Arrythmias is #1 cause of death in MI 4/9/2009 1 http://conceptclues.blogspot.com/

70% stenosis = ST↓ = Angina 4/9/2009 2 http://conceptclues.blogspot.com/

Atrium is the only membrane that uses Calcium(ca2+) to depolarize Rest of the membrane use sodium (Na+) 4/9/2009 3 http://conceptclues.blogspot.com/

Smooth muscle uses calcium 4/9/2009 4 http://conceptclues.blogspot.com/

Heart & Brain do not respond to INSULIN 4/9/2009 5 http://conceptclues.blogspot.com/

1st 4hours = ventricular arrythmia ventricular→Atrial→Ventricular ventricular 90% cause of death in MI 4/9/2009 6 http://conceptclues.blogspot.com/

Anything chronic = x-ray calcification biopsy fibrosis 4/9/2009 7 http://conceptclues.blogspot.com/

For atrial to depolarize ca2+ has to cross membrane ventricle can still depolarize when its in cell 4/9/2009 8 http://conceptclues.blogspot.com/

Nerst Potential = No Net Movement membrane potential @ which the concentration & electrical gradient (E) are equal and opposite 4/9/2009 9 http://conceptclues.blogspot.com/

Only free ions determine the gradient 4/9/2009 10 http://conceptclues.blogspot.com/

Main (+) charge w/in the cell = K+ (potassium) 4/9/2009 11 http://conceptclues.blogspot.com/

Main (–) charge w/in the cell = protein 4/9/2009 12 http://conceptclues.blogspot.com/

Na+ normally follows Cl- ↓ if Na+/Cl- are moved in opposite direction its abnormal. So find the cause 4/9/2009 13 http://conceptclues.blogspot.com/

Main charges outside cell: (+) charge = Na+ (-) charge = Cl- 4/9/2009 14 http://conceptclues.blogspot.com/

Main EC buffer = HCO3- (bicarbonate) 4/9/2009 15 http://conceptclues.blogspot.com/

Monckebergs = calcification w/in the blood vessel (BV) wall 4/9/2009 16 http://conceptclues.blogspot.com/

Nerst # for membrane = -90 4/9/2009 17 http://conceptclues.blogspot.com/

Driving force = how fast you can get to the membrane = [Nerst(E) ] – [Membrane Potential] ex. To calculate driving force of K+ @ rest = -90 – (+96) = 6 4/9/2009 18 http://conceptclues.blogspot.com/

Driving Force = Na+ (sodium) 4/9/2009 19 http://conceptclues.blogspot.com/

Permeability = access across the membrane 4/9/2009 20 http://conceptclues.blogspot.com/

What ion has the most permeability at rest? K+ potassium 4/9/2009 21 http://conceptclues.blogspot.com/

Conductance (G) = actual movement across membrane which is determined by ur permeability K+ has most conductance @ rest Cl- has least conductance @ rest 4/9/2009 22 http://conceptclues.blogspot.com/

All ions are voltage regulated EXCEPT K+ = ½ are open 4/9/2009 23 http://conceptclues.blogspot.com/

Current (I) = what actually happends to the membrane potential = (I) is the change in membrane permeability that is caused by conductance (G) across the membrane 4/9/2009 24 http://conceptclues.blogspot.com/

Depolarization means = to make cell (+) 4/9/2009 25 http://conceptclues.blogspot.com/

Na+ channels have 2 gates ↓ M gate H gate During Depolarization ↓ M gate = closed = cytoplasm H gate= open = plasma During Na+ channel Inactivation ↓ M gate = open H gate = closed 4/9/2009 26 http://conceptclues.blogspot.com/

To reset Membrane Gradient = Na+/K+ pump make cell (-) 4/9/2009 27 http://conceptclues.blogspot.com/

To reset Membrane Potential = Na+/Ca2+ exchange make cell (+) 4/9/2009 28 http://conceptclues.blogspot.com/

ARP – Absolute Refractory Period = No Action Potential RRP – Relative Refractory Period = Action Potential can occur but with low amplitude 4/9/2009 29 http://conceptclues.blogspot.com/

