Multiple system atrophy Health Dictionary

Multiple System Atrophy: From 1 Different Sources


(MSA) a condition that results from degeneration of cells in the *basal ganglia (resulting in *parkinsonism), the *cerebellum (resulting in *ataxia), the *pyramidal system, and the *autonomic nervous system (resulting in symptoms of autonomic failure, such as postural hypotension).
Health Source: Oxford | Concise Colour Medical Dictionary
Author: Jonathan Law, Elizabeth Martin

Atrophy

Wasting of a tissue or organ... atrophy

Central Nervous System

A collective term for the brain, spinal cord, their nerves, and the sensory end organs. More broadly, this can even include the neurotransmitting hormones instigated by the CNS that control the chemical nervous system, the endocrine glands.... central nervous system

Limbic System

A functional, not physical, system in the brain, generally considered to mediate emotions with metabolism.... limbic system

Immune System

See IMMUNITY.

Age Disease and mode of administration

3 days BCG (Bacille Calmette-Guerin) by injection if tuberculosis in family in past 6 months.

2 months Poliomyelitis (oral); adsorbed diphtheria, whooping-cough (pertussis)1 and tetanus2 (triple vaccine given by injection); HiB injection.3

3 months Poliomyelitis (oral); diphtheria, whooping-cough (pertussis)1 and tetanus2 (triple vaccine given by injection); HiB injection.3

4 months Poliomyelitis (oral); diphtheria, whooping-cough (pertussis)1 and tetanus2 (triple vaccine given by injection); HiB injection.3

12–18 months Measles, mumps, and rubella (German measles)4 (given together live by injection).

(SCHOOL ENTRY)

4–5 years Poliomyelitis (oral); adsorbed diphtheria and tetanus (given together by injection); give MMR vaccine if not already given at 12–18 months.

10–14 females Rubella (by injection) if they have missed MMR.

10–14 BCG (Bacille Calmette-Guerin) by injection to tuberculin-negative children to prevent tuberculosis.

15–18 Poliomyelitis single booster dose (oral); tetanus (by injection).

1 Pertussis may be excluded in certain susceptible individuals.

2 Known as DPT or triple vaccine.

3 Haemophilus in?uenzae immunisation (type B) is being introduced to be given at same time, but di?erent limb.

4 Known as MMR vaccine. (Some parents are asking to have their infants immunised with single-constituent vaccines because of controversy over possible side-effects – yet to be con?rmed scienti?cally – of the combined MMR vaccine.)

Recommended immunisation schedules in the United Kingdom... immune system

Multiple Sclerosis

A chronic, usually progressive disease of the central nervous system, with the gradual patchy disorganization of the protective myelin cells. It is almost certainly an auto-immune disorder, although viral infections sometimes seem to initiate the condition, and physical trauma is often seen to anomalously precede the first symptoms.... multiple sclerosis

Respiratory System

All the organs and tissues associated with the act of RESPIRATION or breathing. The term includes the nasal cavity (see NOSE) and PHARYNX, along with the LARYNX, TRACHEA, bronchi (see BRONCHUS), BRONCHIOLES and LUNGS. The DIAPHRAGM and other muscles, such as those between the RIBS, are also part of the respiratory system which is responsible for oxygenating the blood and removing carbon dioxide from it.... respiratory system

Nervous System

This extensive, complex and ?nely tuned network of billions of specialised cells called neurones (see NEURON(E)) is responsible for maintaining the body’s contacts with and responses to the outside world. The network also provides internal communication links – in concert with HORMONES, the body’s chemical messengers – between the body’s diverse organs and tissues, and, importantly, the BRAIN stores relevant information as memory. Each neurone has a ?lamentous process of varying length called an AXON along which passes messages in the form of electrochemically generated impulses. Axons are bundled together to form nerves (see NERVE).

The nervous system can be likened to a computer. The central processing unit – which receives, processes and stores information and initiates instructions for bodily activities – is called the central nervous system: this is made up of the brain and SPINAL CORD. The peripheral nervous system – synonymous with the cables that transmit information to and from a computer’s processing unit – has two parts: sensory and motor. The former collects information from the body’s many sense organs. These respond to touch, temperature, pain, position, smells, sounds and visual images and the information is signalled to the brain via the sensory nerves. When information has been processed centrally, the brain and spinal cord send instructions for action via motor nerves to the ‘voluntary’ muscles controlling movements and speech, to the ‘involuntary’ muscles that operate the internal organs such as the heart and intestines, and to the various glands, including the sweat glands in the skin. (Details of the 12 pairs of cranial nerves and the 31 pairs of nerves emanating from the spinal cord are given in respective texts on brain and spinal cord.)

Functional divisions of nervous system As well as the nervous system’s anatomical divisions, the system is divided functionally, into autonomic and somatic parts. The autonomic nervous system, which is split into sympathetic and parasympathetic divisions, deals with the automatic or unconscious control of internal bodily activities such as heartbeat, muscular status of blood vessels, digestion and glandular functions. The somatic system is responsible for the skeletal (voluntary) muscles (see MUSCLE) which carry out intended movements initiated by the brain – for example, the activation of limbs, tongue, vocal cords (speech), anal muscles (defaecation), urethral sphincters (urination) or vaginal muscles (childbirth). In addition, many survival responses – the most powerfully instinctive animal drives, which range from avoiding danger and pain to shivering when cold or sweating when hot – are initiated unconsciously and automatically by the nervous system using the appropriate neural pathways to achieve the particular survival reaction required.

The complex functions of the nervous system include the ability to experience emotions, such as excitement and pleasure, anxiety and frustration, and to undertake intellectual activities. For these experiences an individual can utilise many built-in neurological programmes and he or she can enhance performance through learning – a vital human function that depends on MEMORY, a three stage-process in the brain of registration, storage and recall. The various anatomical and functional divisions of the nervous system that have been unravelled as science has strived to explain how it works may seem confusing. In practical terms, the nervous system works mainly by using automatic or relex reactions (see REFLEX ACTION) to various stimuli (described above), supplemented by voluntary actions triggered by the activity of the conscious (higher) areas of the brain. Some higher functions crucial to human activity – for example, visual perception, thought, memory and speech – are complex and subtle, and the mechanisms are not yet fully understood. But all these complex activities rest on the foundation of relatively simple electrochemical transmissions of impulses through the massive network of billions of specialised cells, the neurones.... nervous system

Autonomic Nervous System

Part of the nervous system which regulates the bodily functions that are not under conscious control: these include the heartbeat, intestinal movements, salivation, sweating, etc. The autonomic nervous system consists of two main divisions – the SYMPATHETIC NERVOUS SYSTEM and the PARASYMPATHETIC NERVOUS SYSTEM. The smooth muscles, heart and most glands are connected to nerve ?bres from both systems and their proper functioning depends on the balance between these two. (See also NERVES; NERVOUS SYSTEM.)... autonomic nervous system

Extrapyramidal System

This is a complex part of the nervous system, extending from the cortex to the medulla in the BRAIN, from which emerge descending spinal pathways which in?uence voluntary motor activity throughout the body. Although the normal functions of the system are poorly understood, there are characteristic signs of an extrapyramidal LESION. These include disturbance of voluntary movements, notably slowness and ‘poverty’ of movement; disturbance of muscular tone, which may be increased or decreased; and involuntary movements, such as a tremor, irregular jerking movements, or slow writhing movements.

