NAME: UROOBA AKBER

CLASS: BSC (HONS)

DEPARTMENT:
PHYSIOLOGY
SUBJECT: MEDICAL
PHYSIOLOGY
TEACHER: MAAM
MUFZALA
TOPIC: 1
CAUSES AND MANIFESTATION OF SYRINGOMYELLA
SYRINGOMYELLA:

Syringomyelia is a rare disorder in which a cyst forms within your spinal cord. As this fluid-filled
cyst, or syrinx, expands and lengthens over time, it compresses and damages part of your spinal
cord from its center outward.

Damage to the spinal cord caused by a syrinx can lead to symptoms such as
progressive pain, stiffness, and weakness in the:

 back

 shoulders

 arms

 legs

People with the disorder might lose the ability to feel cold and pain normally. Some people with
this disorder won’t have any symptoms and won’t need treatment. For others, syringomyelia
will cause symptoms and complications that worsen as the syrinx expands.

Treatment aims to relieve the pressure on your spinal cord. The treatment your doctor suggests
for you will depend on the cause of your syringomyelia. Follow-up care after surgery is
important because syringomyelia can reoccur.

WHAT CAUSES SYRINGOMYELIA:

Most cases of syringomyelia are caused by a malformation of the brain known as Chiari type 1
malformation (CM1). CM1 occurs where the brain joins the spinal cord. In this malformation,
the brainstem lies lower than normal. Located at the back of the brainstem is the cerebellum.
Often with CM1, the bases of the lobes of the cerebellum, or the cerebellar tonsils, protrude
from the skull and into the spinal canal.

Syringomyelia can develop as a complication of:

 trauma

 meningitis

 hemorrhage

 a tumor

 arachnoiditis

Arachnoiditis is a progressive inflammatory disorder that affects the arachnoid, the membrane
that surrounds the brain and spinal cord. A primary arachnoid cyst is present at birth, but it may
take years for symptoms to appear. Symptoms of this disorder are caused by the pressure the
syrinx puts on the spinal cord and the damage that follows. They may include:

 a progressive weakness and pain in the back, shoulders, arms, or legs

 an inability to feel hot or cold

 a loss of pain sensation

 difficulty walking

 bowel and bladder function problems

 facial pain and numbness

 curvature of the spine, or scoliosis

You should visit your doctor if you have any of these symptoms. If you’ve had a spinal injury, it’s
important to watch for these symptoms. It may take months or even years after your injury for
syringomyelia to develop.

TREATMENT:
Treatment depends on the progression of the disorder and whether you’re experiencing
symptoms that disrupt your life. If you have no symptoms or mild symptoms, you may not need
treatment. Your neurologist will monitor the progression of the disorder.

If your symptoms are negatively affecting your life, your neurologist will recommend
medications or surgery.

Medications such as gabapentin (Neurontin) may help decrease the painful sensation of the
shoulders and arms that frequently occur with syringomyelia.

The goal of surgery is to correct the underlying cause of the syrinx and relieve the pressure on
your spinal cord. The type of surgery will depend on the cause of your syringomyelia.

If you have CM1, your surgeon may suggest surgery to expand the base of your skull and the
covering of your brain. This will take pressure off your spinal cord and your brain. The normal
flow of cerebrospinal fluid should be restored. For most people, this surgery resolves their
syringomyelia.

If you have a tumor or bony growth that’s causing syringomyelia, removal of the growth
frequently resolves the syringomyelia.

In some cases, your surgeon will use a small, flexible tube called a shunt to drain the syrinx.
They’ll place the shunt in the syrinx to drain the excess fluid. Sometimes the surgeon can
completely drain the syrinx during surgery. If that isn’t possible, the shunt will remain in place
after your surgery.

After surgery, you may be prescribed a course of antibiotics to prevent complications from
infection. Your doctor may also recommend physical therapy, which can help strengthen
muscles in limbs that have progressive weakness.

TOPIC: 2
 CAUSES AND MANIFESTATION OF tapes dorsali:

Tape dorsali:
Tabes dorsalis is a slowly progressive parenchymatous degenerative disease involving the
posterior columns (ie, demyelination) and posterior roots (ie, inflammatory change with
fibrosis) of the spinal cord. Thus, the neurologic presentation is one of ongoing loss of pain
sensation, loss of peripheral reflexes, impairment of vibration and position senses, and
progressive ataxia.
Bladder incontinence and loss of sexual function are common. Lancinating pain (ie, lightning-
like, appearing suddenly, spreading rapidly, and disappearing) often is an early symptom and
requires treatment.

