weakness, rigidity

Involuntary movement: tremor, nystagmus, spasticity, seizures, chorea

paralysis

Paralysis

Flaccid- muscles is deprived

Spastic- voluntary control and muscle inhibition are lost--like polio

too much muscle contraction--neurogenic bladder

too little muscle contraction--hirschsprung's disease

sensation

peripheral-numbness, tingling, sensory loss

central-headache, stiff neck

special senses

swelling or bleeding

contuision=bruise, concusson=bruise+loss of consciousness

hemorrhage between layers

-epidural, subdura, subarachnoid

most common

infarct downstream

fragment from clot in left heart or carotid artery

most serious=HIGH PRESSURE

rupture of cerebral artery b/c HTN

small blockage that just goes away

1/3 go on to have a major stroke

heterogenous, non progressive motor disease

lack of oxygen

65% mental retardation

spastic(increased tone) athetoid (increased movenent) atoxic (poor balance)

laceration, fracture

Carpel Tunnel syndrome

impaired judgment

alcoholic liver encephalopathy

pernicious anemia

Infections of nervous system

suppurative meningitis (increased neutrophils)

Neisseria meningitis (person to person)

strep pneumoniae (older adults)

 Tuberculous meningitis (lungs, chronic)

Fungal meningitis (lungs, immune compromised)

symmetric descending weakness

food-borne, wound, infant, young adult

viral meningitis-aseptic meningitis (not serious)

viral encephalitis (very serious)

arboviruses-transmitted by misquitos (west nile virus)

Poliomyelitis-fecal-oral spread, irradication due to immunization

Herpes zoster, sequelae of chickenpox

extreme pain, usually unilateral

Bell's Palsy-CN VII inflammation

Trigeminal Neuralgia-CN V inflammation

Aids- ecephalopathy, like alzheimer's

protein prion disruption of cell function

Creutzfeldt-Jacob and Mad Cow

progressive muscular weakness

distal part of limbs--"glove and stocking" pattern

degeneration of myelin sheaths

accute disturbances, eventually permanent

young women

immune attack on acetylcholine receptors

no reaction by muscles

Children--aspirin use

encephalopathy with brain swelling

Neoplastic

Meningioma-well circumscribed

Glioma (glial cells)-glioblastoma mulitformae=bad

Ependymoma

Medulloblastoma-primitive cells-children

Schwannoma-tumor of schwanna cells

Neurofibromatosis-little moles all over the body

Paraneoplastic syndrome-no room so causes mass effect

anencephaly-upper end

spina bifida-lower end

folic acid, but before conception

too much CSF

compression of brain tissue, brain atrophies

large cerebral arteries at base of brain

danger if rupture

seizures are a symptom

recurrent seizures

partial or generalized seizures

Short-term memory loss

loss or neurons, atrophy

progressive loss of neurons

no dopamine

They can find out if they are going to have it

strange movenents--chorea

AD passed on by father

progressive muscle weakness leading to death

outside to inside

otitis externa, vastibular neuritis

rubella (hearing loss)

inflammatory-conjunctivitis, orbital cellulitis

neoplastic-retinoblastoma

congenital-blindness, color blindness, myopia (near), esotropia, amblyopia

degenerative-glaucoma, cataracs

outer layer-cortex

inner layer-spongy, mesh-like lattice

marrow is the space between

osteoblast-create bone

osteoclast-removal of bone, phagocytes

fibrous-firm union with suture line=skull

cartilaginous-bone ends joined by cartilage

synovial-movable

intramembranous-osteoblasts become calcified bone

endochonral- cartilate cells form model;areas of active formation; long bones; epiphyseal plate

Thickness by periosteum (become osteoblasts

simple or comminuted

complete or imcomplete

displaced or non

compound

bone changes due to stress, risk for microfracture

female athlete triad-activity stimulates cortisol, decreases pituitary=amenorrhea

damage to adjacent tissue

systemic reaction=shock

short-term=emboli

long-term=lack of union

interruption of blood suplly cuases necrosis

usually younger boys

Vitamin D defficiency

bones too soft

sternum projects forward

rocketic rosary

pelvic opening narrowed

decalcification in adults

weight bearing bones bend and fracture

inflimmation of bone marrow=children

growth plate affected

spread by blood

decrease circulation to blood:necrosis

from lungs to ends of long bones

TB of vertebrae=Pott's disease

overproduction of abnormal bone in focal points

increase in bone tumors

major effects in small joints of hands and feet

thickening of synovial membrane

unstbale, displaced joints, adhesions, joint fusion

autoantibody against IgG

fluctiating symptoms

metastases spread from other tumors

benign: osteoma, chondroma-mass effect

Giant Cell tumor (can be malignant also)

oseogenic sarcoma-ends of long bones, painless swelling

multiple myeloma-nodular deposits throughts skeletal system, punched out lesions in skull, Bence-Jones proteins in urine

Congenital in bones

achondroplasia (AD)-problem at epiphyseal plate of long bones. (out of proportion dwarfism)

