Headache Differentials

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Pleural effusion

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Definition Pleural effusion is a collection of fluid in the pleural space between the visceral pleura surounding the lungs and the parietal pleural attatched to the throacic wall. Demographics Pleural effusions are relatively common, but it is a manifestation of other underlying diseases. The prevalence and incidence of pleural effusions is therefore dependent on it's cause. Pathophysiology/causes Pleural fluid is usually filtered from the parietal pleura into the pleural space, due to hydrostatic pressure from the capillaries, negative pressure in the pleural space and pleural oncotic pressure. The visceral pleura is perfused by the pulmonary system which has a lower pressure, and fluid in the pleural space is therefore drawn back in through the visceral pleura due to the higher oncotic pressure in plasma. Some of this fluid is then drained by the lymphatic system.
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Chronic Obstructive Pulmonary Disease (COPD)

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Definition: Chronic obstructive pulmonary disease is defined as a condition of restricted airflow which is not fully reversible. It is often a progressive disease caused by abnormal inflammatory responses to obnoxious substances.  Demographics: COPD is a common condition, The prevalence of COPD increases with age, with most patients being diagnosed at around the age of 50.  Aeitiology and pathophysiology:  Airway obstruction in COPD is caused by;  1) increase in mucus secretion, leading to obstruction.  many COPD patients show increased number of goblet cells in their airways, which block airways.  2) inflammation and scarring to the airways, leading to narrowed airways.  Inflammatory cells infiltrate the bronchi and bronchiole walls. The inflammation causes scarring and thickening of walls which cause small airways to narrow. Initially, inflammation is reversible, but this become irreversible with continued smoking. As the dis...
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Phalen's test and tinel's sign

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Both phalen's test and tinel signs are ways of eliciting symptoms from patients with suspected carpal tunnel syndrome. In phalen's test, the wrist is flexed for 30-60 seconds, and results in tingling/numbness of the thumb, index and middle finger if positive. Sensitivity and specificity of the test is variable. Tinel's sign in carpal tunnel syndrome can be elicited by extending the wrist slightly and tapping on the radial side of the palmar surface of the wrist. It is positive if it results in a tingling sensation of the first 3 fingers.
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