Neck Sprain: Neck sprains refer to a ligament sprain or muscle strain in the neck. They are most typically associated with the whiplash injury (common in a car accident) but also occur frequently during sports. They are the result of a fall, impact or contact with another person, object or surface.

The seven cervical vertebrae are connected to each other by ligaments. A sprain occurs when these ligaments are stretched or torn beyond their normal range of motion. This may happen during sudden movements that causes the neck to extend, then snap back, with extreme force. Common symptoms of a neck sprain include:

• Pain in the back of the neck that increases with movement
• Pain on the sides of the neck
• Delayed onset neck pain that shows up 24 to 48 hours after a neck injury
• Muscle spasms or pain in the upper regions of the shouldersback and shoulders
• Headache at the back of the head
• Sore throat
• Irritability, fatigue, difficulty sleeping and difficulty concentrating
• Stiffness / decreased range of motion in teh nck
• Tingling, numbness or weakness in the hands or arms

Neck Strain:

Neck strains result from acute injury to the neck. Such injuries are caused most often by the indirect trauma when the head is flung backward (hyperextension) or forward (hyperflexion), collectively known as whiplash. Injuries caused by rotation and compression (when the force of impact lands on the top of the head) can also result in neck strains.

• Automobile accidents are responsible for many whiplash injuries because of hyperextension or hyperflexion. A common scenario is when a seat-belted person’s head continues to move forward during a frontal impact and is then often thrown backward (the converse is also true). Side impacts typically result in bending of the head to that side, and rear impact tends to throw the head backward. Any or all of these movements usually result in whiplash.

• People with occupations requiring repetitive or prolonged neck extension (microtrauma) may develop neck strain injury. Picture someone sitting at a computer keyboard, for example, straining to see a monitor that is not adjusted properly for the person’s posture. Also, the person may be trying to see the monitor through poorly adjusted bifocal lenses and must tip the chin upward to view the screen. Now tuck a telephone into the person’s shoulder for much of the day, and you have a formula for neck strain.
• Some people appear prone to neck strain injuries merely as the result of an abnormal posture while awake or asleep with pain syndromes that can be severe, chronic, and quite disabling.

The portion of the spine contained within the neck is referred to as the cervical spine. That’s the site for injuries known as neck strain.

Unlike the rest of the spine (thoracic, lumbar, and sacral), which is relatively well protected from injury because it is enclosed by the torso, the cervical spine is more vulnerable to injury. This portion of the spine is encased in a relatively small amount of muscles and ligaments. Yet its normal function requires extensive range of motion.

The neck contains many vital anatomic structures, the most critical being the airway, the spinal cord, and the blood vessels that supply the brain. By definition, neck strain injuries do not involve serious injury to any of these vital structures and also are not associated with fractures or dislocations of any of the bones of the cervical spine. Significant injury to blood vessels and the spinal cord are also not part of the definition of a strain type of injury.

Orthopedists, doctors of the bones and joints, differentiate “sprains” from “strains.” Injuries of tissues that contract and move, such as muscles, tendons, and their attachments into bones, are termed strains (for example, tendonitis occurs when tendons are involved). Similar injuries to inert (or nonmoving) structures, such as ligaments, joint capsules, nerves, bursae, blood vessels, and cartilage, are termed sprains. Some people, however, use both terms interchangeably.

To be consistent here, the term strain will be used. Both strains and sprains of the neck may involve tears to ligaments covering the cervical vertebrae, the many muscles of the neck (which move the head), and many other associated structures. They may also result in injury to cervical nerves caused by stretching or compression.

The neck is an area where stability has been sacrificed for mobility, making it particularly vulnerable to injury. Because you can be injured in a number of different ways, a detailed medical and job history (including an analysis of work activity) is often needed to ascertain the likelihood of a severe injury. It also helps to predict how long your recovery will take and what your prognosis will be following an injury.

A thorough physical examination is necessary, particularly in instances where symptoms of nerve injury occur. Other studies using the latest computerized imaging methods and other techniques may also be helpful.

Seeing a doctor is vital for all strains with a significant mechanism of injury or for severe, persistent, or unexplained symptoms or problems. As with other conditions, supportive self-care is often enough for you to have a complete recovery.

