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WE did an amazing job together, I too, think we should be very proud of ourselves. <3 You are welcome! x

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Yay we did it! Such a great effort and feels so good to submit it early especially since its just been the two of us. Nice work Sophie and thank you for submitting it :)

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I am uploading it now through LMs, it should appear on your end as uploaded to! Here is the copy if you need it. I can't believe we did it! <3 such great work!

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Hi Isabella! I have updated you question (just cut a few words to still bring it in to the 10% range) but the answer is great otherwise! I will ammend those other edits now in the workbook and then we are good to go! :D woohoo!

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Question 4:

Elderly women are at a greater risk for developing osteoporosis for a number of reasons. These include the decline in estrogen levels which naturally occurs as a woman ages as well as lifestyle factors surrounding alcohol consumption, whether or not they smoke, if they are following a nutritious diet and whether or not they remain physically active and healthy. Out of these factors, smoking has been shown to increase the risks of developing osteoporosis whereas physical activity can protect bone mass as we age. (Bijelic, R., Milicevic, S., & Balaban, J. (2017).

Bijelic, R., Milicevic, S., & Balaban, J. (2017). Risk Factors for Osteoporosis in Postmenopausal Women. Medical archives (Sarajevo, Bosnia and Herzegovina), 71(1), 25–28. https://doi.org/10.5455/medarh.2017.71.25-28

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Here you go! Sitting at 84 words now. If you are happy with it then lets hand this in today! Does only one of us need to submit it?

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Thank you so much for adjusting the word count! I must have thought they were still within the 10% allowance for some reason. I am adjusting Q4 now and will send it through shortly :)

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Once you let me know that you're happy with these changes I'll update it in the eWorkbook! Once you've increased the word count in the Skeletal system Q4, we are good to go and an finally hand this in :D

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Same module: Q4 Edit - it just needed a few more filler words so that it falls within the 10% of the word count.

The hormonal axis in this case is the hypothalamus pituitary thyroid (HPT) axis. The HPT axis controls and regulates thyroid hormones through its secretion of the thyroid stimulating hormone (TSH) which in itself is regulated by the thyrotropin-releasing hormone (TRH). It is only through the release of the thyroid stimulating hormone that the necessary amounts of T3 and T4 are produced for the required energy production and metabolic needs of the individual. The pituitary gland can sense when thyroid hormones are too low or high and is responsible for sending signals which allow TSH to produce more or less of the hormones when needed. The organs directly involved in the release of thyroid hormones are the hypothalamus, pituitary gland and thyroid gland and it is the follicular cells responsible for the production of both T3 and T4 (137 words) (DONE)

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Edit to Endocrine – Q3

Thyroid hormones conduct various actions within the body they’re known as T3 (Triiodothyronine) and T4 (Tetraiodothyronine). Two actions include energy production and regulating different functions as they govern the metabolism. The pituitary gland sends a message to the thyroid gland to make more or less of these hormones depending on the needs of the person. (55 words) (DONE)

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Edit to Q5 same module: Muscle tone is the continuous and partial contraction of a muscle, which allows it to maintain balance, posture, and reflex when needed, as well as providing support to other organ systems. The muscle spindle regulates and maintains muscle tone and it is within these spindles that nuclear bag fibers and nuclear chain fibers are located; containing myosin and actin which enables the spindles to stretch with the muscle. Spasticity is one tonic disorder that can be treated by Botox. (79 words) (DONE)

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I am making some edits today - just minimizing word count. The first change is to Muscular system Q4 – it was just outside of 10% of the word count. I hope this is alright.

