
M: ? be careful, energy work ok
ORTHO ASSESSMENT
Orthopedic: involves assessing disorders of: locomotion, joints, ligaments, tendons, mm, nerve, fascia
Assessment: gathering information and ruling out
Acute vs Chronic
FORCES that destroy soft tissue:
compression: 2 struct. come together with force
tension: pulling apart
shear: opposite force b/w 2 surfaces
torsion: rotary component (ACL, MCL, - knee)
bending: bone; just short of breaking
MM
concentric: bringing 2 end together (shorten and strenghten/ TrPs)
eccentric: contraction with elongation (lengthens, weakens/ TrPs)
isometric: contraction w/o movement
Atrophy: wasting away of mm tissue
due to disuse (48hrs)
denervation: interruption of nerve impulse
Strain: first to third degree
contusion: blunt force trauma
Tendon: transmits contraction from mm to bone
afflictions (4)
1) tendinosis: no inflammation, chronic, degenerative
2) tendonitis: inflammation, and tearing sheath
3) tenosynovitis: inflammation in and around sheath; no tearing
4) avulsion: separation from bone (achilles most common)
Ligaments- sprains (first to third degree)
inert tissue: unable to move or resist motion; because lack of recoil
acute lead to chronic due to lack of recoil/ ligament laxity
dense collagen
Joint capsule-example, tearing labrum of shoulder (whatever that is)
Alpha 1 and barrel chest=emphysema
Formation of urine
glomerular filtration
glomerular filtrate
tubular reabsorption
diffusion
osmosis (same as diffusion but with water)
active transport - requires ATP
Tubular secretion
**countercurrent mechanism
concentration of urine
antidiuretic hormone ADH, reabsorb more water
drink more, more dilute urine; less fluid= less dilute
65% reabsorb in proximal convoluted tube
Control bp
-juxtaglomerular apparatus: specialised cells that regulate kidney function
Triggered by low bp
-secretes renin enzyme
(Dr. Lou drew a picture)
ureters: long slender, mm tubes
epithelial, involuntary
gravity
urinary bladder: transitional epithelium
multi-layer, mucous membrane, 3 layer involuntary mm
urethra
urination (peeing aka micturition)
involuntary, internal urethral sphincter
voluntary, external urethral sphincter
urine
95% water, 5% dissolved solids and gases
pH ave 6.0
specific gravity measures amount of dissolved substance
-normal range 1.002 to 1.040
Normal constituents
-nitrogenous waste: urea, uric acid, creatine
-Electrolytes: sodium chloride, sulfates, phosphates
-pigments
Abnormal const.
-glucose, albumin, blood, ketones, wbc, casts
Body fluids: maintenance; thirst, kidneys, H. , buffers
Sense thirst: hypothalmus
electrolytes: positive and negative ions
aldosterone adrenal cortex
Pathology
Kidney Stones: crystals develop in renal pelvis
people who are dehydrated; M>W, whites
types: calcium oxalate (most commmon)
S&S: silent until stuck; pain, may have referal pain, fever
can cause renal failure
Pyelonephritis: infection of nephrons
acute or chronic, can die from this
S&S: infection, fever, pain/ tender to touch, cloudy pee
preg, diabetes, contaminated medical instruments
chronic silent with damage
comp. sepsis, scarring, renal failure
Tx: antibiotics
M: contra
Renal Failure: not function with demands
acute: pre/intra/post renal problems
chronic: stages
people with hypertension, diabetes, blacks
loss EPO= decrease rbc leads to anemia
Tx: control symptoms
M: ? be careful, energy work ok
ORTHO ASSESSMENT
Orthopedic: involves assessing disorders of: locomotion, joints, ligaments, tendons, mm, nerve, fascia
Assessment: gathering information and ruling out
Acute vs Chronic
FORCES that destroy soft tissue:
compression: 2 struct. come together with force
tension: pulling apart
shear: opposite force b/w 2 surfaces
torsion: rotary component (ACL, MCL, - knee)
bending: bone; just short of breaking
MM
concentric: bringing 2 end together (shorten and strenghten/ TrPs)
eccentric: contraction with elongation (lengthens, weakens/ TrPs)
isometric: contraction w/o movement
Atrophy: wasting away of mm tissue
due to disuse (48hrs)
denervation: interruption of nerve impulse
Strain: first to third degree
contusion: blunt force trauma
Tendon: transmits contraction from mm to bone
afflictions (4)
1) tendinosis: no inflammation, chronic, degenerative
2) tendonitis: inflammation, and tearing sheath
3) tenosynovitis: inflammation in and around sheath; no tearing
4) avulsion: separation from bone (achilles most common)
Ligaments- sprains (first to third degree)
inert tissue: unable to move or resist motion; because lack of recoil
acute lead to chronic due to lack of recoil/ ligament laxity
dense collagen
Joint capsule-example, tearing labrum of shoulder (whatever that is)
Tuesday, February 14, 2012
2-13-12 Monday
PHYS/PATH
Abnormal ventilation
hyperventilation
-high 02/low co2 (hypocapnea)
-increase blood pH
Hypoventilation
-insufficient air in alveoli
-decrease in blood pH
Breathing Pattern
adults: 12-20 breath/min
kids: 20-40
infants: 40+
Altered breath
hyperpnea: increase depth and rate of breathing
hypopnea: decrease rate and depth
tachypnea: excessive rate of breathing (exercise)
apnea: cessation of breathing
dyspnea: difficult/labored breathing
orthopnea: difficult breathing relieved by sitting up
Kussmaul respiratory: abnormal
Cheyne-Stokes respiratory: final breath in death
inadequate breathing
cyanosis: turning blue/purple- lack of O2
hypoxia: not enough o2 in tissue
hypoxemia: lower than normal o2 in arterial blood
suffocation: cessation of respiration/ mechanical blockage
Age-less likely to get fever with lung infection
rigid
PATH
chap 7
Acute Bronchitis: inflammation of bronchial tree
usually viral
smokers, miners more likely
elderly and immunosuppressed
tube swells, cilia damaged, mucous not getting out
last 10 days
S&S: cough, starts dry becomes productive; fever, mm aches, chest pain, fatigue
If 101F or more, possible pneumonia
Tx: warm, humid air, rest
M: contra because acute infection/ you at risk
Common Cold: 200 viruses, upper resp. tract infect (URTI)
last about a week
should be getting 1-2/yr.
etiology: rhinoviruses,
coronaviruses
adenoviruses
resp. syncytial viruses: can infect epiglottis- life threatening
incubation 12hrs
s&s: runny nose, sneezing ....
less than 2 wks
may go to lungs
OTC prolong, vit c (acidic blood), echinacea, rest, fluids
hydro: hot water on feet (soak), cold socks on with wool socks over, lay down; or cold on forehead or opposite
M: no
Influenza: viral infect of lungs
higher fever, mm aches, head aches
most worried with young, old, immunosuppressed
type A: can transfer with species: associated with epidemics; mutates easily
type B,C: mild
incubation: 2-3 days, airborne
S&S: cad cold: 2 wks, no such thing as stomach flu (endnovirus?)
don't eat solid foods during high fever because GI isn't working
vaccine picks the most likely
Pneumonia: infection in lung itself (kids; viral. adults; bacteria (usually))
gas exchange isn't happening: drown in own secretion
consolidation: fluid gets solid
BAD SICK
alveoli filled with pus
infect of pleural fluid (empyema)
cause: viruses, short lived, not serious for most
bacteria more serious, more sick; diff dx: tuberculosis or legionella
mycoplasma: walking pneumonia
fungi: PCP in immunosuppressed
Forms of pneumonia
-primary: rare attack on lungs
-secondary: more common; complication from other problem
double pneumonia is having it in both lungs
nosocomial: hospital acquired
S&S: can look like flu but more intense
Sinusitis: inflammation mucous membrane in nose/sinuses
infection or allergies, weather etc.
can have teeth sensitivity
cause-
acute or chronic(6months)
irritants, smoke, cocaine(can spread HIV and hep)
S&S: headache, local pain, postnasal drip, fever, chills
Tx: humid air, fluids, drugs
M: no acute
Tuberculosis: TB, bump, bacteria infection of macrophages; usually pus filled bumps in lungs
not prevalent here, more likely in homeless or close quarters)
more in underdeveloped air
spread: air borne bacteria
prolong and repeated exposure
primary infection: engulfed by macrophages (doesn't work); builds up wall around it
secondary: re-occurrences; 10% of people; cough with rust
risk factors: alcoholic, immunosuppressed, constant exposure
myasium; thin, mountain, fresh air, new job every 3 months
S&S: primary: mild flu
active phase- fever, sweating
cought with phlegm
Dx: within weeks positive skin test
Tx: previously sanatoria
M: safe in latent phase, not acute/active
Asthma: inflammation and constricting in bronchial
triggers: stress, emotion, exercise, irritant
classified as COPD: chronic obstructive pulmonary disease
but not really a COPD
atopic triangle: hay fever, asthma, eczema
hyperractive bronchioles
-chronic inflammation
-dilation (sympathetic); constriction (parasympathetic)
-membrane secrete excess mucus
S&S: dyspnea, wheezing
Dx: rule out other things, spirometry test
p. 313 of Mem
-tidal volume:
-residual volume: get wind knocked out
-inspiration/expiration reserve volume
Tx: manage exposure to stimuli
beta-agonist inhalers: short term
inhaled or oral steroids: long term
allergy shot
recognized warning signs
M: contra during episode; triggers could be the oils/frags you use
Chronic Bronchitis: part of COPD
long term irritation of bronchi and bronchioles with or without infection
typically smoking leads to this
progressive and irreversible can lead to emphysema
can't get o2 in (blue floaters/bloaters?)
M>W; whites
destruction of cilia: mucus in lungs
scarring harder to breath; acidosis; lead to right heart failure
edema in extremities; look bloated?
S&S: slow onset, cough 3 month, short breath, cynotic
Tx: stop smoking
M: lying down may be issue
Emphysema: part of COPD; work hard to get air out of lungs
"pink puffers" blown up, inflated
barrel chest
smoking #1 causes
genetic problem: lack alpha 1; antitrypsin
elastic in alveoli: don't rebound
reduced surface area
breathing is effort
S&S: takes time, weight loss
comp: pneumothorax; right side heart failure
tX: stop progression
M: positional
Cystic Fibrosis: autosomal recessive genetic disorder
thick, viscous exocrine secretion
respiration tract and digestion, integumentary, reproductive syst.
not able to get **chloride out- too much water absorb
Dx: by age 2
salty sweat
CF most common lethal inherited disease of whites
cupping lungs; usually live to 35
growth medium for infection
GI too thick can't poop, not absorbing
skin: increase risk heat stroke
reproduction: sterile in M; women not
S&S: clubbing finger
complication: lots
Tx: supplements, manage sympt
M: within tolerance
Lung Cancer: growth malignant cell in lung
85-90% related to tobacco exposure
small cell lung cancer
-aka, oat cell carcinoma
15-25% of lung cancer
grows fast, spread quick, most deadly
non-small cell lung cancer
75-85%
squamous cell carcinoma
grows slowly hard to detect
others: carcinoid tumors, mesothelioma
risk: smoking, environment toxins
S&S: no early signs, smoker cough, blood stained phlegm, may put pressure on other areas
Dx: chest film, radiography, usually metastasized before detection
Tx: surgery, radiation, chemo
M: health care team
PHYS
Mem chapter 19
2 kidneys
2 ureters
1 bladder
1 urethra
Excretion
urinary
digest
respir
integ
Kidney activity
-Excretion
urea (amonia first)
-H2o balance maintenance
-body fluid acid-base regulation
-bp reg (main controler of it)-H. secretino of renin?
angiotensin
aldosterone
-rbc production (epo)
structure
-membranous renal capsule
-adipose capsule
-fascia anchors to peritoneum and ab wall
-retroperitoneal space
-left higher than right- accommodation of liver
Blood supply
renal artery supply
branches of ab aorta
subdivides in kidneys
nephrons are functional unit
renal vein drains blood
carries to inferior vena cava
cortex, medullary priamids
Organizatino
-hilum (indent)
-cortex (outer)
-medulla (inner)
afferent arteriole, efferent arteriole, proximal tubule, cuboidial, loop of Henle, distal, collecting duct
nephron:
glomerular (bowman) capsule
afferent
glomerulus
peritubular capil
proximal convoluted tubule
nephron loop (henle)
decending
ascending
distal convoluted tube
collectin duct
blood supply:
afferent arteriole
glomerulus
efferent arteriole
peritubular capillaries
Abnormal ventilation
hyperventilation
-high 02/low co2 (hypocapnea)
-increase blood pH
Hypoventilation
-insufficient air in alveoli
-decrease in blood pH
Breathing Pattern
adults: 12-20 breath/min
kids: 20-40
infants: 40+
Altered breath
hyperpnea: increase depth and rate of breathing
hypopnea: decrease rate and depth
tachypnea: excessive rate of breathing (exercise)
apnea: cessation of breathing
dyspnea: difficult/labored breathing
orthopnea: difficult breathing relieved by sitting up
Kussmaul respiratory: abnormal
Cheyne-Stokes respiratory: final breath in death
inadequate breathing
cyanosis: turning blue/purple- lack of O2
hypoxia: not enough o2 in tissue
hypoxemia: lower than normal o2 in arterial blood
suffocation: cessation of respiration/ mechanical blockage
Age-less likely to get fever with lung infection
rigid
PATH
chap 7
Acute Bronchitis: inflammation of bronchial tree
usually viral
smokers, miners more likely
elderly and immunosuppressed
tube swells, cilia damaged, mucous not getting out
last 10 days
S&S: cough, starts dry becomes productive; fever, mm aches, chest pain, fatigue
If 101F or more, possible pneumonia
Tx: warm, humid air, rest
M: contra because acute infection/ you at risk
Common Cold: 200 viruses, upper resp. tract infect (URTI)
last about a week
should be getting 1-2/yr.
etiology: rhinoviruses,
coronaviruses
adenoviruses
resp. syncytial viruses: can infect epiglottis- life threatening
incubation 12hrs
s&s: runny nose, sneezing ....
less than 2 wks
may go to lungs
OTC prolong, vit c (acidic blood), echinacea, rest, fluids
hydro: hot water on feet (soak), cold socks on with wool socks over, lay down; or cold on forehead or opposite
M: no
Influenza: viral infect of lungs
higher fever, mm aches, head aches
most worried with young, old, immunosuppressed
type A: can transfer with species: associated with epidemics; mutates easily
type B,C: mild
incubation: 2-3 days, airborne
S&S: cad cold: 2 wks, no such thing as stomach flu (endnovirus?)
don't eat solid foods during high fever because GI isn't working
vaccine picks the most likely
Pneumonia: infection in lung itself (kids; viral. adults; bacteria (usually))
gas exchange isn't happening: drown in own secretion
consolidation: fluid gets solid
BAD SICK
alveoli filled with pus
infect of pleural fluid (empyema)
cause: viruses, short lived, not serious for most
bacteria more serious, more sick; diff dx: tuberculosis or legionella
mycoplasma: walking pneumonia
fungi: PCP in immunosuppressed
Forms of pneumonia
-primary: rare attack on lungs
-secondary: more common; complication from other problem
double pneumonia is having it in both lungs
nosocomial: hospital acquired
S&S: can look like flu but more intense
Sinusitis: inflammation mucous membrane in nose/sinuses
infection or allergies, weather etc.
can have teeth sensitivity
cause-
acute or chronic(6months)
irritants, smoke, cocaine(can spread HIV and hep)
S&S: headache, local pain, postnasal drip, fever, chills
Tx: humid air, fluids, drugs
M: no acute
Tuberculosis: TB, bump, bacteria infection of macrophages; usually pus filled bumps in lungs
not prevalent here, more likely in homeless or close quarters)
more in underdeveloped air
spread: air borne bacteria
prolong and repeated exposure
primary infection: engulfed by macrophages (doesn't work); builds up wall around it
secondary: re-occurrences; 10% of people; cough with rust
risk factors: alcoholic, immunosuppressed, constant exposure
myasium; thin, mountain, fresh air, new job every 3 months
S&S: primary: mild flu
active phase- fever, sweating
cought with phlegm
Dx: within weeks positive skin test
Tx: previously sanatoria
M: safe in latent phase, not acute/active
Asthma: inflammation and constricting in bronchial
triggers: stress, emotion, exercise, irritant
classified as COPD: chronic obstructive pulmonary disease
but not really a COPD
atopic triangle: hay fever, asthma, eczema
hyperractive bronchioles
-chronic inflammation
-dilation (sympathetic); constriction (parasympathetic)
-membrane secrete excess mucus
S&S: dyspnea, wheezing
Dx: rule out other things, spirometry test
p. 313 of Mem
-tidal volume:
-residual volume: get wind knocked out
-inspiration/expiration reserve volume
Tx: manage exposure to stimuli
beta-agonist inhalers: short term
inhaled or oral steroids: long term
allergy shot
recognized warning signs
M: contra during episode; triggers could be the oils/frags you use
Chronic Bronchitis: part of COPD
long term irritation of bronchi and bronchioles with or without infection
typically smoking leads to this
progressive and irreversible can lead to emphysema
can't get o2 in (blue floaters/bloaters?)
M>W; whites
destruction of cilia: mucus in lungs
scarring harder to breath; acidosis; lead to right heart failure
edema in extremities; look bloated?
