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

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

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

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
...

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

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

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

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

Tuesday, January 10, 2012

1-9-12 Monday

PHYS/PATH

quiz: lewy bodies= Parkinson
plaques and tangles = Alzheimer
pain, vesicles along dermatome = herpes zoster aka shingles


meningitis: inflammation of meninges (arachnoid, cerebral spinal fluid)
fever, neck pain, bend knees, purple rash

bacteria- antibiotics, steroids; more severe, risk permanent damage, hearing, cognitive function

viral- supportive therapy; enteroviruses, herpes, others

increase pressure in brain, cranial nerves at risk
diagnosis: spinal tap
10day incubation with bact. and 3 wks if viral

passes by mucous secretions contaminated surfaces, oral-fecal
vaccine

Polio and postpolio syndrom (PPS); not common; infantile paralysis
digestive mucosa and anterior horn motor neurons
PPS: progressive mm weakness; 10-40 years later
oral-fecal, contaminated water
digestive
vaccine-one type weak other dead
salk is the inactive one
sabin is the weakend, with higher risk of infection


Anxiety Disorder- irrational fears, and controlling them. "am I safe?"
in women anxiety can be a sign of heart attack
limbic system- amygdala- history of fear response, and hippocampus - verbal memeroy
hypothalamic pituitary adrenal (HPA) imbalance- sympathetic and parasympathetic
fight/flight, HPA axis
lots of cortisol- breaks down body, weak connective tissue, suppressed immunity, shrink hippocampus
neurotransmitters- norepinephrine, GABA, serotonin
types: general anxiety disorder (GAD),
panic disorder- sympathetic reactions: increase heart rate, sweaty, dizzy, faint, impending doom,
acute and posttraumatic stress disorder (1m acute, 3+month post)
limbic system isn't processing well, constant F/F

obsessive compulsive disorder
unwelcome thoughts, effort to control them
common fear are: contamination, violence, being violent/sex act, ....

phobias


Attention deficit (hyperactivity) disorder
neurobiochemical- difficult with mvmt
given Ritalin, an adrenaline, epinephrin
adrenial fatigue; inattentiveness, hyperactive, impulsive

Autism Spectrum disorder: basically, not firing on all cylinders; in own little world
-communication
-specific, predictable mvmt patters
-sensory prob.
-early childhood (3years)
theories? heavy metals, predisposition
S&S: major issues:
-deficit verbal/nonverbal communication
-prob social interactions
-repetitive behaviors, mvmts

types: autistic disorder, asperger syndrome (mild form)


Chemical Dependency: use, abuse, dependence
alcoholism, caffine
alcohol is super sugar, damages every tissue it touches
psychological: it feels good, build tolerence
S&S: craving, can't control etc., withdrawal problems, denial

digestive: gastritis, ulcers, liver damage, pancreatitis (#1 cause is alcohol)
cardiovascular: arrythmia, increase and decrease clotting
nervous:
immune system: decrease resistance, pneumonia
reproduction: decrease sex drive, ED,


Depression: genetic-neurochemical disorder requiring some environmental trigger whose characteristic manifestation is an inability to appreciate sunsets? (that can't be right)
imbalance of serotonin, norepinephrine, dopamine
HPA axis - adrenal stim
hormonal imbalance - progesterone, estrogen, endophins
atrophy in hippocampus, may be related to cortisol levels
cause: genetics, environment, personality, chronic illness
eating sleeping?

major depression- 6-18months
bipolar-manic depression
seasonal affective disorder (SAD)
postpartum

SSRI-selective serotoin reuptake inhibitors: prozac, zoloft
SNRI: serotonin norepinephrin reuptake inhbitors

psychotherapy, light therapy, electric shock?, SAM-e, omega 3.....


Eating disorders
anorexia nervosa: self starvation
bulimia nervosa: normal or high calorie consumption, purging
(these 2 usually type A personality, athletes, power issues..)
binge eating: over eating without purging

complications: mental, emotional, physical
anorexia- bradycardia, hypotension, teeth damage/decay
bulimia- tooth erosion, esphogus prob.


