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National Early Warning Score 2 (NEWS2) Jul 20, 2023

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Thank you for listening to this episode of "Health and Fitness" from the Nezpod Studios! Enjoy your night or the start of your day, spiced by our top-notch health and fitness/wellness updates coined from the best sources around the globe: made only for your utmost enjoyment and enlightenment… Click on subscribe to get more spicy episodes for free! See you again soon on the next episode of Health and fitness updates!

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A to E Assessment for Deteriorating and Acutely Unwell Patients Jul 18, 2023

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"...the 80 assessment is a fundamental tool used to provide a quick assessment for a patient who is critically ill it follows an order going through the potentially life-threatening problems giving priority to the most severe issues all right so the stands for Airway and what we're doing here is basically checking that there's no obstruction but also evaluating the likelihood that the patient will be able to maintain the airway if they deteriorate further there are several things you can do to assess the airway you can watch the patient and look for signs of an obstruction such as paradoxical chest or abdomen movements cyanosis which is a blue discoloration of the skin or use of accessory muscles you can also listen for sounds for example if the patient is talking that a fairly conclusive sign that the airway is obstructed however if you hear sounds extruder which is a high pitch sound mostly in inspiration or even a wheeze these sounds are indicative of a partial obstruction so what happens if you hear nothing you're either have to try and hear the breath sounds using a stethoscope or you'll have to try and feel for it the way you do this is by putting your hand or your ear next to the patient's nose or mouth and feeling for the air flow causes of an airway obstruction include the patient's tongue a foreign body swelling and even fluid it's such as vomiting or blood so what do we do about it well if it's obstructed the patient can rapidly deteriorating die or suffer hypoxic damage to organs such as the brain and heart so the first thing you do is you get help depending on the cause the patient may be moved into the recovery position so on this side you may perform movers like back slaps or the abdominal thrusts in order to help dislodge a foreign body it's patient ventilating and normal respiratory rate is between 12 and 20 breaths per minute hide and 25 is a marker that the patient may deteriorate quickly we would also look at the depth and the effort of the breathing are they using the accessory muscles is the chest expansion symmetrical is the trachea displaced or is the hyper resonance investigations include the use of a pulse oximeter so measuring the oxygen saturation generally we aim at for to 95% with a minimum of eighty eight percent however you need to be careful in COPD patients not to overdo the oxygen therapy because you can end up suppressing their breathing life-threatening causes of breathing issues include acute severe asthma pulmonary edema and tension pneumothorax the treatment again depends on the cause oxygen is given in most cases if no obstruction is present then non-invasive ventilation..."

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Ascending and Descending Spinal Cord Tracts Made Easy Jul 15, 2023

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"...within the spinal cord, there are several different tracts grossly they are divided into ascending and descending tracts on the cross-section of the spinal cord these tracks make up the white matter named because of the whitish color that the myelin around the axon gives the gray matter is located centrally comprising the ventral and dorsal horns the ascending pathways are responsible for transporting information from the body these are sensory tracts we will color these tracks in blue and starting from the posterior column also known as the dorsal column we have the fasciculus Q8 and fasciculus gracilis these are responsible for fine touch or tactile sensation vibration and proprioception fasciculus gracilis lies medially to fasciculus CUNY waiters and the difference between the pathways is at signals from the lower limb generally below TC next travel in the fasciculus gracilis while signals from the Upper Limb generally T6 and above travel in the fasciculus CUNY aters you can remember this with the l in gracilis reminding you of legs or lower limbs these tracks run ipsilateral e through the spinal cord and decussate in the middle of the brain therefore a spinal cord injury will lead to loss of ipsilateral fine touch vibration and proprioceptive sensation next up we have the anterior spinal Salaam and the lateral spinothalamic Pathways the anterior spinal thalamic tract is responsible for crude touch and pressure while the lateral spinothalamic tract is responsible for pain and temperature in contrast to the dorsal column tracks the anthro a lateral Pathways decussate within the spinal cord and then travel up to the brain this means that a lesion of the spinal cord will generally cause a contralateral loss of crew touch pressure pain and temperature sensation this is not a 100% rule however I just nerves entering the anterolateral pathways typically a send one or two vertebral levels before they cross to the other side both the dorsal column and anthro lateral pathways are..."

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Acute and Long Term Treatment of Ischemic and Hemorrhagic Stroke Jul 13, 2023

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"...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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Anterior Cerebral Artery Stroke Syndrome - ACA Stroke Syndrome Jul 12, 2023

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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 syndrome associated with Strokes in the territory of the and IT Supplies the medial and Superior frontal and parietal lobes as well as some other structures such as parts of the corpus callosum and basal ganglia it is made up of segments first arise connects both the left and right hemispheres this segment also gives off the medial lenticular striae arteries that Supply part of the caudate nucleus and the internal capsule the a to new segment extends from the anterior communicating artery up essentially segment A3 A4 and A5 at the proximal middle and distal segments of the pericoloso artery in and the findings very most commonly there is a contralateral weakness of the leg more so than the arm or the face this is due to the arrangement of the cortical neurons known as the motor homunculus which shows that the anterior cerebral artery supplies neurons involved mostly in the motor control of the contralateral leg sensory deficits are less common but when present are generally contralateral other findings can include abulia which is the absence of willpower or the inability to act decisively speech disturbances may also be present specifically another type is transcortical mixed Aphasia meaning there are severe deficits in speaking and comprehension but repetition is preserved as the anterior cerebral artery supplies the area of the brain associated with voluntary bladder control lesions here can result in urinary incontinence A syndrome of ipsilateral ataxia and contralateral lower limb paresis being described as a result of an anterior cerebral artery in fact if both anterior cerebral arteries are involved then they may be buying and frontal disinhibition symptoms which may include the presence of primitive reflexes such as grasping and sucking reflexes that are normally inhibited by amateur frontal lobe another example is personality changes..."

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Acute Ischemic Stroke - Causes;Signs and Symptoms Jul 11, 2023

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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 Jul 08, 2023

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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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Ascending Tracts of the Spinal Cord Jul 04, 2023

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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 Legs Syndrome Explained (Willis-Ekbom Disease) Jul 02, 2023

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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 - Prehepatic⧸Hepatic⧸Post Hepatic Causes of Jaundice Jul 01, 2023

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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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