BOC Review Flashcards
(207 cards)
1
Q
Pes Planus
A
Flat Footed
2
Q
Pes Cavus
A
High Arched
3
Q
Genu Valgus
A
Knees in
4
Q
Genu Varus
A
Knees out (Bowlegged)
5
Q
Coxa Valga
A
Deformity of the hip where the angle formed between the head and neck of the femur and its shafts is increased, usually above 135 degrees. It is caused by a slipped epiphysis of the femoral head.
6
Q
Coxa Vara
A
A deformity of the hip, where the angle between the head and the shaft of the femur is reduced to less than 120 degrees. Commonly caused by injury, such as a fracture.
7
Q
McBurney’s Point
A
A name given to the point over the right side of the abdomen. This point roughly corresponds to the most common location of the base of the appendix. Appedicitis.
8
Q
Kerr’s Point
A
Referred pain in the left shoulder. Ruptured spleen.
9
Q
Erb’s Point
A
TOS above the clavicle.
10
Q
Mallet Finger
A
Injury to the extensor tendon of the DIP. Pt is unable to extend DIP. The distal phalanx stays in flexion.
11
Q
Boutonniere Deformity
A
Injury to the extensor hood of the finger. Pt is unable to extend the IP joint of the finger.
DIP - Extension
PIP- Flexion
MCP - Extension
12
Q
Swan Neck Deformity
A
Stretching of the volar plate causing hyperextenion.
Flexion of the DIP, Hyperextension of the PIP
13
Q
Dupuytren’s Contracture
A
AKA palmar fibromatosis or morbus Dupuytren.
A flexion contracture of the hand due to a palmar fibromatosis, and pt cannot fully extend. Usually in 4th and 5th digits.
14
Q
Trigger Finger
A
A common disorder characterized by catching, snapping or locking of the involved finger flexor tendon associated with dysfuncition and pain.
AKA stenosing tenosynovitis.
15
Q
Normal Leukocyte Count per cu mm
A
4000 to 10000/cu mm
16
Q
Spondylolisthesis
A
When the vertebrae slips forward (anteriorly) over the bone below it.
17
Q
Spondylolysis
A
Fx in the pars interarticularis.
18
Q
Spondylosis
A
Degenerative osteoarthritis of the vertebrae or neural foramina.
19
Q
Osetoarthritis
A
A type of arthritis, aka degenerative joint disease. Results from the breakdown of joint cartilage and underlying bone.
20
Q
Rhuematoid Arthritis
A
An type of arthritis that is actually an auto-immune disease.
21
Q
Cyanosis
A
Blue of purple coloration of the skin, having low oxygen saturation.
22
Q
Levator Palpebrae superioris
A
Superioris - elevates the eyelid
Inferioris - Depresses the eyelid
23
Q
Orbicularis Oculi
A
Closes the eye
24
Q
Bankhart lesion
A
A lesion to the anterior capsule of the shoulder with an associated tear of the glenoid labrum.
Usually the result of a dislocation, and is accompanied by an Hill-Sachs Lesion.
25
Hill-Sachs Lesion
A cortical depression in the posteriolateral head of the humerus.
Resulting from a forceful impaction of the humeral head against the anterioinferior glenoid rim, when the shoulder dislocates anteriorly.
26
Aura
A sensation felt just before a seizure. AKA Pre-ictal.
27
Vaginitis
Inflammation of the vagina that can result in discharge, itching and pain. The cause is usually a change in the normal balance of vaginal bacteria or an infection.
Bacterial vaginitis - overgrowth of bacteria
Yeast infections - fungus called Candida albicans
Trichomoniasis - parasite transmitted by sex.
Vaginal Atrophy - results from reduced estrogen levels after menopause.
28
Osteoporosis
Bones become weak and brittle.
Risk factors include: Early menopause, high consumption of alcohol, cigs, and caffeine, sedentary lifestyle, and lack of folic acid in the diet.
29
Pinna
Also called the auricle, the visible part of the ear the resides outside of the head.
30
Bone Scan
Involves an injection of radioactive substance into a vein , which is absorbed by bone. Bone scans can then detect abnormal levels of uptake or hot spots in the bone. Useful for indicating stress fractures.
31
Crohn's Disease
Inflammatory bowel disease. Causes inflammation of the lining of your digestive tract. Can involve different areas of the digestive tract.
