Real Life Application 2

Questions:

A patient has entered your clinic with the following symptoms:

1. Decreased to absent reflexes in both lower limbs

2. paralysis/paresis (flaccid) in both lower limbs

3. Rapid, severe atrophy of the muscles in the lower limbs

What is causing these symptoms and what is the physiological reason for each of these symptoms?

Describe an injury that may cause these symptoms.

Define the terms hyporeflexia, areflexia, flaccid paralysis, and neurogenic atrophy.

Would any autonomic function be disrupted in this scenario? Why or why not?

Answers:

A.     What is causing these symptoms and what is the physiological reason for each of these symptoms?

1.       Decreased to absent reflexes in both lower limbs are symptoms of a peripheral nerve injury, thrombophlebitis, spinal shock or any injury which occurs below T1. A reflex muscle contraction occurs by the activation of a nerve in a specific area from the legs to the spinal cord. Damage to the nerve along this area will interfere with muscle contraction. 

2.  Paralysis/paresis (flaccid) in both lower limbs can be caused by any damage or interruption of lower motor neurons, because this damage affects nerve fibers traveling from the anterior horn of the spinal cord to the relevant muscle(s). It can also be caused by cauda equine syndrome and any injury at or below the anterior horn cell.

3.  Rapid, severe atrophy of the muscles in the lower limbs are caused by malformations or malfunctions of the central nervous system and lower motor neurons.  It occurs when there is an injury to, or disease of a nerve such as Amyotrophic Lateral Sclerosis.

B.     Describe an injury that may cause these symptoms.

1.       Decreased to absent reflexes in both lower limbs are caused by an injury to the central nervous system. It can be brought on by damage to the nerves that run through the spinal cord and branch out to the extremities. This damage often takes the form of a pinched nerve caused by something pressing against the nerve and disturbing its normal functioning.

2.       Paralysis/paresis (flaccid) in both lower limbs results from an injury to motor cells in the brainstem or spinal cord, or of the axons derived from them; this injury affects nerve fibers traveling from the anterior horn of the spinal cord to the relevant muscle(s). It also can be caused by an injury to nerves within the spinal cord as they exit the lumbar and sacral regions, which usually result from a fracture below L2. Cauda equina syndrome causes flaccid paralysis because the injury occurs at the lumbosacral nerve roots in the spinal canal. These nerves lead to the lower limbs.

3.       The most common causes of severe muscle atrophy in the lower limb are lower motor neuron injuries which cause traumas to peripheral nerves. When a body part is affected by paralysis, the muscles may atrophy through lack of use. Muscle atrophy also results if nerve cells (neurons) waste away or die, and are no longer able to send messages to muscles. This eventually leads to an inability to move the legs, and body, muscle weakening and muscle atrophy due to lack of use. .

C.     Define the terms hyporeflexia, areflexia, flaccid paralysis, and neurogenic atrophy.

a.       The definition of Hyporeflexia is an absent or diminished response to tapping. It usually indicates a disease that involves one or more the components of the two-neuron reflex arc itself.

b.      The definition of Areflexia is absence of reflexes.  It is decreased tendon reflex that is indicative of a breach in any part of the reflex motor arc. It may involve:
           o   the muscle - myopathy
           o   the nerve endings - polyneuritis
           o   the motor nerve - neuropathy
           o   the anterior spinal cord root, e.g. spondylosis
           o   the anterior horn cell, e.g. motor neurone disease, poliomyelitis
          o   the sensory arc sensory root or sensory nerve disease
          o   systemic disease, e.g. abetalipoproteinaemia

c. The definition of flaccid paralysis is weakness or loss of muscle tone resulting from injury or disease of the nerves innervating the muscles. The muscles are limp and cannot contract.
d.  The definition of neurogenic atrophy is muscle wasting due to damage to its peripheral nerve supply.

D. Would any autonomic function be disrupted in this scenario? Why or why not?
Autonomic functions would be disrupted by flaccid paralysis and hyporeflexia. During an injury, the spinal column and the spinal cord can be injured anywhere along their length. In a spinal cord injury, spinal shock occurs, which results in a complete loss of all motor, sensory, reflex, and autonomic function below the level of the injury. This loss is evidenced by peripheral vascular tone, which results in flaccid paralysis. Spinal shocks can recover by complication of autonomic hyperreflexia if the spinal cord injury occurred above T6. 

Osteoporosis Disease

When I think of osteoporosis, I tend to think of an older woman with a loss of height and a hunched-over posture. These are signs of aging and seemingly unavoidable. I realized that my concept of osteoporosis was not entirely true after I learned more about the disease through my Human Anatomy class. Therefore, in this paper I will be discussing what its etiology, symptoms, diagnosis, and current treatments are.  I will also list a few steps to prevent this disease and to take care of your bones.