S&S: slow onset, cough 3 month, short breath, cynotic
Tx: stop smoking
M: lying down may be issue
Emphysema: part of COPD; work hard to get air out of lungs
"pink puffers" blown up, inflated
barrel chest
smoking #1 causes
genetic problem: lack alpha 1; antitrypsin
elastic in alveoli: don't rebound
reduced surface area
breathing is effort
S&S: takes time, weight loss
comp: pneumothorax; right side heart failure
tX: stop progression
M: positional
Cystic Fibrosis: autosomal recessive genetic disorder
thick, viscous exocrine secretion
respiration tract and digestion, integumentary, reproductive syst.
not able to get **chloride out- too much water absorb
Dx: by age 2
salty sweat
CF most common lethal inherited disease of whites
cupping lungs; usually live to 35
growth medium for infection
GI too thick can't poop, not absorbing
skin: increase risk heat stroke
reproduction: sterile in M; women not
S&S: clubbing finger
complication: lots
Tx: supplements, manage sympt
M: within tolerance
Lung Cancer: growth malignant cell in lung
85-90% related to tobacco exposure
small cell lung cancer
-aka, oat cell carcinoma
15-25% of lung cancer
grows fast, spread quick, most deadly
non-small cell lung cancer
75-85%
squamous cell carcinoma
grows slowly hard to detect
others: carcinoid tumors, mesothelioma
risk: smoking, environment toxins
S&S: no early signs, smoker cough, blood stained phlegm, may put pressure on other areas
Dx: chest film, radiography, usually metastasized before detection
Tx: surgery, radiation, chemo
M: health care team
PHYS
Mem chapter 19
2 kidneys
2 ureters
1 bladder
1 urethra
Excretion
urinary
digest
respir
integ
Kidney activity
-Excretion
urea (amonia first)
-H2o balance maintenance
-body fluid acid-base regulation
-bp reg (main controler of it)-H. secretino of renin?
angiotensin
aldosterone
-rbc production (epo)
structure
-membranous renal capsule
-adipose capsule
-fascia anchors to peritoneum and ab wall
-retroperitoneal space
-left higher than right- accommodation of liver
Blood supply
renal artery supply
branches of ab aorta
subdivides in kidneys
nephrons are functional unit
renal vein drains blood
carries to inferior vena cava
cortex, medullary priamids
Organizatino
-hilum (indent)
-cortex (outer)
-medulla (inner)
afferent arteriole, efferent arteriole, proximal tubule, cuboidial, loop of Henle, distal, collecting duct
nephron:
glomerular (bowman) capsule
afferent
glomerulus
peritubular capil
proximal convoluted tubule
nephron loop (henle)
decending
ascending
distal convoluted tube
collectin duct
blood supply:
afferent arteriole
glomerulus
efferent arteriole
peritubular capillaries
Sunday, February 12, 2012
2-10-12 Friday
PHYS
Chapter 16: Respiratory
Phases-process of obtaining O2 from environment
-pulmonary ventilation
-external exchange of gases-lungs
-internal exchange of gases-tissue
75% o2 saturation of blood entering Right atrium
95-99% o2 sat leaving left ventricle
Respiratory system
into lungs:
nasal cavities
pharynx
larynx
trachea (windpipe)
bronchi
Nasal cavity:
nostrils (nares)
mucous membrane (epithilial stratified squamous)
-filters foreign bodies
-warms tissue
-moistens air (humidifies)
conchae
nasal septum
sinuses
Pharynx: carries air to respiratory tract and food digest system
-nasopharynx
superior portion
-odopharynx
middle portion
-laryngeal pharynx
inferior portion
Larynx: voice box, b/w pharynx and trachea
-cartilage framework
thyroid cartilage (adam's apple)
-vocal folds (vocal cords)
used for speech
-glottis
-epiglottis
Trachea: windpipe; air b/w larynx and lungs
framework
horseshoe shape
open at back for expansion during swallowing
Bronchi:
trachea divide into 2 primary bronchi enter:
lungs
hilum
epithelial tissue lining
-pseudostratified
-cilia
right lung more likely to get foreign body due to bigger bronchi
-anatomical dead space
Lungs
-mediastinum: space between
-lobes
bronchial tree
bronchioles
alveoli
-diaphragm
-pleura: covering of lungs
parietal pleura: body cavity
visceral pleura: on organ
pleural space: between the two
Process of respiration
ventilation of lungs
exchange gases
transport of gases in blood
creates a vacuum
pressure gradient
Pulmonary vent.
inhalation is active phase
compliance
exhalation is passive phase
lung capacity
Gas exchange
diffusion of mvmt of molecules higher to lower concentration
external exchange
-gases move between alveoli and capillary blood
internal exchange
-gases move between blood and tissue
Transport of o2
-most o2 in capillary blood binds to hemoglobin
-o2 must separate from hemoglobin to enter cells
Transport of co2
10% dissolved in plasma and fluid in rbc
15% is combined with protein of hemoglobin and plasma protein
75% dissolves in blood fluids and is converted to bicarbonate ion (baking soda)
-first combines with water to form carbonic acid
-carbonic acid ionized (separates) into hydrogen and bicarb
-carbonic anhydrase enzyme spend conversion?
-buffers blood to keep pH steady
Regulation of respiration
fundamental resp. pattern
controlled by CNS centers
partly in medulla (main control centers), partly in ....
Nervous Control
medulla and pons
motor nerves fibers extend into spinal cord
**fibers extend through PHRENIC NERVE to diaphragm
Chemical control
-central chemoreceptors
-
-
-peripheral chemoreceptors
Chapter 16: Respiratory
Phases-process of obtaining O2 from environment
-pulmonary ventilation
-external exchange of gases-lungs
-internal exchange of gases-tissue
75% o2 saturation of blood entering Right atrium
95-99% o2 sat leaving left ventricle
Respiratory system
into lungs:
nasal cavities
pharynx
larynx
trachea (windpipe)
bronchi
Nasal cavity:
nostrils (nares)
mucous membrane (epithilial stratified squamous)
-filters foreign bodies
-warms tissue
-moistens air (humidifies)
conchae
nasal septum
sinuses
Pharynx: carries air to respiratory tract and food digest system
-nasopharynx
superior portion
-odopharynx
middle portion
-laryngeal pharynx
inferior portion
Larynx: voice box, b/w pharynx and trachea
-cartilage framework
thyroid cartilage (adam's apple)
-vocal folds (vocal cords)
used for speech
-glottis
-epiglottis
Trachea: windpipe; air b/w larynx and lungs
framework
horseshoe shape
open at back for expansion during swallowing
Bronchi:
trachea divide into 2 primary bronchi enter:
lungs
hilum
epithelial tissue lining
-pseudostratified
-cilia
right lung more likely to get foreign body due to bigger bronchi
-anatomical dead space
Lungs
-mediastinum: space between
-lobes
bronchial tree
bronchioles
alveoli
-diaphragm
-pleura: covering of lungs
parietal pleura: body cavity
visceral pleura: on organ
pleural space: between the two
Process of respiration
ventilation of lungs
exchange gases
transport of gases in blood
creates a vacuum
pressure gradient
Pulmonary vent.
inhalation is active phase
compliance
exhalation is passive phase
lung capacity
Gas exchange
diffusion of mvmt of molecules higher to lower concentration
external exchange
-gases move between alveoli and capillary blood
internal exchange
-gases move between blood and tissue
Transport of o2
-most o2 in capillary blood binds to hemoglobin
-o2 must separate from hemoglobin to enter cells
Transport of co2
10% dissolved in plasma and fluid in rbc
15% is combined with protein of hemoglobin and plasma protein
75% dissolves in blood fluids and is converted to bicarbonate ion (baking soda)
-first combines with water to form carbonic acid
-carbonic acid ionized (separates) into hydrogen and bicarb
-carbonic anhydrase enzyme spend conversion?
-buffers blood to keep pH steady
Regulation of respiration
fundamental resp. pattern
controlled by CNS centers
partly in medulla (main control centers), partly in ....
Nervous Control
medulla and pons
motor nerves fibers extend into spinal cord
**fibers extend through PHRENIC NERVE to diaphragm
Chemical control
-central chemoreceptors
-
-
-peripheral chemoreceptors
Thursday, February 9, 2012
2-8-12 Wednesday
MFR
For the final on Friday, know the material from all previous quizzes plus, glut max and tfl connect into itband, from a handout- mobilise the it band, popliteal, give correct answers for the false questions in the t and f section.
ETHICS
not that anybody cares, read chap 5,6,7 (not that anybody really will), and do homework handout. Next class is 4hrs on a friday
PHYS/PATH
lacteals absorb fats
thoracic duct drains right leg
B cell are adaptive immunity so, not part of innate immune system
T cells mature in thymus
B cell = antibody production
peyer patches are in small intestine
vaccines stimulate the adaptive immunity
NOT ON FRIDAY'S CELEBRATION
pathology of cancer
Dx=diagnosis
100+ different diseases
normal cells mutate, replicate
from epithelium= carcinoma
from mm, connective tissue = sarcoma
stats: half men, third of women
#2 cause of death U.S. and world wide
5yr survival rate, this is arbitrary
75% or more due to lifestyle choices
skin cancer most common Dx
lung most common death
step in metastasis
oncogene activation (accelerator)
proliferation- cell division
angiogenesis- grows own blood vessels
invasion
migration- tour
colonization
Causes:
internal factors
inhibition of apoptosis
inherited factors
hormonal activity
immune system function
external factors
246 substance as carcinogens
Pathogens:
viruses-HPV, Epstein-Barr, HIV
bacteria
animal parasites
S&S:
depends on site, nature, grade
growth with no pain
change in bowel/bladder habits
sore doesn't heal; comes and goes in same place
unusual bleeding or drainage
lump
indigestion, swallowing difficulties
change wort/mole: A,B,C,D,E
persistent cough, hoarseness
unexplained weight loss
fatigue, anemia
fever, skin changes
Dx: self/ clinic exams, imaging
Staging: pattern growth, TNM (tumor, node, metastisis), Stages 0-4
grade, appearance, aggressiveness
Tx: western medicine looks at tumor being problem, not something causing it
drugs approved of effective to shrink tumor not survival ratee
Prevention: don't get it;
food, fruit, veg, leafy greens, whole grains if any, control dietary fats
exercise regularly/ weight control
protect skin-sun
no smoking/tobacco
moderate alcohol
safe sex
early screening (not prevention)
Massage: not on tumor
Cautions: tumour sites, other areas involved?
Dr. Lou's slides
1 in 4 die of cancer
lung cancer most common in men
breast cancer most common in women (I guess we do need to rally more for Save The Ta-Tas)
cancer cell division is uncontrollable and immortal
Causes:
immune dysfunction
chronic inflammation
lymph stagnation
poor liver detox/ elimination
emotions
For the final on Friday, know the material from all previous quizzes plus, glut max and tfl connect into itband, from a handout- mobilise the it band, popliteal, give correct answers for the false questions in the t and f section.
ETHICS
not that anybody cares, read chap 5,6,7 (not that anybody really will), and do homework handout. Next class is 4hrs on a friday
PHYS/PATH
lacteals absorb fats
thoracic duct drains right leg
B cell are adaptive immunity so, not part of innate immune system
T cells mature in thymus
B cell = antibody production
peyer patches are in small intestine
vaccines stimulate the adaptive immunity
NOT ON FRIDAY'S CELEBRATION
pathology of cancer
Dx=diagnosis
100+ different diseases
normal cells mutate, replicate
from epithelium= carcinoma
from mm, connective tissue = sarcoma
stats: half men, third of women
#2 cause of death U.S. and world wide
5yr survival rate, this is arbitrary
75% or more due to lifestyle choices
skin cancer most common Dx
lung most common death
step in metastasis
oncogene activation (accelerator)
proliferation- cell division
angiogenesis- grows own blood vessels
invasion
migration- tour
colonization
Causes:
internal factors
inhibition of apoptosis
inherited factors
hormonal activity
immune system function
external factors
246 substance as carcinogens
Pathogens:
viruses-HPV, Epstein-Barr, HIV
bacteria
animal parasites
S&S:
depends on site, nature, grade
growth with no pain
change in bowel/bladder habits
sore doesn't heal; comes and goes in same place
unusual bleeding or drainage
lump
indigestion, swallowing difficulties
change wort/mole: A,B,C,D,E
persistent cough, hoarseness
unexplained weight loss
fatigue, anemia
fever, skin changes
Dx: self/ clinic exams, imaging
Staging: pattern growth, TNM (tumor, node, metastisis), Stages 0-4
grade, appearance, aggressiveness
Tx: western medicine looks at tumor being problem, not something causing it
drugs approved of effective to shrink tumor not survival ratee
Prevention: don't get it;
food, fruit, veg, leafy greens, whole grains if any, control dietary fats
exercise regularly/ weight control
protect skin-sun
no smoking/tobacco
moderate alcohol
safe sex
early screening (not prevention)
Massage: not on tumor
Cautions: tumour sites, other areas involved?
Dr. Lou's slides
1 in 4 die of cancer
lung cancer most common in men
breast cancer most common in women (I guess we do need to rally more for Save The Ta-Tas)
cancer cell division is uncontrollable and immortal
Causes:
immune dysfunction
chronic inflammation
lymph stagnation
poor liver detox/ elimination
emotions
Tuesday, February 7, 2012
2-6-12 Monday
PHYS/PATH
digestion - lacteal
thymus: t cell- like K-12 for learning
monocytes: in blood; macrophages (same cell, different location) kupffer,
Non specific
Chemical and mechanical barriers
skin
mucous membrane
body secretion
reflexes
Phagocytosis: wbc takes in and destroys waste and foreign material
-neutrophils
-macrophages
natural killer cells: type of lymphocyte- help protect against cancer; looking for receptors; sugar suppresses these cells :(
can recognise body cells with abnormal membranes
secrete protein that breaks down cell membrane
Inflammation
reaction : heat, redness, swelling, pain ,puss
fever: phagocytes work, release subst., increases body temp
stim phagocytes, increase metabolism, decrease some organisms ability to multiply
Interferon: group of subst that prevent nearby cells from producing more virus
-IFN a
-IFN b
-IFN g
also acts non specifically on immune system cells
Specific defenses immunity
adaptive immunity; develops after birth, acquired naturally and artificially
Adaptive develops in person during lifetime, from encounters with specific harmful agents
antigens: foreign subst. that enters body
induces immune response
t cell- thymus (originate in bone marrow change to t cell in thymus)
b cell- bone marrow
becomes sensitive to specific agent
produce cell mediated immunity
-cytoxic t cell
-helper t cell
-regulatory t cell
-memory t cell
macrophages
B cells and antibodies
antibody (Ab) also know as immunoglobulin (Ig) is subst. produced in response to anitgen
-manufactured by b cells
-must mature in fetal liver or in lymphoid tissue
-provide humoral immunity
-contained in gamma globuin fraction of blood plasma
Antigen/Antibody reaction
-prevent attachment of pathogen
-cause clumping of antigen
-neutralise toxin
-aid phagocytosis
....
Types of vaccines
live: virus/bacteria into person; giving them the disease (best immune response)
attenuated: crippled version of live
toxoid: a piece of the bug
killed by heat or chemical
antigenic component
genetically engineered
Boosters: most don't give lifetime response
passive immunity (artifical)
----
acquired vs. adaptive
neutraphils- bact
b/t cells- viral
80% immune system is digestive
----
Path
Hypersensitivity
Type I: IgE: hay fever, food allergy, immediate reaction
Type II:
Type III:
Type IV: delayed reaction: contact dermis
Edema: swelling, fluid b/w cells 30% more than usual
mechanical: weak heart
chemical: salt
Lymphagitis: inflammation of lymph vessel
trauma or infection
MT with hangnails and lessions
strep and staph most common skin infection
S&S: all signs of inflam.
septicemia: blood poising/ red streaks, contra systemic
can be life threatening
Lymphoma: cancer of lymph nodes, spleen
delineation between lymphoma and lymphocytic leukemia
becoming hazy
2 types:
Hodgkin lymphoma (HL) 8000/yr
Non-Hodgkin lymphoma (NHL) 59000/yr
swollen lymph nodes, alcohol makes pain worse
HL: 15-34 yr olds
NHL: 60-70
mutation of B/T cells
HL: B cells mutate into large, malignant multinucleate
**Reed Sternberg cells
usually submandibular nodes, can be axillary, inguinal
growth in liver
NHL: less aggressive
risk: chemical
Epstein-Barr (mono), HIV.....
S&S: painless symptoms, anemia, fatigue, night sweats, loss appitite
Prognosis: 5yr. survival HL> 86% (kids >95%); NHL: 63%
legally, and board question, no massage
Mononucleosis: viral of salivary glands and throat- invades whole lymphatic syst.
90% Epstein-Barr (EBV)
fatigue for months/years
kissing disease
moves to b lymphocytes in spleen, liver, lymph nodes
incubation up to 60 days
similar to herpes, doesn't have to be active to spread
splenomegaly
debilitates the person; weak and exhausted
similar conditions/differential diag.: HIV/AIDS, measles, strep throat, rubelle
comp: can go Bell's palsy, meningitis, strep throat
Tx: antivirals don't work
Allergic Reaction: Type II IgE; not inherently hazardous
food,
asthma (eczema of lungs), hives
angiodema: massive swelling rapid onset
triggers: nuts, chocolate, fish, eggs etc
anaphylaxis: sever response
massive histamine release
trig: nuts, stings: more severe with each exposure
problem breathing biggest danger
Tx: antihistamines, epinephrine, epipen, O2
Chronic Fatigue Syndrome: causes could be ??? stress, endocrine imbalance
CNS function
hypothalamus-pituitary-adrenal (HPA) axis dysfunction
S&S: poor short term memory, sore throat, mm/jt pain, poor sleep, etc
differential diag: irritable bowel, fibromyalgia, depression, anxiety
Tx: lifestyle changes
Fever: 101F (38.3C)
1-infection
2-wbc increase
3-interleukin decrease; cytokine production increase?
?4- interleukin go to brain increasing temp.