Malformation- syndactyl, polydactyl,clubfoot,hip dysplasia

Osteogenic imperfecta-multiple breaks

scoliosis:decrease thoracic size and lung function

primary-disorder of purine metabolism, deposits uric acid crystals, may cause kidney failure

secondary-leukemia (too much purine), kidney failure

base of great toe

generalized thinning of skeleton

post menopausal women (estrogen acts as breakdown inhibitor)

bone breakdown exceeds production

other cuases: atrophy, cushing's disease, hyperparathyroidism (bones lose calcium)

"wear and tear" degeneration of cartilage

slipped disk

disk composed of fibrous capsule, degeneration leads to decreased water content

disk forced out into spinal canal (damage nerve)

sprain-wrenching, twisting,ruptured blood vessel

strain- tearing of muscle or tendon ex: carpel tunnel

polymyosistis-inflammation and degeneration,systemic connective tissue disease

myasthenia gravis- failure to transmit nerve impulse to muscle

tumors rare

rhabdomysarcoma

Muscular dystrophy-muscle fiber

Duchenne-muscle displaced with fat, big muscles

death in late adolescence

Muscular atrophy-problems with nerves

cancer sores, ulcers

strep, gonnorhea, syphilis, herpes, candida

peridontal disease-absess of tooth leads to loss

Mouth congenital

cleft lip or palate

multifactorial inheritance

unilateral or bilateral

squamous cells

very dangerous

GERD-incompetent sphincter (does not close all the way)

scarring and stricture

Barret's Eophagus-epithelium metaplasia

RF for cancer

TE fistula

Hiatal Hernia-stomach portruding into thorax

spasm of LES

tears- jam upper part of the stomach

varices secondary to indreased pressure downstream

mass effect and infilatration of surrounding area

poor prognosis

aspirin (prostaglandin inhibitor-help lining of stomach)

hemmorhagic-leading to vomiting hematemesis

Chronic wasting-decreased intrinsic factor

decreased HCL

H. Pylori-produces ammonia, breakdown of mucus

Pepsino begin damaging uprotected stomach tissue

gastric and duodenal

H. Pylori-produces urease, neutralizes gastric acid

Ulcers lead to metaplasia of mucoa

bacterial, viral, or toxin

Hemolytic Uremic Syndrome

antibiotic associated: C difficile (toxins)

mass effect into lumen

obstruction downstream

appendicitis- trapped fecal matter

Iflammatory Bowel Disease: genetic predisposition

bacteria provokes intense cell-mediated response

t cells and cytokines cause inflimmation

Whole wall, not just mucosa, fibrotic walls, chronic obstructions, fistulae

"skip lesions"-surgery not helpful

spreads to colon

young adults

Mucosa only, continuous lesions

x-ray: characteristic lack of haustra-strait and rigid colon

lastoce intolerance, gluten intolerance (Celiac Disease)

bleeding due to lack of vitamin K absorption

Irritable Bowel Syndrome

Hirschprungs Disease

Colorectal Cancer-very bad

slow growing but deadly

very successful screening

polyps

Tumor-mass effect

Hernia

Volvulus-twisting of the bowel

Adhesions-connected intestine

Intussesception-telescoping of one part of intestine to another

can replace cells, but chronic disease can cause irreversible damage

fibrotic tissue-nonfunctional

measure blood levels

jaundice-bilirubin accumilation

tumor or gallstone

bile in blood is dark

no bile in poop is clay

decreased fat absorption-bleeding tendency

Hepatitis: A, B, C(Chronic carriers, Chronic infection, cirrhosis), D(After b), E (like A)

Cholecystitis:impaired storage and delivery of bile

decreased blood flow due to swelling

may be due to gallstones--levels of bile salt and cholesterol

fibrous nodules, loss of organization and function

Portal HTN, Impaired Function

circulation impaired, increased pressure, fluid into abdominal cavity, hemorrhage of high tension vessels

build up of toxins, hepatic encephalopathy

deacreased production of Albumin

blockage of bile ducts

estrogen normally inactivated have increased effect

increased ammonia affects brain

cirrhosis of bile ducts

primary-autoimmune

secondary-obstruction

Stage 1: Fatty Liver

Stage 2: Alcoholic Hepatitis

-mallory bodies, irreparable damage

Stage 3: alcoholic cirrhosis-portal HTN, impaired function

Hepatocarcinoma-usually secondary, and metastatic

because the liver is the filtering organ

fatty liver with decreased function

brain sweeling leading to coma

Inflammation of Pancreas

endocrine and exocrine

fat malabsorption

gallstones inflaming pancreatic duct

increased pancreatic enzymes in bood and urine

Congenital of Pancreas

Adenocarcinoma-exocrine tumor

block common bile duct, usually advanced, jaundice, impaired digestion, malabsoprtion, weight loss