32
MRI
Magnetic Resonance Imaging - Allows clinician to view structurs without the pt. injecting or taking dye. No METAL!
33
CT Scan
Cross sectional view.
34
PET Scan
Positron Emission Tomography scan - PET scans use a radioactive drug that can be injected, swallowed, or inhaled. Scans metabolic activity in the body.
35
Fluoroscopy
Real time imaging, mostly used for the vascular structures.
| Does expose the pt. to radiation.
36
Diagnostic US
Used for musculoskeletal reasons.
37
Histamine
Dilates blood vessels, and makes them more permeable.
38
Antihistamine
```
They don't vasoconstrict but they just block histamine receptors.
Dimetapp
Benadryl
Clartin
Allegra
```
39
Ultram
(tramadol) a narcotic-like pain reliever.
40
Tinactin Spray
Treats certain fungal infections such as athletes foot and ringworm.
41
Tetracycline
An antibiotic used to treat bacterial infections such as UTI, Clamydia and acne.
42
Essential Body Fat Percentages for Men and Women.
The least amount of fat you need to survive.
Men 2-5%
Women 10-13%
43
Body Fat Percentages Norm
Athletes Women 14-20% Men 6-13%
Fitness Women 21-24% Men 14-17%
Average Women 25-31% Men 18-25%
Obese Women 32%+ Men 25%+
44
Inflammation Cardinal Signs
```
Pain
Heat
Redness
Swelling
Loss of Function
```
45
Dolor
Pain
46
Calor
Heat
47
Rubor
Redness
48
Tumor
Swelling
49
Functio Laesa
Loss of Function
50
Cortex (brain)
Thinking and voluntary movement.
51
Brain Stem
```
Controls life supporting functions like:
Alertness
Arousal
Breathing
Blood Pressure
Digestion
Heart Rate
Other Autonomic Functions
Relays information between the peripheral nerves and spinal cord to the upper parts of the brain.
```
52
Cerebellum
Coordination and Balance.
53
Frontal Lobe
Judgement and motor function.
54
Partietal Lobes
Sensation, body position.
55
Temporal Lobes
Memory and Hearing
56
Occipital Lobes
Visual processing center.
57
Meningies
```
From superficial to deep:
Epidural space
Dura Mater
Arachnoid Mater
Subarachnoid Space
Pia Mater
```
58
Epidural Hematoma
Bleeding in the epidural space, worse than cerebral hematoma because it bleeds quicker adding pressure faster.
59
Reye's Syndrome
Casues swelling of the liver and brain. Often affect children and teenagers recovering from a viral infection, most commonly the flu or chickenpox.
Aspirin has been liked to Reye's Syndrome. Children and teenagers should never take aspirin when experiencing flu-like, or chickenpox sx's.
60
Raynaud's Syndrome
Vasospastic disorder in which cold temperatures narrows blood vessels in areas of the body, most commonly the distal extremities.
61
Crutches
2 crutches:
Crutches should reach between 1 1/2 and 2 inches belowthe armpit (or 3 finger widths).
Hand grips should be even with the top of the hip line.
Put crutches out 6" to a foot in front of you, swing through landing on the good leg.
62
Canes
Cane should reach the crease of the hand.
Elbow should be slightly bet when holding your cane.
Cane is held on the opposite side that needs support.
Ex.) right leg hurts, then hold cane in left hand.
The cane moves with the bad leg.
63
Calcaneal Stress Fractures
Along with Tibial stress fx and of the second metatarsal are among the most common stress fx in the LE.
64
Sever's Disease
A calcaneal Apophysitis occurs in young pts.
| A traction injury to the apophysis of the cancaneus.
65
Retocalcaneal Bursitis
Inflammation of the bursa that lies between the Achillies tendon and the calcaneus.
66
Cuboid Subluxation
Pronation and trauma have been reported to be prominent causes of cuboid subluxation.
67
Lisfranc Injury
Tarsometatarsal Fracture/Dislocation
| More uncommon.
68
Second Metatarsal Stress Fx
AKA Morton's Toe
Mortons toes is when the second toe is longer than the first toe. More weight then goes onto this toe and can result in a stress fx.
69
Jones Fx
Fx to the diaphysis of the fifth metatarsal
70
Bunions
AKA Hallux Valgus Deformity and tailor's Bunion.
