The document provides information about amputation, including definitions, types, causes, indications, and management. It discusses the epidemiology of amputation globally and regionally. It describes the diagnostic evaluation and various types of amputations, including closed and open amputations. Post-operative care involves pain management, wound care, exercise and rehabilitation to improve mobility and self-care abilities. Nursing focuses on managing pain, promoting mobility and self-esteem, and preventing complications like infection.
Amputation is the removal of a body part, usually an extremity. It is often performed to relieve symptoms of conditions like diabetes, gangrene, trauma, infections, or tumors. There are two main types - open amputation leaves the wound open to drain while closed amputation sutures skin flaps over the end. The level of amputation is determined by circulation and functional usefulness, aiming to conserve length. Complications can include hemorrhage, infection, pain, and contractures. Treatment focuses on wound healing through compression, casting, and avoiding infection. Nursing management assesses the patient and prepares the skin while providing psychological support. Rehabilitation aids acceptance of changes, and a team helps the patient maximize function and participation through
This document discusses amputation, including its definition, causes, types, surgical principles, complications, pain management, psychological adjustment, dressing, skin care, and exercises. It defines amputation as the removal of part of a limb through one or more bones. The main causes include peripheral vascular disease, injuries, infections, tumors, and congenital anomalies. There are two main types - guillotine/open and closed amputations. Key goals after amputation are pain management, psychological counseling, preventing deformities, and regaining range of motion and strength.
This document discusses various types of amputations and their management. It covers:
1. Definitions of different types of amputations including closed/open, levels of amputation for upper and lower limbs.
2. Guidelines for post-operative management and bandaging of the amputated limb to shape the stump and prevent complications.
3. Common issues after amputation like pain management, skin disorders, and the psychological impact of losing a limb.
Contusions, strains, and sprains are soft tissue injuries caused by blunt force, overuse, or twisting motions. Contusions involve bleeding into the injured tissue from ruptured blood vessels. Strains are microscopic muscle tears, while sprains damage ligaments around a joint. Symptoms include pain, swelling, bruising, and limited range of motion. Treatment focuses on RICE - rest, ice, compression, and elevation to reduce swelling along with analgesics and immobilization if severe. Patients are educated on proper care, gradual return to activity, and avoiding reinjury.
This document discusses prosthesis care and maintenance. It defines a prosthesis as an artificial replacement for parts of the upper or lower extremities. Prostheses are used to provide mobility and function for individuals who have had limb amputations. Common types include lower leg/foot prostheses and leg prostheses with knee joints. Proper prosthesis care involves daily cleaning, maintenance to address issues like loose parts, regular check-ups with a prosthetist, and keeping the residual limb clean and moisturized.
Amputation is the surgical removal of a limb or part of a limb. It is used to treat conditions like malignancy, gangrene, or as preventative surgery. The document discusses the history and techniques of amputation, including types of amputations, common causes that necessitate amputation, pre-operative preparation, surgical procedures, post-operative care and rehabilitation, and potential complications. Special considerations are given for pediatric patients to preserve growth plates.
- Skin traction involves applying traction directly to the skin to immobilize a body part. It can be used for short or extended periods using adhesive or non-adhesive devices.
- The purposes of skin traction include reducing fractures and dislocations, maintaining skeletal alignment, relieving muscle spasms, and immobilizing injured areas.
- Common types of skin traction include Buck's traction for femoral fractures, forearm skin traction, and head halter traction for neck injuries. Close monitoring is needed to prevent complications like skin breakdown, neurological issues, and deep vein thrombosis.