Pancreatic endocrine tumors- more rare, insulinoma

Injury-radiation

Ingestion-lack of Iodine

Inflimmation-PID, pancreatitis

Neoplastic-pheochromocytoma, functional or non

Autoimmune-Grave's Disease

Congenital-adrenal hyperplasia, hypothyroidism

degenerative-type 2 diabetes

"central command"

releaseing and inhibiting hormones for pituitary gland

oxytocin, ADH/vasopressin

Hyposecretion-Diabetes Insipidus-failure to secrete ADH so not able to hold onto liquid

Anterior

GH, TSH, ACTH, FSH, LH, Prolactin (not tropic)

generally tumor

panhyperpituitarism-GH most noticeable effect

GH-giantism, acromegaly

TSH-increased metabolism

Prolactin-interrupting menstral cycle

skull fracture, tumor

panhypopituitarism
GH-dwarfism

TSH-obesity

ACTH-decreased cortizol

enlargede thyroid gland

toxic-producing excess hormone

non-toxic-excessive stimuation of thyroid gland

idodine defficieny, increased demand

severe is myxedema

primary: surgery

Congenital: gland fails to form or nonfunctional

Chronic inflammation from autoimmune attack-Hashimoto's thyroiditis

unsuccesffully attempting to produce thyroxine

Thyroid Hyperthyroidism

Grave's Disease (autoimmune): autoantibodies mimic TSH, ignores negative feedback

Tumor: nodular (well differentiated) or diffuse (undifferentiated)

increased metabolism

to much Ca from Bone

weak bones, kidney stones, muscle weakness, slow pulse

usually accidental removal in thyroid surgery

Tetany

Salt(aldosterone), Suger(cortizol), sex(DHEA)

Cushing's Disease-Pituitary tumor

Cushing's Syndrome-Adrenal tumor or tumors elswhere that produce ACTH

Hyperglycemia, Hyperlipidemia

Conn's Syndrome-hold onto aldosterone

Addison's Disease-failure to produce all corticosteriods:pee out a lot of glucose

increased skin pigmentation due to ACTS stimulation of melanin

male-congenital lack of or dysfunctional, atrophy of testes or failure to descend

female-poorly formed or missing ovaries

Ectopic hormones can be produced bye malignant tumors

lung, pancreas, kidney tumors produce ACTH, TSH

paraneoplastic syndrome

Alpha cells-glucagons

Beta cells-Insulin

Delta cells-somatostatin

Mellitus-insulin deficiency or resistance

Insipidus-vasopressin deficiency

autoimmune

sometimes after viral illness

beta cells do not secrete insullin

hyperglycemia

liver keeps turning glycogen into glucose and making glucose from amino acids

starvation in midst of plenty

dehydration leads to coma, renal failure of perfusion of continued diureses

fat breakdown increased blood cholesterol wich deposits in walls of vessels

fat breakdown produces fatty acids and ketone bodies--makes blood more acidodic

Blindness, cardiovascular, HTN, CV disease, decreased delivery of blodd to exremeties

Diabetic coma-metabloic acidosis, dehydration

Insulin shock-hyperglycemia if too much insulin

Normal or increased insulin levels

insulin resistance

no ketosis

beta cells not completely normal-not able to increase insulin production enough in face of increased glucose

increased metabolic demands, insufficient insulin

increased estrogen and progesterone interfere with insulin

risk increases with maternal age

HTN, wt gain

hypothalamus

fat cells produe LEPTIN

satiety signal-signal hypothalamus ot decrease appetite

long term matching of food intake to energy expenditure

onset puberty

undernourished-Intrauterine growth retardation: mother's diet, inborn errors of metabolism, Fetal Alcohol Syndrome

Overnourised-Large Gestational age (LGA)babies

Health consequences of obesity

metabolic syndrome: android vs. gynoid obesity

HTN, Hyperglycemia, Hypertriglyceridemia, abdominal obesity

Sleep Apnea, Obesity-hypoventilation syndrome, orthropedic problems, skin disorders, psychosocial stress

eating disorders, scarce food, alcoholism, Digestion and absorption problems

Protein-energy malnutrition: marasmus-all kinds of nutrients, kwashiorkor- mainly protein

organic, not supplied by body except vitamin D

essential coenzymes

fat soluble vs water-soluble: ADEK deficiency, water soluble deficiency

reversible vs. nonreversible

air-trapping-inability to expire

chronic bronchitis-mainly smokers

emphysema-alveolar walls break down

asthma-"twitchy airway" smooth musles constrict

leading cause of death in males and females

80 percent due to smoking

tumor blocking airway

Autosomal recessive, abnormal transport of Cl and Na

skin-perspiration

Airway- thick mucus

pancreas-blocked ducts decares digestive enzymes

extopic implants, mostly in pelvis, often esymptomatic

pain bleeding and infertility

Diabetic Nephropathy

diabetic glomerular sclerosis, thickening of glomerular basement membrane

protein leaks out

high concentration of salts in urine

urinary tract infection

urinary tract obstruction

calcium

colicky pain

Obstruction-tumor, enlarged prostate, malformation

Renal tubular injury, acute tubular necrosis, nephrotic syndrome, renal failure