The common peroneal nerve is a branch of the sciatic nerve that innervates muscles of the lower leg and foot. Common peroneal neuropathy can result from compression of the nerve due to trauma, fractures, immobilization, or other causes. This leads to weakness of ankle dorsiflexors and foot everters, sensory loss, and a foot drop gait. Diagnosis involves nerve conduction studies and EMG. Treatment may include immobilization, physical therapy, splinting, and tendon transfers in severe cases.
Claw Hand,Definition,Causes,Types,Symptoms and ManagementDr.Md.Monsur Rahman
Dr.Md.Monsur Rahman, Bachelor of Physiotherapy (BPT), Master of Physiotherapy (MPT) in Musculoskeletal Disorders, ABC-Spine in Osteopathic Approach,
Maharishi Markandeshwar (Deemed to be University), Ambala -Haryana.
this presentation explains the different sensory and motor functions of upper and lower limb peripheral nerves , in addition to the common injuries associated with them and their loss of function.
Claw Hand,Definition,Causes,Types,Symptoms and ManagementDr.Md.Monsur Rahman
Dr.Md.Monsur Rahman, Bachelor of Physiotherapy (BPT), Master of Physiotherapy (MPT) in Musculoskeletal Disorders, ABC-Spine in Osteopathic Approach,
Maharishi Markandeshwar (Deemed to be University), Ambala -Haryana.
this presentation explains the different sensory and motor functions of upper and lower limb peripheral nerves , in addition to the common injuries associated with them and their loss of function.
Nerve injuries in the lower limb can result from various causes, including trauma, compression, inflammation, or certain medical conditions.
Nerves play a crucial role in transmitting signals between the brain and different parts of the lower limb, controlling movements, sensations, and functions.
Nerve injuries may range from mild to severe, and the symptoms can vary. Early diagnosis and appropriate medical intervention, which may include physical therapy or, in some cases, surgical repair, are crucial for optimal recovery.
Rehabilitation and nerve regeneration can take time, and the outcome depends on the nature and extent of the injury.
SOUND, TYPES OF SOUND, INTERFERENCE OF SOUND, CALCULATION OF VELOCITY OF SOUND IN AIR, NEWTON'S FORMULA, LAPLACE'S FORMULA, DOPPLER EFFECT, ECHO, RESONANCE, MAGNETO STRICTION & PIEZO ELECTRIC PRODUCTION OF SOUND, APPLICATION OF SOUND
Growth- stages of growth, growth of different tissues & parameters of growth measurements
Developments - Gross motor, fine motor, social & Language development, low birth weight, microcephaly & macrocephaly
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
2. ANATOMY
Common peroneal nerve is also known as lateral popliteal
nerve
Root value – L4,L5,S1,S2
The common peroneal nerve is the smaller and terminal
branch of the sciatic nerve which is composed of the
posterior divisions of Lumbosacral plexus.
MOTOR SUPPLY
DEEP PERONEAL NERVE
Tibialis anterior
Extensor halluces longus
Extensor digitorum
Extensor digitorum brevis
Peroneus tertius
SUPERFICIAL PERONEAL NERVE
Peroneus longus
Peroneus brevis
Sensory
supply
P/B :- DR NIYATI PATEL 2
3. CAUSES
Compression of the nerve by tight plaster or a splint
Fracture of the neck of the fibula
Fracture dislocation of the head of fibula
Hansen’s disease or leprosy
Trauma to the knee including rupture of the fibular
collateral ligament
Entrapped, compressed or irritated nerve by fibrous
arch as it winds around the neck of fibula
Prolonged immobilization during which the leg lies in
external rotation.
P/B :- DR NIYATI PATEL 3
4. SIGN & SYMPTOMS
Sensory
Common peroneal nerve by itself is relatively short having only two
sensory branches and no motor branches. The loss of sensation is as
follows:
a. Skin along the lateral aspect of the knee in the proximal third of the
calf (lateral cutaneous sural nerve).
b. Skin over the posterolateral aspect of the calf and over the lateral
malleolus, lateral aspect of the foot and fourth and fifth toes (Sural
nerve).
Common peroneal nerve divides into deep and superficial peroneal
nerve.
Deep peroneal nerve palsy leads to loss of sensation over the
following areas:
a. Web space between the great and the second toe.
b. Lateral aspect of the dorsum of the great toe.
c. Medial aspect of the dorsum of the second toe.