Amputation is the removal of a body part, usually an extremity. It is often performed to relieve symptoms of conditions like diabetes, gangrene, trauma, infections, or tumors. There are two main types - open amputation leaves the wound open to drain while closed amputation sutures skin flaps over the end. The level of amputation is determined by circulation and functional usefulness, aiming to conserve length. Complications can include hemorrhage, infection, pain, and contractures. Treatment focuses on wound healing through compression, casting, and avoiding infection. Nursing management assesses the patient and prepares the skin while providing psychological support. Rehabilitation aids acceptance of changes, and a team helps the patient maximize function and participation through
This document discusses amputation, including its definition, causes, types, surgical principles, complications, pain management, psychological adjustment, dressing, skin care, and exercises. It defines amputation as the removal of part of a limb through one or more bones. The main causes include peripheral vascular disease, injuries, infections, tumors, and congenital anomalies. There are two main types - guillotine/open and closed amputations. Key goals after amputation are pain management, psychological counseling, preventing deformities, and regaining range of motion and strength.
This document discusses various types of amputations and their management. It covers:
1. Definitions of different types of amputations including closed/open, levels of amputation for upper and lower limbs.
2. Guidelines for post-operative management and bandaging of the amputated limb to shape the stump and prevent complications.
3. Common issues after amputation like pain management, skin disorders, and the psychological impact of losing a limb.
Contusions, strains, and sprains are soft tissue injuries caused by blunt force, overuse, or twisting motions. Contusions involve bleeding into the injured tissue from ruptured blood vessels. Strains are microscopic muscle tears, while sprains damage ligaments around a joint. Symptoms include pain, swelling, bruising, and limited range of motion. Treatment focuses on RICE - rest, ice, compression, and elevation to reduce swelling along with analgesics and immobilization if severe. Patients are educated on proper care, gradual return to activity, and avoiding reinjury.
This document discusses prosthesis care and maintenance. It defines a prosthesis as an artificial replacement for parts of the upper or lower extremities. Prostheses are used to provide mobility and function for individuals who have had limb amputations. Common types include lower leg/foot prostheses and leg prostheses with knee joints. Proper prosthesis care involves daily cleaning, maintenance to address issues like loose parts, regular check-ups with a prosthetist, and keeping the residual limb clean and moisturized.
Amputation is the surgical removal of a limb or part of a limb. It is used to treat conditions like malignancy, gangrene, or as preventative surgery. The document discusses the history and techniques of amputation, including types of amputations, common causes that necessitate amputation, pre-operative preparation, surgical procedures, post-operative care and rehabilitation, and potential complications. Special considerations are given for pediatric patients to preserve growth plates.
- Skin traction involves applying traction directly to the skin to immobilize a body part. It can be used for short or extended periods using adhesive or non-adhesive devices.
- The purposes of skin traction include reducing fractures and dislocations, maintaining skeletal alignment, relieving muscle spasms, and immobilizing injured areas.
- Common types of skin traction include Buck's traction for femoral fractures, forearm skin traction, and head halter traction for neck injuries. Close monitoring is needed to prevent complications like skin breakdown, neurological issues, and deep vein thrombosis.
Bursitis is an inflammation of the bursa, fluid-filled sacs located around joints that reduce friction, most commonly affecting the elbow, shoulder, knee, and hip. It is typically caused by infections, age, gout, rheumatoid arthritis, diabetes or obesity. Symptoms include pain, fever, swelling, tenderness, and trouble moving the affected joint. Treatment involves medications like NSAIDs or corticosteroids, rest, ice, and lifestyle changes such as weight loss.
Assist in application & Removal of plaster cast.Abhishek Yadav
This document provides information on assisting with the application and removal of plaster casts. It defines casts and slabs, describes their purposes and types. The key steps of the application process are outlined, including preparing the patient and materials, applying the cast correctly in layers, and ensuring proper positioning afterwards. Potential complications are listed. The purpose and process of cast removal is also defined, including the use of tools like scissors, vibrators and dilators to carefully cut and remove the cast.
Amputation is the surgical removal of all or part of a limb. There are several types and levels of amputation depending on the condition and location. The main types are non-weight bearing and weight bearing amputations. Some common levels include ray amputations of the toes, below knee amputations, and above knee amputations. It is important to properly mark the incision, ensure adequate blood supply to flaps, round bone cuts, and provide post-operative exercises.