First, I would like to help you understand how the bones develop and to define the back ground of Osteoporosis. Bones grow as our body grows, new bone is added and old bone is removed from the skeleton. During our childhood and the teen years, new bone is added faster than old bone is removed. Your bone mass increases until age 30 when our bones reach what is called "peak bone mass," or maximum density and strength  After that, bone removal begins to outperform formation of new bone, and this, over time, leads to bone loss. The rate of bone loss is greatest in the first few years after menopause. Then bone loss continues but more slowly. Next, your ovaries stop producing estrogen, a hormone that helps prevent bone loss.  Some people develop osteopenia, a condition characterized by low bone density. Osteopenia can eventually lead to osteoporosis, a more severe condition with even lower bone density.

Osteoporosis is a disease that weakens bones over time and it puts one at risk for breaking a bone. According to “About Osteoporosis”, an article on the Boniva website, osteoporosis is a term that means "porous bones." It is a skeletal disease affecting women and men. Osteoporosis is a condition in which bones have lost minerals—especially calcium—making them weaker, more brittle, and susceptible to breaking. Any bone in the body can be affected by osteoporosis, but the most common places where fractures occur are the back (spine), hips, and wrists.  Because the disease makes bones thinner and weaker, fractures can occur during ordinary movements like bending and lifting, or from falls. These fractures can be painful, disfiguring, and often go unnoticed at first. Fractures may also reduce a person's ability to lead an active life. It is estimated that 1 out of every 2 women over the age of 50 will be affected by postmenopausal osteoporosis in her remaining lifetime. Below is the picture of weak bone to help you understand this disease better.

Osteoporosis is most likely caused by a combination of factors. The primary factors are: imbalance of magnesium and calcium; longtime use of steroids; extreme hormonal imbalance; as well as the side effects of some drugs such as the anti-coagulant Warfarin, also known as Coumadin, which works by inhibiting vitamin K production.  According to “A Complete Osteoporosis Reversal Program”, an article on the health report website, Coumadin is often prescribed for reducing high blood pressure, to keep blood flowing where there is calcification of the arteries. One role of vitamin K is to take calcium in the blood and to direct it to the bone. When vitamin K is turned off, the calcium is more likely to stay in the arteries, causing potentially, calcification, and a decrease in bone density. A 2006 retrospective study of 14,564 Medicare recipients showed that warfarin use for more than one year was linked with a 60% increased risk of osteoporosis-related fracture in men; there was no association in women. So for some reason this problem may be more common in men.

Too much acidity can also cause bone loss.  If your diet contains too many soft drinks and foods like grains, pasta, white bread, meat, with too few fruits and vegetables, then your blood starts to become acidic. Since the blood needs to maintain a neutral pH, your body pulls calcium from the bones to neutralize the acidity.

Do you how calcium gets into the bones?  Bones are living tissues that must be constantly rebuilt through a two part process. First, cells called Osteoclasts have the job of getting rid of old weakened bone. They resorb old bone to make room for the creation of healthy strong bone.  Second, Osteoblasts, or immature bone cells, produce a matrix composed of collagen that then becomes mineralized. Bone mass is maintained by a balance between the activity of osteoblasts that form bone and osteoclasts that break it down. In osteoporosis the net rate of bone resorption exceeds the rate of bone formation, resulting in a decrease in bone mass without an increase in bone mineralization. Osteoclasts are activated by parathyroid hormone (PTH) which signals osteoclasts to resorb bones. Calcitonin is the hormone primarily made by the thyroid that inhibits the activity of osteoclasts so that they don’t digest the bone. One reason why the osteoporosis protocol we suggest in this report is so powerful is that it includes many elements that stimulate the increased production of and activity of osteoblasts.

Do you know why hormone imbalance is one of the root causes of bone loss? According to “A Complete Osteoporosis Reversal Program”, an article on the health report website, in women, osteoclast activity is increased because of decreased estrogen after menopause. Men with decreased testosterone also have increased osteoclast activity. Because testosterone levels decrease with age, the older a man gets the more likely he is to develop osteoporosis. Increased osteoclast activity without increased osteoblast activity results in a net loss of bone. However, decrease in estrogen levels and testosterone does not appear to be the primary cause of the development of osteoporosis. This determination is based on the observation that  Asian and African populations with a low intake (about 300 mg) of calcium daily but with higher daily magnesium intake tend to have very little osteoporosis. These people all go through menopause or decreased testosterone levels as they age and yet they do not get osteoporosis. Therefore, the low magnesium and high calcium intake of our Western diet appears to be primary to the development of osteoporosis. Below are two explanations for why this situation can lead to osteoporosis. 

First, the Calcitonin hormone that inhibits osteoclasts relies on magnesium to function properly. If the magnesium is lacking, the balance between PTH which instructs the body to produce osteoclasts and calcitonin tilts is too low. This results in excessive stimulation of osteoclasts, which causes net bone loss. In other words, magnesium suppresses the hormone that tells your body to pull calcium from the bones so that you do not loose so much bone.

Second, Western countries have a high proportion of dairy products in their diets so the average calcium intake is about 1000 mg. There is 6 to 8 times more calcium than magnesium in dairy foods, resulting in a low magnesium intake. If this imbalance occurs, calcium moves out of the bones to increase tissue levels. Conversely, a high magnesium intake causes calcium to move from the tissues into the bones. Thus high magnesium levels lead to bone mineralization.

