AnaPhy-LAB-Module-4 (4) PDF

§ Centers for Disease Control and Prevention (CDC) plays a key role in data collection and prevention recommendations. §...

§ Centers for Disease Control and Prevention (CDC) plays a key role in data collection and prevention recommendations. § Prevention includes vaccination programs and screening activities. § Health workers have opportunities to promote preventive MODULE 1: INTRODUCTION TO PATHOPHYSIOLOGY measures in their communities. § A sound knowledge of pathophysiology is essential for WHAT IS PATHOPHYSILOGY AND WHY STUDY IT? preventive teaching. Pathophysiology involves the study of functional or physiologic changes in the body resulting from disease processes. Complexity of Diseases § Builds on knowledge of the normal structure and function of § Pathophysiology reveals the complexity of diseases, the human body. challenges in diagnosis, treatment, and implications. § As a disease develops: § Availability of sophisticated diagnostic tests depends on ü Changes in the normal anatomy and/or physiology geographic location and resources. of the body may be obvious. ü Changes may also be hidden, occurring at the Ethical, Legal, and Social Issues cellular level. § Scientific developments raise ethical concerns, particularly in genetics. Pathophysiology includes aspects of pathology: § Research is often funded by commercial sources, leading to § Pathology is the laboratory study of cell and tissue changes early announcements of breakthrough therapies. associated with disease. § Understanding the research process and time required for clinical trials is crucial. HEALTH AND DISEASE Disease: Defined as a deviation from the normal state of health or Research Process in Health Sciences wellness. § A three-stage process aiming to demonstrate the safety and § World Health Organization (WHO): Includes physical, mental, effectiveness of new therapies. and social well-being in its definition of health. § Stage 1: Basic science, often involving animal or cell culture studies. State of Health § Stage 2: Small-scale trials in humans to assess safety. § Difficult to define due to genetic differences, life experiences, § Stage 3: Large-scale clinical trials, often double-blind, to test and environmental influences. effectiveness. § The context of health measurement is important (e.g., a § Successful research results are termed "evidence-based person who is blind can still be in good general health). research findings." § Temporary impairments (e.g., from injury or surgery) do not § Findings are reviewed by regulatory bodies like the FDA. necessarily alter overall health status. Evidence-Based Research Disease Development § Does not consider cost, availability, or social and cultural § Occurs when significant changes in the body prevent factors. maintenance of homeostasis without intervention. § These factors can influence the acceptance and use of § Homeostasis: The body's ability to maintain a stable internal therapies. environment (e.g., blood pressure, body temperature, fluid balance). Stopping Research Trials § Compensation Mechanisms: The body’s response to minor § Rare cases where trials are stopped early due to significant changes to restore homeostasis, often without the individual mortality differences between groups. being aware. § Example: AZT research was stopped early due to significant survival rates in the experimental group. Normal Values for Health Indicators § Figures for health indicators (e.g., blood pressure, pulse) Off-Label Use represent an average or a small range, not absolute criteria. § Approved therapies may be used for other diseases, known as § Values are adjusted for factors such as age, gender, genetics, "off-label" use. environment, and activity level. § Requires additional stage three clinical trials for new diseases. § Well-trained athletes may have a slower pulse or heart rate. § Example: Thalidomide used for multiple myeloma. § Blood pressure typically increases slightly with age, even in healthy individuals. Health Care Professionals' Role § Daily fluctuations in blood pressure occur due to minor § Additional responsibilities due to their knowledge and skills. changes in activity or body position. § Patients are more informed and encouraged to question their § A single figure cannot represent the only normal value for care. health indicators like blood pressure or pulse rate. § Early recognition of complications or reactions can prevent § Any health indicator or lab value should be considered within serious consequences. the total assessment of the individual. § Friends and family may rely on healthcare professionals' responses. THE STUDY OF PATHOPHYSIOLOGY Pathophysiology Technology and Ethical Issues § Involves the study of changes in normal structure and function § Advances in technology raise legal and ethical issues (e.g., due to disease. fetal tissue transplants, stem cell therapies). § Many disorders of specific organs display common signs and § Goal: Reduce disease incidence and improve recovery rates. symptoms related to that organ's structure and function. § Concerns include access, costs, and risk vs. benefits of new § Example: Liver damage leads to excessive bleeding due to treatments. the inability to produce clotting factors, and jaundice due to § Public health dilemmas arise in resource allocation. the inability to excrete bilirubin. § Basic pathophysiologic concepts, like inflammation or Alternative and Complementary Therapies infection, are common to many diseases. § Increasingly available alongside traditional therapies. § Example: Inflammation in the liver or kidneys causes swelling, § Knowledge of these therapies is important for healthcare leading to pain. professionals. § Should be considered in the health history of clients. Study of Disease in Text § Focuses on major diseases for a comprehensive overview. Health Care Team § Principles learned can be applied to other conditions. § Team has grown with more specialty groups. § General approach used for diseases with subtypes (e.g., one § Sharing knowledge among team members benefits both type of glomerulonephritis is described). patients and professionals. Prevention of Disease A MEDICAL HISTORY § A primary focus in healthcare. Importance of a Medical History § Preventive programs developed using known causes and § Essential for identifying the impact of healthcare activities on predisposing factors. a patient’s condition. § Efforts to detect significant factors continue to decrease § Helps determine how a patient’s illness might complicate disease incidence. care. 1| AnaPhy LAB Components of a Medical History ü Manifestations: Clinical evidence of disease, § Current and Prior Illnesses: Includes past and ongoing medical including signs (objective indicators like fever) and conditions. symptoms (subjective feelings like pain). § Allergies: Crucial to prevent allergic reactions during ü Lesions: Specific local changes in tissue. treatment. ü Syndrome: A collection of signs and symptoms that § Hospitalizations: Past hospital stays and their reasons provide occur together due to a specific condition. context. § Disease Development: Diseases can have various onsets § Treatment: Any previous or ongoing