Weekly Health and Fitness Corner

"...we will take a look at how Strokes are diagnosed and then how Strokes the treated and managed the diagnosis of a stroke is and with imaging techniques being used to Aid in that diagnosis a big part of stroke diagnosis and management is the early recognition and tools such as and Razia a used Fast involves facial drooping arm weakness and speech disturbances while T is for the time indicating the need for timely action the Razia score which stands for recognition of stroke in the emergency room is similar and involves looking for any loss of consciousness or seizure activity which counts against a stroke diagnosis as well as facial arm or leg weakness speech disturbances or visual disturbances it physical exam should also be done which will cover the NIH SS school including levels of consciousness motor function sensory function language and attention generally suspected stroke patients will undergo a CT of the head without contrast as coagulated blood will appear hyper-dense on these scans however ischemia may not be seen in the early stages there for a CT scan is done more commonly to rule out further investigations may involve an MRI of the head which is more sensitive for chronic hemorrhages and areas of ischemia usually appear hyper-intense on diffusion-weighted a Doppler ultrasound of the Carotid may be done and if the stroke was suspected to be caused by an aneurysm and angiogram may also be done as well as lab investigations including lipids and coagulation screens you may have heard the expression time is brain in the early stages ischemic stroke the aim is to restore cerebral blood flow as fast as possible as this results in fewer brain cells dying according to the nice guidelines patients with non disabling stroke or t.i. a should have early carotid Imaging and Urgent in data Rekha me as well as stenting if they have carotid stenosis in patients who have an acute ischemic stroke 150 to 300 milligrams of aspirin should be given orally or rectally if the patient is dysphasic this 150 to 300 milligram should be continued for two weeks following the stroke until long-term antithrombotic treatment has been prescribed in patients with an allergy to aspirin Clopidogrel may be used and a proton pump inhibitor should be added in patients with a history of dyspepsia in cases of venous sinus thrombosis anticoagulation..."

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"...the World Health Organization definition of stroke is rapidly developing clinical signs of focal or Global disturbance of cerebral function with symptoms lasting 24 hours or longer or leading to death with no apparent cause other than a vascular origin this means that patients with similar symptoms caused by other causes such as tumors subdural hematomas poisoning or trauma and not considered Strokes so the difference between a stroke and a TI a or a transient ischemic attack is that a TI a is a brief episode of neurological dysfunction typically less than one hour but up to 24 hours with a vascular cause and with no evidence of infarction meaning cell death on Imaging they were previously distinguished by the duration of the neurological symptoms but now a distinguished based on the absence of in fact evidence on it Jing and resolution of symptoms the two main types of stroke ischemic stroke or hemorrhagic stroke with around 80% being ischemic an ischemic stroke is caused by the blockage of blood flow while a hemorrhagic stroke is caused by a rupture and extravasation of blood in the brain or surrounding tissue also note that Strokes with ischemic areas have a risk for breeding there for ischemic stroke can undergo what is known as a hammer dragic transformation there are four main mechanisms for an ischemic stroke the first is thrombosis which is divided into large and small vessel disease large vessel disease involves the common and internal carotid 's the vertebral arteries and The Circle of Willis the main causes of thrombi here include atherosclerosis vasoconstriction dissection and vasculitis small vessel disease involves smaller she's of The Circle of Willis and arteries in the distal vertebral and battler arteries causes here include lightbulb highly gnosis which is a build-up of fatty hyelin matter secondary to hypertension and aging as well as micro after ohms which is small atherosclerosis plaques thrombi can also be caused by Sickle Cell red blood cells clumping together and thrombi may also generate emboli which are the second mechanism for ischemic stroke the emboli are entities that travel in the blood and can be part of a thrombus that has been broken off they can be fat they can be air or even cancer or clumps of bacteria most commonly the source of the embolus is the heart due to atrial fibrillation atrial or ventricular thrombi rheumatic heart disease recent myocardial infarction or even recent coronary artery bypass grafting emboli may also travel from sources..."