Commonly the first ray splays outward placing pressure over the first metatarsal head irritating the bursa of the MTP joint. This bursa eventually thickens.
A bunionette or tailor's Bunsion is a bunion on the 5th MTP joint.
71
Sesmoiditis
Sesmoiditis is caused by repetitive hyperextension. Inflammation of the sesmoid bones and tendons.
72
Morton's Neuroma
A mass that occurs about the nerve shealth of the common plantar nerve. Between the 3rd and 4th metatarsal heads.
73
Turf Toe
Hyperextension of the great toe that results in a sprain of the MTP joint.
74
Subungual Hematoma
Blood that accumulates under the toenail
75
Ankle Osteochondritis Dissecans
OCD of the talar dome (superiormedial articular surface of the talar dome).
76
Osteomyelitis
Infection in a bone
77
Compartment Syndrome
Acute - Secondary to trauma , this is a medical emergency. (fasciotomy)
Chronic - symptoms cease when activity stops.
Acute Exertional - Occurs without any precipitating trauma.
78
Patella Alta
The patella sets in a more superior position than normal when the pt. is standing.
79
Patella Baja
The patella sets in a more inferior position than normal when the pt. is standing. The ratio of patellar tendon length to the height of the patella is less than the normal 1:1 ratio.
80
Genu Recuvratum
Hyperextended knees.
81
Hemarthrosis
Blood in the joint cavity.
82
Gerdy's Tubercle
A lateral tubercle of the tibia where the Iliotibial tract inserts and Tibialis Anterior
83
Pes Anseinus
Refers to the conjoined tendons of:
Sartorius
Gracilis
Semitendinosus
84
The A Angle
Measures the patellar orientation to the tibial tubercle. This angle is created by the intersection of a line that bisects the patella longitudinally and a line from the tibial tubercle to the apex of the inferior pole of the patella.
An angle of 35 degrees or greater has been correlated with patellofemoral pathomechanics.
85
The Q Angle
An angle created when lines from the middle of the patella to the ASIS and a line from the tibial tubercle to the center of the patella intersect.
Normal Q-angle for men is 10 degrees
Normal Q-angle for women is 15 degrees.
Q-angles that exceed 20 degrees are considered excessive and could lead to pathologies.
86
Sinding-Larsen-Johanson Disease
Apophysitis occurs at the inferior pole of the patella.
87
HDL Cholesterol
High Density Lipoprotiens Greater than 60 milligrams per deciliter.
Less than 40 milligrams per deciliter is bad.
88
LDL Cholesterol
Low Density Lipoprotiens Should be less than 130 milligrams per deciliter.
Anything above 130 is bad.
89
Osgood-Schlatter Disease
Apophysitis of the tibial tubersosity
90
Runner's Knee
ITBS and/or Pes Anserius Tendinitis or Bursitis.
91
Myositis Ossificans
AKA Heterotrophic Ossification
| Calcifications of bone/cartilage in the pooing blood, if not treated proplery.
92
Otitis Media
Inner ear infection.
93
Otitis Externia
(Swimmers Ear) Outer ear infection
94
Cauliflower Ear
Auricular (Pinna) Hematoma
95
Otoscope
Used for looking into the ear.
96
Impacted Cerumen
Earwax accumulates and clogs the ear canal.
97
Parts of the Small Intestine
```
Duodenum
Jejunum
Ileum (don't confuse this with the Ilium of the pelvis)
```
98
Hip Anteversion
The femoral neck is directed anteriorly.
A hip with excess of the normal 35 degrees of of internal rotation is characteristic of hip anteversion.
Feet and toe in.
99
Hip Retroversion
The femoral neck is directed posteriorly.
A hip with excess of the normal 45 degrees of external rotation is characteristic of femoral retroversion.
Feet and toes out.
100
Azithromyacin
(Zithromax, Z-pack)
| An antibiotic, can be used for URI and Clamydia.
101
Normal Femoral Neck Angle
15 degrees anterior to the long axis of the shaft of the femur.
102
FABER Test
AKA Patrick FABER test.
(Flexion, Abduction, External Rotation)
Detects pathological conditions of the hip and SI joint.
The foot of the painful leg is paced on the opposite extended knee. Pressure is then applied tot he bent knee. Pain may be felt.
