spine - neurological examination.pptx
•Download as PPTX, PDF•
0 likes•75 views
This document provides an overview of performing a neurological examination, including evaluating higher mental functions, cranial nerves, sensory function, motor function, reflexes, and other aspects. It describes testing various parts of the body like muscles, pin prick and light touch sensation, proprioception, and reflexes. It also reviews anatomical features like spinal cord levels and dermatomes. Sensory evaluation techniques like tactile sensitivity, pain, temperature, stereognosis, and proprioception are outlined. The motor evaluation assesses things like muscle bulk, tone, range of motion, strength, and coordination. Deep tendon reflexes and superficial reflexes are also explained.
Report
Share
Report
Share
Recommended
Functional anatomy of the ankle joint complex
website: http://www.am-medicine.com
Facebook page : https://www.facebook.com/pages/Am-medicine/207726329406832
Facebook group: https://www.facebook.com/groups/1409138472653811/
Adult traumatic brachial plexus palsy Management
This document discusses the classification, clinical evaluation, and management of adult traumatic brachial plexus injuries. It describes Chuang's four-level classification of brachial plexus lesions and defines terms like rupture and avulsion. Preganglionic root injuries are described as the most common in adults and can involve single or multiple root injuries. A thorough motor, sensory and neurological examination is outlined to evaluate the specific nerves and spinal levels involved. Classification of injuries, prognostic indicators, and guidance on surgical decision making are provided.
Rotator cuff ppt
The rotator cuff is made up of 4 muscles that stabilize the shoulder joint. Rotator cuff disorders are a common cause of shoulder pain and can range from tendinitis to tears of the muscles. Symptoms include pain that worsens with arm movements above head level. Exams like Neer's impingement sign and empty can test help diagnose tendinitis or tears. Treatment starts with rest, physiotherapy, and anti-inflammatories, while severe tears may require surgery.
Special test for dermatomes and myotomes
The document discusses dermatomes and myotomes, which are areas of skin and muscles innervated by specific spinal nerve roots. It provides detailed instructions for testing dermatomes using pinprick and light touch tests and myotomes using resistance tests of individual muscle groups to evaluate potential nerve root injuries. Key points include identifying the spinal nerve roots that innervate specific areas of the upper and lower limbs and correlating weaknesses to the likely injured nerve roots. Diagrams depict dermatome and myotome maps to guide the clinical tests.
Radial nerve
The radial nerve anatomy and injuries document describes the anatomy and treatment of radial nerve injuries. It summarizes that the radial nerve provides motor innervation to key muscles for wrist, finger, and thumb extension. For severe radial nerve injuries, early tendon transfers can restore lost functions like wrist extension, while allowing for potential nerve recovery. The principles of tendon transfers include preventing contractures, ensuring adequate strength transfer with a straight line of pull and synergistic functions. Common procedures described include transferring the palmaris longus tendon to the rerouted extensor pollicis longus and transferring the flexor carpi ulnaris to the extensor digitorum communis.
Presentation on frozen shoulder
This presentation provides information about frozen shoulder, including its definition, symptoms, stages, pathology, tests used for diagnosis, treatment options, and home exercises. Frozen shoulder, also known as adhesive capsulitis, is characterized by stiffness and pain in the shoulder joint that develops gradually over time in three stages - freezing, frozen, and thawing - and typically resolves within 1-3 years. Symptoms include severe pain and limited range of motion. Treatment involves counseling, medications like NSAIDs, steroid injections, manual therapy, surgery, and a home exercise program.
Practical 8 reflexes
This document provides information on human reflexes including:
1. It classifies human reflexes into monosynaptic, polysynaptic, superficial and deep reflexes and provides examples such as the patellar reflex.
2. It describes the components of the stretch reflex arc including the receptor, afferent neuron, central connection, efferent neuron, and effector.
3. It discusses tendon jerks including types, assessing centers in the spinal cord, and their clinical significance in evaluating motor system integrity.
Somsak nerve transfer
Compiled by Dr S Selvaganesh
Hand Surgery Fellow KTPH
Triceps to axillary nerve transfer is used in partial plexus injuries where the C5/6 component is damaged and the C7/8 and T1 are intact. The typical indication is in the C5 or C5/6 avulsion injury but it may also be used in cases of C5/6 rupture where presentation is delayed, grafting of the upper trunk has not been successful or in continuity lesions of the upper trunk that failed to reinnervate. It may also be used to salvage the axillary nerve rupture at the quadrilateral space associated with high energy shoulder dislocation or the rare non-recovering isolated lesion in continuity of the axillary nerve following a low energy shoulder dislocation.
Recommended
Functional anatomy of the ankle joint complex
website: http://www.am-medicine.com
Facebook page : https://www.facebook.com/pages/Am-medicine/207726329406832
Facebook group: https://www.facebook.com/groups/1409138472653811/
Adult traumatic brachial plexus palsy Management
This document discusses the classification, clinical evaluation, and management of adult traumatic brachial plexus injuries. It describes Chuang's four-level classification of brachial plexus lesions and defines terms like rupture and avulsion. Preganglionic root injuries are described as the most common in adults and can involve single or multiple root injuries. A thorough motor, sensory and neurological examination is outlined to evaluate the specific nerves and spinal levels involved. Classification of injuries, prognostic indicators, and guidance on surgical decision making are provided.
Rotator cuff ppt
The rotator cuff is made up of 4 muscles that stabilize the shoulder joint. Rotator cuff disorders are a common cause of shoulder pain and can range from tendinitis to tears of the muscles. Symptoms include pain that worsens with arm movements above head level. Exams like Neer's impingement sign and empty can test help diagnose tendinitis or tears. Treatment starts with rest, physiotherapy, and anti-inflammatories, while severe tears may require surgery.
Special test for dermatomes and myotomes
The document discusses dermatomes and myotomes, which are areas of skin and muscles innervated by specific spinal nerve roots. It provides detailed instructions for testing dermatomes using pinprick and light touch tests and myotomes using resistance tests of individual muscle groups to evaluate potential nerve root injuries. Key points include identifying the spinal nerve roots that innervate specific areas of the upper and lower limbs and correlating weaknesses to the likely injured nerve roots. Diagrams depict dermatome and myotome maps to guide the clinical tests.
Radial nerve
The radial nerve anatomy and injuries document describes the anatomy and treatment of radial nerve injuries. It summarizes that the radial nerve provides motor innervation to key muscles for wrist, finger, and thumb extension. For severe radial nerve injuries, early tendon transfers can restore lost functions like wrist extension, while allowing for potential nerve recovery. The principles of tendon transfers include preventing contractures, ensuring adequate strength transfer with a straight line of pull and synergistic functions. Common procedures described include transferring the palmaris longus tendon to the rerouted extensor pollicis longus and transferring the flexor carpi ulnaris to the extensor digitorum communis.
Presentation on frozen shoulder
This presentation provides information about frozen shoulder, including its definition, symptoms, stages, pathology, tests used for diagnosis, treatment options, and home exercises. Frozen shoulder, also known as adhesive capsulitis, is characterized by stiffness and pain in the shoulder joint that develops gradually over time in three stages - freezing, frozen, and thawing - and typically resolves within 1-3 years. Symptoms include severe pain and limited range of motion. Treatment involves counseling, medications like NSAIDs, steroid injections, manual therapy, surgery, and a home exercise program.
Practical 8 reflexes
This document provides information on human reflexes including:
1. It classifies human reflexes into monosynaptic, polysynaptic, superficial and deep reflexes and provides examples such as the patellar reflex.
2. It describes the components of the stretch reflex arc including the receptor, afferent neuron, central connection, efferent neuron, and effector.
3. It discusses tendon jerks including types, assessing centers in the spinal cord, and their clinical significance in evaluating motor system integrity.
Somsak nerve transfer
Compiled by Dr S Selvaganesh
Hand Surgery Fellow KTPH
Triceps to axillary nerve transfer is used in partial plexus injuries where the C5/6 component is damaged and the C7/8 and T1 are intact. The typical indication is in the C5 or C5/6 avulsion injury but it may also be used in cases of C5/6 rupture where presentation is delayed, grafting of the upper trunk has not been successful or in continuity lesions of the upper trunk that failed to reinnervate. It may also be used to salvage the axillary nerve rupture at the quadrilateral space associated with high energy shoulder dislocation or the rare non-recovering isolated lesion in continuity of the axillary nerve following a low energy shoulder dislocation.
