Basic and clinical note

📚📚📚 CerebellarAtaxia 📚📚📚

কিন্তু কথাটা হচ্ছে Ataxia আমরা বুঝবো কিভাবে? Disease/Condition Identity করার জন্য আমরা ব্যবহার করি Signs & Symptoms.

📚📚Atxia means " Disturbances in voluntary movement".

📚📚Symptoms of Ataxia: Tremor হবে যখন patient fine movements perform করতে যাবে যেমন buttoning clothes, writing, and shaving.

📚📚Signs of Ataxia: Past-Pointing

📚এটা Upper limb এ elicit করতে পারি Finger-Nose Test এর মাধ্যমে।

(When the patient is asked to touch the tip of the nose with the index fin- ger, the movements are not properly coordinated, and the fin- ger either passes the nose :Past-pointing or Hits the nose. )

📚Lower limb এর ক্ষেত্রে রোগীকে বলতে হবে আপনার পায়ের heel Opposite পায়ের shin এ place করার জন্য। ( 🛑Caution: It is not Heel-shin coordination)

📚📚Reference: Snell Clinical Neuroanatomy 8th edition 241

https://www.drawittoknowit.com/course/neuroanatomy/glossary/pathophysiologic-disorder/ataxia

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Giant Hairy Congenital Melanocytic Naevus

https://momenkhan49.blogspot.com/2021/03/germ-layer-origin-of-glands.html

Germ layer origin of glands Germ layer origin of glands Ø Ectodermal o Glands of skin o Mammary glands o Lacrimal glands o Salivary glands o...

Repetitive minor trauma- most common cause of Osteoarthritis.

Piriformis syndrome


Piriformis syndrome

Sciatica symptoms due to involvement of the piriformis muscle
Often referred to as wallet sciatica fat wallet sciatica
Entrapment of sciatic and/or pudendal nerve

Predisposing factors
Sitting on theek wallet for long periods of time
Trauma to the piriformis
Exercise on hard, uneven surface for a long period.
On toe running

Symptoms
Pain with sitting standing or lying that longer than 15 to 20 minutes.
Pain improve with ambulation and worsen with no movement
Sciatic entrapment+Pain tingling numbness in buttocks, posterior thigh, Hip, Leg.
Pudendal entrapment-Pain tingling numbness at coccyx, groin
It may cause bowel and/or bladder incontinence

Sign
Tenderness over piriformis muscle, greater sciatic notch, SI joint

Clinical examination
FAIR test (piriformis test)
Flexion, adduction ,internal rotation of hip joint.
Positive test produce pain on sciatic/ gluteal area. The fair test perform with
the patient in a lateral recumbent position with the affected side up.

Differential diagnosis
SI Joint dysfunction, Inflammation
Lumbar, sacral radiculopathy
Unrecognised pelvic fracture.

Treatment
NSAID
Muscles relaxant
ICE compression

Meralgia paraesthesia is a common condition arising from
impingement of the lateral cutaneous nerve of thigh
There are numbness, burning, stabbing form front of the
thigh to just above the knee.
Etiology
Mechanical
Pregnancy, Obesity
increased intra-abdominal pressure
Wearing tight clothes belt in the waist area
Metabolic
Diabetes alcoholism
Hypothyroidism
Lead poisoning

Iatrogenic
Prolong traction during spine surgery
Injury to the nervous during retroperitoneal destruction.

Differential diagnosis
Radiculopathy at L1 to L3
Malignancy or metastasis to the iliac crest.
Uterine fibroids or pelvic mass that compress the nerve.
Chronic appendicitis

Diagnosis
Clinical examination such as pelvic compression test,
SLR for rule out Lumbar radiculopathy
Investigation - x ray pelvis, MRI, thyroid function CBC etc.

Management
85% patient respond with conservative management.
Physiotherapy
injection

Hormones involve in milk production, secretion, ejection;

Estrogen:
Stimulates growth of ductal systems of breast.

Progesterone:
Required for full development of lobule alveoli system.

Prolactin:
Stimulate milk secretion and production.

Growth hormone, Cortisol, Parathyroid hormones, Insulin:
Necessary to provide amino acids, fatty acids, glucose, calcium

Oxytocin:
Milk ejection

References
Guyton and hall textbook of medical physiology edition 13 th