This document provides information on applying anti-embolic stockings, including their purpose to prevent deep vein thrombosis, contraindications for use, assessment steps, equipment needed, and application procedure and rationale. Key points are that stockings promote blood flow from the legs and prevent clots, should be properly fitted to avoid constriction or looseness, and removed twice daily to assess skin while encouraging leg exercises in between.
This document discusses methods for preventing venous stasis when mobility is limited. Venous stasis can lead to blood clots and leg swelling. To prevent this, proper positioning, leg exercises, anti-embolic stockings, and sequential compression devices are recommended. Anti-embolic stockings help circulation by compressing the legs to push blood back to the heart. They are useful after surgery or for those who are immobile or have vascular issues. Sequential compression devices work similarly by alternately filling and deflating sleeves on the legs to mimic muscle pumping of the calves.
Total joint replacement is a common orthopedic procedure that replaces damaged bone and cartilage in a joint with prosthetic implants. The document discusses several types of total joint replacements including hip, knee, finger, elbow, and ankle replacements. It provides details on the surgical procedures, materials used in implants, rehabilitation process, and common causes for failure or reoperation. Total joint replacement is an effective procedure that can relieve pain and restore mobility for conditions like osteoarthritis and rheumatoid arthritis.
it explain about introduction, definition, purpose of applying cast, indcation, type of cast, procedure of application and removal of plaster and management.
Bursitis is inflammation of fluid-filled sacs called bursae located around joints. It is caused by repeated pressure or overuse of a joint. Common types include prepatellar bursitis around the kneecap, trochanteric bursitis near the hip joint, and retrocalcaneal bursitis in the heels. Symptoms include pain, swelling, warmth, and restricted movement near the affected joint. Diagnosis involves physical exam, imaging tests, and fluid aspiration. Treatment focuses on rest, ice, braces, anti-inflammatory medications, corticosteroid injections, and physical therapy. Prevention emphasizes proper posture, warming up before exercise, maintaining a healthy weight, and avoiding repetitive motions.
The document provides information about a seminar on fractures presented by Ms. Durga Joshi. It defines a fracture as a break in the bone's continuity. It then lists the objectives of the seminar which are to define fracture, discuss causes and types, pathophysiology, clinical manifestations, and medical and nursing management. It proceeds to define types of fractures such as complete, incomplete, closed, and open fractures. It also discusses classification, causes, and complications of fractures as well as diagnosis, management including splinting and traction, and nursing care of patients with fractures.
This document provides information on fractures, including definitions, types, patterns, causes, clinical manifestations, diagnostic evaluation, management, and nursing care. It defines a fracture as a break in the continuity of bone. The objectives are to introduce fractures, explain causes such as direct blows or muscle contractions, and describe types including complete, incomplete, closed and open. Patterns like transverse, oblique, and comminuted are also outlined. Clinical signs involve pain, swelling and deformity. Management includes reduction, immobilization with casting or fixation devices, and exercises. Complications can be early like fat embolism or delayed like nonunion. Nursing care focuses on pain management, range of motion, hygiene, nutrition, and mobility assistance
This document discusses fluid and electrolyte imbalances. It begins by explaining that water makes up 60% of the adult body weight and is divided between intracellular and extracellular fluid. The five major types of fluid imbalances are then defined as extracellular fluid volume deficit, intracellular fluid volume deficit, extracellular fluid volume excess, intracellular fluid volume excess, and extracellular fluid volume shift. Causes, signs and symptoms, and treatment approaches are provided for each type of imbalance. Common electrolyte imbalances like hyponatremia, hypernatremia, and hypokalemia are also explained.
This document discusses traction, which uses weights and pulleys to gently pull broken or dislocated body parts back into position. It defines traction, outlines its purposes and principles, and describes types like skin and skeletal traction. Potential complications are noted. Nursing management focuses on skin integrity, traction care, observations, pain management, and activity as tolerated.