Neck Strain Causes

Neck strains result from acute injury to the neck. Such injuries are caused most often by the indirect trauma when the head is flung backward (hyperextension) or forward (hyperflexion), collectively known as whiplash. Injuries caused by rotation and compression (when the force of impact lands on the top of the head) can also result in neck strains.

• Automobile accidents are responsible for many whiplash injuries because of hyperextension or hyperflexion. A common scenario is when a seat-belted person’s head continues to move forward during a frontal impact and is then often thrown backward (the converse is also true). Side impacts typically result in bending of the head to that side, and rear impact tends to throw the head backward. Any or all of these movements usually result in whiplash.

• People with occupations requiring repetitive or prolonged neck extension (microtrauma) may develop neck strain injury. Picture someone sitting at a computer keyboard, for example, straining to see a monitor that is not adjusted properly for the person’s posture. Also, the person may be trying to see the monitor through poorly adjusted bifocal lenses and must tip the chin upward to view the screen. Now tuck a telephone into the person’s shoulder for much of the day, and you have a formula for neck strain.
• Some people appear prone to neck strain injuries merely as the result of an abnormal posture while awake or asleep with pain syndromes that can be severe, chronic, and quite disabling.

Neck Strain Symptoms

The cardinal symptom of neck strain is pain. Although you typically have pain after an accident, it is not uncommon for you to be free of discomfort initially, because inflammatory changes may happen slowly. The presence of immediate pain at the time of injury should serve as a red flag that the injuries may be more severe than first thought.

Other symptoms include the inability to perform daily work or activities that you could do before. Be wary of symptoms suggesting nerve problems such as weakness, numbness, tingling, incoordination, and dizziness.

Neck stiffness usually occurs and may radiate into the lower back when severe. Difficulty chewing, swallowing, and breathing occur rarely. You should contact your doctor if you have these symptoms.

When to Seek Medical Care

If your symptoms do not go away as expected or if new symptoms appear, you should seek medical attention without delay.

• Call your doctor if you experience the following symptoms:
  • Severe, unremitting neck pain

  • Neck pain unaffected by changes in position or pain that is not controlled with appropriate medication
  • Severe night neck pain
  • Severe, persistent neck muscle spasms
  • Inability to perform daily work or activities that you could do prior your illness
• In addition, symptoms suggesting possible injury to the vital structures contained in the neck should prompt early contact with your doctor. These may include the following:
  • Weakness

  • Numbness
  • Tingling or loss of function particularly in the upper extremities
  • Difficulty breathing
  • Dizziness, headache, or nausea and vomiting
  • Ringing in the ears or decreased hearing
• If you are unable to reach your doctor (or do not have one), you should go to a hospital’s emergency department without delay for evaluation of any of these types of problems.
• If you get sick or reinjured while your neck pain is present, you should contact your doctor.

You must seek immediate medical attention for any symptom suggesting a problem affecting the nervous system, airway, or spinal cord.

• Examples of spinal cord injury
  • Bowel or bladder retention or incontinence, that is, inability to control the bowels or bladder

  • Inability to urinate
  • Leg weakness or any new inability to walk
  • Ataxia (loss of balance)
  • Vertigo
  • Dizziness
  • Nausea and vomiting
  • Tinnitus (ringing in the ears)
  • Any other acute symptoms suggesting a nerve problem
• Evaluation by an orthopedist or neurosurgeon may be required to check for a condition requiring urgent surgical treatment.

Extracted from Wikipedia.

Urticaria (from the Latin urtica, nettle (whence It. ortica, Sp. ortiga, Pg. urtiga) urere, to burn^[1]) (or hives) are a kind of skin rash notable for dark red, raised, itchy bumps. Hives are frequently caused by allergic reactions; however, there are many non-allergic causes. For example, most cases of hives lasting less than six weeks (acute urticaria) are the result of an allergic trigger. Chronic urticaria (hives lasting longer than six weeks) are rarely due to an allergy. The majority of patients with chronic hives have an unknown (idiopathic) cause. Perhaps as many as 30-40% of patients with chronic idiopathic urticaria will, in fact, have an autoimmune cause. Acute viral infection is another common cause of acute urticaria (viral exanthem). Less common causes of hives include friction, pressure, temperature extremes, exercise, and sunlight. It may be true that hives are more common in those with fair skin.