Common among many adults today, lack of physical activity is believed to contribute to lower bone density because the skeleton is not being taxed enough to stimulate new bone growth.

There are no obvious symptoms for bone loss occurs. Even though your bones may not feel weaker, you may experience some vague symptoms without realizing that they're associated with osteoporosis. These symptoms include: a loss of height, change in posture, or severe back pain, all of which may be caused by osteoporosis.

Many people do not discover that they have osteoporosis until a bone fracture occurs. Early diagnosis and treatment of osteoporosis may help lessen the risk of broken bone. 



According to “Osteoporosis Tests and diagnosis”, an article on the Mayo Clinic website, Doctors commonly diagnoses osteoporosis by measuring bone density. The three tests that can accurately measure bone density include: Ultrasound, Quantitative computerized tomography (CT) scanning, and Single-photon absorptiometry.

Many websites provide information and advertise their products for treating and preventing osteoporosis problems.  So which is the best product? This question can’t be answered without an “it depends”. Below are a few medicines or products that are advertised for treating and prevent this disease.

1. BONIVA is a prescription medicine used to treat or prevent osteoporosis in women after menopause. BONIVA helps increase bone mass and helps reduce the chance of having a spinal fracture (break). It is not known how long BONIVA works for the treatment and prevention of osteoporosis. You should see your doctor regularly to determine if BONIVA is still right for you.

2. Biphosphonate, Fosamax, and Actonel drugs. These work by stopping the production of osteoclasts which are supposed to resorb old, infirm bone. So when you take these medications, your bones may stay denser, but they will be composed of a higher amount of old, poor quality bone cells which makes them over time brittle and weak. You must have balanced bone resorption and creation. These drugs create weak bones.

3. Prednisone and other steroids. Prescription drugs that block the absorption of calcium into bones. These drugs are commonly used to treat autoimmune, asthma, and inflammatory diseases.

Personally, I would recommend some of the following steps to prevent osteoporosis problems.

1. Make weight-bearing exercise a part of your daily routine, such as walking, stair climbing, aerobic exercise and resistance training to develop the muscles that support the skeleton.

2. Stop drinking soft drinks. The phosphorus in soft drinks appears to have a deleterious effect on bone tissue. Coke and beverages with caffeine and phosphorus appear to cause bone resorption (a problem for children and adults).

3. Quit smoking. This can reduce the risk for osteoporosis and most other diseases.

4. Reduce consumption of dairy products and increase magnesium intake.  Magnesium is necessary for calcium absorption; it suppresses PTH and stimulates calcitonin so magnesium works to keep calcium in our bones. Magnesium deficiency will prevent this chemical action from taking place, and no amount of calcium can correct it. This results in an imbalance of magnesium and calcium in your body that for most people is the single most important cause of bone loss.

5. Get more sun. Increase Vitamin D intake.

6. Eat greens. Increase Vitamin K intake.

7. Reduce stress. Cortisol is a hormone produced when your body is under stress. Excess cortisol causes calcium to be pulled from the bones. In this day and age, it isn’t easy to reduce stress, so excess cortisol may also be initiating the pull of calcium your bones.

Now, you should have a clear understanding of what osteoporosis disease is, and what the root cause this disease.  In addition, you should have a good idea of how to diagnose, treat and prevent this disease.  It is up to you to take charge of your health.  You can use this information to build a foundation of knowledge that supports healthy bones and a healthy lifestyle.

References

1. Osteoporosis Tests and diagnosis http://www.mayoclinic.com/health/osteoporosis/DS00128/DSECTION=tests-and-diagnosis

2. A Complete Osteoporosis Reversal Program http://www.health-reports.com/Osteoporosis.html

3. About Osteoporosis http://www.boniva.com/osteoporosis/default.aspx?C=P000316_S0261_F000302

Why it is important to spend more time with your family and friends

During this holiday, I   received much useful advice from my closest friend and family members about why it is important to spend time with my family. One of the stories deeply touched my heart and mind. Through this story, I learned valuable lessons about life, regret and sympathy. Also how sick patients feel about death and how they prepare for it.   Therefore, I would like to share this story with you.

The sad story was shared with me by my special friend.   Ten years ago, she was diagnosed with lung cancer and went through two surgeries to remove these tumors.   Two years ago, the doctor found the cancer had returned and some new tumors had formed. The doctor also predicted that she only had a few years to live.   She was not surprised by the news because her sister had lost her life to this disease last February.  Her mother also passed away one year before her sister due to other illnesses.  The loss of family members had not affected her cancer treatment and she hoped that she would feel better one day.  Even though her cancer is currently under control, the treatment has affected other organs of her body such as her brain, kidney and liver.  She is constantly in pain, and recently, her memory has begun to decay.  Sometimes, she cannot remember things, conversations, and the street to her house.  Doctors have ordered some tests on her brain, such as MRI, SCAN, and XRAY, to determine the root cause of these symptoms but the result have been inconclusive.  She now lives in a state where she is prepared to die at any time.  Could you image yourself living in this state? Have you ever wondered how you would feel if you lived in this hopeless state? Could you live without a dream?  What would you do? 