Diseases There are several diseases that result from lesions to the extrapyramidal system, of which the most common is PARKINSONISM. Others include WILSON’S DISEASE, KERNICTERUS, CHOREA and ATHETOSIS.... extrapyramidal system

Optic Atrophy

A deterioration in the ?bres of the optic nerve (see EYE) resulting in partial or complete loss of vision. It may be caused by damage to the nerve from in?ammation or injury, or the atrophy may be secondary to disease in the eye.... optic atrophy

Peripheral Nervous System

See NERVOUS SYSTEM.... peripheral nervous system

System

A network of interdependent components that work together to attain the goals of the complex whole.... system

Sympathetic Nervous System

Part of the AUTONOMIC NERVOUS SYSTEM. It consists of scattered collections of grey matter known as ganglia, united by an irregular network of nerve-?bres; those portions where the ganglia are placed most closely and where the network of ?bres is especially dense being known as plexuses. The chief part of the sympathetic system consists of two ganglionated cords that run through the neck, chest, and abdomen, lying close in front of the spine. In conjunction with the other part of the autonomic nervous system – the parasympathetic – this part controls many of the body’s involuntary activities involving glands, organs and other tissues. (For further details, see NERVOUS SYSTEM.)... sympathetic nervous system

Lymphatic System

Lymph is the same fluid which oozes from a cut when bleeding stops. It surrounds every living cell. Lymph conveys to the blood the final products of digestion of food. It also receives from the blood waste products of metabolism. This is a two-way traffic.

Lymph fluid, loaded with waste, excess protein, etc, is sucked into the lymph tubes to be filtered by the spleen and the lymph nodes. The tubes are filled with countless one-way valves referred to collectively as the lymphatic pump, which propels the flow of lymph forwards. Lymph ultimately is collected in the main thoracic duct rising upwards in front of the spine to enter the bloodstream at the base of the neck.

A number of disorders may arise when the fluid becomes over-burdened by toxaemia, poor drainage and enlarged nodes (glands). Such un-eliminated wastes form cellulite – unwanted tissue formation and swelling. Thus, the soil may be prepared for various chronic illnesses from glandular disorders to arthritis. If the lymph is circulating freely it is almost impossible to become sick.

This system is capable of ingesting foreign particles and building up an immunity against future infection. Some herbal Lymphatics are also antimicrobials, natural alternatives to conventional antibiotics.

Treatment. Clivers is particularly relative to glandular swellings of neck and axillae.

For active inflammation: Echinacea, Goldenseal, Ginseng (Panax).

Alternatives. Teas: Clivers, Red Clover, Agnus Castus herb, Bladderwrack, Violet leaves, Marigold petals.

Decoctions: Blue Flag, Echinacea, Fenugreek seeds, Saw Palmetto.

Tablets/capsules. Agnus Castus, Echinacea, Bladderwrack, Red Clover, Thuja, Poke root, Fenugreek. Formula No 1. Echinacea 2; Clivers 1; Burdock 1; Poke root half. Dose: Liquid Extracts: one 5ml teaspoon. Tinctures: two 5ml teaspoons. Powders: 500mg (two 00 capsules or one-third teaspoon). Thrice daily.

Formula No 2. Equal parts: Blue Flag root, Poke root, Senna. Dose: as above.

Topical. Poultices: Slippery Elm, Fenugreek seeds, Marshmallow. Horsechestnut (Aesculus) ointment. ... lymphatic system

Cardiovascular System

This refers to the whole circulatory system: the heart, the systemic circulation (the arteries and veins of the body) and the pulmonary circulation (the arteries and veins of the lungs). Blood circulates throughout the cardiovascular system bringing oxygen and nutrients to the tissues and removing carbon dioxide and other waste products.... cardiovascular system

Multiple Personality Disorder

The individual with this psychiatric disorder has two or more di?erent personalities, often contrasting. The dominant personality at the time determines the behaviour and attitude of the individual, who customarily seems not to know about the other personality – or personalities. The switch from one personality to another is abrupt and the mental condition of the di?ering personalities is usually normal. It is possible that child abuse is a factor in the disorder, which is treated by psychotherapy. The classic multiple personality was the ?ctional form of Dr Jekyll and Mr Hyde.... multiple personality disorder

Hla System

The major histocompatibility complex, or human leucocyte antigen (HLA) region, consists of genetically determined antigens, situated on chromosome 6. Found in most tissues, though to a di?ering extent, the four gene loci are known as A, B, C, D, while the individual alleles at each locus are numbered 1, 2, 3, etc. The number of possible combinations is thus enormous, and the chance of two unrelated people being identical for HLA is very low.

HLA incompatibility causes the immune response, or rejection reaction, that occurs with unmatched tissue grafts. Strong associations between HLA and susceptibility to certain diseases – notably the AUTOIMMUNE DISORDERS such as rheumatoid arthritis, insulin-dependent diabetes, and thyrotoxicosis – have been described. Certain HLA antigens occur together more frequently than would be expected by chance (linkage disequilibrium), and may have a protective e?ect, conferring resistance to a disease. (See IMMUNITY.)... hla system

Portal System

A vein or collection of veins which ?nish at both ends in a bed of capillary blood vessels. An important example is the hepatic portal system, comprising the portal vein and its tributaries. Blood from the stomach, pancreas, spleen and intestines drains into the veins that join up to comprise the portal vein into the liver, where it branches into sinusoids.... portal system

Reproductive System

A collective term for all the organs involved in sexual reproduction. In the female these are the OVARIES, FALLOPIAN TUBES, UTERUS, VAGINA and VULVA. In the male these are the testes (see TESTICLE), VAS DEFERENS, SEMINAL VESICLES, URETHRA and PENIS.... reproductive system

