Path 2 Lab Final

Jerky movements predominately of facial muscles & extremities

An incurable, inherited, autosomal dominant disorder characterized by jerky movememnts & progressive dementia (leads to loss of intellect)

Atrophy of the striatal neurons (caudate, putamen, & globus pallidus nuclei) resulting in motor fxn disturbances such as jerky movements

The entire body, but mostly the extremities & facial muscles

normally b/w 30-35 yoa

Gene that regulates the normal fxn of striatal nuclei. Normally the body has 33 CAG triplets but in Huntingtons there are extra. The more extra, the earlier the onset.

Parkinson's or hypokinesia/rigidity

Usually within 15 years from onset of infection from a weakening immune system (#1 cause) or suicide (#2 cause)

Atrophy of the neurons along the ventricular walls causes distention of the ventricles; does not lead to increased ICP

An acquired disorder associated w/ rheumatic fever

In pts younger than 15 yoa, usually female

Mild vasculitis of cerebral vessels

Yes

Condition in which a tubular cavity in the central area of the SC gradually expands & produces neuronal & tract damages. Accumulation/obstruction of CSF in the central canal causes distention

Type 1 Arnold-Chiari malformation

• Inborn inclanation of cerebellar tonsils into the CSF
• Associated w/ the cerebellum & medulla protruding through the foramen magnum which leads to compression of the brainstem (which causes breaking of the fibers) & hydrocephalus (lumen narrows, CSF can't leave)

• Affects the spinothalamic tract causing loss of pain & temp sensation
• Cervical involvement of the shoulder jt shows shawl/cape like distribution, shoulder may swell, & humeral head may undergo lysis (just shoulder jt)

Inflammation of the dura mater & tissues around the subarachnoid space

• Pathogen virulence
• Strength of immunity
• Predisposing risk factors

• Exposure of head to cold
• Sinusitis
• Otitis media or accumulation of pus in the middle ear
• Pneumonia leading to pleural empyema (widespread accumulation of pus in pleural cavity)
• Basal skull fracture

• Epidural abscess- in SC can compress nerve roots
• Subdural empyema- can spread to other meninges
• MC by staph/strep

• Acute (purulent) leptomeningitis
• Acute lymphatic (viral) leptomeningitis aka aseptic meningitis
• Chronic Meningitis
• TB meningitis
• Syphilitic meningitis

• Bacteria:
• Hemophilus influenza- pus around the bottom of the brain
• Streptococcus pneumoniae- pus around the hemispheres

Neisseria meningitis

• Streptococcus pneumoniae
• Listeria monocytogenes

• HA
• Hydrocephalus & increased ICP
• Fever
• Neck pain (stiffness)
• Mental disorder (disorientation or decreased cognitive fxn)

CSF from lumbar puncture will show increased neutrophils, increased proteins from exudate, & decreased glucose

• Caused by virus, not bacterial
• Mumps virus- parotiditis (may cause viral meningitis or orchitis)
• Echo virus
• Coxsackie virus
• Epstein-Barr virus

• HA
• Hydrocephalus & increased ICP
• Fever
• Neck pain (stiffness)
• Mental disorder (disorientation or decreased cognitive fxn)

CSF shows increased lymphocytes, increased proteins, & normal glucose levels

• Myobacterium TB
• Treponema pallidum
• Cryptococcus neoformans
• Brucella species

CSF shows increased monocytes, increased protein, & decreased glucose

Accumulation of fibrous tissue at the base of the brain which results in changes in anatomy that compromise the fxn of vessels & nerves

Casseous necrosis of vertebral bodies which leads to formation of hump from collapse of vertebrae

Usually develops in the second stage of syphilis

• Generalized lymphadenopathy (cervical & groin)
• Skin rash- condylomata lata
• Chronic meningitis
• Serologically positive
• Duration 2 months

• Gummatous necrosis
• Involvement of posterior columns- Tabes dorsalis
• Associated w/ atrophy of the cortical layer of the brain
• aka general paresis of the insane
• Grey matter atrophy (stupid)
• Cardiovascular- syphilitic aortitis (aortic insufficiency)

10-15 years

Full jt fusion (eventually)

Inflammation of verterbral jts

Pathological changes beginning in the ligamentous attachments to the bone, rather than in the synovium

Insertion of the ligament/tendon to bone; very rich w/ nociceptors (painful) and has a poor blood supply (limited healing)

100% involvement of SI jts along w/ 50-75% involvement w/ peripheral inflammatory arthritis

