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Woltman Sign
Woltman's sign (also called Woltman's sign of hypothyroidism or, in older references, myxedema reflex) is a delayed relaxation phase of an elicited deep tendon reflex, usually tested in the Achilles tendon of the patient. Woltman's sign is named for Henry Woltman, an American neurologist. __TOC__ Associated conditions The delayed ankle jerks are associated with: * hypothyroidism; * Huntington's disease; * several neurological symptoms; * anorexia nervosa; * extreme old age; * beta-blocker Beta blockers, also spelled β-blockers, are a class of medications that are predominantly used to manage abnormal heart rhythms, and to protect the heart from a second heart attack after a first heart attack ( secondary prevention). They are a ...s or other drugs; and/or * hypothermia. History In 1924, William Calvert Chaney (1888–1965), who worked under Henry Woltman at the Mayo Clinic, seems to have been the first to publish a description of the sign, but Woltman had no authorship and w ...
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Hypothyroidism
Hypothyroidism (also called ''underactive thyroid'', ''low thyroid'' or ''hypothyreosis'') is a disorder of the endocrine system in which the thyroid gland does not produce enough thyroid hormone. It can cause a number of symptoms, such as poor ability to tolerate cold, a feeling of tiredness, constipation, slow heart rate, depression, and weight gain. Occasionally there may be swelling of the front part of the neck due to goiter. Untreated cases of hypothyroidism during pregnancy can lead to delays in growth and intellectual development in the baby or congenital iodine deficiency syndrome. Worldwide, too little iodine in the diet is the most common cause of hypothyroidism. Hashimoto's thyroiditis is the most common cause of hypothyroidism in countries with sufficient dietary iodine. Less common causes include previous treatment with radioactive iodine, injury to the hypothalamus or the anterior pituitary gland, certain medications, a lack of a functioning t ...
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Myxedema
Myxedema is a term used synonymously with severe hypothyroidism. However, the term is also used to describe a dermatological change that can occur in hyperthyroidism and (rare) paradoxical cases of hypothyroidism. In this latter sense, myxedema refers to deposition of mucopolysaccharides in the dermis, which results in swelling of the affected area. One manifestation of myxedema occurring in the lower limb is pretibial myxedema, a hallmark of Graves disease, an autoimmune form of hyperthyroidism. Myxedema can also occur in Hashimoto thyroiditis and other long-standing forms of hypothyroidism. The word myxedema originates from , taken from ancient Greek to convey 'mucus' or 'slimy substance', and for "swelling". It can also be thought as nonpitting edema, in contrast to pitting edema. Signs and symptoms Myxedema can occur in the lower leg ( pretibial myxedema) and behind the eyes (exophthalmos). Severe cases, requiring hospitalization can exhibit signs of hypothermia ...
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Achilles Tendon
The Achilles tendon or heel cord, also known as the calcaneal tendon, is a tendon at the back of the lower leg, and is the thickest in the human body. It serves to attach the plantaris, gastrocnemius (calf) and soleus muscles to the calcaneus (heel) bone. These muscles, acting via the tendon, cause plantar flexion of the foot at the ankle joint, and (except the soleus) flexion at the knee. Abnormalities of the Achilles tendon include inflammation ( Achilles tendinitis), degeneration, rupture, and becoming embedded with cholesterol deposits ( xanthomas). The Achilles tendon was named in 1693 after the Greek hero Achilles. History The oldest-known written record of the tendon being named for Achilles is in 1693 by the Flemish/Dutch anatomist Philip Verheyen. In his widely used text he described the tendon's location and said that it was commonly called "the cord of Achilles." The tendon has been described as early as the time of Hippocrates, who described it as the ...
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Henry Woltman
Henry William Woltman (16 June 1889 – 1 November 1964) was an American neurologist and the first neurologist at the Mayo Clinic in Rochester, MN. In his career as a research and clinical neurologist he discovered several new diseases, several of which still bear his name, including: Moersch-Woltman syndrome, the Woltman sign Woltman's sign (also called Woltman's sign of hypothyroidism or, in older references, myxedema reflex) is a delayed relaxation phase of an elicited deep tendon reflex, usually tested in the Achilles tendon of the patient. Woltman's sign is named f .... Woltman obtained a BS in 1911 before proceeding to medical school. Upon his death, he was survived by his wife and four children. References American neurologists 1964 deaths 1889 births {{US-physician-stub ...