'Sodium plays a key role in producing an action potential, as its fluctuation (specifically re-entering the cell and elevating the charge) influences the cell charge from negative to positive within a cell, allowing the threshold to be reached and action potential to be produced. This process arises at the axon hillock as a consequence of depolarisation where voltage-gated sodium ion channels are forced to open due to an electrical stimulus.' (71 words)

(DONE)

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Hi Isabella! I'm sorry I was referring to Q4 (Skeletal System) - I must have got that mixed up. Oh no, don't stress anymore, you have done such a great job, I am so grateful to have been able to work with someone so well for a group assignment :D

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I think it's fine to leave the week 7 peer reviews there as they are a part of the whole e workbook journey and Tom knows that it is just the two of us now anyways. I will submit mine into the chat now :)

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Hey, thank you so much that means a lot! I was stressing that I hadn't done a good enough job or that I wouldn't be able to get it all done but we did it! yay! We really have done a great job especially it just being the two of us. So just to clarify, I just need to increase the word limit a bit for Q3 of Skeletal? I can do it before the end of the weekend (just busy with work) and then submit the updated version here.

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Okay, I have finished everything except having a last check over for final edits, reducing word counts (if need be) etc. I am pretty brain dead haha but I will attend to this Monday morning and as soon as you've done your final edits we can download this baby and upload her! :D Please have a look over and let me know if you see anything I have missed or haven't mentioned. I uploaded your peer review in the last column also, I thought to leave the originals there but what do you think - should we check with Tom if we need them? And, have an amazing weekend! you deserve it :D

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Firstly, I am so impressed! You have researched your questions so much, well done!

I have uploaded all of your content and just have some edits to do later this week and then we can submit it! As it is a group assignment, I am pretty certain once one person uploads it, it will be uploaded for the other automatically.

Due to feedback from Tom I need to edit a couple of my questions – so I will get to that as soon as I can.

As for the skeletal system edit you did (firstly thank you!) just Q3 is under the word count and it’ll be worth just adding a bit more to that one – (it needs to be 75 words or 10% under or over, currently, it’s at 46 words).

I can do a check over the rest of our questions and if any are over, I can do an edit to bring the word count down, are you happy for me to do that? I have brought the other question you edited down a few words as well but didn’t take away from the content! I am also yet to add the rest of your references too but will do that when I work on the other stuff :)

I need to change these questions: Nervous System

Tom: For Q2 I was referring to the lack of the neurolemma in the CNS unlike in the PNS - since the PNS have a neurolemma there is the capacity for regeneration after injury.

Tom: Q4. You might want to include the concept of decussate for the second order neuron.

Isabella, I must say, we have worked so well and are almost finished! We just have little edits to make and we have finished this assignment all on our own and EARLY! It’s only Week 12 which is a week early than what we planned haha! GO us!

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Here are my answers/edits for Q3 and Q4 of the Skeletal module based on the feedback and questions asked. The first one might take the original word count over a bit so may need to be amended but otherwise all good to go! I'm happy to submit my Peer Review feedback form asap as well and then we can download the final padlet and submit :).           Question 3:

Fracture repair can take months as it is required to go through different stages. When this type of injury occurs, the bone fracture forms a hematoma which lasts around five days. Afterwards, for five to six days, a fibrocartilaginous callus is formed followed by a bony callus which lasts around two weeks. Lastly, remodelling takes place which can take months or years depending on the patient’s recovery and health status. Cells such as macrophages, monocytes, and lymphocytes work to remove damaged tissue and release cytokines which allow for bone healing and repair to begin.

Jonathon R. Sheen; Vishnu V. Garla. (2020), Fracture Healing Overview, Stat Pearls, https://www.ncbi.nlm.nih.gov/books/NBK551678/

Question 4:

Elderly women are at a greater risk for developing osteoporosis for a number of reasons. These include the decline in estrogen as women age as well as lifestyle factors such as alcohol consumption, smoking, lack of a nutritious diet and ensuring that they remain physically active (Bijelic, R., Milicevic, S., & Balaban, J. (2017).

Bijelic, R., Milicevic, S., & Balaban, J. (2017). Risk Factors for Osteoporosis in Postmenopausal Women. Medical archives (Sarajevo, Bosnia and Herzegovina), 71(1), 25–28. https://doi.org/10.5455/medarh.2017.71.25-28

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Endocrine system

Question 3: The synthetic thyroid hormone replaces the deficient production of the endogenous thyroid hormone. Discuss two (2) actions of thyroid hormone within the body.

