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Dix–Hallpike Test
The Dix–Hallpike test — or Nylén–Bárány test — is a diagnostic maneuver from the group of rotation tests used to identify benign paroxysmal positional vertigo (BPPV). Procedure When performing the Dix–Hallpike test, patients are lowered quickly to a supine position (lying horizontally with the face and torso facing up) with the neck extended 30 degrees below horizontal by the clinician performing the maneuver. The Dix–Hallpike and the side-lying testing position have yielded similar results. As such, the side-lying position can be used if the Dix–Hallpike cannot be performed easily. Steps: The examiner looks for nystagmus (usually accompanied by vertigo). In BPPV, the nystagmus typically occurs in A or B only, and is torsional—the fast phase beating toward the lower ear. Its onset is usually delayed a few seconds, and it lasts 10–20 seconds. As the patient is returned to the upright position, transient nystagmus may occur in the opposite direction. Both ...
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Benign Paroxysmal Positional Vertigo
Benign paroxysmal positional vertigo (BPPV) is a disorder arising from a problem in the inner ear. Symptoms are repeated, brief periods of vertigo with movement, characterized by a spinning sensation upon changes in the position of the head. * This can occur with turning in bed or changing position. Each episode of vertigo typically lasts less than one minute. Nausea is commonly associated. BPPV is one of the most common causes of vertigo. BPPV is a type of balance disorder along with labyrinthitis and Ménière's disease. It can result from a head injury or simply occur among those who are older. Often, a specific cause is not identified. When found, the underlying mechanism typically involves a small calcified otolith moving around loose in the inner ear. Diagnosis is typically made when the Dix–Hallpike test results in nystagmus (a specific movement pattern of the eyes) and other possible causes have been ruled out. In typical cases, medical imaging is not needed. BPPV is ...
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Rheumatoid Arthritis
Rheumatoid arthritis (RA) is a long-term autoimmune disorder that primarily affects joints. It typically results in warm, swollen, and painful joints. Pain and stiffness often worsen following rest. Most commonly, the wrist and hands are involved, with the same joints typically involved on both sides of the body. The disease may also affect other parts of the body, including skin, eyes, lungs, heart, nerves and blood. This may result in a low red blood cell count, inflammation around the lungs, and inflammation around the heart. Fever and low energy may also be present. Often, symptoms come on gradually over weeks to months. While the cause of rheumatoid arthritis is not clear, it is believed to involve a combination of genetic and environmental factors. The underlying mechanism involves the body's immune system attacking the joints. This results in inflammation and thickening of the joint capsule. It also affects the underlying bone and cartilage. The diagnosis is made mos ...
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Epley Maneuver
The Epley maneuver or repositioning maneuver is a maneuver used by medical professionals to treat one common cause of vertigo, benign paroxysmal positional vertigo (BPPV) of the posterior or anterior canals of the ear. The maneuver works by allowing free-floating particles, displaced otoconia, from the affected semicircular canal to be relocated by using gravity, back into the utricle, where they can no longer stimulate the cupula, therefore relieving the patient of bothersome vertigo. The maneuver was developed by the physician, John M. Epley, and was first described in 1980. A version of the maneuver called the "modified" Epley does not include vibrations of the mastoid process originally indicated by Epley, as the vibration procedures have been proven ineffective. The modified procedure has become that now described generally as the Epley maneuver. Effectiveness An Epley maneuver is a safe and effective treatment for BPPV, although the condition recurs in approximatel ...
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Tilt Table Test
A tilt table test (TTT), occasionally called upright tilt testing (UTT), is a medical procedure often used to diagnose dysautonomia or syncope. Patients with symptoms of dizziness or lightheadedness, with or without a loss of consciousness (fainting), suspected to be associated with a drop in blood pressure or positional tachycardia are good candidates for this test. The procedure tests for causes of syncope by attempting to cause syncope by having the patient lie flat on a special table or bed and then be monitored with ECG and a blood pressure monitor that measure continuous, beat to beat, non-invasively. The table then creates a change in posture from lying to standing. Preparations Before taking the test, the patient may be instructed to fast for a period before the test will take place and to stop taking any medications. On the day of the tilt table test, an intravenous line may be placed in case the patient needs to be given medications quickly; however, this may influ ...
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Syncope (medicine)
Syncope, commonly known as fainting, or passing out, is a loss of consciousness and muscle strength characterized by a fast onset, short duration, and spontaneous recovery. It is caused by a decrease in blood flow to the brain, typically from low blood pressure. There are sometimes symptoms before the loss of consciousness such as lightheadedness, sweating, pale skin, blurred vision, nausea, vomiting, or feeling warm. Syncope may also be associated with a short episode of muscle twitching. Psychiatric causes can also be determined when a patient experiences fear, anxiety, or panic; particularly before a stressful event usually medical in nature. When consciousness and muscle strength are not completely lost, it is called presyncope. It is recommended that presyncope be treated the same as syncope. Causes range from non-serious to potentially fatal. There are three broad categories of causes: heart or blood vessel related; reflex, also known as neurally mediated; and orthos ...
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Radiculopathy
Radiculopathy, also commonly referred to as pinched nerve, refers to a set of conditions in which one or more nerves are affected and do not work properly (a neuropathy). Radiculopathy can result in pain (radicular pain), weakness, altered sensation (paresthesia) or difficulty controlling specific muscles. Pinched nerves arise when surrounding bone or tissue, such as cartilage, muscles or tendons, put pressure on the nerve and disrupt its function. In a radiculopathy, the problem occurs at or near the root of the nerve, shortly after its exit from the spinal cord. However, the pain or other symptoms often radiate to the part of the body served by that nerve. For example, a nerve root impingement in the neck can produce pain and weakness in the forearm. Likewise, an impingement in the lower back or lumbar-sacral spine can be manifested with symptoms in the foot. The radicular pain that results from a radiculopathy should not be confused with referred pain, which is different bo ...
