Chvostek's Sign
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Chvostek's Sign
The Chvostek sign () is a clinical sign that someone may have a low blood calcium level (a decreased serum calcium, called hypocalcemia). The Chvostek sign is the abnormal twitching of muscles that are activated (innervated) by the facial nerve (also known as Cranial Nerve Seven, or CNVII). When the facial nerve is tapped in front of the ear, the facial muscles on the same side of the face will contract sporadically (called ipsilateral facial spasm). The muscles that control the nose, lips and eyebrows are often the ones that will spasm. These facial spasms are caused by the nerves that control the muscle being easily excited (called hyperexcitability) due to hypocalcemia. Hypocalcemia can be caused by many things, including parathyroid conditions (such as when the parathyroid gland does not function well, called hypoparathyroidism) and vitamin diseases (such as a vitamin D deficiency). Sometimes, the Chvostek sign can be caused by other conditions which interfere with the balanc ...
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Sign (medicine)
Signs and symptoms are the observed or detectable signs, and experienced symptoms of an illness, injury, or condition. A sign for example may be a higher or lower temperature than normal, raised or lowered blood pressure or an abnormality showing on a medical scan. A symptom is something out of the ordinary that is experienced by an individual such as feeling feverish, a headache or other pain or pains in the body. Signs and symptoms Signs A medical sign is an objective observable indication of a disease, injury, or abnormal physiological state that may be detected during a physical examination, examining the patient history, or diagnostic procedure. These signs are visible or otherwise detectable such as a rash or bruise. Medical signs, along with symptoms, assist in formulating diagnostic hypothesis. Examples of signs include elevated blood pressure, nail clubbing of the fingernails or toenails, staggering gait, and arcus senilis and arcus juvenilis of the eyes. Indication ...
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Nathan Weiss
Nathan Weiss (8 May 1851 – 13 September 1883) was an Austrian physician and neurologist born in Groß Meseritsch (today known as Velké Meziříčí, Czech Republic). His father was the Talmudic scholar Isaac Hirsch Weiss. He studied medicine in Vienna, earning his doctorate in 1874. He worked as secondary physician at the ''Allgemeines Krankenhaus'' in Vienna, and in 1879 became habilitated for internal medicine. Weiss is remembered for pioneer systematic research of the spinal marrow, medulla oblongata and basal ganglia. The eponymous "Weiss's sign" is named after him, which today is usually referred to as "Chvostek's sign". In 1881 he showed a causal relationship between tetany and the removal of goitre. Among his written works is a treatise on tetany (''Über Tetanie'') that is included in Richard von Volkmann's ''Sammlung klinischer Vorträge''. A friend of Sigmund Freud, Weiss committed suicide on 13 September 1883, at the age of 32, shortly after returning from h ...
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Myxedema
Myxedema is a term used synonymously with severe hypothyroidism. However, the term is also used to describe a dermatological change that can occur in hyperthyroidism and (rare) paradoxical cases of hypothyroidism. In this latter sense, myxedema refers to deposition of mucopolysaccharides in the dermis, which results in swelling of the affected area. One manifestation of myxedema occurring in the lower limb is pretibial myxedema, a hallmark of Graves disease, an autoimmune form of hyperthyroidism. Myxedema can also occur in Hashimoto thyroiditis and other long-standing forms of hypothyroidism. The word myxedema originates from , taken from ancient Greek to convey 'mucus' or 'slimy substance', and for "swelling". It can also be thought as nonpitting edema, in contrast to pitting edema. Signs and symptoms Myxedema can occur in the lower leg (pretibial myxedema) and behind the eyes (exophthalmos). Severe cases, requiring hospitalization can exhibit signs of hypothermia, hypogl ...
