Heart

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Heart Attack

Heart:

The heart is a muscular organ that pumps blood containing the oxygen and nutrients the body needs. The heart weighs 200 to 425 grams. The main pumping chamber of the heart is the left ventricle. Heart is made up of three layers of tissue.

·                          Epicardium

·                         Myocardium

·                        Endocardium.

Functions of the heart:

·                        It pumps blood throughout the body.

·                       Controls heart rate.

·                       It maintains blood pressure.

·                      Pumping hormones and other vital substances to different parts of the              body.

·                      Receiving deoxygenated blood and carrying metabolic waste products             from the body and pumping it to the lungs for oxygenation.

              When the left ventricle contracts, it sends oxygen-rich blood through a         large artery called the aorta. The small arteries called coronary arteries             are connected to the aorta. Blood flows from the aorta through the                   coronary arteries to deliver oxygen and nutrients to the heart muscle.

Heart attack:

During a heart attack, blood flow through one of the coronary arteries may be severely reduced or completely blocked. Low blood flow may be due to the deposition of a fatty substance called plaque in the coronary arteries.

Signs and symptoms of heart attack:

·                          Pressure, tightness, pain, or a squeezing or aching sensation in the chest           or arms that may spread to the neck, jaw or back.

·                        Nausea, indigestion, heartburn or abdominal pain.

·                        Shortness of breath.

·                       Cold sweat.

·                      Excessive fatigue.

·                      Lightheadedness or sudden dizziness.

·                      Feeling of fullness.

·                      Anxiety

A heart attack, also called a myocardial infarction, happens when a part of the heart muscle does not get enough blood. Heart attacks are most likely to occur in the mornings and within the first few hours of waking. Heart disease can affect anyone, any age. 

Cardiologist may recommend that medications to treat a heart attack might include:

·                        Aspirin

·                     Clot blusters

·                    Other blood-thinning medications

·                     Nitroglycerin

·                     Morphine

·                   Beta blockers.

Best treatment for a heart attack:

 ·                    Clot dissolving drugs.

·                     Balloon angioplasty.

·                    Surgery or a combination of treatments.

To prevent risk of a heart attack:

·                       Stop smoking

·                       High blood cholesterol and high blood pressure under control by modifying the diet, losing weight, taking medication, or doing a combination of these things.

A diet that protects the heart:

The best diet for preventing heart disease is one that is full of fruits and vegetables, whole grains, nuts, fish, and vegetable oils.

Time	food
At 7:00AM	A cup of tea/coffee or green tea, or leftover rice gruel.
By8:30AM	Flaxseeds, almonds, walnuts, 50g each or 3Idlies/ 3crisp savory pancake (dosa)+ mint/ peanut/ celery/ tomato/ onion chutney.
11:00 - 11:30 AM	Red, yellow, and orange vegetable salad or Red, yellow, and orange fruits or boiled sugarbeet-150g, Buttermilk (In summer), Weekly once Strawberry-100grams.
12:00 -2:00PM	Brownrice100grams+1/2cup lentil based, vegetable stew (Sambar)+ 1cup greens Weekly twice Fish100g.
4:00 -6:00PM	Gingertea-1cup+Boiled Peas or rajma or black chickpeas 100g.
7:00 -9:00PM	Unleavened flat bread (Chapati)3+ hodgepodge (Vegetable kootu) or lentil based, vegetable stew, Weekly once Tofu paneer 100grams.

 Foods to avoid after a heart attack:

Fried foods: 

·       Reducing the blood cholesterol after a heart attack is one of the top methods for lowering the risk of a future heart attack or stroke.

·       Saturated and trans fats can lead to high blood cholesterol and build-up of plaque in the arteries, so it’s wise to cut fried foods from the diet.

·       Try frying or stir frying the favourite foods at home, using healthier fats like olive, vegetable and nut oils.

Hot dogs, sausage, and other processed meats:

·       Processed meats, like hot dogs, sausage and lunch meat, are loaded with sodium and nitrates. This can raise the blood pressure and the risk of another heart attack.

·       High blood pressure is particularly dangerous because there usually are not any symptoms.

·       Instead of grabbing a deli sandwich or hotdog for lunch, opt for a chicken breast sandwich or turkey burger.

Salted nuts and snacks:

·       To eat a smart diet for heart disease, you need to take note of where salt slips into the diet unexpectedly.

·       Nuts are rich with good-for-you-fats, but try to switch from salted to unsalted ones. The same goes for crackers and other savoury snacks.

Milk chocolate:

·       Milk chocolate isn’t the worst food to eat, but dark chocolate is much better for you if you are trying to improve the diet after a heart attack.