treatments, including (sudden or gradual), durations (acute or chronic), and stages surgeries. (latent, prodromal, etc.). § Current Health Status: Focuses on specific difficulties and any ü Acute Disease: Develops quickly with severe therapy or medications the patient is currently undergoing. symptoms. § Medications and Supplements: Includes prescription drugs, ü Chronic Disease: Develops gradually and lasts a non-prescription drugs, herbal items, and food supplements. long time, often with intermittent acute episodes. § Outcomes and Prognosis: Process of Completing a Medical History ü Complications: Secondary problems that arise from § A basic form is typically provided for the patient to complete. the original disease. § The health professional follows up with additional questions to ü Sequelae: Unwanted outcomes following the clarify the patient's current condition. primary condition, like paralysis after a stroke. § Understanding pathophysiology is key to formulating relevant ü Prognosis: The likelihood of recovery or other questions, interpreting the information, and deciding on outcomes based on statistical averages. necessary precautions. § Epidemiology: The study of the distribution and determinants of diseases within populations. This includes: Application of Medical History ü Incidence: Number of new cases in a population § Breathing Difficulties: Patients with severe respiratory problems within a specific time period. or congestive heart failure may have trouble breathing in a ü Prevalence: Total number of existing cases (new supine position. and old) in a population during a specific period. § Stress Management: Reducing stress is crucial for patients with ü Epidemics and Pandemics: Higher-than-expected high blood pressure. disease cases in a specific area (epidemic) or § Prophylactic Medication: May be required to prevent globally (pandemic). infection or excessive bleeding in certain patients. § Prevention and Management: § Medication Effects: Additional problems or undesirable effects ü Preventive Measures: Strategies like vaccinations, of medications may be identified through the medical history. lifestyle modifications, and early screenings to prevent disease. NEW DEVELOPMENTS ü Therapeutic Interventions: Treatments aimed at Continuous Learning recovery or slowing disease progression, such as § Both students and practitioners must constantly update their surgery, medication, and therapy. knowledge due to rapid advancements in healthcare § Reporting and Research: Notifiable diseases must be reported technologies. to authorities to prevent spread and aid in epidemiological § New discoveries about the causes of diseases, research. Regular updates and new research in healthcare pathophysiology, improved diagnostic tests, and more are critical for practitioners and students to stay informed effective drugs are being made regularly. about new developments in disease management and treatment technologies. Impact of Technology § Technology has significantly transformed many aspects of healthcare. § Research has led to breakthroughs like the HPV vaccine, which has reduced the incidence of cervical cancer. § Although not 100% effective, the vaccine is expected to dramatically lower the number of cervical cancer cases and treatment costs in the future. Staying Informed § Practitioners should regularly consult reliable resources like professional websites, journals, and seminars to stay updated. § Anticipated changes in healthcare include the increased use of electronic devices, such as sensors for monitoring blood glucose levels in diabetic patients. Global Data and Research § Data from health professionals worldwide are collected by organizations like WHO, CDC, and other health agencies. § This information is used to track new diseases, research efforts, and signal warnings about predisposing conditions or treatments. Responsibility to Stay Updated § Awareness of unexpected outcomes is a crucial responsibility for healthcare professionals. § Although the influx of new information can be overwhelming, staying updated is essential for effective practice. THE LANGUAGE OF PATHOPHYSIOLOGY Understanding pathophysiology involves mastering the basic terminology and revisiting foundational concepts in anatomy and physiology. This foundational knowledge is essential for comprehending how diseases affect various organs and systems in the body. Here are the key points: § Terminology: Familiarity with terms related to disease processes is crucial. These include: ü Diagnosis: Identifying a specific disease through evaluation of signs, symptoms, and diagnostic tests. ü Etiology: The causative factors of a disease, such as infections, genetic defects, or environmental influences. ü Pathogenesis: The development and sequence of events in a disease's progression. 2| AnaPhy LAB  ü Significance: Basis for grading the aggressiveness of a tumor. § Neoplasm ü New growth or tumor; can be benign or malignant. ü Types: MODULE 2: INTRODUCTION TO CELLULAR CHANGES Benign: Non-cancerous, does not spread, less serious unless located in INTRODUCTION critical areas like the brain. Cells have adaptive mechanisms to respond to altered conditions in the Malignant: Cancerous, can spread and body. Here’s an overview of how cells handle these changes and the is life-threatening. potential consequences: ü Characteristics: Depends on the specific cell type § Adaptation to Change: from which the tumor arises. ü Normal Adaptations: Cells can undergo changes as a normal response to body conditions. For CELL DAMAGE AND NECROSIS example, breast and uterine tissue increase during Cell Damage and Necrosis pregnancy due to hormonal stimulation. § Apoptosis ü Reversible Changes: Many cellular adaptations, ü Programmed cell death, a normal process for cells such as tissue modification due to environmental with abnormal development, excessive numbers, stimuli or irritation, are reversible once the stimulus is or aging. removed. ü Process: Cells self-destruct, digest themselves § Irreversible Changes: enzymatically, and disintegrate into fragments. ü DNA Changes: Irreversible changes in cells often § Causes of Cell Injury involve alterations in DNA structure or function. This ü Ischemia: Deficit of oxygen due to respiratory can signal a risk of permanent tissue damage or problems or circulatory obstruction. development of tumors. ü Physical Agents: Excessive heat, cold, or radiation ü Metabolic and Structural Damage: Cells may suffer exposure. damage due to: ü Mechanical Damage: Pressure or tearing of tissue. Reduced ATP Levels: ATP is crucial for ü Chemical Toxins: Harmful substances affecting cell cellular energy. Low levels can impair function. cell function. ü Microorganisms: Bacteria, viruses, and parasites. Altered pH: Changes in intracellular pH ü Abnormal Metabolites: Accumulation of harmful can affect enzyme activity and cellular compounds. processes. ü Nutritional Deficits: Lack of essential nutrients. Damage to Cell Membrane: Damage to ü Fluid/Electrolyte Imbalance: Disruption of normal the cell membrane or receptors can fluid or electrolyte levels. disrupt cellular function and integrity. § Ischemia § Monitoring and Prevention: ü Impact: Insufficient