Valley University Faculty of Health Sciences

HISTOLOGY II
Pathology and Scientific Novelty
Group H
Student: Oliver Mérida Zapata
Teacher: Dr. Norma Paz Méndez 2006
Pathology of the Herniated Disc Definition .- The hernia is a defect or injury c
aused by intervertebral disc degeneration. It consists of a nucleus pulposus sur
rounded by a fibrous ring. When it breaks the ring facilitating the exit outside
the nucleus, we have a herniated disk.
Fissure. The fissure disc is tearing the fibrous disc. The most typical is the r
adial crack, in which the tear is perpendicular to the direction of the fibers.
The disc protrusion is the deformation of the fibrous material by the impact of
gelatinous nucleus pulposus against it.
Herniated disc. If the shell does break and part of the nucleus gets out of the
enclosure, is diagnosed with a herniated disk.
Side view of the hernia
The pathologies of the spine are becoming more common in humans due to lack of i
nformation possessed by them, because of inadequate movements they made and the
charges made on the spine of these factors being responsible for a hernia disk,
which may occur more frequently mind cervical and lumbar. The herniated nucleus
pulposus or slipped disk is a condition in which part or all of the central port
ion of a soft gelatinous intervertebral disc (nucleus pulposus) is forced throug
h a weakened part of the disk, eg pain Produce neck and arm (cervical herniation
) due to nerve root irritation.
Discs are between every two vertebrae and serve to cushion the load on the spine
. When discs degenerate with age or repeated efforts, they can get out of its no
rmal location, which is known as a herniated disc. The exit can compress neural
structures. Although the disks are the entire spine, disc herniations are locate
d mainly in the neck (cervical) and lower back. Causes The main causes of a hern
iated disc are as follows: For joint degeneration or aging, with vertebral osteo
phyte formation. It is not yet known but the mechanisms have reported the existe
nce of several genes. Microtrauma.
By a mechanism repetitive flexion - extension of trunk loading too much weight (
professions which requires great effort). A continuous pressure on the disc caus
es it to be deteriorating. Rotational motion on a continuing basis (professions
where it is prolonged sitting, carrying continuous changes of direction and mean
ing through swivel chairs, driven most often by foot - shear effect). Excess bod
y weight and volume, accentuating the risk with a large abdomen. There is then e
xcessive pressure on the back due to vertebral curve accentuating lumbar lordosi
s (swayback). Atrophy back lumbar paravertebral muscles. Some factors related to
lifestyle, such as smoking, lack of regular exercise and inadequate nutrition c
ontribute substantially to poor health of the disc. As the body ages, natural bi
ochemical changes cause discs gradually dry out, affecting the strength and elas
ticity. Poor posture combined with the habitual use of incorrect body mechanics
can exert additional stress on the cervical spine. If you combine these factors
with the effects of everyday wear and tear, injury, a wrong way to lifting or tw
isting movements, it is easy to understand what causes a herniated disc. A disc
herniation may develop suddenly or gradually, over weeks or months.
Gradual steps towards Herniation Disc Degeneration: chemical changes associated
with aging weaken the discs, but not because of hernia. Prolapse: the form or po
sition of the disc changes and a slight invasion into the spinal canal. Also cal
led bulging. Extrusion: the gel-like nucleus pulposus through the wall like a ri
m (annulus fibrosus) but remains within the disc. Kidnapped Kidnapping or Disc:
the nucleus pulposus through the annulus fibrosus and lies outside the disc into
the spinal canal (herniated nucleus pulposus or HNP, for its acronym in English
).
PATHOLOGIES SECONDARY TO CERVICAL DISK HERNIA root compression of peripheral ner
ves. The compression of the spinal nerve root causes pain in the area of distrib
ution of root€but remember that the pain may spread more widely than imagined,
feeling pain at the root of the scapular region C4 and C7 root pain in the anter
ior chest. Typically, acute spasms of pain in addition to a dull base. The pain
may cause muscle spasms with reduced movement in the spine or total loss of moti
on associated with torticollis. The commitment of the motor root results in musc
le weakness and decreased or absent reflexes in her arms. Listed below are the m
uscles innervated by the roots most commonly involved: Deltoid ... ... ... ... .
