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

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

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!!!

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

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

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)

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

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

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

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

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)

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....