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lec23 Nat part1

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Michael Baker

BCH210H1LECTURE 23Case Study Nat1Blood supply to the Brain and Stenosis2Embolus and Ischemia3LDL Cholesterol in Blood and Risk4Lipoproteins and Cholesterol5LDL production Internalization6Athersclerotic Plaque7Dietary Fat and Health8Arachidonate COX Eicosanoids and ASATransient Ischemic Attack Part INat is a 59 yearold male stock trader at the TSE oKnown as a very talkative individual by his familyoStressful life because of TSENat gave up smoking 10 months agooBefore this he smoked 45 cigarettes a dayNat 82 kg weight 175 cm tallRecently began medication to control hypertensionoHigh blood pressure oBefore meds BP 14590oNow with meds BP 12580 optimal BB12080One day at work Nat finds he cant talkHe can move and see and hear but cannot produce speechoInability to talk is called aphasiaSingle neurological deficitSuggesting that something is happening at the command centreoIf you can talk but you are talking gibberishcalleddysarthriaNat goes quickly to the Emergency at St MikesDuring aphasia found that he could not pick up a pen to write notes to communicate oWeakness on right sideSome 30 minutes after his aphasia began Nat finds his speech is coming backBut he has a tingling sensation in his right armoCan pick up a pen a bit better but still having a weird feelingNat is given a CT Head scan computed tomography where the neurologist can visualize Nats brainoXray around his head looking for problems Looking for bleeding since hypertension maybe he broke a blood vesselLooking for tumours that may be pressing on speech centresLooking for concussions accidents Neurologist finds that there is no bleeding or tumour present oTherefore more than likely it is a blood flow problem1BCH210H1LECTURE 23Blood Supply to BrainNeurologist also listens to the blood flow in Nats carotid arteries and detects an unusual sound over Nats left carotid artery oGently put stethoscope on both sides of neckoHearing high pitch on left carotid artery Bruitnoise neurologist is hearingTwo internal carotid arteries left and rightAlso two vertebral arteries left and rightoComing up from backboneoFuse to form basilar artery just before going into headAll three two internal carotid artery and basilar artery come together to form a ring in headoCalled circle of willis Get blood supply from three major arteries Circle supplies blood supply for entire brain Can get trouble with blood flow in any one of these arteriesoTrouble with basilproduce migraines Spasm ie contracts of artery What Nat has is called stenosisoAppears because he is getting problems on right side of body Left side of brain is affectedhearing high pitch in left carotid artery Nats left carotid artery has a narrowing Other tests ultrasound conform a narrowing of Nats left carotid arteryoThis is called stenosisoSound Bruit2
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