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Neurological Examination
A neurological examination is the assessment of sensory neuron and motor responses, especially reflexes, to determine whether the nervous system is impaired. This typically includes a physical examination and a review of the patient's medical history, but not deeper investigation such as neuroimaging. It can be used both as a screening tool and as an investigative tool, the former of which when examining the patient when there is no expected neurological deficit and the latter of which when examining a patient where you do expect to find abnormalities. If a problem is found either in an investigative or screening process, then further tests can be carried out to focus on a particular aspect of the nervous system (such as lumbar punctures and blood tests). In general, a neurological examination is focused on finding out whether there are lesions in the central and peripheral nervous systems or there is another diffuse process that is troubling the patient. Once the patient has been ...
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Sensory Neuron
Sensory neurons, also known as afferent neurons, are neurons in the nervous system, that convert a specific type of stimulus, via their receptors, into action potentials or graded potentials. This process is called sensory transduction. The cell bodies of the sensory neurons are located in the dorsal ganglia of the spinal cord. The sensory information travels on the afferent nerve fibers in a sensory nerve, to the brain via the spinal cord. The stimulus can come from ''exteroreceptors'' outside the body, for example those that detect light and sound, or from ''interoreceptors'' inside the body, for example those that are responsive to blood pressure or the sense of body position. Types and function Different types of sensory neurons have different sensory receptors that respond to different kinds of stimuli. There are at least six external and two internal sensory receptors: External receptors External receptors that respond to stimuli from outside the body are called ex ...
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Acute (medicine)
In medicine, describing a disease as acute denotes that it is of short duration and, as a corollary of that, of recent onset. The quantification of how much time constitutes "short" and "recent" varies by disease and by context, but the core denotation of "acute" is always qualitatively in contrast with " chronic", which denotes long-lasting disease (for example, in acute leukaemia and chronic leukaemia). In addition, "acute" also often connotes two other meanings: sudden onset and severity, such as in acute myocardial infarction (AMI), where suddenness and severity are both established aspects of the meaning. It thus often connotes that the condition is fulminant (as in the AMI example), but not always (as in acute rhinitis, which is usually synonymous with the common cold). The one thing that acute MI and acute rhinitis have in common is that they are not chronic. They can happen again (as in recurrent pneumonia, that is, multiple acute pneumonia episodes), but they are not t ...
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Microvascular Disease
Microangiopathy (also known as microvascular disease, small vessel disease (SVD) or microvascular dysfunction) is a disease of the microvessels, small blood vessels in the microcirculation. It can be contrasted to coronary heart disease, an angiopathy that affects the larger vessels. Type Cerebral small vessel disease refers to a group of diseases that affect the small arteries, arterioles, venules, and capillaries of the brain. Age-related and hypertension-related small vessel diseases and cerebral amyloid angiopathy are the most common forms. Coronary small vessel disease is a type of coronary heart disease that affects the arterioles and capillaries of the heart. Coronary small vessel disease is also known as microvascular angina, microvascular dysfunction, non-obstructive coronary disease, or previously ''cardiac syndrome X''. Pathophysiology One cause of microangiopathy is long-term diabetes mellitus. In this case, high blood glucose levels cause the endothelial cells linin ...
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Fundoscopy
Ophthalmoscopy, also called funduscopy, is a test that allows a health professional to see inside the fundus of the eye and other structures using an ophthalmoscope (or funduscope). It is done as part of an eye examination and may be done as part of a routine physical examination. It is crucial in determining the health of the retina, optic disc, and vitreous humor. The pupil is a hole through which the eye's interior will be viewed. Opening the pupil wider (dilating it) is a simple and effective way to better see the structures behind it. Therefore, dilation of the pupil ( mydriasis) is often accomplished with medicated eye drops before funduscopy. However, although dilated fundus examination is ideal, undilated examination is more convenient and is also helpful (albeit not as comprehensive), and it is the most common type in primary care. An alternative or complement to ophthalmoscopy is to perform a fundus photography, where the image can be analysed later by a professional. ...
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Intracranial Pressure
Intracranial pressure (ICP) is the pressure exerted by fluids such as cerebrospinal fluid (CSF) inside the skull and on the brain tissue. ICP is measured in millimeters of mercury (mmHg) and at rest, is normally 7–15 Millimeter of mercury, mmHg for a Supine position, supine adult. The body has various mechanisms by which it keeps the ICP stable, with CSF pressures varying by about 1 mmHg in normal adults through shifts in production and absorption of CSF. Changes in ICP are attributed to volume changes in one or more of the constituents contained in the cranium. CSF pressure has been shown to be influenced by abrupt changes in intrathoracic pressure during coughing (which is induced by contraction of the diaphragm and abdominal wall muscles, the latter of which also increases intra-abdominal pressure), the valsalva maneuver, and communication with the vasculature (venous and arterial systems). Intracranial hypertension (IH), also called increased ICP (IICP) or raised intracrani ...