 For the last nine months, my friend has traveled to many states and countries to visit her family members for the last time. She also has spent as much time with her family, two children, grandchildren, and twelve sisters and brothers in Texas, as she possibly can.   This Christmas, she wanted travel to Colorado to visit me and my family but she could not come because her doctor advised her not to.  The remaining half of her lung might not survive the cold weather and she could die.  She called me once a week to update her health conditions and family.   We talked for hours. She explained what went through her mind when she learned about her illness.  She was scared of dying but then she realized that no one on this earth can escape death.  Death is one of the stages in the cycle of life.  If one makes peace with death then it will come naturally and won’t be scary any more.   Also if one believes that death is the way to end this miserable life then one would gladly accept it.  No one wants to die nor are they willing to face the fact of death; therefore, these ideals would not come to their mind easily.   Death is always on the elders ‘minds so they usually worry about what will happen to their family if they die; however teenagers typically never consider   this issue.  My friend is constantly worrying about what will happen to her family   emotionally when she dies.   She is trying to prepare her family to deal with her sickness and potential death   every day.  Have you ever tried to prepare your family to deal with your death before?  I would hope you never have gone through this sad and emotional process.  It wouldn’t be easy to say “I am dying” to your family members, especially your children.

We become scared, panicked and worried if a member of our family becomes ill. Sometimes we blame ourselves for not taking good care of that person. We never think of illness as part of our cycle of life.  The cycle of life are consists of birth, growth, sickness and death.  We also never consider how the sick patient feels and what is on their mind. We do not realize that our actions and reactions have a strong impact on patient behavior and the recovery process as well.  My friend said, “The pain on my family member’s face is hurting me more than the pain I feel in my body.”  This sentence has reminded me of my own experience. A few months ago, when my uncle was sick, I immediately felt angry, scared and blamed myself for not taking good care of his health,   even though I knew in my heart that I was not responsible for his illness.  I wanted to understand the root causes of his heart failure and cough.  I was always stressed out and worried when his Coumadin test results were not normal.  I hid my truth feelings and fear from him.  I noticed that my uncle was worried and depressed about his illness but I didn’t know how much.   Have you ever thought about long term care for yourself? What should we do if a member of our family has an illness that requires long term care and support? If we have a lot of money then we would hire a home care nurse to take of this patient.  Unfortunately, we are not millionaires; money is limited.  We have to work to support ourselves and pay the bills. As a result, we don’t have time to take care of a sick patient and the patient usually ends up in hospital care or a nursing home.  After the patient’s death, we will regret this decision.  We will be unhappy and feel sorry when we witness how much pain the patient has to suffer.

My friend shared with me the story of how her family dealt with their mother long term illness.   What tough decisions they had to make in the last minute. How they felt about their decision after their loving mother funeral.  Six years ago, my friend’s mother was really ill and required 24 hours care.  Everyone in her family decided to send their mom to a nursing home because they could not take care of their mother.   Their mom cried and begged them not to send her to hospital care and she promised not to bother them anymore.   For three days she begged her children to let her live with them and see her grandchildren, but nothing could change her children’s minds and she had no other choice rather than to accept their decision.  On the moving day, she was sad and cried.  For the first three months, her children took turns to come to visit her once a day and then after that once a week.  However, no one realized that their mom was constantly depressed and sad.  She also felt lonely and a burden to her children.  Every night, she cried herself to sleep.  Her recover process was not improved. Her memory began to fade after one year in nursing care.  She could not remember any of her children.  Her children were strangers to her, so they only came to visit her a few times a year, for her birthday and holidays.  Her children thought that their mom could not recognize them; therefore, they did not want to waste any more time.  A year later she slipped into a coma and her children only came when there was an urgent message from nurses or doctors.    On Valentine Day of 2009, she asked to see all her children for the last time and said, “I love you all”.  That night, she passed away.  They learned how their mom survived her last five years of her life when a nurse shared her story at the funeral.     The funeral woke up her children from their selfishness and they regretted their decision.  There was nothing they could do to reverse their decision because the time had passed.  They realized that it was too late to fix their mistake.  However, they hope that you and I will avoid making the same mistake as they did.

Tears dropped on my friend’s cheek each time she drove by the nursing home where her mom had stayed.  Also each time she saw an elderly lady go to the church, shopping or celebrating with family, she was sad.  She told me if god gave her a second chance with her mom she would do differently.  Also if she could trade all the money that she had  for one day with her mom she would be happy to do it.  

The best Christmas gift that I received this year was her advice on how to care for, love and spend time family and friends.   Money cannot buy time and love.   Money is only a survival tool for us on this earth but it is worth nothing to us when we die.   However, love will cherish us and live in the hearts of our friends and family forever. The time we spend with someone will create a special memory in their heart and mind.  This memory will last forever in their mind.   We will feel lonely if we have no one to love and care for.  I hope this story will help you understand why it is important to spend more time with your family and friends.