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"...hypoalbuminemia is defined as a low level of albumin in the blood and the normal range is around 3.5 to five point five grams per deciliter I'll is the most abundant protein in human blood making up around half of all serum protein it plays a key role in maintaining oncotic pressure in the blood and since its hide therefore soluble in water albumin can transport lipophilic compounds such as hormones fatty acids and unconjugated bilirubin through the blood albumin also has in acting as a pH buffer Scavenging reactive oxygen species as well as binding some drugs and calcium hypoalbuminemia can be caused by an impact this is within the liver increased utilization by tissues problems in distribution or an increase in the loss of albumin this occurs in liver disease such as cirrhosis or chronic hepatitis weather is it decrease in the production of albumin as well as a distribution problem we're more album in leaks from the capillaries into the extracellular space kidney disease is another cause hypoalbuminemia is one of the features of nephrotic syndrome where patients are losing more than 3 grams per day of protein we take this few seconds off to inform you are valued loyal listener about the best from The Nest pod Studios join us as we give you the best of the best health and wellness updates you can rely on for the treatment of chronic health problems classic functional medicine Back to Basics health tips and special as doctors in the United States of America check out this health and wellness podcast shows explore Health talk weekly healthy lifestyle matters excellent Health digest healthy and free daily and last but not least weekly health and fitness Corner also check out nasty boy CC the truest story never told Fiction podcast for that real-life on-the-go experience with the 27 year old Golden Boy Who made our guest invite number one list he tells us about his story it's nasty boy CC the truest story never told go get a load of that happiness because happiness is healthy as we know it join us every week as we continue to provide you the best of health and fitness enjoy the show it can also occur in chronic kidney disease with a protein is not as quick but over a long period of time small consistent losses will lead to hypoalbuminemia malnutrition or malabsorption at other causes severe malnutrition can lead to conditions such as kwashiorkor syndrome but even mild malnutrition as is often seen in the elderly can also cause from anemia conditions affecting the absorption such as ulcerative colitis Crohn's disease and celiacs disease may also end up causing hypoalbuminemia out itself is a negative phase reactant meaning its level decreases with information cytokines like il-6 and tnf cause increased leakage from the capillaries increased and less Gene transcription of the album and Gene meaning less synthesis conditions like sepsis and septic shock particularly favorite the clinical findings are often known Civic and I linked it to the underlying cause the more common findings include weakness peripheral edema and swelling all the way up to a site he's thin hair and if they have an underlying liver disease in terms of the diagnosis when albumin levels are found to be low tests are performed to identify the cause which include liver function tests assessing for liver disease urine Vermin and protein levels to assess for nephrotic syndrome and to assess for a protein losing enteropathy we could look at levels of alpha-1 antitrypsin in the stool which if l suggest a protein leakage or increased permeability of the intestinal mucosa treatment focuses on finding and managing the underlying causes while infusions of a itself a performed in some situations such as major surgery rapidly progressing hepatorenal syndrome and certain cases of nephrotic syndrome..."

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"...the ascending track to the spinal cord carries sensory information from the body up towards the central nervous system they are grossly divided into tracts that carry conscious sensation and unconscious Sensation will start with a conscious sensation the first that we will cover is the anterolateral system which is made up mostly by the anterior and lateral spinothalamic tract but it also features the spinal reticular and spinal technical tracks the anterior spinal thalamic tract is responsible for crude touch and pressure sensation while the lateral spinothalamic tract is responsible for pain and temperature generally the ascending Pathways have three neurons in the path compared to only two neurons in the descending Pathways the first order neuron in the anterolateral system comes from The receptors in the periphery and signups is with the second order neuron that has its cell body in the also Horn of the gray matter note that the first order neuron can Ascend one to two levels before sign up Ting on to the second order new run the second or the neuron then deficits to the other side of the spinal cord and it is at this point that they form the separate tracts the anterior and lateral spinothalamic tract these second-order neurons will carry the information up the spinal cord to the thalamus where they synapse to the third order on really they are located on the ventral posterolateral nucleus of the thalamus and from there the fibers will travel to the somatosensory cortex of the postcentral gyrus passing through the internal capsule note that the third order neurons do not decussate they travel to the ipsilateral cortex we said that the anterolateral system is made up mostly by the spinothalamic tract but there are also two others the spine reticular which is involved in the automatic response to pain and the spine a technical track which is involved in orienting the head and eyes to stimuli the other system involved in conscious sensation is the dorsal column medial lemniscus pathway named due to the fibers traveling in the dorsal column of the spinal cord and passing through the medial lemniscus in the brainstem the dorsal column medial lemniscus pathway is responsible for transmitting sensations of fine touch to touch discrimination vibration and proprioception slightly we take this few seconds our valued loyal listener about the best health and fitness podcast shows from the Nez pod Studios join us as we give you the best of the best health and wellness updates you can rely on for the treatment of chronic health problems class..."