Every membrane in your body has ↓ phase 0 phase 3 phase 4 4/9/2009 30 http://conceptclues.blogspot.com/

Every membrane depolarizes with Na+ EXCEPT Atrium which uses Ca+ to depolarize depolarization = phase 0 resetting = phase 4 rate = phase 4 4/9/2009 31 http://conceptclues.blogspot.com/

Ectopic = there is a pause than SA node takes over and resets 4/9/2009 32 http://conceptclues.blogspot.com/

Synchronize = uc P wave = means ectopic site in Atrium if u defib and SA node discharges you will kill the patient 4/9/2009 33 http://conceptclues.blogspot.com/

De-synchronize = No P wave = you can defib the patient 4/9/2009 34 http://conceptclues.blogspot.com/

Normal Sinus Rate = 60-100 To calculate Max Sinus Rate = 200 – Age if faster than your max sinus rate = Arrhythmia < 60 = bradycardia > 100 = tachycardia 4/9/2009 35 http://conceptclues.blogspot.com/

Points to remember about SA node Location: atrium Ca2+ ion Has most rapid phase 4 No fast Na+ channel 4/9/2009 36 http://conceptclues.blogspot.com/

TENS Unit = Transcutaneous Electrical Nerve Stimlus Unit = Gate Theory ↓ if all gates are used up signal won’t go through 4/9/2009 37 http://conceptclues.blogspot.com/

Points to remember about AV node Slowest conduction site in heart b/c it has no purkinje fibers Nodal Rhythm Takes over when SA rhythm is lost Has intrinsic build = Long Refractory Period PR interval = 0.2 sec = Longest Part of EKG 4/9/2009 38 http://conceptclues.blogspot.com/

Most automaticity in heart = SA > AV > Ventricles 4/9/2009 39 http://conceptclues.blogspot.com/

Points to remember about ventricle Takes too long to reset Fires faster & depolarizes slower than every other membrane Plateau phase = phase of contraction Phase 2 tells u how long u had to hold your contraction Depolarization = Anterior to Posterior Repolarization = Posterior to Anterior 4/9/2009 40 http://conceptclues.blogspot.com/

Heart has the longest refractory period = cannot die from tetany 4/9/2009 41 http://conceptclues.blogspot.com/

Pause = Flat Line = 1. Ectopic Beat 2. Na+ channel are reseting 4/9/2009 42 http://conceptclues.blogspot.com/

Neurons = Na+ Skeletal Muscle = Na+ Smooth Muscle = Na+ Cardiac ventricle = Na+ Cardiac Atrium = Ca2+ 4/9/2009 43 http://conceptclues.blogspot.com/

P wave = Atrial depolarization Phase 0 → Ca2+ ions 4/9/2009 44 http://conceptclues.blogspot.com/

PR segment = sustained contraction of atrium 4/9/2009 45 http://conceptclues.blogspot.com/

Atrium = NO=Can’t see → phase 3,4 YES=Can see → phase 0,1 4/9/2009 46 http://conceptclues.blogspot.com/

Ventricle = NO = Only one can’t see is PHASE 1 4/9/2009 47 http://conceptclues.blogspot.com/

PR interval = total condution time ion → ca2+ beginning of P to begnning of Q 4/9/2009 48 http://conceptclues.blogspot.com/

Ventricular depolarization Phase 0 = Q → Septum R → Ant wall S → Post wall 4/9/2009 49 http://conceptclues.blogspot.com/

Height = Voltage Width = Duration 4/9/2009 50 http://conceptclues.blogspot.com/

EKG P wave = phase 0 P wave ion = Ca2+ PR segment phase 2 = Ca2+ Pause in AV node Pause to allow blood to flow from atria to ventricle 4/9/2009 51 http://conceptclues.blogspot.com/

EKG ST segment Sustained contraction of phase 2 Ca2+ T wave Phase 3 = K+ Ventricular = repolarization/relaxation U wave = Na+ Phase 4 = reseting Note: electrodes don’t see (-) charges they only see (+) charges that’s why T wave is (+) 4/9/2009 52 http://conceptclues.blogspot.com/