Claw Hand
Claw hand is a condition where the fingers are noticeably curved or bent, resembling a bear's claw. It can affect one or more fingers on one or both hands. Claw hand can be present at birth (congenital) or caused by nerve damage, skin scarring from burns, or bacterial diseases like leprosy. The main cause is nerve injury or damage, which can result from birth defects, trauma, repetitive motions, or compression of the ulnar nerve in the wrist. There are two main types: partial/ulnar claw hand where the fourth and fifth fingers are affected, and complete claw hand where all fingers are curved. Treatment options include physical therapy, surgery to repair nerves or tendons, medication
ULNAR NERVE PALSY AND TENDON TRANSFERS
The document discusses ulnar nerve palsy and tendon transfers used to treat it. It begins by describing the anatomy of the ulnar nerve and its motor and sensory functions. It then discusses clinical findings associated with ulnar nerve injuries at different locations. Various tendon transfers are summarized that aim to restore small and ring finger flexion, key pinch, correct clawing, and improve grip strength for patients with ulnar nerve palsy. These include transferring forearm muscles like the ECRB to restore key pinch or correct clawing. The modified Stiles-Bunnell procedure is also summarized, which uses the middle finger superficialis tendon to dynamically correct clawing during finger flexion.
peripheral nerve injuries
This document provides information on radial, median, and ulnar nerve injuries, including anatomy, causes, examination findings, and treatment options. It describes the anatomy and branches of each nerve. Common causes of injury include lacerations, fractures, and entrapment syndromes. Examination involves testing specific muscles innervated by each nerve. Surgical treatment may include nerve repair or reconstruction using tendon transfers to restore function when nerve recovery is not possible. The document outlines various tendon transfer procedures used to treat different patterns of nerve injury.
Upper and Lower Extremity fractures
A hand fracture is a break in one of the bones in the hand, including the small finger bones (phalanges) and long palm bones (metacarpals). Common causes are falls, crush injuries, or sports impacts. Treatment options include casting, splinting, or surgery using pins, plates or screws to stabilize the fracture. Complications can include stiffness or deformity of fingers. Specific types of fractures include boxer's fractures of the pinky knuckle, Bennett fractures of the thumb base, and fractures of the finger bone bases (Busch fractures). Wrist fractures include breaks of the scaphoid bone which can lead to avascular necrosis if missed.
Tracts of the spinalcord
This document summarizes the ascending and descending tracts of the central nervous system. It describes the functional anatomy and regional anatomy of the ascending tracts that transmit sensory information from the periphery to the brain, including the dorsal column-medial lemniscal system and anterolateral system. It also discusses the different classes of sensory receptors, pathways, and relay nuclei involved in transmitting different somatic sensations like touch, proprioception, pain, itch and temperature.
Cervical disc prolapse
Cervical disc prolapse occurs when a cervical disc herniates and compresses the nerve root. The cervical spine has 7 vertebrae and 6 intervertebral discs that act as shock absorbers and allow motion. A disc is composed of an inner nucleus pulposus surrounded by the outer annulus fibrosus. Common sites of prolapse are C5-C6 and C6-C7. Clinical features include neck pain radiating to the arm. Imaging like MRI or CT is used to confirm prolapse. Treatment involves rest, medications, traction and surgery like anterior cervical discectomy if non-operative measures fail.
Applied Anatomy of Hip Joint
Supine position
Transducer: Transverse over medial thigh
2/22/2015Dept of Sports Medicine, AFMC55
USG – ADDUCTOR MUSCLE
2/22/2015Dept of Sports Medicine, AFMC56
Adductor longus, brevis and magnus seen as hypoechoic structures.
Tendons appear as hyperechoic lines.
Bursa seen as anechoic structure.
Bony landmarks like pubis and ischial tuberosity appear hyperechoic.
USG helps to identify muscle tears, tendon injuries and bursitis.
It is a useful tool for dynamic assessment during
Traumatic brachial plexus injury
This document presents a case report of a 53-year-old female who sustained a traumatic brachial plexus injury after falling down a flight of stairs. On examination, she had sensory and motor deficits in her right upper limb consistent with an infraclavicular brachial plexus palsy. She underwent conservative therapy including physiotherapy and splinting. Over an 18-month period, her function gradually improved but she was left with some residual weakness. The document discusses the anatomy of the brachial plexus, mechanisms of injury, clinical examination findings, and prognosis factors for peripheral nerve injuries.
Spinal cord Gross anatomy with Clinical Anatomy.pptx
The spinal cord is the main pathway connecting the brain and peripheral nervous system. It extends from the foramen magnum to the L1-L3 vertebrae in adults. It is surrounded by three meningeal layers and occupies the upper two-thirds of the vertebral canal. It gives rise to 31 pairs of spinal nerves. Internally, it contains grey matter in an H-shaped arrangement surrounded by white matter. The grey matter contains sensory and motor neurons that help supply different regions like the limbs. Major tracts include the corticospinal, spinothalamic and spinocerebellar tracts. The spinal cord receives its blood supply from the anterior and posterior spinal arteries. Injuries can cause
Median nerve injuries
This document provides details on the anatomy, clinical examination, treatment, and tendon transfer procedures for median nerve injuries. It discusses:
1) The anatomy of the median nerve from its origin through the arm, forearm, wrist and hand.
2) Causes of median nerve injuries including trauma, leprosy, and neurological disorders.
3) Clinical signs of median nerve injuries including weakness of thumb opposition and flexion of the wrist.
4) Surgical techniques for median nerve repair and tendon transfers to restore thumb and hand function, including the Royle-Thompson and Burkhalter procedures.
Cubital Tunnel Syndrome
Cubital tunnel syndrome is caused by compression of the ulnar nerve at the elbow, which can cause numbness, tingling, and weakness in the fourth and fifth fingers. It is often caused by repetitive elbow bending or prolonged pressure on the elbow. Diagnosis involves testing for sensory and motor function deficits in the ulnar nerve distribution and provocative tests that reproduce symptoms. Treatment may include splinting, anti-inflammatory medications, corticosteroid injections, physical therapy, and surgery if conservative measures fail.
Spinal cord injury
This document provides an overview of spinal cord injuries, including causes, prognosis, types of paralysis, assessment scales, and the roles of healthcare professionals. It discusses topics like complete vs. incomplete injuries, spinal shock, specific syndromes (central cord, Brown-Sequard), levels of injuries from C1-S5, pre-hospital care, and the kinesiologist's role in areas like evaluation, treatment planning, equipment, and consulting other specialists.
Hand deformities
The document discusses several hand deformities including mallet finger, swan neck deformity, and boutonniere deformity.
Mallet finger is an injury where the distal phalanx is forcibly flexed, rupturing the extensor tendon and preventing extension of the distal interphalangeal (DIP) joint. Treatment involves splinting the DIP joint in extension for 6-10 weeks.
Swan neck deformity involves hyperextension of the proximal interphalangeal (PIP) joint and flexion of the DIP joint. It can be caused by tendon injuries or ligament laxity. Treatment focuses on stretching intrinsics and splinting to balance extension.
Anatomy of median nerve
The median nerve originates from the brachial plexus and provides sensation and motor function to parts of the arm, forearm, and hand. It is susceptible to compression as it passes through the carpal tunnel at the wrist, which can cause carpal tunnel syndrome. Symptoms include pain, tingling, and numbness in the hand. Diagnosis involves physical exams like Tinel's sign and electrodiagnostic tests. Treatment begins with splinting and anti-inflammatories, while surgery may be needed for persistent or severe symptoms. Carpal tunnel syndrome is the most common entrapment neuropathy.
Anatomy of lumbosacral plexus (by Murtaza Syed)
This document provides an overview of the anatomy of the lumbosacral plexus, which is formed from the combination of the lumbar and sacral plexuses. It describes the roots, branches, divisions, and terminal branches that form the various nerves. These include the femoral, obturator, superior gluteal, inferior gluteal, and sciatic nerves. It also outlines the motor and sensory distributions of the nerves of the lumbosacral plexus to the lower limbs and related structures.
Brachial plexus injury
This document discusses the anatomy, types of injuries, clinical presentation, investigations and classification of brachial plexus injuries.
