j b medicos ,mangni

14/07/2023

Cranial nerves

Cranial nerves are nerves which derive directly from the brain and run out of the skull. There are twelve pairs, and each has an individual name that is used interchangeably with their Roman numeral designation-CN II is the optic nerve. Unlike the "standard" nerves of the PNS, cranial nerves have limited regenerative capacity; in part, this is why some classify cranial nerves as part of the CNS. How they are categorized ultimately doesn't matter.

This diagram shows the twelve cranial nerves, their origins and destinations. In text form:

CN I is the olfactory nerve- it is a direct extension of the brain, and from the far end of the olfactory tract small filaments project into the top part of the nasal cavity to serve the sense of smell.

CN II is the optic nerve. It starts within the retina as individual cells that collect themselves into bundles that run out of the eye towards the brain as a discrete nerve. Upon entering the cranium the two optic nerves join to form the optic chiasm, which sorts out all the bundles, and then sends them on towards the thalamus (relay center) and ultimately to the occipital lobe.

CN III, IV, and VI are the oculomotor, trochlear, and abducens nerves respectively. These are the nerves that move the eye, and open the eyelid. The fibers that control the pupil and the lacrimal gland (makes tears) hitch a ride with the oculomotor nerve.

CN V is the trigeminal nerve. It's name derives from the fact that prior to leaving the skull it divides into three sections-sort of like three fingers arising from a hand.The trigeminal nerve supplies sensation to the face and forehead. It also runs the chewing muscles and some of the salivary glands (it tells them when to make your mouth water).

CN VII is the facial nerve. It runs the muscles of facial expression, some of our salivary glands, and the special taste fibers on the front part of the tongue also run with the facial nerve.

CN VIII is the vestibulocochlear nerve. It's actually two nerves-one that runs our hearing, and one that runs our balance. They run together (with the facial nerve) from our inner ear to the medulla.

CN IX is the glossopharyngeal nerve. It's our swallowing nerve, and like the facial nerve also runs some salivary glands, and carries taste fibers (from the back of the tongue).

CN X is the vagus nerve. It's a very important nerve, bringing parasympathetic information to most of the body-including the heart. Like the glossopharyngeal nerve, it is also involved with swallowing; it also innervates the voice box-allowing us to speak and protect our airway.

CN XI is the spinal accessory nerve, and has two parts- the largest portion is actually part of the vagus nerve, and performs the same actions.The second part is the spinal portion which arises from the upper cervical cord and ascends into the cranium to run out of the skull to innervate some of the neck muscles. It's a very confused nerve.

CN XII is the hypoglossal nerve, and it simply innervates the muscles of the tongue.

Read here more: https://my-ms.org/anatomy_brain_part4.htm

14/07/2023

26/04/2023

Henoch-Schönlein Purpura
http://jama.jamanetwork.com/article.aspx?articleid=1104987
Henoch-Schönlein purpura (HSP) is a vasculitis (inflammation of blood vessels) that affects small blood vessels mainly in the skin, intestines, and kidneys. Symptoms can begin in children, most commonly between the ages of 4 and 7 years, soon after an upper respiratory tract infection or a streptococcalpharyngitis (sore throat infection). Children may develop arthritis (inflammation of the joints), leading to pain. A rash may start as hive-like spots (urticaria) or small raised red spots (erythematous maculopapules) on the legs and buttocks. Eventually these spots blend to form bigger areas of bruising (purpura) in the skin. Children may also develop abdominal pain that can be quite severe. Children younger than 2 years with HSP are more likely to develop edema (swelling of various areas of their bodies), which is a result of leaky small blood vessels in the skin. Kidney involvement can also cause edema, hematuria (visible or microscopic blood in the urine), or proteinuria (protein in the urine).
INITIAL TESTING
The signs and symptoms of HSP may mimic other serious illnesses. Therefore, a doctor may obtain tests to check for other conditions, such as an infection (suggested by the rash), thrombocytopenia (low number of platelet cells, suggested by bruising), or intussusception (telescoping of the small intestine on itself, suggested by intense abdominal pain in a young child). Tests may include
Blood tests to check the number of white blood cells (infection-fighting cells), platelets (cells that form clots), and the presence of any bacteria
Abdominal ultrasound to look for intussusception
Urinalysis to check for hematuria and proteinuria
Stool samples to check for blood in the gastrointestinal tract
TREATMENT
Treatment is usually supportive. Unlike for other vasculitis diseases, corticosteroids (medications used to reduce inflammation) have not been shown to change the disease course. However, corticosteroids may shorten the length of severe abdominal pain.
Children with HSP may be hospitalized if their abdominal pain is too severe to control at home, if they have gastrointestinal bleeding, if joint pain prevents them from walking, or if their kidney function worsens with a change in urine output.
FURTHER EVALUATION
Although their overt symptoms usually last for 3 to 12 weeks, children diagnosed as having HSP need to be followed up by their doctor even after their symptoms have resolved. Pediatricians may ask to see these children for 3 to 6 months after their initial symptoms, more often at first. Pediatricians will check children's urine for hematuria and proteinuria until these results are normal and stable. They may also check blood pressure at these visits, since this can be affected by HSP.

07/12/2022

06/12/2022

Diagnostic tests.. ?

06/12/2022

08/11/2022