• Absence of rheumatoid factor
• HLA-B27- 95-97% of people w/ AS are HLAB27 +, while only 5% of gen population are +

Ossification of the outer layers of the annulus fibrosis (sharpey's fibers)

Complete ossification forming a bony bridge (in AS- of ivd so that 2 vertebrae can't move)

Crohn's & ulcerative colitis

• Marie-Strumpells
• Bechterew's

• Severe low back pain (young people- age crucial)
• Non-mechanical pain that is severe in the morning & diminishes during the day
• Relieved by exercise

• Measure under the nipple line w/ full inspiration & full expiration - normal chest expansion is 6-12 cm & less than 3 cm indicates AS
• Finger to floor exam will show decreased flexibility
• Decreased ROM in all 3 plane
• All signs b/c spine fuses together

• Iridocycitis
• Dilation of the aortic ring w/ aortic insufficiency

• aka Iritis
• Irregularly shaped pupil due to adhesion of the iris to lens from inflammation/exudates

• 1 Bacterial endocarditis
• 2 Syphilis
• 3 Ankylosing spondylitis

Joints more so than spine

• 2-7% have psoriasis w/ an avg 5%
• 2-7% of those people have arthritis & spondylitis

Very rapid

Occiput

• Dermatosis
• Joint involvement
• Pitting of nails
• Pencil in cup deformity (on x-ray)

Non-inflammatory disease of skin; common areas include the scalp, axilla, belly button, groin (hair portions), & elbows

• Asymmetrical involvement of jts of hands/feet
• Advanced-> chaotic deformity of jts
• Axial arthritis- one entire finger/toe

• Only in psoriatic & Reiter's
• Asymmetrical
• Involvement of one entire finger/toe
• Causes sausage toe

• Special type of psoriatic arthritis
• Marked by intra-articular osteolysis
• Bone is lost & tissue retracts resulting in shrinking toes/fingers
• Painless

Infection, typically chlamydia (MC std in US) or various intestinal infections often in children

Men

20%

• 4 major signs: Can't see, can't pee can't dance w/ me
• Bilateral conjuctivitis
• Urethritis
• Arthritis of peripheral & spinal jts
• Keratoderma

• Spine almost all of the time
• Larger or medium sized jts
• Assymetrical
• Mostly leg jts rarely arms
• Bilateral & symmetrical SI jts

painful urination or balanitis

pustules on the soles or palms

• achillobursitis associated w/ localized osteopenia stemming from inflammation of soft tissue near the bone
• Tearing of the achilles tendon (possible not always)
• Achillodynia

swelling of the ankle

pain in the bursa/tendon; may be w/ or w/o inflammation & bursitis

Injection of corticosteroids into bursa

• aka Collapsed lung
• Loss of lung volume due to incomplete expansion of air spaces

• Obstructive aka Resorption/Absorption
• Compressive aka Passive/Relaxation
• Pathcy aka Microatelectasis
• Contraction

Obstruction of the airways in the alveolar ducts which causes space to become void of air as it is absorbed into circulation which creates a vacuum. The total pressure in the lungs becomes lower than atmospheric pressure which leads to collapse & compression. The decreased space causes the mediastinum to deviate toward the lower pressure (involved side)

• Aspiration of foreign body
• Excessive secretion of exudates within smaller bronchi (as in COPD)
• Tumor of any organ in chest, leading to obstruction of the airway
• Other lung pathologies- bronchial asthma, chronic bronchitis, bronchiectasis

• Compression of the lung tissue from accumulation of fluid, air, or tissue in the pleural cavity (pleurisy or pneumothorax) which causes the mediastinum to deviate away from the involved lung
• Reversible

• Right sided cardiac failure (from vena cava congestion & pooling of blood into the cavities
• Neoplastic effusions (tumor)
• Pleural empyema
• Mesothelioma
• TB
• Nephritic syndrome
• Pleurisy or pneumothorax

• Traumatic= stabbing- damage to parietal layer
• Non-tramatic or spontaneous= sickness- damage to visceral layer (#2 cause of death by TB)
• Rib fracture can involve both layers
• Causes immediate lung collapse

• 1 TB
• 2 Emphysema
• 3 Interstitial lung disease

• aka Microatelectasis
• Due to a loss of pulmonary surfactant
• Surfactant decreases adhesion strength of the alveoli- w/o surfactant alveoli adhese together
• Respiratory distress syndrome, common in peds

• Intersitial lung disease causing replacement of normal lung tissue w/ fibrous CT or scar tissue
• Irreversible