It describes the formation of the brachial plexus from the cervical nerve roots and its divisions. Injuries can be preganglionic or postganglionic, and include traction injuries, avulsions or lacerations. Clinical exam focuses on assessing motor and sensory deficits. Investigations include imaging like MRI/CT, myelography and EMG/NCV to localize the lesion. Seddon's classification is used to describe the severity of injury.
Brachial Plexus Injury
The brachial plexus is formed from nerve roots exiting the cervical and thoracic spinal cord. It can be injured through trauma, tumors, or birth injuries. A brachial plexus injury causes weakness, numbness, pain and deformities in the arm and hand. Physical examination tests specific muscles innervated by different nerve roots to localize the level of injury. Imaging studies and electrodiagnostic tests help evaluate the severity and location of injury to guide treatment.
Median nerve injuries
This document discusses the anatomy and clinical evaluation of median nerve injuries as well as various management strategies. It describes the anatomy of the median nerve and its branches that innervate different muscle groups in the arm and hand. Clinical presentations of high and low median nerve palsies are outlined. Surgical techniques for restoring function are proposed, including nerve transfers to regain opposition, sensation, flexion and pronation. Tendon transfers are also mentioned to help with opposition and finger flexion.
Brachaial Plexus Injury
The document discusses brachial plexus injuries, which involve damage to the network of nerves between the neck and arm. It describes the anatomy of the brachial plexus and its branches. There are two main types of brachial plexus injuries - Erb's palsy, which involves the upper trunk and results in weakness of shoulder and arm muscles, and Klumpke's palsy, which involves the lower trunk and causes hand deformities. Causes include difficult childbirth and other stretching or trauma to the neck and shoulders. Management involves medical treatment of pain as well as potential surgical interventions and physical therapy.
RADIAL NERVE PALSY[1].pptx
The radial nerve provides motor innervation to the posterior arm and forearm muscles and sensory innervation to the back of the hand. It is susceptible to injury at various points along its course from the axilla to the forearm. High radial nerve palsies occur near the radial groove of the humerus and cause loss of wrist and finger extension while sparing elbow extension. Low radial nerve palsies affect function below the elbow. Physical exam assesses affected muscle groups and sensory areas. Treatment involves splinting and may include injections or surgery to repair the nerve or transfer tendons.
spinal Trauma.ppt
This document provides an overview of spinal trauma. It begins with relevant spinal anatomy and the epidemiology of spinal injuries. The most common mechanisms of injury are motor vehicle accidents and falls. Clinical signs include neurological deficits that correspond to the level and completeness of injury. Radiological imaging such as X-rays, CT, and MRI are used to identify fractures and spinal instability. Early management focuses on immobilization, corticosteroids, and treating associated conditions like neurogenic shock. Surgical stabilization is indicated for incomplete injuries with neural compression or unstable fractures with neurological deficits. The goals of treatment are to preserve neurological function, minimize compression, stabilize the spine, and rehabilitate the patient.
Examination of motor system
This document summarizes the steps for examining a patient's motor and sensory systems. It outlines how to assess muscle tone, reflexes, strength, coordination, and sensation. The motor exam evaluates muscles for wasting, fasciculations, and abnormalities in tone. Reflexes like biceps, triceps, knee, and ankle jerks are tested. Strength is graded from 0-5. Coordination is tested using finger-nose, heel-shin, and rapid alternating movements. Sensation is assessed over dermatomes for pain, temperature, vibration and fine touch. The goal is to localize signs to upper or lower motor neuron lesions.
More Related Content
What's hot
Claw Hand
Claw hand is a condition where the fingers are noticeably curved or bent, resembling a bear's claw. It can affect one or more fingers on one or both hands. Claw hand can be present at birth (congenital) or caused by nerve damage, skin scarring from burns, or bacterial diseases like leprosy. The main cause is nerve injury or damage, which can result from birth defects, trauma, repetitive motions, or compression of the ulnar nerve in the wrist. There are two main types: partial/ulnar claw hand where the fourth and fifth fingers are affected, and complete claw hand where all fingers are curved. Treatment options include physical therapy, surgery to repair nerves or tendons, medication
ULNAR NERVE PALSY AND TENDON TRANSFERS
The document discusses ulnar nerve palsy and tendon transfers used to treat it. It begins by describing the anatomy of the ulnar nerve and its motor and sensory functions. It then discusses clinical findings associated with ulnar nerve injuries at different locations. Various tendon transfers are summarized that aim to restore small and ring finger flexion, key pinch, correct clawing, and improve grip strength for patients with ulnar nerve palsy. These include transferring forearm muscles like the ECRB to restore key pinch or correct clawing. The modified Stiles-Bunnell procedure is also summarized, which uses the middle finger superficialis tendon to dynamically correct clawing during finger flexion.
peripheral nerve injuries
This document provides information on radial, median, and ulnar nerve injuries, including anatomy, causes, examination findings, and treatment options. It describes the anatomy and branches of each nerve. Common causes of injury include lacerations, fractures, and entrapment syndromes. Examination involves testing specific muscles innervated by each nerve. Surgical treatment may include nerve repair or reconstruction using tendon transfers to restore function when nerve recovery is not possible. The document outlines various tendon transfer procedures used to treat different patterns of nerve injury.
Upper and Lower Extremity fractures
A hand fracture is a break in one of the bones in the hand, including the small finger bones (phalanges) and long palm bones (metacarpals). Common causes are falls, crush injuries, or sports impacts. Treatment options include casting, splinting, or surgery using pins, plates or screws to stabilize the fracture. Complications can include stiffness or deformity of fingers. Specific types of fractures include boxer's fractures of the pinky knuckle, Bennett fractures of the thumb base, and fractures of the finger bone bases (Busch fractures). Wrist fractures include breaks of the scaphoid bone which can lead to avascular necrosis if missed.
Tracts of the spinalcord
This document summarizes the ascending and descending tracts of the central nervous system. It describes the functional anatomy and regional anatomy of the ascending tracts that transmit sensory information from the periphery to the brain, including the dorsal column-medial lemniscal system and anterolateral system. It also discusses the different classes of sensory receptors, pathways, and relay nuclei involved in transmitting different somatic sensations like touch, proprioception, pain, itch and temperature.
Cervical disc prolapse
Cervical disc prolapse occurs when a cervical disc herniates and compresses the nerve root. The cervical spine has 7 vertebrae and 6 intervertebral discs that act as shock absorbers and allow motion. A disc is composed of an inner nucleus pulposus surrounded by the outer annulus fibrosus. Common sites of prolapse are C5-C6 and C6-C7. Clinical features include neck pain radiating to the arm. Imaging like MRI or CT is used to confirm prolapse. Treatment involves rest, medications, traction and surgery like anterior cervical discectomy if non-operative measures fail.
Applied Anatomy of Hip Joint
Supine position
Transducer: Transverse over medial thigh
2/22/2015Dept of Sports Medicine, AFMC55
USG – ADDUCTOR MUSCLE
2/22/2015Dept of Sports Medicine, AFMC56
Adductor longus, brevis and magnus seen as hypoechoic structures.
Tendons appear as hyperechoic lines.
Bursa seen as anechoic structure.
Bony landmarks like pubis and ischial tuberosity appear hyperechoic.
USG helps to identify muscle tears, tendon injuries and bursitis.
It is a useful tool for dynamic assessment during
Traumatic brachial plexus injury
This document presents a case report of a 53-year-old female who sustained a traumatic brachial plexus injury after falling down a flight of stairs. On examination, she had sensory and motor deficits in her right upper limb consistent with an infraclavicular brachial plexus palsy. She underwent conservative therapy including physiotherapy and splinting. Over an 18-month period, her function gradually improved but she was left with some residual weakness. The document discusses the anatomy of the brachial plexus, mechanisms of injury, clinical examination findings, and prognosis factors for peripheral nerve injuries.
Spinal cord Gross anatomy with Clinical Anatomy.pptx
The spinal cord is the main pathway connecting the brain and peripheral nervous system. It extends from the foramen magnum to the L1-L3 vertebrae in adults. It is surrounded by three meningeal layers and occupies the upper two-thirds of the vertebral canal. It gives rise to 31 pairs of spinal nerves. Internally, it contains grey matter in an H-shaped arrangement surrounded by white matter. The grey matter contains sensory and motor neurons that help supply different regions like the limbs. Major tracts include the corticospinal, spinothalamic and spinocerebellar tracts. The spinal cord receives its blood supply from the anterior and posterior spinal arteries. Injuries can cause
Median nerve injuries
This document provides details on the anatomy, clinical examination, treatment, and tendon transfer procedures for median nerve injuries. It discusses:
1) The anatomy of the median nerve from its origin through the arm, forearm, wrist and hand.