Parasympathetic Nervous System

That part of the AUTONOMIC NERVOUS SYSTEM which is connected with the BRAIN and SPINAL CORD through certain nerve centres in the midbrain, medulla, and lower end of the cord. The nerves from these centres are carried in the third, seventh, ninth and tenth cranial nerves and the second, third and fourth sacral nerves. The action of the parasympathetic system is usually antagonistic to that of the sympathetic system. Thus it inhibits the action of the HEART and augments the action of the INTESTINE; whereas the sympathetic augments the action of the heart and inhibits that of the intestine. (See diagram of sympathetic and parasympathetic nervous systems under NERVOUS SYSTEM.)... parasympathetic nervous system

Circulatory System

The heart and blood vessels, which together maintain a continuous flow of blood throughout the body. The system provides tissues with oxygen and nutrients, and carries away waste products. The circulatory system consists of 2 main parts: the systemic circulation, which supplies blood to the whole body apart from the lungs; and the pulmonary circulation to the lungs. Within the systemic circulation, there is a bypass (the portal circulation), which carries nutrient-rich blood from the stomach, intestine, and other digestive organs to the liver for processing, storage, or re-entry into general circulation.

In the systemic circulation, oxygen-rich blood from the pulmonary circulation is pumped under high pressure from the left ventricle of the heart into the aorta, from where it travels through arteries and smaller arterioles to all parts of the body. Within body tissues, the arterioles branch into networks of fine blood vessels called capillaries. Oxygen and other nutrients pass from the blood through the capillaries’ thin walls into body tissues; carbon dioxide and other wastes pass in the opposite direction. Deoxygenated blood is returned to the heart via venules, veins, and the venae cavae.

Venous blood returns to the right atrium of the heart to enter the pulmonary circulation. It is pumped from the right ventricle through the pulmonary artery

to the lungs, where carbon dioxide is exchanged for oxygen. The reoxygenated blood then returns through the pulmonary veins to the heart and re-enters the systemic circulation.... circulatory system

All Payer System

A system in which prices for health services and payment methods are the same, regardless of who is paying. For instance, in an all payer system, federal or state government, a private insurer, a self-insured employer plan, an individual, or any other payer could pay the same rates. The uniform fee bars health care providers from shifting costs from one payer to another. See “cost shifting”.... all payer system

Alternative Medical System

A complete system of theory and practices that has evolved independently of, and often prior to, the conventional biological approach. Many are traditional systems of medicine that are practised by individual cultures throughout the world. Traditional Oriental medicine and Ayurveda, India’s traditional system of medicine, are two examples.... alternative medical system

Appointment Scheduling System

A system for planning of appointments between resources such as clinicians and facilities and patients. It is used in order to minimize waiting times, prioritize appointments and optimize the utilization of resources.... appointment scheduling system

Assessment System

A structured process developed to ensure that assessment is relevant, consistent, fair and valid. The system requires rules of operation, a regular review process and competent assessors.... assessment system

Buffering System

The several blood factors that enable the acid waste products of metabolism to be carried in the alkaline blood without disrupting its chemistry. These include carbolic acid, carbonates, phosphates, electrolytes, blood proteins, and erythrocyte membranes.... buffering system

Circulatory System Of The Blood

The course of the circulation is as follows: the veins pour their blood, coming from the head, trunk, limbs and abdominal organs, into the right atrium of the HEART. This contracts and drives the blood into the right ventricle, which then forces the blood into the LUNGS by way of the pulmonary artery. Here it is contained in thin-walled capillaries, over which the air plays freely, and through which gases pass readily out and in. The blood gives o? carbon dioxide (CO2) and takes up oxygen (see RESPIRATION), and passes on by the pulmonary veins to the left atrium of the heart. The left atrium expels it into the left ventricle, which forces it on into the aorta, by which it is distributed all over the body. Passing through capillaries in the various tissues, it enters venules, then veins, which ultimately unite into two great veins, the superior and the inferior vena cava, these emptying into the right atrium. This complete circle is accomplished by any particular drop of blood in about half a minute.

In one part of the body there is a further complication. The veins coming from the bowels, charged with food material and other products, split up, and their blood undergoes a second capillary circulation through the liver. Here it is relieved of some food material and puri?ed, and then passes into the inferior vena cava, and so to the right atrium. This is known as the portal circulation.

The circle is maintained always in one direction by four valves, situated one at the outlet from each cavity of the heart.

The blood in the arteries going to the body generally is bright red, that in the veins dull red in colour, owing to the former being charged with oxygen and the latter with carbon dioxide (see RESPIRATION). For the same reason the blood in the pulmonary artery is dark, that in the pulmonary veins is bright. There is no direct communication between the right and left sides of the heart, the blood passing from the right ventricle to the left atrium through the lungs.

In the embryo, before birth, the course of circulation is somewhat di?erent, owing to the fact that no nourishment comes from the bowels nor air into the lungs. Accordingly, two large arteries pass out of the navel, and convey blood to be changed by contact with maternal blood (see PLACENTA), while a large vein brings this blood back again. There are also communications between the right and left atria, and between pulmonary artery and aorta. The latter is known as the ductus arteriosus. At birth all these extra vessels and connections close and rapidly shrivel up.... circulatory system of the blood

Clinical Information System

An information system that collects, stores and transmits information that is used to support clinical applications (e.g. transmission of laboratory test results, radiology results, prescription drug orders). Electronic medical records are one method by which clinical information systems can be created.... clinical information system

Complement System

This is part of the body’s defence mechanism that comprises a series of 20 serum peptides (see PEPTIDE). These are sequentially activated to produce three signi?cant effects: ?rstly, the release of small peptides which provoke in?ammation and attract phagocytes (see PHAGOCYTE); secondly, the deposition of a substance (component C3b) on the membranes of invading bacteria or viruses, attracting phagocytes to destroy the microbes; thirdly, the activation of substances that damage cell membranes – called lytic components – which hasten the destruction of ‘foreign’ cells. (See IMMUNOLOGY.)... complement system

