HLAは単純暗記ですね。
・HLA-DR2：MS、花粉症、SLE、Goodpasture syndrome。
・HLA-DR4：Addison disease、1型糖尿病、関節リウマチ。
・HLA-B8：Addison disease、myasthenia gravisMG重症筋無力症、Graves disease.
・HLA-DQ8：celiac disease
・Mitral stenosis(caused by rheumatic fever)の合併症
→atrial enlargement→recurrent laryngeal nerve and cause hoarseness, a condition known as Ortner syndrome.
The recurrent laryngeal nerve反回神経：a branch of the vagus nerve迷走神経の枝、支配筋はpalatoglossus口蓋舌筋, an intrinsic muscle of the tongue内舌筋.
・The obturator nerve閉鎖神経はスポーツ選手など、スクワットをして圧迫され、内転障害を引き起こす。
・The femoral nerve大腿神経 innervates muscles that flex the thigh and extend the knee.
・The inferior gluteal nerve下殿神経 extends and laterally rotates the thigh via the gluteus maximus.
・The obturator internus nerve内閉鎖神経 laterally rotate and flex the thigh.
・The sciatic nerve innervates the posterior thigh muscles.
・SSSS
Staphylococcal scalded skin syndrome (SSSS)はStaphylococcus aureusが産生するtwo exotoxins (epidermolytic toxins A and B)が原因。
The exotoxinsがdesmoglein 1と結合し、細胞間の結合を障害する。
→Nikolsky sign(+)
S多すぎ。
・A fracture of the scaphoid is associated with pain at the anatomic snuffbox. The scaphoid has a weak blood supply via retrograde flow, so it is at high risk of osteonecrosis as compared to other bones of the wrist.
A thumb spica cast is the most common treatment.
転倒した時に舟状骨骨折多い。
血液の供給が少ない場所で壊死のリスクなんですね。
手根骨たち。
・The hamate fractures are uncommon, but can present with pain on movement, and ulnar nerve neuropathies and deficits, such as hand weakness or loss of sensation in pinky and ring finger.
・The lunate is most often dislocated from a fall on an outstretched hand.
・The pisiform does not play a function in wrist movement！動きには関係ない！
・The trapezoid bone is in a well-protected position and has little movement near the third metacarpal bone.
・The trapezium forms the distal part of the carpal tunnel.
・Medicareは65歳以上と、65歳以下でwith certain disabilitiesとwith end-stage renal disease at any age.
