Greater splanchnic nerve

Greater splanchnic nerve

• Preganglionic fibers :

  Arise from Lateral Horn Cells (L.H.Cs) of lower six thoracic segments.

• Relay :

  In coeliac and superior mesentric collateral ganglia.
  - Nerve fibers to adrenal medulla relay in adrenal medulla itself.

• Postganglionic fibers :

  Fibers pass along blood vessels to reach abdominal viscera.

• Functions :

  1. Splanchnic vessels : vasoconstrictor and vasodilator to the blood vessels of stomach, liver, pancreas, kidney, small intestine and proximal colon. (Vasoconstriction is more powerful )
  2. GIT : inhibitory to their walls and motor to their sphincters. Also , inhibitory to gastric and intestinal secretions and motility.
  3. Liver : stimulates glycogenolysis > increased blood glucose level
  4. Spleen : motor to splenic capsule > squeeze of blood rich in RBCs.
  5. Kidney : vasoconstriction > decreased renal blood flow and urine output. Also, stimulate renin secretion.
  6. Pancreas : inhibits insulin hormone and pancreatic juice secretion.
  7. Gall bladder : inhibitory to the wall and motor to the sphincter of oddi.
  8. Adrenal medulla : secretion of adrenaline 80% and nor-adrenalin 20% .

  
  

  

Complications of some common diseases - Part 4

Complications of some common diseases - Part 4

 

• Mitral incompetence :

  1. Hypertrophy followed by dilatation of left atrium and ventricle
  2. Chronic venous congestion of lungs
  3. Pulmonary hypertension
  4. Hypertrophy followed by dilatation of right atrium and ventricle
  5. Picture of chronic venous congestion

• Aortic stenosis and incompetence :

  1. Hypertrophy followed by dilatation of left ventricle.

• Ischemic heart disease :

  1. Sudden death due to ventricular fibrillation, cardiogenic shock or acute heart failure.
  2. Myocardial infarction

• Buerger's disease :

  1. Pain due to ischemia
  2. Gangrene

• Polyarteritis nodosa :

  1. Thrombosis and infarction
  2. Mycotic aneurysms

• Infectious rhinitis :

  1. Spread of infection > sinusitis, otitis media, pharyngitis, laryngitis and bronchitis.
  2. Chronic rhinitis
  3. Anosmia which maybe permanent

• Pulmonary hypertension :

  1. Right ventricular hypertrophy and failure ( cor pulmonale )
  2. Death due to cor pulmonale ( specially in pregnant women )

• Pulmonary embolism :

  1. Small emboli > undergo fibrinolysis or organisation and canalization.
  2. Large emboli >
  1. Occlusion of pulmonary trunk or the main bronchus leading to sudden death
  2. Occlusion of small pulmonary artery leading to lung infarction only on top of chronic venous congestion of the lung.
  3. Recurrent pulmonary embolism leading to pulmonary hypertension and right-sided heart failure.

• Carcinoid syndrome of ileum :

  1. Flushing of the face due to vasodilatation
  2. Diarrhea and bronchospasm due to smooth muscle stimulation
  3. Right-sided heart failure

• Hemolytic jaundice :

  1. Splenomegaly
  2. Pigment stones of the gall bladder

• Obstructive jaundice :

  1. Itching due to bile acids
  2. Increased cholesterol and alkaline phosphatase enzyme.
  3. Hemorrhage due to vitamin K deficiency

• Carcinoma of the exocrine portion of the pancreas :

  1. Obstructive jaundice ( in carcinoma of head )
  2. Venous thrombosis ( in carcinoma of body and tail )

• Acute pyelonephritis :

  1. Papillary necrosis and renal failure
  2. Chronic pyelonephritis
  3. Recurrence

• Gonorrhea in males :

  1. Acute prosatitis
  2. Acute inflammation of seminal vesicles
  3. Epididymo-orchitis
  4. Arthritis and acute infective endocarditis
  5. Urethral stricture

• Testicular tumors :

  1. Hydrocele
  2. Germ cell tumors secrete HCG and AFP. 

• Endometriosis :