Thyroid hormones carry out various actions within the body and are known as T3 (Triiodothyronine) and T4 (Tetraiodothyronine). Two actions of these hormones include energy production and regulating different bodily functions as they govern the metabolism. The pituitary gland sends a message to the thyroid gland to make more or less of these hormones depending on the needs of the person (NCBI, 2018).  (61 words)

Institute for Quality and Efficiency in Health Care (2018), How does the thyroid gland work? National Center for Biotechnology Information, https://www.ncbi.nlm.nih.gov/books/NBK279388/

Question 4: Hormonal axes are pathways that direct neuroendocrine function. Identify the relevant axis, in this case, and describe the associated control and regulation of thyroid hormones. Include the relevant organs, hormones and cells from which they are released/produced

The hormonal axis in this case is the hypothalamus pituitary thyroid (HPT) axis. The HPT axis controls and regulates thyroid hormones through its secretion of the thyroid stimulating hormone (TSH) which in itself is regulated by the thyrotropin-releasing hormone (TRH). It is only through the release of thyroid stimulating hormone that the necessary amounts of T3 and T4 are produced for the required energy production and metabolic needs of the individual. The pituitary gland can sense when thyroid hormones are too low or high and sends signals which allow TSH to produce more or less of the hormones. The organs directly involved in the release of thyroid hormones are the hypothalamus, pituitary gland and thyroid gland and it is the follicular cells responsible for the production of both T3 and T4 (Mariotti, S & Beck-Peccoz, P. 2016). (131 words)

Mariotti, S & Beck-Peccoz, P. (2016), Physiology of the Hypothalamic-Pituitary-Thyroid Axis, National Center for Biotechnology Information, https://www.ncbi.nlm.nih.gov/books/NBK278958/

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Muscular system

Question 1: Name the collective structure where Botox exerts its action and identify specific components (minimum of four) within the structure.

The collective structure where Botox exerts its action is within the neuromuscular junction. Some of the specific components which make up its structure include, but are not limited to, the muscle belly, epimysium, myosin, muscle fascicle, sarcomere, perimysium, myofilament as well as the actin (Perry, C. 2020).  (44 words)

Perry, Carolyn. (2020). The neuromuscular junction: Structure and function, Ken Hub, https://www.kenhub.com/en/library/anatomy/the-neuromuscular-junction-structure-and-function

Question 2: Outline the role that calcium plays in the initiation of a muscle action potential.

Calcium plays a significant role in the initiation of a muscle action potential as it is one of two ions, the other being sodium, that are shuttled through various channels after acetylcholine has attached to receptors on the respective muscle surface. As a direct result of this, calcium drives the resting membrane to become positive in value and voltage gated channels are then switched on alongside the action potential of the muscle (Kuo, I. Y., Ehrlich, B. E. 2015).  (72 words)

Kuo, I. Y., & Ehrlich, B. E. (2015). Signaling in muscle contraction. Cold Spring Harbor perspectives in biology, 7(2), a006023. https://doi.org/10.1101/cshperspect.a006023

Question 3: How does Botulinum Neurotoxin A prevent the initiation of a muscle action potential at the structure identified in Q. 1?

Botulinum Neurotoxin A prevents the initiation of a muscle action potential within the neuromuscular junction through inhibiting the required neural transmission by obstructing acetylcholine from being released. Botulinum Neurotoxin A is administered into the muscle and interferes by causing paralysis within the neuromuscular junction. It successfully does this as the presynaptic motor neurons are subsequently unable to release any acetylcholine and as a result, initiation of any muscle action is prevented (Nigam, P. K., Nigam, A. 2010).  (71 words)

Nigam, P. K., Nigam, A. (2010). Botulinum toxin. Indian journal of dermatology, 55(1), 8–14. https://doi.org/10.4103/0019-5154.60343

Question 4: Outline the role that sodium plays in the production of a muscle action potential.