  

Development of the human brain

By now, you should have an understanding of what the brain is from my previous post. I have been wondering what would make the human brain different from other species such as monkeys. When the human brain is beginning to develop, how does it develop and then how does it work. Also, are there any differences between the brains of males and females? If the answer is “yes”, then what are these differences?  I have learned the basic concept about the human brain from Human Anatomy class. However, the material that this class provided was not enough to answer my curious questions.  For this reason, I would like to research and discuss the above issues in depth.  

The human brain is a dynamic organ composed of trillions of neurons, or brain cells and it is the portion of the central nervous system that lies within the skill in vertebrates. Neurons communicate with one another through dendrites, which function as branches connecting one cell to another. The human brain is the most complex and important part of our body because it continues to develop after our birth.  85% of our brain's  development will happen after birth.  Therefore, the brain requires a series of developmental processes that occurs through the addition, change, and movement of cells. The brain begins to develop in the embryo after three weeks of pregnancy. First, the neural plate developes and then it rolles up to form the neural tube on day 22.  After four weeks, the brain stem, cerebellum (small brain),  nerve sheathes, the nervous system and other parts are formed. Nerve cells begin to develop during week four of the pregnancy and finish when the baby is born.  These nerve cells are like a mass of unconnected electrical wires and govern our lives every day. The following pictures should help you to understand how the human brain developes.

According to “Infant and Child Brain Growth and Development”, an article on the Parenting Tips and Guide Info website, “Infant and child brain growth and development are one of the critical period in development process. An infant or child's brain is an organ that is still growing and growing. An infant or child’s brain will grow big, bigger, and still be growing from the original immature brain into the mature brain. During the period of 2 weeks after conception (pre-embryos), egg cell division occurs. While at 2-8 weeks of gestation, it referred to as the embryo.”

At birth the brain consists of 10 billion neurons. Development is primarily to connecting a process of the wires. What makes the wires connect? Each time a child is held, read to, or plays with a toy, these nerves make a connection. During the early years of life, these wires confirm to connect through our learning of certain tasks and sensory experiences, such as feeling, touching, seeing, hearing, and tasting. These tasks actually teach brain cells their jobs. A lack of such sensory experiences results in brain cells failing to make connections and eventually dying off. The wiring for sight and intelligence are developed during the third and fourth month of life. If the visual system is not stimulated during this time, the ability to form the connections for sight is lost. If a minor eye condition goes undiagnosed, they can experience lifelong vision problems because their brain development during this critical period was incomplete.

After birth, only mature nerve cells function, but new nerves or myelin sheathes are still growing. The growth of nerves will increase the number of glia cells; therefore, the brain increases in volume and weight, and the baby looks more intelligent. The human brain weights about 3.5 pounds. The first three years of life are a critical phase in brain development, because the brain is growing and changing rapidly in response to the emotional and intellectual of stimuli experienced by the child.  The effects of this emotional and intellectual development will not be seen until a child reaches the third grade. During these early years, 75 percent of brain growth is completed. According to the “At what Age is the Development of the Human Brain complete?” article on the eHow.,“a child who is read to has a much better chance of becoming a reader, and a child whose curiosity is encouraged has a better chance to become a lifetime learner.” Therefore, it is important to establish the basic brain wiring during this very early age. According to the same article, “Children who have experienced gentle, loving care and the establishment of firm connections with other people from a very young age appear to experience more even and full brain development. Likewise, children who are exposed to rich and varied stimuli including music, art, speech, and so forth tend to have better brain development over time. Neglect, abuse, and lack of exposure to a variety of experiences can actually harm a developing brain.”

The brain is the control center for movement, sleep, hunger, thirst, and virtually every other vital activity necessary to survive. The brain consists of two hemispheres. The left hemisphere processes information sequentially and is described as analytical because it specializes in recognizing parts which make a whole. It is most efficient at processing verbal information, language should not be considered as being 'in' the left hemisphere. This hemisphere is able to recognize that one stimulus comes before another and verbal perception and generation depends on the awareness of the sequence in which sounds occur. The right hemisphere organizes simultaneously. It specializes in a method that perceives and constructs patterns. It is most efficient at visual and spatial processing and it is thought that nonverbal stimuli are processed primarily in the right hemisphere. The brain is especially primed to acquire new skills through age 12. Languages are best mastered by age 10.

Each area of the brain has an associated function. The cerebellum is the hind part of the brain. It is made up of gray unmyelinated cells on the exterior and white myelinated cells in the interior. The cerebellum coordinates muscular movements and, along with the midbrain, monitors posture. It controls movements of the human body in space. The brain stem, that incorporates the medulla and the pons, monitors involuntary activities such as breathing and vomiting. The thalamus, that forms the major part of the diencephalon receives incoming sensory impulses and routes them to the appropriate higher centers. It works in conjunction with the corpus callosum, a neuron rich membrane, to connect the two hemisphere of the cerebrum. The hypothalamus occupying the rest of the diencephalon regulates heartbeat, body temperature, and fluid balance. The cerebrum occupies the topmost portion of the skull and splits vertically into left and right hemispheres. It is the largest part of the brain and makes up 85% of the brain’s weight. The cerebral cortex contains most of the master control of the body. here the ultimate analysis of sensory data occurs, and motor impulses originate that initiate, and inhibit the entire spectrum of muscle and gland activity. The left half of the cerebrum controls the right side of the body, and the right half controls the left side. Therefore, if a stroke occurs in the left half of the brain, then the right side of the body is affected.