·       Milk chocolate contains more sugar and fat solids than the darker version.

·       Dark chocolate is packed with antioxidants and flavonoids, which can lower the blood pressure and reduce inflammation.

·       Look for dark chocolate that contains at least 60-70% cocoa.

Sugary baked goods:

·       A heart-healthy diet limits sweet treats because they often contain saturated fats that raise the blood cholesterol and refined sugar that sends the blood sugar levels skyrocketing.

·       If you have a sweet tooth, switch to fresh fruit if you are craving sugar.

·       Processed sweets may also contain sodium that you wouldn’t normally expect in a sugary snack.

Condiments and cream sauces:

·       Sauces are sneaky, adding refined sugar and fat to the diet.

·       Condiments such as salad dressing and ketchup may not seem sweet, but they contain sugar that can raise the blood sugar levels.

·       Cream sauces are also a food to avoid after a heart attack because they usually contain solid fats that could include saturated and trans fats and high-fat dairy products.

Fatty red meat:

·       Many experts don’t consider red meat to be a heart healthy food.

·       The problem is that often red meats are loaded with extra fat that can increase the cholesterol.

Sugary soda:

·       Sodas packed with sugar can raise the blood sugar levels and add stress to the walls of the arteries, increasing the risk for heart problems.

·       If you miss the sweetness, try infusing the water with strawberries or kiwi.

·       Iced coffee or tea are also healthier substitutes when you want a drink with a little extra flavour.

Too much alcohol:

·       Alcohol can put stress on the arteries by raising the blood pressure and blood sugar.

Note:

§  Fish oil tablets can be consumed with doctor’s advice.

§  Eating foods that increase good cholesterol and lower bad cholesterol are good for the heart.

§  Eating any food without frying it in oil, without applying spices, but steaming it is good for the heart.

§  Gingelly oil or groundnut oil or sunflower oil can be used 3 teaspoons daily. 

 

Spinal Cord

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Spinal Cord

The spinal cord is the communication gateway between the brain and spinal nerves, which innervate the trunk and limbs. The cord is a long, tube-like band of nervous tissue. It is enclosed in 3 membranes of the meninges which in turn, are protected within the bones of the vertebral column. It connects the brain to the lower back.

The 31 pairs of the spinal nerves arise from the cord and emerge from the vertebrae. The spinal cord extends from the brain stem to the level of upper lumbar vertebrae. In the lower lumbar and sacral regions, nerve roots disembark within the spinal canal before exiting, forming the cauda equina. In cross section, two types of nervous tissue can be seen in the cord. A butterfly- shaped central core of grey matter, and a surrounding white matter.

Functions of spinal cord:

·        Control body movements and functions.                                                               It carries nerve signals from brain to body and vice versa.

·      Report senses to brain.                                                   

     Signals from other parts of the body help the brain record and process sensations such as pressure or pain.

·        Manage Reflexes.  Spinal cord controls certain reflexes with involving the brain.

Grey matter:

Grey matter is a darker hue. The grey matter contains cell bodies and dendrites of neurons. This is where neurons synapse and transmit information to each other.

White matter:

White matter appears pinkish- white. The white matter, on the other hand, is made of bundles of axons, and serves to conduct information up and down the cord. The white matter of the spinal cord contains a mixture of ascending and descending tracts.

Ascending tract   - sensory or afferent                                                                    Descending tract - motor or efferent.

Spinal tracts:

Bundles of axons are organized into specific groups with specific functions, forming the so-called spinal tracts. Spinal tracts are pathways that carry certain type of information, in a one-way traffic up and down the spinal cord between brain and body.

Ascending tracts conduct sensory information up to the brain, while descending tracts convey motor instructions down the cord.

Key facts about the ascending and descendingtracts:

·        Lateral spinothalamic - Pain and temperature.

·        Ventral spinothalamic - Pressure and crude touch.

·        Dorsal column               - Vibration, proprioception, two- point discrimination.

·        Spinocerebellar             - Proprioception in joints and muscles.

·        Cuneocerebellar            - Proprioception in joints and muscles.

·        Spinotectal                     - Tactile, painful, and thermal stimuli.

·        Spinoreticular                - Integration of stimuli from joints and muscles into the reticular formation.

·        Spino- olivary                 - Additional information to the cerebellum as an accessory pathway.

·        Corticospinal                  - Voluntary, discrete, skilled motor activities.

·        Reticulospinal                - Regulation to voluntary movements and reflexes.

·        Rubrospinal                   - Promotion of flexor and inhibition of extensor muscle activity.