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Aminoglycoside
Aminoglycoside is a medicinal and bacteriologic category of traditional Gram-negative antibacterial medications that inhibit protein synthesis and contain as a portion of the molecule an amino-modified glycoside (sugar). The term can also refer more generally to any organic molecule that contains amino sugar substructures. Aminoglycoside antibiotics display bactericidal activity against Gram-negative aerobes and some anaerobic bacilli where resistance has not yet arisen but generally not against Gram-positive and anaerobic Gram-negative bacteria.ME Levison, MD, 2012, Aminoglycosides, The Merck Manua accessed 22 February 2014. Streptomycin is the first-in-class aminoglycoside antibiotic. It is derived from ''Streptomyces griseus'' and is the earliest modern agent used against tuberculosis. Streptomycin lacks the common 2-deoxystreptamine moiety (image right, below) present in most other members of this class. Other examples of aminoglycosides include the deoxystreptamine-containi ...
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Parathyroid Hormone
Parathyroid hormone (PTH), also called parathormone or parathyrin, is a peptide hormone secreted by the parathyroid glands that regulates the serum calcium concentration through its effects on bone, kidney, and intestine. PTH influences bone remodeling, which is an ongoing process in which bone tissue is alternately resorbed and rebuilt over time. PTH is secreted in response to low blood serum calcium (Ca2+) levels. PTH indirectly stimulates osteoclast activity within the bone matrix (osteon), in an effort to release more ionic calcium (Ca2+) into the blood to elevate a low serum calcium level. The bones act as a (metaphorical) "bank of calcium" from which the body can make "withdrawals" as needed to keep the amount of calcium in the blood at appropriate levels despite the ever-present challenges of metabolism, stress, and nutritional variations. PTH is "a key that unlocks the bank vault" to remove the calcium. PTH is secreted primarily by the chief cells of the parathyroi ...
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Adenylate Cyclase
Adenylate cyclase (EC 4.6.1.1, also commonly known as adenyl cyclase and adenylyl cyclase, abbreviated AC) is an enzyme with systematic name ATP diphosphate-lyase (cyclizing; 3′,5′-cyclic-AMP-forming). It catalyzes the following reaction: :ATP = 3′,5′-cyclic AMP + diphosphate It has key regulatory roles in essentially all cells. It is the most polyphyletic known enzyme: six distinct classes have been described, all catalyzing the same reaction but representing unrelated gene families with no known sequence or structural homology. The best known class of adenylyl cyclases is class III or AC-III (Roman numerals are used for classes). AC-III occurs widely in eukaryotes and has important roles in many human tissues. All classes of adenylyl cyclase catalyse the conversion of adenosine triphosphate (ATP) to 3',5'-cyclic AMP (cAMP) and pyrophosphate.Magnesium ions are generally required and appear to be closely involved in the enzymatic mechanism. The cAMP produced by AC t ...
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Hypomagnesemia
Magnesium deficiency is an electrolyte disturbance in which there is a low level of magnesium in the body. It can result in multiple symptoms. Symptoms include tremor, poor coordination, muscle spasms, loss of appetite, personality changes, and nystagmus. Complications may include seizures or cardiac arrest such as from torsade de pointes. Those with low magnesium often have low potassium. Causes include low dietary intake, alcoholism, diarrhea, increased urinary loss, poor absorption from the intestines, and diabetes mellitus. A number of medications may also cause low magnesium, including proton pump inhibitors (PPIs) and furosemide. The diagnosis is typically based on finding low blood magnesium levels (hypomagnesemia). Normal magnesium levels are between 0.6 and 1.1 mmol/L (1.46–2.68 mg/dL) with levels less than 0.6 mmol/L (1.46 mg/dL) defining hypomagnesemia. Specific electrocardiogram (ECG) changes may be seen. Treatment is with magnesium either ...
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Tetany
Tetany or tetanic seizure is a medical sign consisting of the involuntary contraction of muscles, which may be caused by disorders that increase the action potential frequency of muscle cells or the nerves that innervate them. Muscle cramps caused by the disease tetanus are not classified as tetany; rather, they are due to a lack of inhibition to the neurons that supply muscles. Tetanic contractions (physiologic tetanus) are a broad range of muscle contraction types, of which tetany is only one. Signs and symptoms Tetany is characterized by contraction of distal muscles of the hands (carpal spasm with extension of interphalangeal joints and adduction and flexion of the metacarpophalangeal joints) and feet (pedal spasm) and is associated with tingling around the mouth and distally in the limbs. Causes * The usual cause of tetany is a deficiency of calcium. An excess of phosphate (high phosphate-to-calcium ratio) can also trigger the spasms. * Underfunction of the parathyroid gla ...