Comp: 104-106 gets dangerous
dehydration, acidosis, brain damage
Death at 112-114 for adults
fever decrease too fast = shock/ increase fever too quick = seizure
HIV (human immunodeficiency virus)/ AIDS (acquired immune deficiency)
infect t helper cells: immune system doesn't know what to do
recognised in 1983: probably before that
90% heterosexual infections
blood, breast milk, semen, vaginal secretino: saliva very low risk, tears, sweat
-virus invader cells with CD4 receptor site
it's an RNA
progression
phase 1: 6 month window
phase 2:
phase 3: asymptomatic periods, meds prolong phase; 1-20 years average 10
Phase 4: HIV+ to AIDS, t cell drop
get rare infections
easily killed by bleach, unstable outside host
indicator disease: pneumoocystis carinii, CMV, Kaposi Sarcoma (herpes 8?)
Diag:
Tx: virus constantly mutates; hard to deal with
M: universal precautions; keep you safe
Lupus: attack various tissues by bodies own antibodies
autoimmune; butterfly rash over cheeks/nose
3 varieties
causes: systemic/ rash, change in brain, lung stuff, heart, kidneys
skin stuff isn't just skin
photosensitivity
ulcers
arthritis
massage contra in flares
FOR TEST/STUFF TO REVIEW
endocrine, blood, heart, blood vessels, lymph, path
H. puts calcium from bone to blood: parathyroid
---from blood to bone: calcitonin
H affects sodium/potassium: aldosterone
cushing too much cortisol/ physical appearance
acromegly: GH makes giant/gigantism in kids
Type I: autoimmune: islets of langerhans destroyed
adision: too little cortisol/ skin orange
ACTH: anterior pituitary/ adrenals
H. store in post. pit: oxytocin, antidiuretic H by hypothalamus
pineal gland: light/dark
thyroxcine: t4 thyroid (metab. body temp)
thymus: t cells; immune
hyperthyroid: thin, active/energy, heart palp, lack sleep
hypothyroid: fatigue, depress, weight increase, lat 3rd eyebrow
metabolic syndrome: Syn X: pre type II
insulin resistance: takes more to get sugar in (key cards)
2 things H made from: protein and lipids
H stim breast milk: prolactin
H activates vit D: parathyroid
RBC, Wbc, thrombocytes, megacaryocytes?
plasma=serum + clot
H kidney secret stim bone marrow production rbc, erythroprowheaton
lymphocyte: b/t cells
cookie monster cells: macrophages/monocytes
blood types: antennas and universals
struct of heart: myocardium mm, epi, endo, peri
chambers 4; function, veins, arteries, valves
systolic/diastolic
chorday tend____ with pulomonary mm (spelling)
Pacemaker: SA node, AV node, bundle of HIS, pejenkey
coronary artery: infarction
ischemia + time = infarction
athlerosclrosis: plaques
hypertension: pressure on blood vess
hepatic portal vein
valves, veins; DVT signs
arteries
good luck
digestion - lacteal
thymus: t cell- like K-12 for learning
monocytes: in blood; macrophages (same cell, different location) kupffer,
Non specific
Chemical and mechanical barriers
skin
mucous membrane
body secretion
reflexes
Phagocytosis: wbc takes in and destroys waste and foreign material
-neutrophils
-macrophages
natural killer cells: type of lymphocyte- help protect against cancer; looking for receptors; sugar suppresses these cells :(
can recognise body cells with abnormal membranes
secrete protein that breaks down cell membrane
Inflammation
reaction : heat, redness, swelling, pain ,puss
fever: phagocytes work, release subst., increases body temp
stim phagocytes, increase metabolism, decrease some organisms ability to multiply
Interferon: group of subst that prevent nearby cells from producing more virus
-IFN a
-IFN b
-IFN g
also acts non specifically on immune system cells
Specific defenses immunity
adaptive immunity; develops after birth, acquired naturally and artificially
Adaptive develops in person during lifetime, from encounters with specific harmful agents
antigens: foreign subst. that enters body
induces immune response
t cell- thymus (originate in bone marrow change to t cell in thymus)
b cell- bone marrow
becomes sensitive to specific agent
produce cell mediated immunity
-cytoxic t cell
-helper t cell
-regulatory t cell
-memory t cell
macrophages
B cells and antibodies
antibody (Ab) also know as immunoglobulin (Ig) is subst. produced in response to anitgen
-manufactured by b cells
-must mature in fetal liver or in lymphoid tissue
-provide humoral immunity
-contained in gamma globuin fraction of blood plasma
Antigen/Antibody reaction
-prevent attachment of pathogen
-cause clumping of antigen
-neutralise toxin
-aid phagocytosis
....
Types of vaccines
live: virus/bacteria into person; giving them the disease (best immune response)
attenuated: crippled version of live
toxoid: a piece of the bug
killed by heat or chemical
antigenic component
genetically engineered
Boosters: most don't give lifetime response
passive immunity (artifical)
----
acquired vs. adaptive
neutraphils- bact
b/t cells- viral
80% immune system is digestive
----
Path
Hypersensitivity
Type I: IgE: hay fever, food allergy, immediate reaction
Type II:
Type III:
Type IV: delayed reaction: contact dermis
Edema: swelling, fluid b/w cells 30% more than usual
mechanical: weak heart
chemical: salt
Lymphagitis: inflammation of lymph vessel
trauma or infection
MT with hangnails and lessions
strep and staph most common skin infection
S&S: all signs of inflam.
septicemia: blood poising/ red streaks, contra systemic
can be life threatening
Lymphoma: cancer of lymph nodes, spleen
delineation between lymphoma and lymphocytic leukemia
becoming hazy
2 types:
Hodgkin lymphoma (HL) 8000/yr
Non-Hodgkin lymphoma (NHL) 59000/yr
swollen lymph nodes, alcohol makes pain worse
HL: 15-34 yr olds
NHL: 60-70
mutation of B/T cells
HL: B cells mutate into large, malignant multinucleate
**Reed Sternberg cells
usually submandibular nodes, can be axillary, inguinal
growth in liver
NHL: less aggressive
risk: chemical
Epstein-Barr (mono), HIV.....
S&S: painless symptoms, anemia, fatigue, night sweats, loss appitite
Prognosis: 5yr. survival HL> 86% (kids >95%); NHL: 63%
legally, and board question, no massage
Mononucleosis: viral of salivary glands and throat- invades whole lymphatic syst.
90% Epstein-Barr (EBV)
fatigue for months/years
kissing disease
moves to b lymphocytes in spleen, liver, lymph nodes
incubation up to 60 days
similar to herpes, doesn't have to be active to spread
splenomegaly
debilitates the person; weak and exhausted
similar conditions/differential diag.: HIV/AIDS, measles, strep throat, rubelle
comp: can go Bell's palsy, meningitis, strep throat
Tx: antivirals don't work
Allergic Reaction: Type II IgE; not inherently hazardous
food,
asthma (eczema of lungs), hives
angiodema: massive swelling rapid onset
triggers: nuts, chocolate, fish, eggs etc
anaphylaxis: sever response
massive histamine release
trig: nuts, stings: more severe with each exposure
problem breathing biggest danger
Tx: antihistamines, epinephrine, epipen, O2
Chronic Fatigue Syndrome: causes could be ??? stress, endocrine imbalance
CNS function
hypothalamus-pituitary-adrenal (HPA) axis dysfunction
S&S: poor short term memory, sore throat, mm/jt pain, poor sleep, etc
differential diag: irritable bowel, fibromyalgia, depression, anxiety
Tx: lifestyle changes
Fever: 101F (38.3C)
1-infection
2-wbc increase
3-interleukin decrease; cytokine production increase?
?4- interleukin go to brain increasing temp.
Comp: 104-106 gets dangerous
dehydration, acidosis, brain damage
Death at 112-114 for adults
fever decrease too fast = shock/ increase fever too quick = seizure
HIV (human immunodeficiency virus)/ AIDS (acquired immune deficiency)
infect t helper cells: immune system doesn't know what to do
recognised in 1983: probably before that
90% heterosexual infections
blood, breast milk, semen, vaginal secretino: saliva very low risk, tears, sweat
-virus invader cells with CD4 receptor site
it's an RNA
progression
phase 1: 6 month window
phase 2:
phase 3: asymptomatic periods, meds prolong phase; 1-20 years average 10
Phase 4: HIV+ to AIDS, t cell drop
get rare infections
easily killed by bleach, unstable outside host
indicator disease: pneumoocystis carinii, CMV, Kaposi Sarcoma (herpes 8?)
Diag:
Tx: virus constantly mutates; hard to deal with
M: universal precautions; keep you safe
Lupus: attack various tissues by bodies own antibodies
autoimmune; butterfly rash over cheeks/nose
3 varieties
causes: systemic/ rash, change in brain, lung stuff, heart, kidneys
skin stuff isn't just skin
photosensitivity
ulcers
arthritis
massage contra in flares
FOR TEST/STUFF TO REVIEW
endocrine, blood, heart, blood vessels, lymph, path
H. puts calcium from bone to blood: parathyroid
---from blood to bone: calcitonin
H affects sodium/potassium: aldosterone
cushing too much cortisol/ physical appearance
acromegly: GH makes giant/gigantism in kids
Type I: autoimmune: islets of langerhans destroyed
adision: too little cortisol/ skin orange
ACTH: anterior pituitary/ adrenals
H. store in post. pit: oxytocin, antidiuretic H by hypothalamus
pineal gland: light/dark
thyroxcine: t4 thyroid (metab. body temp)
thymus: t cells; immune
hyperthyroid: thin, active/energy, heart palp, lack sleep
hypothyroid: fatigue, depress, weight increase, lat 3rd eyebrow
metabolic syndrome: Syn X: pre type II
insulin resistance: takes more to get sugar in (key cards)
2 things H made from: protein and lipids
H stim breast milk: prolactin
H activates vit D: parathyroid
RBC, Wbc, thrombocytes, megacaryocytes?
plasma=serum + clot
H kidney secret stim bone marrow production rbc, erythroprowheaton
lymphocyte: b/t cells
cookie monster cells: macrophages/monocytes
blood types: antennas and universals
struct of heart: myocardium mm, epi, endo, peri
chambers 4; function, veins, arteries, valves
systolic/diastolic
chorday tend____ with pulomonary mm (spelling)
Pacemaker: SA node, AV node, bundle of HIS, pejenkey
coronary artery: infarction
ischemia + time = infarction
athlerosclrosis: plaques
hypertension: pressure on blood vess
hepatic portal vein
valves, veins; DVT signs
arteries
good luck
Sunday, February 5, 2012
2-3-12 Friday
PHYS/PATH
Thrombophlebitis (lesser, great saphenous vein)/DVT: popliteal, femoral, iliac vein
veins have become obstructed with clot
usually calves, thighs, pelvis
feels like a guitar string
Thrombi=stationary clots; travel usually to lung
this is a 911 emergency
***Virchow Triad (factors that greatly affect having clot)
1-injury to endothelium (inner lining of artery/vein)
2-hypercoagulability: easy clots
3-venous stasis
possible triggers: trauma, varicose veins, infection, immobility, decrease circulation, preg and childbirth, certain cancers, surgery, smoking, birth control, genetic condition
S&S: may show pitting edema
diag: ultrasound
tx: vena cava filter if they have multiple events
Aortic Aneurysm: bulge in blood vessel wall or heart
usually at aorta or in brain; Marfan at risk
rupture leads to extensive bleeding and death
as aneurysm grows, walls get thinner
factors are smoking, smooth mm compromise, trauma, inflammation, congenital weak arterial wall mm, untreated syphilis
S&S sometimes silent, may press on other structures- dysphagia, chest pain, hoarseness, coughing, back pain
Diag: blood makes specific sound- bruit; palpable; CT, MRI
complication: pressure on surrounding structure
blood clots
rupture, hemorrhage
Atherosclerosis: hardening of arteries due to plaque
we see: 1, endothelial damage- carbon monoxide, triglycerides (chronic inflammation with sugar and startch)(diabetics at high risk)
2)monocytes: arrive and become,
3macrophages: take up LDL
4, foam cells
5 platelets arrive
LDL is "bad". it goes to the tissu
HDL is "good" and returns to liver
CRP, homocysteine, fibrinogen, bleeding time (cardiovascular health)
Factors: heredity, genetics, gender, age,kidney disorder, changeble smoking, increase cholesterol/bp, sedentary lifestyle, diabetes
S&S: none early, 50% of blockage to show signs
complications, increase bp, aneurysm, arrthtmia, thrombus, E., angina
Tx: #1 is diet and exercise
Hypertension: high BP. major contributing factor to heart and other problems
stress is a big driver bp 140/90
1 in 3 adults
factors are obesity, smoking, water retentino, high cholesterol, artheroscleroisis, genetic
pressure inside pushing out
pressure outside of vessel
blood volume
vessel diameter
Types: essential -95%
secondary
malignant hypertension: diastolic (liver, kidney) increases very quickly
S&S: silent killer; short breath, ringing ears, vision, swell of ankles, dizzy/headache, sweating, anxiety
complication: edema, stroke, atherosclerosis, aneurysm, enlarged heart/failure, kidney disease, vision problems
Tx: DASH, diet-low sodium, drugs-diuretics, vasodilatoin, beta blockers, side effects low bp, decrease sex drive etc.
Raynaud Syndrome: vasoconstriction in extremities plus ears, nose, lips
secondary raynaud phenomenon: complication of underlying disorder
autoimmune-mostley women 15-40
arterioles spasm, cold and stress triggers
Red, White, and Blue: cycle of colors, episodes last 1 minute to hours
Tx: no caffine, soda, chocolate, smoking
Varicose Veins, varix=twisted
valves superficial veins collapse
can lead to hemoroids
W>M, progesterone weakens
history of preg-half people 50 years or older
in the leg
damage valves in superficial veins
wear and tear
standing all day
watching for underlying systemic problem; kidney, liver
S&S: lumpy, wandering lines, protrude from skin, throbbing pain, clots and dvts are a risk
Tx: support hose, elevate feet
M: local, telangiectasias (spider veins) are okay
Heart Attack: damage to cardiac mm from ischemia
CAD
mm tissue doesn't repair; replaced by scar tissue
damaged area=infarct
heart attack=myocardial infarction
#1 cause of death
fit vs. healthy
risk: sedentary, hypertension, high cholesterol, smoking, weight,
M 45+, W 55+, family history, F 35+ birth control
etiology: usually clot/thrombus
cardiac cells die of ischemia, seriousness determined by size, location of infarct
impairs mm function
damage conduction system
S&S: pressure, pain in chest
spreading pain, lightheaded, nausea, sweating, short breath, anxiety, fainting, cold sweat, stomach pain
Angina Pectoris: spasms in blood vessels
stable angina: triggered by extra effort (common)
unstable angina: sudden, no trigger
complication: embolism, atrial and ventricular fibrillation (uncoordinated heart beat), aneurysm, heart failure, shock
Tx: break it up, thrombolytics, pain management, lifestyle changes
Heart Failure: progressive loss of heart function
not cardiac arrest
mostly among survivors of heart attack
cor pulmonoli
resistance= compensates= cardiomegaly
can be congenital weakness with mm or valves
systolic- left ventrical
diastolic- both sides ventrical
Left: resistance in arteries; back up fluid in lungs
Right: cor pulmonoli/pulmonale: resistance in lungs, backup fluid into legs; can also cause liver, kidney (main fluid regulator) damage
biventrical
S&S: depends on which side
Tx, rest, change in diet, diuretics, vasodialator
Chapter 15- LYMPH
system tissues and vessels, scattered thoughout body
service alomst all reigons
fluid balance
protect from infection
absorption of fat in digestive system? lacteal
Circulation
-one way system
-begins in tissues, ends in bloodstream
capillaries (more leaky)
capillary walls (endothelium) are flattened epithetial cells
more permeable than blood capillaries
overlapping cells form one way valves
arise blindly (closed at one end)
lacteal absorb digested fats
vessels-superficial and deep, nodes, right lymphatic duct
*Thoracic duct (left lymphatic duct) 3/4th of body- cisterna chyli
Mvmt: segments and vessels between valves contract rhythmically
skel mm compress vessel
nodes: structure: fiberous connective tissue
hilum indent?, groups
Spleen: cleanses blood, filtration, phagocytosis destroys old RBC, produces RBC before birth reservoir for blood
Thymus: early immune system development, produces thymosin
develops T lymphocyte cells, promotes lymphocyte growth
promotes lymphoid tissue activity, shrink after puberty
Tonsils: removes contaminates and traps pathogens
palative tonsils, pharyngeal tonsil (adenoids), lingual tonsils
Appendix
Gut-associated lymphoid tissue (GALT
-peyer patches
mucosal- associated lymphoid tissue (MALT)
Reticuloendothelial: cell that destroys worn out cells, bacteria, cancer cells, harmful foreign substance
-monocytes
-macrophages: Kupffer cells (liver), dust cells (lung
non specific/Innate: gonna work on whatever infection
adaptive/acquired/active/specific: B cells (antibodies); T cells -T helper ( tell other what to do); -cytotoxic and NK (enforcers/ natural killers)
Thrombophlebitis (lesser, great saphenous vein)/DVT: popliteal, femoral, iliac vein
veins have become obstructed with clot
usually calves, thighs, pelvis
feels like a guitar string
Thrombi=stationary clots; travel usually to lung
this is a 911 emergency
***Virchow Triad (factors that greatly affect having clot)
1-injury to endothelium (inner lining of artery/vein)
2-hypercoagulability: easy clots
3-venous stasis
possible triggers: trauma, varicose veins, infection, immobility, decrease circulation, preg and childbirth, certain cancers, surgery, smoking, birth control, genetic condition
S&S: may show pitting edema
diag: ultrasound
tx: vena cava filter if they have multiple events
Aortic Aneurysm: bulge in blood vessel wall or heart
usually at aorta or in brain; Marfan at risk
rupture leads to extensive bleeding and death
as aneurysm grows, walls get thinner
factors are smoking, smooth mm compromise, trauma, inflammation, congenital weak arterial wall mm, untreated syphilis
S&S sometimes silent, may press on other structures- dysphagia, chest pain, hoarseness, coughing, back pain
Diag: blood makes specific sound- bruit; palpable; CT, MRI
complication: pressure on surrounding structure
blood clots
rupture, hemorrhage
Atherosclerosis: hardening of arteries due to plaque
we see: 1, endothelial damage- carbon monoxide, triglycerides (chronic inflammation with sugar and startch)(diabetics at high risk)
2)monocytes: arrive and become,
3macrophages: take up LDL
4, foam cells
5 platelets arrive
LDL is "bad". it goes to the tissu
HDL is "good" and returns to liver
CRP, homocysteine, fibrinogen, bleeding time (cardiovascular health)
Factors: heredity, genetics, gender, age,kidney disorder, changeble smoking, increase cholesterol/bp, sedentary lifestyle, diabetes
S&S: none early, 50% of blockage to show signs
complications, increase bp, aneurysm, arrthtmia, thrombus, E., angina
Tx: #1 is diet and exercise
Hypertension: high BP. major contributing factor to heart and other problems
stress is a big driver bp 140/90
1 in 3 adults
factors are obesity, smoking, water retentino, high cholesterol, artheroscleroisis, genetic
pressure inside pushing out
pressure outside of vessel
blood volume
vessel diameter
Types: essential -95%
secondary
malignant hypertension: diastolic (liver, kidney) increases very quickly
S&S: silent killer; short breath, ringing ears, vision, swell of ankles, dizzy/headache, sweating, anxiety
complication: edema, stroke, atherosclerosis, aneurysm, enlarged heart/failure, kidney disease, vision problems
Tx: DASH, diet-low sodium, drugs-diuretics, vasodilatoin, beta blockers, side effects low bp, decrease sex drive etc.
