Clinical Correlates- Osteoporosis: - Porous bones- Decreased bone mass, weakened bones that are prone to fracture- Greater among the elderly and among women (especially postmenopausal) because they have less bone mass than men, lose it earlier and faster and no longer produce estrogen which helps bone growth- Less severe when men have it than women - About 90% of hip (neck of femur) fractures related to osteoporosis- Caused by genetics, insufficient Ca, vitamin D, insufficient weight bearing physical activity - Best treatment is prevention- Medical treatments: slowing rate of bone loss and attempting to stimulate new bone growth- Osteoarthritis:- AKA: degenerative joint disease- Degeneration of the articular cartilage with bony overgrowth around periphery of the joint, and eventual erosion of subchondral bone- Most common form of arthritis - About 25% of women and about 15% of men over 60 years old show signs of this disease- Has a multifactorial etiology, a component of which appears to be cumulative mechanical wear and tear and occupational stress- Common sites: 1st carpometacarpal joint in hand, and in joints that support the body weight such as hips and knees- Rheumatoid Arthritis: - Chronic, autoimmune, systemic, inflammatory disorder that attacks synovial membranes- Highest incidence in women aged 20-50 years, affects about 2.5% of the adult population- Primarily affects all of the small joints of the hands and feet, not the weight bearing joints- Herniated Disc:- AKA: slipped disc injury- Severe or unexpected compression of the vertebral column leads to nucleus pulposus bulging out of the annulus fibrosis- Leads to compression of the adjacent spinal nerve root resulting in severe leg or back pain (sciatica) - Most common sites are C5-C6, L4-L5, and L5-S1- Lumbar Puncture (Spinal Tap):- Preformed to draw CSF (3-9ml) from subarachnoid space- Inserting a needle midline between spinous processes of L3 and L4 (or L4 and L5)- Lower insertion in infants and children- CSF is analyzed to detect viruses, bacteria, toxins, drugs, blood cells, glucose and protein levels, CSF pressure- Normal CSF is clear and odorless- Spinal Block (spinal anesthesia) :- Injected from a needle into the subarachnoid space, typically between spinous processes of L3 and L4- Works very quickly, provides motor and sensory anesthesia - Used for many surgical procedures below the level of umbilicus - Midshaft fracture of the Humerus:- Occurs in the radial groove- Leads to radial nerve damage - Medial Epicondyle fracture of the Humerus: - Ulnar nerve damage- Carpal Tunnel Syndrome:- Median nerve at the wrist- Median nerve entrapment in carpal tunnel- Tunnel formation= carpal bones + flexor retinaculum - Carpal tunnel contents: median nerve + 9 flexor tendon- Common cause is inflammation of any component of the carpal tunnel, such as swollen tendons as a result of overuse- Weak grip, lose thumb opposition, loss of sensation in lateral 3 (1/2) digits- Unhappy Triad:- Injury to 3 structures in the knee - ACL, MCL and medial meniscus- Most common type of football injury- Leg is forcibly abducted and laterally rotated - Treatment: immobilizing knee or surgically repairing or replacing the ligament(s)- Horner Syndrome:- Condition caused by damage to the sympathetic innervation to the head- Symptoms: ptosis (superior eyelid drooping), miosis(constricted pupil), anhydrosis (absence of sweat), and distinct flushing ( redness and increased temperature of skin) due to lack of innervation to the blood vessel walls- Damage to CN VII if affects left eye- Caused: impingement, injury, or severing the cervical sympathetic trunk or the T1 sympathetic trunk ganglion- Raynaud’s Syndrome: - A sudden spasm or constriction of the small arteries of the digits- Immediate decrease in blood flow leads to blanching of skin (loss of redness) in the distal area of vascular constriction -> pain- Triggered by exposure to cold, or sometimes emotional stress due to an exaggerated response of sympathetic division - Can affect fingers, toes, ears, nose- Patent Foramen Ovale (open): blood typically goes from LA to RA- Kidney Stones (renal calculi) - Caused by: calcification of urine, most stones are formed by calcium containing material- Symptoms: pain in flank and blood in urine- Prevention: diet modification: decrease intake of oxalates (spinach, sweet potatoes, chocolate)- Treatment: pass the stones during micturition with help of painkillers, shockwave technique (ultra sonic), for large stones best if removed surgically via endoscopy - Urinary Incontinence- Inability to control micturition- Most common in women over 50 (postmenopausal)- -caused by thinning or drying of skin in vagina and urethra- Men with prostate enlargement - Women who recently gave birth and have weakened pelvic muscles- Treatment: kegel exercises- target pelvic and UG diaphragm muscles- Urinary Tract Infection (UTI)- Caused by bacterial, fungal, viral, or parasitic infection in urethra usually ascending infection into bladder- Symptoms: pain upon urination, bladder sensitive to pressure, urge to pee- Treatment: specific to pathogen- If untreated, can lead to pyelonephritis( inflammation of renal cortex and medulla) - Transplanted Kidney - Requires genetic match from donor- Transplant: hooked up to pelvic vessels- Immunosuppressant drugs for life: so the body will not reject the transplanted kidney- Humans can live with only one functional kidney- Peritonitis- Parietal peritoneum - Caused by infection from perforated digestive tube (ulcer, cancer, burst appendix), infection from bacterial invasion due to nonsterile equipment or piercing trauma, or leakage of blood, pus, etc. into the peritoneal cavity- Symptoms: intense abdominal pain and tenderness, abdominal guarding (patient lies with knees flexed), positive rebound tenderness test (pain from removal of pressure)- Impacted Wisdom Teeth- Can damage alveolar nerve- Can lead to complications with maxillary sinus- Mumps- AKA; epidemic parotitis- Virus targets salivary glands, especially parotids swelling of pancreas and testicles can also occur- Spread by saliva and respiratory secretions- Mumps is rare in the US because children here are vaccinated- Parotid Tumor- Abnormal swelling, slow growing- 80-85% are benign- May impair facial verve (CN VII) bell’s palsy(paralysis of facial muscles)- Abdominal Pain- Disease of injury of an abdominal organ or structure can produce 3 types of pain, which can be
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