2) Causes of median nerve injuries including trauma, leprosy, and neurological disorders.
3) Clinical signs of median nerve injuries including weakness of thumb opposition and flexion of the wrist.
4) Surgical techniques for median nerve repair and tendon transfers to restore thumb and hand function, including the Royle-Thompson and Burkhalter procedures.
Cubital Tunnel Syndrome
Cubital tunnel syndrome is caused by compression of the ulnar nerve at the elbow, which can cause numbness, tingling, and weakness in the fourth and fifth fingers. It is often caused by repetitive elbow bending or prolonged pressure on the elbow. Diagnosis involves testing for sensory and motor function deficits in the ulnar nerve distribution and provocative tests that reproduce symptoms. Treatment may include splinting, anti-inflammatory medications, corticosteroid injections, physical therapy, and surgery if conservative measures fail.
Spinal cord injury
This document provides an overview of spinal cord injuries, including causes, prognosis, types of paralysis, assessment scales, and the roles of healthcare professionals. It discusses topics like complete vs. incomplete injuries, spinal shock, specific syndromes (central cord, Brown-Sequard), levels of injuries from C1-S5, pre-hospital care, and the kinesiologist's role in areas like evaluation, treatment planning, equipment, and consulting other specialists.
Hand deformities
The document discusses several hand deformities including mallet finger, swan neck deformity, and boutonniere deformity.
Mallet finger is an injury where the distal phalanx is forcibly flexed, rupturing the extensor tendon and preventing extension of the distal interphalangeal (DIP) joint. Treatment involves splinting the DIP joint in extension for 6-10 weeks.
Swan neck deformity involves hyperextension of the proximal interphalangeal (PIP) joint and flexion of the DIP joint. It can be caused by tendon injuries or ligament laxity. Treatment focuses on stretching intrinsics and splinting to balance extension.
Anatomy of median nerve
The median nerve originates from the brachial plexus and provides sensation and motor function to parts of the arm, forearm, and hand. It is susceptible to compression as it passes through the carpal tunnel at the wrist, which can cause carpal tunnel syndrome. Symptoms include pain, tingling, and numbness in the hand. Diagnosis involves physical exams like Tinel's sign and electrodiagnostic tests. Treatment begins with splinting and anti-inflammatories, while surgery may be needed for persistent or severe symptoms. Carpal tunnel syndrome is the most common entrapment neuropathy.
Anatomy of lumbosacral plexus (by Murtaza Syed)
This document provides an overview of the anatomy of the lumbosacral plexus, which is formed from the combination of the lumbar and sacral plexuses. It describes the roots, branches, divisions, and terminal branches that form the various nerves. These include the femoral, obturator, superior gluteal, inferior gluteal, and sciatic nerves. It also outlines the motor and sensory distributions of the nerves of the lumbosacral plexus to the lower limbs and related structures.
Brachial plexus injury
This document discusses the anatomy, types of injuries, clinical presentation, investigations and classification of brachial plexus injuries.
It describes the formation of the brachial plexus from the cervical nerve roots and its divisions. Injuries can be preganglionic or postganglionic, and include traction injuries, avulsions or lacerations. Clinical exam focuses on assessing motor and sensory deficits. Investigations include imaging like MRI/CT, myelography and EMG/NCV to localize the lesion. Seddon's classification is used to describe the severity of injury.
Brachial Plexus Injury
The brachial plexus is formed from nerve roots exiting the cervical and thoracic spinal cord. It can be injured through trauma, tumors, or birth injuries. A brachial plexus injury causes weakness, numbness, pain and deformities in the arm and hand. Physical examination tests specific muscles innervated by different nerve roots to localize the level of injury. Imaging studies and electrodiagnostic tests help evaluate the severity and location of injury to guide treatment.
Median nerve injuries
This document discusses the anatomy and clinical evaluation of median nerve injuries as well as various management strategies. It describes the anatomy of the median nerve and its branches that innervate different muscle groups in the arm and hand. Clinical presentations of high and low median nerve palsies are outlined. Surgical techniques for restoring function are proposed, including nerve transfers to regain opposition, sensation, flexion and pronation. Tendon transfers are also mentioned to help with opposition and finger flexion.
Brachaial Plexus Injury
The document discusses brachial plexus injuries, which involve damage to the network of nerves between the neck and arm. It describes the anatomy of the brachial plexus and its branches. There are two main types of brachial plexus injuries - Erb's palsy, which involves the upper trunk and results in weakness of shoulder and arm muscles, and Klumpke's palsy, which involves the lower trunk and causes hand deformities. Causes include difficult childbirth and other stretching or trauma to the neck and shoulders. Management involves medical treatment of pain as well as potential surgical interventions and physical therapy.
RADIAL NERVE PALSY[1].pptx
The radial nerve provides motor innervation to the posterior arm and forearm muscles and sensory innervation to the back of the hand. It is susceptible to injury at various points along its course from the axilla to the forearm. High radial nerve palsies occur near the radial groove of the humerus and cause loss of wrist and finger extension while sparing elbow extension. Low radial nerve palsies affect function below the elbow. Physical exam assesses affected muscle groups and sensory areas. Treatment involves splinting and may include injections or surgery to repair the nerve or transfer tendons.
What's hot (20)
Spinal cord Gross anatomy with Clinical Anatomy.pptx
Spinal cord Gross anatomy with Clinical Anatomy.pptx
Similar to spine - neurological examination.pptx
spinal Trauma.ppt
This document provides an overview of spinal trauma. It begins with relevant spinal anatomy and the epidemiology of spinal injuries. The most common mechanisms of injury are motor vehicle accidents and falls. Clinical signs include neurological deficits that correspond to the level and completeness of injury. Radiological imaging such as X-rays, CT, and MRI are used to identify fractures and spinal instability. Early management focuses on immobilization, corticosteroids, and treating associated conditions like neurogenic shock. Surgical stabilization is indicated for incomplete injuries with neural compression or unstable fractures with neurological deficits. The goals of treatment are to preserve neurological function, minimize compression, stabilize the spine, and rehabilitate the patient.
Examination of motor system
This document summarizes the steps for examining a patient's motor and sensory systems. It outlines how to assess muscle tone, reflexes, strength, coordination, and sensation. The motor exam evaluates muscles for wasting, fasciculations, and abnormalities in tone. Reflexes like biceps, triceps, knee, and ankle jerks are tested. Strength is graded from 0-5. Coordination is tested using finger-nose, heel-shin, and rapid alternating movements. Sensation is assessed over dermatomes for pain, temperature, vibration and fine touch. The goal is to localize signs to upper or lower motor neuron lesions.
Spinal Injury Trauma.pptx
This document discusses spinal anatomy, trauma, and injury. It covers the epidemiology, mechanisms, classifications, diagnosis, and management of spinal cord injuries. Some key points include:
- The cervical spine has greater range of motion while the thoracic and lumbar vertebrae are more rigid.
- Spinal cord injuries can be complete or incomplete. Complete injuries have no motor or sensory function below the level of injury while incomplete injuries have some spared function.
- Common mechanisms of injury are motor vehicle accidents, falls, and sports/recreation injuries. Indirect injuries from compression are most likely to cause significant damage.
- Imaging like CT and MRI are important for diagnosis but patient stabilization takes priority over imaging in trauma situations
Spinal Injury Trauma.pptx
This document discusses spinal anatomy, trauma, and injury. It covers the epidemiology, mechanisms, classifications, diagnosis, and management of spinal cord injuries. Some key points include:
- The cervical spine has greater range of motion while the thoracic and lumbar vertebrae are more rigid.
- Spinal cord injuries can be complete or incomplete. Complete injuries have no motor or sensory function below the level of injury while incomplete injuries have some spared function.
- Common mechanisms of injury are motor vehicle accidents, falls, and sports/recreation injuries. Indirect injuries from compression are most likely to cause significant damage.