Cleavers Tea - Best Tonic For The Lymphatic System Available In Nature

Cleavers tea has been used for centuries, even in ancient Greece. It is considered probably the best tonic for the lymphatic system available. Discover all of its benefits and learn how to make the most of this type of tea. Description of Cleavers tea Cleavers is an annual green plant that grows mostly in Britain, North America and Eurasia regions. The green to white flowers look like small balls and they are very sticky, similar to the leaves. Scientifically named gallium aparine, cleavers is also called bedstraw, barweed, catchweed, grip grass. The entire cleavers plant is used in herbal medicine and is harvested just before it blooms in early summer. The active constituents of cleavers tea are chlorophyll, citric acide, rubichloric acid, galiosin and tannins. To benefit the most from these constituents, you can consume cleavers, usually found in the form of tea, extracts, capsule, or fresh for many cooking recipes. The roasted seeds are used as a coffee substitute and the young leaves can be eaten like spinach. Cleavers tea has a slightly bitter taste and no odor. Cleavers tea brew For a tasty Cleavers tea, take 2 to 3 teaspoons of the dried above-ground parts of the plant and infuse them in a 250 mg cup of hot water for 10 or 15 minutes. You may add sugar or honey to improve its taste and drink up to three times per day. Cleavers tea  Benefits Cleavers tea is a strong detoxifying for the lymphatic system. It is diuretic, thus treating most of urinary tract infections. It cleans the blood, the liver and kidneys. The tea can be used together with Uva Ursi or Echinacea for best results. Applied topically, Cleavers tea helps in the treatment of many skin conditions like acne, eczema, psoriasis, dandruff, itchy scalp, sunburns or even wounds. Cleavers tea can be used as a facial tonner because it helps clear the complexion. Cleavers tea Side effects Cleavers tea has no known side effects. Though it is widely safe, children, pregnant or nursing women should drink it with precaution. Cleavers tea can surely be included in a healthy lifestyle. As long as you don’t exaggerate with it, you can enjoy the benefits of this tea and even use the plant to prepare many tasty recipes and salads.... cleavers tea - best tonic for the lymphatic system available in nature

Comprehensive Health System

A health system that includes all the elements required to meet all the health needs of the population.... comprehensive health system

Decision Support System

See “decision analysis”.... decision support system

Disuse Atrophy

The wasting of muscles after prolonged immobility. This can be seen after lengthy immobilisation in a plaster cast, and is particularly severe following paralysis of a limb through nerve injury. (See ATROPHY.)... disuse atrophy

Health Care Delivery System

See “health system”.... health care delivery system

Health Information System

The generation and the use of appropriate health information to support decision-making, health care delivery and management of health services at national and subnational level.... health information system

Health System Infrastructure

Services, facilities, institutions, personnel or establishments, organizations and those operating them for the delivery of a variety of health programmes.... health system infrastructure

Integrated Delivery System / Integrated Services Network (isn)

A network of organizations, usually including hospitals and medical practitioner groups, that provides or arranges to provide a coordinated continuum of services to a defined population and is held both clinically and financially accountable for the outcomes in the populations served.... integrated delivery system / integrated services network (isn)

Management Information System

A system of databases designed to process and exchange information to support decision-making as well as implementation, monitoring and evaluation of programmes, activities and projects. See also “health information system”.... management information system

Multiple Risk / Causation

More than one risk factor for the development of a disease or other outcome is present and their combined presence results in an increased risk. The increased risk may be due to the additive effects of the risks associated with the separate risk factors, or to synergism.... multiple risk / causation

Health System

The people, institutions and resources, arranged together in accordance with established policies, to improve the health of the population they serve, while responding to people’s legitimate expectations and protecting them against the cost of ill-health through a variety of activities, the primary intent of which is to improve health. Health systems fulfil three main functions: health care delivery, fair treatment of all, and meeting non-health expectations of the population. These functions are performed in the pursuit of three goals: health, responsiveness and fair financing. A health system is usually organized at various levels, starting at the community level or the primary level of health care and proceeding through the intermediate (district, regional or provincial) to the central level.... health system

Multiple Births

Twins occur about once in 80 pregnancies, triplets once in 6,000, and quadruplets about once in 500,000. Quintuplets are exceedingly rare. Such is the natural state of a?airs.

In recent years, however, the position has been altered by the introduction of the so-called fertility drugs, such as CLOMIPHENE, and human menopausal gonadotrophin which, through the medium of the PITUITARY GLAND, stimulate the production of ova (see OVUM). Their wide use in the treatment of INFERTILITY has resulted in an increase in the number of multiple births, a recognised hazard of giving too large a dose.

Twins may be binovular or uniovular. Binovular, or fraternal, twins are the result of the mother’s releasing two ova within a few days of each other and both being fertilised by separate spermatozoa (see SPERMATOZOON). They both develop separately in the mother’s womb and are no more alike than is usual with members of the same family. They are three times as common as uniovular, or identical, twins, who are developed from a single ovum fertilised by a single spermatozoon, but which has split early in development. This is why they are usually so remarkably alike in looks and mental characteristics. Unlike binovular twins, who may be of the same or di?erent sex, they are always of the same sex.

So far as fraternal, or binovular, twins are concerned, multiple pregnancy may be an inherited tendency; it certainly occurs more often in certain families, but this may be partly due to chance. A woman who has already given birth to twins is ten times more likely to have another multiple pregnancy than one who has not previously had twins. The statistical chance of a third pair of twins is 1:512,000. Identical twins do not run in families.

The relative proportion of twins of each type varies in di?erent races. Identical twins have much the same frequency all over the world: around 3 per 1,000 maternities. Fraternal twins are rare in Mongolian races: less than 3 per 1,000 maternities. In Caucasians they occur two or three times as often as identical twins: between 7 (Spain and Portugal) and 10 (Czech and Slovak Republics and Greece) per 1,000 maternities. They are more common in Afro-Caribbeans, reaching 30 per 1,000 maternities in certain West African populations.

Rarely, uniovular twins may not develop as separate individuals, being physically joined in some way. They are called conjoined or (traditionally) Siamese twins. Depending on the extent of common structures shared by the infants – this ranges from a common umbilical cord to twins with conjoined heads or a common liver – the infants may be successfully separated by surgery. (See CONJOINED TWINS.)

Parents of twins, triplets, etc. can obtain advice and help from the Twins and Multiple Births Association (TAMBA).... multiple births

Nervous System, Disorders Of

The following conditions are discussed under their individual headings: APHASIA; BRAIN, DISEASES OF; CATALEPSY; CHOREA; CRAMP; EPILEPSY; HYSTERIA; LEARNING DISABILITY; MEMORY; MENTAL ILLNESS; MULTIPLE SCLEROSIS (MS); NERVES, INJURIES TO; NEURALGIA; NEURITIS; PARALYSIS; PSYCHOSOMATIC DISEASES; SPINE AND SPINAL CORD, DISEASES AND INJURIES OF; STROKE; TABES.... nervous system, disorders of

Multiple Sclerosis (ms)

Multiple sclerosis is a progressive disease of the BRAIN and SPINAL CORD, which, although slow in its onset, in time may produce marked symptoms such as PARALYSIS and tremors (see TREMOR), and may ultimately result in a severely disabled invalid. The disorder consists of hardened patches, from the size of a pin-head to that of a pea or larger, scattered here and there irregularly through the brain and spinal cord. Each patch is made up of a mass of the CONNECTIVE TISSUE (neuroglia), which should be present only in su?cient amount to bind the nerve-cells and ?bres together. In the earliest stage, the insulating sheaths (MYELIN) of the nerve-?bres in the hardened patches break up, are absorbed, and leave the nerve-?bres bare, the connective tissue being later formed between these.

