This document provides an overview of orthopaedics and the key components of taking a patient history. It describes the musculoskeletal system and main divisions of orthopaedics, including common diseases and injuries. The importance of systematically and carefully compiling a patient's history is emphasized. Key elements to cover include presenting complaints, symptoms of pain, stiffness, swelling, instability, and deformity. Details on grading and characterizing pain and assessing loss of function are also outlined.
Osteoarthritis is a chronic degenerative disorder of synovial joints in which there is progressive softening and erosion/disintegration of the articular cartilage. In the presentation, I will deal in detail about the condition in every dimension with the most recent evidence.
Osteoarthritis is a chronic degenerative disorder of synovial joints in which there is progressive softening and erosion/disintegration of the articular cartilage. In the presentation, I will deal in detail about the condition in every dimension with the most recent evidence.
Dr Zahida Chaudnary talks with the students about what causes, and how you treat Arthritis.
Check out the slideshow by itself here.
Want an audio version? Subscribe to our Podcast on iTunes!
Want to join us for the live discussion? Check out our Social Media in the noon hour every Monday as we sit down on Google Hangout OnAir! Follow us on Twitter, Facebook, or Google+ to get updated with the link when we start!
oft tissue injuries (STI) are when trauma or overuse occurs to muscles, tendons or ligaments. Most soft tissue injuries are the result of a sudden unexpected or uncontrolled movement like stepping awkwardly off a curb and rolling over your ankle.
a painful knee can be classified into arthritic and non-arthatic. Many doctor forget non-arthic knee pain. This non-arthritic pain affect many pat.. younger more affected than old pat.,
Back Pain, How do you maintain a healthy back.Sherif Watidy
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Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
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Defecation
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2. Orthopaedics:
Ortho – straight
Paedics – children
Musculoskeletal systems
Bones, joints, muscles,
tendons,
ligaments, peripheral
nerves,
blood vessels.
special tissue:–
meniscus, bursa, cartilage
etc.
3. Divisions of Orthopaedics
Trauma Surgery
Spine Surgery
Arthroscopy & Sports Medicine
Hand Surgery
Paediatric Orthopaedics
Joint Replacement (Arthroplasty)
Oncology
Trauma - 80 % (worldwide)
Our setup - 95%
4. Group of Diseases
Congenital & Developmental abnormalities
Infection & inflammation
Arthritis & rheumatic disorders
Metabolic & Endocrine disorders
Tumors & Lesions that mimic them
Sensory disturbance & muscle weakness
Injury & Mechanical derangement
5. History Taking
Patient – story
Doctor constructs – history
history – systematic, carefully, patiently
compiled & informative
6. Points in history taking
• General Information
Age
Sex
Occupation
• Presenting Complaint
7. • Pain
• Stiffness
• Swelling
• Instability
• Deformity
• Limp
• Altered Sensation
• Loss of function
Symptoms
8. Pain
Most Common complain
Grading of pain
I No pain
II Mild, can be ignored
III Moderate, requires treatment
IV Severe, intrusive despite analgesics
V Very severe, inhibits virtually all activities
9. • At the site of the pathology:
Location, duration, progression,
nature, intensity
10. Specific Characters of pain
Sharp shooting pain of back - PIVD
Chronic pain, ↑ activities - Degenerative Changes
Constant boring pain - Infective, neoplastic
11. • Referred pain:
From To
Neck Shoulder
Shoulder Arm
Elbow Forearm, hand
Lumbar Spine Groin
LS Spine Gluteal Region
Hip Thigh, knee, leg
Thigh Knee
12. Autonomic pain:
from autonomic nerves
& accompany peripheral blood vessels
e.g. after operation
Poorly understood, often doubted
13. Stiffness
Symptom of joint involvement
Protective mechanism, spasm around joint
Generalized: Systemic disorder like RA, AS
Localized: to particular joint
14. Swelling
Soft tissue, joint, bone
After trauma, injury or reactive
Rapidly or slowly
Painful or not
Constant or comes and goes
Same size or ↑
19. Loss of function
Depends on individual needs
Judged on social, professional,
domestic & recreational demands
20. • Personal history & background
work, travel, recreation, home
circumstances,
support from family & friend
• Family history
genetic disease RA. Communicable
disease TB