This document defines crutches and describes different types of crutch gaits and crutches. It discusses the purpose of walking aids, prerequisites for crutch use, and measurements for proper crutch fitting. Types of crutches described include axillary/underarm crutches, elbow/Lofstrand crutches, and forearm support crutches. Instructions are provided for different weight bearing statuses and ambulation techniques like stairs. Precautions and patient education topics are also outlined.
this is a infectious condition of bone and for b.bsc. and gnm students for their refrence for the care of patients in bone disorder this topic includes its definition, etiology, pathophysiology, clinical menistification, diagnostic evaluation and its management
Skin grafts and skin flaps are surgical procedures used to repair skin defects and promote wound healing. In a skin graft, healthy skin is removed from a donor site and transplanted to a recipient site, but does not maintain its original blood supply. A skin flap retains part or all of its original blood supply after being moved from a donor to recipient site. Common donor sites include the thigh, arm, and buttocks. Skin grafts and flaps are used to treat burns, wounds, and reconstructive procedures. Care of the graft and donor site is needed to promote healing.
Total knee replacement surgery aims to relieve pain and restore mobility and function. It involves replacing damaged cartilage and bone in the knee joint with prosthetic components. Pre-operative evaluation assesses a patient's medical history, physical exam, labs, and risk factors. Post-operatively, patients undergo physical therapy including range of motion exercises to regain mobility while avoiding high-impact activities. Nursing care focuses on wound monitoring, pain management, and early ambulation to aid recovery.
This document provides definitions and information about orthotics. It defines orthotics as externally applied devices that modify the structural and functional characteristics of the neuromuscular and skeletal systems to enable better use of the body part. The document then discusses principles, functions, indications, prescription processes, and nomenclature of various orthotic devices for the spine, upper limbs, lower limbs, knees, and hips. Examples and purposes of different orthotic devices are provided for each body region.
Range of motion and muscle strengthening exercisesShweta Sharma
This document discusses range of motion and muscle strengthening exercises presented by Miss. Shweta Sharma. It describes isometric and isotonic exercises and their purposes, which include increasing muscle strength and endurance. A variety of exercises are presented targeting different parts of the body, along with benefits of physical activity for neurological conditions and patient education tips.
Chest physiotherapy involves techniques like postural drainage, percussion, and vibration to mobilize pulmonary secretions and make them easier to cough up. It aims to assist coughing, improve lung ventilation, and reeducate breathing muscles. Specific positions drain different lung lobes by gravity. Therapies are contraindicated in some injuries or conditions and require monitoring for side effects like hypoxemia, bronchospasm, or increased intracranial pressure. Proper positioning, techniques, and secretion removal are important parts of the chest physiotherapy procedure.
Crutches are assistive devices that help patients who cannot walk on their own due to injury or illness. Proper crutch use requires strengthening the shoulder and arm muscles. There are different gaits taught for crutch walking depending on a patient's mobility level and weight bearing status. Exercises are important to prepare patients for crutch walking by building muscle strength and preventing contractures. Nurses teach patients crutch safety and proper technique.
Amputation is the complete removal of an injured or deformed body part. It is performed to treat conditions such as peripheral vascular disease, trauma, infection, tumors, and congenital anomalies. The goals of amputation are to remove diseased tissue, reduce morbidity and mortality from severe conditions, and allow for reconstruction to produce a functional end organ. Various techniques are used depending on the condition and location of the amputation. Postoperative management focuses on wound healing, pain management, rehabilitation, and prevention of complications.
The document discusses amputation, including definitions, indications, common causes, types of amputation, levels of amputation for lower limbs, complications, and goals of physiotherapy. It defines amputation and disarticulation. Common causes include trauma, peripheral vascular insufficiency, malignant tumors, nerve injuries/infections, congenital anomalies, and extreme heat/cold. Types include closed and open amputation. Levels for lower limbs range from hip disarticulation to toe amputation. Complications include hematomas, infections, necrosis, and phantom sensation. Physiotherapy aims to achieve independence and mobility, preventing contractures postoperatively.
