Pathol

Neuromuscular Pathology

Side Stitch

Common symptom in runners

• Symptom: A sharp/stabbing pain in the right upper abdominal quadrant

• Cause: Diaphragmatic muscle spasm 2° hypoxia

• Rx #1: Breathe in through the nose & expire forcefully through pursed lips

• Rx #2: Stretch the right UE over the head

• Becomes evident between 2 and 15 years of age

Source: Lillegard WA, Burcher JD & Rucker KS (1999).

Tourette's Syndrome

Defined by multiple motor & vocal tics lasting for >1 year

• Becomes evident between 2 and 15 years of age

• Most common 1st symptom is a facial tic (eye blink, nose twitch, grimace)

• Involuntary movements (tics) of the arms, limbs, or trunk

• Other symptoms such as touching, repetitive thoughts & movements, & compulsions can occur

• Verbal tics (vocalizations) usually occur with the mov'ts

• Although unusual, verbal tics may also be expressed as coprolalia (the involuntary use of obscene words) or copropraxia (obscene gestures)

Source: http://www.tsa-usa.org/aboutts.html.

Possible Signs & Symptoms of a Brain Tumor

• H/A— ↑ intracranial pressure

• Vomiting

• Visual changes

• Mentation changes

• Seizures

• Muscle weakness

• Bladder dysfunction

• Coordination changes

• (+) Babinski

• Clonus (ankle or wrist)

Romberg's Test

Used to assess balance & coordination problems that may indicate a cerebellar pathology or an inner ear infection

• Have athlete stand in a place free from obstacles

• Instruct athlete to close his or her eyes

• Instruct athlete to abduct arms to 90° with elbows extended

• Instruct athlete to tilt head back & lift 1 leg off floor

• Positive test = unsteadiness

Tandem Walking

• Have athlete stand heel-to-toe (1 foot in front of the other)

• Instruct the athlete to walk 10' along a straight line

• Positive test = unsteady gait

Systemic Lupus Erythematosus

An autoimmune, disease of unknown etiology that results in inflammation & damage to various organs

Onset: 15–45 yo ♀ > ♂ 10–15:1

African (3x more common), Native-American, Asian > Caucasians

Signs & Symptoms

• Unexplained fever

• Swollen glands

• Constitutional symptoms

• Arthralgia—symmetrical

• Swollen joints

• Skin rash—"butterfly" pattern (cheeks)

• Chest pain upon deep breathing

• Extreme fatigue

• Photosensitivity

• Unusual hair loss

• Pale or purple fingers or toes from cold or stress (Raynaud's phenomenon)

• CNS px—seizures, h/a, neuropathy, CVA, OBS

• Mouth, nose, vaginal ulcers

• Symptoms get worse during menstruation

Complications of Lupus

• Seizures/psychosis

• Pleuritis/pericarditis

• Endocarditis/myocarditis

• Anemia

• Glomerulonephritis

Note: A severe side effect of the acne medication minocycline, is lupuslike symptoms

Source: Gulick D (2006).