.. ... ... ... ... ... ......................... ...............................
...... C5-C6. Biceps ... ... ... ... ... ... ... ... ... ... ... ...............
....................... ......................... C5-C6. Triceps ...............
.................................. .............................................
..... ....... C6-C7-C8. Extensors and wrist flexors and finger .................
.......................... ....... C7-C8. Abductors and extensors of the thumb .
.. ... ... ... ... ... ... ... ... ... .... ... ..... C7-C8. Intrinsic muscles o
f the hands ... ... ... ... ... ... ... ... ... ... ... ... ... .... ... .. C8-D
1. The commitment of the sensory root can produce paresthesia and therefore chan
ges all the modalities of sensation in the affected dermatome. In the early stag
es, the motor root irritation can cause increased sensitivity and unpleasant (hy
peresthesia). Compression of the cervical spinal cord. Compression of the cervic
al spinal cord is a very serious condition that occurs most commonly at C5-C6. A
lthough there are a variety of presentations involving more usual
findings by upper motor neuron lesion in one or both legs with findings by lower
motor neuron lesion in the upper limbs. It can also be a variety of sensory abn
ormalities in her arms and legs. Vertebral artery compression. The compression o
f the vertebral artery can lead, particularly in the patient, brain stem ischemi
a and the production of vertigo, tinnitus, visual disturbances, difficulty speak
ing and swallowing, ataxia and other signs of brain dysfunction. Pathophysiology
fissure, protrusion or herniated disc occurs when pressure inside the disc is g
reater than the resistance of the fibrous. As the fibrous thickening is third in
the anterior wall in the back, most of the cracks, protrusions and herniations
occur in the latter. The typical mechanism consists of the following sequential
movement: Flexion of the spine forward: In doing so the wheel is more load on th
e front. As a gelatinous consistency, the nucleus pulposus is compressed against
the back wall of the fibrous. Weight Carrying important: Doing so tends to comp
ress a vertebra against the other, increasing the pressure within the disc. Exte
nsion of the spine with the weight loaded: In doing so, the increase in disc pre
ssure leading to weight bearing is "squeezing" the nucleus pulposus back harder.
If the pressure against the back wall of the fibrous enough, the envelope tears
(fissures disk), balloons (prorusión disk) or part (herniated disk). A similar
effect can be achieved by repeated flexion and extension movements with a small
er load or no load. Each time, generate small impacts against the rear wall of t
he fibrous.
These mechanisms occur more readily when the back muscles are very powerful. If
they are sufficiently developed, these muscles protect the disc by several mecha
nisms. Since the posterior longitudinal ligament is strongest in the midline, th
e portion of the annulus fibrous posterolateral has to bear a disproportionate s
hare of the load. For that reason, the majority of lumbar disc herniations occur
in the back, slightly lateralized, and compress the nerve root for, which gener
ates the characteristic intense radicular pain. There have been several distinct
ions between the bulge, kidnapping or free disk fragment, often based on operati
ve findings or pathological. From a clinical standpoint, these distinctions are
generally minor, with the possible exception of "contained herniation, which may
cause the patient becomes a candidate for intradiscal procedures. Clinical char
acteristic data provides the history are: Symptoms may begin with a low back tha
t after days or weeks to us, gradually or sometimes suddenly, evolucjo to radicu
lar pain,€frequently Lumbala attenuation. Rarely identify triggers. Relieves pa
in of knee and thigh. In general, patients avoid making excessive movements but
stay in one position (either sitting, standing or lying down) for a long time ma
y worsen the pain, which is necessary to change their position at intervals rang
ing from a few minutes 10-20 minutes. This attitude of change of position is not
the same as writhe in pain, as, for example, in cases of ureteral obstruction.