Bursitis is an inflammation of the bursa, fluid-filled sacs located around joints that reduce friction, most commonly affecting the elbow, shoulder, knee, and hip. It is typically caused by infections, age, gout, rheumatoid arthritis, diabetes or obesity. Symptoms include pain, fever, swelling, tenderness, and trouble moving the affected joint. Treatment involves medications like NSAIDs or corticosteroids, rest, ice, and lifestyle changes such as weight loss.
Assist in application & Removal of plaster cast.Abhishek Yadav
This document provides information on assisting with the application and removal of plaster casts. It defines casts and slabs, describes their purposes and types. The key steps of the application process are outlined, including preparing the patient and materials, applying the cast correctly in layers, and ensuring proper positioning afterwards. Potential complications are listed. The purpose and process of cast removal is also defined, including the use of tools like scissors, vibrators and dilators to carefully cut and remove the cast.
Amputation is the surgical removal of all or part of a limb. There are several types and levels of amputation depending on the condition and location. The main types are non-weight bearing and weight bearing amputations. Some common levels include ray amputations of the toes, below knee amputations, and above knee amputations. It is important to properly mark the incision, ensure adequate blood supply to flaps, round bone cuts, and provide post-operative exercises.
This document provides information on applying anti-embolic stockings, including their purpose to prevent deep vein thrombosis, contraindications for use, assessment steps, equipment needed, and application procedure and rationale. Key points are that stockings promote blood flow from the legs and prevent clots, should be properly fitted to avoid constriction or looseness, and removed twice daily to assess skin while encouraging leg exercises in between.
This document discusses methods for preventing venous stasis when mobility is limited. Venous stasis can lead to blood clots and leg swelling. To prevent this, proper positioning, leg exercises, anti-embolic stockings, and sequential compression devices are recommended. Anti-embolic stockings help circulation by compressing the legs to push blood back to the heart. They are useful after surgery or for those who are immobile or have vascular issues. Sequential compression devices work similarly by alternately filling and deflating sleeves on the legs to mimic muscle pumping of the calves.
Total joint replacement is a common orthopedic procedure that replaces damaged bone and cartilage in a joint with prosthetic implants. The document discusses several types of total joint replacements including hip, knee, finger, elbow, and ankle replacements. It provides details on the surgical procedures, materials used in implants, rehabilitation process, and common causes for failure or reoperation. Total joint replacement is an effective procedure that can relieve pain and restore mobility for conditions like osteoarthritis and rheumatoid arthritis.
it explain about introduction, definition, purpose of applying cast, indcation, type of cast, procedure of application and removal of plaster and management.
Bursitis is inflammation of fluid-filled sacs called bursae located around joints. It is caused by repeated pressure or overuse of a joint. Common types include prepatellar bursitis around the kneecap, trochanteric bursitis near the hip joint, and retrocalcaneal bursitis in the heels. Symptoms include pain, swelling, warmth, and restricted movement near the affected joint. Diagnosis involves physical exam, imaging tests, and fluid aspiration. Treatment focuses on rest, ice, braces, anti-inflammatory medications, corticosteroid injections, and physical therapy. Prevention emphasizes proper posture, warming up before exercise, maintaining a healthy weight, and avoiding repetitive motions.
The document provides information about a seminar on fractures presented by Ms. Durga Joshi. It defines a fracture as a break in the bone's continuity. It then lists the objectives of the seminar which are to define fracture, discuss causes and types, pathophysiology, clinical manifestations, and medical and nursing management. It proceeds to define types of fractures such as complete, incomplete, closed, and open fractures. It also discusses classification, causes, and complications of fractures as well as diagnosis, management including splinting and traction, and nursing care of patients with fractures.