·        Vestibulospinal            - Inhibition of flexor and promotion of extensor muscle activity.

·        Tectospinal                   - Postrual movements from visual stimuli.

Some tracts cross over to the other side of the cord, before they reach the brain. They convey sensory information from one side of the body to the other side of the brain. When this happens, the information is said to be transmitted contralaterally. Tracts that stay on the same side all the way are said to conduct information ipsilaterally.

Spinal nerves:

The spinal nerves. consist of 31 symmetrical pairs of nerves that connect the spinal cord to the periphery. There are 8 cervical, 12 thoracic, 5 lumbar, 5 sacral, and 1 coccygeal nerve. Spinal nerves are mixed nerves, they contain both sensory and motor fibres, they therefore have both sensory and motor functions.

Sensory fibres enter the cord via the dorsal root, while motor fibres exit via the ventral root.

Functions of spinal nerves:

·        For sensory functions, the spinal nerves receive sensory messages from the skin, internal organs and the bones.

·        For motor functions, the motor roots receive nerve messages via the front of the spinal cord and then transmits these messages to the spinal nerves.

Cervical nerves:

·        C1, C2, and C3 – spinal nerves succor to control the head and neck, including forward, backward, and sideward movements.

·        C4                    – these help to control the upper shoulder movements, as well as helping to power the diaphragm.

·        C5                    – these assist to control the deltoids and biceps, the areas of the upper arm, down to the elbows.

·        C6                   – these help to control the wrist extensions, with some supply given to the biceps.

·        C7                   – It aid and abet to control the triceps as well as the wrist extensor muscles.

·        C8                  – these help to control the hands, as well as finger flexion.

Thoracic nerves:

·        T1 and T2             – these thoracic spinal nerves furnish the top of the chest, arms, and hands.

·        T3, T4, T5             – these nerves supply into the chest wall as well as backing in breathing.

·        T6, T7, T8             – these nerves endow into the chest and down into the abdomen.

·        T9, T10, T11, T12 – these nerves supply into the abdomen and lower in the back.

Lumbar nerves:

·        L1                     – these lumbar spinal nerves bestow sensations to the groin as well as the genitals.

·        L2, L3, and L4 – these nerves assign sensations to the front of the thighs and the inner side of the lower legs.

·        L5                    – these nerves dispense sensations to the outer side of the lower legs and the upper foot. These also help to control the hips, knees, feet, and toe movements.

Sacral nerves:

·        S1             – these sacral spinal nerves affect the hips and the groin area.

·        S2             – these nerves affect the back of the thighs.

·        S3             – these nerves affect the medial buttock area.

·        S4 and S5 – these nerves affect the perineal area.

Coccygeal nerves:

·        These spinal nerves innervate the skin around the coccygeal region, including around the tailbone.

Sensory pathway of spinal cord:

Ascending tracts are sensory pathways that begin at the spinal cord and stretch all the way up to the cerebral cortex. A somatosensory pathway will typically consist of three neurons: primary (First-order), secondary (Second-order), and tertiary (Third-order).

·        First-order neurons detect stimuli and transmit signals to the spinal cord.

·        Second-order neurons – Inside the cord, first-order neurons synapse with second-order neurons, which ascend a specific tract to the brainstem, or further up to the thalamus. In some pathways first-order neurons ascend the tract to the brainstem, where they synapse with second-order neurons, which continue to the thalamus.

·        Third-order neurons conduct the information the rest of the way to the sensory cortex.

Motor pathway of spinal cord:

The motor pathway, also called the pyramidal tract or the corticospinal tract, serves as the motor pathway for upper motor neuronal signals coming from the cerebral cortex and from primitive brainstem motor nuclei. There are upper and lower motor neurons in the corticospinal tract.

·        An upper motor neuron starts in the motor cortex or brainstem, and a lower motor neuron continues from the brainstem or spinal cord.

·        The axons of lower motor neurons exit the cord via the ventral root of spinal nerve, where they continue as motor fibres to effector organs.

Somatic reflexes:

The spinal cord is also responsible for fast, involuntary responses of skeletal muscles, called somatic reflexes. A somatic reflex involves a reflex arc composed of a somatic receptor, a sensory neuron, an interneuron, a motor neuron, and an effector muscle.

Reflex	Muscle tested	Spinal nerve
Brachioradialis reflex	Brachioradialis	C5-C6
Triceps reflex	Triceps	C7-C8
Knee reflex	Quadriceps	L3-L4
Ankle reflex	Gastrocnemius	S1-S2

 

Some reflexes are however more complex, and require multiple pathways, as well as central coordination from the brain.