Difference between revisions of "Neuromuscular pathology"
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m (→SMH labeling) |
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**Men: 24-195 unit/litre. | **Men: 24-195 unit/litre. | ||
**Women: 24-170 units/litre. | **Women: 24-170 units/litre. | ||
==Muscle structure/histology== | ==Muscle structure/histology== | ||
| Line 115: | Line 57: | ||
===Normal findings=== | ===Normal findings=== | ||
====Muscle-tendon junction==== | |||
Features: | |||
*Myofibrils frayed + adjacent to dense connective tissue. | |||
**Image: [http://www.lab.anhb.uwa.edu.au/mb140/corepages/connective/Images/mtj040vg.jpg Muscle-tendon junction (anhb.uwa.edu.au)].<ref>URL: [http://www.lab.anhb.uwa.edu.au/mb140/corepages/connective/connect.htm http://www.lab.anhb.uwa.edu.au/mb140/corepages/connective/connect.htm]. Accessed on: 4 November 2010.</ref> | **Image: [http://www.lab.anhb.uwa.edu.au/mb140/corepages/connective/Images/mtj040vg.jpg Muscle-tendon junction (anhb.uwa.edu.au)].<ref>URL: [http://www.lab.anhb.uwa.edu.au/mb140/corepages/connective/connect.htm http://www.lab.anhb.uwa.edu.au/mb140/corepages/connective/connect.htm]. Accessed on: 4 November 2010.</ref> | ||
====Muscle-nerve junction==== | |||
Features: | |||
*Dunno. (???) | |||
Images: | |||
*[http://commons.wikimedia.org/wiki/File:Skeletal_muscle_-_cross_section,_nerve_bundle.jpg MN junction - crappy image (WC)]. (???) | |||
====Muscle spindle==== | |||
Features: | |||
*Weird looking muscle cell. (???) | |||
Image: [http://www.lab.anhb.uwa.edu.au/mb140/corepages/muscle/Images/mspindle041he.jpg Muscle spindle (anhb.uwa.edu.au)].<ref>URL: [http://www.lab.anhb.uwa.edu.au/mb140/corepages/muscle/muscle.htm http://www.lab.anhb.uwa.edu.au/mb140/corepages/muscle/muscle.htm]. Accessed on: 28 November 2010.</ref> | |||
===Abnormal findings=== | ===Abnormal findings=== | ||
| Line 162: | Line 119: | ||
**Stained with methylene blue.<ref>URL: [http://www.nature.com/modpathol/journal/v18/n5/full/3800344a.html http://www.nature.com/modpathol/journal/v18/n5/full/3800344a.html]. Accessed on: 26 November 2010.</ref> (???) | **Stained with methylene blue.<ref>URL: [http://www.nature.com/modpathol/journal/v18/n5/full/3800344a.html http://www.nature.com/modpathol/journal/v18/n5/full/3800344a.html]. Accessed on: 26 November 2010.</ref> (???) | ||
*Normal SMH numbering = "paraffin". | *Normal SMH numbering = "paraffin". | ||
==Patterns (pathologic)== | |||
===Overview=== | |||
{{familytree/start}} | |||
{{familytree | | | | | | | | | A01 | | | | | |A01=Neuromuscular<br>pathology}} | |||
{{familytree | | | | |,|-|-|-|-|+|-|-|-|-|.| |}} | |||
{{familytree | | | | B01 | | | B02 | | | B03|B01=Neurogenic|B02=Myogenic|B03=Other/Mixed }} | |||
{{familytree/end}} | |||
{| class="wikitable" | |||
| | |||
| '''Neurogenic''' | |||
| '''Myogenic''' | |||
| Notes | |||
| Image | |||
|- | |||
| Shape of fibres | |||
| angulated | |||
| round | |||
| | |||
| [http://nmdinfo.org/lectures/wineinger/wineinger/ppt/Slide25.JPG round fibres]<ref>URL: [http://nmdinfo.org/lectures/info.php?id=8 http://nmdinfo.org/lectures/info.php?id=8]. Accessed on: 25 October 2010.</ref> | |||
|- | |||
| Small fibres | |||
| groups <br>("group atrophy") | |||
| singular | |||
| | |||
| [http://neuropathology.neoucom.edu/chapter9/images9/13-7.jpg group atrophy]<ref>URL: [http://neuropathology.neoucom.edu/chapter9/chapter9fALS.html http://neuropathology.neoucom.edu/chapter9/chapter9fALS.html]. Accessed on: 25 October 2010.</ref> | |||
|- | |||
| Large fibres<br> | |||
| no | |||
| +/-scattered | |||
| "hypercontracted<br>fibres" | |||
| [http://commons.wikimedia.org/wiki/File:Duchenne-muscular-dystrophy.jpg DMD (WC)] | |||
|- | |||
| Fibre type<br>grouping | |||
| yes (d/t chronic <br>denervation + <br>reinnervation)<ref>URL: [http://neuromuscular.wustl.edu/lab/mbiopsy.htm#fibertype http://neuromuscular.wustl.edu/lab/mbiopsy.htm#fibertype]. Accessed on: 26 October 2010.</ref> | |||
| yes (???) | |||
| based on ATPase, <br>NADH-TR stains | |||
| [http://missinglink.ucsf.edu/lm/ids_104_musclenerve_path/student_musclenerve/subpages/ng.atp.9.4.1.html ATPase 9.4]<ref>URL: [http://missinglink.ucsf.edu/lm/ids_104_musclenerve_path/student_musclenerve/musclepath.html http://missinglink.ucsf.edu/lm/ids_104_musclenerve_path/student_musclenerve/musclepath.html]. Accessed on: 26 October 2010.</ref>, [http://moon.ouhsc.edu/kfung/JTY1/Com04/Com04Image/Com401-3-12.gif NADH-TR]<ref>URL: [http://moon.ouhsc.edu/kfung/JTY1/Com04/Com401-3-Diss.htm http://moon.ouhsc.edu/kfung/JTY1/Com04/Com401-3-Diss.htm]. Accessed on: 28 October 2010.</ref> | |||
|} | |||
====List==== | |||
Neurogenic: | |||
*Angulated myocytes. | |||
*Groups of small fibres. | |||
*Apparent increase of nuclei. | |||
Myogenic: | |||
*Round myocytes. | |||
*+/-Intense (darker) cytoplasm. | |||
*+/-Fibrosis (between fibres). | |||
*+/-Necrosis. | |||
===Detail=== | |||
#Segmental demyelination - nerve/CNS abnormality. | |||
#Axonal degeneration - nerve/CNS abnormality. | |||
#Reinnervation - nerve injury. | |||
#Myopathy - something is wrong with the muscle fibres. | |||
==Stains for muscle biopsies== | ==Stains for muscle biopsies== | ||