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Neurology
Neurology (from el, νεῦρον (neûron), "string, nerve" and the suffix -logia, "study of") is the branch of medicine dealing with the diagnosis and treatment of all categories of conditions and disease involving the brain, the spinal cord and the peripheral nerves. Neurological practice relies heavily on the field of neuroscience, the scientific study of the nervous system. A neurologist is a physician specializing in neurology and trained to investigate, diagnose and treat neurological disorders. Neurologists treat a myriad of neurologic conditions, including stroke, seizures, movement disorders such as Parkinson's disease, autoimmune neurologic disorders such as multiple sclerosis, headache disorders like migraine and dementias such as Alzheimer's disease. Neurologists may also be involved in clinical research, clinical trials, and basic or translational research. While neurology is a nonsurgical specialty, its corresponding surgical specialty is neurosurgery ...
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Ankle Jerk
The ankle jerk reflex, also known as the Achilles reflex, occurs when the Achilles tendon is tapped while the foot is dorsiflexed. It is a type of stretch reflex that tests the function of the gastrocnemius muscle and the nerve that supplies it. A positive result would be the jerking of the foot towards its plantar surface. Being a deep tendon reflex, it is monosynaptic. It is also a stretch reflex. These are monosynaptic spinal segmental reflexes. When they are intact, integrity of the following is confirmed: cutaneous innervation, motor supply, and cortical input to the corresponding spinal segment. Root value This reflex is mediated by the S1 spinal segment of the spinal cord. Procedure and components Ankle of the patient is relaxed. It is helpful to support the ball of the foot at least somewhat to put some tension in the Achilles tendon, but don’t completely dorsiflex the ankle. A small strike is given on the Achilles tendon using a rubber hammer to elicit the response ...
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Anorexia Nervosa
Anorexia nervosa, often referred to simply as anorexia, is an eating disorder characterized by underweight, low weight, Calorie restriction, food restriction, body image disturbance, fear of gaining weight, and an overpowering desire to be thin. ''Anorexia'' is a term of Greek origin: ''an-'' (ἀν-, prefix denoting negation) and ''orexis'' (ὄρεξις, "appetite"), translating literally to "a loss of appetite"; the adjective ''nervosa'' indicating the functional and non-organic nature of the disorder. ''Anorexia nervosa'' was coined by Gull in 1873 but, despite literal translation, the feeling of hunger is frequently present and the pathological control of this instinct is a source of satisfaction for the patients. Individuals with anorexia nervosa have a fear of being overweight or being seen as such, although they are in fact underweight. The DSM-5 describes this perceptual symptom as "disturbance in the way in which one's body weight or shape is experienced". In resea ...
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Beta-blocker
Beta blockers, also spelled β-blockers, are a class of medications that are predominantly used to manage abnormal heart rhythms, and to protect the heart from a second heart attack after a first heart attack ( secondary prevention). They are also widely used to treat high blood pressure, although they are no longer the first choice for initial treatment of most patients. Beta blockers are competitive antagonists that block the receptor sites for the endogenous catecholamines epinephrine (adrenaline) and norepinephrine (noradrenaline) on adrenergic beta receptors, of the sympathetic nervous system, which mediates the fight-or-flight response. Some block activation of all types of β-adrenergic receptors and others are selective for one of the three known types of beta receptors, designated β1, β2 and β3 receptors. β1-adrenergic receptors are located mainly in the heart and in the kidneys. β2-adrenergic receptors are located mainly in the lungs, gastrointestinal tract, li ...
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Medical Signs
Signs and symptoms are the observed or detectable signs, and experienced symptoms of an illness, injury, or condition. A sign for example may be a higher or lower temperature than normal, raised or lowered blood pressure or an abnormality showing on a medical scan. A symptom is something out of the ordinary that is experienced by an individual such as feeling feverish, a headache or other pain or pains in the body. Signs and symptoms Signs A medical sign is an objective observable indication of a disease, injury, or abnormal physiological state that may be detected during a physical examination, examining the patient history, or diagnostic procedure. These signs are visible or otherwise detectable such as a rash or bruise. Medical signs, along with symptoms, assist in formulating diagnostic hypothesis. Examples of signs include elevated blood pressure, nail clubbing of the fingernails or toenails, staggering gait, and arcus senilis and arcus juvenilis of the eyes. Indicat ...
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Thyroid Disease
Thyroid disease is a medical condition that affects the function of the thyroid gland. The thyroid gland is located at the front of the neck and produces thyroid hormones that travel through the blood to help regulate many other organs, meaning that it is an endocrine organ. These hormones normally act in the body to regulate energy use, infant development, and childhood development. There are five general types of thyroid disease, each with their own symptoms. A person may have one or several different types at the same time. The five groups are: # Hypothyroidism (low function) caused by not having enough free thyroid hormones # Hyperthyroidism (high function) caused by having too many free thyroid hormones # Structural abnormalities, most commonly a goiter (enlargement of the thyroid gland) # Tumors which can be benign (not cancerous) or cancerous # Abnormal thyroid function tests without any clinical symptoms (subclinical hypothyroidism or subclinical hyperthyroidism). In ...
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