Category: Fundamentals
Cardioselective β-blocker agents are as antihypertensive as the nonselective ones. Selective agents are preferable in patients with chronic lung disease or chronic smoking, insulin-requiring diabetes mellitus and in stroke prevention.
Category: Fundamentals
By blocking β1-receptors, it affects heart rate, conduction and contractility, yet by blocking β2-receptors, it tends to cause smooth muscle contraction with risk of bronchospasm in predisposed individuals.
Category: Fundamentals
Third-generation β-blocker vasodilatory agents act through two mechanisms: first, direct vasodilation, mediated by the release of nitric oxide as in carvedilol and nebivolol and, second, added α-adrenergic blockade, as in labetalol and carvedilol.
Category: Fundamentals
First-generation nonselective β-blockers block all the β-receptors (β1 and β2). Second-generation cardioselective agents, such as atenolol, metoprolol, bisoprolol, and others, have selectivity for the β1 (largely cardiac) receptors.
Category: Fundamentals
In patients with atrial fibrillation, management often aims at controlling ventricular rate rather than restoration and maintenance of sinus rhythm. β-blockers, with low dose digoxin, play an important role in rate control in such patients.
Category: Fundamentals
β-blockers are no longer recommended as first-line treatment for hypertension by the Joint National Council (JNC) of the USA and have been relegated to fourth or even fifth line choices by the National Institute of Clinical Excellence of the UK.
Category: Fundamentals
β-blockade reduces the oxygen demand of the heart by reducing the double product (HR × BP) and by limiting exercise-induced increases in contractility. Of these, the most important and easiest to measure is the reduction in heart rate.
Category: Fundamentals
β-blockers were originally designed by the Nobel prize winner Sir James Black to counteract the adverse cardiac effects of adrenergic stimulation. His work led to the design of the prototype β-blocker, propranolol.
Category: Fundamentals
Patellofemoral pain, also known as anterior knee pain, chondromalacia, or “runner’s knee,” describes any pain involving the patellofemoral joint. The pain affects any or all of the anterior knee structures.
Category: Fundamentals
The menisci act as shock absorbers within the knee. Injuries to a meniscus can lead to pain, clicking, and locking sensation. Most meniscus injuries occur with acute injuries or repeated microtrauma, such as squatting or twisting.
Category: Fundamentals
The posterior cruciate ligament (PCL) is the strongest ligament in the knee. PCL injuries usually represent significant trauma and are highly associated with multi-ligament injuries and knee dislocations.
Category: Fundamentals
The medial collateral ligament (MCL) is the most commonly injured ligament in the knee. It is usually injured with a valgus stress to the partially flexed knee. It can also occur with a blow to the lateral leg.
Category: Fundamentals
Anterior cruciate ligament (ACL) injuries usually lead to acute swelling of the knee, causing difficulty with motion. After the swelling has resolved, the patient can walk with a “stiff-knee” gait or quadriceps avoidance gait because of the instability.
Category: Fundamentals
The anterior cruciate ligament (ACL) connects the posterior aspect of the lateral femoral condyle to the anterior aspect of the tibia. Its main function is to control anterior translation of the tibia on the femur.
Category: Fundamentals
The knee is stabilized by the collateral ligaments against varus and valgus stresses. The tibia is limited in its anterior movement by the anterior cruciate ligament (ACL) and in its posterior movement by the posterior cruciate ligament (PCL).
Category: Fundamentals
The knee is the largest joint in the body and is susceptible to injury from trauma, inflammation, infection and degenerative changes. The knee is a hinge joint. The joint line exists between the femoral condyles and tibial plateaus.
Category: Fundamentals
Almost all patients with a hip fracture will require surgery. Surgery is recommended within the first 24 hours because studies have shown that delaying surgery 48 hours results in at least twice the rate of major and minor medical complications.
Category: Fundamentals
With a hip fracture, patients typically report pain in the groin, though pain radiating to the lateral hip, buttock or knee is common. If a displaced fracture is present, the patient will not be able to bear weight and the leg may be externally rotated.
Category: Fundamentals
Carpal tunnel syndrome is a painful disorder caused by compression of the median nerve between the carpal ligament and other structures within the carpal tunnel. Carpal tunnel syndrome can also be a feature of many rheumatic diseases.