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Mini Mental State Examination
The Mini is a small, two-door, four-seat car, developed as ADO15, and produced by the British Motor Corporation (BMC) and its successors, from 1959 through 2000. Minus a brief hiatus, original Minis were built for four decades and sold during six, from the last year of the 1950s into the last year of the 20th century, over a single generation, as fastbacks, estates, and convertibles. The original Mini is considered an icon of 1960s British popular culture. Its space-saving transverse engine and front-wheel drive layout – allowing 80% of the area of the car's floorpan to be used for passengers and luggage – influenced a generation of car makers. In 1999, the Mini was voted the second-most influential car of the 20th century, behind the Ford Model T, and ahead of the Citroën DS and Volkswagen Beetle.
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Abbreviated Mental Test Score
The Abbreviated Mental Test score (AMTS) is a 10-point test for rapidly assessing elderly patients for the possibility of dementia. It was first used in 1972, and is now sometimes also used to assess for mental confusion (including delirium) and other cognitive impairments. A 4-item version called the Abbreviated Mental Test - 4 (AMT4) has been developed and tested. Questionnaire The following questions are put to the patient. Each question correctly answered scores one point. A score of 7–8 or less suggests cognitive impairment at the time of testing, although further and more formal tests are necessary to confirm a diagnosis of dementia, delirium or other causes of cognitive impairment. Culturally-specific questions may vary based on region. Abbreviated Mental Test - 4 (AMT4) The AMT4 uses 4 items from the AMTS: (i) What is your age? (ii) What is your date of birth? (iii) What is the name of this place? (iv) What is the year? A cut off score of 3/4 performs comparably to a ...
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Glasgow Coma Scale
The Glasgow Coma Scale (GCS) is a clinical scale used to reliably measure a person's level of consciousness after a brain injury. The GCS assesses a person based on their ability to perform eye movements, speak, and move their body. These three behaviours make up the three elements of the scale: eye, verbal, and motor. A person's GCS score can range from 3 (completely unresponsive) to 15 (responsive). This score is used to guide immediate medical care after a brain injury (such as a car accident) and also to monitor hospitalised patients and track their level of consciousness. Lower GCS scores are correlated with higher risk of death. However, the GCS score alone should not be used on its own to predict the outcome for an individual person with brain injury. Scoring The Glasgow Coma Scale is used for people above the age of two and composed of three tests: eye, verbal, and motor responses. The scores for each of these tests are indicated in the table below. The Glasgow Com ...
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Consciousness
Consciousness, at its simplest, is sentience and awareness of internal and external existence. However, the lack of definitions has led to millennia of analyses, explanations and debates by philosophers, theologians, linguisticians, and scientists. Opinions differ about what exactly needs to be studied or even considered consciousness. In some explanations, it is synonymous with the mind, and at other times, an aspect of mind. In the past, it was one's "inner life", the world of introspection, of private thought, imagination and volition. Today, it often includes any kind of cognition, experience, feeling or perception. It may be awareness, awareness of awareness, or self-awareness either continuously changing or not. The disparate range of research, notions and speculations raises a curiosity about whether the right questions are being asked. Examples of the range of descriptions, definitions or explanations are: simple wakefulness, one's sense of selfhood or sou ...
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Mental Status Examination
The mental status examination (MSE) is an important part of the clinical assessment process in neurological and psychiatric practice. It is a structured way of observing and describing a patient's psychological functioning at a given point in time, under the domains of appearance, attitude, behavior, mood and affect, speech, thought process, thought content, perception, cognition, insight, and judgment. There are some minor variations in the subdivision of the MSE and the sequence and names of MSE domains. The purpose of the MSE is to obtain a comprehensive cross-sectional description of the patient's mental state, which, when combined with the biographical and historical information of the psychiatric history, allows the clinician to make an accurate diagnosis and formulation, which are required for coherent treatment planning. The data are collected through a combination of direct and indirect means: unstructured observation while obtaining the biographical and social inform ...
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Breast
The breast is one of two prominences located on the upper ventral region of a primate's torso. Both females and males develop breasts from the same embryological tissues. In females, it serves as the mammary gland, which produces and secretes milk to feed infants. Subcutaneous fat covers and envelops a network of ducts that converge on the nipple, and these tissues give the breast its size and shape. At the ends of the ducts are lobules, or clusters of alveoli, where milk is produced and stored in response to hormonal signals. During pregnancy, the breast responds to a complex interaction of hormones, including estrogens, progesterone, and prolactin, that mediate the completion of its development, namely lobuloalveolar maturation, in preparation of lactation and breastfeeding. Humans are the only animals with permanent breasts. At puberty, estrogens, in conjunction with growth hormone, cause permanent breast growth in female humans. This happens only to a much lesser ...
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Metastasis
Metastasis is a pathogenic agent's spread from an initial or primary site to a different or secondary site within the host's body; the term is typically used when referring to metastasis by a cancerous tumor. The newly pathological sites, then, are metastases (mets). It is generally distinguished from cancer invasion, which is the direct extension and penetration by cancer cells into neighboring tissues. Cancer occurs after cells are genetically altered to proliferate rapidly and indefinitely. This uncontrolled proliferation by mitosis produces a primary heterogeneic tumour. The cells which constitute the tumor eventually undergo metaplasia, followed by dysplasia then anaplasia, resulting in a malignant phenotype. This malignancy allows for invasion into the circulation, followed by invasion to a second site for tumorigenesis. Some cancer cells known as circulating tumor cells acquire the ability to penetrate the walls of lymphatic or blood vessels, after which they are abl ...
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