There are several diseases of the brain such as stroke, coma, multiple sclerosis, meningitis Parkinson’s disease, cerebral palsy, and migraine headache. Stroke is damage to the brain due either to blockage in blood flow or to loss of blood from blood vessels in the brain. According to “Brain,” an article, on mamahealth.com, “Coma is an extended period of unconsciousness from which a person cannot be aroused even with the most painful stimuli. Multiple sclerosis affects transmission of electrical signals to nerve cells. Meningitis is an inflammation of the meninges. Parkinson’s disease is a disorder of the brain characterized by shaking and difficulty with walking, movement and coordination. Cerebral palsy is a group of disorders which are caused by injuries to the brain that occur during fetal development or near the time of birth. A migraine headache is a recurrent, throbbing headache usually felt on one side of the head.”  

 Below is a picture of all the areas of the human brain to help you to understand it better.

           

Males and females differ not only in their physical aspects and reproductive function but also in many other characteristics. This includes the way they solve problems. We know that males are more aggressive than females. Young males engage in more rough-and-tumble play than fmales and females are more nurturing. We also know that in general, males are better at a variety of spatial or navigational tasks. What is the root cause of the difference between female behavior? According to  “Sex differences in the brain,” an article on changelingaspects.com, “Parts of the corpus callosum, a major neural system connecting the two hemispheres, as well as another connector, the anterior commissure, appear to be larger in women, which may permit better communication between hemispheres. Perceptual techniques that measure brain asymmetry in normal-functioning people sometimes show smaller asymmetries in women than in men, and damage to one brain hemisphere sometimes has less of an effect in women than the comparable injury in men does.” 




My first goal in this paper is to have you understand that experiences early in life have an impact on the developing brain. Therefore, if you want your next child to have a high quality brain, then you need to pay attention to the development of the brain, thi attention should begin before a pregnancy, during the pregnancy, and after birth until the development of the infant and child brain is complete.  The first four years of life are especillary important because that is when the brain is built.  Possible reason for brain damage are caused by birth trauma or a lack or lipids (fats) in the diet at key stages in the early weeks after birth.

Source/words cite

At What Age Is the Development of the Human Brain Complete? | eHow.comhttp://www.ehow.com/facts_5817063_age-development-human-brain-complete_.html#ixzz176hc02oR

http://www.enfant-encyclopedie.com/pages/PDF/MustardANGxp.pdf

http://www.suite101.com/content/fatherhood-and-brain-development-a311394

The brain

 Our behavior comes from our brain; therefore, in this paper, I will discuss what the brain is and what all components of the brain are.

The brain is one of the most important parts of the body; therefore, we need to take a good care of this.  This amazing organ acts as a control center by receiving, interpreting, and directing sensory information throughout the body. There are three major divisions of the brain. According to “Anatomy of the brain”, an article on the About.com Biology website, these divisions of the brain are:

The forebrain is responsible for a variety of functions including receiving and processing sensory information, thinking, perceiving, producing and understanding language, and controlling motor function. There are two major divisions of forebrain: the diencephalon and the telencephalon. The diencephalon contains structures such as the thalamus and hypothalamus which are responsible for such functions as motor control, relaying sensory information, and controlling autonomic functions. The telencephalon contains the largest part of the brain, the cerebral cortex. Most of the actual information processing in the brain takes place in the cerebral cortex.

The midbrain and the hindbrain together make up the brainstem. The midbrain is the portion of the brainstem that connects the hindbrain and the forebrain. This region of the brain is involved in auditory and visual responses as well as motor function.

The hindbrain extends from the spinal cord and is composed of the metencephalon and myelencephalon. The metencephalon contains structures such as the pons and cerebellum. These regions assist in maintaining balance and equilibrium, movement coordination, and the conduction of sensory information. The myelencephalon is composed of the medulla oblongata, which is responsible for controlling such autonomic functions as breathing, heart rate, and digestion. Below is the picture of the brain to help you to understand this structure better.

There are two important nervous systems in the brain.  One is called the central nerve system (CNS) and the other is called the peripheral nerve system (PNS). The CNS consists of the brain and spinal cord. It acts as the central control region of the human nervous system, processing information and issuing commands. The autonomic nervous system (ANS) is the command network the CNS uses to maintain the body's homeostasis. It automatically regulates heartbeat and controls muscle contractions in the walls of blood vessels, digestive, urinary, and reproductive tracts. It also carries messages that help stimulate glands to secrete tears, mucus, and digestive enzymes. If the central nerve system in the brain is damaged, then we can get a stroke and paralysis. Normally, strokes occur when you have a blood clot.