Bells Palsy
**CN VII- facial nerve, mostly motor
preceded by herpes outbreak/cold
sudden onset
usually only one side of face

Cerebral Palsy
before, during, right after birth
damage to basal ganglia, cerebrum
spastic (one side hypertonic) CP is most common type

Complex Regional Pain Syndrome (CRPS) or (RSDS)
-hypersensitive nerves to pain
pain becomes self-fulfilling prophecy
burning pain at site
autonomic dysfunction
motor dysfunction


Spina Bifid: the bone didn't close
main risk factor- folate deficiency (pregnancy period)

occulta
meningocela
myelomeningoccele
complication hydrocephalus: water head


Spinal cord injury: self evident
concussion, contusion, compression, laceration, trasection
secondary: embolism due to bed rest, UTI


Stroke: heart attack in brain, blood vessel blockage or embolism, or hemorrhage (worst headache ever!)
blood on nerves
#3 cause of death - vascular issue, cardiovascular
most common CNS
O2 deprvation

TIA- transient ischemia attack, looks like stroke but temporary
aphysia- talk

Traumatic brain injuries: think of rebound injury sites too

Saturday, January 7, 2012

1-6-12 Friday

PHYS/PATH

Diencephalon
-Thalamus (old time telephone operator):sorts sensory inputs; directs impulse within cerebral cortex
-Hypothalamus:
maintains homeostasis
controlas sympathetic and parasym. a division of ANS
influences heart beat, blood flow, hormone secretion
only part of brain in contact with blood
says when full

Limbic system
b/w cerebrum and diencephalon
-involved in emotional states, behavior, learning, long term memory
stimulates reticular formation?
link function of cerebral cortex and brain stem

Brain Stem
-connects cerebrum and diencephalon with spinal cord
-composed of midbrain, pons, medulla oblongata:

midbrain
-superior part of BS
-4 masses form superior part of midbrain
-reflex involving eyes and ears
-conducts impulses between higher centers of cerebrum and lower centers of pons,and others

Pons:
-connecting link b/w cerebellum and rest of nervous system
-mainly respiration

Medulla Oblongata: (survival type reflexes)
-respiratory, cardiac, vasomotor centers
-contralateral control


Cerebellum
3parts
-Vermis, left and right hemisphere

function
-coordinate voluntary mm (smooth mvmts out)
-maintain balance
-maintain mm tone

Brain studies:
CT scan- computed tomography
MRI- magnetic resonance imaging
PET- positron emission tomography

electrocephalograph
records electric currents given off by brain nerve cells
sleep
diagnose disease
locate tumors
study drag effect
determine brain death

Cranial nerves! p.180-81)
12 pairs
4 categories
-special sensory impulse
-general sensory impulse
-somatic motor impulse
-visceral motor impulse

I. olfactory
II. optic nerve
III. oculomoto
IV. trochlear
VI. auducens
V. trigeminal
-ophthamic
-maxillary
-mandibular
VII. facial
VIII. vestibulocochlear
IX. glossopharyngeal
**X. vagus
XI. accessory
XII. hypoglossal

Aging nervous system
decrease brain size and weight
decrease speed information process
slowed mvmt
diminished memory
reduced blood flow to brain

CHAP. 10 Sensory system

The senses detects environmental changes
this initiates nerve impulses (stimulus)
stim interpreted by cerebral cortex
sensatoin

Sensory receptors (afferent)
structure
-free dendrite of sensory neuron
-end-organ on dendrite of afferent neuron
-specialized cell ass. with afferent neuron

type of stim/ receptors
chemo-chemical
photo-light
thermo-heat
mechano-mvmt

specialized
vision
hearing
equilibrium
taste
smell

general
pressure, temp, pain, touch
sense of position (like to know where head is)

Eye and Vision
eye protection structure
-eye cavity bones
-eyelids, lashes, brow
-conjunctiva
-lacrimal gland (tears produced)

Coats of eyeball
tunics (same as meninges of brain)
-sclera
-choroid
-retina

cornea, aqueous humor, lens, vitreous body

function of retina
-detects light and color
rods: dim light, shades of gray, blurred image
cones: bright light, color sensitive, sharp image
connects neurons

MM of eye
-intrinsic: lens and iris (adrenal gland stuff)
-extrinsic: outer surface, voluntary

Ear: hearing and equilibrium
outer and middle are air filled/hollow
inner is fluid filled

Outer
-pinna (aurick): directs sound waves into ear
-external auditory canal (meatus): ceruminous gland
-tympanic membrane (ear drum): vibrates as sound waves enter ear

Middle ear and ossicles (small bones inside) amplify sound waves and transmit sounds
-malleus (hammer)
-incus (anvil)
-stapes (stirrup)
Eustachian tube
-connects mid ear with throat (pharynx)
-allows pressure equalize on both sides of tympanic mem.
-continuous mucous mem. form pharynx to mid ear cavity

Inner ear
bony and membranous labyrinth
-vestibule (forward and back)
-semicicular canals (acts as level)
-cochlea
-perilymph fluid (bony); endolymph fluid (membranous)

hearing organ corti
-located in membranous cochlea (cochlear duct)
-ciliated receptors cells
-tectorial membrane

Equilibrium
located in vestibules and semicircular canals
types of equilibrium
-Static
vestibule: F/B (moving?)
maculae receptors
otoliths fluid
-Dynamic (more directions)
semicircular canals
cristae receptors

Taste; on tongue; basics are sweet, salty etc....
Smell; nasal cavity
-stim by subst. in solution in nasal fluids
-smells stims appetite and flow of digestive juices
olfacotry nerve (cranial nerve I)

Touch
-baroreceptors monitor BP and respond
Pressure
Temp.
Position
-proprioceptors (position)
-in mm, tendon, joints
-relay impulses in body parts in relation to each other
-send impulse to cerebellum for coord.