Causes:
Tabes dorsalis is caused by demyelination by advanced syphilis infection (tertiary syphilis),
when the primary infection by the causative spirochete bacterium, Treponema pallidum, is left
untreated for an extended period of time (past the point of blood infection by the organism). [3].
The spirochete invades large myelinated fibers, leading to the involvement of the dorsal column
medial leminiscus pathway rather than the spinothalamic tract.

Symptoms:

Symptoms of tabes dorsalis are caused by damage to the nervous system. Symptoms include any of
the following:

 Abnormal sensations (paresthesia), often called "lightning pains"

 Problems walking such as with the legs far apart

 Loss of coordination and reflexes

 Joint damage, especially of the knees

 Muscle weakness

 Vision changes

 Bladder control problems

 Sexual function problems

 TREATMENT:

The goals of treatment are to cure the infection and slow the disease. Treating the infection
helps prevent new nerve damage and may reduce symptoms. Treatment does not reverse
existing nerve damage.

Medicines likely to be given include:

 Penicillin or other antibiotics for a long time to make sure the infection goes away

 Painkillers to control pain

Symptoms of existing nervous system damage need to be treated. People who are unable to
eat, dress themselves, or take care of themselves may need help. Rehabilitation, physical
therapy, and occupational therapy may help with muscle weakness.

TOPIC 3:

is the extensive scarring (fibrosis) of the liver caused by long-term injury. The damage is due to
persistent and ongoing inflammation which is most often in response to chronic liver injury,
whether from chronic viral hepatitis infection, excessive alcohol consumption, or many other
causes.

The liver has the ability to repair itself but as it gradually builds up scar tissue, it is less able to
function properly. Over time, as the amount of scarring increases and the circulatory flow to
the liver is decreased, essential liver functions are compromised. In some cases, this can lead to
liver failure and even death.

Over one million people die each year of cirrhosis, including 40,000-plus in the United States. It
is today the country's 12th leading cause of death, affecting nearly twice as many men as it
does women.

Symptoms

The progression of liver damage from early-stage fibrosis to cirrhosis generally takes years, and
even decades, to manifest symptomatically. In the early years, there are often few, if any,
symptoms.
When symptoms do appear, they are sometimes misdiagnosed, ignored, or attributed to other
possible causes. As the disease progresses, however, the tell-tale symptoms can become more
apparent and include:

 fatigue
 weakness
 itching
 loss of appetite
 weight loss
 nausea
 easy bruising
 jaundice (the yellowing of skin and/or eyes)
 spider angioma (the spider veining on the skin, often around the nose and cheeks)
 edema (the swelling of feet, ankles, and legs due to a buildup of fluid)
 abdominal bloating from ascites (a buildup of fluid in the belly)

Many of these symptoms are caused by portal hypertension, in which scar tissue partially
blocks the normal flow of blood to the liver.

Causes :

The most common causes of cirrhosis are alcohol-related liver disease, hepatitis B, hepatitis
C and non-alcoholic fatty liver disease.

 Hepatitis C leads in the number of cirrhosis diagnoses in the United States, as well as
being the leading indicator for liver transplants.
 Alcohol-related liver disease follows close behind and is typically associated with heavy
drinking over several years (on average, over two drinks per day for women and over
three for men ten or more years).
 Hepatitis B-related cirrhosis is not very common in people born in the United States.
However, it is a prevalent cause of cirrhosis in many other countries. Vaccination against
hepatitis B in many countries has been successful in decreasing the rates of hepatitis B-
related complications, like cirrhosis and liver cancer.
 Non-alcoholic fatty liver disease is typically associated with obesity, as well as diabetes,
high blood pressure, and high cholesterol. People with metabolic syndrome, characterized
by a large waist size, high triglycerides, abnormal cholesterol level, high blood pressure,
and higher than normal blood glucose levels, are most prone to cirrhosis.

Some less common causes of cirrhosis are obstructed bile ducts of the liver and gallbladder,
autoimmune hepatitis, and hereditary diseases like Wilson's disease or hemochromatosis.