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"...restless leg syndrome sometimes known as Willis ekblom disease is a common neurological condition characterized by an intense irresistible urge to move the legs on the surface this may tumnus however it can cause significant distress to patients and negatively affect multiple aspects of their lives the condition features unusual unpleasant Sensations described as crawling pitching and stretching of the deeper structures of the leg referred to as dysesthesia but importantly it does not typically feature pain or sensitivity to touch the sensations are usually worse in the evening and are often worst overnight typically when at rest interestingly these feelings are subsided by walking or moving there for patients feel a compulsion to move the legs giving the name restless leg we take this few seconds off to inform you are valued loyal listener about the best health and fitness podcast shows from the Nez pod Studios join us as we give you the best of the best health and wellness updates you can rely on for the treatment of chronic classic functional medicine Back to Basics health tips and special updates from the best doctors in the United States of America check out this health and wellness podcast shows explore Health talk healthy lifestyle matters excellent Health digest healthy and free daily and last but not least weekly health and fitness Corner also check out nasty Boise see the truest story never told Fiction podcast for that real life on the go experience with the 27 year old Golden Boy Who made our guests in like number one list he tells us about his story as it happens in real time and in real life it's nasty boy CC the truest story never told go get a load of join us every week as we continue to provide you the best of health and fitness Wellness updates from around the globe enjoy the show in 80% of cases there are periodic leg moments during sleep which maybe twitching of periodic dorsiflexion of the foot this can last up to five seconds occurring approximately every 22 the second although the name States legs it can also affect the arms depending on severity this can mean A reduced quality of life including poor sleep leading to daytime somnolence which can affect concentration as well as performance in work or school restless leg syndrome is divided into primary and secondary where primary is mostly idiopathic meaning there is no apparent cause it is thought to be familial in many cases and tends to be inherited in an autosomal dominant pattern these patients are more likely to be affected earlier in life even as early as childhood it can demonstrate genetic anticipation which is where the age of onset gets younger through each generation secondary restless leg syndrome is the result of another underlying process examples could be pregnant Ian deficiency and end stage renal disease with 25 to 50 percent of patients on hemodialysis experiencing it it can even be due to some..."

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"...jaundice is the yellow discoloration of the skin that is seen when bilirubin levels go above approximately 3 milligrams per deciliter but it can also be seen a particularly well in the sclera so first of all we need to know a little bit about bilirubin bilirubin is a breakdown product of him and is released from red blood cells when they are destroyed now bilirubin needs to get to the liver in order to be and the way it gets there is by initially being bound by albumin and then been transported to the liver via the blood it then gets taken up into the hepatic cells and is by the enzyme glucose urinal transfer is then secreted into the biliary system now this is the distinction between conjugated and unconjugated bilirubin the presence or absence of this glucose Iran sometimes this is referred to as soluble and insoluble bilirubin now direct and indirect bilirubin are often used as equivalence to conjugate it and unconjugated bilirubin but technically correct direct bilirubin includes conjugated bilirubin and Delta bilirubin which is the bilirubin bound to albumin that we mentioned earlier from there the conjugated bilirubin is present in the bayou and is secreted into the duodenum from the duodenum it travels through the small intestine up to the terminal ileum when most of the biological hepatic circulation but conjugated bilirubin is not reabsorbed it instead passes into the colon where the bacteria remove the gluco uronic acid that was added in the liver and forms urobilinogen which is colorless which is then oxidized into Starck or billion which gives feces it's brown color this is why in cases where the common bile duct is blocked you'll end up seeing pale stools right for anyone who's not been bored out of their mind by that bit will get into the causes of jaundice that you've probably heard split up into different categories these are pre hepatic hip-hop all post hypnotic jaundice which is also sometimes known as obstructive jaundice pre hepatic jaundice will have increased levels of unconjugated bilirubin because we are talking problem occurring before the bilirubin gets deliver these are going to be causes featuring excessive hemolysis so red blood cells being destroyed quicker than usual hemolytic anemia blood transfusions and hemolytic drugs hepatic causes are due to either having damaged hepato sites which is the case in hepatitis cirrhosis..."