Pain and relief
different nerves fire at different rates


PATHOLOGY-chapter 4-nervous system

numbness can be more dangerous than pain
(non)verbal communication
meds

Alzheimer (AD) progressive degenerative brain disorder
-memory loss
-dementia
-personality change

-plaques (beta amyloid deposits)
-neourfibrillary tangles (tau protein)

chronic inflammation, injury, gluten? may be causes

Amyotrophic Lateral Sclerosis (ALS, Lou Gehrig disease)
progressive degen of motor neurons usually CNS but also PNS
starts as spasm in hands

Multiple Sclerosis (MS)
autoimmune, destroys mylein sheath
can be seen on both sides of body
pain, vision, bladder
symptoms come and go

Peripheral Neuropathy (PN)
issues with PNS damage
injury
infection
systemic disease
toxic exposure
Tx: antidepressants, TENS, etc.
numbness and pain

Dystonia
repetitive, involuntary, sustained contraction in skel. mm.
issue with basal gangia
burst of elect. activity
similar to parkinson, tourette, neck injury

Parkinson Disease
shaking palsy
prog. degen. mvmt disorder
dopamine problem with basal cell ganglia
*causes Lewy bodies build up (a protein)
S&S: resting tremor, bradaykinesia
Tx: meds, others

Tremor: rhythmic oscillation (a symptom)
an essential tremor
Huntington's disease


infection = systemic contra.

Encephalitis
infection of brain
usually viral
with myelitis, meningitis
primary
secondary: herpes simplex, measles, mumps,

Herpes Zoster
'shingles' extremely painful

Wednesday, January 4, 2012

1-4-12 Wednesday

PHYS/PATH

chap 8 of memmlers

Nervous system: coordinates body systems; detects and responds to stimuli

structural
central nervous system: CNS, brain and spinal cord
peripheral nervous system: PNS, cranial and spinal nerves

F(x):
somatic nervous system: voluntary, effectors are skeletal mm
autonomic (visceral) nervous system ANS: involuntary, smooth and cardiac mm, glands, divide by:
sympathetic - fight/flight, adrenaline
parasympathetic - rest and digest

Neuron-nerve cell
structure: cell body-nucleus, other organelles; cell fibers-dendrites, axon (some have myelin sheath)
schqann cell helps signal go faster, very outer layer neurilemma. This is called white matter

Types of neurons:
-sensory or afferent neurons: to the brain
-motor or efferent neurons: leave brain to mm
-interneuron/central or association neuron: within CNS

Nerves and Tracts
nerves are fiber bundles within PNS
Tracts are fiber bundles within CNS
organized into fascicles
connective tissue:
-endoneurium
-perineurium
-epineurium

Neuroglia (glial cells)
-protects and nourish nervous tissue
-supports nervous tissure
-aid in cell repair
-removes pathogens/impurities
astrocytes: blood brain barrier-go b/w capillary and neuron (p.149-50)

Nerve impulse
-plasma membrane carries elect. charge (potential)
-plasma membrane is polarized (neg charge)
-membrane potential reverses, generates elec. charge (action potential)
resting state
depolarization
repolarization
sodium/potassuim pump (Na+/K+)
myelin sheath speeds conduction

know chart p. 150

The synapse: junctino point for transmitting nerve impulse
axon (presynaptic) coming in
dendrite (postsynaptic)
synaptic cleft - space
neurotransmitters:
-epinephrine (adrenaline)
-norepinephrine (noradrenaline)
-acetylcholine- parasympathetic
-receptors

spinal cord - CNS
link b/w PNS and brain
coordinate impulses within CNS
contained and protected by vertebrae
-structure
unmyelinated tissue (gray matter) inside
-dorals horn (afferent)
-ventral horn (efferent)
-gray commissure
-central canal
myelinated axons (white matter) outside
-posterior median sulcus
-anterior median fissure
-ascending and decending tracts (nerve in CNS)

The reflex Arc
-recptor detects stimulus
-sensory neuron transmits impulse to CNS
-CNS coordinates impulses and org. response
-motor neuron carries impulses away from CNS
-effector carries out response
testin afferent and efferent : knee jerk/patellar reflex
reflex activities
-simple
-spinal

spinal nerves:
31 pairs
each nerve attached to spinal cord
-
-
-

Braches
-cerviacal plexus: phrenic nerve
-Brachial: radial
-lumbrosacral: sacral
-dermatomes: skin

Autonomic Nervous System: ANS
-reg. action of organs and glands, smooth and cardiac mm
-preganglionic neruon connects spinal to ganglion
-postganglionic neuron connects gang. to effector (always use actocolyn?)
ganglion: big group of cell bodies

sympathetic nervous system
-thoracolumbar area (T1-T12)
-collateral ganglia
-celiac ganglion
-superior mesenteric ganglion
-inferior mesenteric ganglion
-adrenergic system (adrenaline/sympathetic)


Parasympathetic
-carniosacral areas
-cholinergic system - actycholine?

