-
why would you use percussion
to determine if the underlying tissue is fluid-filled, air-filled, or consolidated
-
percussion technique
- use middle finger on left hand as pleximeter finger
- plexor finger is the middle right hand finger
- perform in ladder position
- both anterior and posterior
-
important things to remember about the percussion tech
- use a floppy wrist
- other fingers should not be touching the chest wall
- has to be done on the skin
- listening for one full breath in each location
- have pt cough before starting
- pt should breather through an open mouth
- shoud be performed on both anterior and posterior of pt. body
-
Ausculation
listening from internal sounds of the body
-
kartegeners syndrome
- defective movement of cilia
- autosome recessive disease
-
findings og kartegeners syndrome
- infertility
- recurrent chest infection
- HEENT symptoms
-
Kartegener's syndrome comprises the triad of
bronchiectasis, sinus inversus, and chronis sinusitis
-
bronchiectasis
- lung condition where mucus build up and breeds infection
- manifests as daily cough and large amounts of phelm
-
what are the 3 types of lung sounds
- breathe sounds
- adventitious lung sounds
- transmitted voice sounds
-
where would you hear a vesiular sound?
over most of the lung
-
what is the sound duration of a vesicular sound
long inspiration than expiration
-
what is the intensity and pitch od expiration
soft, and relatively low, respectively.
-
where would you hear bronchovesicular breath sounds?
scapula and 1st and 2 intercostal space
-
describe the duration of sounds of bronchovesicular sounds?
inspiration sound equal to expiratory
-
what is the intensity and pitch of expiratory sounds in bronchovesicular
intermediate for bth
-
what are the duration sounds of bronchial breath sounds?
Expiratory sounds last long than inspiratory sounds
-
where do you hear bronchial breathe sounds
over the manubrium
-
where do you hear tracheal breath sounds
over the tracheal and neck
-
what are the anatomical lines of the chest
- anterior
- the midsternal,
- the mid clavicle,
- sides anterior axillary ( in both ant and lat.)
- middle axillary
- posterior axillary
- back
- vertebral
- scauplar
-
how many ausculation location are their on each side of the chest in the front? in the posterior?
-
what are discontinuous adventitious sounds?
crackles and pleural rub
-
what are continous adventitous ausculation sounds?
-
what sugar causes cataracts
sorbitol
-
what goes in what direction of water chemical energy
from high water energy to low
-
what happens when there us increased blood volume
fluid rushed and small solute rush from plasma/vascular top the intersitutum
-
what is the normal intracellular and extracellular concentration of Na
140mM in 20mM out
-
what is the normal intracellular and extracellular concentration of K
120mM in 5nM outside
-
what is normal osmolarity
~300mOsm
-
if a compound had a reflection coefficent of 1 what does this mean for osmatic pressure
- there is osmotic pressure
- it is maximal
- meaning the solute can drive water movement
-
if a compound had a reflection coefficent of 0what does this mean for osmatic pressure
- there is no osmotis pressure
- no water movement
- the solute cannot move water if something is added with zero reflection coefficient
-
what is fisks first law of diffusion eq. and what does it tell you?
- tell you if water will move and if there is osmotic pressure
- J=σ*Δc
- molecule move = reflection coefficent * osmolarity
-
what are the different types of exocytosis and what is similar and different about them
- contitutive and regulated
- both depend on Ca2+
- regulated responds to signal anf contitutive is continuous and does not
-
what is exocytosis
tethering/liking secretory vesicles to plasma membrane in a way so that the content can be released from the cell carrying said secretory vesicle
-
how does Exocytosis work?
- V-Snare and T-snare bind to form conducting channel spanning the lipid bilayer and facilitate cell fusion.
- For example a V snare on the secretory vescile will bind to the TSnare on the lipid Bilayer and this will cause fusion of the membrane and ultimately contents of the vesciel will be released to the the extracellular space
-
what some examples of V-snare
VAMP synaptobrevin
-
what some examples of T-snare
SNAP-25 and syntaxin
-
how do V-snare and T-snares know how and where to bind?
- the apposing snare have specificity.
- different vSnare and t-Snare combination impart either consitutive or induced vescile fusion
-
tethering vessel is mediated by?
RAB proteins these are thethers
-
fusion of exocytotic vesicle to plasma membrane is mediated by
SNARE
-
how many chromosome in tripolidy?
-
what are the statistics against triploidy and one cause
- dispermy
- 1:10,000
- 15% incidence of spontaneous abortions
- die shortly after birth
-
what is tetra ploidy
- 4 sets of normal chromsome for humans
- hence 92
-
what are the characteristics of tetraploidy
- rare conception and
- %5 incidence of chromosomale spontaneous abortions
-
aneuploidy
an abnormal amoutn of chromosomes in a cell
-
what are some example of aneuploidies
-
what kind of Monosomy is incompatible with life
Autosomal
-
Nondijunction
- the most common cause of aneuploidy.