HYPOKALEMIA VS. HYPERKALEMIA HYPOKALEMIA HYPERKALEMIA Kills by arresting in reporalization phase = slow heart K+ is more likely to leave the cardiac cell EKG Narrow T-wave T-wave inversion Cells are more positive during depolarization & are slow in coming out b/c concentration gradient will oppose it, forming a peak T wave = longer time to depolarize EKG = widen T wave b/c cells are more + 4/9/2009 53 http://conceptclues.blogspot.com/

Hyperkalemia treatment Ca+ gluconate Insulin Glucose = makes K+ goes inside cell & resets HCO3- (bicarbonate) = gets rid of extra K+ Kayexalate = to pull out K+ from GI tracts and patient deficates it out 4/9/2009 54 http://conceptclues.blogspot.com/

Classic sign of tetany Chvostek Trosseau Check for both Ca2+ & Mg2+ 4/9/2009 55 http://conceptclues.blogspot.com/

Calcium (Ca2+) 60% of plasma calcium is filtered across glomerular capillaries Proximal Tubule + Thick Ascending Limb = 90% reabsorbed of filtered Ca2+ by passive processes that are coupled to Na+ reabsorption Distal tubule + Collecting duct = Reabsorb 8% of filtered Ca2+ by active process 4/9/2009 56 http://conceptclues.blogspot.com/

Calcium (Ca2+) Loop Diuretics Thiazide diuretics Type = Furosemide Causes = increased urinary Ca2+ secretion ↓ b/c Ca2+ reabsoption is liked to Na+ reabsorption in loop of henle, inhibiting Na+ reabsorption also inhibits Ca2+ reabsorption, thus ca2+ is seen in urine Used for = Hyper-Ca2+ Function = increases Ca2+ reabsorption in distal tubule, thus decreases Ca2+ Excretion Used for = Idiopathic Hypercalciuria 4/9/2009 57 http://conceptclues.blogspot.com/

Hyper-calcemia vs. Hypo-calemia HYPER-CALCEMIA HYPO-CALCEMIA Less likely to depolarize EXCEPT for Atrium GI has 2 phases: 1st blocks nerve conduction to GI = Constipation 2nd takes awhile but Ca2+ will leak through the cell = IP3/DAG = Diarrhea Symptoms Tetany Cramps Seizure Ventricular tachycardia Remember that atrium needs Ca2+ = Atrium slows down 4/9/2009 58 http://conceptclues.blogspot.com/

Magnesium (Mg2+) Reabsorbed in: proximal tubule thick ascending limb of loop of henle Mg2+ & Ca2+ compete for reabsorption, thus hyper-Ca2+ cause an ↑ in Mg2+ excretion by inhibiting Mg2+ reabsorption Hyper-Mg2+ causes an increase in Ca2+ excretion by inhibiting Ca2+ reabsorption distal tubule 4/9/2009 59 http://conceptclues.blogspot.com/

Mg2+ sulfate Can be used for: Ischemia Eclampsia Function: blocks Na+ channels from entering Why not give Ca2+? b/c Ca2+ will cause more vasoconstriction and more ischemia 4/9/2009 60 http://conceptclues.blogspot.com/

HYPER-Mg2+ VS. HYPO-Mg2+ HYPER-Mg2+ HYPO-Mg2+ Less likely to depolarize b/c ↑↑↑ competition to Na+ More likely to depolarize b/c ↓↓↓ competition to Na+ Atrium remain unaffected Ventricle affected = v.tachycardia 4/9/2009 61 http://conceptclues.blogspot.com/

Ischemia = most common cause of spontaneous depolarization 4/9/2009 62 http://conceptclues.blogspot.com/