This document provides information on fractures, including definitions, types, patterns, causes, clinical manifestations, diagnostic evaluation, management, and nursing care. It defines a fracture as a break in the continuity of bone. The objectives are to introduce fractures, explain causes such as direct blows or muscle contractions, and describe types including complete, incomplete, closed and open. Patterns like transverse, oblique, and comminuted are also outlined. Clinical signs involve pain, swelling and deformity. Management includes reduction, immobilization with casting or fixation devices, and exercises. Complications can be early like fat embolism or delayed like nonunion. Nursing care focuses on pain management, range of motion, hygiene, nutrition, and mobility assistance
This document discusses fluid and electrolyte imbalances. It begins by explaining that water makes up 60% of the adult body weight and is divided between intracellular and extracellular fluid. The five major types of fluid imbalances are then defined as extracellular fluid volume deficit, intracellular fluid volume deficit, extracellular fluid volume excess, intracellular fluid volume excess, and extracellular fluid volume shift. Causes, signs and symptoms, and treatment approaches are provided for each type of imbalance. Common electrolyte imbalances like hyponatremia, hypernatremia, and hypokalemia are also explained.
This document discusses traction, which uses weights and pulleys to gently pull broken or dislocated body parts back into position. It defines traction, outlines its purposes and principles, and describes types like skin and skeletal traction. Potential complications are noted. Nursing management focuses on skin integrity, traction care, observations, pain management, and activity as tolerated.
This document defines crutches and describes different types of crutch gaits and crutches. It discusses the purpose of walking aids, prerequisites for crutch use, and measurements for proper crutch fitting. Types of crutches described include axillary/underarm crutches, elbow/Lofstrand crutches, and forearm support crutches. Instructions are provided for different weight bearing statuses and ambulation techniques like stairs. Precautions and patient education topics are also outlined.
this is a infectious condition of bone and for b.bsc. and gnm students for their refrence for the care of patients in bone disorder this topic includes its definition, etiology, pathophysiology, clinical menistification, diagnostic evaluation and its management
Skin grafts and skin flaps are surgical procedures used to repair skin defects and promote wound healing. In a skin graft, healthy skin is removed from a donor site and transplanted to a recipient site, but does not maintain its original blood supply. A skin flap retains part or all of its original blood supply after being moved from a donor to recipient site. Common donor sites include the thigh, arm, and buttocks. Skin grafts and flaps are used to treat burns, wounds, and reconstructive procedures. Care of the graft and donor site is needed to promote healing.
Total knee replacement surgery aims to relieve pain and restore mobility and function. It involves replacing damaged cartilage and bone in the knee joint with prosthetic components. Pre-operative evaluation assesses a patient's medical history, physical exam, labs, and risk factors. Post-operatively, patients undergo physical therapy including range of motion exercises to regain mobility while avoiding high-impact activities. Nursing care focuses on wound monitoring, pain management, and early ambulation to aid recovery.
This document provides definitions and information about orthotics. It defines orthotics as externally applied devices that modify the structural and functional characteristics of the neuromuscular and skeletal systems to enable better use of the body part. The document then discusses principles, functions, indications, prescription processes, and nomenclature of various orthotic devices for the spine, upper limbs, lower limbs, knees, and hips. Examples and purposes of different orthotic devices are provided for each body region.
Range of motion and muscle strengthening exercisesShweta Sharma
This document discusses range of motion and muscle strengthening exercises presented by Miss. Shweta Sharma. It describes isometric and isotonic exercises and their purposes, which include increasing muscle strength and endurance. A variety of exercises are presented targeting different parts of the body, along with benefits of physical activity for neurological conditions and patient education tips.
Chest physiotherapy involves techniques like postural drainage, percussion, and vibration to mobilize pulmonary secretions and make them easier to cough up. It aims to assist coughing, improve lung ventilation, and reeducate breathing muscles. Specific positions drain different lung lobes by gravity. Therapies are contraindicated in some injuries or conditions and require monitoring for side effects like hypoxemia, bronchospasm, or increased intracranial pressure. Proper positioning, techniques, and secretion removal are important parts of the chest physiotherapy procedure.