The peripheral nervous system is a channel for the relay of sensory and motor impulses between the central nervous system on one hand and the body surface, skeletal muscles, and internal organs on the other hand. It is contains two subsystems of nerves. One is called the motor system and the other is called the autonomic system.  As in the central nervous system, peripheral nervous pathways are made up of neurons (that is, nerve cell bodies and their axons and dendrites) and synapses, the points at which one neuron communicates with the next. 

According to The Human Brain, an article on The University of Texas, “Your brain includes billions of neurons which are specialized cells, allowing your brain to learn, reason, and remember. Through the activity of neurons, the body responds and adjusts to changes in the environment. Every time you feel something - including the effects of a drug - millions of neurons are "firing" messages to and from one another. These messages consist of chemical and electrical impulses.”

When the brain is damaged, there is no medicine or treatment can help to rebuild our mental power.  We will have to go through surgery to rebuild it. For example, when you have a blood clot in the brain, blood will not return back to your heart.  As the result, you will not get enough oxygen to the brain. That is a stroke.

sources/words cite

http://www.onelife.com/evolve/brain.html

http://www.enchantedlearning.com/subjects/anatomy/brain/Structure.shtml

http://www.utexas.edu/research/asrec/brain_p.html

Periodontal Disease

            Do you know why your gums are bleeding when you brush them? If your answer is No, then you are in luck. My goals for this research paper are to explain what the root causes of Periodontal Disease are. This includes the definition or background of the disease and what bacteria are involved. I will also discuss what the symptoms are, how it is diagnosed, what treatments are available and what techniques are useful for prevent ion of the disease. We will also look at who might most likely be affected by this disease?

            First, I would like to define the background of periodontal disease.  It is a chronic inflammatory disease of the gum and tissues that surround and support the teeth. If left untreated, periodontal disease can lead to tooth loss. This disease is divided into two types:

1.      Gingivitis: causes lesions (wounds) and affects the gums.  Gingivitis is due to the long-term effects of plaque deposits.  Plaque is a sticky material made of bacteria, mucus, and food debris that develops on the exposed parts of the teeth. It is a major cause of tooth decay. If you do not remove plaque, it turns into a hard deposit called tartar that becomes trapped at the base of the tooth. Plaque and tartar irritate and inflame the gums. Bacteria and the toxins they produce cause the gums to become infected, swollen, and tender.

2.      Periodontitis: damages the bone and connective tissue that support the teeth. In periodontitis, plaque builds and hardens under the gums. The gums pull away from the teeth, forming “pockets” of infection. The infection leads to loss of the bone that holds the tooth in its socket and might lead to tooth loss.  The following picture should help you to understand the root cause of this disease better.

            Periodontal disease is caused by “plaque” bacteria.  The three types of bacteria most likely to cause aggressive periodontal disease are: Actinobacillus actinomycetemcomitans (A. actinomycetemcomitans), Porphyromonas gingivalis (P. gingivalis), and Bacteroides forsythus. These bacteria are also known as gram negative anaerobic bacteria. Both A. actinomycetemcomitans and P. gingivalis are caused gum disease.  In our mouth, the sulcus is teeming with harmless varieties of bacteria. However, increasing the bacteria quantity and changing the balance of bacterial types from harmless to disease-causing bacteria will cause problems.  To be exact three-hundred fifty species of microorganisms are found in the typical health mouth, but only four percent of these species are linked to periodontal disease. The helpful bacteria are usually known as gram positive aerobic bacteria. These harmful bacteria increase in mass and thickness until they form a sticky film. Below is the picture of a tooth to help you to understand this disease better

           

According to “Periodontal Disease”, an article on the About Health website, plaque actually provides a barrier against outside bacterial invasion. It is only when it accumulates to excessive levels that bacterial plaque sticks to the surfaces of the teeth and adjacent gums and causes infection. It is also when transforms into calculus (commonly known as tartar), which is much more difficult to remove than plaque. The bacteria that cause periodontal disease thrive in acidic environments. Eating sugars and other foods that increase the acidity in the mouth increase bacterial counts. The bacterium that causes periodontal disease may be able to be passed to others through saliva.

The development of disease is also dependent on several other factors.  According to “Gingivitis and Periodontal Disease (Gum Disease)”, an article on the WebMD website, these factors are:

·        Hormonal changes, such as those occurring during pregnancy, puberty, menopause, and monthly menstruation, make gums more sensitive, which makes it easier for gingivitis to develop.

·        Illnesses may affect the condition of your gums. These include diseases such as cancer or HIV that interfere with the immune system. People with diabetes are more likely to have periodontal disease than people without diabetes, because many kinds of bacteria (germs) thrive on sugars, including glucose -- the sugar linked to diabetes. When diabetes is poorly controlled, high glucose levels in mouth fluids may help germs grow and set the stage for gum disease.

·        Medications can affect oral health because some lessen the flow of saliva, which has a protective effect on teeth and gums. Some drugs, such as the anticonvulsant medication Dilantin and the anti-angina drug Procardia and Adalat, can cause abnormal growth of gum tissue.