The pain is aggravated by coughing, sneezing or straining: the "piston effect" w
as found positive in 87% of the cases studied in a publication.
Bladder symptoms: the incidence of voiding dysfunction is between 1% and 18% and
are, in most cases, problems emptying, urinary retention or stress. The first s
ign may be the bladder hypoesthesia; symptoms is not unusual to find "irritating
," including urinary urgency, urinary frequency (including nocturia) and an incr
eased postvoid residual. Enuresis is less common. It has been reported incontine
nce drip cases of radiculopathy (note: the true urinary retention can be seen in
cauda equina syndrome. Occasionally a lumbar disc herniation can occur only wit
h bladder symptoms, which can improve after surgery, although it is impossible t
o ensure that such improvement will occur. Low back pain itself is generally a m
inor component (only 1% of patients have reported low back pain have sciatica) a
nd, when the only symptom, it is necessary to look for other causes. Sciatica ha
s such a high sensitivity to indicate the presence of a herniated disk that the
probability of finding a herniated disc without sciatica is clinically important
= 1 in 1000. Among the exceptions include the central disc herniation, which ma
y raquiestenosis cause symptoms of lumbar (neurogenic claudication), or cauda eq
uina syndrome. radicular compression caused a series of signs and symptoms that
may be present in varying degrees. syndromes characteristic of the nerve roots m
ost commonly affected are:
L3-L4 (disc between the 3rd and 4th lumbar vertebra) lower in front of the knee,
inside of the ankle or leg and internal malleolus. L4-L5 (disc between the 4th
and 5th lumbar vertebrae) on outside lower leg, dorsum of the foot, sole, inner
edge of the foot and big toe. L5-S1 (disc between the 5th lumbar and 1st sacral
vertebra) on the posterior lower leg, outside edge of the foot, ankle or externa
l malleolus and the little finger or pinky. Functional disability that causes lu
mbar disc herniation can be measured by scales such as the Oswestry .... The low
er extremity pain by VAS (Visual Analogic Scale).
SYMPTOMS cervical herniated cervical disc pain, especially in the back or side p
ain near or over deep blades on the affected side pain radiating to the shoulder
, upper arm, forearm, and sometimes the hand, fingers or chest Worsening pain wh
en coughing, straining or laughing Increased pain when bending the neck or turni
ng head to one side of the neck muscles spasm Weak arm muscles Exploration Diagn
osis: Disorders of the vertebral static Loss of lumbar lordosis physiological co
nditioning the rigid backbone. Scoliosis right or left (called by the side of co
nvexity, present in 60%). Ramond Signs: muscle contracture paralumbar unilateral
or bilateral defense is the phenomenon, present in more than 60%. It consists o
f a scoliosis, low ribs, scapula and elevation of the iliac crest. Alterations r
oot trunk flexion causes leg pain is a sign of conflict root disk pressure of th
e paraspinal muscle mass may trigger pain in the leg (ring sign). Motor disorder
s will be walking on tiptoe (S1) and heels (L5). Oppose flexion of the foot (L5)
and the extension movement of the foot (S1). It will check the strength of the
quadriceps (L3 and L4). Were tested for the presence of muscle atrophy and fasci
culations.
It will explore the patella or patellar reflex (L3 and L4) and for the root aqui
llano L5 and S1. Sensory disturbances are explored the sensitivity of the anteri
or thigh (roots, L1, L2 and L3). It explores the inside of the leg (L4 root). Th
e outer side of the leg, the inner half of the dorsum of the foot including the
great toe (L5 root). The outer half of the back of the feet including the lower
finger (root S1). Also€will explore the sensitivity of the perianal region and
posterior thigh, leg and plantar region for roots S1, S2. Sphincter disorders is
explored the presence of bladder balloon.