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Zygomatic Process
The zygomatic processes are three processes (protrusions) from other bones of the skull which each articulate with the zygomatic bone. The three processes are: * Zygomatic process of frontal bone from the frontal bone * Zygomatic process of maxilla from the maxilla (malar process) * Zygomatic process of temporal bone from the temporal bone The term ''zygomatic'' derives from the Greek ''Ζυγόμα'', ''zygoma'', meaning "yoke". The zygomatic process is occasionally referred to as the zygoma, but this term usually refers to the zygomatic bone or occasionally the zygomatic arch. Zygomatic process of frontal bone The supraorbital margin of the frontal bone ends laterally in its zygomatic process, which is strong and prominent, and articulates with the zygomatic bone. The zygomatic process of the frontal bone extends from the frontal bone laterally and inferiorly. Zygomatic process of maxilla The zygomatic process of the maxilla
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František Chvostek
František Chvostek (german: Franz Chvostek) () (May 21, 1835 – November 16, 1884) was a Czech-Austrian military physician. He is most notable for having described Chvostek's sign which he described in 1876.Chvostek F. ''Beitrag zur Tetanie.'' Wien Med Press 1876;17:1201-3, 1225-7, 1253-8, 1313-16. Chvostek was born in Frýdek-Místek, Moravia. He studied at the medical-surgical Josephs-Akademie where he received his doctorate in 1861. He served the ''Garnisonsspital Nr. 1'' in Vienna until 1863. From 1863 to 1867 he was the assistant of Adalbert Duchek (1824–1882) and from 1868 to 1871 he lectured on electrotherapy Electrotherapy is the use of electrical energy as a medical treatment. In medicine, the term ''electrotherapy'' can apply to a variety of treatments, including the use of electrical devices such as deep brain stimulators for neurological dise ... at the Josephs-Akademie, an academy for military physicians. In 1871 Chvostek took over Duchek's medical clinic ...
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Hypocalcemia
Hypocalcemia is a medical condition characterized by low calcium levels in the blood serum. The normal range of blood calcium is typically between 2.1–2.6 mmol/L (8.8–10.7 mg/dL, 4.3–5.2 mEq/L) while levels less than 2.1 mmol/L are defined as hypocalcemic. Mildly low levels that develop slowly often have no symptoms. Otherwise symptoms may include numbness, muscle spasms, seizures, confusion, or cardiac arrest. The most common cause for hypocalcemia is iatrogenic hypoparathyroidism. Other causes include other forms of hypoparathyroidism, vitamin D deficiency, kidney failure, pancreatitis, calcium channel blocker overdose, rhabdomyolysis, tumor lysis syndrome, and medications such as bisphosphonates or denosumab. Diagnosis should generally be confirmed with a corrected calcium or ionized calcium level. Specific changes may be seen on an electrocardiogram (ECG). Initial treatment for severe disease is with intravenous calcium chloride and possibly magnesium ...
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Brachial Artery
The brachial artery is the major blood vessel of the (upper) arm. It is the continuation of the axillary artery beyond the lower margin of teres major muscle. It continues down the ventral surface of the arm until it reaches the cubital fossa at the elbow. It then divides into the radial and ulnar arteries which run down the forearm. In some individuals, the bifurcation occurs much earlier and the ulnar and radial arteries extend through the upper arm. The pulse of the brachial artery is palpable on the anterior aspect of the elbow, medial to the tendon of the biceps, and, with the use of a stethoscope and sphygmomanometer (blood pressure cuff), often used to measure the blood pressure. The brachial artery is closely related to the median nerve; in proximal regions, the median nerve is immediately lateral to the brachial artery. Distally, the median nerve crosses the medial side of the brachial artery and lies anterior to the elbow joint. Structure The brachial artery give ...
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