Raynaud Syndrome: vasoconstriction in extremities plus ears, nose, lips
secondary raynaud phenomenon: complication of underlying disorder
autoimmune-mostley women 15-40
arterioles spasm, cold and stress triggers
Red, White, and Blue: cycle of colors, episodes last 1 minute to hours
Tx: no caffine, soda, chocolate, smoking
Varicose Veins, varix=twisted
valves superficial veins collapse
can lead to hemoroids
W>M, progesterone weakens
history of preg-half people 50 years or older
in the leg
damage valves in superficial veins
wear and tear
standing all day
watching for underlying systemic problem; kidney, liver
S&S: lumpy, wandering lines, protrude from skin, throbbing pain, clots and dvts are a risk
Tx: support hose, elevate feet
M: local, telangiectasias (spider veins) are okay
Heart Attack: damage to cardiac mm from ischemia
CAD
mm tissue doesn't repair; replaced by scar tissue
damaged area=infarct
heart attack=myocardial infarction
#1 cause of death
fit vs. healthy
risk: sedentary, hypertension, high cholesterol, smoking, weight,
M 45+, W 55+, family history, F 35+ birth control
etiology: usually clot/thrombus
cardiac cells die of ischemia, seriousness determined by size, location of infarct
impairs mm function
damage conduction system
S&S: pressure, pain in chest
spreading pain, lightheaded, nausea, sweating, short breath, anxiety, fainting, cold sweat, stomach pain
Angina Pectoris: spasms in blood vessels
stable angina: triggered by extra effort (common)
unstable angina: sudden, no trigger
complication: embolism, atrial and ventricular fibrillation (uncoordinated heart beat), aneurysm, heart failure, shock
Tx: break it up, thrombolytics, pain management, lifestyle changes
Heart Failure: progressive loss of heart function
not cardiac arrest
mostly among survivors of heart attack
cor pulmonoli
resistance= compensates= cardiomegaly
can be congenital weakness with mm or valves
systolic- left ventrical
diastolic- both sides ventrical
Left: resistance in arteries; back up fluid in lungs
Right: cor pulmonoli/pulmonale: resistance in lungs, backup fluid into legs; can also cause liver, kidney (main fluid regulator) damage
biventrical
S&S: depends on which side
Tx, rest, change in diet, diuretics, vasodialator
Chapter 15- LYMPH
system tissues and vessels, scattered thoughout body
service alomst all reigons
fluid balance
protect from infection
absorption of fat in digestive system? lacteal
Circulation
-one way system
-begins in tissues, ends in bloodstream
capillaries (more leaky)
capillary walls (endothelium) are flattened epithetial cells
more permeable than blood capillaries
overlapping cells form one way valves
arise blindly (closed at one end)
lacteal absorb digested fats
vessels-superficial and deep, nodes, right lymphatic duct
*Thoracic duct (left lymphatic duct) 3/4th of body- cisterna chyli
Mvmt: segments and vessels between valves contract rhythmically
skel mm compress vessel
nodes: structure: fiberous connective tissue
hilum indent?, groups
Spleen: cleanses blood, filtration, phagocytosis destroys old RBC, produces RBC before birth reservoir for blood
Thymus: early immune system development, produces thymosin
develops T lymphocyte cells, promotes lymphocyte growth
promotes lymphoid tissue activity, shrink after puberty
Tonsils: removes contaminates and traps pathogens
palative tonsils, pharyngeal tonsil (adenoids), lingual tonsils
Appendix
Gut-associated lymphoid tissue (GALT
-peyer patches
mucosal- associated lymphoid tissue (MALT)
Reticuloendothelial: cell that destroys worn out cells, bacteria, cancer cells, harmful foreign substance
-monocytes
-macrophages: Kupffer cells (liver), dust cells (lung
non specific/Innate: gonna work on whatever infection
adaptive/acquired/active/specific: B cells (antibodies); T cells -T helper ( tell other what to do); -cytotoxic and NK (enforcers/ natural killers)
Thursday, February 2, 2012
2-1-12 Wednesday
MFR
quiz for friday
all steps in arm pull series
directions of scapula mvmt
reasons for uncoiling traps
sign of Thoracic Outlet syndrome and what techniques to relieve it
how do you know you're on psoas
4 activities of daily life that lengthens fascia or facilitates it
playtsma release steps
ex. credit: know what to do for certain aliments
anterior hip rot
LB
thoracic outlet
siatica
piraformis
neck pain, rom
itb
achilles
PHYS/PATH
Chapt 5 circulatory system function
delivers nutrients and o2
**interruption- ischemia: lack of o2 to cells
infarction: cell death due to long ischemia
clotting: interruption, hemophilia (can't clot), thrombopenia (not enough)
chemical balance- alkalosis (too much of alkaline), acidosis (too much of acid)
RBC- 120 day lifetime- spleen (like Florida) removes dead RBC
turnover rate 2million/sec
no nuclei, lots of hemoglobin (iron-based)
WBC, granular/agranular
platelets
Anemia: not enough rbc, insufficient o2- carrying capacity often sysptom of complication rather than freestanding problem
mostly women because of menstrual cycles
-cancer, infection, bone marrow-EPO-Kidney, blood leak somewhere
nutritional: iron deficient most common
iron needs vit C, copper, and stomach acid to absorb
iron holds on to o2 in blood cells-- decrease energy if lacking
-folic acid, b12 deficient- needed to form rbc
-pernicious anemian- inadequate vit b12
-hemorrhagic: blood loss,(ulcer, endometriosis), bleed out
-hemolytic: premature rbc death- splenomegaly, jaundice
-aplastic: suppressed bone marrow, shortage of all blood cells
autoimmune problem, renal failure
myelodysplastic- similar problem related to leukemia, myeloma
secondary - ulcers, kidney, hepatitis, leukemia, myeloma, lymphoma
S&S: pallor (pale), dyspnea, fatigue, increase heart rate
Embolism and Thrombus
embolism: traveling clot, usually brain, heart, lung
thrombus: lodged clot
platelets flow through circulatory system
clots form at site of damage, area of slow irregular blood flow
embolism travels until vessel is too small
Pulmonary embolism (PE) 650k/yr, 200k/yr die-lung
often related to DVT
risk factor: cardiovascular disease, recent trauma, bed/plane/car rest, surgery, preg, overweight, smoking (makes blood sticky), oral birth control
S&S: dyspnea, chest pain, looks like heart attack, cough with blood, increase risk of another event
loss of lung function- right side heart failure
Tx: thrombolytics (sometimes), anticoags, asprin, surgery
prevent: id risks, diet, life style, external compress leg
Arterial embolism- complication of atherosclerosis
when septum is intact, venous em travels to lung; with arterial..
the embolism can go anywhere except the lung.
such as:
-coronary artery (heart attack)
carotid/cervical (stroke)
renal artery (renal infarction)
femoral (mm infarction)
S&S: may be silent, involve sharp tingling pain, tissue damage and death
Tx: prophylactic anticoag
Hematoma: pooling of blood
-bruise: superficial capillaries (ecchymosis)
b/w mm sheath in brain- serious!
S&S: bruises- color, yellow/green is subacute
Hemophilia: inability to clot- genetic disorder
mostly men, carried on the x chromosome
Hemophilia A- 80%, clot factor XIII
Hemophilia B- 15% (christmas disease) factor IX
frequent nose bleeds, easily bruise
mm and nerve damage, more likely to get infection in blood, hep a,b, due to transfusions
Leukemia: cancer bone marrow
high wbc count, low number of platelets
myeloid or lymphoid (b cells, t cells) form bone marrow (abnormal shape and non-functioning wbc)
acute=aggressive, chronic=slow-grow
usually genetic mutation, exposure to toxin, radiation
4 main types:
AML: acute myelognous leukemia
CML: chronic myelognous leukemia
ALL: acute lymphocytic leukemia (most common cancer in kids)
CLL: chronic lymphocytic leukemia
S&S: suppressed production rbc-fatigue, anemia, easy bruise/bleed
diag: blood test, bone marrow biop, spinal tap
tx: chemo, radiation; tx can exacerbate symptoms
Malaria: parasitic infection of blood; vector-borne infection of blood cells
4 species of protozoa
spread by anopheles mosquitoes
90% of cases in Africa
life cycle of plasmodium:
-human bitten by female mosquitoes
-immature parasite introduced to bloodstream
-travels to liver, grows 6-9 days
-reenters bloodstream
-invades healthy rbc; feed on hemoglobin, replicates, ruptures and releases
S&S: fluctuation b/w fever and chills, anemia, jaundice; usually lasts 2 wks. you make it you live
often missed in U.S because not common
Tx: chloroquine- sincono bark?- beginning of homeopathy
prevent: prophylactic med
Myeloma: cancer bone marrow, specifically maturing B cells
multiple myeloma- holes in bones
usually older, 70, black men
flat bones more likely affected
secrete cytokines?
clocking osteoblast activity, stimulation of osteoclasts
**fragments in urine- Bence Jones Protein
kidney can be damaged
3 types:
multiple myeloma
solitary myeloma
extramedullary plastocytoma
S&S: silent early , bone pain, fracture, anemia, amyloidosis
diag: urinalysis, etc.
Sickle Cell Disease
autosomal recessive genetic condition (the little xx)
production of abnormal hemoglobin
most common in black, hispanic ...
S&S: inadequate o2 carrying - fatigue, short breath, pallor, jaundice, spleno....
quiz for friday
all steps in arm pull series
directions of scapula mvmt
reasons for uncoiling traps
sign of Thoracic Outlet syndrome and what techniques to relieve it
how do you know you're on psoas
4 activities of daily life that lengthens fascia or facilitates it
playtsma release steps
ex. credit: know what to do for certain aliments
anterior hip rot
LB
thoracic outlet
siatica
piraformis
neck pain, rom
itb
achilles
PHYS/PATH
Chapt 5 circulatory system function
delivers nutrients and o2
**interruption- ischemia: lack of o2 to cells
infarction: cell death due to long ischemia
clotting: interruption, hemophilia (can't clot), thrombopenia (not enough)
chemical balance- alkalosis (too much of alkaline), acidosis (too much of acid)
RBC- 120 day lifetime- spleen (like Florida) removes dead RBC
turnover rate 2million/sec
no nuclei, lots of hemoglobin (iron-based)
WBC, granular/agranular
platelets
Anemia: not enough rbc, insufficient o2- carrying capacity often sysptom of complication rather than freestanding problem
mostly women because of menstrual cycles
-cancer, infection, bone marrow-EPO-Kidney, blood leak somewhere
nutritional: iron deficient most common
iron needs vit C, copper, and stomach acid to absorb
iron holds on to o2 in blood cells-- decrease energy if lacking
-folic acid, b12 deficient- needed to form rbc
-pernicious anemian- inadequate vit b12
-hemorrhagic: blood loss,(ulcer, endometriosis), bleed out
-hemolytic: premature rbc death- splenomegaly, jaundice
-aplastic: suppressed bone marrow, shortage of all blood cells
autoimmune problem, renal failure
myelodysplastic- similar problem related to leukemia, myeloma
secondary - ulcers, kidney, hepatitis, leukemia, myeloma, lymphoma
S&S: pallor (pale), dyspnea, fatigue, increase heart rate
Embolism and Thrombus
embolism: traveling clot, usually brain, heart, lung
thrombus: lodged clot
platelets flow through circulatory system
clots form at site of damage, area of slow irregular blood flow
embolism travels until vessel is too small
Pulmonary embolism (PE) 650k/yr, 200k/yr die-lung
often related to DVT
risk factor: cardiovascular disease, recent trauma, bed/plane/car rest, surgery, preg, overweight, smoking (makes blood sticky), oral birth control
S&S: dyspnea, chest pain, looks like heart attack, cough with blood, increase risk of another event
loss of lung function- right side heart failure
Tx: thrombolytics (sometimes), anticoags, asprin, surgery
prevent: id risks, diet, life style, external compress leg
Arterial embolism- complication of atherosclerosis
when septum is intact, venous em travels to lung; with arterial..
the embolism can go anywhere except the lung.
such as:
-coronary artery (heart attack)
carotid/cervical (stroke)
renal artery (renal infarction)
femoral (mm infarction)
S&S: may be silent, involve sharp tingling pain, tissue damage and death
Tx: prophylactic anticoag
Hematoma: pooling of blood
-bruise: superficial capillaries (ecchymosis)
b/w mm sheath in brain- serious!
S&S: bruises- color, yellow/green is subacute
Hemophilia: inability to clot- genetic disorder
mostly men, carried on the x chromosome
Hemophilia A- 80%, clot factor XIII
Hemophilia B- 15% (christmas disease) factor IX
frequent nose bleeds, easily bruise
mm and nerve damage, more likely to get infection in blood, hep a,b, due to transfusions
Leukemia: cancer bone marrow
high wbc count, low number of platelets
myeloid or lymphoid (b cells, t cells) form bone marrow (abnormal shape and non-functioning wbc)
acute=aggressive, chronic=slow-grow
usually genetic mutation, exposure to toxin, radiation
4 main types:
AML: acute myelognous leukemia
CML: chronic myelognous leukemia
ALL: acute lymphocytic leukemia (most common cancer in kids)
CLL: chronic lymphocytic leukemia
S&S: suppressed production rbc-fatigue, anemia, easy bruise/bleed
diag: blood test, bone marrow biop, spinal tap
tx: chemo, radiation; tx can exacerbate symptoms
Malaria: parasitic infection of blood; vector-borne infection of blood cells
4 species of protozoa
spread by anopheles mosquitoes
90% of cases in Africa
life cycle of plasmodium:
-human bitten by female mosquitoes
-immature parasite introduced to bloodstream
-travels to liver, grows 6-9 days
-reenters bloodstream
-invades healthy rbc; feed on hemoglobin, replicates, ruptures and releases
S&S: fluctuation b/w fever and chills, anemia, jaundice; usually lasts 2 wks. you make it you live
often missed in U.S because not common
Tx: chloroquine- sincono bark?- beginning of homeopathy
prevent: prophylactic med
Myeloma: cancer bone marrow, specifically maturing B cells
multiple myeloma- holes in bones
usually older, 70, black men
flat bones more likely affected
secrete cytokines?
clocking osteoblast activity, stimulation of osteoclasts
**fragments in urine- Bence Jones Protein
kidney can be damaged
3 types:
multiple myeloma
solitary myeloma
extramedullary plastocytoma
S&S: silent early , bone pain, fracture, anemia, amyloidosis
diag: urinalysis, etc.
Sickle Cell Disease
autosomal recessive genetic condition (the little xx)
production of abnormal hemoglobin
most common in black, hispanic ...
S&S: inadequate o2 carrying - fatigue, short breath, pallor, jaundice, spleno....