- the failure of chromsomes to disjoin normally during meiosis
-
what is polydactyly
extra fingera
-
what are the statistics of Patau
- 1:16,000-20,000
- 80% are full trisomies others occur from mosacic or translocations
-
addition finding of Patau outside of the 6 P's
- Microcephaly
- Microopthalmia
-
what percent of trisomy 13 Patau syndrome are lost due to spontaneous aboriton
95%
-
what are the statistics of 47,XX or XY, +18
- 1:6000 meaning that they are the second most common to trisomy 21
- <5% survive to birth
- 5-8 % survival in the first year
-
clinical presentation of down syndrome
- short stature
- loos skin on nape
- hypotonia
- clinodactyly
-
Dysmosphic down syndrome facial feature
- flat occiput
- epicanthal fold
- brushfield spots
- flat nasal bridge hypoplastic alae nasi, nostril are ridigid
- brachdactyly, short toes and fingers
- upslanting palpebrea , slanted eyes
- microbrachiocephaly
-
dysmorphic features of patau
- sloping forehead
- ocular
- microphthalmia
- cleft lip and palate
-
dysphormic feeature of edwards syndrome
- receding jaw
- small ear and mouth
- short sternum and toes
-
aneuploidies are most common inwhich se
males
-
what are aneuploidies of the sex chromosomes less server ( except X0) thant autosomal?
this is because the sex chromsomes do not carry much information.
-
what is x chromsome inactivation regulated by
- the XIST gene, a non coding RNA
- and the Xic( x incactivation center) that is required
-
Klinefelter syndrome findings
- taller
- hypertonia
- gynecomastia
- sterile
- hypogonadism
- shy
- mild learnign difficulties
-
statisc againt those wilth klinfelters
- 1:500-1000
- 30% have breast
- increased risk of breat cancer and osteporosis
-
Fragile X syndrome cause and genetics
- x linked dominant
- trinuclotide repeat in FMR1 gene
- hyper methylatin and decressed expression
- happens during oogenesis
- CGG
- Chin protruding and giant Gonads
-
what are the finding of Klinfelter syndrome
- long face with large jaw
- large everted ears
- autism
- mitral valve prolapse
- hyper mobile joints
- potpubertal macroorchidism(enlarge testes)
- long arms and les
-
what is the karyotype for klinefielter syndrome
- 47,XXY
- this is alwasy male
-
what is genomic impriting?
- one gene copy is silence by methylation and the other is expressed
- has parent of oriign effects
-
signs and symptoms of prader willi syndrome
- hypotonia
- obesity; hyperphagia
- small hands /feet
- moderare/mild intellectual disability
- hypogonadism
- short stature
- ataxic gate
- microcephaly
- severe speech impairment
-
signs and symptoms of prader willi syndrome
- set SAILs for angel island
- siezures
- ataxia
- severe intellectual disability
- inappropraite laughter ( happy puppet)
-
what causes angelman syndrome on the genetics side
- maternal allelle is deleted or mutates:UBE3A copy of chromsome 15
- paternal UBE3A is silenced
-
what causes McArdle disease and which type of glyocgen storage disease is this?
- glycogen phosphorylase in the skeletal muscles
- McAdle =Muscle
- increa glycogen inmuscles but they cannot break it down
- type V
-
what casues Cori disease and its type
- type III
- debranching enzymes
- α-1,6-glucosidase and 4-a-d-glucotransferase
-
what cause pompe diease and what type
- type II
- Lysosomal acid a-1,4-lucosidase (acid maltase )
- Pompe trashes the Pump (1st amd 4th leter: heart liver and muscle)
- similar to on Gierke
-
what cause Von gierke disease
Glucose 6 phosphate
-
Glycogen storage diseases
- very Poor Carbohydrate Metabolism
- Von Gierken
- Pompe
- Cori
- McArdle
-
what kind of epithelium lines the bladder
transitional epitehlium
-
how does white adipose appear ?
large white vacules with peripheral nuclei
-
hemolytic anemia can be caused as a result of
inihibition of glycose-6 phosphat dehydroenase because it reduces the amoutn og NADPH which is created thus the amoutn og gluthaione that is reduce to stop oxidative spieces from harming hemoglobin in blood
-
what are the goal of FPR
decrease strain on the joint capsule
-
what artery is commonly used for coronary bypasses
the internal thoracic
-
what is anticipation in genetics
repeat expression and early onset of disease in successive egneration
-
what is the main goal of HVLA
Increase circulation and venous lymph return
-
does Muscle energy need to be repeated?
yes 3-5 times
-
what is the treatment goal of counterstrain
- shortening of the tissue bearing the counterstrain
- counterstran the tender point
-
Result of HVLA
- soft tissue relaxation
- joint mobilization
- and increased circulation
-
result of Muscle energy
- joint mobilization
- Golgi tedon reflex
- postisometric relaxation
- joint mobilization
- reciprocal inhibition
- respiratoy asssistance
-
result of counterstain
- shorten muscle cause decrease in firing via myotatis reflex mechnaism
- restore local movement and bloodfloe
-
how are FPr and counterstain different
- FPR is compression
- Counterstrain is shortening
-
what is the result of FPR
less sensitivity duw to muscle spindle mechanism
-
what are the strecth of ligament and their ranges
- crimp2
- elasticity2-4
- microfailure4-8
- complete failure8-10
-
what kinf of connective tissue are ligaments? fascia
- dense regular
- the oppostie irregular
-
what mechanism is bLT/LAS
reciprocal inhibition
-
what are some lymph drainage techniques
- thoracic pumping
- eflerage
- Muscle energy ad excercises or other active technique
compression garment
-
wat are chapman reflex
- area od lymp congestion and symptathetic excitation that reflec specific visceral structures
- the nodules canbe painful
-
cranial osteopathy
gentle treatment that is used to release stress and tension in the body can be used for lymph drainage
|
|
