If a person has hypopituitarism, what effect would you expect on the adrenals?

( answer and more general notes )

LATERAL EPICONDYLITIS
--most common overuse injury of elbow (90% of elbow tendonitis)
--inflam, microscopic tears, fibrosis of the extensor carpi radialis brevis tendon
--"tennis elbow" -- from backhand, mind you
--S/Sx: PAIN: lateral elbow, w/ gripping, resisted wrist ext, forearm supination, ext of mid finger
--pain: gradual onset, intermittent
--pt may report weakness, tenderness
--dt degeneration, tendonosis, periostitis
--at jct of common extensor and lateral epicondyle of humerus
--usu no visible swelling or inflam
--AROM and PROM usu normal
--trigger points in extensors of wrist
--PROGnosis: good with conservative care (3 months or less to good as new)
--Tx: pain control, anti-inflam, rest, avoid aggrav, exercise as tolerated, ice, ultrasound, laser, splint, manip, forearm soft tissue tx, ergonomic changes
( more )

Nice table on DRUG INTERACTIONS here:
http://medicine.iupui.edu/flockhart/table.htm
( a little liver review )

Pain =
--a feeling of distress, suffering, or agony,
--an unpleasant sensation that can range from mild, localized discomfort to agony
--has physical and emotional components
--emotions have strong effects on physical perception
--algophobia = an irrational dread of pain
--depression etc strongly associated with inadequately treated pain
--also "pain" = painful uterine contraction occurring in childbirth.
--from the Latin "poena" meaning a fine, a penalty
--acute or nociceptive pain vs neuropathic pain
--nociceptive and neuropathic pain are caused by different neuro–physiological processes, and therefore tend to respond to different treatment modalities
( more )

Test your ability to tell the difference, thanks to the BBC, at: http://www.bbc.co.uk/science/humanbody/mind/surveys/smiles/index.shtml. I can tell that John McCain's smile is phoney, and so is the smile of Bill Richardson. I wouldn't mind politicians and their fake smiles to much if they weren't plastered all over. Hints for recognizing real and fake smiles are ( behind the cut. )

Just finished my first test of the day, palpation. On my patient I located the 7th thoracic vertebra, the manubrium and quadratus lumborum, and did passive flexion motion palpation of the cervical spinous processes. Pie. Easy, that is. The next test is in organ systems, on the four segments that I posted about last night. That one will be harder.

Well tonight I went to another yoga class, same studio, different teacher. I had not been to this teacher before and she immediately checked me for all the same pet peeves that the other teachers from this school focus on. Are my knees hyperextended? I made sure that they were not. Are my hips level? Yes they are. I passed the first 10 tests or so before we made it to the crux of the matter. At TYE I was taught to use the rhomboids to pull the shoulder blades onto the back to toward each other in the middle of the back. At Amrita the staff is in rebellion against John Friend regarding this teaching, and they are not teaching it. Rather than saying "melt your heart" they say to keep your back "broad" and not allow the pinching between the shoulderblades. Tonight I had a social work nurse and a physical therapist, both yoga teachers, try to authoritize me into believing that they way is right. I don't believe anything just because somebody said so! And I told them this. I tried to open the conversation about the anatomy involved. The main teacher of the class said that she thinks Americans overuse their rhomboids and in such is the essence of our postural problems. I so disagree with her. We did this partner stretch that involved having one person hold another person's wrists behind their backs and lean forward to open the chest. I was instructed to do this without my shoulderblades coming together. When I resisted the stretch and exerted my pecs to hold my shoulders forward, she was satisfied. When I allowed the pose to open my heart, my shoulderblades were too close and she was dissatisfied. I am so far not impressed with the level of awareness of this school. There is too much pedantry, too much authoritarian zeal. I will do what I choose based on what I decide based on the assimilation of teachings, studies and body knowledge. This is my yoga. One rebel school can disagree with one brand new master about the ultimate truth, and I will synthesize my own truth.

From now on I'm going to read through the lecture notes and post about it instead of going to Brons lectures. What I'm doing is simply looking up each item that appears on his powerpoint slides.

Quiz Questions:
1. Which hand muscles act to clench your thumb against your index finger?
2. Name the fibrous band which arches over the carpus making the CARPAL TUNNEL
(through which the Flexor tendons of the digits and the median nerve pass).
3. Which thumb muscle is deep to the other two?
a. Abductor pollicis brevis
b. Flexor pollicis brevis
c. Opponens pollicis
4. Which two muscles work together to allow us to flex the metacarpal phalangeal joints while we extend the interphalangeal joints?
5. Between which two bones in the hand do you find a saddle joint?
6. What kind of joint is found between the metacarpals and the phalanges?
7. Which muscles connect into the dorsal extensor expansion?
8. Damage to which nerve causes you to loose your power grip?
( answers )

Here's my (new) mnemonic for remembering the cranial nerves:
"On Old Olympic Towering Tops A Feisty Virgin Grows Vines And Hops"

Next week I will be presenting on the nerves and the basics for testing them. I am beginning from a place of total ignorance, so skip or bear with me as I develop my notes. Free free to contribute relevant information, even if you are on my shit list. =-]
( getting nervy )

Today at 8am I went into the lab and held in my hands a human heart. I have studied anatomy many times before. I have dissected a living pregant mouse, a frog, and a pelican whose gut contents did not reveal the reason he was dead on the beach. I have dissected a fetal pig, complete with colored plastic injected into his arteries and veins. I have held a cow's heart in my hands. I have studied the flows and construction of hearts. But holding a human heart is different.

( Heart notes from lab )

Shakti wakes me up at first light, and that is very early this time of year. She's high energy and wants to play--which in effect means that she tears things up and crawls where she doesn't belong. For example, she will go into the refrigerator if I open it. I must be careful not to forget her. If I get rattle a plastic shopping bag, she goes wild. When I put one where she can get to it, she crawls straight inside and lays down. I pick her up and twirl her in it. She loves it. She fights and plays with the bag until her paws are sticking out of it. She plays with electrical cords until everything is unplugged. And she finds rapture when she hears the buzz of a hummingbird outside the window, and goes to catch it. So far she hasn't caught any hummingbirds, but she catches the other birds by hanging out under the bird bath table.

There is a plague of grasshoppers who have devoured half of my plants. The mint, which just a few weeks ago was blooming glorious purple outside my window, has been chowed down to a few brown sticks. The grasshoppers come in the window and lurk in my apartment. One time they found some flowers on my bedside table and ate the whole boquet while I was at work. I have become efficient at catching them and throwing them back out the window. I used to capture them under a glass but now I just grab them in my fist. They have strong legs. The kitten likes to play with them, and eats them, all but the legs.
( Ramblings )