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Belt of Fire, originate from, insert into, works to, include, include,…

- - - - Weak immune system
    - - Live attenuated
        
        Subcutaneously
        
        Between 12 and 15 months
        
        between 4 and 6
  - - - People aged 60 and above
  - - - Polymerase chain reaction (PCR)
- - - - Molecular mimicry
- - - - Humero-ulnar head
        
        Medial epicondyle - coronoid process
      - Radial head
        
        The anterior oblique line
      - Flex the MCP & PIP & wrist joint
      - The palmar surfaces of the 4 middle phalanges
  - - - Palmar surface of distal phalanx of thumb.
      - Flex IP & MP joint of the thumb
      - Anterior surface of radius & interosseous membrane
    - - Anterior surface of ulna
      - Anterior surface of radius
      - Pronate the hand
    - - The palmar surfaces of the distal 4 phalanges
      - Flex MCP & PIP & DIP & the wrist joints of the four fingers.
      - The anterior and medial surfaces of the ulna & the interosseous Membrane
  - - - Medial epicondyle
      - Base of metacarpals II and III
      - Flex and abduct the wrist
    - - Medial epicondyle
      - Flexor retinaculum and palmar aponeurosis
      - Flex the wrist joint
    - - Ulnar head
        
        Coronoid process
      - lateral surface of the radius
      - Humeral head
        
        Medial epicondyle of humerus - supracondylar ridge of the humerus
      - Pronate & Flex the forearm
    - - Humeral head
        
        Medial epicondyle
      - Ulnar head
        
        Olecranon and posterior border of ulna
      - Pisiform – Hamate- base of metacarpal V
      - Flex and adduct the wrist joint
- - - - brachioradialis
        
        lateral supracondylar ridge of humerus
        
        lateral surface of distal end of radius
        
        flexes forearm
      - extensor carpi radialis longus
        
        lateral supracondylar ridge of humerus
        
        base of 2nd Metacarpal
        
        extends & abducts hand
      - extensor carpi radialis brevis
        
        lateral epicondyle of humerus
        
        base of 3rd metacarpal
        
        extends hand at wrist
    - - extensor digitorium
        
        lateral epicondyle of humerus
        
        extensor expansion of 2nd 3rd 4th 5th digits
        
        extends medial 4 digits at MCP, PIP ,DIP joints
      - extensor digiti minimi
        
        lateral epicondyle of humerus
        
        extensor expansion of 5th digit
        
        extends 5th digit at MCP, PIP ,DIP joints
      - extensor carpi ulnaris
        
        lateral epicondyle of humerus & posterior border of ulna
        
        base of 5th metacarpal
        
        extends and adducts hand at wrist
  - - - supinator
        
        lateral epicondyle of humerus & posterior surface of ulna
        
        lateral, posterior & anterior surface of radius
        
        supinates forearm
    - - abductor pollicis longus
        
        posterior of ulna, radius & interosseous membrane
        
        base of 1st metacarpal
        
        abducts thumb & extends
      - extensor pollicies brevis
        
        base of proximal phalanx
        
        extends at carpometacarpal and MCP joints
      - extensor pollicis longus
        
        posterior of 1/3 ulna& interosseous membrane
        
        base of distal phalanx
        
        extends MCP & IP joints
    - - extensor indicis
        
        posterior surface of ulna & interosseous membrane
        
        extensor expansion of 2nd digit
        
        extend 2nd digit assists in extension of hand
- - - - Pain arising from damage to the nervous system
    - - Pain arising from tissue damage
- - - - Sensory nerves
      - Motor nerves
      - Autonomic nerves
    - - Mononeuropathy
      - Polyneuropathy
  - - - Negative symptoms
      - Positive symptoms
    - - Muscle weakness
  - - - Nerve conduction study (NCS)
      - Electromyography (EMG)
    - - Nerve biopsy
    - - Quantitative sudomotor axon reflex test (QSART)
- - - - Antiviral therapy should be initiated within this time frame to maximize the potential benefits of treatment
    - - there is likely minimal benefit of antiviral therapy in the patient who has lesions that have encrusted.
    - - nucleoside analogues
        
        acyclovir
        
        valacyclovir
        
        famciclovir
  - - - Gabapentin and Pregabalin
      - MOA:
        
        binding to the α2-δ site of the presynaptic voltage-gated calcium channels in the CNS, which inhibits excitatory neurotransmitter release including glutamate and substance P
      - PK:
        
        Half-life elimination: 5-9 hours.
        
        eliminated by urine (mostly as unchanged drug)
    - - MOA:
        
        Inhibit the reuptake of norepinephrine, dopamine and serotonin in the central nervous system (increase the inhibition of pain signals).
      - different clases
        
        TCAs
        
        SNRIs
    - - Lidocane
        
        Local anesthetic that block nerve conduction
        Na+ channels blocker
        
        Applied to the skin, it can relieve itching, burning, and pain from inflammation.
      - Capsaicin
        
        Activates the vanilloid receptor 1 (TRPV1).
        Prevent release of excitatory neurotransmitters like substance P.