  1. Endometrial or chocolate cysts in the ovary
  2. Adhesions due to rupture of endometrial glands

• Multiple myeloma of bone marrow :

  1. Anemia, leucopenia and thrombocytopenia
  2. Hypercalcemia and metastatic calcification
  3. Pathological fracture
  4. Increased immunoglobulins in blood
  5. Increased light-chains immunoglobulins which appear in urine
  6. Obstruction of renal tubules by pericipitated protiens and metastatic calcification
  7. Secondary amyloidosis
  
  

Complications of some common diseases - Part 3

Complications of some common diseases - Part 3

 

• Acute appendicitis :

  1. Gangrene, perforation and septic peritonitis.
  2. Appendicular mass
  3. Appendicular abscess
  4. Faecal fistula
  5. Portal pyemia
  6. Mucocele of the appendix due to obstruction by fibrosis
  7. Rupture of the mucocele  leads to pseudomyxoma peritonei.

• Ulcerative colitis :

  1. Hemorrhage
  2. Perforation and septic peritonitis
  3. Malignant change

• Piles :

  1. Bleeding
  2. Inflammation
  3. Portal pyemia

• Acute hemorrhagic pancreatitis :

  1. Septic peritonitis
  2. Chronic pancreatitis
  3. Diabetes mellitus

• Acute polycystic disease :

  1. Renal failure
  2. Hypertension
  3. Haematuria due to rupture of the cyst

• Chronic pyelonephritis :

  1. Bilateral chronic renal failure
  2. Hypertension

• Hydronephrosis :

  1. Bilateral chronic renal failure
  2. Secondary infection leading to pyonephrosis.

• Renal calculi :

  1. Renal colic
  2. Haematuria
  3. Infection as cystitis and pyelonephritis.
  4. Obstruction leading to hydroureter and hydronephrosis.
  5. Squamous metaplasia of the renal pelvis and squamous cell carcinoma

• Transitional cell ( villous ) papilloma :

  1. Haematuria
  2. Cystitis
  3. Malignant change into transitional cell carcinoma

• Benign prostatic hyperplasia :

  1. Compression of prostatic urethra leading to obstruction to the flow of the urine.
  2. Hypertrophy of bladder muscle followed by dilatation, trabeculation and diverticulum formation.
  3. Stasis of urine leads to cystitis and phosphate stones
  4. Bilateral hydroureter and hydronephrosis
  5. Ascending infection leads to pyelonephritis in early stage or pyonephritis in late stage.
  6. Death due to chronic renal failure

• Gonorrhea in females :

  1. Bilateral salpingitis
  2. Pelvic peritonitis
  3. Blood spread > septicemia > arthritis and acute infective endocarditis.

• Puerperal sepsis :

  1. Salpingitis
  2. Peritonitis
  3. Pyemia
  4. Septicemia

• Endometrial hyperplasia :

  1. Uterine bleeding
  2. Malignant change

• Leiomyoma :

  1. Infection
  2. Necrosis
  3. Hyaline degeneration
  4. Malignant change into leiomyosarcoma

• Papillary cystadenoma :

  1. Malignant change is common

• Mucinous cystadenoma :

  1. Torsion of the pedicles with necrosis.
  2. Pseudomyxoma peritonei due to rupture of the cyst
  3. Malignant change is less common

• Dermoid cystadenoma :

  1. Torsion of a pedicle
  2. Rupture of a cyst leading to aseptic peritonitis.
  3. Malignant change
  4. Hyperthyroidism

• Nodular goiter :

  1. Pressure effect on the trachea and esophagus
  2. Secondary hyperthyroidism without exophthalmos
  3. Hemorrhage and necrosis
  4. Dystrophic calcification
  5. Malignant change

• Rheumatoid arthritis :

  1. Secondary amyloidosis
  2. Splenomegaly

Complications of some common diseases - Part 2

Complications of some common diseases - Part 2

 

• Acute infective endocarditis :

  1. Systemic pyemia
  2. Ulceration or perforation of the cusps leading to incompetence and heart failure.

• Mitral stenosis :

  1. The auricular thrombus leads to embolism
  2. Haemoptysis due to lung congestion
  3. Subacute infective endocarditis

• Myocardial infarction :