Sodium (Na+) HPYER-NATREMIA HYPO-NATREMIA 1st Na+ rushes inside cell = More likely to depolarize = Causing → seizure, HTN 2nd Na+/K+ pump kicks in and ATPase will pump Na+ out making the cell more negative = Making cell less likely to depolarize = Causing → Heart Failure Low Na+ = Na+ will flow out of the cell thru Ca2+/Na+ exchange = Ca2+ goes inside the cell, making cell more (+) = Making cell more likely to depolarize Eg. Exercise will cause excretion of NaCl & H2O 2B excreted = Na+ is low making muscles more likely to depoloarize = Causing→muscle cramps, flatus (gas) Note: Na+/Ca2+ pump is concentration driven, when it is switched its pathologic and ration becomes 1:1 4/9/2009 63 http://conceptclues.blogspot.com/

Physiologically cell is always (+) = 3 Na+ IN / 1 Ca2+ OUT 3 Na+ OUT / 2 K+ IN 4/9/2009 64 http://conceptclues.blogspot.com/

Inhibitory Neurotransmitter causes Cl- influx to inhibit the tissue = Brain → GABA Spinal Cord → Glycine 4/9/2009 65 http://conceptclues.blogspot.com/

All sympathetic neurtransmiter = Nicotinic EXCEPT sweat glands which are muscuranic 4/9/2009 66 http://conceptclues.blogspot.com/

All parasympathetic receptor = 90% muscuranic EXCEPT skeletal muscle & ganglion which are Nicotnic 4/9/2009 67 http://conceptclues.blogspot.com/

Alpha(α) 1 receptor G protein = Gq Mechanism = ↑ IP3/Ca2+ Produce = Excitation = contraction, constriction Location = smooth muscle of the: Skin and splachnic regions GI sphincters Bladder Sphincters Radial muscle of iris All sphincters = tightening (contraction) Arteries = constriction Radial muscle of eyes = mydriasis (dilated pupils) w/o cycloplegia (no accomodation) 4/9/2009 68 http://conceptclues.blogspot.com/

Alpha(α) 1 Agonist Norepinephrine Phenylephrine Antagonist Phenoxybenzamine Phentolamine Prazosin 4/9/2009 69 http://conceptclues.blogspot.com/

Alpha(α) 2 receptors Located in presynaptic nerve terminals ↓ NT (neurotransmitter) release & Norepinp synthesis Autoregulation Platelets = aggregation Fat cell Wall of GI tract G protein = Gi Mechanism = ↓ CAMP α2 → Gi → ↑adenylate cyclase → ↓CAMP Pancreas = ↓ insulin secretion (dominant), which inhibits β cell release Produces = Inhibition → relaxation or dilation 4/9/2009 70 http://conceptclues.blogspot.com/

Alpha(α) 2 Agonist Clonidine Antagonist Yohimbine 4/9/2009 71 http://conceptclues.blogspot.com/

β1 Located in: SA node AV node Ventricular muscle of heart Produce Excitation: Increased heart rate = SA node (chronotropic) Increased Conduction = AV node (dromotropic) Increased Contractibility Muscle Increase force of contraction + ionotrophy Increase conduction velocity Increase O2 consumption due to inc O2 demand His-purkinje = inc sutomaticity & conduction velocity, means inc activity Kidney (JGA) = inc. renin release Pancreas = α cells of pancreas, means ↑ glucagon G protein = Gs = ↑ CAMP Mechanism of action: Β1(♥) → Gs → ↑adenylate cyclase → ↑CAMP 4/9/2009 72 http://conceptclues.blogspot.com/

β1 Agonist Norepinephrine Isoproterenol Dobutamine Antagonist Propranolol Metoprolol 4/9/2009 73 http://conceptclues.blogspot.com/

β2 Located on: Vascular smooth muscle of skeletal muscle Bronchial smooth muscle Walls of GI tract and bladder Produce Relations: Dilation of vascular smooth muscle Dilation of bronchioles Relaxation of bladder wall G protein = Gs = ↑ CAMP Mechanism of action: Β1(♥) → Gs → ↑adenylate cyclase → ↑CAMP Blood Vessels = vasodilation ↓PVR =↓diastolic pressure =↓ afterload Uterus = Relaxation → No contraction Bronchioles = Dilation Skeletal muscle = ↑ glycogenolysis – contractility (tremor) Liver = ↑ glycogenolysis Pancreas = ↑ insulin secretion (islet cells) 4/9/2009 74 http://conceptclues.blogspot.com/