Superficial peroneal nerve palsy leads to loss of sensation over the
following areas:
a. Anterior and lateral aspect of the leg
b. Dorsum of the foot and toes except a small wedge shape area in the
web space between the great and the second toe.
P/B :- DR NIYATI PATEL 4
5. Motor
Deep peroneal nerve palsy leads to paralysis of
tibialis anterior, extensor hallucis longus,
extensor digitorum longus, extensor digitorum
brevis and peroneus tertius.
Superficial peroneal palsy leads to paralysis of
the peroneus longus and peroneus brevis
Reflex
Ankle jerks diminishes
P/B :- DR NIYATI PATEL 5
6. Deformity
Equino varus deformity (Foot drop) results due
to over action of the posterior compartment
muscles and the invertors.
Gait
High Steppage gait / foot drop gait
Muscle wasting
Present over dorsiflexors of leg
ROM
AROM Loss of dorsiflexion, eversion, extension
of toes
P/B :- DR NIYATI PATEL 6
7. FUNCTIONAL DISABILITY
Pt is dependent for functional activities
such as walking, squatting, dressing,
transfers, toilet activities
P/B :- DR NIYATI PATEL 7
8. INVESTIGATIONS
RADIOGRAPH :- shows whether there is presence of fracture
MRI :- To delineate complete avulsion of nerve roots
SD CURVE:- abnormality in conduction can be verified.
Sharp curve, long chronaxie, low rheobase and the absence
of contraction with repetitive stimuli indicates
denervation. If it is done 2-3 weeks after injury, it shows
the sign of denervation and to find out whether it is
moderate or severe injury
NCV:- To find out the severance of nerve fibers with
wallerian degeneration.
EMG:- it will help to find out reversible and irreversible
nerve damage and will help map out whether it pre
ganglionic/ post ganglionic lesion
P/B :- DR NIYATI PATEL 8
9. TYPES OF INJURY
In Neuropraxia pain, numbness, muscle weakness,
minimal muscle wasting is present. Recovery occurs
within minutes to days
In Axonotmesis there is pain, evident muscle wasting,
complete loss of motor, sensory and sympathetic
functions. Recovery time– months (axon regeneration at
1-1.5 mm/day)
In Neurotmesis no pain, complete loss of motor,
sensory and sympathetic functions. Recovery time –
months and only with surgery
P/B :- DR NIYATI PATEL 9
10. SPECIAL TEST
Tinnel’s sign - Tinel's sign is a reliable clinical sign to
localise area of nerve irritation or entrapment - Tapping
along the course of the nerve (particularly around the
fibular neck) causing shooting pain and tingling into the
foot
SLR test
P/B :- DR NIYATI PATEL 10
11. SURGICAL MANAGEMENT
tendon transfer wherein the Tibialis posterior is used to
substitute for the lost muscles.
The tibialis posterior transfer may be done in two ways:
• Circumtibial route: The tibialis posterior is detached
from its insertion circles around tibia and is divided into
two clips—onegoing to tibialis anterior and extensor
hallucies longus whereas the other go to extensor
digitorum longus. This procedure is more commonly
done but adhesions are likely to occur which are treated
with US, laser and kneading technique
Interosseous route: Insertions are the same as above but
the transfer is done by piercing the interosseus
membrance.
P/B :- DR NIYATI PATEL 11
13. PREVENTION
• Total period of immobilization is six weeks. For the
first three weeks the knee is in flexion and the ankle is
in full dorsiflexion.
In the next three weeks the knee is kept free but the
ankle is still maintained in full dorsiflexion. This method
gives a better range of dorsiflexion.
• The ankle is immobilized in full dorsiflexion for a
period of six weeks.
P/B :- DR NIYATI PATEL 13
14. PHYSIOTHERAPY
MANAGEMENT
Conservative treatment consists of the
following:
IG stimulation of the paralyzed muscles
Passive movements to maintain the joint
range
Stretching of the Tendoachilles
Non Weight bearing and weight bearing
exe
Splints or Orthosis: The commonly used
orthosis aims to maintain the ankle in
neutral position preventing equinous
hence either a caliper with dorsiflexion
stop or plastic ankle foot orthosis in the
form of shoe insert may be prescribed.
P/B :- DR NIYATI PATEL 14