Tuesday, January 31, 2012
1-30-12 Monday
PHYS/PATH
Blood types: A,B,AB,O
AB is universal recipient, O is universal donor
Rh factor, if you have it you're positive, if you don't, you're negative
Mom with Rh- and baby with Rh+ can lead to Hemolytic disease of newborn (HDN)
uses of blood-last 35 days in blood bank
transfusion
hemopheresis
plasmapheresis
use plasma: replace blood volume, replace clotting factor
hematocrit: normal, anemia, poly c_____
hemaglobin: carries o2
blood cell count, smear, CBC complete blood count
also a blood chemistry test
coagulation studies- bleed time, clot time
bone marrow biopsy, ouch
CHAPT 13- THE HEART
heart, pumps and valves, circulation
location b/w lungs, left side, tilted left, T5-T6 apex, media stinum?
structure 3 layers
endocardium: lines heart interior
myocardium: thickest layer, heart mm
epicardium: thin outmost layer
Pericardium: protective bag around heart, symbol is dog (protector)
Fibrous pericardium holds heart in place
Serous membrane: parietal layer: body cavity side?
pericardial cavity: in between
visceral layer (epicardium): heart side
Myocardium
lightly striated
single nucleous
involuntary
*p.247
4 chambers of heart: R,L atrium; R,L ventricle
4 valves: atrioventriculart valve; tricuspid, mitral/bicuspid.
semilaunar valves
Blood supply to myocardium
coronary circulation
R coronary, Left, coronary sinus
cardiac output; CO=HR 3 SV
Heart conduction system
electrical energy stimulates heart mm
nodes:
-sinoatrial (SA) node (pacemaker): right atrium, generates action potentials
-atrioventricular (AV) nodes
Specialised fibers
-atrioventricular bundle (bundle of His)
-Parkinje fibers (conduction myofibers)
Intercalated disk
Conduction pathway
control heart rate
-autonomic nerve system (ANS)
sympathetic nerv..
parasympathetic
-cranial nerve X vagus
Bradycardia: slow bpm
tachycardia: fast bpm
sinus arrhythmia: an occasional extra beat, normal on occasion
premature beat (extrasystole)
systolic/systole: pressure with the beat
diastolic/diastole: pressure with rest
sounds: lub, dup, murmurs (extra noises)-organic, functional
in elderly: shrink, decrease strength, damage, blockage
factors: smoking, diet, weight, diabetes, gout
stethoscope, ECG, EKG, cath, echo
p.247: chordae tendinease, papillary mm
foramen oval?: closes with first breath
CHAPTER 14
Vascular system: closed system
blood vessels, 4 heart chambers
arteries, arterioles, capillaries, venules, veins
Circuits- 2 groups
Pulmonary
-pulmonary artery and its branches
-capilleries in lungs
-pulmonary vein
Systemic circuit
-aorta
-systemic capillary
-systemic vein
Vessel struct.
3 tunic (coats) of artery and vein
Inner (endothelium) tunic
Middle (smooth involuntary mm) tunic
-controlled by ANS
-thinner in veins
Outer (supporting connective tissue)tunic
capillaries are simple squamous
Systemic Arteries
*aorta: largest artery, receives blood form L ventricle, branches to all organs
ascending aorta-coming up out of heart
aortic arch-bend to go down
thoracic aorta-chest
abdominal aorta- below diaphragm
-cleiac trunk
-superior/inferior mesenteric
-paired lateral branches
Iliac arteries
*anastomoses- communication b/w 2 vessels
**circle of Willis
superficial palmar arch
mesenteric
arterial
*middle cerebral artery most common in stroke
Systemic veins
-superficial veins
cephalic, etc.
saphenous vein
-Deep veins
femoral and iliac, brachial, axillary subclavian .....
superior/inferior vena cava
azygos vein-chest wall
*hepatic portal system: carries blood from ab organs to liver
capillary exchange
diffusion (main process)
bp-moves material into tissue fluid
osmotic- move material into cap.
hydrostatic pressure: push fluid out of capillary
oncotic(osmotic) pressure: water (fluid) back in capillary bed
Nervous system in brain
medulla regulates vasomotor activity
vasodialation/constriction
precapillary sphincter
return blood: contraction of skel. mm, valves, breathing
Pulse: ventricules contract, recoil. Body size, age, activity, emotional state
BP: force on vessel wall: increase bp can cause damage. thickness also determines pressure
Resistance blood flow
peripheral resistance is affected by:
-vasomotor changes
-baroreceptors in large arteries (pressure recept)
-elasticity of blood vessel
-viscosity , total blood volume
BPM-sphygmomanometer: bp cuff
systolic pressure: contraction 120mmHg normal
diastolic: relax 80mmHg normal
Blood types: A,B,AB,O
AB is universal recipient, O is universal donor
Rh factor, if you have it you're positive, if you don't, you're negative
Mom with Rh- and baby with Rh+ can lead to Hemolytic disease of newborn (HDN)
uses of blood-last 35 days in blood bank
transfusion
hemopheresis
plasmapheresis
use plasma: replace blood volume, replace clotting factor
hematocrit: normal, anemia, poly c_____
hemaglobin: carries o2
blood cell count, smear, CBC complete blood count
also a blood chemistry test
coagulation studies- bleed time, clot time
bone marrow biopsy, ouch
CHAPT 13- THE HEART
heart, pumps and valves, circulation
location b/w lungs, left side, tilted left, T5-T6 apex, media stinum?
structure 3 layers
endocardium: lines heart interior
myocardium: thickest layer, heart mm
epicardium: thin outmost layer
Pericardium: protective bag around heart, symbol is dog (protector)
Fibrous pericardium holds heart in place
Serous membrane: parietal layer: body cavity side?
pericardial cavity: in between
visceral layer (epicardium): heart side
Myocardium
lightly striated
single nucleous
involuntary
*p.247
4 chambers of heart: R,L atrium; R,L ventricle
4 valves: atrioventriculart valve; tricuspid, mitral/bicuspid.
semilaunar valves
Blood supply to myocardium
coronary circulation
R coronary, Left, coronary sinus
cardiac output; CO=HR 3 SV
Heart conduction system
electrical energy stimulates heart mm
nodes:
-sinoatrial (SA) node (pacemaker): right atrium, generates action potentials
-atrioventricular (AV) nodes
Specialised fibers
-atrioventricular bundle (bundle of His)
-Parkinje fibers (conduction myofibers)
Intercalated disk
Conduction pathway
control heart rate
-autonomic nerve system (ANS)
sympathetic nerv..
parasympathetic
-cranial nerve X vagus
Bradycardia: slow bpm
tachycardia: fast bpm
sinus arrhythmia: an occasional extra beat, normal on occasion
premature beat (extrasystole)
systolic/systole: pressure with the beat
diastolic/diastole: pressure with rest
sounds: lub, dup, murmurs (extra noises)-organic, functional
in elderly: shrink, decrease strength, damage, blockage
factors: smoking, diet, weight, diabetes, gout
stethoscope, ECG, EKG, cath, echo
p.247: chordae tendinease, papillary mm
foramen oval?: closes with first breath
CHAPTER 14
Vascular system: closed system
blood vessels, 4 heart chambers
arteries, arterioles, capillaries, venules, veins
Circuits- 2 groups
Pulmonary
-pulmonary artery and its branches
-capilleries in lungs
-pulmonary vein
Systemic circuit
-aorta
-systemic capillary
-systemic vein
Vessel struct.
3 tunic (coats) of artery and vein
Inner (endothelium) tunic
Middle (smooth involuntary mm) tunic
-controlled by ANS
-thinner in veins
Outer (supporting connective tissue)tunic
capillaries are simple squamous
Systemic Arteries
*aorta: largest artery, receives blood form L ventricle, branches to all organs
ascending aorta-coming up out of heart
aortic arch-bend to go down
thoracic aorta-chest
abdominal aorta- below diaphragm
-cleiac trunk
-superior/inferior mesenteric
-paired lateral branches
Iliac arteries
*anastomoses- communication b/w 2 vessels
**circle of Willis
superficial palmar arch
mesenteric
arterial
*middle cerebral artery most common in stroke
Systemic veins
-superficial veins
cephalic, etc.
saphenous vein
-Deep veins
femoral and iliac, brachial, axillary subclavian .....
superior/inferior vena cava
azygos vein-chest wall
*hepatic portal system: carries blood from ab organs to liver
capillary exchange
diffusion (main process)
bp-moves material into tissue fluid
osmotic- move material into cap.
hydrostatic pressure: push fluid out of capillary
oncotic(osmotic) pressure: water (fluid) back in capillary bed
Nervous system in brain
medulla regulates vasomotor activity
vasodialation/constriction
precapillary sphincter
return blood: contraction of skel. mm, valves, breathing
Pulse: ventricules contract, recoil. Body size, age, activity, emotional state
BP: force on vessel wall: increase bp can cause damage. thickness also determines pressure
Resistance blood flow
peripheral resistance is affected by:
-vasomotor changes
-baroreceptors in large arteries (pressure recept)
-elasticity of blood vessel
-viscosity , total blood volume
BPM-sphygmomanometer: bp cuff
systolic pressure: contraction 120mmHg normal
diastolic: relax 80mmHg normal
1-27-12 Friday
PHYS/PATH
Acromegaly: too much GH, get too big.
can happen in kids is called gigantism, adults it is acromegaly
affects flat bones more, big forehead and jaw
shorter life- Andre the Giant
GH also release insulin like growth factor (IGF-I[one]) (somatomedin C)
problems with heart-careful with massage
Addison Disease: not enough adrenal H.; not enough aldosteral- balance o f electrolytes/ help absorb sodium
not absorbing water because not enough aldosteral
low cortisol too, adrojenic H.
tumors can be a cause
70% of the time it's autoimmune
tuberculosis
Primary Addison's is with the adrenals
Secondary Addison's is decreased anterior pituitary secretion of ACTH (too much makes people look too tan/orange)
Tertiary Addison's is problem with hypothalamus
-cortisol depletion-- weak mm, fatigue, decreased bp, hypoglycemia, irritability, depression, hyperpigmentation,
tend to be thin due to electrolyte imbalance; nausea, vomiting, diarrhea
Addisonia crisis: sudden onset of extreme symptoms if these come on real quick they can die
Die without adrenal H.
M-bp concern
Cushing Syndrome (opposite Addison's): too much adrenal H.; hyypercortisolism
exogennous-external source (Cushing's syndrome)- from meds, cortisol-based steriodes
endogenous (Cushing's disease)-- body is doing it-autoimmune; too much ACTH
--pituitary adenoma- benign tumor W>M
--eptopic ACTH- secreted outside of pituitary M>W
S&S: cortisol breads down body producing: weak lig, fatty deposits neck, face, abs, upperback, bone thinning, purple stretch marks, hirutism: hair growth
M risks: increase bp, delicate skin, bone, compromised immunity
Diabetes Mellitus
Type 1: autoimmune reaction; islets of Langerhans (can't grow back) killed off?
can't produce insulin (dependent)
Type 2: dietary; $132 bill/yr = 11% of health care
some genetic and social aspects involved
insulin (key to get in cells) in short supply
insulin resistant
either way glucose accumulates in blood cells
Type 1: autoimmune or complication of infection, exposure to drugs or chemical
Type 2: 90% obese, diet, exercise; can wear and tear pancreas causing decrease insulin production
gestational diabetes - with pregnancy and can become type 2
**S&S: 3Ps:
-Polyuria: pee a lot more; sweet pee; water follows sugar and salt
-polydipsia: increase thirst do to lots of peeing
-Polyphagia: increase hunger
fatigue, wight loss, etc.
ketoacidosis: fruity breath, type 1 only,
metabolism of fat and protein = ketomes, acidosis which leads to convulsions
triggered by stress, infection, trauma
leads to shock, coma, death
Hyperosmolality: insulin shock
Complications: cardiovascular, edema, kidney (**number 1 cause of renal failure), impaired vision, endothelium, ulcers, gangrene, amputation, neuropathy at cranial nerves
HgbA1C (hemoglobin) 80-90 is great blood sugar reading
Tx: type 1: insulin supplementation
type 2: diet, exercise, the meds and insulin
Hyperthyroidism: thyroid produces excessive hormones that stimulate metabolism of ___into energy
Graves- autoimmune and most common (70-80%); goiter(thyroid grows), excess thyroxine
w>m, can see other autoimmune
Graves, lupus, type1
inflammation of thyroid
nodules on thyroid
S&S: can't sleep, hot, diarrhea, increase heartbeat, brittle nails, bones are osteoporosis, eyes are exophthalmus? bulging out looking
Hypothyroidism: decrease thyroid production
Hashimoto thyroiditis
autoimmune, high TSH, T4 low, T3 normal
factors: complication with hyperthroid, birth defect, postpardum, meds, radiation, Iodine deficiency
S&S: metabolism decrease, weight gain, fatigue, depression, sluggish, digestion, intolerant to cold
edema-swell carpal tunnel
goiter
hair loss at lateral eyebrow
heavy menses
increase risk heart disease
Metabolic syndrome: aka syndrome X, on way to type 2 or heart disease; Pre-diabetes
S&S: central obesity, increase bp, increase fasting glucose, increase triglyceride
limit alcohol
Thyroid Cancer:
papillary thyroid cancer- 70-80% of cases, stays near thyroid
follicular thyroid cancer- 10%, goes other places too
respect the cancer
Tx; remove thyroid
CHAPTER 12 - BLOOD
circulating blood
important in maintaining homeostasis
classified as connective tissue
8% of body weight
Function
Transportation: (gases, nutrients, waste) carries O2 to tissues, carries CO2, hormones, ...
Regulations: pH levels 7.35-7.45, substance maintain osmotic/oncotic pressure (pull waste in veins, and regulation of heat
Protection: disease, blood loss- cells and antibodies of immune system, carries factors to protect blood loss
Blood constituents
Plasma: liquid portion (salty)
**Formed elements:
-erythrocytes: rbc, no organelles, lots of hemoglobins
-leukocytes: wbc
-platelets (thrombocytes): tiny things help with clotting; pieces of a meagcarrior cell
Plasma: 91% water, 8% protein: albumin, clotting fact, antibodies, complement; and 1% other: glucose, amino acids, lipids, electrolytes, ...
Plasms = serum + clotting factors
Formed elements- produced in red bone marrow
-hematopietic (making blood) stem cells
can develop into any bc
short lived 3months
rbc are about 7micrometers
Erythrocytes:
RBC, most numerous
biconcave shape, mature cells anuclear
contain hemoglobin
-binds to o2 for transport
-carries hydrogen ions for buffering
-carries co2 for elimination
Leukocytes: WBC, colorless, round, 2 goups:
-Granulocytes (shotgun guys)
neutrophils (polymorphs) should have more of these
eosinophis: seen with parasites or allergies
basophils: high number can mean cancer
-Agranulocytes (gobble things up)
lymphocytes: B-cells and T-cells
monocytes: gobble things up
Platelets: blood coagulation
meagkaryocytes fragments
Hemostasis
Bloodclotting: needs calcium
fibrinogen converts into fibrin
procoags
anticoags
serum is fluid left over after blotting takes place
Blood types, must be compatible; protein
Acromegaly: too much GH, get too big.
can happen in kids is called gigantism, adults it is acromegaly
affects flat bones more, big forehead and jaw
shorter life- Andre the Giant
GH also release insulin like growth factor (IGF-I[one]) (somatomedin C)
problems with heart-careful with massage
Addison Disease: not enough adrenal H.; not enough aldosteral- balance o f electrolytes/ help absorb sodium
not absorbing water because not enough aldosteral
low cortisol too, adrojenic H.
tumors can be a cause
70% of the time it's autoimmune
tuberculosis
Primary Addison's is with the adrenals
Secondary Addison's is decreased anterior pituitary secretion of ACTH (too much makes people look too tan/orange)
Tertiary Addison's is problem with hypothalamus
-cortisol depletion-- weak mm, fatigue, decreased bp, hypoglycemia, irritability, depression, hyperpigmentation,
tend to be thin due to electrolyte imbalance; nausea, vomiting, diarrhea
Addisonia crisis: sudden onset of extreme symptoms if these come on real quick they can die
Die without adrenal H.
M-bp concern
Cushing Syndrome (opposite Addison's): too much adrenal H.; hyypercortisolism
exogennous-external source (Cushing's syndrome)- from meds, cortisol-based steriodes
endogenous (Cushing's disease)-- body is doing it-autoimmune; too much ACTH
--pituitary adenoma- benign tumor W>M
--eptopic ACTH- secreted outside of pituitary M>W
S&S: cortisol breads down body producing: weak lig, fatty deposits neck, face, abs, upperback, bone thinning, purple stretch marks, hirutism: hair growth
M risks: increase bp, delicate skin, bone, compromised immunity
Diabetes Mellitus
Type 1: autoimmune reaction; islets of Langerhans (can't grow back) killed off?
can't produce insulin (dependent)
Type 2: dietary; $132 bill/yr = 11% of health care
some genetic and social aspects involved
insulin (key to get in cells) in short supply
insulin resistant
either way glucose accumulates in blood cells
Type 1: autoimmune or complication of infection, exposure to drugs or chemical
Type 2: 90% obese, diet, exercise; can wear and tear pancreas causing decrease insulin production
gestational diabetes - with pregnancy and can become type 2
**S&S: 3Ps:
-Polyuria: pee a lot more; sweet pee; water follows sugar and salt
-polydipsia: increase thirst do to lots of peeing
-Polyphagia: increase hunger
fatigue, wight loss, etc.
ketoacidosis: fruity breath, type 1 only,
metabolism of fat and protein = ketomes, acidosis which leads to convulsions
triggered by stress, infection, trauma
leads to shock, coma, death
Hyperosmolality: insulin shock
Complications: cardiovascular, edema, kidney (**number 1 cause of renal failure), impaired vision, endothelium, ulcers, gangrene, amputation, neuropathy at cranial nerves
HgbA1C (hemoglobin) 80-90 is great blood sugar reading
Tx: type 1: insulin supplementation
type 2: diet, exercise, the meds and insulin
Hyperthyroidism: thyroid produces excessive hormones that stimulate metabolism of ___into energy
Graves- autoimmune and most common (70-80%); goiter(thyroid grows), excess thyroxine
w>m, can see other autoimmune
Graves, lupus, type1
inflammation of thyroid
nodules on thyroid
S&S: can't sleep, hot, diarrhea, increase heartbeat, brittle nails, bones are osteoporosis, eyes are exophthalmus? bulging out looking
Hypothyroidism: decrease thyroid production
Hashimoto thyroiditis
autoimmune, high TSH, T4 low, T3 normal
factors: complication with hyperthroid, birth defect, postpardum, meds, radiation, Iodine deficiency
S&S: metabolism decrease, weight gain, fatigue, depression, sluggish, digestion, intolerant to cold
edema-swell carpal tunnel
goiter
hair loss at lateral eyebrow
heavy menses
increase risk heart disease
Metabolic syndrome: aka syndrome X, on way to type 2 or heart disease; Pre-diabetes
S&S: central obesity, increase bp, increase fasting glucose, increase triglyceride
limit alcohol
Thyroid Cancer:
papillary thyroid cancer- 70-80% of cases, stays near thyroid
follicular thyroid cancer- 10%, goes other places too
respect the cancer
Tx; remove thyroid
CHAPTER 12 - BLOOD
circulating blood
important in maintaining homeostasis
classified as connective tissue
8% of body weight
Function
Transportation: (gases, nutrients, waste) carries O2 to tissues, carries CO2, hormones, ...