β2 Agonist Isoproterenol Albuterol Antagonist Propranolol Butoxamine 4/9/2009 75 http://conceptclues.blogspot.com/

Actin = Retrograde Transport = Backward Movement 4/9/2009 76 http://conceptclues.blogspot.com/

Kinesis = Anterograde Transport = Fwd Movement 4/9/2009 77 http://conceptclues.blogspot.com/

Black Window Spider = ↑ Ach Release 4/9/2009 78 http://conceptclues.blogspot.com/

If you block ATP Ca2+ Microtubule you will cause Neuropathy 4/9/2009 79 http://conceptclues.blogspot.com/

Diagnosing MI Quickest way EKG 1st = ST depression b/c ischemia causes K+ to come out sub-endocardial ischemia 2nd = ST elevation b/c Na+ is trapped in cell transmural ischemia Troponin I = most sensitive blood test Rise = 2 hours Peak = 2 days Gone = 7 days CKMB Rise = 6 hours Peak = 12 hours Gone = 24-36 hours LDH1 = last one = least specific of all hormones Rise = 24 hours Peak = 48 hours Gone = 3 days (72 hours) 4/9/2009 80 http://conceptclues.blogspot.com/

Soma = all proteins are made here and than transported to wherever its needed 4/9/2009 81 http://conceptclues.blogspot.com/

Competitive Inhibtor of Ach = Hemicholium 4/9/2009 82 http://conceptclues.blogspot.com/

Reserpine = blocks cathecholamines (DA,NE) 4/9/2009 83 http://conceptclues.blogspot.com/

Guanethidine = Uptaken by presynaptic terminal Displaces NE so can be degraded in MAO Transient HTN Retrograde Ejaculation 4/9/2009 84 http://conceptclues.blogspot.com/

Botulin Toxin = (-) release of ACH from presynaptic terminal 4/9/2009 85 http://conceptclues.blogspot.com/

Tetanus Toxin Strychmine = (-) release of glycine muscle contracts but cannot relax 4/9/2009 86 http://conceptclues.blogspot.com/

Contains Only Actin = I band → area of non-overlap between 2 sacromeres H band → area of non-overlap between 2 sacromeres 4/9/2009 87 http://conceptclues.blogspot.com/

I & H band = shrinks w/ muscle contraction 4/9/2009 88 http://conceptclues.blogspot.com/

H band = contains only myosin 4/9/2009 89 http://conceptclues.blogspot.com/

A band = myosin length contains heavy & light chain 4/9/2009 90 http://conceptclues.blogspot.com/

Muscle Contraction Z-line = stays same but moves closer A band = stays same but moves closer Length of muscle ↓ Force of tension ↑ I/H band shrink 4/9/2009 91 http://conceptclues.blogspot.com/

CPR located in ↓ M-line 4/9/2009 92 http://conceptclues.blogspot.com/

Sacromere = from 1 z-line to 1 z-line 4/9/2009 93 http://conceptclues.blogspot.com/

T-tubule of skeletal muscle are found between A-I Junction 4/9/2009 94 http://conceptclues.blogspot.com/

Cardiac muscles T-tubules comes from Z-lines 4/9/2009 95 http://conceptclues.blogspot.com/

Smooth muscle has no troponin = means actin & myosin are bound and this is called latching ↓ this is why you hear bowl sounds 4/9/2009 96 http://conceptclues.blogspot.com/

EDV = determines length of cardiac muscle 4/9/2009 97 http://conceptclues.blogspot.com/

↓ K+ = causes cell to be more negative causing more arrhythmia 4/9/2009 98 http://conceptclues.blogspot.com/

Isometric Exercise = you keep ↑ing muscle causing muscle hypertrophy which causes arterial compression = HTN 4/9/2009 99 http://conceptclues.blogspot.com/

Isotonic Exercise = keep same tone but change length 4/9/2009 100 http://conceptclues.blogspot.com/