Cause Although this is one of the most common diseases of the central nervous system in Europe – there are around 50,000 affected individuals in Britain alone – the cause is still not known. The disease comes on in young people (onset being rare after the age of 40), apparently without previous illness. The ratio of women-to-men victims is 3:2. It is more common in ?rst and second children than in those later in birth order, and in small rather than big families. There may be a hereditary factor for MS, which could be an autoimmune disorder: the body’s defence system attacks the myelin in the central nervous system as if it were a ‘foreign’ tissue.

Symptoms These depend greatly upon the part of the brain and cord affected by the sclerotic patches. Temporary paralysis of a limb, or of an eye muscle, causing double vision, and tremors upon exertion, ?rst in the affected parts, and later in all parts of the body, are early symptoms. Sti?ness of the lower limbs causing the toes to catch on small irregularities in the ground and trip the person in walking, is often an annoying symptom and one of the ?rst to be noticed. Great activity is shown in the re?ex movements obtained by striking the tendons and by stroking the soles of the feet. The latter re?ex shows a characteristic sign (Babinski sign) in which the great toe bends upwards and the other toes spread apart as the sole is stroked, instead of the toes collectively bending downwards as in the normal person. Tremor of the eye movements (nystagmus) is usually found. Trembling handwriting, interference with the functions of the bladder, giddiness, and a peculiar ‘staccato’ or ‘scanning’ speech are common symptoms at a later stage. Numbness and tingling in the extremities occur commonly, particularly in the early stages of the disease. As the disease progresses, the paralyses, which were transitory at ?rst, now become con?rmed, often with great rigidity in the limbs. In many patients the disease progresses very slowly.

People with multiple sclerosis, and their relatives, can obtain help and guidance from the Multiple Sclerosis Society. Another helpful organisation is the Multiple Sclerosis Resources Centre. Those with sexual or marital problems arising out of the illness can obtain information from SPOD (Association to Aid the Sexual and Personal Relationships of People with a Disability). (See APPENDIX 2: ADDRESSES: SOURCES OF INFORMATION, ADVICE, SUPPORT AND SELFHELP.)

Treatment is di?cult, because the most that can be done is to lead a life as free from strain as possible, to check the progress of the disease. The use of INTERFERON beta seems to slow the progress of MS and this drug is licensed for use in the UK for patients with relapsing, remitting MS over two years, provided they can walk unaided – a controversial restriction on this (expensive) treatment. CORTICOSTEROIDS may be of help to some patients.

The NATIONAL INSTITUTE FOR CLINICAL EXCELLENCE (NICE) ruled in 2001 that the use of the drugs interferon beta and glatiramer acetate for patients with multiple sclerosis was not cost-e?ective but recommended that the Department of Health, the National Assembly for Wales and the drug manufacturers should consider ways of making the drugs available in a cost-e?ective way. Subsequently the government said that it would consider funding a ‘risk-sharing’ scheme in which supply of drugs to patients would be funded only if treatment trials in individuals with MS showed that they were e?ective.

The Department of Health has asked NICE to assess two CANNABIS derivatives as possible treatments for multiple sclerosis and the relief of post-operative pain. Trials of an under-thetongue spray and a tablet could, if successsful, lead to the two drugs being available around 2005.

It is important to keep the nerves and muscles functioning, and therefore the patient should remain at work as long as he or she is capable of doing it, and in any case should exercise regularly.... multiple sclerosis (ms)

Organized Delivery System

See “integrated delivery system”.... organized delivery system

Pluralistic System

A system that is based on incorporating divergent provider modalities (e.g. public, private, non-profit, etc.).... pluralistic system

Prospective Payment System

A system whereby reimbursement rates are set for a given period of time prior to the circumstances giving rise to actual reimbursement claims.... prospective payment system

Reticulo-endothelial System

This consists of highly specialised cells scattered throughout the body, but found mainly in the SPLEEN, BONE MARROW, LIVER, and LYMPH nodes or glands. Their main function is the ingestion of red blood cells and the conversion of HAEMOGLOBIN to BILIRUBIN. They are also able to ingest bacteria and foreign colloidal particles.... reticulo-endothelial system

Sudek’s Atrophy

Osteoporosis (see under BONE, DISORDERS OF) in the hand or foot which develops quickly as a result of injury, infection or malignant growth.... sudek’s atrophy

Liver – Acute Yellow Atrophy

Necrosis. Fatal disease in which the substance of the liver is destroyed. Incidence is rare since the public has been alerted to the dangers of certain chemical toxins, fumes from synthetic glues, solvents, and poisonous fungi.

Symptoms: jaundice, delirium and convulsions.

As it is the work of the liver to neutralise incoming poisons it may suffer unfair wear and tear, alcohol and caffeine being common offenders.

Treatment for relief of symptoms only: same as for abscess of the liver.

Treatment by or in liaison with a general medical practitioner. ... liver – acute yellow atrophy

Endocrine System

The collection of glands around the body that produce hormones.

These glands include the thyroid gland, pancreas, testes, ovaries, and adrenal glands.

Their hormones are responsible for numerous bodily processes, including growth, metabolism, sexual development and function, and response to stress.

Any increase or decrease in the production of a specific hormone interferes with the process it controls.

To prevent under- or overproduction, hormone secretion from many endocrine glands is regulated by the pituitary gland, which is in turn influenced by the hypothalamus in the brain according to a feedback mechanism.... endocrine system

Picture Archiving And Communications System (pacs)

The use of digital imaging systems to replace conventional X-ray pictures and other imaging techniques. Though expensive to operate, digital imaging and storage systems o?er promising possibilities for transmission of clinical images within and between hospitals and community health-care units, providing fast access and remote working that will bene?t patients and health-care sta? alike. When security and con?dentiality are assured, images could be transferred via the Internet and teleradiology. In future, hospitals might be able to eliminate the costly physical transfer and storage of X-ray ?lms. The integration of PACS with hospital information systems in the NHS will (hopefully) facilitate the introduction of electronic radiology.... picture archiving and communications system (pacs)