The symptoms and examination of sensitivity, mobility and motor reflexes will of
fer a perfect map of the possible affected root. Confirm the process by NMR (Nuc
lear Magnetic Resonance) or a CT (Computed Tomography). Sometimes We performed a
nerve conduction study by researching Electromyographic
Scientific Novelty
New discovery may improve treatment of neurodegenerative diseases and type II di
abetes New Discovery
Universitat Autònoma de Barcelona
UAB scientists identify therapeutic targets against illnesses caused by protein
aggregates. The discovery opens the door to designing new drugs to cure Parkinso
n's, type II diabetes, Alzheimer's and the human variant of mad mad cow disease.
The formation of protein aggregates is the cause of several neurodegenerative di
seases such as Parkinson's, Alzheimer's and evil the human variant of mad cow di
sease, as well as dysfunction of the pancreas that causes type II diabetes.
A team of scientists from the UAB has developed a method to identify specific ar
eas of the proteins associated with these diseases that facilitate the formation
of aggregates. The research opens the door to designing new drugs aimed at bloc
king these areas and to stabilize the molecules do not form aggregates. Proteins
are long molecular chains that travel from one place to another cell, carrying
information vital to the body's activity. The function of each protein depends l
argely on the form it takes in space. In some cases, without
however, the proteins lose this form to conflict with other, get together, form
a twist and added without any functions are growing calls to form amyloid fibers
. This causes neurodegenerative diseases like Parkinson's and Alzheimer's, is th
e origin of transmissible spongiform encephalopathies, as the evil mad cow disea
se and its variant in humans (Creutzfeldt Jacob disease), and also triggers the
pancreatic malfunctions that result in type II diabetes. A team of scientists fr
om the Universitat Autònoma de Barcelona, led by the researcher Salvador Ventur
a, has developed a method to identify those parts of the proteins that initiate
the formation of aggregates. This method can identify the precise zones of each
protein that, when in contact with other molecules, forcing the withdrawal and t
he formation of aggregates and amyloid fibers. Scientists have tested the method
with different proteins involved in conformational diseases, identifying segmen
ts that were known for their role in protein aggregation in these diseases. Acco
rding to Salvador Ventura, does our method identifies potential therapeutic targ
ets against illnesses caused by protein aggregation, such as Alzheimer's, Parkin
son's and diabetes type II. Allows identification of the targets with better acc
uracy to attack them, theoretically more effectively?.
The method developed by the UAB researchers identifies the areas that cause prot
ein aggregation both in globular proteins, thread-shaped folded, as in those wit
h extended wire form, and may be useful for designing new drugs diseases related
to protein aggregation. In the case of proteins with extended wire form, you ca
n design drugs that work by coating and blocking the areas identified by the new
method, so that they can not contact other proteins and aggregate. If the prote
ins are globular, the aggregation areas are usually protected on the inside, and
are not dangerous unless they are accidentally exposed to the outside. In this
case, the drugs must be aimed at stabilizing the structure of the protein, preve
nting areas from becoming exposed.
The research, published recently in BMC Structural Biology, was conducted by res
earchers Natalia Sánchez de Groot, Irantzu Pallares, Francesc Xavier Avilés, J
osep Vendrell and Salvador Ventura, Department of Biochemistry and Molecular Bio
logy and Institute of Biotechnology and Biomedicine (IBB) of the Universitat Aut
ònoma de Barcelona.
BIBLIOGRAPHY www.neurocirugia.com/diagnostico/ hernialumbar / www.enbuenasmanos.
com / articles / sample.asp www.diariomedico.com/traumatologia/n240400.html www.
escuela.med.puc.cl / publications / Manual to / DolorOseo.html DOWNIE A Patricia
. Kinesiology in orthopedics and rheumatology. Buenos Aires Argentina. Editorial
Médica Panamericana. 1987. Haro H: [The basic research of herniated lumbar dis
c.]. Clin Calcium 15:365-370, 2005.