oxygen leads to decreased ü Assessing Abnormalities: Not all abnormal cellular cellular metabolism and ATP production. changes lead to permanent damage or cancer, ü Effect: Loss of sodium pump function, cell swelling, but monitoring and determining the cause of rupture of cell membrane, and metabolic abnormalities is essential. impairment. ü Risk Management: Understanding and addressing § Physical Injury cellular changes helps in reducing the risk of serious ü Types: Thermal and mechanical pressures; outcomes, including diseases and tumors. radiation affecting blood supply or DNA. § Chemical Injury TERMS USED FOR COMMON CELLULAR ADAPTATIONS ü Sources: Environmental (exogenous) and internal Terms Used for Common Cellular Adaptations (endogenous) toxins. § Atrophy ü Effects: Altered cell membrane permeability, ü Decrease in the size of cells, leading to reduced production of free radicals. tissue mass. § Infectious Diseases ü Causes: Reduced use of tissue, insufficient nutrition, ü Mechanism: Microorganisms cause damage decreased neurologic or hormonal stimulation, through various mechanisms. aging. § Genetic Defects/Metabolic Errors ü Example: Shrinkage of skeletal muscle from ü Consequences: Abnormal metabolic processes immobilization in a cast. leading to toxic accumulation and cell destruction. § Hypertrophy § Stages of Cell Damage ü Increase in the size of individual cells, resulting in ü Initial Damage: Alters metabolic reactions, enlarged tissue mass. potentially reversible if the cause is removed ü Causes: Increased workload on the tissue, quickly. excessive hormonal stimulation. ü Irreversible Damage: Leads to structural changes ü Example: Enlarged heart muscle from increased and cell death if damage persists. demands, or muscle growth from consistent § Types of Cell Death exercise. ü Liquefaction Necrosis: Dead cells liquefy, § Hyperplasia commonly seen in brain tissue or bacterial ü Increased number of cells leading to enlarged infections. tissue mass. ü Coagulative Necrosis: Cell proteins denature, seen ü Causes: Compensatory mechanism for increased in myocardial infarctions. demands or hormonal imbalances. ü Fat Necrosis: Breakdown of fatty tissue into fatty ü Example: Uterine enlargement during pregnancy; acids, causing inflammation. potential cancer risk in some cases. ü Caseous Necrosis: Formation of a thick, cheesy § Metaplasia substance, typical in tuberculosis. ü Replacement of one mature cell type by a ü Infarction: Area of dead cells due to lack of different mature cell type. oxygen, significant functional loss in affected ü Causes: Deficit of vitamin A or adaptive areas. mechanism to provide more resistant tissue. § Gangrene ü Example: Replacement of ciliated columnar ü Necrotic tissue invaded by bacteria. epithelium with stratified squamous epithelium in ü Types: Wet or dry, may cause gas buildup and smokers. reduced blood supply. § Dysplasia ü Treatment: Often requires surgical removal, such as ü Abnormal changes in cell size, shape, and amputation. increased mitosis; may indicate precancerous § Cell Death Rates changes. ü Brain Cells: Die quickly (4-5 minutes) without ü Causes: Chronic irritation or infection. oxygen. ü Example: Atypical cells detected in Pap smears. ü Heart Muscle: Can survive approximately 30 § Anaplasia minutes without oxygen. ü Undifferentiated cells with variable nuclear and cell § Diagnosis of Death structures and numerous mitotic figures; characteristic of cancer. 3| AnaPhy LAB ü Modern Criteria: Brain death is used for diagnosing somatic death, based on lack of responses, EEG changes, and decreased brain perfusion. 4| AnaPhy LAB  ü Squamous Cell Carcinoma: Arises from stratum spinosum, can metastasize and be fatal if untreated. ü Malignant Melanoma: Arises from melanocytes, often in a preexisting mole, can be fatal if not MODULE 3: INTEGUMENTARY SYSTEM diagnosed and treated early. § Prevention: Limiting sun exposure and using broad-spectrum CLINICAL DISORDERS OF THE INTEGUMENTARY SYSTEM sunscreens to block both UVA and UVB radiation. Diagnostic Use of the Integumentary System § Cyanosis: A bluish discoloration of the skin, indicating BURNS decreased blood oxygen levels, often related to circulatory or When a person suffers from a severe burn, especially over a large area, respiratory issues. it triggers a cascade of systemic effects that can be life-threatening. § Jaundice: A yellowish tint to the skin due to an accumulation These effects are primarily due to the impact on the body's capillaries, of bile pigments in the blood, often linked to liver conditions the tiny blood vessels responsible for exchanging fluids, gases, nutrients, like hepatitis. and waste between the blood and tissues. § Rashes and Lesions: Skin abnormalities can be indicative of systemic issues, such as the pink-red rash in scarlet fever due Capillary Permeability and Fluid Loss to a bacterial toxin, or hives from allergic reactions. Within minutes of a significant burn injury, the capillaries at the burn site, § Nutritional Indicators: Skin, hair, and nail conditions may reflect and throughout the body, become more permeable. This increased nutritional deficiencies, like excess keratin in vitamin A permeability leads to the leakage of fluid and electrolytes from the deficiency or spoon-shaped nails in iron-deficiency anemia. bloodstream into the surrounding tissues. The consequence of this fluid § Hair Analysis: Although not always reliable for general health, loss is a decrease in blood volume, which in turn diminishes the heart's hair can indicate specific issues like lead poisoning. ability to pump blood effectively. Reduced blood flow to tissues can result in tissue damage, shock, and potentially death. Bacterial Infections § Staphylococcus aureus: Common in pimples, boils, and Treatment carbuncles; causes impetigo, characterized by pus-filled The primary treatment for preventing death from burn-induced shock is blisters that form a yellowish crust. the administration of intravenous fluids at a rate faster than the fluid loss § Streptococcus pyogenes: Causes erysipelas, characterized by from the capillaries. This approach helps to stabilize blood volume and swollen red patches on the skin. pressure, reversing the shock. However, even with fluid replacement, the § Pseudomonas aeruginosa: Often infects burns, producing a leakage continues, leading to significant tissue swelling, known as characteristic blue-green pus. edema. After about 24 hours, capillary permeability generally begins to normalize, and the need for intravenous fluid decreases significantly. Acne § Causes: Factors include hormones, sebum production, Systemic Effects and Hypermetabolism abnormal keratinization, and Propionibacterium acnes. § Burns not only affect capillaries but also induce a range of § Development: Begins with hyperproliferation of hair follicle systemic immunologic and metabolic changes. The release of epidermis, leading to blockages and the formation of inflammation mediators, triggered by tissue damage, plays a whiteheads, blackheads, and pimples. significant role in altering capillary permeability across the body. Additionally, substances released from the burn site can Viral Infections cause cells to function