Myositis Inflammatory myopathy = 1 muscle hurts Can be due to drugs disease = hypothyrodism, cushings infection = trichinella spiralis - parasite 4/9/2009 101 http://conceptclues.blogspot.com/

Drugs that cause myositis R = rifampin I = INH P = prednisone S = statins 4/9/2009 102 http://conceptclues.blogspot.com/

Polymyositis Bunch of muscle hurting E.G = Dermatomyositis 4/9/2009 103 http://conceptclues.blogspot.com/

Dermatomyositis Muscle hurt Helicotrophic Rash Deep purple Eyelids or knuckles Only muscular disease with rash a/w colon cancer = do colonoscopy 4/9/2009 104 http://conceptclues.blogspot.com/

Fibrositis Hurts only when you move the muscle Muscle insertion hurts = tendon hurts 4/9/2009 105 http://conceptclues.blogspot.com/

Fibromyalgia Tendon Trigger Points = inflamed muscle insertion + muscle Hurts all the time = hurts when u sit or move Chronic pain = Amytriptyline + Exercise 4/9/2009 106 http://conceptclues.blogspot.com/

Polymyalgia Rheumatica Weakness in shoulder girdle Hard time lifting their hand to do action ↑ incidence of temporal arteritis AKA giant cell arteritis 4/9/2009 107 http://conceptclues.blogspot.com/

Temporal Arteritis AKA = Giant Cell Arteritis Rule of 60 > 60 year old > 60 mg prednisone = IV methylprednisone > 60 ESR Temporal headache If present w/o visual problem Biopsy steroid If presents with visual problem Steroid Biopsy 4/9/2009 108 http://conceptclues.blogspot.com/

Sed Rate = inflammation exsits False (+) sed rate = Anemia False (-) sed rate = sickle cell anemia polycythemia multiple myeloma 4/9/2009 109 http://conceptclues.blogspot.com/

Muscular Dystrophy = Duchene Beckers Gullian Barre 4/9/2009 110 http://conceptclues.blogspot.com/

Duchenes X-L Onset B4 age 5 Nonsense Frameshift Defect dystrophin protein Clues Gower’s sign = weakness starts in hips so they need help to walk Walding gait = transfer weight from 1 hip to another Pseudohypertrophy of calf = b/c of fat deposition 4/9/2009 111 http://conceptclues.blogspot.com/

Beckers Onset after age 5 Missense b/c of late onset Defect dystrophin protein Clues Gower’s sign = weakness starts in hips so they need help to walk Walding gait = transfer weight from 1 hip to another Pseudohypertrophy of calf = b/c of fat deposition 4/9/2009 112 http://conceptclues.blogspot.com/

GBS=Gullian Barre Syndrome 2 wks after respiratory infection Can’t move Ascending Paralysis start in feet & moves up symmetrical called polyradiculoneuropathy = inflammed lung peripheral nerve normal proteins 4/9/2009 113 http://conceptclues.blogspot.com/

Myotonic Dystrophy Bird beak face Increased muscle tone = hard time to release grip when shaking hands 4/9/2009 114 http://conceptclues.blogspot.com/

Neuropathy in diabetes = due to sorbitol ↓ sorbitol can’t leave the neuron and pulls H2O inside causing death of neuron 4/9/2009 115 http://conceptclues.blogspot.com/

Syphilis Pain + Neuropathy ↓ Lancinating (sharp) pain Shooting pain Stabbing pain 4/9/2009 116 http://conceptclues.blogspot.com/

Myasthenia Gravis (MG) Ab against Ach receptor thus destroying receptor Middle age ♀ w/ ptosis (droopy eyelids) Gets weaker as day goes by A/W thymoma For dx = endrophonium → patient gets stronger (note: stronger the patient feel worst the MG) If you are using endrophonium and patient gets worst than its cholinergic crisis than give atrophine Treatment: 1st line = neostigmine (long lasting) 2nd line = pyridostigmine 4/9/2009 117 http://conceptclues.blogspot.com/

Lambert-Eaton myasthenic syndrome Gets stronger as the day goes by a/w small cell cancer of lung Endrophonium = patient gets weaker 4/9/2009 118 http://conceptclues.blogspot.com/

