Hollenhorst Plaque
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Hollenhorst Plaque
A Hollenhorst plaque (also known as a retinal cholesterol embolus) is a cholesterol embolus that is seen in a blood vessel of the retina. It is usually found when a physician performs ophthalmoscopy, during which a plaque will appear as a small, bright crystal that is refractile (reflects the light from the ophthalmoscope) and yellow. This is a medical exam finding, and is not a medical condition, though it may be related to cardiovascular conditions such as atherosclerosis of the internal carotid artery. It was first described by United States, American Ophthalmology, ophthalmologist Robert Hollenhorst in 1961. Cause A Hollenhorst plaque is the result of embolization (breaking off) of cholesterol forming an atheromatous plaque. This occurs in a blood vessel that is upstream of the eye, such as the internal carotid artery on the same side as the eye (ipsilateral), or the aorta. This cholesterol embolus is then able to travel via the bloodstream to distal (downstream) vessels. When ...
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Retinal Embolism
Retinal (also known as retinaldehyde) is a polyene chromophore. Retinal, bound to proteins called opsins, is the chemical basis of visual phototransduction, the light-detection stage of visual perception (vision). Some microorganisms use retinal to convert light into metabolic energy. In fact, a recent study suggests most living organisms on our planet ~3 billion years ago used retinal to convert sunlight into energy rather than chlorophyll. Since retinal absorbs mostly green light and transmits purple light, this gave rise to the Purple Earth hypothesis, Purple Earth Hypothesis. There are many forms of vitamin A — all of which are converted to retinal, which cannot be made without them. Retinal itself is considered to be a form of vitamin A when eaten by an animal. The number of different molecules that can be converted to retinal varies from species to species. Retinal was originally called retinene, and was renamed after it was discovered to be vitamin A aldehyde. Vertebra ...
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Transient Ischemic Attack
A transient ischemic attack (TIA), commonly known as a mini-stroke, is a minor stroke whose noticeable symptoms usually end in less than an hour. TIA causes the same Symptoms of stroke, symptoms associated with strokes, such as weakness or numbness on one side of the body, sudden dimming or loss of vision, difficulty speaking or understanding language, dysarthria, slurred speech, or altered mental status, confusion. All forms of stroke, including TIA, result from a disruption in blood flow to the central nervous system. A TIA is caused by a temporary disruption in cerebral blood flow, blood flow to the brain, or cerebral blood flow (CBF). The primary difference between a major stroke and the TIA's minor stroke is how much tissue death (infarction) can be detected afterwards through medical imaging. While a TIA must by definition be associated with symptoms, strokes can also be symptomatic or silent. In silent stroke, also known as ''silent cerebral infarct'' (SCI), there is per ...
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Cerebrovascular Disease
Cerebrovascular disease includes a variety of medical conditions that affect the blood vessels of the brain and the cerebral circulation. Arteries supplying oxygen and nutrients to the brain are often damaged or deformed in these disorders. The most common presentation of cerebrovascular disease is an ischemic stroke or mini-stroke and sometimes a hemorrhagic stroke. Hypertension (high blood pressure) is the most important contributing risk factor for stroke and cerebrovascular diseases as it can change the structure of blood vessels and result in atherosclerosis. Atherosclerosis narrows blood vessels in the brain, resulting in decreased cerebral perfusion. Other risk factors that contribute to stroke include smoking and diabetes. Narrowed cerebral arteries can lead to ischemic stroke, but continually elevated blood pressure can also cause tearing of vessels, leading to a hemorrhagic stroke. A stroke usually presents with an abrupt onset of a neurologic deficit – such as hemi ...
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Carotid Endarterectomy
Carotid endarterectomy is a surgical procedure used to reduce the risk of stroke from carotid artery stenosis (narrowing the internal carotid artery). In endarterectomy, the surgeon opens the artery and removes the plaque. The plaque forms and thickens the inner layer of the artery, or ''intima'', hence the name of the procedure which simply means removal of part of the internal layers of the artery. An alternative procedure is carotid stenting, which can also reduce the risk of stroke for some patients. Medical uses Carotid endarterectomy is used to reduce the risk of strokes caused by carotid artery stenosis over time. Carotid stenosis can either have symptoms (i.e., be symptomatic), or be found by a doctor in the absence symptoms (asymptomatic) - and the risk-reduction from endarterectomy is greater for symptomatic than asymptomatic patients. Carotid endartectomy itself can cause strokes, so to be of benefit in preventing strokes over time, the risks for combined 30-day mo ...
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Bruit
Bruit, also called vascular murmur, is the abnormal sound generated by turbulent flow of blood in an artery due to either an area of partial obstruction or a localized high rate of blood flow through an unobstructed artery. The bruit may be heard (" auscultated") by securely placing the head of a stethoscope to the skin over the turbulent flow, and listening. Most bruits occur only in systole, so the bruit is intermittent and its frequency dependent on the heart rate. Anything increasing the blood flow velocity such as fever, anemia, hyperthyroidism, or physical exertion, can increase the amplitude of the bruit. Etymology It is naturalized from the French word for "noise", although another notes that and are also common, and others give only for the cardiac sense. Associated terms Describing location of a partial obstruction * Peripheral vascular disease; femoral artery stenosis * Renal artery stenosis * Stroke, carotid artery stenosis * Aortic aneurysm * Tinnitus – a sym ...