Regulations: pH levels 7.35-7.45, substance maintain osmotic/oncotic pressure (pull waste in veins, and regulation of heat
Protection: disease, blood loss- cells and antibodies of immune system, carries factors to protect blood loss
Blood constituents
Plasma: liquid portion (salty)
**Formed elements:
-erythrocytes: rbc, no organelles, lots of hemoglobins
-leukocytes: wbc
-platelets (thrombocytes): tiny things help with clotting; pieces of a meagcarrior cell
Plasma: 91% water, 8% protein: albumin, clotting fact, antibodies, complement; and 1% other: glucose, amino acids, lipids, electrolytes, ...
Plasms = serum + clotting factors
Formed elements- produced in red bone marrow
-hematopietic (making blood) stem cells
can develop into any bc
short lived 3months
rbc are about 7micrometers
Erythrocytes:
RBC, most numerous
biconcave shape, mature cells anuclear
contain hemoglobin
-binds to o2 for transport
-carries hydrogen ions for buffering
-carries co2 for elimination
Leukocytes: WBC, colorless, round, 2 goups:
-Granulocytes (shotgun guys)
neutrophils (polymorphs) should have more of these
eosinophis: seen with parasites or allergies
basophils: high number can mean cancer
-Agranulocytes (gobble things up)
lymphocytes: B-cells and T-cells
monocytes: gobble things up
Platelets: blood coagulation
meagkaryocytes fragments
Hemostasis
Bloodclotting: needs calcium
fibrinogen converts into fibrin
procoags
anticoags
serum is fluid left over after blotting takes place
Blood types, must be compatible; protein
Thursday, January 26, 2012
1-25-12 Wednesday
MFR
Quiz on Fri.:
3 questions regarding pelvic stabilisation; long/short leg and what to do
assess assess and reassess
3 techniques with people who have siatic/pseuosiatic, LB issues
3 joints of Illium/pelvis (pubic sympysis and 2 SI)
psoas shorten/lengthen with internal rotation of femur?
unwinding with diaphragm- 50/50 lead follow, guiding ...
basics of cross hand release- time, location
4 different qualities of ground substance.
ETHICS
finish reading notes
Homework (still looks long . . . ugh)
quiz??? i don't remember
PHYS/PATH
Review of what we went over on Monday
Quiz on Fri.:
3 questions regarding pelvic stabilisation; long/short leg and what to do
assess assess and reassess
3 techniques with people who have siatic/pseuosiatic, LB issues
3 joints of Illium/pelvis (pubic sympysis and 2 SI)
psoas shorten/lengthen with internal rotation of femur?
unwinding with diaphragm- 50/50 lead follow, guiding ...
basics of cross hand release- time, location
4 different qualities of ground substance.
ETHICS
finish reading notes
Homework (still looks long . . . ugh)
quiz??? i don't remember
PHYS/PATH
Review of what we went over on Monday
Tuesday, January 24, 2012
1-23-12 Monday
Plantar fasciitis: pain, bould be inflammatory (diet/adreanal) or degenerative in foot
men=women, 2 mil/yr., runners (shoes)
aggravate: overweight, flat feet, bad/worn shoes, hypertonic calf mm,
secondary: gout, diabetes, FA
Tx: orthotics, massage, etc
Scleroderma: basically things are hardening up; autoimmune-production abnormal amounts of collagen
skin, hard skin, other tissues hard too
esophagus doesn't close leads to stomach acid easy to get out
women over men
lots of collagen (type 3) laid down (scar tissue)
local scleroderma-skin hard
systemic, blood vessels, skin, heart, jts, evertything
S&S: ***CREST syndrome
C-calciniosis: calcium deposits in skin
R-Raynaud phenomenon
E- Esophageal dysmotility
S- sclerodactyly- hard fingers
T-terangiectasia- spider veins
systemic (like RA, ) sjogren syndrome: dry up
Tx: drugs/meds, manage, immune suppressant
M: be careful of circulatory system/kidney
Tendinopathies: injury/damage to tendons
intrinsic: overuse, poor flexibility, underlying disease, direct force
extrinsic: training
S&S: looks like mm strain, pain resisted contraction
Tx; anti inflams, rice, stretch
m: respect acute injury
Tenosynovitis: tendon pass through synovial sheath becomes irritated/inflamed
at thumb type of de Quervain ??
S&S: pain, swell, heat, crepitas
Tx: anti symptoms
Whiplash: strain sprain neck
MVA and other injuries
20mph has amplified effect---12g
get checked out
jts, disks, subluxatoin vertebrae, TMJ, nerves, wholee body
radicular pain, pain in other areas
Tx: neck collar as short as possible, mm relaxants, anti inflam
Carpal Tunnel Syndrome: entrapment median nerve; symptom in hand
10% adults at sometime
women 3:1
nerve, artery
S&S: pain, numb, pins and needles, thenar atrophy, sleep position,
diabetes, RA, others
diag: Tinel test, Phalen maneuver
Disc Disease: problems with nucleus palposus (inside disc), or annulus fibrosis (outer part of disc)
herniated, bulge, protrusion, rupture ....
complications: spinal cord compression, cauda equina syndrome
Myasthenia Gravis: sutoimmune, destructino of receptor site at NMJ
women in their 20s and men in 50s
testing/diag: mm fatigue with eyes blinking; all mm fatigue easily
can affect arms, legs, respiratory
Tx: surgery and stuff
Thoracic Outlet Syndrome: brachial plexus impingment
anterior/middle scalene, coracoid, pec minor, clavicle and 1st rib, lung cancer
Test things
bones, three cells, osteoblast,clast,cytes and funct
basic unit of bone, osteons, havershian systems, compact,supongy, diaphysis,epiphysis parts
know the bones. little with origin and insertion of stuff
mm physiology, sacromere, thinck and thin filliments, calcium role---the whole operation of contraction
sarcoplasmic reticulum, no ATP=rigamortis
myofiber/cell and myofibrill, three types of tissue mm: smooth,cardiac, skel.
conditions: fibromyalgia, women, tenderpoints fatigue
osteroporosis, decrease calcium, weak bones
isotonic and isometric
what do you do with pathology
akylosing spondylosis
ajogrens
RA vs. osteroarthritis, DIP PIP
carrpal tunnel
whiplash
osgood schlater
Chapter 11 the Endocrine system; glands and hormones
Endocrine system: coordinates all other body systems, works with nervous system
endocrine glands: produce hormone into blood
adrenal gland get most blood supply?
Hormones (abbreviated H for ease): chemical messengers with regulatory effect on cells or organs
release directly into tissue/not ducts
affect many tissue
growth, thyroid H., insulin (blood sugar)
Affect specific tissue
thyroid stimulating H. (TSH) stim thyroid to work
adrenocortinotropic H (ACTH): stim adrenal glands
Hormone Chemistry
-amino acid compound
proteins of related compounds
all hormones except steroids
-lipids
most are steroids, from cholesterol
produced in adrenal cortex and sex gland
prostaglandings are also lipids
order
pineal gland: carcadin rhythm setter; melatonin, cortisol?
hypothalamus: monitoring blood
pituitary: produce TSH, ACTH
thyroid: T4 and T3 stuff?
ovaries/testes
adrenals
Hormone regulation
most negative feedback
some post. feedback
rhythmic pattern
brain, digestive organs, kidney also produce hormones
****p.210 and 211***
Pituitary (hypophysis) gland
*master gland
release H that affect working of other glands
controlled by hypothalamus
2 H from posterior pituitary (only stores them)
both made in hypothalamus: oxytocin and ADH- anti diarehtic H (pee less)
Control of Pituitary
Hypothalamus
-sends releasing H (RH) and inhibiting hormones (IH)
-produces antidiuretic H (ADH) and oxytocin
Hormones of Anterior lobe
growth H (GH) or somatotropin
thyroid stim H (TSH) or thyro____
ACTH
prolactin (PRL)
gonadotrpins: follick stim (FSH) and ____ (LH)
Posterior lobe
stores ADH and oxytocin
Thyroid gland- largest endocrine gland
lateral lobes on either side of larynx
Hormones of thyroid (speed things up)
thyroxine (T4)
principle H
increase energy and protein metabolism rate
triiodothyronine (T3)
increase energy and protein metabolism rate
calcitonin (red-headed step child)
reg. calcium metabolism
works with parathyroid H and vit D
Parathyroid gland (back of thyroid gland)
4 gland in posterior capsule of thyroid
secrete parathyroid H (PTH)
works with calcitonin to reg calcium meta.
Calcium metabolism
calc. balance requires:
calcitriol (dihydroxycholecalciterol) - produced by modifying vit D in liver than in kidney
parathyroid H
Calcitonin
Adrenal Gland
2 small glands on top of kidneys
each with 2 parts that act as separate glands
medulla- adrenalin/norepinephrine
cortex- cortisol, DHDA?, progesteron, etc. (longer lasting H)
vit C big co-factor
H. from
adrenal cortex:
glucucorticoids- cortisol (increase glucose levels in blood) or hydrocortisone
mineralocorticoids- aldosterone
sex hormones
Panreas and __ H.
islets of Langerhans* are specialised pancreas cells that secrete:
-insulin (gets sugar inside cells), decrease blood sugar, stim manufacture amino acids into protein
-glucagon- increase blood sugar
Sex glands
ovaries/testes produce H. to develop sexual characteristics, maintain reproductive organs
men=testosterone
women=estrogen, progesteron
Thymus gland- T cells
mass of lymphoid tissue in upper chest superior heart
important in development of immunity
produces thymosin- assist in maturity of T lymphocytes
Pineal Gland- cone shaped, posterior mid brain
produce melatonin
influence sleep/wake cycle
appears to delay onset of puberty
Other H. producing tissue
stomach, small intestine, kidney, brain, atria of heart, placenta
prostaglanding- group H. made by most body tissue
-produced, act, and rapid inactivited in or close to origin?
-constrict struct
-dilate struct
-promote inflammation
H. and Tx
-synthetics or animal replacements
H. Stress
stress response involves nervous and endocrine system.
H. release during stress help body cope
unchecked levels of H. can harm body
Aging
pancreas- adult onset diabetes
...
men=women, 2 mil/yr., runners (shoes)
aggravate: overweight, flat feet, bad/worn shoes, hypertonic calf mm,
secondary: gout, diabetes, FA
Tx: orthotics, massage, etc
Scleroderma: basically things are hardening up; autoimmune-production abnormal amounts of collagen
skin, hard skin, other tissues hard too
esophagus doesn't close leads to stomach acid easy to get out
women over men
lots of collagen (type 3) laid down (scar tissue)
local scleroderma-skin hard
systemic, blood vessels, skin, heart, jts, evertything
S&S: ***CREST syndrome
C-calciniosis: calcium deposits in skin
R-Raynaud phenomenon
E- Esophageal dysmotility
S- sclerodactyly- hard fingers
T-terangiectasia- spider veins
systemic (like RA, ) sjogren syndrome: dry up
Tx: drugs/meds, manage, immune suppressant
M: be careful of circulatory system/kidney
Tendinopathies: injury/damage to tendons
intrinsic: overuse, poor flexibility, underlying disease, direct force
extrinsic: training
S&S: looks like mm strain, pain resisted contraction
Tx; anti inflams, rice, stretch
m: respect acute injury
Tenosynovitis: tendon pass through synovial sheath becomes irritated/inflamed
at thumb type of de Quervain ??
S&S: pain, swell, heat, crepitas
Tx: anti symptoms
Whiplash: strain sprain neck
MVA and other injuries
20mph has amplified effect---12g
get checked out
jts, disks, subluxatoin vertebrae, TMJ, nerves, wholee body
radicular pain, pain in other areas
Tx: neck collar as short as possible, mm relaxants, anti inflam
Carpal Tunnel Syndrome: entrapment median nerve; symptom in hand
10% adults at sometime
women 3:1
nerve, artery
S&S: pain, numb, pins and needles, thenar atrophy, sleep position,
diabetes, RA, others
diag: Tinel test, Phalen maneuver
Disc Disease: problems with nucleus palposus (inside disc), or annulus fibrosis (outer part of disc)
herniated, bulge, protrusion, rupture ....
complications: spinal cord compression, cauda equina syndrome
Myasthenia Gravis: sutoimmune, destructino of receptor site at NMJ
women in their 20s and men in 50s
testing/diag: mm fatigue with eyes blinking; all mm fatigue easily
can affect arms, legs, respiratory
Tx: surgery and stuff
Thoracic Outlet Syndrome: brachial plexus impingment
anterior/middle scalene, coracoid, pec minor, clavicle and 1st rib, lung cancer
Test things
bones, three cells, osteoblast,clast,cytes and funct
basic unit of bone, osteons, havershian systems, compact,supongy, diaphysis,epiphysis parts
know the bones. little with origin and insertion of stuff
mm physiology, sacromere, thinck and thin filliments, calcium role---the whole operation of contraction
sarcoplasmic reticulum, no ATP=rigamortis
myofiber/cell and myofibrill, three types of tissue mm: smooth,cardiac, skel.
conditions: fibromyalgia, women, tenderpoints fatigue
osteroporosis, decrease calcium, weak bones
isotonic and isometric
what do you do with pathology
akylosing spondylosis
ajogrens
RA vs. osteroarthritis, DIP PIP
carrpal tunnel
whiplash
osgood schlater
Chapter 11 the Endocrine system; glands and hormones
Endocrine system: coordinates all other body systems, works with nervous system
endocrine glands: produce hormone into blood
adrenal gland get most blood supply?
Hormones (abbreviated H for ease): chemical messengers with regulatory effect on cells or organs
release directly into tissue/not ducts
affect many tissue
growth, thyroid H., insulin (blood sugar)
Affect specific tissue
thyroid stimulating H. (TSH) stim thyroid to work
adrenocortinotropic H (ACTH): stim adrenal glands
Hormone Chemistry
-amino acid compound
proteins of related compounds
all hormones except steroids
-lipids
most are steroids, from cholesterol
produced in adrenal cortex and sex gland
prostaglandings are also lipids
order
pineal gland: carcadin rhythm setter; melatonin, cortisol?
hypothalamus: monitoring blood
pituitary: produce TSH, ACTH
thyroid: T4 and T3 stuff?
ovaries/testes
adrenals
Hormone regulation
most negative feedback
some post. feedback
rhythmic pattern
brain, digestive organs, kidney also produce hormones
****p.210 and 211***
Pituitary (hypophysis) gland
*master gland
release H that affect working of other glands
controlled by hypothalamus
2 H from posterior pituitary (only stores them)
both made in hypothalamus: oxytocin and ADH- anti diarehtic H (pee less)
Control of Pituitary
Hypothalamus
-sends releasing H (RH) and inhibiting hormones (IH)
-produces antidiuretic H (ADH) and oxytocin
Hormones of Anterior lobe
growth H (GH) or somatotropin
thyroid stim H (TSH) or thyro____
ACTH
prolactin (PRL)
gonadotrpins: follick stim (FSH) and ____ (LH)
Posterior lobe
stores ADH and oxytocin
Thyroid gland- largest endocrine gland
lateral lobes on either side of larynx
Hormones of thyroid (speed things up)
thyroxine (T4)
principle H
increase energy and protein metabolism rate
triiodothyronine (T3)
increase energy and protein metabolism rate
calcitonin (red-headed step child)
reg. calcium metabolism
works with parathyroid H and vit D
Parathyroid gland (back of thyroid gland)
4 gland in posterior capsule of thyroid
secrete parathyroid H (PTH)
works with calcitonin to reg calcium meta.
Calcium metabolism
calc. balance requires:
calcitriol (dihydroxycholecalciterol) - produced by modifying vit D in liver than in kidney
parathyroid H
Calcitonin
Adrenal Gland
2 small glands on top of kidneys
each with 2 parts that act as separate glands
medulla- adrenalin/norepinephrine
cortex- cortisol, DHDA?, progesteron, etc. (longer lasting H)
vit C big co-factor
H. from
adrenal cortex:
glucucorticoids- cortisol (increase glucose levels in blood) or hydrocortisone
mineralocorticoids- aldosterone
sex hormones
Panreas and __ H.
islets of Langerhans* are specialised pancreas cells that secrete:
-insulin (gets sugar inside cells), decrease blood sugar, stim manufacture amino acids into protein
-glucagon- increase blood sugar
Sex glands
ovaries/testes produce H. to develop sexual characteristics, maintain reproductive organs
men=testosterone
women=estrogen, progesteron
Thymus gland- T cells
mass of lymphoid tissue in upper chest superior heart
important in development of immunity
produces thymosin- assist in maturity of T lymphocytes
Pineal Gland- cone shaped, posterior mid brain
produce melatonin
influence sleep/wake cycle
appears to delay onset of puberty
Other H. producing tissue
stomach, small intestine, kidney, brain, atria of heart, placenta
prostaglanding- group H. made by most body tissue
-produced, act, and rapid inactivited in or close to origin?
-constrict struct
-dilate struct
-promote inflammation
H. and Tx
-synthetics or animal replacements
H. Stress
stress response involves nervous and endocrine system.
H. release during stress help body cope
unchecked levels of H. can harm body
Aging
pancreas- adult onset diabetes
...
Sunday, January 22, 2012
1-20-12 Friday
PHYS/PATH (what else)
Spasms, Cramps: involuntary contraction of voluntary mm; can involve O2 supply, nutrition, ischemia, exercise, splinting?