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Myelopathy
Myelopathy describes any neurologic deficit related to the spinal cord. The most common form of myelopathy in humans, '' cervical spondylotic myelopathy (CSM)'', also called ''degenerative cervical myelopathy'', results from narrowing of the spinal canal (spinal stenosis) ultimately causing compression of the spinal cord. When due to trauma, myelopathy is known as (acute) spinal cord injury. When inflammatory, it is known as myelitis. Disease that is vascular in nature is known as vascular myelopathy. In Asian populations, spinal cord compression often occurs due to a different, inflammatory process affecting the posterior longitudinal ligament. Presentation Clinical signs and symptoms depend on which spinal cord level (cervical, thoracic, or lumbar) is affected and the extent (anterior, posterior, or lateral) of the pathology, and may include: * Upper motor neuron signs—weakness, spasticity, clumsiness, altered tonus, hyperreflexia and pathological reflexes, including Hoffma ...
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Odontoid Process
In anatomy, the axis (from Latin ''axis'', "axle") or epistropheus is the second cervical vertebra (C2) of the spine, immediately inferior to the atlas, upon which the head rests. The axis' defining feature is its strong odontoid process (bony protrusion) known as the dens, which rises dorsally from the rest of the bone. Structure The body is deeper in front or in the back and is prolonged downward anteriorly to overlap the upper and front part of the third vertebra. It presents a median longitudinal ridge in front, separating two lateral depressions for the attachment of the longus colli muscles. Odontoid Process of Axis (Dens) The dens, also called the odontoid process or the peg, is the most pronounced projecting feature of the axis. The dens exhibits a slight constriction where it joins the main body of the vertebra. The condition where the dens is separated from the body of the axis is called ''os odontoideum'' and may cause nerve and circulation compression syndrome ...
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Aplasia
Aplasia (; from Greek ''a'', "not", "no" + ''plasis'', "formation") is a birth defect where an organ or tissue is wholly or largely absent. It is caused by a defect in a developmental process. Aplastic anemia is the failure of the body to produce blood cells. It may occur at any time, and has multiple causes. __TOC__ Examples * Acquired pure red cell aplasia * Aplasia cutis congenita * Aplastic anemia * Germ cell aplasia, also known as Sertoli cell-only syndrome * Radial aplasia * Thymic aplasia, which is found in DiGeorge syndrome and also occurs naturally as part of the gradual loss of function of the immune system later in life See also * Atrophy * Hyperplasia * Hypoplasia * Neoplasia * List of biological development disorders References Bibliography * Reece JB, Urry LA, Cain ML, Wasserman SA, Minorsky PV, Jackson RB. Campbell Biology (10th ed.). Addison Wesley Longman; 2014. {{DEFAULTSORT:Biological development disorders Lists of diseases Disability-related ...
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Atlantoaxial
The atlanto-axial joint is a joint in the upper part of the neck between the atlas bone and the axis bone, which are the first and second cervical vertebrae. It is a pivot joint. Structure The atlanto-axial joint is a joint between the atlas bone and the axis bone, which are the first and second cervical vertebrae. It is a pivot joint. There is a pivot articulation between the odontoid process of the axis and the ring formed by the anterior arch and the transverse ligament of the atlas. Lateral and median joints There are three atlanto-axial joints: one median and two lateral: * The median atlanto-axial joint is sometimes considered a triple joint: ** one between the posterior surface of the anterior arch of atlas and the front of the odontoid process ** one between the anterior surface of the ligament and the back of the odontoid process * The lateral atlantoaxial joint involves the lateral mass of atlas and axis. Between the articular processes of the two bones the ...
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Contraindications
In medicine, a contraindication is a condition that serves as a reason not to take a certain medical treatment due to the harm that it would cause the patient. Contraindication is the opposite of indication, which is a reason to use a certain treatment. ''Absolute contraindications'' are contraindications for which there are no reasonable circumstances for undertaking a course of action. For example, children and teenagers with viral infections should not be given aspirin because of the risk of Reye syndrome, and a person with an anaphylactic food allergy should never eat the food to which they are allergic. Similarly, a person with hemochromatosis should not be administered iron preparations. ''Relative contraindications'' are contraindications for circumstances in which the patient is at higher risk of complications from treatment, but these risks may be outweighed by other considerations or mitigated by other measures. For example, a pregnant woman should normally avoid gett ...
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Supine Position
The supine position ( or ) means lying horizontally with the face and torso facing up, as opposed to the prone position, which is face down. When used in surgical procedures, it grants access to the peritoneal, thoracic and pericardial regions; as well as the head, neck and extremities. Using anatomical terms of location, the dorsal side is down, and the ventral side is up, when supine. Semi-supine In scientific literature "semi-supine" commonly refers to positions where the upper body is tilted (at 45° or variations) and not completely horizontal. Relation to sudden infant death syndrome The decline in death due to sudden infant death syndrome (SIDS) is said to be attributable to having babies sleep in the supine position. The realization that infants sleeping face down, or in a prone position, had an increased mortality rate re-emerged into medical awareness at the end of the 1980s when two researchers, Susan Beal in Australia and Gus De Jonge in the Netherlands, indep ...
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