103
Anatomical (True) Leg Length Discrepancy
Measured from the ASIS to the Medial malleoli.
104
Functional Leg Length Discrepancy
Measured from the umbllicus to the medial malleoli.
105
Cirrhosis
A condition where the liver does not function properly due to long term damage.(Scarring)
106
Myopia
Near Sited
107
Hyperopia
Farsightedness
108
Wolf-Parkinson White Disease
Preexcitation of the heart. Elongated QRS, Short PR. Early Depolarization
109
Decorticate
Flexion of wrist and elbows. Rigid Body (and D) hehe
110
Decellebrate
Full extension of the body.
111
Chemotaxis
The movement of cells to a location. Like in inflammation.
112
Pediculosis
Lice
113
Goiter
Enlargement of the thyroid gland
114
Diaphoresis
Sweating, especially to an unusual degree. Like after taking some sort of medication.
115
Myoglobin
Muscle Protien
116
Parotitis
Inflammation of the paratoid glands
117
Spina Bifida Occulta
Incomplete closing of the veratbrae.
118
Tay-Sachs Disease
A disorder in which lipids accumulate in the brain, causing spasticity and death.
119
Claudication
Limping or impaired walking.
120
Snellen Chart
Used to check visual acuity.
121
Opthalmascope
Instrument to view the inside of the eye.
122
Otoscope
Instrument to view the inside of the ear
123
Sphygomoanometer
Blood Pressure Cuff
124
Hand Dynamometer
Measures grip strength
125
Stethoscope
Instrument used to listen to the body.
126
Potentiating Drug
A drug that is used to increase the effects of another drug.
127
Normal Dosage for Aspirin
325 mg
128
Cystitis
UTI, Bladder bacterial infection.
129
Antitussive
Cough Suppressant. Can also be used to increase the production of fluid in the respiratory system (expectorants).
130
Antipyretic
Fever Reducer
131
Antipruritic
Anti-Itch
132
Corticosteroids
Cortisone is most common, used primarily for chronic inflammation
133
Antiemetics
Treat nausea and vomiting.
134
Carminatives
Anti-FART
135
Carthartics
Laxitives
136
Histamines -2 Blockers
Treat peptic and gastric ulcers and other gI hypersecretory conditions..
Like: Tagamet and Zantac.
137
Analgesic
Treat Pain.
138
Acetaminophen
(Tylenol) is an analgesic and antipyretic but has NO anti-inflammatory effect.
139
Acetylsalicylic Acid
(Aspirin)
Analgeics
Antiinflammatory
Antipyretics.
Asthmatic pts may be at greater risk of allergic aspirin.
140
NSAIDs
Have antiinflammaotry, antipyretics and analgesic properties.
141
Margination
Neutrophiles and macrophages line up along the cell wall.
142
Neutrophils
A type of leukocyte.
143
Inflammation Sequences
```
Injury
Vasoconstriction
Injured mast cells release chemical mediators (Histamine, Leukotrienes, Cytokines)
Vasodialation
Exudate
Platlets and leukocytes adhere to vascular wall
Phagocytosis
Clot formation
```
144
Blood Coagulation (Formation of a clot)
```
thromboplastin
Prothrombin
Thrombin
Fibrinogen
Insoluable Fibrin Clot
```
Clot formation begins around 12 hours after injury and is completed within 48 hours.
145
Hypoxemia
Low concentration of oxygen in the blood.
146
Hyperhidrosis
Sweating excessively
147
Hyernatremia
Elevated sodium level in the blood.
148
Risk Factors for Cold Injuries
```
Lean Body Composition
Females
Older Age
Black race
Lower Fitness Level
Presence of comorbidity
```
149
Macule
Freckle or flat spot
150
Papule
Wart
151
Plaque or Patch
A macule or papule larger tan 1/2 inch in diameter.
152
Nodule
Solid mass less than 1/2 inch deeper into the dermis than a papule.
ex.) Dermatofibroma fibrosis
153
Tumor
Solid mass larger than 1/2 inch.
| ex.) cavernous hemangioma (tumor filled with blood vessels)
154
Cyst
Encapsulated, fluidfilled lesion in the dermis or subcutis.
ex.) Epidermoid Cyst
155
Wheal
Papule or plaque caused by serum collected into the dermis, allergic reactions.
ex.) Uticaria
156
Vesicle
Fluid filled elevation less than 1/2 inch just below the epidermis.
ex.) Smallpox, chickenpox.