Cellular receptors
-cholinergic (actycholine)
-nicotinic (binds nicotine) (somatic): on skel. mm cells, preganglionic
-muscarininc: effector cells of PNS (binds muscarin, a poison)

Adrenergic receptor
-found on receptor cells of sympathetic nervous system
-binds norepinephrine, epinephrine



Chapter 9

Brain:

Cerebrum:
-cerebral hemisphere
-longitudinal fissure divides into 2 hemispheres
-lobes

Diencephalon:
-thalamus
-hypothalamus (only part mixes with blood/ monitor internal conditions)

Brains Stem:
-midbrain: heart/lung fx
-pons: respiratory center
-medulla oblongata

Cerebellum: coordination and mm memory

**p. 169

right side: artistic
left side: analytical

Meninges: connective tissue membrane
3 layers:
-dura mater
-dural sinuses
-arachnoid
-pia mater

Cerebropinal fluid (CSF)
support nerve tissue, cushion shock
carries nutrients to cells
transport waste
produced in ventricles

Cerebral hemisphere
-lobes
>frontal: motor function
>parietal: sensory
>temporal: hearing
>occipital: vision
>insula (within hemisphere)

Cerebral cortex
-gyri
-sulci
-cenral sulcus
-lateral sulcus
-basal nuclei (basal ganglia)
-corpus callosum: connects right and left sides
-internal capsule

F(x) of cerebral cortex:

Front lobes:
-motor area
-speech center
-Broca area (motor speech area)

Parietal:
-sensory area
-est. distance, size, shape

Temporal:
-auditory
-olfactory (smell)
-Wernicke area (speech comprehension)

Occipital:
-visual receive
-visual association



short term/long term memory





MFR

-soul purpose of MFR is relieves pain and restore function (star question)
-3D application of sustained pressure and movement into fascial system
-eliminate fascial restrictions and old movement patterns (no longer relevant and are impeding health and well being [still moving as if injured])
-whole body hands on approach Tx of human structure
-tech. that address fascia - soft tissue mobilization, deep transverse friction, pelvic stabil.
-assit emotional release
-return order/equilibriu to whole person
-Indications: Acute and chronic pain, neurological and movement dysfunction, birth trauma, pelvic dysfun, scar tissue, headaches, ROM.
-Contraindications: general/systemic, local, thorough intake before Tx, assess, assess, assess and then, reassess,
avoid injury- never do anything to hurt cl., good pain vs. bad pain, observe cl., don't do anything you're unsure of
-talk to cl.
-listen to cl.
-watch body lang/ look for tension
-breathing patterns
-changes in skin color
-changes in voice pattern

Fascia
Barnes definition: continuous web connective tissues covering every surface of body; tendency to bind down, distort and cause pain when traumatized in any way; no such thing as a muscle-all is fascia; every muscle, fascicle, microfibril,bone, organ, vessel is surrounded or is fascia.

Tabers Definition: fibrous membrane covering, supports, separates mm, unites skin with underlying tissue, fascia may be superficial, a merely subcutaneous covering permitting free mvmt of skin, or deep enveloping and binding mm; tough connective tissue spreads from head to toe without interruption.

malfunction of fascia cause fibers to bind down/restrict with abnormal pressure on any _____ of body
creates pain with restriction
can cause malfunction in unrelated areas


**fascia responds (quicker) to time, heat, pressure.
divides body and holds up
tightens down in a coiled fashion
without fascia we be bag of bones

*3 components of fascia (collagen, elastin, ground substance)
-collagen:
trauma, stress, and dehydro causes fiber shorten
is protein which creates fibers, ensures no weakness
3 polypeptide chains provide strength over extension- known for its strength
root word= glue producer
most likely to be dysfunctional
tends to be shorten and thicken with trauma
tensile strength: 2000lbs/sq. in.

-elastin:
rubber like/ elastic
laid down parallel to collagen
mostly in skin and arteries
allows mvmt
rebounds and recoils- after being stretched
holds memory, both physical and emotional

-ground substance
used for protection
shock absorption
allows ease of mvmt. w/in tissue (inner fiber distance)
carries nutrients and O2
carries and diffuses waste
great conductor
offers glide viscosity