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"...stroke syndromes are collections of signs and symptoms resulting from Strokes in different regions of the brain or central nervous system in this video we will cover the stroke syndromes associated with Strokes in the territory of the posterior cerebral arteries they Supply the occipital lobe the inferior surface of the temporal lobes as well as some deeper structures such as the thalamus and the midbrain of the brainstem the posterior cerebral arteries arise from the distal end of the basilar artery which itself is formed from the vertebral arteries there is a connection with the anterior circulation via the posterior communicating artery our first syndrome is Alexia without a graph here which means the inability to read without the loss of writing here the affected regions are thus plenum of the corpus callosum and typically left occipital lobe the combination of these two areas being affected results in a pure word blindness meaning that the patient is able to write but is not able to read due to the involvement of the left occipital lobe contralateral homonymous hemianopia may also be present next is a similar syndrome the unilateral occipital stroke syndrome here as the name suggests the occipital lobe on one side side is affected and part of the inferior temporal lobe may also be involved in some instances the primary finding here is a contralateral homonymous hemianopia which may often be the only neurological deficit found we may see macular sparing due to the collateral blood supply to the macular region of the cortex in some instances and no Mia maybe present which is the inability to name in this case it's the inability T2 name colors and objects thirdly we have Anton syndrome also known as cortical blindness this occurs where there is an involvement of both occipital lobes either due to involvement of both posterior cerebral arteries or due to a lesion at the level of the distal basilar artery as a result there is visual loss however an interesting feature is that these patients may not be aware of the vision loss or we take this few our valued loyal listener about the best health and fitness podcast shows from the Nez pod Studios join us as we give you the best of the best health and wellness updates you can rely on for the treatment of chronic health problems classic functional medicine Back to Basics health tips and special updates..."

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"...portal hypertension refers to a higher than normal blood pressure in the portal system a normal range for this pressure is 5 to 10 millimeters of mercury portal hypertension can also be defined as a portal pressure more than 5 millimeters of mercury higher than the pressure in the inferior vena cava so the portal system refers to the portal vein which drains River and the main vessels that link to the portal vein and Superior mesenteric vein which comes from the small intestines the splenic vein which of course carries blood from the spleen the inferior mesenteric connects onto the splenic vein and carries blood from the large intestine but the gastric veins connect also on to the portal vein another thing to note is the umbilical vein which is normally obliterated and becomes the round ligament of the liver but if the pressure in the portal system gets high enough it can reopen varices are dilated veins that from an increased pressure in the portal system inside the liver you have structures known as sinusoids which are specialized capillaries within the liver the hepatocyte of the a separated from these sinusoids by a space known as the space of dese venous blood from the portal system mixes with arterial blood from the hepatic artery in the sign and then flows through into a central vein these Central veins collect together in the hepatic veins which takes blood into the inferior vena cava you can also see a which collects bile produced by the hepatocyte it's and takes it down towards the gallbladder the cell in red that you see inside the sinusoid is a cup for sale A specialized type of Mac the Scavenging and phagocytic activity the orange star shaped cells are important in Portal hypertension and cirrhosis these are hepatic stellate cells found in the space of these that are involved in fiberglass this and scaf formation in response to liver injury so what causes pressure in the portal system to increase the pathophysiology of portal hypertension ultimately comes down to blood being unable to pass smoothly from the portal circulation through the liver and into the inferior vena cava we typically divide the causes into pre hepatic intrahepatic post about it causes but remember that pre hepatic here means before the blood gets into the liver meaning causes in the portal vein itself well post hypnotic causes referred to causes after that two problems involving the inferior vena cava pre hepatic causes include portal vein thrombosis splenic vein thrombosis and arteriovenous malformation and splenomegaly intrahepatic causes include the most common cause cirrhosis which can come from alcohol abuse chronic viral hepatitis metabolic..."