157
Bulla
Like a vesicle but larger.
ex.) second degree burn, friction blister.
158
Pustule
Like a vesicle or bulla but contains pus.
ex.) Acne
159
Cellulitis
An inflammation of cells and connective tissue that extend deep into the tissues.
160
Secondary Skin Lesions
```
Scales
Crust
Fissure
Excoriation
Erosion
Ulcer
Scar
```
161
Hyperkeratosis
Calluses!!!!!!!!!!!!!!!!
162
Soft and Hard Corns
Hyperkeratoses caused by abnormal skin pressure and friction.
163
Bacillis
A bacteria often found in salivia, soil and feces. Tentinus is a type of bacillis.
164
Bleach Concentration to Water
1:10
165
Xerotic Skin
Dry Skin
166
Wounds
```
Abrasions
Punctures
Lacerations
Incisions
Avulsions
Bruises
```
167
Bacterial Skin Infections
```
Bacterial infections can be Staphylococcus, Streptococcus or Bacillus and include:
Methicillin-Resistant Staphlococcus aurea (MSRA)
Impetigo Contagiosa
Furuncles
Carbuncles
Folliculitis
Kidradentis Suppurativa
Acne Vulgaris
Paronychia and Onychia
Tetanus Infection
```
168
Fungal Skin Infections
```
Tinea Capitis (Scalp)
Tinea Corporis (body)
Tinea Unguiun/Onychomycosis (Nails)
Tinea Cruris (Groin)
Tines Pedis (Foot)
Candidiasis
Tinea Versicolor
```
169
Dermatophytes
(Ringworm Fungi) are the cause of most skin, nail, and hiar fungal infections. They belong to the three genera: Microsporum, Trichophyton and Epidermophyton.
170
Viral Skin Infection
Herpes simplex
Herpes Zoster
Verruca (Warts)
Molluscum Contagiosum (Poxvirus)
171
Impetigo
Can be Strep or Staph
Sings and Sx's
Itching and soreness
Smal vesciles and/or pustules that rupture to form honey-colored crust
172
Furuncles
or Boils are infections of the hair follicle that usually result in pustule formation.
173
Carbuncles
The difference between a carbuncle and a furuncle is that a carbuncle is larger ad deeper and usually has several openings in the skin.
It may produce a fever and an elevation in white blood cell count.
174
Folliculitis
Inflammatory condition of the hair follicle. This can be infectious or non infectious.
175
Hidradenitis Suppurativa
a chronis inflammatory condition of the apocrine glands or large sweat glands, commonly found in the axilla, sctroum, labia majora and nipples.
176
Acne Vulgaris
Inflammatory disease that involves the hair follicles and the sebaceous glands. It is characterized as comedones (whiteheads), open comedones (blackheads), papules, pustules, and cysts.
177
Candidiasis
A skin, mucous membrane, or internal infection caused by the yeastlike fungus Candida Albicans and some other species
178
Herpes Simplex
```
Type 1 (Galdiatorum) Extragenitally
Type 2 Genitally
```
179
Herpes Labialis
Cold Sore
180
Herpes Zoster
Shingles. Appears in a specific pattern on the body in an area that is innervated by a specific nerve root.
Antiviral drugs, such as valacyclovir, are used to shorten the course and reduce the recurrence of herpes outbreaks.
181
Verruca
Warts
Common wart
Verruca Plantaris (Plantar Wart)
182
Molluscum Contagiosum
A poxvirus infection.
| Treatment include cleansing thoroughly and using destructive procedure such as the use of a powerful counterirritant.
183
Allergic Reactions
Immediate hypersensitivity reactions manifest as uticaria or hives.
184
Contact Dermatitis (Allergic and Irritant)
Allergic contact dermatitis is an immmunologically mediated reaction to a foreign to a foreign substance, whereas irritant contact dermatitis is a nonimmunological reaction to a chemical irritant.
185
Mites
(Scabies)
Caused by the mite Sarcoptes scabiei.
Produces night time itching. The mite buries and lays eggs in 1/4 to 1/2 inches down.
Treated by Elimite. a topical cream.
186
Pediculosis
Lice.
Treatment is rapid with the use of any number of agents. NIX is an over-the-counter synthetic pyrethroid permethrin that is very effective in treating head and pubic lice.