Crutches are assistive devices that help patients who cannot walk on their own due to injury or illness. Proper crutch use requires strengthening the shoulder and arm muscles. There are different gaits taught for crutch walking depending on a patient's mobility level and weight bearing status. Exercises are important to prepare patients for crutch walking by building muscle strength and preventing contractures. Nurses teach patients crutch safety and proper technique.
Amputation is the complete removal of an injured or deformed body part. It is performed to treat conditions such as peripheral vascular disease, trauma, infection, tumors, and congenital anomalies. The goals of amputation are to remove diseased tissue, reduce morbidity and mortality from severe conditions, and allow for reconstruction to produce a functional end organ. Various techniques are used depending on the condition and location of the amputation. Postoperative management focuses on wound healing, pain management, rehabilitation, and prevention of complications.
The document discusses amputation, including definitions, indications, common causes, types of amputation, levels of amputation for lower limbs, complications, and goals of physiotherapy. It defines amputation and disarticulation. Common causes include trauma, peripheral vascular insufficiency, malignant tumors, nerve injuries/infections, congenital anomalies, and extreme heat/cold. Types include closed and open amputation. Levels for lower limbs range from hip disarticulation to toe amputation. Complications include hematomas, infections, necrosis, and phantom sensation. Physiotherapy aims to achieve independence and mobility, preventing contractures postoperatively.
This document outlines principles of fracture management including reduction, retention, and rehabilitation. It discusses various methods of reduction including closed and open reduction. Immobilization techniques like skin traction, skeletal traction, casting, and internal/external fixation are explained. Complications and indications for different techniques are also provided. The goal of fracture management is to reduce fractures, immobilize the bone during healing, and rehabilitate the injury through regaining function and range of motion.
1. Amputation involves removing part of a limb, while disarticulation separates bones at a joint. Common indications are gangrene, trauma, burns, infections, and tumors.
2. Types of amputation include provisional, guillotine, and formal amputations. Formal amputations create flaps to cover the bone and form an ideal stump.
3. Complications can be early like hemorrhage and infection, or late like pain, ulceration, neuromas, and phantom limb sensation. Proper technique and postoperative care can help reduce complications.
Knee amputation involves the surgical removal of part or all of the lower leg and knee joint. There are different types including below knee amputation (BKA), through knee amputation, and above knee amputation (AKA). Indications for knee amputation include severe trauma, gangrene, peripheral vascular disease, and malignant tumors. The appropriate level of amputation is determined by factors like the disease process and viability of tissues. Post-operative nursing management focuses on pain management, infection prevention, and rehabilitation including physiotherapy and prosthesis fitting to aid mobility and function.
The document discusses amputations, including definitions, indications, types, techniques, and rehabilitation. Amputation is the surgical removal of a limb or part of a limb. It may be necessary for conditions like peripheral vascular disease, trauma, burns, or malignant tumors. The main types are provisional, definitive end-bearing, and definitive non-end-bearing amputations. Proper pre-surgical evaluation, anesthesia use, soft tissue and bone cutting techniques, and post-operative care including physiotherapy and prosthetics are essential to optimize outcomes. Complications can include flap breakdown, gas gangrene, skin issues, ulceration, nerve damage, and phantom limb sensation.
Amputation is the complete removal of an injured or deformed body part. It is indicated for conditions like peripheral vascular disease, infection, trauma, tumors and diabetes. The goals of amputation are to remove diseased tissue, reduce morbidity/mortality, and allow for maximum independent function with prosthetics. Determining the appropriate amputation level considers factors like circulation, soft tissues, bone/joint condition and infection control. Techniques aim to debride nonviable tissue, close wounds primarily or with flaps/grafts, smooth bone edges and allow for rapid rehabilitation. Complications include non-healing, infection, phantom pain/sensation and contractures.
The document discusses amputation, which is the surgical removal of a limb or extremity. It defines amputation and describes the various types including those for the legs and arms. It outlines the causes of amputation such as circulatory disorders, trauma, infection, tumors and congenital deformities. The document also discusses the surgical procedure for amputation, complications, nursing management both pre-and post-operatively, and the use of prosthetics to replace amputated limbs.