abnormally. § Common Infections: Include chickenpox, measles, German § One of the critical systemic responses to burn injury is the onset measles, cold sores, and warts. of a hypermetabolic state, which begins almost immediately § Warts: Caused by viral infections of the epidermis, usually and persists until the burn wounds are closed. This increased harmless and self-resolving. metabolism is partly driven by a resetting of the body's temperature control center in the brain to a higher Fungal Infections temperature, further exacerbating the body's energy § Ringworm: Affects keratinized areas like skin, hair, and nails; demands. known by different names depending on the location, such as jock itch or athlete's foot. Types of Burns § Partial-Thickness Burns: These burns affect the outer layers of Decubitus Ulcers the skin (epidermis and part of the dermis). They are § Cause: Develop in immobile patients due to tissue characterized by redness, swelling, blistering, and pain. compression and ischemia, leading to necrosis and potential § Full-Thickness Burns: These burns extend through all layers of infection. the skin and into underlying tissues. They often appear white, blackened, or charred, and are usually numb due to nerve Bullae (Blisters) damage. § Formation: Fluid-filled areas caused by tissue damage and inflammation, resulting from infections or physical injuries. Psoriasis § Characteristics: Involves thickened stratum corneum, leading to silvery scales and potential bleeding if scraped. Likely has a genetic component and involves immune system stimulation. Eczema and Dermatitis § Causes: Inflammatory skin conditions triggered by allergies, infections, poor circulation, or exposure to irritants like chemicals or extreme temperatures. Birthmarks § Types: Congenital disorders of the capillaries, such as strawberry birthmarks (usually disappear by age 7) and portwine stains (persistent throughout life). Vitiligo § Description: White patches of skin due to autoimmune destruction of melanocytes. Moles § Nature: Benign aggregations of melanocytes, common and typically appearing in childhood, enlarging until puberty. Skin Cancer § Types: ü Basal Cell Carcinoma: Most common, starting in the stratum basale, rarely metastasizes if treated early. 5| AnaPhy LAB  their testosterone levels decrease more slowly, usually after age 65. 3. Other Contributing Factors ü Estrogen Deficiency: Conditions such as the removal of ovaries, extreme exercise leading to MODULE 4: SKELETAL SYSTEM amenorrhea, anorexia nervosa, and smoking can decrease estrogen levels, contributing to BONE DISORDERS osteoporosis. Giantism ü Calcium and Vitamin D Deficiency: Insufficient § Cause: Excessive secretion of pituitary growth hormone leads intake or absorption of calcium, often worsened by to abnormal height due to excessive cartilage and bone aging, can lead to osteoporosis. Certain drugs can formation at the epiphyseal plates of long bones. also hinder calcium absorption. § Types: ü Lack of Exercise: Physical inactivity or ü Pituitary Giantism: Results from excessive pituitary immobilization, such as after fractures or paralysis, growth hormone secretion. can lead to significant bone loss within weeks. ü Genetic Factors: Some individuals may have large 4. Treatment and Prevention stature due to genetics rather than hormonal ü Diet and Supplements: Increasing dietary intake of imbalances. calcium (1000-1500 mg daily) and vitamin D (800 IU § Related Condition: Acromegaly, which involves growth of daily) can help improve bone health. connective tissue and bones after the epiphyseal plates have ü Exercise: Weight-bearing exercises like walking and ossified, leading to an increase in bone diameter, especially using light weights can reduce bone loss and in the face and hands. potentially increase bone mass. ü Hormone Replacement Therapy (HRT): In Dwarfism postmenopausal women, HRT with estrogen can § Pituitary Dwarfism: Caused by abnormally low levels of reduce bone loss by decreasing osteoclast activity, pituitary growth hormone, leading to a proportionally small though it may not increase bone mass and has risks stature. like breast cancer. § Achondroplastic Dwarfism: A more common type of dwarfism ü Selective Estrogen Receptor Modulators where the trunk and head are nearly normal-sized, but the (SERMs): These drugs, like raloxifene, can stimulate limbs are shorter than normal. It is usually due to genetic estrogen receptors in bones without increasing defects affecting cartilage growth at the epiphyseal plates breast cancer risk. and often involves deficient collagen synthesis. ü Calcitonin: Available as a nasal spray, it inhibits osteoclasts and can slightly increase bone mass. Osteogenesis Imperfecta ü Bisphosphonates (e.g., Alendronate): These drugs § Cause: A group of genetic disorders that result in very brittle concentrate in bones and inactivate osteoclasts, bones due to insufficient collagen, making bones prone to effectively increasing bone mass and reducing fractures. fractures. § Effects: Intrauterine fractures may heal poorly, causing limbs to ü Statins: Besides lowering cholesterol, statins also appear bent and short. stimulate osteoblast activity, potentially reducing fracture risk. Bacterial Infections: ü Slow-Release Sodium Fluoride and Calcium § Osteomyelitis: Inflammation of the bone often caused by Citrate: This combination has shown potential in bacterial infection, particularly Staphylococcus aureus, which increasing bone mass. can be introduced through wounds. It can lead to complete 5. Emerging Treatments destruction of the bone. ü Leptin Pathway: Research suggests that leptin, a § Bone Tuberculosis: A specific type of osteomyelitis caused by hormone from fat cells, might influence bone the spread of Mycobacterium tuberculosis from the lungs to formation by increasing osteoblast activity. the bones via the circulatory system. Understanding this pathway could lead to new osteoporosis treatments. Tumors: ü Early Diagnosis: Techniques like dual-energy X-ray § Bone Tumors: Can be benign or malignant, leading to various absorptiometry (DEXA) are currently the most bone defects. Malignant bone tumors can metastasize to effective for early detection and prevention of other parts of the body or spread from other tumors to the osteoporosis. bone. JOINT DISORDERS Decalcification Disorders: Arthritis § Osteomalacia: Softening of bones due to calcium depletion, § Arthritis is the inflammation of any joint, and it is the most which may occur during conditions that increase calcium common joint disorder, affecting 10% of the world's demand, such as pregnancy. This can lead to bones population. becoming soft and weakened. § There are over 100 types of arthritis, categorized based on § Osteoporosis: A major disorder of decalcification, resulting in causes such as infections, metabolic disorders, trauma, and weakened bones, discussed in more detail elsewhere. immune disorders. § Treatment: Mild exercise, particularly swimming and walking, is OSTEOPOROSIS recommended to slow joint degeneration. Anti-inflammatory Osteoporosis is a condition characterized by porous bones resulting from drugs are commonly used, and research is exploring the a decrease in bone tissue. It occurs when the rate of bone resorption development of antibodies to combat inflammation. (breakdown) surpasses the rate of bone formation, leading to weakened bones that are prone to deformation and fractures. Osteoarthritis (OA) § OA is the most common form of arthritis, affecting 10% of Key Points: people in the U.S., especially those over 70. 