- Imaging like CT and MRI are important for diagnosis but patient stabilization takes priority over imaging in trauma situations
Human reflexes
Human reflexes
Definition: It is involuntary response of an organ to a stimulus.
- It is the arrangement of neurons through which the reflex is carried out.
- It is usually formed of:
Afferent (sensory) neuron.
2) An interneuron (may be absent).
3) nerve center (cell body of the efferent neuron).
4) Efferent (motor) neuron.
Peripheral Nerve Injury
This document provides information on the diagnosis and classification of nerve injuries, as well as details on specific nerves including their anatomy, causes of injury, clinical features, and management approaches. It discusses the axillary, radial, ulnar, median, sciatic, femoral, and lumbosacral plexus nerves. Diagnosis involves history, examination, and investigations such as nerve conduction studies, electromyography, and imaging. Surgical management of nerve injuries includes neurolysis, nerve repair, grafting, and the use of nerve conduits.
Lower limb neurological examination
Lower limb neurological examination frequently appears in OSCEs. You’ll be expected to pick up the relevant clinical signs using your examination skills. This lower limb neurological examination OSCE guide provides a clear, concise, step-by-step approach to performing a neurological examination of the lower limb
Neuro
1. The patient presents with weakness in her right upper and lower limbs and loss of sensation in her left upper and lower limbs.
2. Based on the subacute onset over days to weeks, the examiner suspects an inflammatory, infectious, or neoplastic lesion.
3. On examination, the examiner would assess motor strength, tendon reflexes, and distinguish between upper and lower motor neuron signs to help localize the lesion.
Hand Soft Tissue Injuries
This document discusses soft tissue injuries of the hand. It begins with the anatomy of the hand including bones, joints, muscles, tendons, blood vessels and nerves. It then discusses injury assessment, emphasizing the importance of a thorough examination to identify injuries and establish a treatment plan. The principles of treatment are also outlined, focusing on stabilizing fractures, revascularizing tissues, ensuring coverage of tissues, and repairing muscles, tendons and nerves, with the overall goal of early mobilization and functional restoration. Surgical treatment may include debridement, skeletal stabilization, revascularization, nerve repair and tendon repair.
Dermatomes & Myotomes By Firdous Hussain
This document discusses dermatomes and myotomes, which relate to the sensory and motor innervation of the body by spinal nerve roots. It provides detailed information on:
- The anatomy and distribution of dermatomes for each spinal nerve from C1 to S5.
- Clinical tests for dermatomes using pinprick and light touch at key points on the body.
- The muscles (myotomes) innervated by each spinal nerve root from C1 to S1.
- Clinical tests of myotomes through resisted movement exercises to evaluate motor function.
Sci classification
1. Spinal cord injuries have an annual incidence of 15-40 cases per million people, with motor vehicle accidents and falls being the most common causes.
2. The American Spinal Injury Association (ASIA) impairment scale is the most widely used classification system for spinal cord injuries, grading injuries as complete or incomplete.
3. Common spinal cord syndromes include anterior cord syndrome (involving motor and pain pathways), posterior cord syndrome (involving proprioception and touch), and Brown-Sequard syndrome (unilateral involvement of pathways on one side of the spinal cord).
Somatic mechanoceptive sensation.hussein f. sakr
This document defines and describes different types of sensation, including somatic, visceral, and special sensations. It focuses on somatic sensation, which is initiated by receptors in the skin, muscles, bones and joints. Somatic sensation includes tactile sensations like touch and pressure, thermal sensations, and pain sensation. It discusses the receptors involved and pathways for transmitting different types of somatic sensation, including the dorsal column medial lemniscus system and anterolateral system. Proprioceptive sensation and vibration sense are also defined and their receptors and pathways described.
Management of Nerve Injury
This document discusses the management of various nerve injuries. It begins by defining the peripheral nervous system and describing the different types of nerve injuries including transient ischemia, neuropraxia, axonotmesis, and neurotmesis. It then examines specific nerves that are commonly injured such as the brachial plexus, long thoracic nerve, radial nerve, median nerve, and ulnar nerve. For each nerve, it discusses anatomy, causes of injury, clinical features, treatment approaches, and prognosis. The document provides a comprehensive overview of managing different peripheral nerve injuries.
Neurological assessment for asia chart
How to assess neurological deficit in spinal cord injury patient? this slide will give u some of the information.
Carpal Tunnel Syndrome
This is a powerpoint slide show with information for patients and allied personnel about carpal tunnel syndrome
neurology (1).pptx
The document provides information about the nervous system and various types of headaches. It discusses the organization of the nervous system including the central nervous system (CNS), peripheral nervous system, and divisions of the nervous system. It then summarizes assessment of the neurological system including history, physical exam, and diagnostic tests. Specific types of headaches discussed include migraine headaches, which often have an aura phase and are exacerbated by light and sound, and cluster headaches, which occur in distinct cluster periods with pain-free intervals in between. Treatment options for both migraine and cluster headaches are also outlined.
ASIA IMPAIREMENT SCALE
The American Spinal Injury Association created the International Standards for Neurological Classification of Spinal Cord Injury to standardize how severity of spinal cord injuries are determined and documented. The standards provide a standardized examination of motor and sensory function to assess the extent of loss after an injury. It examines dermatomes and myotomes to determine the affected spinal cord segments. The examination involves detailed sensory and motor testing to determine sensory and motor levels, neurological level, and whether the injury is complete or incomplete.
Sensory, coordination & gait Examination for Undergrad
The document provides information on examining the sensory system. It discusses the different types of sensation including somatic, visceral, and special senses. It then describes in detail how to examine superficial sensation, deep sensation including vibration, joint position, nerve, and muscle sensation. The document outlines examining dermatomal distribution and patterns of sensory loss. It also discusses examining cortical sensation including tactile localization, two-point discrimination, stereognosis, and other tests. Finally, it provides guidance on examining coordination and gait abnormalities.
neurological examination
1. The neurological examination document outlines the process and components of examining a patient's nervous system, including terminology, indications, and aspects of the exam such as level of consciousness, cranial nerve function, motor function, and reflexes.
2. Nurses play an important role in conducting and documenting the neurological exam. This includes setting up equipment, assessing vital signs, performing tests of mental status, cranial nerves, motor skills, sensation, and reflexes, and communicating findings to doctors.
3. The goal of the neurological exam is to determine if there is any disease or abnormality present in the nervous system by thoroughly assessing multiple domains of neurological function.
Peripheral nerve injuries by Dr.Harishma R.pdf
Peripheral nerves arise from spinal nerves and branch throughout the body, carrying motor, sensory and autonomous functions to limbs. When injured, patients may experience weakness, numbness or inability to move part of a limb. Peripheral nerve injuries can be caused by penetrating wounds, medical procedures, or neurotoxic agents. On examination, signs may include sensory loss, absent reflexes, muscle wasting or temperature changes in the affected area. Treatment involves splinting, physiotherapy and surgery such as nerve repair or grafts. Recovery depends on factors like the nerve injured, tension at repair site, and time since injury.
Similar to spine - neurological examination.pptx (20)
Sensory, coordination & gait Examination for Undergrad
Sensory, coordination & gait Examination for Undergrad
Recently uploaded
快速办理(UAM毕业证书)马德里自治大学毕业证学位证一模一样
学校原件一模一样【微信：741003700 】《(UAM毕业证书)马德里自治大学毕业证学位证》【微信：741003700 】学位证，留信认证（真实可查，永久存档）原件一模一样纸张工艺/offer、雅思、外壳等材料/诚信可靠,可直接看成品样本，帮您解决无法毕业带来的各种难题！外壳，原版制作，诚信可靠，可直接看成品样本。行业标杆！精益求精，诚心合作，真诚制作！多年品质 ,按需精细制作，24小时接单,全套进口原装设备。十五年致力于帮助留学生解决难题，包您满意。
本公司拥有海外各大学样板无数，能完美还原。
1:1完美还原海外各大学毕业材料上的工艺：水印，阴影底纹，钢印LOGO烫金烫银，LOGO烫金烫银复合重叠。文字图案浮雕、激光镭射、紫外荧光、温感、复印防伪等防伪工艺。材料咨询办理、认证咨询办理请加学历顾问Q/微741003700
【主营项目】
一.毕业证【q微741003700】成绩单、使馆认证、教育部认证、雅思托福成绩单、学生卡等！
二.真实使馆公证(即留学回国人员证明,不成功不收费)
三.真实教育部学历学位认证（教育部存档！教育部留服网站永久可查）
四.办理各国各大学文凭(一对一专业服务,可全程监控跟踪进度)
如果您处于以下几种情况：
◇在校期间，因各种原因未能顺利毕业……拿不到官方毕业证【q/微741003700】
◇面对父母的压力，希望尽快拿到；
◇不清楚认证流程以及材料该如何准备；
◇回国时间很长，忘记办理；
◇回国马上就要找工作，办给用人单位看；
◇企事业单位必须要求办理的
◇需要报考公务员、购买免税车、落转户口
◇申请留学生创业基金
留信网认证的作用:
1:该专业认证可证明留学生真实身份
2:同时对留学生所学专业登记给予评定
3:国家专业人才认证中心颁发入库证书
4:这个认证书并且可以归档倒地方
5:凡事获得留信网入网的信息将会逐步更新到个人身份内，将在公安局网内查询个人身份证信息后，同步读取人才网入库信息
6:个人职称评审加20分
7:个人信誉贷款加10分
8:在国家人才网主办的国家网络招聘大会中纳入资料，供国家高端企业选择人才
(June 12, 2024) Webinar: Development of PET theranostics targeting the molecu...