Tea For Immune System

Your immune system consists of a series of antibodies and other microorganisms whose main purpose is to defend your system against external attacks. When we have a cold or flu, the main thing that keeps us alive is this line of defense that keeps all bacteria, infections and microbes away from us. Unfortunately, our immune system is not strong enough to fight all causes, so we need to enhance its power by taking a treatment. How a Tea for Immune System Works A Tea for Immune System must contain enough active constituents to fight a wide range of diseases. First of all, it must contain minerals, manganese, magnesium, iron, volatile oils, acids, tannins, nutrients and enzymes. These teas can be taken as cures for a short amount of time (1 or 2 weeks) to enhance your body strength, so you mustn’t exaggerate when taking it. Efficient Tea for Immune System A Tea for Immune System must contain a lot of active constituents and it must be very effective. If you don’t know which teas to choose from, here’s a list to guide you on: - Garlic Tea – can be found almost anywhere on the globe and it has a wide range of uses, from cuisine to pharmaceutical purposes. Also a great cure for diarrhea, this Tea for Immune System has a rather unpleasant taste and smell. Feel free to add honey, lemon, ginger or mint in order to make it more adequate. - Green Tea – probably the most important tea in the world, Green Tea contains all the ingredients necessary to promote a healthy life, full of great benefits. However, don’t take it in case you suffer from menstrual and menopausal pains in order to avoid stomach and uterus irritations. - Yerba Mate Tea – the South American tea has a series of health advantages and it’s been named by the scientific society “the new green tea”. Drink it from a traditional bombilla or straight from a normal glass, but make sure you know which the risks are and that you’re taking this treatment under supervision. - Ginseng Tea – this wonderful Chinese Tea is used as a main ingredient in the Asian cuisine, but also as a great adjuvant in cases of nausea, vomiting and auto-immune deficiencies. However, make sure that you’re using the right amount of herbs when preparing this decoction in order to avoid developing a acid foods and drinks intolerance! Tea for Immune System Side Effects When taken properly, these teas are generally safe. However, drinking more tea than it’s recommended may lead to constipation, upset stomach or even death. Talk to your doctor before starting any kind of herbal treatment and find out which are the risks. Don’t take a treatment based on a Tea for Immune System if you’re pregnant, breastfeeding, on anti coagulants, blood thinners or preparing for a surgery. Also, children must be kept away from these teas since there’s no study to prove how safe it is for them. When in doubt, always ask your doctor. If he says there’s nothing that could interfere with your treatment, choose a tea that fits you best and enjoy its health benefits!... tea for immune system

Multiple Personality

A rare disorder in which a person has 2 or more distinct personalities, each of which dominates at different times. The personalities are usually very different from each other.... multiple personality

Multiple Pregnancy

See pregnancy, multiple.... multiple pregnancy

Myeloma, Multiple

See multiple myeloma.... myeloma, multiple

Peroneal Muscular Atrophy

A rare, inherited disorder characterized by muscle wasting in the feet and calves and then in the hands and forearms.

The condition, also known as Charcot–Marie– Tooth disease, is caused by degeneration of some peripheral nerves.

It is more common in boys, and usually appears in late childhood or adolescence.

Muscle wasting stops halfway up the arms and legs, making them look like inverted bottles; sensation may be lost.

There is no treatment, but the sufferer rarely becomes totally incapacitated because the disease usually progresses very slowly.

Life expectancy is normal.... peroneal muscular atrophy

Pregnancy, Multiple

The presence of more than 1 fetus in the uterus. Multiple pregnancy can occur if 2 or more ova (eggs) are fertilized at the same time, or if a single fertilized egg divides early in development.

Twins occur in about 1 in 80 pregnancies, triplets in about 1 in 8,000, and quadruplets in about 1 in 73,000.

Multiple pregnancies are more common in women who are treated with fertility drugs or if a number of fertilized ova are implanted during in vitro fertilization.... pregnancy, multiple

Progressive Muscular Atrophy

A type of motor neuron disease in which the muscles of the hands, arms, and legs become weak and wasted and twitch involuntarily. The condition eventually spreads to other muscles.... progressive muscular atrophy

Tea For Nervous System

The nervous system is responsible for almost any reaction that comes from your body. From eyes to muscles and even hair, your body is a very complex electric system directed by your brain. Most of the problems that a person has in a lifetime are related to a nervous system failure. In order to treat this kind of problems or prevent them from happening, you may want to try a tea instead of all those traditional pills. How a Tea for Nervous System Works A Tea for Nervous System is indeed helpful if it contains an important amount of nutrients, enzymes, tannins, volatile oils and minerals (sodium, iron, magnesium and manganese). You may want to avoid a tea that has an elevated acids level since it may cause you even more damages. A Tea for Nervous System will make your body send all the active constituents to the affected areas and heal the damaged tissue. Efficient Tea for Nervous System In order to work properly, a Tea for Nervous System must show results in a short time period and be one hundred percent safe (you don’t want any more complications than you already have). However, before starting any kind of herbal treatment, remember to take the indicated dose and never surpass it in order to avoid other health problems. If you don’t know which teas could be helpful for you, here’s a list for guidance: - Oolong Tea – contains half the amount of caffeine that other teas have so it’s best for your health to give it a try every once in a while. This Tea for Nervous System will also strengthen your entire organism and rejuvenate the aspect of your skin. However, don’t drink more than 2 cups per day. - Green Tea – as the scientists have proved, this decoction contains all the ingredients necessary to sustain life, so it’s good for a number of other health complaints, such as infertility, headaches, nausea, loss of appetite, anemia and asthenia. Just make sure you avoid it at all costs in case you’re experiencing some menstrual or menopausal symptoms (it may cause uterine contractions and internal bleedings). - Black Tea – some say that it does more damages than good for your nervous system and some others think that this tea is worth a try. Having an elevated level of caffeine, this tea is highly addictive. In right amount, it can treat infertility, erectile dysfunctions, sore throats and colds. However, ask an herbalist before starting a treatment based on this Tea for Nervous System in order to find out which are the risks. Tea for Nervous System Side Effects When taken according to specifications, these teas are generally safe. However, exceeding the number of cups recommended per day may lead to other health complaints, such as nausea, diarrhea, uterine contractions, internal bleedings and headaches. If you’ve tried one of these teas and something doesn’t feel quite right, talk to your doctor as soon as possible! Don’t take a Tea for Nervous System if you’re pregnant, breastfeeding, on blood thinners or anticoagulants. The same advice if you’re preparing for a surgery (some of the active compounds in these teas may interfere with your anesthetic and cause death). But if you have the green light from your doctor, choose a tea that fits best your requirements and enjoy its wonderful health benefits!... tea for nervous system

Sudeck’s Atrophy

Swelling and loss of use of a hand or foot after a fracture or other injury.

Treatment includes elevation of the affected hand or foot, gentle exercise, and heat treatment.