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Auscultation
Auscultation (based on the Latin verb ''auscultare'' "to listen") is listening to the internal sounds of the body, usually using a stethoscope. Auscultation is performed for the purposes of examining the circulatory and respiratory systems (heart and breath sounds), as well as the alimentary canal. The term was introduced by René Laennec. The act of listening to body sounds for diagnostic purposes has its origin further back in history, possibly as early as Ancient Egypt. (Auscultation and palpation go together in physical examination and are alike in that both have ancient roots, both require skill, and both are still important today.) Laënnec's contributions were refining the procedure, linking sounds with specific pathological changes in the chest, and inventing a suitable instrument (the stethoscope) to mediate between the patient's body and the clinician's ear. Auscultation is a skill that requires substantial clinical experience, a fine stethoscope and good listening s ...
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Malaise
As a medical term, malaise is a feeling of general discomfort, uneasiness or lack of wellbeing and often the first sign of an infection or other disease. The word has existed in French since at least the 12th century. The term is often used figuratively in other contexts, in addition to its meaning as a general state of angst or melancholy. Cause Malaise is a non-specific symptom and can be present in the slightest ailment, such as an emotion (causing fainting, a vasovagal response) or hunger (light hypoglycemia), to the most serious conditions (cancer, stroke, heart attack, internal bleeding, etc.). Malaise expresses a patient's uneasiness that "something is not right" that may need a medical examination to determine the significance. Malaise is thought to be caused by the activation of an immune response, and the associated pro-inflammatory cytokines. Figurative use "Economic malaise" refers to an economy that is stagnant or in recession (compare depression). The ter ...
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Chronic Kidney Disease
Chronic kidney disease (CKD) is a type of kidney disease in which a gradual loss of kidney function occurs over a period of months to years. Initially generally no symptoms are seen, but later symptoms may include leg swelling, feeling tired, vomiting, loss of appetite, and confusion. Complications can relate to hormonal dysfunction of the kidneys and include (in chronological order) high blood pressure (often related to activation of the renin–angiotensin system system), bone disease, and anemia. Additionally CKD patients have markedly increased cardiovascular complications with increased risks of death and hospitalization. Causes of chronic kidney disease include diabetes, high blood pressure, glomerulonephritis, and polycystic kidney disease. Risk factors include a family history of chronic kidney disease. Diagnosis is by blood tests to measure the estimated glomerular filtration rate (eGFR), and a urine test to measure albumin. Ultrasound or kidney biopsy may be performe ...
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Echocardiogram
An echocardiography, echocardiogram, cardiac echo or simply an echo, is an ultrasound of the heart. It is a type of medical imaging of the heart, using standard ultrasound or Doppler ultrasound. Echocardiography has become routinely used in the diagnosis, management, and follow-up of patients with any suspected or known heart diseases. It is one of the most widely used diagnostic imaging modalities in cardiology. It can provide a wealth of helpful information, including the size and shape of the heart (internal chamber size quantification), pumping capacity, location and extent of any tissue damage, and assessment of valves. An echocardiogram can also give physicians other estimates of heart function, such as a calculation of the cardiac output, ejection fraction, and diastolic function (how well the heart relaxes). Echocardiography is an important tool in assessing wall motion abnormality in patients with suspected cardiac disease. It is a tool which helps in reaching an early ...
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Stroke Symptom
A stroke is a medical condition in which poor blood flow to the brain causes cell death. There are two main types of stroke: ischemic, due to lack of blood flow, and hemorrhagic, due to bleeding. Both cause parts of the brain to stop functioning properly. Signs and symptoms of a stroke may include an inability to move or feel on one side of the body, problems understanding or speaking, dizziness, or loss of vision to one side. Signs and symptoms often appear soon after the stroke has occurred. If symptoms last less than one or two hours, the stroke is a transient ischemic attack (TIA), also called a mini-stroke. A hemorrhagic stroke may also be associated with a severe headache. The symptoms of a stroke can be permanent. Long-term complications may include pneumonia and loss of bladder control. The main risk factor for stroke is high blood pressure. Other risk factors include high blood cholesterol, tobacco smoking, obesity, diabetes mellitus, a previous TIA, end-stag ...
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Primary Care Provider
Primary care is the day-to-day healthcare given by a health care provider. Typically this provider acts as the first contact and principal point of continuing care for patients within a healthcare system, and coordinates other specialist care that the patient may need. Patients commonly receive primary care from professionals such as a primary care physician ( general practitioner or family physician), a physician assistant, or a nurse practitioner. In some localities, such a professional may be a registered nurse, a pharmacist, a clinical officer (as in parts of Africa), or an Ayurvedic or other traditional medicine professional (as in parts of Asia). Depending on the nature of the health condition, patients may then be referred for secondary or tertiary care. Background The World Health Organization attributes the provision of essential primary care as an integral component of an inclusive primary healthcare strategy. Primary care involves the widest scope of healthcare, inc ...
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Carotid Artery Stenosis
Carotid artery stenosis is a narrowing or constriction of any part of the carotid arteries, usually caused by atherosclerosis. Signs and symptoms The common carotid artery is the large artery whose pulse can be felt on both sides of the neck under the jaw. On the right side it starts from the brachiocephalic artery (a branch of the aorta), and on the left side the artery comes directly off the aortic arch. At the throat it forks into the internal carotid artery and the external carotid artery. The internal carotid artery supplies the brain, and the external carotid artery supplies the face. This fork is a common site for atherosclerosis, an inflammatory build-up of atheromatous plaque inside the common carotid artery, or the internal carotid arteries that causes them to narrow. The plaque can be stable and asymptomatic, or it can be a source of embolization. Emboli break off from the plaque and travel through the circulation to blood vessels in the brain. As the vessels get ...
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