Wheals (raised areas surrounded by a red base) from urticaria can appear anywhere on the surface of the skin. Whether the trigger is allergic or non-allergic, there is a complex release of inflammatory mediators, including histamine from cutaneous mast cells, resulting in fluid leakage from superficial blood vessels. Wheals may be pinpoint in size, or several inches in diameter. Angioedema is a related condition (also from allergic and non-allergic causes), though fluid leakage is from much deeper blood vessels. Individual hives that are painful, last >24 hours, or leave a bruise as they heal are more likely to be a more serious condition called urticaria pigmentosa. Hives caused by stroking the skin (often linear in appearance) are due to a benign condition called dermatographism.

The skin lesions of urticarial disease are caused by an inflammatory reaction in the skin, causing leakage of capillaries in the dermis, and resulting in an edema which persists until the interstitial fluid is absorbed into the surrounding cells.

Allergic urticaria on the skin induced by an antibiotic

Urticaria are caused by the release of histamine and other mediators of inflammation (cytokines) from cells in the skin. This process can be the result of an allergic or non-allergic reaction, differing in the eliciting mechanism of histamine release.

Allergic urticaria on the arm

Allergic urticaria

Histamine and other pro-inflammatory substances are released from mast cells in the skin and tissues in response to the binding of allergen-bound IgE antibodies to high affinity cell surface receptors. Basophils and other inflammatory cells are also seen to release histamine and other mediators, and are thought to play an important role, especially in chronic urticarial diseases.

Autoimmune urticaria

In the past decade, it has been noted that many cases of chronic idiopathic urticaria are the result of an autoimmune trigger. For example, roughly one third of patients with chronic urticaria spontaneously develop auto-antibodies directed at the receptor FcεRI located on skin mast cells. Chronic stimulation of this receptor leads to chronic hives. Patients often have other autoimmune conditions such as autoimmune thyroiditis.

Infectious

Hive-like rashes commonly accompany viral illnesses, such as the common cold. They usually appear 3–5 days after the cold has started, and may even appear a few days after the cold has resolved.

Non-allergic urticaria

Mechanisms other than allergen-antibody interactions are known to cause histamine release from mast cells. Many drugs, for example morphine, can induce direct histamine release not involving any immunoglobulin molecule. Also, a diverse group of signaling substances called neuropeptides have been found to be involved in emotionally induced urticaria. Dominantly inherited cutaneous and neurocutaneous porphyrias (porphyria cutanea tarda, hereditary coproporphyria, variegate porphyria and erythropoietic protoporphyria) have been associated with solar urticaria. The occurrence of drug-induced solar urticaria may be associated with porphyrias. This may be caused by IgG binding not IgE.

Dietary histamine poisoning

This is termed scombroid food poisoning. Ingestion of free histamine released by bacterial decay in fish flesh may result in a rapid-onset allergic-type symptom complex which includes urticaria. However, the urticaria produced by scromboid is reported not to include wheals. ^[2]

Stress and chronic idiopathic urticaria

Chronic idiopathic urticaria has been anecdotally linked to stress since the 1940s^[3]. There is a large body of evidence demonstrating an association between this condition and both poor emotional well-being^[4] and reduced health related quality of life^[5]. More recent research has investigated hypotheses about stress as a causal factor in triggering the condition. Evidence has been found for a link between stressful life events (e.g. bereavement, divorce etc…)^[6] and preliminary evidence has been reported for a link between posttraumatic stress and chronic idiopathic urticaria^[7]. Less is known about the individual experiences and characteristics of people who develop chronic idiopathic urticaria following stress. Research into these factors in the relationship between stress and chronic idiopathic urticaria is ongoing by a number of researchers, including an online project^[8] currently being undertaken by researchers at the University of Plymouth [7].

Me: Without doing a swap, how do you know who has H1N1 and who hasn't?
Doctor: Well, I wouldn't know.
Me: -_-" Like that, there must be lots of H1N1 patients walking around without knowing? Which is like me.
Doctor: If you scare then you go TTSH lor.
Me: No la. I just ask for knowledge purpose.