In the production of a muscle action potential, sodium plays a key role as it is the change from negative to positive within a cell that allows a threshold to be reached and action potential to be produced. This process arises at the axon hillock as a consequence of depolarisation where voltage gated sodium ion channels are forced to open due to an electrical stimulus. It is the sodium reentering the cell which then elevates the cell charge from a negative to a positive allowing for muscle action potential (Aarushi, K. 2020). (89 words)

Action Potential, Teach Me Physiology, Khanna, Aarushi, 2020, https://teachmephysiology.com/nervous-system/synapses/action-potential/

Question 5: Botulinum Neurotoxin A can also be used for dystonic conditions. Define muscle tone and outline the mechanism by which muscles maintain it. Identify which tonic disorder can be treated by Botox.

Muscle tone is defined as the continuous and partial contraction of a muscle which allows it to maintain balance and posture, reflex when needed as well as provide support to other organ systems. It is the muscle spindle that regulates and maintains muscle tone and it is within these spindles that nuclear bag fibers and nuclear chain fibers are located. These contain myosin and actin which enables the spindles to stretch with the muscle (Medicine LibreTexts, 2020). Spasticity is one tonic disorder which can be treated by Botox (Camargo, C., & Teive, H. 2019). (85 words)

Medicine LibreTexts (2020), 9.3D: Muscle Tone, Anatomy and Physiology, https://med.libretexts.org/Bookshelves/Anatomy_and_Physiology/Book%3A_Anatomy_and_Physiology_(Boundless)/9%3A_Muscular_System/9.3%3A_Control_of_Muscle_Tension/9.3D%3A_Muscle_Tone

Camargo, C., & Teive, H. (2019). Use of botulinum toxin for movement disorders. Drugs in context, 8, 212586. https://doi.org/10.7573/dic.212586

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Okay great, just finishing my questions for the endocrine module and then I'll send both through today. Yes of course, I am happy to have a go at the last two questions :)

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Hi Isabella! I hope you had a good day too. Amazing, nice work!  That would be great if you can submit it all in here :) Yes, in regards to the edits its just for the skeletal module, are you happy to do the last two questions or would you like me to do another? Let me know how you go :)

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Hey Sophie, I hope you have had a great Australia Day! I have just completed all 5 questions to the Muscle Module. Would you still prefer me to submit them in this chat alongside their respective references? If so I can post through tonight before I get started on my questions for the Endocrine module. With regards to the list of edits, are we simply going back to the skeletal module and adjusting the answers as needed? Just wanted to double check. Thank you :)

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Hi Isabella,

I am sorry to hear you've been unwell! I hope you feel better soon.

I have been working on the eWorkbook today, I've uploaded all of my tasks but am still waiting on some feedback from Tom - I'll amend once I get that if need be.

I have rearranged the references; they needed some editing (APA style) and to be ordered (let me know if you pick up something I have missed)

When you upload your work in here can you make sure your questions have the in-text citation and also the full reference with it so I can add it to the Reference column also. :)

There is also a list of edits (last column in the eWorkbook) to be made from the previous group, is there any way you would mind grabbing one or two of those to edit?  I'll start with Q2 and I'll pick up whichever you don't grab... it’s frustrating the person isn’t here to edit their own work but if we do this, it’ll improve our grade!

I hope you get some rest and are back to normal soon!

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Hey Sophie, thank you for that info.. I will definitely contact him for some feedback. Sorry for the late reply, I have been sick in bed for the last 2 days. I see you've posted the article to the eworkbook so I'll check it out now! Have a lovely day :)

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What do you think of this article for the Endocrine Module? - I found it really difficult to find one specifically on Hashimoto's disease however - this one is discussing the synthetic T-4 replacement which is relevant to the condition. https://www.frontiersin.org/articles/10.3389/fendo.2019.00826/full (2019 & a clinical trial)

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eWorkbook - https://padlet.com/svanpamelen/pmoto68ry2zrdvxo

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Hi Isabella! That's okay :) Amazing! we are doing well for just the two of us! Sounds great, about us both finishing our individual modules this week and then we can start working on the Endocrine system after! That's pretty amazing to have it done by then - it still gives us lots of time but at least we will have time to check over anything and edit the eWorkbook if we need to! The link for the eworkbook is right at the top of our back channel chat here. But I'll post it here too for you now :).. Also with the module questions—I've been doing this when I need clarification—don't hesitate to forward your answers through to Tom to check you've understood the question right, he's great for that and has said that he's happy to check any of it for us..