(June 12, 2024) Webinar: Development of PET theranostics targeting the molecu...Scintica Instrumentation
Targeting Hsp90 and its pathogen Orthologs with Tethered Inhibitors as a Diagnostic and Therapeutic Strategy for cancer and infectious diseases with Dr. Timothy Haystead.MICROBIAL INTERACTION PPT/ MICROBIAL INTERACTION AND THEIR TYPES // PLANT MIC...
MICROBIAL INTERACTION PPT/ MICROBIAL INTERACTION AND THEIR TYPES // PLANT MIC...ABHISHEK SONI NIMT INSTITUTE OF MEDICAL AND PARAMEDCIAL SCIENCES , GOVT PG COLLEGE NOIDA
Microbial interaction
Microorganisms interacts with each other and can be physically associated with another organisms in a variety of ways.
One organism can be located on the surface of another organism as an ectobiont or located within another organism as endobiont.
Microbial interaction may be positive such as mutualism, proto-cooperation, commensalism or may be negative such as parasitism, predation or competition
Types of microbial interaction
Positive interaction: mutualism, proto-cooperation, commensalism
Negative interaction: Ammensalism (antagonism), parasitism, predation, competition
I. Mutualism:
It is defined as the relationship in which each organism in interaction gets benefits from association. It is an obligatory relationship in which mutualist and host are metabolically dependent on each other.
Mutualistic relationship is very specific where one member of association cannot be replaced by another species.
Mutualism require close physical contact between interacting organisms.
Relationship of mutualism allows organisms to exist in habitat that could not occupied by either species alone.
Mutualistic relationship between organisms allows them to act as a single organism.
Examples of mutualism:
i. Lichens:
Lichens are excellent example of mutualism.
They are the association of specific fungi and certain genus of algae. In lichen, fungal partner is called mycobiont and algal partner is called
II. Syntrophism:
It is an association in which the growth of one organism either depends on or improved by the substrate provided by another organism.
In syntrophism both organism in association gets benefits.
Compound A
Utilized by population 1
Compound B
Utilized by population 2
Compound C
utilized by both Population 1+2
Products
In this theoretical example of syntrophism, population 1 is able to utilize and metabolize compound A, forming compound B but cannot metabolize beyond compound B without co-operation of population 2. Population 2is unable to utilize compound A but it can metabolize compound B forming compound C. Then both population 1 and 2 are able to carry out metabolic reaction which leads to formation of end product that neither population could produce alone.
Examples of syntrophism:
i. Methanogenic ecosystem in sludge digester
Methane produced by methanogenic bacteria depends upon interspecies hydrogen transfer by other fermentative bacteria.
Anaerobic fermentative bacteria generate CO2 and H2 utilizing carbohydrates which is then utilized by methanogenic bacteria (Methanobacter) to produce methane.
ii. Lactobacillus arobinosus and Enterococcus faecalis:
In the minimal media, Lactobacillus arobinosus and Enterococcus faecalis are able to grow together but not alone.
The synergistic relationship between E. faecalis and L. arobinosus occurs in which E. faecalis require folic acid
The cost of acquiring information by natural selection
This is a short talk that I gave at the Banff International Research Station workshop on Modeling and Theory in Population Biology. The idea is to try to understand how the burden of natural selection relates to the amount of information that selection puts into the genome.
It's based on the first part of this research paper:
The cost of information acquisition by natural selection
Ryan Seamus McGee, Olivia Kosterlitz, Artem Kaznatcheev, Benjamin Kerr, Carl T. Bergstrom
bioRxiv 2022.07.02.498577; doi: https://doi.org/10.1101/2022.07.02.498577
HUMAN EYE By-R.M Class 10 phy best digital notes.pdf
Class 10 human eye notes physics
Handwritten best quality
Candidate young stellar objects in the S-cluster: Kinematic analysis of a sub...
Context. The observation of several L-band emission sources in the S cluster has led to a rich discussion of their nature. However, a definitive answer to the classification of the dusty objects requires an explanation for the detection of compact Doppler-shifted Brγ emission. The ionized hydrogen in combination with the observation of mid-infrared L-band continuum emission suggests that most of these sources are embedded in a dusty envelope. These embedded sources are part of the S-cluster, and their relationship to the S-stars is still under debate. To date, the question of the origin of these two populations has been vague, although all explanations favor migration processes for the individual cluster members. Aims. This work revisits the S-cluster and its dusty members orbiting the supermassive black hole SgrA* on bound Keplerian orbits from a kinematic perspective. The aim is to explore the Keplerian parameters for patterns that might imply a nonrandom distribution of the sample. Additionally, various analytical aspects are considered to address the nature of the dusty sources. Methods. Based on the photometric analysis, we estimated the individual H−K and K−L colors for the source sample and compared the results to known cluster members. The classification revealed a noticeable contrast between the S-stars and the dusty sources. To fit the flux-density distribution, we utilized the radiative transfer code HYPERION and implemented a young stellar object Class I model. We obtained the position angle from the Keplerian fit results; additionally, we analyzed the distribution of the inclinations and the longitudes of the ascending node. Results. The colors of the dusty sources suggest a stellar nature consistent with the spectral energy distribution in the near and midinfrared domains. Furthermore, the evaporation timescales of dusty and gaseous clumps in the vicinity of SgrA* are much shorter ( 2yr) than the epochs covered by the observations (≈15yr). In addition to the strong evidence for the stellar classification of the D-sources, we also find a clear disk-like pattern following the arrangements of S-stars proposed in the literature. Furthermore, we find a global intrinsic inclination for all dusty sources of 60 ± 20◦, implying a common formation process. Conclusions. The pattern of the dusty sources manifested in the distribution of the position angles, inclinations, and longitudes of the ascending node strongly suggests two different scenarios: the main-sequence stars and the dusty stellar S-cluster sources share a common formation history or migrated with a similar formation channel in the vicinity of SgrA*. Alternatively, the gravitational influence of SgrA* in combination with a massive perturber, such as a putative intermediate mass black hole in the IRS 13 cluster, forces the dusty objects and S-stars to follow a particular orbital arrangement. Key words. stars: black holes– stars: formation– Galaxy: center– galaxies: star formation
Sexuality - Issues, Attitude and Behaviour - Applied Social Psychology - Psyc...
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
Pests of Storage_Identification_Dr.UPR.pdf
InIndia-post-harvestlosses-unscientificstorage,insects,rodents,micro-organismsetc.,accountforabout10percentoftotalfoodgrains
Graininfestation
Directdamage
Indirectly
•theexuviae,skin,deadinsects
•theirexcretawhichmakefoodunfitforhumanconsumption
About600speciesofinsectshavebeenassociatedwithstoredgrainproducts
100speciesofinsectpestsofstoredproductscauseeconomiclosses
Summary Of transcription and Translation.pdf
Hello Everyone Here We are Sharing You with The process of protien Synthesis in very short points you will be Able to understand It Very well
Describing and Interpreting an Immersive Learning Case with the Immersion Cub...