Strain: injury to mm, tendon
can be trauma, overuse
myofibers are torn, fibroblasts lay down scar tissue (1st-3rd degrees severity)
moderate to severe pain, local, scar tissue leads to adhesion
mvmt makes worse
***healing Phase
1- acute in flammation
2- collagen deposition (proliferative phase) can start 48hrs post to 12 months (3 wks typical)
3- **(most important for MT)- reorganization of collagen, up to 12 months (remodeling phase) **8-10 wks post collagen formation becomes permanent
Tx- RICE, rehab
Avascular Osteonecrosis/Necrosis: blood supply to bone is impeded leading to loss/death of bone tissue
femur head and distal end of scaphoid main areas
clots and embolisms can occur
S&S: pain (occurs with tissue dying) joint collapse
diag: radiography
Fractures: broken bone; simple, incomplete, compound, etc.
Tx. immobilization, hydro opposite limb
Osteoporosis: porous, bones, calcium removed faster than replaced (bone loss)
woman higher risk due to frame, childbearing (adrenals), menopause,
calcium consumption influence bone density also vitamins, minerals, exercise, blood pH, meds, moods, diseases
Calcium absorb- vit D,K, acidic environment in stomach (true for all minerals), too much vit A impede calcium uptake
Calcium loss- caffeine, hyperthyroid, alcohol, smoking, inflammatory bowel disease
maintain
osteoblasts/clasts, ends of bones
femur head and vertebrae are common area affected
DEXA- bone density scan
prevent, get calcium from absorbable source
Paget Disease: bone broken down 50x faster; replaced with disorganized fibrous connective tissue
osteoclasts are 5x larger than normal
areas: skull, vertebrae, pelvis, legs
S&S: plapable heat
complication- fractures
local contra
Postural Diviations
-hyperkyphosis: humpback
-hyperlordosis: wayback
-scoliosis: s,c curve
Ankylosing Spondylitis: autoimmune disease, progressive inflammation, arthritis of spine with fusing
hip, SI joint, low back
**most common in 16-35yr old men
goes with Crohn disease (inflam of intestines), psoriasis, other autoimmune disease
Pain LB, refers to butt, legs
flare and remission
during flare, generral malais?, irits** (inflammation in eyes), possible fracture
complications: cauda equina syndrome (PNS pressure), inflammation of kidneys, eyes, etc.
Tx- PT, anti inflam, surgery
Dislocation: bone not where it should be
shoulders, fingers, hip
hip dysplasia, (Marfan, Ehlers Disease)
S&S: swelling, discoloration, loss function, pain
Complications: ligament laxity
Gout: chemistry based inflam. arthritis (big toes, spleen/liver meridian)
men 10:1
uric acid crystals- very painful
metabolic gout and
penal gout
trigger- drinking, diet, high-purine (meat), obesity, alcohol, hypertension,
sudden onset
complication: kidney stones, renal failure
pseudogout
Tx- drugs
Lyme Disease: infection with spirochete
Stages- bull's eye rash (50/50), high fever, fatigue, stiff neck
diag- difficult to be accurate
Tx- antibiotics
prevention: long sleeves, pants, check for ticks
Osteoarthritis: synovial jt (especially weight bearing), usually due to wear and tear*
bone on bone
degenerative joint disease
-most common type of arthritis
MT- take care of saddle joint (thumb)
causes risk: age, overweight, decrease h2o, history of trauma, surgery
with fingers: DIPs (Heberden nodes) over PIPs (Bouchard nodes)*
Tx- NSAID
exercise within pain tolerance, maintain ROM, strength mm, stamina/weight
Patellofemoral Syndrome: inflammation behind patella
precursor for osteoarthritis
main causes- overuse/overloading, alignment
S&S: pain anterior knee, stiff, crepitas (crunchy knees/jt), difficulty with walking(especially down stairs)
Rheumatoid Arthritis (whole body thing): autoimmune on synovial membrane
women>men
thick/welling in synovial, nodules
typically bilateral, may not be symmetrical
nodules on sclera, pleuritis, hepatitis, vasculitis (Raynaud)
Sjogren syndrome: dry up glands
diag: super stiff AM, hot showers help
Tx- anti-inflam, decrease pain, suppress immune system
Spondylosis: shrink between joint spaces (disk space), and edges of bones move out
not all cause pain, can put pressure on nerves
Sprains: injured/torn ligaments (1st-3rd degree severity)
repair = collagen fibers laid down
swelling is greater than strain
Tempromandibular Joint Disorder: issues with jaw
problems with spine leads to jaw/TMJ
common after MVA
common with fibromyalgia and others
bruxiam: grinding teeth
Ehlers-Danlos Syndrome: (producing bad collagen) weak connective tissue lead to jt dislocation
Rare
don't heal well after injury
delicate skin
detach retina
Marfan Syndrome: genetic, dysfunctional fibrillin
tend to be tall, with bulge or caved sternum, long fingers and toes
connective tissue is weak
eye disorders, heart aorta
Tx- manage symptoms
Massage- gentle
Muscular Dystrophy: degenerative wasting mm tissue
mm being replaced with fat
noticed by age 2- walking on toes
Duchene and Becker are X linked (more common in men)
other types not gender specific
blood test- creatine kinase super high
short life expectancy
Osteogenesis Imperfecta: bones formed with weak collagen; super easy to break (movie Unbreakable)
Baker Cyst: behind knee, cyst in synovial
common in kids, also adults with other trauma, RA, complications
could impair blood flow-lead to clots
Bunions: big toe deviates inward
woman 10:1
Bursitis: inflammation of bursa
adrenal imbalance, inflammatory diet
make sure not infection
Dupuyten Contracture: palmar aponerousis tighten with 4-5th digit fingers tighten up (palmar fascitis)
men>women, idiopathic, can lose function
Ganglion Cyst: pouch on jt, capsule or tendenous sheath; most common on extensors
local contra
Hernia: hole in abdominal wall, diaphragm
men7:1
all types of hernias
tx- surgical repair
complications: strangulation and all kinds of stuff
Osgood-Schlatter Disease: bones not grown as fast as mm
inflammation at tibial tuberosity with pull from quad mm
local contral
Pes Planus (flat feet)
Pes Cavus (big arches/caved/jammed)
feet=shock absorbers
footwear, adrenals, posterior tibialis
Spasms, Cramps: involuntary contraction of voluntary mm; can involve O2 supply, nutrition, ischemia, exercise, splinting?
Strain: injury to mm, tendon
can be trauma, overuse
myofibers are torn, fibroblasts lay down scar tissue (1st-3rd degrees severity)
moderate to severe pain, local, scar tissue leads to adhesion
mvmt makes worse
***healing Phase
1- acute in flammation
2- collagen deposition (proliferative phase) can start 48hrs post to 12 months (3 wks typical)
3- **(most important for MT)- reorganization of collagen, up to 12 months (remodeling phase) **8-10 wks post collagen formation becomes permanent
Tx- RICE, rehab
Avascular Osteonecrosis/Necrosis: blood supply to bone is impeded leading to loss/death of bone tissue
femur head and distal end of scaphoid main areas
clots and embolisms can occur
S&S: pain (occurs with tissue dying) joint collapse
diag: radiography
Fractures: broken bone; simple, incomplete, compound, etc.
Tx. immobilization, hydro opposite limb
Osteoporosis: porous, bones, calcium removed faster than replaced (bone loss)
woman higher risk due to frame, childbearing (adrenals), menopause,
calcium consumption influence bone density also vitamins, minerals, exercise, blood pH, meds, moods, diseases
Calcium absorb- vit D,K, acidic environment in stomach (true for all minerals), too much vit A impede calcium uptake
Calcium loss- caffeine, hyperthyroid, alcohol, smoking, inflammatory bowel disease
maintain
osteoblasts/clasts, ends of bones
femur head and vertebrae are common area affected
DEXA- bone density scan
prevent, get calcium from absorbable source
Paget Disease: bone broken down 50x faster; replaced with disorganized fibrous connective tissue
osteoclasts are 5x larger than normal
areas: skull, vertebrae, pelvis, legs
S&S: plapable heat
complication- fractures
local contra
Postural Diviations
-hyperkyphosis: humpback
-hyperlordosis: wayback
-scoliosis: s,c curve
Ankylosing Spondylitis: autoimmune disease, progressive inflammation, arthritis of spine with fusing
hip, SI joint, low back
**most common in 16-35yr old men
goes with Crohn disease (inflam of intestines), psoriasis, other autoimmune disease
Pain LB, refers to butt, legs
flare and remission
during flare, generral malais?, irits** (inflammation in eyes), possible fracture
complications: cauda equina syndrome (PNS pressure), inflammation of kidneys, eyes, etc.
Tx- PT, anti inflam, surgery
Dislocation: bone not where it should be
shoulders, fingers, hip
hip dysplasia, (Marfan, Ehlers Disease)
S&S: swelling, discoloration, loss function, pain
Complications: ligament laxity
Gout: chemistry based inflam. arthritis (big toes, spleen/liver meridian)
men 10:1
uric acid crystals- very painful
metabolic gout and
penal gout
trigger- drinking, diet, high-purine (meat), obesity, alcohol, hypertension,
sudden onset
complication: kidney stones, renal failure
pseudogout
Tx- drugs
Lyme Disease: infection with spirochete
Stages- bull's eye rash (50/50), high fever, fatigue, stiff neck
diag- difficult to be accurate
Tx- antibiotics
prevention: long sleeves, pants, check for ticks
Osteoarthritis: synovial jt (especially weight bearing), usually due to wear and tear*
bone on bone
degenerative joint disease
-most common type of arthritis
MT- take care of saddle joint (thumb)
causes risk: age, overweight, decrease h2o, history of trauma, surgery
with fingers: DIPs (Heberden nodes) over PIPs (Bouchard nodes)*
Tx- NSAID
exercise within pain tolerance, maintain ROM, strength mm, stamina/weight
Patellofemoral Syndrome: inflammation behind patella
precursor for osteoarthritis
main causes- overuse/overloading, alignment
S&S: pain anterior knee, stiff, crepitas (crunchy knees/jt), difficulty with walking(especially down stairs)
Rheumatoid Arthritis (whole body thing): autoimmune on synovial membrane
women>men
thick/welling in synovial, nodules
typically bilateral, may not be symmetrical
nodules on sclera, pleuritis, hepatitis, vasculitis (Raynaud)
Sjogren syndrome: dry up glands
diag: super stiff AM, hot showers help
Tx- anti-inflam, decrease pain, suppress immune system
Spondylosis: shrink between joint spaces (disk space), and edges of bones move out
not all cause pain, can put pressure on nerves
Sprains: injured/torn ligaments (1st-3rd degree severity)
repair = collagen fibers laid down
swelling is greater than strain
Tempromandibular Joint Disorder: issues with jaw
problems with spine leads to jaw/TMJ
common after MVA
common with fibromyalgia and others
bruxiam: grinding teeth
Ehlers-Danlos Syndrome: (producing bad collagen) weak connective tissue lead to jt dislocation
Rare
don't heal well after injury
delicate skin
detach retina
Marfan Syndrome: genetic, dysfunctional fibrillin
tend to be tall, with bulge or caved sternum, long fingers and toes
connective tissue is weak
eye disorders, heart aorta
Tx- manage symptoms
Massage- gentle
Muscular Dystrophy: degenerative wasting mm tissue
mm being replaced with fat
noticed by age 2- walking on toes
Duchene and Becker are X linked (more common in men)
other types not gender specific
blood test- creatine kinase super high
short life expectancy
Osteogenesis Imperfecta: bones formed with weak collagen; super easy to break (movie Unbreakable)
Baker Cyst: behind knee, cyst in synovial
common in kids, also adults with other trauma, RA, complications
could impair blood flow-lead to clots
Bunions: big toe deviates inward
woman 10:1
Bursitis: inflammation of bursa
adrenal imbalance, inflammatory diet
make sure not infection
Dupuyten Contracture: palmar aponerousis tighten with 4-5th digit fingers tighten up (palmar fascitis)
men>women, idiopathic, can lose function
Ganglion Cyst: pouch on jt, capsule or tendenous sheath; most common on extensors
local contra
Hernia: hole in abdominal wall, diaphragm
men7:1
all types of hernias
tx- surgical repair
complications: strangulation and all kinds of stuff
Osgood-Schlatter Disease: bones not grown as fast as mm
inflammation at tibial tuberosity with pull from quad mm
local contral
Pes Planus (flat feet)
Pes Cavus (big arches/caved/jammed)
feet=shock absorbers
footwear, adrenals, posterior tibialis
Thursday, January 19, 2012
1-16-12
PHYS/PATH
1- AP (action potential)
2- ACh in synapse (NMJ)
3- AP continues
4- ca released from sacroplasmic reticulum
5- ca causes troponin/tropomyosin to uncover binding site on actin
6- myosin binding head with ADP+P attaches to actin binding site
7- attaching causes ADP+P gets knocked off; explosion causes myosin head to bend
8- ATP enters the cell and binds to myosin head causing it to release from actin attaching causes ADP+P formation
myoglobin: 'back up' stones reserves of O2
Glycogen: 'starch in a plant' storage form of glucose
creatine phosphate: stores energy
mm contraction requires ATP oxidized in mm cells from o2, glucose or other usable nutrient
effects of exercise
increase balance, jt flex, mm size (hypertrophy), mm tissue, vasodilation, weight control, stronger bones, strengthen heart mm, breathing and respiratory efficiency.
mm contration
isotonic: no change in tension, mm length shortens, mvmt (lifting)
isometric: great increase in tension, mm length unchanged, no mvmt (pushing)
partial contraction: tonus
tendons to bone
prime movers and synergists
antagonists
lever-bone
fulcrum-joint
force-applied by mm
3classes of levers (3rd is most common in body)
mm physiology
PATHOLOGY SECTION
syndrome is collection of symptoms
Fibromyalgia: chronic pain in mm, tendon, etc.; tender points, chest sternum, back, trap; symmetric, main jts
fatigue, lack of sleep
85-90% in women
usually have autoimmune too
tender points-9 predictable pain, all quadrants
stiff after rest, poor stamina
complications- depression
tx- ed, meds
m- within tolerance, don't use tender points as trigger points, avoid ice,
Myofascial Pain Syndrome
-development of trigger points
men=women
knot or taut bands in mm
Tx. botox, acupuncture
Myositis Ossificans
-mm inflammation with bone formation
calcification of mm to bone
most common with injury
local contra
tx is rest
Shin Splints: umbrella term for variety of lower leg problems
S&S- mild to sever pain, mm contraction makes it worse
stress fracture-makes it worse overtime
Tx- decreased activity/rest, shoe change, hydrotherapy, steroid injection, surgery
1- AP (action potential)
2- ACh in synapse (NMJ)
3- AP continues
4- ca released from sacroplasmic reticulum
5- ca causes troponin/tropomyosin to uncover binding site on actin
6- myosin binding head with ADP+P attaches to actin binding site
7- attaching causes ADP+P gets knocked off; explosion causes myosin head to bend
8- ATP enters the cell and binds to myosin head causing it to release from actin attaching causes ADP+P formation
myoglobin: 'back up' stones reserves of O2
Glycogen: 'starch in a plant' storage form of glucose
creatine phosphate: stores energy
mm contraction requires ATP oxidized in mm cells from o2, glucose or other usable nutrient
effects of exercise
increase balance, jt flex, mm size (hypertrophy), mm tissue, vasodilation, weight control, stronger bones, strengthen heart mm, breathing and respiratory efficiency.