1. Age-Related Bone Loss § It may start as a molecular abnormality in cartilage, ü Both men and women experience a decrease in influenced by heredity and wear-and-tear, with inflammation bone mass starting around age 35. usually secondary. ü Women can lose up to 50% of their cancellous § Treatment: Lifestyle changes to reduce stress on joints, (spongy) bone, while men lose about 25%. moderate exercise, heat applications, and medications like ü Osteoporosis is 2.5 times more common in women acetaminophen, NSAIDs, and corticosteroids are due to factors like menopause. recommended. Surgical options include arthroscopy, 2. Role of Hormones osteotomy, and joint replacement. ü In Women: After menopause, decreased estrogen levels lead to increased osteoclast activity (cells Rheumatoid Arthritis (RA) that break down bone), resulting in bone loss. This is § RA affects about 3% of women and 1% of men in the U.S. particularly evident in the vertebrae and forearm § Nature: RA is a connective tissue disorder that primarily affects bones, sometimes leading to conditions like small joints and can be severely disabling. It is possibly linked kyphosis or "dowager’s hump." to autoimmune reactions. ü In Men: Decreased testosterone levels can also § Symptoms: RA leads to the thickening of the joint capsule and cause bone loss, but the effects are generally less destruction of articular cartilage, and in advanced stages, severe because men start with denser bones and joints can fuse. 6| AnaPhy LAB Other Joint Disorders § Hemophilic Arthritis: Caused by bleeding into the joint cavity due to hemophilia, leading to cartilage degeneration. § Lyme Disease: A bacterial infection transmitted by ticks that can cause chronic arthritis and other symptoms. § Suppurative Arthritis: Pus-forming arthritis caused by infections, potentially leading to joint surface degeneration. § Tuberculous Arthritis: Secondary to pulmonary tuberculosis, affecting large joints and causing significant damage. § Gout: A metabolic disorder characterized by increased uric acid, leading to urate crystal accumulation in joints, causing inflammation and potential kidney damage. Joint Replacement § Joint replacement (arthroplasty) is used to eliminate pain in patients, especially those with osteoarthritis or RA. § Prosthetic joints are made from metals and plastics, with varying success rates depending on the joint, patient condition, and technological advancements. 7| AnaPhy LAB MODULE 5: MUSCLES AND MUSCULAR SYSTEM DISORDERS OF MUSCLE TISSUE Atrophy: Decrease in muscle size due to loss of muscle fibers and myofibrils. § Types: ü Disuse Atrophy: Results from lack of muscle use (e.g., bedridden individuals or those with limbs in casts). This atrophy can be temporary if the muscle is exercised after a period of disuse but can become permanent if extreme. ü Denervation Atrophy: Occurs when nerves supplying muscles are severed, leading to flaccid paralysis. If reinnervation occurs, function and muscle mass can be restored. Permanent denervation leads to irreversible muscle atrophy and replacement by connective tissue. § Treatment: Transcutaneous stimulators can provide electric stimuli to prevent atrophy in temporarily damaged nerves or immobilized muscles. Muscular Dystrophy: A group of inherited disorders causing progressive degeneration of muscle tissue, eventually replaced by connective tissue. § Types: ü Duchenne’s Muscular Dystrophy: An X-linked recessive disorder affecting mostly males, leading to progressive muscle weakness and atrophy, typically resulting in wheelchair confinement by adolescence. ü Facioscapulohumeral Muscular Dystrophy: A less severe condition affecting both sexes, primarily involving muscles of the face and shoulder girdle. It is inherited as an autosomal-dominant trait. § Treatment: No cure exists. Management focuses on exercises, braces, and corrective surgery to address posture abnormalities. Fibrosis: Replacement of damaged muscle tissue (cardiac or skeletal) by connective tissue due to severe trauma or heart attack (myocardial infarction). Fibrositis: Inflammation of fibrous connective tissue causing stiffness, pain, or soreness. It is not progressive and does not lead to tissue destruction. § Causes: Repeated muscular strain or prolonged tension. Cramps: Painful, spastic contractions of muscles usually caused by irritation within the muscle, leading to reflex contraction. § Causes: Local inflammation from lactic acid buildup and fibrositis. Fibromyalgia: A chronic muscle pain syndrome characterized by widespread pain in muscles and tendon attachment sites, with no known cure. § Symptoms: Chronic, widespread muscle pain with identifiable tender points. It is not progressive, crippling, or life-threatening, and is diagnosed by ruling out other causes of chronic pain. 8| AnaPhy LAB  PERIPHERAL NERVOUS SYSTEM DISORDERS – SPINAL NERVES General Types of PNS Disorders 1. Anesthesia ü Loss of sensation. It can occur pathologically or be induced for medical procedures. MODULE 6: NERVOUS TISSUE AND NERVOUS SYSTEM 2. Hyperesthesia ü Abnormal increased sensitivity to sensory stimuli, SPINAL CORD INJURY such as pain, pressure, or light. Damage to the spinal cord can disrupt: 3. Paresthesia § Ascending Tracts: Pathways carrying sensory information from ü Abnormal spontaneous sensations like tingling, the spinal cord to the brain, leading to loss of sensation. prickling, or burning. § Descending Tracts: Pathways carrying motor commands from 4. Neuralgia the brain to spinal motor neurons, resulting in loss of motor ü Severe pain along the path of a nerve, often function. described as throbbing or stabbing, due to inflammation or damage. Epidemiology 5. Sciatica (Ischiadica) § Causes: Predominantly automobile and motorcycle ü Neuralgia affecting the sciatic nerve, causing pain accidents, followed by gunshot wounds, falls, and swimming radiating down the back of the thigh and leg. accidents. ü Common Causes: Herniated lumbar disk, ischiadic neuritis from mechanical stretching, vitamin Classification of Spinal Cord Injury deficiencies, or metabolic disorders. 1. Vertebral Level: The specific vertebra where the injury occurs. 6. Neuritis 2. Extent of Damage: Whether the entire cord at that level or only ü Inflammation of a nerve with various causes, a portion is damaged. including mechanical injury, infections, or vitamin 3. Mechanism of Injury: Includes concussion, contusion, or deficiencies. laceration due to excessive flexion, extension, rotation, or ü Effects: Sensory neuritis may cause neuralgia, compression. anesthesia, or loss of reflexes. Motor neuritis results in loss of motor function. Types of Damage 1. Primary Mechanical Damage Infections ü Concussion: Injury from a blow. 1. Herpes Simplex Virus ü Contusion: Injury with hemorrhage. ü Causes skin lesions due to viruses residing in sensory ü Laceration: Tear or cut in the spinal cord. nerve ganglia. ü Cause: Typically results from excessive movement ü Types: or displacement of bone or disk into the cord. Herpes Simplex I: Causes cold sores or 2. Secondary Tissue Damage fever blisters on the lips or nose. ü Onset: Begins within minutes of the primary injury. Herpes Simplex II: Causes genital ü Causes: Ischemia, edema, ion imbalances, herpes, leading to lesions on external excitotoxicity (e.g., glutamate), and inflammatory genitalia. cell invasion. 