Saturday, June 13, 2009

55 - Sherrington law of reciprocal innervation

During the initiation of an eye movement, increased innervation to an extraocular muscle is accompanied by simultaneous inhibition ( a reciprocal decrease in innervation ) of the direct antagonist of the contracting muscle of the same eye.
If the left medial rectus muscle receives innervational flow to initiate adduction of the left eye, there is simultaneous decreased and inhibitory flow to the left lateral rectus muscle to make it relax and enable the eyeball to move medially.

Tuesday, June 2, 2009

54 - Reinke's crystals, Reinke's space and Reinke's oedema

Reinke's crystals are rod-shaped crystals in the interstitial cells of the testis and hilus cells of the ovary .

Reinke's space is seen in chronic laryngitis with swelling of the membranous part of the vocal cords .
This swelling of the vocal cords due to edema is also called Reinke's edema .  

These are named after Friedrich Berthold Reinke ( 1862-1919 ), who was an anatomist from France .

1q: What is Reinke’s Oedema?

Reinke’s Oedema is a fluid filled swelling of one or both of the vocal cords.
The quality of the voice is likely to be affected by Reinke’s Oedema. Speaking may become more difficult and sound breathy or rough. The pitch of the voice may sound lower than it used to. These changes can be gradual.

2q: Causes and risks : 

Reinke’s Oedema is most commonly associated with smoking. Some research shows a link with acid reflux and an under-active thyroid. It tends to affect women more than men.

3q: Diagnosing Reinke’s Oedema :

Usually an Ear Nose and Throat (ENT) doctor will examine the larynx (voice box) using a small flexible camera which goes through the nose ( flexible laryngoscope ) . This takes place in the outpatient’s clinic and does not require admission to hospital.If the ENT doctor suspects that an under-active thyroid is the cause of Reinke’s Oedema, they will arrange the appropriate tests.

4q: Treatments available :

The choice of treatment depends on the cause of Reinke’s Oedema.
• Surgery may be required to remove some of the fluid from the vocal cords.
• Speech and language therapy can help to improve vocal health and voice quality. speech and language therapist explains how to care for the voice and reduce vocal misuse and irritants.
• Medication to reduce acid reflux or balance the hormones produced by the thyroid gland if needed.
• Stopping smoking alone may result in Reinke’s Oedema subsiding.

5q: What a patient can do :

Looking after your voice, stopping smoking and reducing irritants can help the vocal cords to recover. Advice on how to do this will be given to you by the speech and language therapist. Advice sheets that are given to you should only be used under the direction and supervision of a qualified Speech and Language Therapist
If you continue to smoke and irritate your vocal cords after treatment, Reinke’s Oedema is likely to return.

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