https://radiopaedia.org/
http://www.radiologymasterclass.co.uk/tutorials/musculoskeletal/x-ray_trauma_upper_limb/elbow_fracture_x-ray
Monday, December 5, 2016
bursa
source: http://study.com/academy/lesson/bursa-definition-anatomy.html
Bursae are fluid-filled sacs located around a joint that cushion bones when muscles, tendons, or skin rub against the bone. They are very important in movement of the bones because they help reduce friction. Without them, movement would be difficult and even painful. Now let's try and relate this to something you may know about.
Let's say your friend told you about an incident that happened last week in the factory where he works. One of the machines made a very loud grinding sound and then suddenly stopped working. On inspection, your friend tells you that the washers that lie between the metal parts of one of the machines broke. The grinding was the sound made when metal rubbed on metal. In this example, the washers were crucial to having the machine work. Likewise, the bursae are crucial for having the joint work properly
Anatomy
Wherever there are tendons moving across a bony surface, there is a bursa. There are approximately 150 bursa found in the body. Most are present at birth, but a bursa may form in an area where there is friction. Bursae are filled with a thin layer of thick fluid (like the consistency of a raw egg white) and a lining of synovial fluid, which also works as a 'shock absorber' for the joint and supplies molecules to the cartilage. This is known as 'dissipating force'. Normally, the bursae are thin and provide a very slippery surface so there will be very little friction when there is movement of the joint.
Think of a slide on a playground. If a child has a piece of wax paper and sits on it to slide, they go down very quickly don't they? This would represent the function of a bursa. But if the child has on shorts and tries to slide down - the skin can cause more friction and the child can hardly move down the slide. If no bursae are present at the joint, bending your elbow would be like trying to go down a slide with shorts on.
Sunday, December 4, 2016
My notes for Microcytic anemia
Microcytic => IRON studies. Look at IRON => Then Look at TIBC&Ferritin
1. Low ironmicrocytic anemia =
a. Iron deficiency:
i. Labs:
1. Low Serum Fe
2. High TIBC
3. Low Ferritin levels are generally accepted as reliable single indicators of the presence of iron deficiency.
ii. Interpretation: The liver produces a lot of TIBC trying to maximize little Fe that is available. Not enuf Fe to store in Ferritin (Low ferritin). The body tries to produce lots of TIBC/transferritin to absorb all little Fe there is to absorb.
iii. Dx: Low iron deficiency
iv. Tx: here’s the iron pill, have a nice day!
b. Chronic disease anemia:
i. Labs:
1. Low serum Fe
2. Low TIBC
3. High Ferritin
ii. Interpretation: The body holds Fe intracellularly via Ferritin to keep Fe away from offending tumor/bacteria. The body produces more Ferritin in order to store and keep all Fe there is that is required for the synthesis of offending organism or tumor as they use Fe for their pathosynthetic disease.
iii. Dx: chronic disease anemia
iv. Tx: address underlying causes.
2. Normal iron microcytic anemia
a. Labs:
i. Normal Fe
ii. High TIBC
b. Interpretation:
i. Normal Serum Fe => there’s sth happening that the body is n
c. Dx: do Hgb electrophoresis to r/o thalassemia (genetically abnormal Hgb), do BMP, pregnancy or use of hormonal contraception
~Qt
Friday, December 2, 2016
Thursday, December 1, 2016
Top 4 Common Extensor Surface Skin Conditions
Source: https://www.verywell.com/extensor-surface-1069321
An extensor surface is the skin on the opposite side of a joint. In other words, it's the surface of an extensor muscle: a muscle that flexes when it bends and extends when it straightens.
Take the elbow, for example. When you bend your elbow, the skin on the inner forearm and inner upper forearm touch. That's known as a flexor surface, or the parts of the skin that touch when a joint bends. The flexor surface of the leg is the back of the leg.
The extensor surface of the arm is the outer arm, or the parts of the skin on the opposite side of the joint. Extensor surfaces do not touch. The legs are another example. The extensor surface of the leg is the front of the leg. The flexor surface is the back of the leg.
Types of Extensor Surfaces
Extensor muscles exist in the arms, hands, legs and feet. They specifically include:
- Arm and shoulder
- Forearm and elbow
- Hand and wrist
- Fingers
- Thigh and hip
- Leg and knee
- Toes
Extensor Surfaces & Skin Conditions
There are several different skin conditions that seem to favor taking hold of extensor surfaces. These conditions include psoriasis, erythema multiforme, eczema and dermatitis herpetiformis.
Psoriasis
Psoriasis, one of the most common skin diseases, involves the overproduction of keratinocytes in the epidermis, which, in turn, increases the cell turnover rate. There are several different types of psoriasis, all of which can appear nearly anywhere on the body.
Chronic stationary psoriasis, also referred to as psoriasis vulgaris, is the most common type of psoriasis. It commonly appears on extensor surfaces such as the knees and elbows. Plaque psoriasis almost exclusively affects extensor surfaces, like the elbows.
Psoriatic arthritis is a type of arthritis associated with psoriasis.
Symptoms of each condition develop separately, and in most cases psoriasis symptoms precede arthritis symptoms. Any joint on the body can be affected by psoriatic arthritis. Symptoms of psoriatic arthritis include stiffness of joints, fatigue, swelling of the fingers and toes, tendinitis, lower back pain and even conjunctivitis.
Erythema Multiforme
The exact cause of the skin condition erythema multiforme is unknown, but it's believed to be caused by an allergic reaction or infection. Certain medications including barbiturates, penicillin, phenytoin and sulfonamides can trigger a reaction, as can illnesses like herpes simplex and mycoplasma.
There are many symptoms associated with erythema multiforme, many of which are related to the skin. Specifically, round, bullseye-shaped lesions appear on extensor surfaces like the arms and legs.
Eczema
Eczema is a type of skin condition characterized by patches of rough, inflamed skin that seems to overwhelmingly favor flexor surfaces, but it can appear on extensor surfaces.
In cases of nummular eczema, circular, well-defined, scaly plaques appear on extensor surfaces including the arms, legs and hips.
Dermatitis Herpetiformis
Dermatitis herpetiformis is a somewhat uncommon type of extremely itchy, persistent rash. It's thought to appear due to an autoimmune disorder, and recent research suggests a link between the skin condition and celiac disease. It's characterized by itchy bumps and blisters that appear on extensor surfaces such as the elbows and knees.
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