2. Varicella-Zoster Virus ü Extent: Secondary damage often spreads beyond ü Causes chickenpox in children and shingles (herpes the initial injury site, making it the primary focus of zoster) in adults. current research and treatment. ü Symptoms: Shingles present as unilateral skin blisters and discoloration along the path of one or more Treatment Approaches spinal nerves, commonly around the waist. 1. Primary Damage 3. Poliomyelitis ü Prevention: Use of seat belts and avoiding diving in ü Caused by an Enterovirus, affects peripheral nerves shallow water to prevent injury. and muscles. It infects motor neurons in the spinal 2. Secondary Damage cord's anterior horn, leading to paralysis and ü Immediate Treatment: Administration of muscle atrophy. methylprednisolone (a synthetic steroid) within 8 4. Anesthetic Leprosy hours to reduce inflammation and edema. ü Bacterial infection by Mycobacterium ü Additional Measures: leprae causing anesthesia, paralysis, ulceration, Anatomic Realignment and and gangrene in peripheral nerves. Stabilization: Correcting and stabilizing the vertebral column. Genetic and Autoimmune Disorders Decompression: Relieving pressure on 1. Myotonic Dystrophy the spinal cord. ü Autosomal dominant hereditary disease causing Rehabilitation: Focusing on retraining the muscle weakness, dysfunction, atrophy, and visual patient to use any residual functional impairment due to nerve degeneration. connections. 2. Myasthenia Gravis ü Autoimmune disorder where the immune system Regeneration and Research reduces the number of functional acetylcholine § Historical Perspective: Previously believed that the spinal cord receptors at neuromuscular junctions. could not regenerate after severe injury. ü Symptoms: Fatigue and progressive muscular § Current Understanding: weakness due to impaired neuromuscular ü Neuronal Survival: Most adult spinal cord neurons transmission. survive but only regenerate minimally before becoming inactive. PERIPHERAL NERVOUS SYSTEM DISORDERS – CRANIAL NERVES ü Fetal and Neonatal Regeneration: Higher Trigeminal Neuralgia (Tic Douloureux) regenerative ability and functional improvement § Trigeminal neuralgia involves one or more branches of the observed in fetuses and newborns. trigeminal nerve (cranial nerve V) and is characterized by ü Regeneration Challenges: sudden, severe facial pain. Scar Formation: Scar tissue, including § Symptoms: Sharp bursts of pain, often triggered by touch or myelin and astrocytes, forms at the injury stimuli around the mouth or face. site and inhibits regeneration. § Cause: The exact cause is unknown. It may be related to Potential Solutions: vascular compression of the trigeminal nerve. § Peripheral Nerves and Schwann Cells: Can bridge Facial Palsy (Bell’s Palsy) the scar and stimulate some § Bell’s palsy results in unilateral facial muscle paralysis, affecting regeneration. the facial nerve (cranial nerve VII). § Fetal CNS Tissue and Growth § Symptoms: Drooping of the affected side of the face due to Factors: May aid in loss of muscle tone, potentially accompanied by loss of facial regeneration. expression on that side. § Cause: Often linked to facial nerve neuritis, and may be associated with viral infections such as herpes simplex. 9| AnaPhy LAB Infections 1. Herpes Simplex I Chronic Pain ü A viral infection that primarily affects the lips or § Pain lasting beyond the expected healing time or without an nose, known for recurrent lesions. apparent cause. ü Symptoms: Painful sores or blisters on the lips or § Impact: Can lead to disability, social isolation, depression, and around the nose, commonly referred to as cold interference with daily activities and employment. sores or fever blisters. § Mechanisms: ü Virus Behavior: The herpes simplex virus remains ü Peripheral Sensitization: Increased sensitivity of dormant in the trigeminal ganglion and reactivates nerve endings in the injured area. during periods of reduced immune resistance, such ü Central Sensitization: Decreased pain threshold as during colds. and increased sensitivity in the CNS, often involving excitatory neurotransmitters like glutamate and Genetic and Autoimmune Disorders aspartate. 1. Neurofibromatosis § Treatment Approaches: ü A genetic disorder characterized by the appearance of ü Multidisciplinary: Includes medication, therapy, skin lesions and the development of neurofibromas. and sometimes surgery or psychotherapy. ü Symptoms: Small skin lesions in early childhood followed ü Future Directions: Development of by multiple subcutaneous neurofibromas (benign "antihyperalgesics" to target sensitization tumors). These tumors result from the proliferation of specifically without affecting normal sensations. Schwann cells. ü Progression: Neurofibromas can slowly increase in size DYSKINESIAS and number, potentially causing significant disfiguration Dyskinesias are disorders characterized by abnormal, uncontrolled over time. movements often linked to dysfunction in the basal nuclei. These movements are usually involuntary and can range from mild to severe. PAIN Pain Sensation Types and Causes 1. Components of Pain Sensation 1. Sydenham’s Chorea ü Sharp, Well-Localized Pain: Conducted rapidly by ü Also known as St. Vitus' dance, this condition is large-diameter, myelinated axons. typically associated with a toxic or infectious ü Diffuse, Burning or Aching Pain: Conducted more disorder that temporarily disrupts the function of the slowly by smaller, less heavily myelinated axons. corpus striatum. 2. Mechanism: ü Affected Group: Usually affects children. ü Pain receptors (nociceptors) have consistent 2. Huntington’s Chorea sensitivity. Variations in pain perception result from ü A dominant hereditary disorder that begins in differences in the integration of action potentials middle life, leading to progressive mental and stimulation mechanisms. deterioration and degeneration of the corpus ü Superficial Pain: Well-localized due to simultaneous striatum. stimulation of pain and mechanoreceptors in the ü Onset: Typically starts in middle age. skin. 3. Cerebral Palsy ü Deep or Visceral Pain: Less localized, often ü Refers to various motor function defects caused by perceived as diffuse pain due to fewer brain damage, either due to abnormal brain mechanoreceptors in deeper structures. development or birth-related injury. It can involve increased muscle tension and basal nuclei Gate-Control Theory dysfunction. 