  1. Serofibrinous pericarditis.
  2. Rupture of recent infarct leading to haemopericardium
  3. Rupture of cardiac aneurysm leading to haemopericardium
  4. Congestive heart failure due to healing by fibrosis
  5. Detachment of mural thrombus leading to embolism

• Congenital heart disease :

  1. Heart failure
  2. Infective endocarditis

• Coarctation of the aorta :

  1. Hypertrophy followed by dilatation of left ventricle
  2. Cerebral hemorrhage due to hypertension
  3. Rupture of the aorta
  4. Infective endocarditis

• Aneurysms :

  1. Pressure effects on the surrounding structures
  2. Rupture and hemorrhage
  3. Thrombosis and embolism

• Carcinoma of larynx :

  1. Laryngeal obstruction
  2. Dysphagia due to infiltration of oesophagus
  3. Inhalation pneumonia and lung abscess

• Bronchopneumonia :

  1. Lung abscess ( more common than lobar pneumonia )
  2. Spread of infection > Pericarditis, empyemia and septicemia.
  3. Broncheictasis due to destruction of bronchial walls

• Lung abscess :

  1. Direct spread of infection leading to empyemia or septic pericarditis
  2. Blood spread of infection leading to pyemia
  3. Rupture of the cavity into the pleura leading to pyopneumothorax.
  4. Gangrene of the lung
  5. Pulmonary fibrosis
  6. Secondary amyloidosis

• Silicosis :

  1. Pulmonary hypertension and right-sided heart failure
  2. Predisposes to tuberculosis.

• Asbestosis :

  1. Pulmonary hypertension and right-sided heart failure
  2. Predisposes to bronchogenic carcinoma and pleural mesothelioma

• Hypertrophic ( obstructive ) emphysema :

  1. Barrel-shaped chest
  2. Cyanosis, dyspnea and polycythemia due to hypoxia
  3. Pulmonary hypertension and right-sided heart failure
  4. Pneumothorax due to rupture of superficial bullae.

• Atelectasis :

  1. Infection of collapsed lung leads to bronchiectasis or lung abscess.

• Pulmonary fibrosis :

  1. Pulmonary hypertension and right-sided heart failure.

• Bronchial adenoma :

  1. Haemoptysis
  2. Bronchial obstruction
  3. Carcinoid syndrome

• Bronchiolo-alveolar carcinoma :

  1. Partial bronchial obstruction leading to focal carcinoma
  2. Complete bronchial obstruction leading to atelectasis.
  3. Impaired drainage leading to bronchiectasis or lung abscesses.

• Squamous cell carcinoma of the tongue :

  1. Inhalation lung abscess.

• Pleomorphic adenoma of salivary gland :

  1. Recurrence after removal due to local extension of the tumor through the capsule.
  2. Malignant change

• Gastric Carcinoma :

  1. Hemorrhage leading to haematemesis and melaena.
  2. Pyloric stenosis

• Meckel's diverticulum :

  1. Imflammation giving signs and symptoms of acute appendicitis.
  2. Peptic ulcer due to heterotropic gastric mucosa.
  3. Tumor formation as carcinoid tumor
  4. Intestinal obstruction ( volvulus or intussusception )

• Crohn's disease :

  1. Intestinal obstruction
  2. Perforation and fistula formation

What will you study in medical school

What will you study in medical school ?

There are many variations in the way of learning medicine according to the medical school you join. However, in the end of your long studying career , you will have to cover the basic concepts of the following branches :

Basic Study

1. Anatomy ( + Embryology + Histology )

2. Physiology

3. Biochemistry

4. Pharmacology

5. Parasitology

6. Pathology

7. Microbiology

Clinical Study

8. E.N.T

9. Ophthalmology

10. Community medicine ( + Public health )

11. Forensics ( + Toxicology )

12. Internal Medicine

13. Pediatrics

14. Surgery

15. Gynecology ( + Obstetrics )

You will find medical notes that will help you in your study and exams in my blog. so SUBSCRIBE and join us @FACEBOOK and follow me @TWITTER