Current descriptions of immersive learning cases are often difficult or impossible to compare. This is due to a myriad of different options on what details to include, which aspects are relevant, and on the descriptive approaches employed. Also, these aspects often combine very specific details with more general guidelines or indicate intents and rationales without clarifying their implementation. In this paper we provide a method to describe immersive learning cases that is structured to enable comparisons, yet flexible enough to allow researchers and practitioners to decide which aspects to include. This method leverages a taxonomy that classifies educational aspects at three levels (uses, practices, and strategies) and then utilizes two frameworks, the Immersive Learning Brain and the Immersion Cube, to enable a structured description and interpretation of immersive learning cases. The method is then demonstrated on a published immersive learning case on training for wind turbine maintenance using virtual reality. Applying the method results in a structured artifact, the Immersive Learning Case Sheet, that tags the case with its proximal uses, practices, and strategies, and refines the free text case description to ensure that matching details are included. This contribution is thus a case description method in support of future comparative research of immersive learning cases. We then discuss how the resulting description and interpretation can be leveraged to change immersion learning cases, by enriching them (considering low-effort changes or additions) or innovating (exploring more challenging avenues of transformation). The method holds significant promise to support better-grounded research in immersive learning.
Discovery of An Apparent Red, High-Velocity Type Ia Supernova at 𝐳 = 2.9 wi...
We present the JWST discovery of SN 2023adsy, a transient object located in a host galaxy JADES-GS
+
53.13485
−
27.82088
with a host spectroscopic redshift of
2.903
±
0.007
. The transient was identified in deep James Webb Space Telescope (JWST)/NIRCam imaging from the JWST Advanced Deep Extragalactic Survey (JADES) program. Photometric and spectroscopic followup with NIRCam and NIRSpec, respectively, confirm the redshift and yield UV-NIR light-curve, NIR color, and spectroscopic information all consistent with a Type Ia classification. Despite its classification as a likely SN Ia, SN 2023adsy is both fairly red (
�
(
�
−
�
)
∼
0.9
) despite a host galaxy with low-extinction and has a high Ca II velocity (
19
,
000
±
2
,
000
km/s) compared to the general population of SNe Ia. While these characteristics are consistent with some Ca-rich SNe Ia, particularly SN 2016hnk, SN 2023adsy is intrinsically brighter than the low-
�
Ca-rich population. Although such an object is too red for any low-
�
cosmological sample, we apply a fiducial standardization approach to SN 2023adsy and find that the SN 2023adsy luminosity distance measurement is in excellent agreement (
≲
1
�
) with
Λ
CDM. Therefore unlike low-
�
Ca-rich SNe Ia, SN 2023adsy is standardizable and gives no indication that SN Ia standardized luminosities change significantly with redshift. A larger sample of distant SNe Ia is required to determine if SN Ia population characteristics at high-
�
truly diverge from their low-
�
counterparts, and to confirm that standardized luminosities nevertheless remain constant with redshift.
在线办理(salfor毕业证书)索尔福德大学毕业证毕业完成信一模一样
学校原件一模一样【微信：741003700 】《(salfor毕业证书)索尔福德大学毕业证》【微信：741003700 】学位证，留信认证（真实可查，永久存档）原件一模一样纸张工艺/offer、雅思、外壳等材料/诚信可靠,可直接看成品样本，帮您解决无法毕业带来的各种难题！外壳，原版制作，诚信可靠，可直接看成品样本。行业标杆！精益求精，诚心合作，真诚制作！多年品质 ,按需精细制作，24小时接单,全套进口原装设备。十五年致力于帮助留学生解决难题，包您满意。
本公司拥有海外各大学样板无数，能完美还原。
1:1完美还原海外各大学毕业材料上的工艺：水印，阴影底纹，钢印LOGO烫金烫银，LOGO烫金烫银复合重叠。文字图案浮雕、激光镭射、紫外荧光、温感、复印防伪等防伪工艺。材料咨询办理、认证咨询办理请加学历顾问Q/微741003700
【主营项目】
一.毕业证【q微741003700】成绩单、使馆认证、教育部认证、雅思托福成绩单、学生卡等！
二.真实使馆公证(即留学回国人员证明,不成功不收费)
三.真实教育部学历学位认证（教育部存档！教育部留服网站永久可查）
四.办理各国各大学文凭(一对一专业服务,可全程监控跟踪进度)
如果您处于以下几种情况：
◇在校期间，因各种原因未能顺利毕业……拿不到官方毕业证【q/微741003700】
◇面对父母的压力，希望尽快拿到；
◇不清楚认证流程以及材料该如何准备；
◇回国时间很长，忘记办理；
◇回国马上就要找工作，办给用人单位看；
◇企事业单位必须要求办理的
◇需要报考公务员、购买免税车、落转户口
◇申请留学生创业基金
留信网认证的作用:
1:该专业认证可证明留学生真实身份
2:同时对留学生所学专业登记给予评定
3:国家专业人才认证中心颁发入库证书
4:这个认证书并且可以归档倒地方
5:凡事获得留信网入网的信息将会逐步更新到个人身份内，将在公安局网内查询个人身份证信息后，同步读取人才网入库信息
6:个人职称评审加20分
7:个人信誉贷款加10分
8:在国家人才网主办的国家网络招聘大会中纳入资料，供国家高端企业选择人才
The debris of the ‘last major merger’ is dynamically young
The Milky Way’s (MW) inner stellar halo contains an [Fe/H]-rich component with highly eccentric orbits, often referred to as the
‘last major merger.’ Hypotheses for the origin of this component include Gaia-Sausage/Enceladus (GSE), where the progenitor
collided with the MW proto-disc 8–11 Gyr ago, and the Virgo Radial Merger (VRM), where the progenitor collided with the
MW disc within the last 3 Gyr. These two scenarios make different predictions about observable structure in local phase space,
because the morphology of debris depends on how long it has had to phase mix. The recently identified phase-space folds in Gaia
DR3 have positive caustic velocities, making them fundamentally different than the phase-mixed chevrons found in simulations
at late times. Roughly 20 per cent of the stars in the prograde local stellar halo are associated with the observed caustics. Based
on a simple phase-mixing model, the observed number of caustics are consistent with a merger that occurred 1–2 Gyr ago.
We also compare the observed phase-space distribution to FIRE-2 Latte simulations of GSE-like mergers, using a quantitative
measurement of phase mixing (2D causticality). The observed local phase-space distribution best matches the simulated data
1–2 Gyr after collision, and certainly not later than 3 Gyr. This is further evidence that the progenitor of the ‘last major merger’
did not collide with the MW proto-disc at early times, as is thought for the GSE, but instead collided with the MW disc within
the last few Gyr, consistent with the body of work surrounding the VRM.
Methods of grain storage Structures in India.pdf
•Post-harvestlossesaccountforabout10%oftotalfoodgrainsduetounscientificstorage,insects,rodents,micro-organismsetc.,
•Totalfoodgrainproductioninindiais311milliontonnesandstorageis145mt.InIndia,annualstoragelosseshavebeenestimated14mtworthofRs.7,000croreinwhichinsectsaloneaccountfornearlyRs.1,300crores.
•InIndiaoutofthetotalproduction,about30%ismarketablesurplus
•Remaining70%isretainedandstoredbyfarmersforconsumption,seed,feed.Hence,growerneedstoragefacilitytoholdaportionofproducetosellwhenthemarketingpriceisfavourable
•TradersandCo-operativesatmarketcentresneedstoragestructurestoholdgrainswhenthetransportfacilityisinadequate
EWOCS-I: The catalog of X-ray sources in Westerlund 1 from the Extended Weste...
Context. With a mass exceeding several 104 M⊙ and a rich and dense population of massive stars, supermassive young star clusters
represent the most massive star-forming environment that is dominated by the feedback from massive stars and gravitational interactions
among stars.
Aims. In this paper we present the Extended Westerlund 1 and 2 Open Clusters Survey (EWOCS) project, which aims to investigate
the influence of the starburst environment on the formation of stars and planets, and on the evolution of both low and high mass stars.
The primary targets of this project are Westerlund 1 and 2, the closest supermassive star clusters to the Sun.
Methods. The project is based primarily on recent observations conducted with the Chandra and JWST observatories. Specifically,
the Chandra survey of Westerlund 1 consists of 36 new ACIS-I observations, nearly co-pointed, for a total exposure time of 1 Msec.