1. Theory Overview ü Athetosis: Characterized by slow, sinuous, and ü Dorsal-Column/Medial-Lemniscal System: Involves aimless movements, often affecting the face, neck, tactile and mechanoreceptors. Neurons in this and tongue. system can inhibit pain signals in the lateral 4. Hemiballismus spinothalamic tract. ü Results from damage to the subthalamic nucleus, ü Gate Mechanism: Increased activity in the dorsal- leading to uncontrolled, purposeless, and forceful column/medial-lemniscal system can close the movements, often of the arm. It can also cause gate, reducing pain perception. twitching of the face and neck. ü Regulation: Descending pathways from the brain 5. Parkinson’s Disease can influence this gating mechanism. ü A condition caused by dysfunction in the 2. Applications: substantia nigra, leading to muscular rigidity, loss of ü Methods to Reduce Chronic Pain: facial expression, tremor, and a slow, shuffling gait. Electric Stimulation: Activates dorsal- ü Symptoms: Includes resting tremor ("pill-rolling"), column/medial-lemniscal neurons. rigidity, and bradykinesia (slow movement). Transcutaneous Electric Nerve ü Pathophysiology: Deficiency of dopamine, an Stimulation (TENS): Applies weak electric inhibitory neurotransmitter, due to degeneration of stimulus to the skin. melanin-containing cells in the substantia nigra. Acupuncture, Massage, Exercise: ü Treatment: Increase frequency of action potentials Levodopa (L-Dopa): A precursor to in the dorsal-column/medial-lemniscal dopamine. system, helping reduce pain intensity. Sinemet: A combination of L-Dopa and carbidopa; carbidopa prevents L-Dopa Referred Pain from being absorbed outside the brain. § Pain perceived in an area different from the source of the pain Dopamine Agonists: Ropinirole and stimulus. Often due to convergence of sensory neurons from pramipexole are examined as different regions onto the same ascending neurons. alternatives. § Both cutaneous and visceral sensory neurons converge, and Other Treatments: GDNF for promoting the brain struggles to distinguish the exact source, often dopamine neuron survival, chronic referring pain to more superficial areas. electrical stimulation of the globus § Referred pain helps diagnose the underlying issue (e.g., heart pallidus, and experimental attack often causes pain in the left shoulder and arm). transplantation of dopamine-producing tissues. Phantom Pain 6. Cerebellar Lesions § Pain or sensations felt in an amputated or removed structure ü Lead to a range of functional disorders: as if it were still present. Ataxic Movements: Jerky and § Stimulation of neuron pathways that were previously uncoordinated. connected to the missing part can still be perceived as pain. Dysmetric Movements: Overshooting or § Contributing Factors: deviating from intended marks. ü Loss of Sensory Input: Absence of touch, pressure, Clumsy Alternating Movements: and proprioceptive impulses from the amputated Difficulty with tasks requiring precise limb may increase phantom pain. movements, such as supination and ü Brain Representation: The brain retains a mental pronation. image of the amputated limb, which can influence Nystagmus: Constant eye movements. the perception of pain. 10 | AnaPhy LAB  Cerebellar Tremor: An intention tremor 2. Limbic System Functions where tremors become more ü Functions: Emotion regulation, memory formation, pronounced with careful movement satisfaction, and motivation. attempts, contrasting with basal nuclei 3. Depression tremors that may diminish during ü Types: Endogenous (treatable with purposeful movement. antidepressants) and psychologic. May be linked to brain chemistry and psychological factors. GENERAL CNS DISORDERS 4. Headaches Infections ü Types: Extracranial (e.g., sinus inflammation, muscle 1. Encephalitis tension) and intracranial (e.g., tumors, ü Inflammation of the brain, primarily viral. inflammation). ü Symptoms: Fever, paralysis, coma, death. 5. Concussion 2. Myelitis ü Momentary loss of consciousness from head ü Inflammation of the spinal cord, caused by trauma, trauma. May lead to postconcussion syndrome. multiple sclerosis, or infections. 6. Alexia and Dyslexia ü Symptoms: Varies with injury or infection extent. ü Alexia: Loss of the ability to read. 3. Meningitis ü Dyslexia: Reading deficiency with normal ü Inflammation of the meninges, often bacterial. intelligence, often involving letter transposition and ü Symptoms: Neck stiffness, headache, fever, pus spatial confusion. accumulation leading to hydrocephalus, potential 7. Attention Deficit/Hyperactivity Disorder (ADHD) paralysis, coma, death. ü Characterized by distractibility, short attention 4. Reye’s Syndrome span, fidgetiness, and impulsivity. ü Occurs in children post-viral infection, linked to aspirin use. THE SPECIAL SENSES ü Symptoms: Vomiting, lethargy, loss of EYE DISORDERS consciousness, coma, permanent brain damage. Myopia (Nearsightedness) 5. Rabies § Ability to see close objects clearly, but distant objects appear ü Viral disease transmitted by mammal bites. blurry. This occurs because the cornea and lens are too ü Symptoms: Pharyngeal muscle spasms powerful or the eyeball is too long (axial myopia). The focal (hydrophobia), aggression, paralysis, death. point is in front of the retina. 6. Tabes Dorsalis § Correction: ü Progressive disorder from untreated syphilis. ü Concave Lenses: Diverge light rays, shifting the ü Symptoms: Ataxia, anesthesia, paralysis. focal point back onto the retina. 7. Multiple Sclerosis (MS) ü Radial Keratotomy: Involves making radial cuts in ü Autoimmune response leading to demyelination in the cornea to flatten it. Results can be brain and spinal cord. unpredictable and may lead to glare. ü Symptoms: Exaggerated reflexes, tremor, ü Laser Corneal Sculpturing: A more precise nystagmus, speech defects. technique to reshape the cornea. Other Disorders Hyperopia (Farsightedness) 1. Brain Tumors § Ability to see distant objects clearly, but close objects appear ü Tumors from neuroglial cells. blurry. This occurs because the cornea and lens are too weak ü Symptoms: Headaches, neuralgia, paralysis, or the eyeball is too short, causing the focal point to be behind seizures, coma, death. Meningiomas make up 25% the retina. of primary intracranial tumors. § Correction: 2. Stroke (Cerebrovascular Accident, CVA) ü Convex Lenses: Converge light rays to shift the ü Caused by hemorrhage, thrombosis, embolism, or focal point forward onto the retina. vasospasm leading to neuronal cell death. Presbyopia ü Symptoms: Anesthesia or paralysis opposite the § Age-related decline in the eye's ability to focus on close infarct site. Smoking increases risk. Aspirin reduces objects due to the lens becoming less flexible. Typically begins risk. in the mid-forties. 3. Aneurysm § Correction: ü Dilation of an artery, common in brain arteries. ü Reading Glasses: For close work. ü Symptoms: Hemorrhage causing pressure on brain ü Bifocals or Half Glasses: Provide dual focus for both tissue, toxic to brain tissue. near and distant vision. 4. Cerebral Compression ü Caused by hematomas, hydrocephalus, tumors, or Astigmatism edema. § A refractive error caused by an irregular curvature of the ü Symptoms: Increased intracranial pressure, cornea or lens, leading to blurred vision. Light rays do not compression of brainstem, possible death. converge at a single point but form a blurred circle. 