Full recovery is usual within about 4 months.... sudeck’s atrophy

Urinary System

See urinary tract.... urinary system

Abo System

see blood group.... abo system

Apache Scoring System

acute physiological and chronic health evaluation: a tool used to assess the severity of illness in a critically ill patient and to estimate mortality. The assessment uses information from 12 physiological measurements, including temperature, blood pressure, arterial pH, and certain blood results.... apache scoring system

Early Warning System

(EWS) a system to detect deteriorating patients on the ward. Certain physical parameters are accorded scores: the higher the scores for individual patients, the greater the deterioration in their condition. Parameters scored include blood pressure, respiratory rate, pulse rate, blood oxygen saturation, and level of consciousness. Adjustments can be made for increased age.... early warning system

Biliary System

The organs and ducts by which bile is formed, concentrated, and carried from the liver to the duodenum (the first part of the small intestine). Bile is secreted by the liver cells and collected by a network of bile ducts that carry the bile out of the liver by way of the hepatic duct. A channel called the cystic duct branches off the hepatic duct and leads to the gallbladder where bile is concentrated and stored. Beyond this junction, the hepatic duct becomes the common bile duct and opens into the duodenum at a controlled orifice called the ampulla of Vater. The presence of fat in the duodenum after a meal causes secretion of a hormone, which opens the ampulla of Vater and makes the gallbladder contract, squeezing stored bile into the duodenum.

The main disorders affecting the biliary system are gallstones, congenital biliary atresia and bile duct obstruction.

(See also gallbladder, disorders of.)... biliary system

Digestive System

The group of organs responsible for digestion. It consists of the digestive tract (also known as the alimentary tract or canal) and various associated organs. The digestive tract consists of the mouth, pharynx, oesophagus, stomach, intestines, and the anus. The intestines are the small intestine (comprising the duodenum, jejunum, and ileum) and the large intestine (comprising the caecum, colon, and rectum). The associated organs, such as the salivary glands, liver, and pancreas, secrete digestive juices that break down food as it goes through the tract.

Food and the products of digestion are moved from the throat to the rectum by peristalsis (waves of muscular contractions of the intestinal wall).

Food is broken down into simpler substances before being absorbed into the bloodstream.Physical breakdown is performed by the teeth, which cut and chew, and the stomach, which churns the food. The chemical breakdown of food is performed by the action of enzymes, acids, and salts.

Carbohydrates are broken down into simple sugars. Proteins are broken down into polypeptides, peptides, and amino acids. Fats are broken down into glycerol, glycerides, and fatty acids.

In the mouth, saliva lubricates food and contains enzymes that begin to break down carbohydrates. The tongue moulds food into balls (called boli) for easy swallowing. The food then passes into the pharynx. From here, it is pushed into the oesophagus and squeezed down into the stomach, where it is mixed with hydrochloric acid and pepsin. Produced by the stomach lining, these substances help break down proteins. When the food has been converted to a semi-liquid consistency, it passes into the duodenum where bile salts and acids (produced by the liver) help to break down fats. Digestive juices released by the pancreas into the duodenum contain enzymes that further break down food. Breakdown ends in the small intestine, carried out by enzymes produced by glands in the intestinal lining. Nutrients are absorbed in the small intestine. The residue enters the large intestine, where water is absorbed. Undigested matter is expelled via the rectum and anus as faeces.... digestive system

Four-layer System

a continuous compression bandage consisting of four layers that are applied and left in situ for up to seven days to treat venous leg ulcers, increasing the chance of healing by up to 30%. Thorough assessment of the patient’s status must be undertaken before the application.... four-layer system

Gyrate Atrophy

a rare hereditary condition causing night blindness and constricted visual fields, usually developing in the first decade of life. Clinically it is characterized by a progressive atrophy of the choroid and retina.... gyrate atrophy

Haversian System

one of the cylindrical units of which compact *bone is made. A Haversian canal forms a central tube, around which are alternate layers of bone matrix (lamellae) and lacunae containing bone cells. The lacunae are linked by minute channels (canaliculi).... haversian system

Hereditary Multiple Exostoses

see exostosis.... hereditary multiple exostoses

House–brackmann Facial Nerve Grading System

(House–Brackmann score, House–Brackmann scale, House–Brackmann facial weakness scale) a six-point grading system for patients with *Bell’s palsy or other forms of facial nerve palsy. Grade I is normal function; grade VI is a total palsy. [J. W. House and D. E. Brackmann (21st century), US otorhinolarygologists]... house–brackmann facial nerve grading system

Human Leucocyte Antigen System

see HLA system.... human leucocyte antigen system

Multiple Myeloma

Also called myelomatosis, multiple myeloma is a rare, cancerous condition in which plasma cells in the bone marrow proliferate uncontrollably and function incorrectly. It occurs in middle- to old age.

Plasma cells are a type of B-lymphocyte that produce immunoglobulins, which help protect against infection. In multiple myeloma, the proliferating plasma cells produce excessive amounts of one type of immunoglobulin, while production of other types is impaired. This makes infection more likely.Proliferation of the abnormal cells causes pain and destroys bone tissue.

Affected vertebrae may collapse and compress nerves, causing numbness or paralysis. Blood calcium levels increase as bone is destroyed, as may the level of one or more immunoglobulins. These changes in the blood may damage the kidneys, leading to kidney failure. There may also be anaemia and a tendency for abnormal bleeding.

The disease is diagnosed by a bone marrow biopsy, by blood tests or urinalysis, and by X-rays. Treatment includes the use of anticancer drugs, radiotherapy, and supportive measures, including blood transfusions, antibiotic drugs, and analgesic drugs.... multiple myeloma

Muscular System

The muscles of the body that are attached to the skeleton. These muscles are responsible for voluntary movement, and also support and stabilize the skeleton. In most cases, a muscle attaches to a bone (usually by means of a tendon) and crosses over a joint to attach to another bone. Muscles can produce movement by contracting and shortening to pull on the bone to which they are attached. They can only pull, not push, and are therefore arranged so that the pull of one muscle or group of muscles is opposed to another, enabling a movement to be reversed. Although most actions of the skeletal muscles are under conscious control, reflex movements of certain muscles occur in response to stimuli.

There are more than 600 muscles in the body, classified according to the type of movement they produce.

An extensor opens out a joint, a flexor closes it; an adductor draws a part of the body inwards, an abductor moves it outwards; a levator raises it, a depressor lowers it; and constrictor or sphincter muscles surround and close orifices.... muscular system

Reproductive System, Female

The female organs involved in ovulation, sexual intercourse, nourishing a fertilized ovum until it has developed into a full-grown fetus, and childbirth. With the exception of the vulva, which protects the opening of the vagina, these organs lie within the pelvic cavity.