Additionally, we included 8 archival Chandra/ACIS-S observations. This paper presents the resulting catalog of X-ray sources within
and around Westerlund 1. Sources were detected by combining various existing methods, and photon extraction and source validation
were carried out using the ACIS-Extract software.
Results. The EWOCS X-ray catalog comprises 5963 validated sources out of the 9420 initially provided to ACIS-Extract, reaching a
photon flux threshold of approximately 2 × 10−8 photons cm−2
s
−1
. The X-ray sources exhibit a highly concentrated spatial distribution,
with 1075 sources located within the central 1 arcmin. We have successfully detected X-ray emissions from 126 out of the 166 known
massive stars of the cluster, and we have collected over 71 000 photons from the magnetar CXO J164710.20-455217.
Mending Clothing to Support Sustainable Fashion_CIMaR 2024.pdf
Ozturkcan, S., Berndt, A., & Angelakis, A. (2024). Mending clothing to support sustainable fashion. Presented at the 31st Annual Conference by the Consortium for International Marketing Research (CIMaR), 10-13 Jun 2024, University of Gävle, Sweden.
Recently uploaded (20)
(June 12, 2024) Webinar: Development of PET theranostics targeting the molecu...
(June 12, 2024) Webinar: Development of PET theranostics targeting the molecu...
MICROBIAL INTERACTION PPT/ MICROBIAL INTERACTION AND THEIR TYPES // PLANT MIC...
MICROBIAL INTERACTION PPT/ MICROBIAL INTERACTION AND THEIR TYPES // PLANT MIC...
The cost of acquiring information by natural selection
The cost of acquiring information by natural selection
HUMAN EYE By-R.M Class 10 phy best digital notes.pdf
HUMAN EYE By-R.M Class 10 phy best digital notes.pdf
Candidate young stellar objects in the S-cluster: Kinematic analysis of a sub...
Candidate young stellar objects in the S-cluster: Kinematic analysis of a sub...
Sexuality - Issues, Attitude and Behaviour - Applied Social Psychology - Psyc...
Sexuality - Issues, Attitude and Behaviour - Applied Social Psychology - Psyc...
Juaristi, Jon. - El canon espanol. El legado de la cultura española a la civi...
Juaristi, Jon. - El canon espanol. El legado de la cultura española a la civi...
Describing and Interpreting an Immersive Learning Case with the Immersion Cub...
Describing and Interpreting an Immersive Learning Case with the Immersion Cub...
Discovery of An Apparent Red, High-Velocity Type Ia Supernova at 𝐳 = 2.9 wi...
Discovery of An Apparent Red, High-Velocity Type Ia Supernova at 𝐳 = 2.9 wi...
The debris of the ‘last major merger’ is dynamically young
The debris of the ‘last major merger’ is dynamically young
EWOCS-I: The catalog of X-ray sources in Westerlund 1 from the Extended Weste...
EWOCS-I: The catalog of X-ray sources in Westerlund 1 from the Extended Weste...
Microbiology of Central Nervous System INFECTIONS.pdf
Microbiology of Central Nervous System INFECTIONS.pdf
Mending Clothing to Support Sustainable Fashion_CIMaR 2024.pdf
Mending Clothing to Support Sustainable Fashion_CIMaR 2024.pdf
spine - neurological examination.pptx
- 2. Neurological examination 1. Higher mental functions. 2. Cranial nerves. 3. Sensory examination. 4. Motor examination. 5. Reflexes. 6. Abnormal reflexes. 7. Bladder and Bowel status. 8. Skin condition.
- 3. Basic principles 1. Test muscle activity and power in all groups below lesion. 2. Test pin prick and light touch. 3. Test proprioception. 4. Test reflexes.
- 4. Basic principles 1. Identify neurological level and co-relate with anatomical level. 2. Absence of signs of bony injury – imaging + investigations. 3. In case of complete spinal cord injury – Re-asses after 6 hours, 12 hours and 24 hours.
- 5. 1. Injuries proximal to C3-C4 may lead to respiratory paralysis. (Phrenic nerve) 2. Those with lesions distal to C4-C5 are capable of respiration without support. 3. C5-T1 contribute to the Brachial plexus. Anatomical Features
- 6. 1. Spinal cord ends at L1. Any injury distal to this will involve cauda and not the cord. 2. All lumbar and sacral segments lie between D10 and L1. Anatomical Features
- 7. Anatomical Features Vertebral level Cord level C1-C7 Add one T1-T6 Add two T7-T9 Add three T10 L1 and L2 T11 L3 and L4 T12 L5 and S1 L1 Sacral and Coccygeal segments Below L1 Cauda equina
- 10. Incomplete spinal cord injuries Dorsal Column
- 11. Incomplete spinal cord injuries Dorsal Column
- 12. Incomplete spinal cord injuries Dorsal Column
- 13. Sensory evaluation Prerequisites - • Obtain consent and explain procedure. • Expose the area under examination completely. • Patient’s eyes to be closed. • Test normal side and index side simultaneously and ask for any difference. • “negative test” – Malingering.
- 14. Dermatomes
- 18. MRC Sensory Grading Grade Clinical features S0 Absence of all modalities of sensation in the area exclusively supplied by the affected nerve. S1 Recovery of deep pain sensation. S2 Recovery of protective sensation. (Skin touch, pain, thermal) S3 Recovery of protective + accurate localization. Sensitivity (and hypersensitivity) to cold as usual. S3+ Recognize objects and texture. Cold hypersensitivity now minimal. In hand 2PD less than 8mm. S4 Normal sensation.
- 19. Sensory evaluation 1. Tactile sensitivity – a) Wisp of cotton. (Anterior) b) 2 point discrimination. (2mm) (Posterior) 2. Pain – a) Superficial b) Deep (Lateral) 3. Temperature - Test tubes with warm + cold water (Lateral) 4. Stereognosis – Familiar objects. (Posterior) 5. Proprioception – Passively move and position the joint. (Posterior) 6. Vibration – 128Hz. (Posterior)
- 20. Motor evaluation Components - 1. Nutrition or Bulk of muscle 2. Tone 3. Range of motion (ROM) 4. Manual muscle test (MMT) 5. Reflexes 6. Coordination + involuntary movements 7. Functional Assessment
- 21. Motor evaluation • First assess unaffected side. • Check ROM and note if painful. • Always palpate the muscle being tested. (trick movements) • Start with Grade 3 testing. Move to grade 4 or 2 accordingly.
- 22. Motor evaluation 1. Position 2. Stabilization 3. Demonstration 4. Application of Grades 5. Application of Resistance 6. Checking normal strength 7. Objectivity 8. Documentation
- 23. MRC Motor Grading Grade Clinical features 0 Complete paralysis. 1 Flicker of contraction. 2 Contraction with gravity eliminated. (Horizontal plane of motion) 3 Contraction against gravity alone. (Full range of motion) 4 Contraction against gravity and some resistance. 5 “Normal power” Contraction against powerful resistance.
- 26. C5
- 27. C5 Reflex
- 29. C6
- 30. C6 Reflex
- 32. C7
- 33. C7 Reflex
- 35. C8
- 37. T1
- 39. L2
- 40. L2
- 41. L3
- 42. L3
- 44. L4
- 45. L4 Reflex
- 47. L5
- 49. S1
- 50. Superficial reflexes Plantar reflex (S1) – The lateral aspect of the sole is rubbed with a blunt instrument so as not to cause pain, discomfort, or injury to the skin. The instrument is run from the heel along a curve to the first metatarsal base. There are three responses possible: • Flexor • Indifferent/Mute • Extensor: the hallux dorsiflexes, and the other toes fan out.
- 52. Superficial reflexes Abdominal Reflexes (T7-T11) – They are elicited by stroking the abdominal wall parallel to the costal margins and iliac crests and observing movement of the muscles. Cremasteric Reflex (T12) – This is elicited by scratching the skin at the upper and inner part of the thigh causing the testis to be drawn upwards.
- 53. Hoffman’s reflex – Place your index finger under the DIP joint of patient’s middle finger. Using your thumb flick the patient’s finger downwards. Abnormal reflexes
- 54. Finger jerk – Place your middle and index fingers across the palmar surface of the patient’s proximal phalanges. Tap your own fingers. Observe for flexion of patient’s fingers Abnormal reflexes
- 55. References