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"...stroke syndromes are collections of signs and symptoms resulting from Strokes in different regions of the brain or central nervous system in this video we will cover the stroke syndromes associated with Strokes in of the middle cerebral artery IT supplies in most of the temporal lobe the anterolateral frontal lobe and the parietal lobe the middle cerebral artery comes off the internal carotid and is divided into segments the segments are the M1 or the horizontal segment which is the most proximal part and gives off a lenticular striate a tree which are deeper penetrating arteries that Supply the basal ganglia and surrounding region the M2 segment known as the Sylvian segment is next which typically includes a bifurcation into the superior and inferior segments em three segments a cortical supplying the cortex our first syndrome results from a stroke affecting the middle cerebral artery Superior division which normally supplies the lateral frontal lobe I'm the superior parietal lobes in this syndrome findings include contralateral weakness of the upper Limbs and the lower Limbs and a weakness of the contralateral lower face with a greater effect seen on the face and the Upper Limb rather than the lower limb this is because of the motor homunculus where we see that the areas of the cortex responsible for the legs are supplied more so by the anterior and so a less affected in Middle cerebral artery Strokes also remember that it is the lower part of the face that is affected because this only receives unilateral from the facial nerve while the upper two-thirds receives bilateral Innovation there is also often a Hemi sensory loss on the contralateral side that may affect the face or leg if the stroke involves the dominant hemisphere which is usually the left side then an expressive Aphasia it may be seen as Broca's area is found on the dominant side and is responsible for the production of speech if the stroke is on the non-dominant side then we see a contralateral any neglect where the patient may be unaware or unresponsive to stimulate on one side which may include not being able to recognize their own limbs next we have the middle cerebral artery inferior division..."

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"...Danish is a mnemonic to help you remember the cerebellar signs these are signs that indicate the presence of cerebellar lesions d stands for dysdiadochokinesia which is the inability to perform a rapid alternating movement such as flipping one hand against the palm of the other in a coordinated and controlled manner Desmet Rhea is a lack of coordination of movement involving the judgment of distance and this can be seen when asking the patient to reach a particular point with a finger a central Ataxia which literally means we take this few our valued loyal listener about the best health and fitness podcast shows from the Nez pod Studios join us as we give you the best of the best health and wellness updates you can rely on for the treatment of chronic health problems classic functional medicine Back to Basics health tips and special updates from the best doctors in the United States of America check out this health and wellness podcast shows explore Health talk weekly healthy lifestyle matters excellent Health digest healthy and free daily and weekly health and fitness Corner also check out nasty boy CC the truest story never told Fiction podcast for that real-life on-the-go experience with the 27 year old Golden Boy Who made our he tells us about his story as it happens in real time and in real life it's nasty boy CC the truest story never told go get a load of that happiness because happiness is healthy as we know it join us every week continue to provide you the best of health and fitness Wellness updates from around the globe enjoy the show means without coordination and this can affect not only the legs but also the arms trunk and other muscles in the body the most common manifestation we think of in this instance is an unsteady gait it can also be highlighted in the upper limbs by asking the patient to abduct their arms out to the side and then pressing down again and then Letting Go you may then see rebounding with a limb rebounds up Beyond its original position n is for nystagmus which are involuntary uncontrollable I move it can be elicited by asking the patient to move their gaze to the extremities and can have various characteristics including the speed rotation and Direction meaning either 200 vertical beating as well as to the left or to the right I is for intention tremor which is a Tremor that is worsened or exaggerated by movement or when the need for precise movement increases s stands for speech which may be slurred inappropriate or slow while he h stands for hypotonia..."

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