Ova (eggs) are released at monthly intervals from the 2 ovaries, which also secrete oestrogen hormone; and progesterone hormones that control the reproductive cycle. The ova travel through the fallopian tubes to the uterus. Fertilization takes place if a sperm released into the vagina during sexual intercourse travels through the cervix and uterus to penetrate an ovum while it is in the fallopian tube.... reproductive system, female

Reproductive System, Male

The male organs involved in the production of sperm and in sexual intercourse. Sperm and male sex hormones (androgen hormones) are produced in the testes, which are suspended in the scrotum. From each testis, sperm pass into an epididymis, where they mature and are stored. Shortly before ejaculation, sperm are propelled into a duct called the vas deferens, which carries the sperm to the seminal vesicles behind the bladder. These 2 sacs produce seminal fluid, which is added to the sperm to produce semen.

Semen travels along 2 ducts to the urethra.

The ducts pass through the prostate gland, which produces secretions that are added to the semen.

At orgasm, semen is ejaculated from the urethra through the erect penis, which is placed in the woman’s vagina during sexual intercourse.... reproductive system, male

Complaints System

a process that enables patients to voice concerns about the standard of care they receive. In the UK, any complaints should be raised as soon as possible, in the first instance locally with the NHS provider involved. Various statutory and voluntary advice and advocacy services are available to assist in this. If a patient is not satisfied with the outcome of local resolution, the matter can be referred to the *Parliamentary and Health Service Ombudsman. Legal action cannot usually proceed at the same time and only a small proportion of complaints proceed to law. Disciplinary procedures are separate from the complaints procedure although complaints may prompt or inform disciplinary action.... complaints system

Induction Loop System

(loop system) a device for helping people with some types of *hearing aid or *cochlear implant to hear more effectively in certain situations. Electrical signals from a television, sound system, or microphone are passed through an amplifier to a wire that is positioned in a loop encompassing the desired listening area. This creates an electromagnetic field that can be picked up by a coil within the hearing aid or cochlear implant. Induction loops are installed in such places as public buildings, lecture theatres, classrooms, and churches. See also assistive listening device.... induction loop system

Injury Scoring System

(injury severity scale, ISS) a system used, particularly in *triage, for grading the severity of an injury. See also abbreviated injury scale.... injury scoring system

Intrauterine System

see IUS.... intrauterine system

Leber’s Optic Atrophy

a rare hereditary disorder, usually affecting young males, that is characterized by loss of central vision due to neuroretinal degeneration. Visual loss in one eye is rapid and usually followed by loss in the second eye. [T. Leber]... leber’s optic atrophy

Loop System

see induction loop system.... loop system

Multiple Endocrine Neoplasia

(MEN) see MENS.... multiple endocrine neoplasia

Multiple Organ Dysfunction Syndrome

(MODS, multi-organ failure, multiple organ failure, MOF) a common cause of death following severe injury, overwhelming infection, or immune deficiency states.... multiple organ dysfunction syndrome

Neuroendocrine System

the system of dual control of certain activities of the body by means of both nerves and circulating hormones. The functioning of the autonomic nervous system is particularly closely linked to that of the pituitary and adrenal glands. The system can give rise to neuroendocrine tumours (NETs), which have special structural features and often produce active hormones. See also neurohormone; neurosecretion.... neuroendocrine system

Picture Archiving And Communication System

see PACS.... picture archiving and communication system

Pyramidal System

a collection of nerve fibres in the central nervous system that extend from the *motor cortex in the brain to the spinal cord and are responsible for initiating movement. In the medulla oblongata the fibres form a *pyramid (hence the name), within which they cross from one side of the brain to the opposite side of the spinal cord; this is called the decussation of the pyramids. Damage to the pyramidal system manifests in a specific pattern of weakness in the face, arms, and legs, abnormally brisk reflexes, and an extensor *plantar reflex (Babinski response).... pyramidal system

Radiology Information System

(RIS) a computer database used to keep details of all the patients attending a clinical radiology department. It records patient demographics, imaging procedures done, medications given and dosage, person performing the imaging, and time and place of examination. Radiologist reports interpreting the images will also feature here. The RIS is vital to the functioning of a picture archiving and communications system (see PACS) and the electronic medical record system.... radiology information system

Reticular Activating System

the system of nerve pathways in the brain concerned with the level of consciousness – from the states of sleep, drowsiness, and relaxation to full alertness and attention. The system integrates information from all of the senses and from the cerebrum and cerebellum and determines the overall activity of the brain and the autonomic nervous system and patterns of behaviour during waking and sleeping.... reticular activating system

Reticuloendothelial System

(RES) a community of cells – *phagocytes – spread throughout the body. It includes *macrophages and *monocytes. The RES is concerned with defence against microbial infection and with the removal of worn-out blood cells from the bloodstream. See also spleen.... reticuloendothelial system

Scoring System

any of various methods in which the application of an agreed numerical scale is used as a means of estimating the degree of a clinical situation, e.g. the severity of an injury, the degree of patient recovery, or the extent of malignancy. Examples include the *Glasgow Coma Scale (or scoring system) and the *injury scoring system.... scoring system

Single-payer System

a type of health-care system in which there is only one purchaser of health-care services, usually the government. The NHS is a single-payer system.... single-payer system

Spinal Muscular Atrophy

(SMA) a hereditary condition in which cells of the spinal cord die and the muscles in the arms and legs become progressively weaker. Eventually the respiratory muscles are affected and death usually results from respiratory infection. Most affected individuals are wheelchair-bound by the age of 20 and few survive beyond the age of 30. The gene responsible has been located: in affected children it is inherited as a double *recessive. There are three forms of the disease, based on severity of the symptoms and the age at which they appear. Type 1 (infantile spinal muscular atrophy) is the most acute and aggressive form of the condition (see Werdnig–Hoffmann disease). Type 2 develops between the ages of 6 months and 2 years and type 3 (Kugelberg–Welander disease), the least severe form, appears between 2 and 17 years of age.... spinal muscular atrophy

Sudek’s Atrophy

see complex regional pain syndrome. [P. H. M. Sudek (1866–1938), German surgeon]... sudek’s atrophy

Vascular System

see cardiovascular system.... vascular system

Vestibular System

those parts of the body involved in balance. The peripheral vestibular system, or *vestibular apparatus, is in the inner ear. The central vestibular system comprises those parts of the brain that are involved in balance. The central vestibular system receives other inputs as well as from the ear, in particular inputs from the eyes and proprioceptors.... vestibular system



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