·        Bad habits such as smoking make it harder for gum tissue to repair itself.

·        Poor oral hygiene habits, such as not brushing and flossing on a daily basis, make it easier for gingivitis to develop.

·        Family history of dental disease can be a contributing factor for the development of gingivitis.

According to “Gingivitis and Periodontal Disease (Gum Disease)”, an article on the WebMD website, four symptoms of this disease are:

Ÿ  Red, tender and swollen gums.

Ÿ   Bleeding of the gums.  Even during brushing, bleeding gums are a sign of inflammation and the major marker of periodontal disease.

Ÿ  Debris and bacteria. They can cause a bad taste in the mouth and persistent bad breath.

Ÿ  Loose teeth. They can sometimes cause a change in the way the upper and lower teeth fit together when biting down or in how partial dentures fit.

The following picture should help you to understand symptoms of this disease better.

The main approach in the diagnosis of this disease is to check the color and shape of gingival tissue on the cheek (buccal) side and the tongue (lingual) side of every tooth.  Redness, puffiness, and bleeding upon probing indicate inflammation and possible periodontal disease.  Deposits of plaque and tartar may be seen at the base of the teeth. The gums are usually painless or only mildly tender.  At the dental office, dental bone measurements may be done to determine whether the inflammation has spread to the supporting structures of the teeth. Below is a picture of how a dentist performs the measurement used to diagnose of this disease.

 

Two approaches can be used to treat periodontal disease:

·        Nonsurgical Approaches. Deep cleaning of tartar and bacteria from gum line and tooth root surfaces. 

·        Surgical Approaches. Periodontal surgical techniques include flap surgery (periodontal pocket reduction), bone grafts, and guided tissue regeneration.

            The best method to prevent this disease is daily brushing and flossing.  Brushing gets rid of plaque from the easily reached surfaces of the teeth; flossing removes food particles and plaque from in between the teeth and under the gum line. Antibacterial mouth rinses can reduce bacteria in the mouth that cause plaque and gum disease.  These steps can be done at home. For proper plaque control one should have professional cleanings at least twice a year. According to “Gingivitis and Periodontal Disease (Gum Disease)”, an article on the WebMD website, four steps for prevention of this disease are:

·    Stop smoking. Tobacco use is a significant risk factor for development of periodontitis. Smokers are seven times more likely to get gum disease than nonsmokers, and smoking can lower the chances of success of some treatments.

·    Reduce stress.  Stress may make it difficult for your body's immune system to fight off infection.

·    Maintain a well-balanced diet. Proper nutrition helps your immune system fight infection. Eating foods with antioxidant properties, such as, those containing vitamin E or vitamin C can help your body repair damaged tissue (vitamin E-containing foods include vegetable oils, nuts, green leafy vegetables. Vitamin C-containing foods include citrus fruits, broccoli, and potatoes).

·    Avoid clenching and grinding your teeth. These actions may put excess force on the supporting tissues of the teeth and could increase the rate at which these tissues are destroyed.

This disease affects both men and women.  According to Periodontal (Gum) Disease Causes, Symptoms, and Treatments, an article on NIDCR website, “People usually don't show signs of gum disease until they are in their 30s or 40s. Men are more likely to have gum disease than women. Although teenagers rarely develop periodontitis, they can develop gingivitis, the milder form of gum disease. Most commonly, gum disease develops when plaque is allowed to build up along and under the gum line.”  Why men are more likely to have gum disease than women.  According to "5 months average time men go before changing their tooth brush", an article on Health line, "Among women and men in the survey, 86 percent of women brush their teeth twice or more a day, yet only 66 percent of men do so."

            Now, you should have a clear understanding of what periodontal disease is, and what bacteria cause this disease.  In additional, you should have a good idea of how to diagnose, treat and prevent this disease.  It is up to you to take charge of your health, and develop good habits to prevent this disease from damaging your teeth, because this disease might cause other illness such as heart disease, stroke, diabetes, respiratory diseases and worsening chronic lung conditions.

Words Cites/Reference

1.      The new Merriam-Webster Dictionary

2.      Marjorie Kelly Cowan and Kathleen Park Talaro. Periodontal disease. In Microbiology A System Approach, 2^nd edition. Page 691-693.

3.      Periodontal disease. Available at:  http://adam.about.com/reports/Periodontal-disease.htm

4.      Gingivitis and Periodontal Disease (Gum Disease). Available at http://www.webmd.com/oral-health/guide/gingivitis-periodontal-disease

5.      Steven R. Pohlhaus, DDS,  Balttimore Center for Laser Dentistry. Copy of text available at :http://www.stevedds.com/periodon.htm

6.      Periodontal disease. Available at http://www.nidcr.nih.gov/OralHealth/Topics/GumDiseases/PeriodontalGumDisease.htm

7.  http://issuu.com/reporterherald/docs/healthline_sept16

Picture of tooth: https://health.google.com/health/ref/graphic/1121

Picture of periodontal disease: https://health.google.com/health/ref/graphic/1136

Picture of how dentist measurement of gum disease: https://health.google.com/health/ref/graphic/9348