5. Syringomyelia § Correction: ü Cavitation of the spinal cord's central canal, often ü Glasses: With specific curvatures to counteract the from tumors. irregular shape. ü Symptoms: Neuralgia, paresthesia, loss of pain and ü Irregular Astigmatism: Difficult to correct with temperature sensation, paresis. glasses. 6. Alzheimer’s Disease ü Severe dementia affecting older individuals; Strabismus characterized by neuron loss in cerebral cortex. § Misalignment of the eyes, which can be convergent (inward) ü Symptoms: Intellectual deficiency, memory loss, or divergent (outward). Can cause diplopia (double vision) if moodiness, irritability. Associated with amyloid the image on one retina differs significantly from the other. plaques and neurofibrillary tangles. § Types: 7. Tay-Sachs Disease ü Concomitant Strabismus: Constant angle between ü Hereditary disorder of sphingolipid metabolism in visual axes regardless of gaze direction. infants. ü Noncomitant Strabismus: Angle varies with gaze ü Symptoms: Paralysis, blindness, death before age 5. direction. 8. Lead Poisoning ü Caused by environmental lead contamination. Retinal Detachment ü Symptoms: Brain damage, reduced intelligence, § Separation of the sensory retina from the pigmented retina learning disabilities, psychoses. due to fluid accumulation. Can lead to blindness if the sensory 9. Epilepsy retina degenerates. ü Group of brain disorders with seizure episodes. § Causes: Severe eye injury, aging, diabetes. ü Symptoms: Sudden neuronal discharge causing muscle contractions or convulsions. Color Blindness § Dysfunction in one or more of the three photopigments Special Topics responsible for color vision. 1. Pheromones ü Dichromatism: Involves the lack of one pigment, ü Molecules released into the air to attract individuals like red-green color blindness. of the same species. 11 | AnaPhy LAB  ü Genetics: Genes for color vision are located on the EAR DISORDERS X chromosome, making color blindness more Otosclerosis common in males. § A condition where spongy bone growth over the oval window § Key Exons: Exon 5 is crucial for normal red-green vision. immobilizes the stapes, leading to progressive hearing loss. § Surgical Treatment: Involves breaking away the bony growth Night Blindness and replacing the immobilized stapes with a small rod § Difficulty seeing in low light. Can be caused by retinal connected to the oval window and the incus. degeneration, abnormal rod function, or vitamin A deficiency. Tinnitus § Correction: Special electronic devices like monocular pocket § Perception of noises like ringing, clicking, whistling, or booming scopes and binocular goggles that amplify light. in the ears. § Causes: Can result from disorders in the middle or inner ear or Glaucoma central neuronal pathways. § Increased intraocular pressure due to aqueous humor buildup. It can damage the retina, optic disc, and optic Motion Sickness nerve, leading to blindness if untreated. § Nausea, weakness, and other symptoms caused by § Symptoms: Gradual loss of peripheral vision without pain. stimulation of the semicircular canals during motion. § Treatment: Eyedrops, laser, or conventional surgery. § Medications: Antiemetics such as anticholinergics (e.g., scopolamine) and antihistamines (e.g., cyclizine, Cataract dimenhydrinate, diphenhydramine) are used. Scopolamine § Clouding of the lens due to protein buildup, leading to blurred can be administered via a transdermal patch. vision. Common with aging. § Treatment: Removal of the cloudy lens and replacement with Otitis Media an artificial lens. Glasses may be needed for near vision. § Infection of the middle ear, often resulting from infections spreading from the pharynx through the auditory tube. Macular Degeneration § Symptoms: Low-grade fever, lethargy, irritability, and § Loss of acute vision due to degeneration of the macula, often temporary hearing loss due to fluid buildup. associated with aging. § Treatment: Optical aids such as magnifying glasses; no Earache satisfactory medical treatment yet. § Causes: Can result from otitis media, otitis externa (inflammation of the external auditory meatus), dental Diabetic Retinopathy abscesses, or temporomandibular joint pain. § Retinal damage resulting from poor circulation due to diabetes. It is a leading cause of blindness. DISORDERS OF THE AUTONOMIC NERVOUS SYSTEM § Treatment: Management of diabetes and regular eye exams Sympathectomy to monitor retinal health. § Removal of sympathetic ganglia. § Effects: Infections ü Loss of normal body temperature regulation. § Trachoma: Caused by Chlamydia trachomatis, leading to ü Reduced ability to lose heat in hot environments scarring of the cornea. Preventable with hygiene measures due to decreased blood flow to the skin and and antibiotics. reduced sweating. § Neonatal Gonorrheal Ophthalmia: Bacterial infection from ü Decreased ability to conserve heat in cold Neisseria gonorrhoeae, preventable by treating infants’ eyes environments due to reduced ability to decrease at birth with antibiotics. blood flow to the skin. ü Low blood pressure due to dilation of peripheral DEAFNESS AND FUNCTIONAL REPLACEMENT OF THE EAR blood vessels. Types of Deafness ü Inability to increase blood pressure during physical § Conduction Deafness activity. ü Mechanical deficiency in transmitting sound waves from the external ear to the spiral organ of the inner Orthostatic Hypotension ear. § Drop in blood pressure upon standing from a sitting or lying ü Correction: Often surgically correctable. Hearing position. aids can boost sound volume to assist with such § Causes: Often associated with conditions like diabetes hearing deficiencies. mellitus that decrease the frequency of action potentials in § Sensorineural Deafness sympathetic nerves. ü Involves damage to the spiral organ or nerve § Mechanism: Blood pools in dilated blood vessels of the lower pathways, making it more challenging to correct. extremities, reducing the amount of blood returning to the ü Correction: More difficult to address compared to heart and decreasing cardiac output, leading to decreased conduction deafness. blood pressure and reduced brain blood flow, which can cause fainting. Cochlear Implants § Purpose: To replace damaged hearing pathways with electric Raynaud’s Disease circuits, particularly for sensorineural deafness where hair cells § Spasmodic contraction of peripheral blood vessels, in the spiral organ are impaired. particularly in the digits. § Components and Procedure: § Symptoms: Pale, cold hands prone to ulcerations and 1. Implantation: gangrene due to poor circulation. A receiver, transmitter, and antenna are § Cause: Exaggerated sensitivity of blood vessels to sympathetic implanted under the skin near the innervation. auricle. § Treatment: Preganglionic denervation may be performed to A small lead is inserted through the alleviate symptoms. external auditory meatus, tympanic membrane, and middle ear into the Hyperhidrosis cochlea. § Excessive sweating. 2. Function: § Cause: Exaggerated sympathetic innervation of the sweat The cochlear nerve is directly stimulated glands. by electric impulses from the receiver. The system includes a microphone to Achalasia pick up sound waves, a microelectronic § Difficulty in swallowing and controlling esophageal processor to convert sound into electric contractions, affecting peristalsis. signals,