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Hey Sophie! sorry for the late response. happy to have it all done by the end of week 13/7th Feb. Yes I should be finished the Muscular one by then too so then we can finish the other one together. Silly question but how do I gain access to the workbook? I don't seem to have the link on my end

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Hi Isabella, I have uploaded some of my tasks to the eWorkbook, feel free to have a look, I should be finished the Nervous system unit by next week. Have a lovely weekend! We will catch up next week!

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The eWorkbook isn't due until week 14 (which is the first study week for exams) I was wondering if you wanted to be able to finish this by week 13 at the latest so that we can focus on our exam prep for week 14 & 15? I am happy to get through it as quickly as you'd like! Let me know what you think! :) I'll do a full read of the article tomorrow! great work Isabella :)

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Is that reference APA style? Just uploading it now but let me know what you think, at first glance I'm unsure.. I've been digging into the articles for the nervous system too, there are so many to choose from!

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Cogné, M., Petit, H., Creuzé, A. et al. Are paraspinous intramuscular injections of botulinum toxin a (BoNT-A) efficient in the treatment of chronic low-back pain? A randomised, double-blinded crossover trial. BMC Musculoskelet Disord 18, 454 (2017), https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-017-1816-6

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Okay sounds good! I still need to catch up on some content as well. I have chosen a much more comprehensive article/research paper for the Muscular module so here is the citation for it

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Hi Isabella! Good pick up - the last module does have 4! I'll update that :) Ah! yes they do need to be within the last 5 years - I'll have a look at the new article when you send it through! I'll be working on my module soon (most likely start of next week) just getting through the rest of the nervous system content first.

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It might not have enough information actually so I'll keep looking and then send through the reference

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Also, I just saw that the article is from 2012 if not earlier and we need one that's max 5 years old. What do you think of this one instead? https://www.spineuniverse.com/treatments/pain-management/botox-chronic-back-neck-pain

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Hey Sophie! Yes a little disappointing but at least it's not due for a little while so gives us time. Happy with the updated module plan (the last one only has 4 questions though) and yes I'll write out the reference for the article and post it back in here :)

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I think that article is good! If you are happy with it I'll upload it and can you write the proper reference out for me? I'll post it in the reference column

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I just edited the Module plan above, let me know what you think? I've given us each a whole module to make it easier to manage and just split the work for the last one and we can do that one together.

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Hey Isabella! I have received news from Tom that Georgia will no longer be continuing her studies! So its just you and me now. I'll reallocate the questions :(.. it's a bit disappointing we have more work to do but if we work efficiently we can do this well! :)

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I'll have a look at the article properly tomorrow :)

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haha! It's all good, I might just delete those posts if we don't need them :)

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https://www.practicalpainmanagement.com/pain/spine/botox-treatment-chronic-refractory-low-back-pain

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Hey team! Not sure what was just reposted into the chat... my laptop is giving me some issues at the moment! As for the suggestions re the modules I am totally happy with all of that moving forward. What did you guys think of this article for the Muscular System module?

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*MODULE EDIT*

Muscular System

Article & Module: Isabella

Nervous System:

Article & Module: Sophie

Endocrine System:

Article, Q1, Q2: Sophie

Q3 & Q4: Isabella

Isabella, what do you think? Is this okay?

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An article to tickle our fancy - in relation to the next Module scenario (muscular system) https://www.practicalpainmanagement.com/pain/spine/botox-treatment-chronic-refractory-low-back-pain

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Hi Everyone, welcome to the new backchannel! Please see the link to our eWorkbook. https://padlet.com/svanpamelen/pmoto68ry2zrdvxo