SPINAL TAP
S
SPIROMETRY
A spirometer is used to measure the volume of air (in litres) that you can inhale and
exhale over a period of time. The results of spirometry show whether or not the
airways are narrowed as a result of lung disorders such as asthma. The procedure
can also be used to monitor the effectiveness of certain treatments for lung
disorders, such as bronchodilator drugs, which widen the airways.
Using the spirometer
The patient is asked to inhale and exhale
fully through a mouthpiece several times.
The volume of air inhaled and exhaled is
displayed on the monitor.
treatment to widen the air passages in
a person with asthma. The volume of
air that is exhaled in 1 second rises
from about 1 litre to 2 litres soon after
the drugs have been taken.
D is c p r o la p s e
m a y
l e a d t o
p r e s s u r e
o n
a
s p i n a l
n e r v e ,
w h i c h
c a u s e s
p a i n .
N e r v e i n j u r y m a y r e s u l t i n l o s s o f s e n s a -
t i o n o r m o v e m e n t i n t h e s p e c i f i c a r e a
t h a t i s s u p p l i e d b y t h e n e r v e .
s p in a l ta p
S e e
lu m b a r p u n c t u re .
s p in e
T h e c o l u m n o f b o n e s a n d c a r t i l a g e t h a t
e x t e n d s f r o m t h e b a s e o f t h e s k u l l t o t h e
p e l v i s , e n c l o s i n g t h e
s p in a l c o rd
a n d s u p -
p o r t i n g t h e t r u n k a n d h e a d .
STRUCTURE AND FUNCTION
T h e
s p i n e
i s
m a d e
u p
o f 3 3
r o u g h l y
c y l i n d r i c a l b o n e s c a l l e d
v e rte b ra e .
E a c h
p a i r o f a d j a c e n t v e r t e b r a e i s c o n n e c t e d
b y a f a c e t
jo in t ,
w h i c h h e l p s b o t h t o s t a -
b i l i z e t h e s p i n e a n d a l l o w m o v e m e n t i n
i t .
B e t w e e n
t h e
v e r t e b r a e
l i e
p a d s
o f
t o u g h f i b r o u s c a r t i l a g e w i t h a j e l l y l i k e
c o r e ,
c a l l e d
i n t e r v e r t e b r a l
d i s c s
( s e e
d is c , in t e rv e rte b ra l
) .
T h e s e
p a d s
a c t
a s
s h o c k - a b s o r b e r s
d u r i n g
s u c h
m o v e -
m e n t s a s r u n n i n g a n d j u m p i n g .
I n a n o r m a l s p i n e , t h e t o p m o s t s e c -
t i o n , c o n s i s t i n g o f s e v e n v e r t e b r a e a n d
k n o w n a s t h e c e r v i c a l s p i n e , c u r v e s f o r -
w a r d ; t h e t h o r a c i c s p i n e ,
m a d e u p
o f
t h e 1 2 v e r t e b r a e a t t h e r e a r o f t h e c h e s t ,
c u r v e s
b a c k w a r d s ;
t h e
l u m b a r
( l o w e r
b a c k ) s e c t i o n c u r v e s f o r w a r d s , p a r t i c u -
l a r l y i n w
o m
e n ; a n d t h e p e l v i c s e c t i o n
c u r v e s b a c k w a r d s .
T h e s p i n e
e n c l o s e s t h e
s p in a l c o rd ,
a
c o l u m n o f n e r v e t r a c t s r u n n i n g f r o m t h e
b r a i n .
S p in a l n e rv e s
b r a n c h o f f f r o m t h e
s p i n a l c o r d , a t t h e n e r v e r o o t s , t o f o r m
t h e p e r i p h e r a l n e r v e s ( s e e
p e r ip h e r a l n e r-
v o u s s y s t e m
) ,
t h e
r o o t s
o f w h i c h p a s s
b e t w e e n t h e v e r t e b r a e t o s u p p l y e v e r y
p a r t o f t h e b o d y .
T h e v e r t e b r a e a r e b o u n d t o g e t h e r b y
t w o l o n g , t h i c k
lig a m e n ts
r u n n i n g t h e
l e n g t h o f t h e s p i n e a n d b y s m a l l e r l i g a -
m e n t s
b e t w e e n
t h e
i n d i v i d u a l
b o n e s .