187
Fleas
Little nasty fucks.
| Treated with an antipruritic lotion, such as calamine or a topical corticosteroid.
188
Ticks
Little nasty shits.
To remove a tick, mineral oil or fingernail polish is applied to its body, at which time it will withdraw its head. Grasping or pulling the tick by its head is an acceptable method for removal.
RMSF and Lyme disease are serious illnesses with significant morbidity and mortality which is treated with systemic antibiotics.
189
Pityriasis Rosea
An acute inflammatory skin rash of unknown origin that occurs most commonly in people between the ages of 10 and 35,
Characterized by "herald patch".
Treatment is conservative.
190
Psoriasis
A chronic skin disease that causes itching.
Unknown cause but there is some genetic factor present.
Treatment involves pt education, topical corticoids in combination with kerolytic agents to remove the scales.
191
Sporonox and Lamisil
Itraconazole and terbenafine respectively.
| Are systemic medications for fingal ungiuim/onychomycosis.
192
Suffix -zole
Antifungals
193
Volkman's Contracture
Volkmann's contracture is a type of forearm ischemia (lack of blood flow) resulting from brachial artery injury, usually associated with supracondylar fractures of the humerus. Classic involvement is with the median nerve. Contracture results from insufficient arterial perfusion and venous stasis followed by ischemic degeneration of the muscle.
Irreversible damage begins after 4 to 6 hours .
194
Guyon's Canal
AKA The Ulnar Canal
A canal in the wrist that allows passage of the ulnar artery and ulnar nerve.
Boundries: Roof - superficial palmar carpal ligament.
Floor - Flexor retinaculum and hypothernar muscles.
Associated with handle bar palsy
195
Colles Fx
A fx of the distal radius with dorsal and radial displacement of the wrist and hand. "Dinner Fork" of "Bayonet" deformities.
196
Smith Fx
AKA the reverse Colles or Goyrand-Smith Fx.
| A fracture of the distal radius that is displaced volarly
197
Bennet's Fx
A fracture of the base of the first metacarpal.
198
Tarsal Tunnel
Posterior to the medial Malleolus.
Roof: Flexor retinaculum
Floor: Medial surfaces of the talus and calcaneus.
Contents: Tibialis Posterior, Flexor digitorum longus, flexor hallicus longus, posterior tibial artery, posterior tibial vein and tibial nerve.
TT Syndrome is compression of the tibial nerve.
199
Sinus Tarsi
The "eye" of the ankle. Found on the lateral side of the foot, distal and slightly anterior to the lateral mallelous.
Boundaries: Neck of the talus and the anterodsuperior aspect of the calcaneus.
ST Syndrome usually develops following an ankle sprain or due to repetitive strain from running or walking on a flat foot.
200
Diabetic Coma
Hyperglycemia
Too much glucose in the blood, can lead to acidosis because there is not enough insulin in the blood to get the glucose to the body.
A loss of sodium, potassium, and ketone bodies through excessive urination produces ketoacidosis, which can lead to a coma.
Sx's
Labored breathing, fruity-smelling breath, nausea and vomitting, thirst, dry mouth, flushed skin, and mental confusion.
201
Insulin Shock
Hypoglycemia when the body has to much insulin and too little blood sugar.
Sx's
tingling in the mouth, hands or other body part, physical weakness, headaches and abdominal pain. It may be observed that the pt. has normal or shallow respirations, rapid heartbeat and tremors along with irritability and drowsiness.
202
Barton's Fracture
An intra-articular fracture of the distal radius with dislocation of the radiocarpal joint.
203
Intra-articular
Within a joint
| ACL, PCL
204
Immediate care for seizures
Get them side-lying, do NOT try and open their mouth. Nothing much you can do.
Activate EMS if:
No history of seizures
Seizures longer then..
If seizures become more violent or severe.
205
ALS
Amyotrophic Lateral Sclerosis - a fatal, progressive neurological disease that slowly attacks neurons responsible for voluntary muscular actions; there are no effective treatments to stop or reverse the progression.
206
MS
Multiple Sclerosis - A neurodegenerative, lifelong chronic disease diagnosed primarily in young adults, characterized by the gradual accumulation of focal plaques of demyelination in the brain.
207
Hypoxia
Low oxygen in the tissue.
