membaca al-Quran
tanpa memahami maksudnya,
ibarat membaca GANONG
tanpa memahami isinya
tanpa memahami maksudnya,
ibarat membaca GANONG
tanpa memahami isinya
-malam untukmu palestin-
[selamat beramal]
Saturday, January 10, 2009
Friday, January 9, 2009
ptosis-2
Mrs P,a 44 year old female,came to the emergency room complaining of severe headache.She describing the pain as sharp and shooting into the front of her head,then aching.She allso says that her left eye wants to stay shut.She has had this pain on and off for five days.Four days ago,she saw her family physician who ordered a CT of the head.This shown no abnormlities.
Her physical exam was unremarkable.Blood pressure was 131/79mmHg with resting heart rate 97 beat/minute.
other systems reveal normal except;
- she has weak upward and medial movement of the left eye.On foward gaze,the eye is deviated down and laterally. There is mild ptosis of the left eyelid
- the left pupil was larger than the right.The left eye did not react to light either direct or consensual.The right pupil responses was normal.
provisional diagnosis: posterior communicating artery aneurysm
please refer to X'PRESS revision in short cases by Universiti Malaya,page 8,approach to ptosis.please understand how Horner's syndrome,diabetes mellitus and PCOM aneursym can cause unilateral ptosis but different pupil size.
[happy study]
this short case was prepared by my studygroup mate,faten aqilah.please ask this makcik for better uderstanding.Jangan stress ye~~~~~~~~~
ptosis-1
haha,dulu2 suka panggil org mata kuyu mata stim.ngokngek!!!!!!!
our levator palpebrae superioris muscle or eyelids is innervated by cranial nerve III bilaterally.maksudnya right CNIII innervated both levator palpebrae superioris muslce.so klau ada CN palsy at one side,yang lagi satu bleh still akan bukak eyelid tu.(mcm dalam kes upper motor neuron and lower motor neuron lesion dekat face tu).so kalau peripheral nerve yg innervate each eyelids rosak,so satu jela mata yg berlaku ptosis.paham tak?tak reti nak terang pulak=(
when someone is having ptosis only at one eye,please check the pupil size.either small,normal or large.
pupillary reflex
our levator palpebrae superioris muscle or eyelids is innervated by cranial nerve III bilaterally.maksudnya right CNIII innervated both levator palpebrae superioris muslce.so klau ada CN palsy at one side,yang lagi satu bleh still akan bukak eyelid tu.(mcm dalam kes upper motor neuron and lower motor neuron lesion dekat face tu).so kalau peripheral nerve yg innervate each eyelids rosak,so satu jela mata yg berlaku ptosis.paham tak?tak reti nak terang pulak=(
when someone is having ptosis only at one eye,please check the pupil size.either small,normal or large.
pupillary reflex
- sympathetic:pupil constrict
- parasympathetic:pupil dilate
kalau sympathetic rosak,pupil tak boleh nak dilate kan,so pupil akan kecik.
small pupil,unilateral partial ptosis in Horner's syndrome
horner's syndrome
horner's syndrome:
- decrease sweating over each eyebrow
- pupil constrict due to unbalanced parasympathetic action
- partial ptosis as sympathetic fiber supply the SMOOTH muslce of eyelids.
occur due to interruption of sympathetic innervation of the eye at any point.
