Thursday, May 25, 2017
Authors' diary: How to study during Ramzaan
Wednesday, May 24, 2017
Autism and ADHD : The clinical intersection
Autism and Attention - Deficit Hyperactivity Disorder (ADHD) may co - occur in upto 80% of children and they share about 50 - 75% of their genetic factors and pathologic features, thus resulting in some clinical intersection.
NBME 7 question on muscle weakness
CMS neurology form 2 question on fibromuscular dysplasia with paresis, occulomotor palsy
CMS neurology form 2 question on headache, seizures, urinary incontinence, broad based gait
NBME 7 question on intoxication
Tuesday, May 23, 2017
Fact of the day : Pinenes for refreshing your Airways
Did you know? One of the reasons your lungs feel refreshed ( increased mental focus and energy ) when you walk through the shades of beautiful pine forest is because of an anti - inflammatory compound called alpha -Pinene, that is found in conifers. It is used as a bronchodilator in the treatment of asthma and is abundantly present in marijuana.
- Jaskunwar Singh
Pill induced esophagitis mnemonic
Pill induced esophagitis is caused by a pill! :D
Causes of pill induced esophagitis mnemonic: A PILL.
Aspirin
Alendronate
Antibiotics like tetracycline, clindamycin
Potassium chloride
Iron
Less water
Lying down immediately
Interesting anatomy correlation:
The most common sites of injury are the proximal esophagus near the compression from the aortic arch and the distal esophagus in patients with left atrial enlargement.
The typical endoscopic appearance of pill-induced esophageal injury is a discrete ulcer with relatively normal surrounding mucosa.
That's all!
-IkaN
Motor nuclei in the brainstem : An overview
2. Branchial motor efferent - 4
3. Visceral motor efferent - 4
- Sach somite gives rise to a particular set of muscles called its myotome.
So this is simple.
There are 3 pre otic somites giving rise to distinct groups of extraocular muscles supplied by their own cranial nerve.
Muscles -
All Extra ocular muscles except Lateral Rectus and Superior oblique.
Nerve -
Oculomotor nerve (III)
Nucleus -
Oculomotor nucleus in the Upper Midbrain.
Muscles -
Superior oblique.
Nerve -
Trochlear nerve (IV)
Nucleus -
Trochlear motor nucleus in the Lower Midbrain.
Muscles -
Lateral Rectus.
Nerve -
Abducent nerve (VI)
Nucleus -
Abducent motor nucleus in the Pons.
All muscles of the tongue except Palatoglossus
Nerve -
Hypoglossal I'm nerve (XII)
Nucleus -
Hypoglossal nucleus in the Medulla.
All muscles of mastication + TT (Tensor tympani + Tensor veli Palatini) + Digastric anterior belly. ( And Meckel cartilage)
Nerve -
Mandibular branch of Trigeminal
Nucleus -
All muscles of facial expressions + Stapedius + Digastric posterior belly. ( And Reichter cartilage)
Nerve -
Facial nerve (VII)
Nucleus -
Stylopharyngeus
Nerve -
Glossopharyngeal nerve (IX)
Nucleus -
- All muscles of Soft palate ( except Tensor veli which is up in the 1st arch) by the 4th. + cricothyroid muscle of Larynx.
Nerve -
4th arch - Superior laryngeal nerve of the Vagus.(X)
Nucleus -
Sphincter pupillae - Constricts pupil
Nerve -
Oculomotor nerve
Nucleus -
Lacrimal glands, nasal mucosal, sinuses mucosal glands and pharynx mucosal - Secretomotor.
Facial nerve (Greater Petrosal)
Nucleus -
Submandibular glands , sublingual glands - Secretomotor.
Facial nerve (Chorda tympani)
Nucleus -
Parotid gland
Glosspharyngeal nerve (Lesser Petrosal)
Nucleus -
Monday, May 22, 2017
Lacunar strokes : An Overview
Fact of the day: Marchiafava-Bignami disease
Marchiafava-Bignami disease is a rare disorder of demyelination or necrosis of the corpus callosum and adjacent subcortical white matter that occurs predominantly in malnourished alcoholics. Dementia, spasticity, dysarthria, and inability to walk may present as an acute, subacute or chronic condition.
Lesions appear as hypodense areas in portions of the corpus callosum on CT and as discrete or confluent areas of decreased T1 signal and increased T2 signal on MRI. Alcohol abusers without liver disease, amnesia, or cognitive dysfunction show thinning of the corpus callosum at autopsy and on MRI, suggesting that alcohol or malnutrition damages the corpus callosum commonly in the absence of the necrotic lesions of Marchiafava-Bignami disease.
Interesting, isn't it?
-IkaN
Sunday, May 21, 2017
Atrial fibrillation begets Atrial fibrillation: Explanation
Hi ! Short post on pathophysiology of Atrial Fibrillation!
- Atrial Fibrillation is a fairly common disorder of rhythm, where the atria begin to beat at random , irregular and very high rates. Like 300-600 beats / min !
- Some of these MANY contractions get transmitted to the ventricles causing an Irregular , yet High , Ventricular rate - around 100-160 per minute or even higher.
Now how this occurs is a very interesting yet much-ignored mechanism.
- Due to some pre existing factors like Rheumatic heart disease , Myocardial ischemia or Thyroid abnormalities among many others, the atria get electrically irritated and begin to fire on their own.
- These ectopic foci are common along the opening of the pulmonary veins = called the pulmonary sleeve.
This area of hyperactivity and automaticity begins to fire from the left Atrium creating a wavefront of abnormal impulses.
- Say one of these myocytes becomes ectopic one day and produces an abnormal wavefront. This wavefront progresses across the atrium and in turn stimulates the other Atrial myocytes to inturn fire ectopically -- causing formation of multiple Daughter ectopic foci.
- These daughter ectopic foci produce daughter wavelets that then propagate through the atria , in turn producing more duaghter wavefronts.
- Eventually there are A LOT of Atrial foci causing multiple wavelets to produce multiple electrical wavefronts.
- Thus A-Fib causes multiple wavefronts which in turn cause more wavefronts eventually propogating A fib as a positive feedback mechanism.
- In the long term, due to this constant irregular beating there is fibrosis and electrophysiological remodelling making the atrium more irritable and automatic.
Thus A-Fib begets A-Fib!
Hope you liked this !
Happy Studying !
Stay awesome.
~A.P.Burkholderia