mm contration
isotonic: no change in tension, mm length shortens, mvmt (lifting)
isometric: great increase in tension, mm length unchanged, no mvmt (pushing)
partial contraction: tonus
tendons to bone
prime movers and synergists
antagonists
lever-bone
fulcrum-joint
force-applied by mm
3classes of levers (3rd is most common in body)
mm physiology
PATHOLOGY SECTION
syndrome is collection of symptoms
Fibromyalgia: chronic pain in mm, tendon, etc.; tender points, chest sternum, back, trap; symmetric, main jts
fatigue, lack of sleep
85-90% in women
usually have autoimmune too
tender points-9 predictable pain, all quadrants
stiff after rest, poor stamina
complications- depression
tx- ed, meds
m- within tolerance, don't use tender points as trigger points, avoid ice,
Myofascial Pain Syndrome
-development of trigger points
men=women
knot or taut bands in mm
Tx. botox, acupuncture
Myositis Ossificans
-mm inflammation with bone formation
calcification of mm to bone
most common with injury
local contra
tx is rest
Shin Splints: umbrella term for variety of lower leg problems
S&S- mild to sever pain, mm contraction makes it worse
stress fracture-makes it worse overtime
Tx- decreased activity/rest, shoe change, hydrotherapy, steroid injection, surgery
Saturday, January 14, 2012
1-13-12 Friday
PHYS/PATH
Section A of the appendix in the pathology book-drugs/meds
anti-anxiety:
-benzodiazepenes (for short term anxiety): valium, ativan, xanax
complications: decrease heartrate, unaware of pain
-buspirone Hcl
anti-depressant: try to mimic, block, inhibit
-tricyclics: monamine oxidse inhibitors (MAOIs)
selective serotonin reuptake inhibitors (SSRIs): prozac, zoloft, paxil
others: wellbutrin
Anti-inflammatory and analgesic
salicylates: asprin (thin blood), bayer
acetaminophen: tylenoal
steroidal anti-inflam: prednizone, cortisone, hydrocortine
non steroidal ai (NSAID): celebrex, advil, excedrin, aleve
narcotics and mixed narcs: codeine, oxycotin, vicodin, dulaudid
Autonomic nervous system drugs
cholinergic- parasympathetic
anticholinergic
adrenergic-sympathetic: flomax
Cardiovascular
beta blocker
calcium channal blockers
ACE inhibitors (side effect can be cough)
digitalis
anti angina: nitroglycerin-vasodialation
anti lipemic: lipitor, zocor, questran
diuretics (make pee more): thiazide - losing potassium
Cancer drugs: stop cell replication or tumor itself. not prolonging life, just shrinking tumor
clotting
anticoagulants- heparin, coumadin
massage can bruise
antiplatelet: asprin, plavix
diabetes: type 1: cannot produce insulin; low blood sugar = non responsive
type 2: environment, diet
insulin
oral glucose
muscle relaxant
centrally acting skeletal mm relaxants: flexeril, norflex, valium,
thyroid: T4-inactive T3-gets activated
evothyroxine, synthetic T4 - going to speed things up
dessicated-armour thyroid T4 and T3, not synthetic
liothyronin- cytomet, synthetic T3
class on drugs: A,B,C,D
less toxic is A, to most toxic which is D
Chapter 6 in Memmler's
skeletal system: bones, jt, connective tissue
Bones: framework, protective structure, calcium source, blood cells, leverage for mvmt
types: compact bone: **Haversion system (osteons)-circle with artery and vein in the middle (p92)
spongy (cancellous)
bone marrow: red and yellow
bone membranes
periosteum (outside)
endosteum (inside)
***types of bone cells
osteoblasts: matrix
osteocytes: repair/maintain
osteoclasts: resorb bone tissue
ossification: conversion of cartilage to bone
formation long bone
cartilage turns into bone
epiphyseal plates on both ends
bones continue to lengthen
bone stop
bones resorption and formation continues
bone markings
projections
depressions
axial, appendicular
cranial ,facial
anterior fontanel (soft spots on infant skull)
vertebral
aging:
decrease: calcium salts, protein, collagen, height, chest diameter
Chapter 7-mm
smooth, cardiac, skeletal
smooth: tapered end, narrow, long, no striated, involuntary,
stim-nerve impulses, hormones, stretching
cardiac: involuntary, heart, branching interconnection, ***intercalated disc**, single central nucleus, striated
Stim- electrical impulse, para/sympathetic
skeletal: voluntary, striated,
muscular system:
mvmt of skeletal,
posture maintenance
heat generation-mvmt creates heat
structure of mm
connective tissue layers
-endomysium: around individual fibers
-perimysium: bundles of mm fibers
-epimysium: over entire mm, part of deep fascia
tendons
mm cell=mm fiber
**mm fibrills are within each fiber
mm cell in action
each mm fiber attches to synaps
neuromuscular junction (NMJ) (special synapse for mm)
-neurotransmitter
-synaptic cleft
-receptors
-motor end plate
Acetocholyin with nicotinic receptor
properties of mm
excitability
-action potential
contractility
-actin-thin red/orange fiber
-myosin-thick blue fiber
-sarcomere
-ATP
need ATP and calcium for mm contraction
calcium:
released when nerve fiber stim mm cell
attaches to proteins blocking receptor sites
allows cross bridges to form between actin and myosin
returns to endoplasmic reticulum (ER) whick is called "sarcoplasmic reticulum" in mm cell
Energy sources
ATP
O2
glucose or others
myoglobin?
O2 consumption
aerobic glucose metabolism
-requires O2
-used during normal _____
anaerobic glucose metabolism
-doesn't require o2
-used during strenuous activity
-less ATP produced
-lactic acid accumulates
-o2 debt develops
recovery o2 consumtion
Section A of the appendix in the pathology book-drugs/meds
anti-anxiety:
-benzodiazepenes (for short term anxiety): valium, ativan, xanax
complications: decrease heartrate, unaware of pain
-buspirone Hcl
anti-depressant: try to mimic, block, inhibit
-tricyclics: monamine oxidse inhibitors (MAOIs)
selective serotonin reuptake inhibitors (SSRIs): prozac, zoloft, paxil
others: wellbutrin
Anti-inflammatory and analgesic
salicylates: asprin (thin blood), bayer
acetaminophen: tylenoal
steroidal anti-inflam: prednizone, cortisone, hydrocortine
non steroidal ai (NSAID): celebrex, advil, excedrin, aleve
narcotics and mixed narcs: codeine, oxycotin, vicodin, dulaudid
Autonomic nervous system drugs
cholinergic- parasympathetic
anticholinergic
adrenergic-sympathetic: flomax
Cardiovascular
beta blocker
calcium channal blockers
ACE inhibitors (side effect can be cough)
digitalis
anti angina: nitroglycerin-vasodialation
anti lipemic: lipitor, zocor, questran
diuretics (make pee more): thiazide - losing potassium
Cancer drugs: stop cell replication or tumor itself. not prolonging life, just shrinking tumor
clotting
anticoagulants- heparin, coumadin
massage can bruise
antiplatelet: asprin, plavix
diabetes: type 1: cannot produce insulin; low blood sugar = non responsive
type 2: environment, diet
insulin
oral glucose
muscle relaxant
centrally acting skeletal mm relaxants: flexeril, norflex, valium,
thyroid: T4-inactive T3-gets activated
evothyroxine, synthetic T4 - going to speed things up
dessicated-armour thyroid T4 and T3, not synthetic
liothyronin- cytomet, synthetic T3
class on drugs: A,B,C,D
less toxic is A, to most toxic which is D
Chapter 6 in Memmler's
skeletal system: bones, jt, connective tissue
Bones: framework, protective structure, calcium source, blood cells, leverage for mvmt
types: compact bone: **Haversion system (osteons)-circle with artery and vein in the middle (p92)
spongy (cancellous)
bone marrow: red and yellow
bone membranes
periosteum (outside)
endosteum (inside)
***types of bone cells
osteoblasts: matrix
osteocytes: repair/maintain
osteoclasts: resorb bone tissue
ossification: conversion of cartilage to bone
formation long bone
cartilage turns into bone
epiphyseal plates on both ends
bones continue to lengthen
bone stop
bones resorption and formation continues
bone markings
projections
depressions
axial, appendicular
cranial ,facial
anterior fontanel (soft spots on infant skull)
vertebral
aging:
decrease: calcium salts, protein, collagen, height, chest diameter
Chapter 7-mm
smooth, cardiac, skeletal
smooth: tapered end, narrow, long, no striated, involuntary,
stim-nerve impulses, hormones, stretching
cardiac: involuntary, heart, branching interconnection, ***intercalated disc**, single central nucleus, striated
Stim- electrical impulse, para/sympathetic
skeletal: voluntary, striated,
muscular system:
mvmt of skeletal,
posture maintenance
heat generation-mvmt creates heat
structure of mm
connective tissue layers
-endomysium: around individual fibers
-perimysium: bundles of mm fibers
-epimysium: over entire mm, part of deep fascia
tendons
mm cell=mm fiber
**mm fibrills are within each fiber
mm cell in action
each mm fiber attches to synaps
neuromuscular junction (NMJ) (special synapse for mm)
-neurotransmitter
-synaptic cleft
-receptors
-motor end plate
Acetocholyin with nicotinic receptor
properties of mm
excitability
-action potential
contractility
-actin-thin red/orange fiber
-myosin-thick blue fiber
-sarcomere
-ATP
need ATP and calcium for mm contraction
calcium:
released when nerve fiber stim mm cell
attaches to proteins blocking receptor sites
allows cross bridges to form between actin and myosin
returns to endoplasmic reticulum (ER) whick is called "sarcoplasmic reticulum" in mm cell
Energy sources
ATP
O2
glucose or others
myoglobin?
O2 consumption
aerobic glucose metabolism
-requires O2
-used during normal _____
anaerobic glucose metabolism
-doesn't require o2
-used during strenuous activity
-less ATP produced
-lactic acid accumulates
-o2 debt develops
recovery o2 consumtion
Thursday, January 12, 2012
1-11-12 Wednesday
ETHICS
3 broader goals of course: critical thinking skills, personal empowerment, resources/authorities
Professional Ethics
-Integrity: respect boundaries, high moral standards, respect
-Personal responsibility
-Self-accountability
-Self respect
Key Terms
-values: what is important to you
-morals: good/bad, right/wrong
-principles: values and morals in action
-ethics: system or rules of conduct
-laws: formal, societal rules of conduct with consequences
professionalism
2 cornerstone duties
-non-maleficence: do no harm
-beneficence: do good
Clients rights
-respect
-informed and prior consent
-self determination - choose or refuse
-safety/competency and confidentiality
Therapeutic relationships
-client centered: co-creation. Every MT action is in service to client, who has a voice.
-Fiduciary relationship: based upon trust
-Power differential: client trusts specialist with their well being
Psychological Concepts
-Transference (counter): client unconsciously redirects feelings from prior relationship with caretaker figure toward MT
-Projection: client or MT attributes their own (uncomfortable) feelings to MT.
-Repression: client or MT removes painful experience, feelings from consciousness
-Denial: distorted interpretation of events, often rationalizing a diminished impact of reality
-6 steps in resolution P.11
MFR
for next class be in 'assessment' clothes
Quiz:
different forces: torque, sheer, etc.
3 primary components: collagen, elastin, ground substance and their basic function
3 things fascia responds to: time, heat, pressure
soul purpose of MFR: relieve pain and restore function
describe basics of diaphragm unwinding
know all diaphragms and where they are
vasomotor response
PHYS/PATH
Trigeminal Neuralgia aka tic douloureux
: nerve pain along 1 or more of three branches of CN V
usually older people 60+
CN V is irritated, cause is questionable
artery or vein wraps around CN V as it emerges from pons
sharp, electric, burning pain/sensation
can last up to 2 min. or several jabs in succession
Type 1: sharp blasts of pain on one side face, related to mild trigger
Type 2: long lasting burning pain, ache, with occasional blots of severe pain
triggers: ? chew, swallow, speak, draft, light touch
Tx: rule out tooth infection, sinus
acupuncture, anticonvulsant drug, microvascular surgery
Guillain-Barre Syndrome : acute inflammation and destruction of myelin layers of peripheral nerves (loss of feeling)
kind of like MS but after viral infection usually
-worry when it gets to diaphragm, no breathing
on both sides
starting distal, legs, moving proximal
S&S: symmetrical, fast, severe onset, reflex diminished, S&S are distinct, most have full recovery if they don't die (5-7%)
Headaches
-most self contained temporary problems
-some have serious underlying conditions
Types
-primary (freestanding) vs. secondary (symptom of another problem)
Tension-type HA: most common 90-92%
-mm tension, bony misalignment
-episodic or chronic
Vascular HA
-migraine - vasoconstriction
classic and common
trigger- weather, stress, food, hormones
cluster HA aka suicide HA: more common in men
sinus HA: allergy, infection
chemical HA: alcohol (hangover), decrease blood sugar, rebound HA med overusage
traction inflammation HA: tumor etc.
Tx- trigger management and journal
Meniere Disease
-inner ear dysfunction
*S&S: vertigo, tinnitus (ringing in ear), hearing loss, (fullness in middle ear)
mostly younger 20-50
men=women
causes? autoimmune, rupture in labyrinth ?
onset is fast
similar symptoms as neuroma - tumor, MS
Tx- BP management
Seizure Disorder: interconnecting neurons in brain give off bursts of energy
lots of triggers
causes: could be many things
partial seizures
generalized seizures
-absence seizure
-status epileptieus
diag. EEG, CT, MRI
tx. meds, diet
Sleep disorders: trouble sleeping
not sleeping=not healing
melatonin=sleep
cortisol?=wake
sleep cycles
Types:
-parasomnia: disrupts sleep (night terrors)
-dyssomnia: can't initiate, maintain sleep
-insomnia: apnea: no breath; central sleep apnea
-restless leg syndrome
-narcolepsy: sleeping attacks
circadian rhythm disruption
-certain times of days for certain things day/night rhythms
tired, irritable, grumpy, mood
tx: sleep hygiene, no caffeine, exercise
Vestibular Balance disorder
vertigo
CN VIII
vomit, dizzy
benign paroxysmal -- -- ?
labyrinthitis
meneirs disease
head injury
drugs, tumor, stroke
one S&S nystagmus: eyes move back and forth
Things for celebration:
CN: names and numbers and function
2 disease of CN, which, symptoms, who gets them
ear: 3 chambers, fluid inner, tympanic membrane, 3 bones, virtation? tube to equalize pressure
parts and function of eye: cornea, lens, sclera choriod retina, white part of eye, cone, rodss
action potential parts and players and relation
synapse: neurotransmitters
adrenergic? and coloergic?
nicotini? and muscoinic?
structure of nerve
meningines order and layer
corpus colosum; connect right and left
giri, sulcus, lobes and function
limbic system function
3 parts of brain stem and function
diencephalon
afferent/efferent-dorsal vs. ventral horn, reflex arch and parts
ventricles: function: produce cerebral spinal fluid
alzeimers, parkinsons, gillian berrie, meyer? disease, spina bif, polio and ms difference, stroke, key age groups ms/trigen
3 broader goals of course: critical thinking skills, personal empowerment, resources/authorities
Professional Ethics
-Integrity: respect boundaries, high moral standards, respect
-Personal responsibility
-Self-accountability
-Self respect
Key Terms
-values: what is important to you
-morals: good/bad, right/wrong
-principles: values and morals in action
-ethics: system or rules of conduct
-laws: formal, societal rules of conduct with consequences
professionalism
2 cornerstone duties
-non-maleficence: do no harm
-beneficence: do good
Clients rights
-respect
-informed and prior consent
-self determination - choose or refuse
-safety/competency and confidentiality
Therapeutic relationships
-client centered: co-creation. Every MT action is in service to client, who has a voice.
-Fiduciary relationship: based upon trust
-Power differential: client trusts specialist with their well being
Psychological Concepts
-Transference (counter): client unconsciously redirects feelings from prior relationship with caretaker figure toward MT
-Projection: client or MT attributes their own (uncomfortable) feelings to MT.
-Repression: client or MT removes painful experience, feelings from consciousness
-Denial: distorted interpretation of events, often rationalizing a diminished impact of reality
-6 steps in resolution P.11
MFR
for next class be in 'assessment' clothes
Quiz:
different forces: torque, sheer, etc.
3 primary components: collagen, elastin, ground substance and their basic function
3 things fascia responds to: time, heat, pressure
soul purpose of MFR: relieve pain and restore function
describe basics of diaphragm unwinding
know all diaphragms and where they are
vasomotor response
PHYS/PATH
Trigeminal Neuralgia aka tic douloureux
: nerve pain along 1 or more of three branches of CN V
usually older people 60+
CN V is irritated, cause is questionable
artery or vein wraps around CN V as it emerges from pons
sharp, electric, burning pain/sensation
can last up to 2 min. or several jabs in succession
Type 1: sharp blasts of pain on one side face, related to mild trigger
Type 2: long lasting burning pain, ache, with occasional blots of severe pain
triggers: ? chew, swallow, speak, draft, light touch
Tx: rule out tooth infection, sinus
acupuncture, anticonvulsant drug, microvascular surgery
Guillain-Barre Syndrome : acute inflammation and destruction of myelin layers of peripheral nerves (loss of feeling)
kind of like MS but after viral infection usually
-worry when it gets to diaphragm, no breathing
on both sides
starting distal, legs, moving proximal
S&S: symmetrical, fast, severe onset, reflex diminished, S&S are distinct, most have full recovery if they don't die (5-7%)
Headaches
-most self contained temporary problems
-some have serious underlying conditions
Types
-primary (freestanding) vs. secondary (symptom of another problem)
Tension-type HA: most common 90-92%
-mm tension, bony misalignment
-episodic or chronic
Vascular HA
-migraine - vasoconstriction
classic and common
trigger- weather, stress, food, hormones
cluster HA aka suicide HA: more common in men
sinus HA: allergy, infection
chemical HA: alcohol (hangover), decrease blood sugar, rebound HA med overusage
traction inflammation HA: tumor etc.
Tx- trigger management and journal
Meniere Disease
-inner ear dysfunction
*S&S: vertigo, tinnitus (ringing in ear), hearing loss, (fullness in middle ear)
mostly younger 20-50
men=women
causes? autoimmune, rupture in labyrinth ?
onset is fast
similar symptoms as neuroma - tumor, MS
Tx- BP management
Seizure Disorder: interconnecting neurons in brain give off bursts of energy
lots of triggers
causes: could be many things
partial seizures
generalized seizures
-absence seizure
-status epileptieus
diag. EEG, CT, MRI
tx. meds, diet
Sleep disorders: trouble sleeping
not sleeping=not healing
melatonin=sleep
cortisol?=wake
sleep cycles
Types:
-parasomnia: disrupts sleep (night terrors)
-dyssomnia: can't initiate, maintain sleep
-insomnia: apnea: no breath; central sleep apnea
-restless leg syndrome
-narcolepsy: sleeping attacks
circadian rhythm disruption
-certain times of days for certain things day/night rhythms
tired, irritable, grumpy, mood
tx: sleep hygiene, no caffeine, exercise
Vestibular Balance disorder
vertigo
CN VIII
vomit, dizzy
benign paroxysmal -- -- ?
labyrinthitis
meneirs disease
head injury
drugs, tumor, stroke
one S&S nystagmus: eyes move back and forth
Things for celebration:
CN: names and numbers and function
2 disease of CN, which, symptoms, who gets them
ear: 3 chambers, fluid inner, tympanic membrane, 3 bones, virtation? tube to equalize pressure
parts and function of eye: cornea, lens, sclera choriod retina, white part of eye, cone, rodss
action potential parts and players and relation
synapse: neurotransmitters
adrenergic? and coloergic?
nicotini? and muscoinic?
structure of nerve
meningines order and layer
corpus colosum; connect right and left
giri, sulcus, lobes and function
limbic system function
3 parts of brain stem and function
diencephalon
afferent/efferent-dorsal vs. ventral horn, reflex arch and parts
ventricles: function: produce cerebral spinal fluid
alzeimers, parkinsons, gillian berrie, meyer? disease, spina bif, polio and ms difference, stroke, key age groups ms/trigen
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