Atrophine DOC for = heart block 1mg minimum <1mg will stimulate vagus & makes it worst 4/9/2009 119 http://conceptclues.blogspot.com/

Pre-operative to ↓ pulmonary secretion = atrophine glycopyrolate 4/9/2009 120 http://conceptclues.blogspot.com/

Benztropine = dystonia 4/9/2009 121 http://conceptclues.blogspot.com/

Scopolamine = motion sickness 4/9/2009 122 http://conceptclues.blogspot.com/

Multiple Sclerosis 2 weeks after virus infection Anti-myelin antibody Middle age ♀ w/ visual problems optic neurtis = inflammed nerve = halo vision Internuclear ophthalmoplegia Demyelination of medial longitudinal fasciculation Connection btw 3/6 on left eye is cut MRI is best diagnosis = UC demyelinated plaques Lumbar Puncture = myelin basic proten = demyelinated plaques CSF ↑ protein b/c its inflammation Oligoclonal band = IgM,IgG Anti-myelin antibodies T-cell & Lymphocytes 4/9/2009 123 http://conceptclues.blogspot.com/

Metachromatic Leukodystrophy Child w/ visual problems 5-10 year old child Arylsulfatase enzyme = eosinophils secrete arylsulfatase Rest is same as Multiple Sclerosis Tx. Prednisone Gamma globulin plamaphoresis 4/9/2009 124 http://conceptclues.blogspot.com/

Lower Motor Neuron = Fasiculation = means nerve 4/9/2009 125 http://conceptclues.blogspot.com/

ALS Vasiculation in middle age male Fasiculation = corticospinal tract & ant horn Descending paralysis = starts from top to bottom AKA Leu Gerigs No sensory involvement all motor 4/9/2009 126 http://conceptclues.blogspot.com/

Werding Hoffman Fasiculations in newborn Newborn child Born w/ anterior horn = no motor neurons Constipation Die of respiratory failure 4/9/2009 127 http://conceptclues.blogspot.com/

Polio Child 2wks after gastroneuritis 2 wk after diarrhea than parlysis Children < 2 asymetrical 4/9/2009 128 http://conceptclues.blogspot.com/

Cerebellar Problem Btw 5-10 years Friedrich’s Ataxia Ataxia Telangiectasia Adrenaleukodystrophy 4/9/2009 129 http://conceptclues.blogspot.com/

Friedrich’s Ataxia Retinitis pigmentosum = Brown blk spots = pigment in retina Scoliosis Trinucleotide repeats Affects 3 pathways dorsal column spinocerebellar CST (corticospinaltract) 4/9/2009 130 http://conceptclues.blogspot.com/

Ataxia Telangiectasia Spider veins all over their body IgA deficiency GI GU Respiration Infection Anaphylaxis due to transfusion 4/9/2009 131 http://conceptclues.blogspot.com/

Adrenaleukodystrophy Defective long chain fatty acid transport with carnitine = fatty acid in cytoplasm Problem with adrenal gland = electrolytes Corticospinal Tract = Cortex affected early → spasity 4/9/2009 132 http://conceptclues.blogspot.com/

Cerebral Palsy Permanent neurological damage suffered by age 21 Types: Spasity = cortex involved Diplegia = middle legs affected more than arm Clue = corticol = midline problem 4/9/2009 133 http://conceptclues.blogspot.com/

CMV = mid-line fires = hydrocephalus 4/9/2009 134 http://conceptclues.blogspot.com/

Spastic Hemiplegia Lateral problem = cortex = affects 1 side or the other side If toxoplasmosis is the cause than parietal lobe is affected If herpes is the cause than temporal lobe is affected 4/9/2009 135 http://conceptclues.blogspot.com/

Chorioathetotis = movement disorder basal ganglia = damaged due to = kernicterus ( quvivering voice) 4/9/2009 136 http://conceptclues.blogspot.com/

Atonic Frontal lobe problem = corticospinal tract comes from frontal cortex and deals with motor fiber, thus no muscle tone 4/9/2009 137 http://conceptclues.blogspot.com/