A t t a c h e d t o t h e s p i n e a r e s e v e r a l g r o u p s
o f
m u s c le s ,
w h i c h c o n t r o l i t s m o v e m e n t
a n d h e l p t o s u p p o r t i t . S e e
S tru c t u re of
th e s p in e
b o x a n d
D is o r d e r s o f th e s p in e
b o x , p r e v i o u s p a g e .
s p ir a l fra c tu re
A t y p e o f
fra c tu re
i n w h i c h t h e b o n e i s
b r o k e n b y s e v e r e t w i s t i n g .
s p iro c h a e te
A n y o f a g r o u p o f s p i r a l - s h a p e d b a c t e r i a
t h a t c a u s e v a r i o u s i n f e c t i o n s , i n c l u d i n g
s y p h ilis , le p t o s p ir o s is , re la p s in g fe v e r,
a n d
L ym e d is e a s e .
s p iro m e try
A
p u lm o n a r y fu n c tio n te st
u s e d t o
d i a g -
n o s e
o r
a s s e s s
a
lu n g
d i s o r d e r
o r
t o
m
o n i t o r t r e a t m e n t . I t r e c o r d s t h e r a t e a t
w h i c h
a p e r s o n
e x h a l e s
a i r
f r o m
t h e
l u n g s a n d t h e t o t a l v o l u m e e x h a l e d .
S p i r o m e t r y
m a y
b e
u s e d
t o
a s s e s s
c o n d i t i o n s
i n
w h i c h
t h e
a i r w a y s
a r e
n a r r o w e d , s u c h a s
a s th m a ,
o r t h o s e i n
w h i c h
l u n g
e x p a n s i o n
i s
r e s t r i c t e d ,
s u c h a s
in t e rs t it ia l p u lm o n a r y f ib r o s is .
s p iro n o la c to n e
A p o t a s s i u m - s p a r i n g
d iu r e t ic d r u g
u s e d
t o t r e a t h e a r t f a i l u r e a n d a s c i t e s ( f l u i d
b u i l d u p i n t h e p e r i t o n e a l c a v i t y o f t h e
a b d o m e n ) .
S p i r o n o l a c t o n e
m a y
c a u s e
s i d e
e f f e c t s
i n c l u d i n g
g a s t r o i n t e s t i n a l
u p s e t ,
l e t h a r g y ,
r a s h ,
i m p o t e n c e ,
a n d
i r r e g u l a r m e n s t r u a t i o n . H i g h d o s e s m a y
c a u s e
g y n a e c o m a s t i a ( a b n o r m
a l b r e a s t
e n l a r g e m e n t ) i n m e n .
s p le e n
A
f i s t - s i z e d ,
d a r k
r e d
s p o n g y
o r g a n
i n
t h e
u p p e r
l e f t
o f
t h e
a b d o m e n
b e h i n d
t h e
l o w e r
r i b s .
T h e
s p l e e n
r e m o v e s
w o r n - o u t
a n d
d e f e c t i v e
r e d
b l o o d
c e l l s
f r o m
t h e
c i r c u l a t i o n
a n d
h e l p s
t o
f i g h t
i n f e c t i o n
b y
p r o d u c i n g
s o m e
o f t h e
a n t ib o d ie s
( p r o t e i n s ) a n d
ly m p h o c y te s
a n d
p h a g o c y t e s
( t y p e s
o f
w h i t e b l o o d c e l l ) t h a t d e s t r o y i n v a d i n g
m i c r o o r g a n i s m s .
T h e s p l e e n e n l a r g e s i n m a n y d i s e a s e s ,
i n c l u d i n g
i n f e c t i o n s
s u c h
a s
m a la ria
a n d
in f e c tio u s m o n o n u c le o s is ;
b l o o d d i s -
o r d e r s
s u c h a s
le u k a e m ia , t h a la s s a e m ia
,
a n d
s ic k le c e ll a n a e m ia ;
a n d
t u m o u r s
s u c h a s
ly m p h o m a s .
E n l a r g e m e n t m a y b e
a c c o m p a n i e d
b y
h y p e rs p le n is m
( o v e r -
a c t i v i t y o f t h e s p l e e n ) . T h e o r g a n m a y
b e r u p t u r e d b y a s e v e r e b l o w t o t h e a b -
d o m e n ; t h i s m a y c a u s e p o t e n t i a l l y f a t a l
h a e m o r r h a g e ,
n e e d i n g
a n
e m e r g e n c y
s p le n e c t o m y
( r e m o v a l o f t h e s p l e e n ) .
s p le n e c to m y
S u r g i c a l r e m o v a l o f t h e
s p le e n .
S p l e n e c -
t o m y i s p e r f o r m e d a f t e r t h e s p l e e n h a s
b e e n s e r i o u s l y i n j u r e d , o r t o t r e a t
h y p e r-
s p le n is m
o r
c e r t a i n f o r m s
o f
a n a e m ia
.
T h e a b s e n c e o f t h e s p l e e n d o e s n o t n o r -
m a l l y
c a u s e
a n y p r o b l e m s
b e c a u s e
i t s
f u n c t i o n i s l a r g e l y t a k e n o v e r b y o t h e r
p a r t s o f t h e
ly m p h a tic s y s te m
a n d t h e
liver.
P e o p l e w h o h a v e h a d a s p l e n e c t o m y a r e
m
o r e
s u s c e p t i b l e
t o
c e r t a i n
i n f e c t i o n s
708
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