An above-the-knee amputation involves surgically removing part or all of the leg above the knee. It may be required due to inadequate blood flow, severe infection, trauma, tumors, or congenital disorders. The surgery involves cutting the thigh bone after tying off arteries and veins, suturing muscles and skin. Post-operative care focuses on pain management, preventing infection and swelling, and beginning physical therapy soon after to prepare for mobility with a prosthesis or wheelchair. Complications can include infection, wound issues, swelling and pain, but with treatment many patients regain mobility.
Fractures of the elbow are common injuries that can occur from falls, blows to the elbow, or other traumatic events. The elbow is a complex joint formed by the humerus, radius, and ulna bones. Signs of a fractured elbow include swelling, deformity, bruising, and limited range of motion. Treatment depends on the severity of the injury and may involve splinting, casting, medications to manage pain and reduce swelling, surgery to repair broken bones or damaged tissues, and physical therapy. Complications can include infection, stiffness, nonunion of broken bones, nerve damage, and arthritis. Following medical advice is important for proper healing.
1) The document discusses limb amputation in animals, including the definition, indications, surgical anatomy, blood and nerve supply, site of operation, anesthesia procedure, surgical procedure, and postoperative care.
2) Key points covered include that amputation involves removing all or part of a limb through dividing one or more bones, indications for amputation include various medical conditions and injuries, and the surgical procedure described is for amputation of the hind limb in animals at the middle third of the femur above the stifle joint.
3) Postoperative care involves administering antibiotics, antihistamines, anti-inflammatories, dressing changes, and suture removal to aid healing after the amputation surgery.
The document provides an overview of general principles and techniques for amputation. It discusses:
1. The definition of amputation and its historical development from ancient times to modern antiseptic techniques.
2. The common indications for amputation including peripheral vascular disease, trauma, infections, and tumors.
3. Surgical principles such as ideal stump shape and length, techniques for blood vessels, nerves, muscles and bone, and postoperative care including rigid dressings.
4. Potential complications like hematoma, infection, wound necrosis, contractures and phantom limb pain.
1. Amputation involves cutting through bone or joint to remove part or all of a limb. It is usually done as a treatment for a dead, dangerous, or severely problematic limb.
2. Several factors determine the appropriate level of amputation, including the patient's age, underlying condition, and goals for mobility.
3. Proper rehabilitation following amputation, including exercises, stump care, desensitization, and eventually prosthesis training, can help patients regain function and mobility. Complications are minimized with a coordinated post-op care plan.
The document discusses amputation, including definitions, history, indications, types, postoperative care, complications, and special procedures. It notes that amputation involves surgical removal of part or all of a limb through bone or joints. The main indications are trauma, peripheral vascular disease, infection, tumors, and congenital anomalies. Postoperative goals are prompt healing, edema control, pain management, and early rehabilitation and prosthesis training. Complications can include wound issues, infection, phantom pain, and psychological impacts.
The document discusses amputation, including its history, common causes, indications, types, and surgical principles. It notes that amputation was historically a crude procedure but improved with the introduction of ligatures and artery forceps. Common causes today include trauma, peripheral vascular disease, infection, tumors, and congenital limb deficiencies. Key surgical principles involve managing skin, bone, nerves, and vessels to allow for tension-free closure and prosthetic use. Imaging helps determine surgical margins and viability. Postoperative monitoring of labs like hematocrit and creatinine is important.
The effect of intact fibula on functional outcome of reamed intramedullary in...Love2jaipal
detailed journal club presentation on The effect of intact fibula on functional outcome of reamed intramedullary interlocking nail in open and closed isolated tibial shaft fractures
Fractures are breaks in bone continuity that can range from complete breaks to incomplete breaks. Globally in 2000, there were an estimated 9 million new fragility fractures, including over 1.6 million at the hip. Fractures are classified based on their anatomic features such as type, comminution, location, and displacement. Other classifications include the AO classification system for long bones, Salter-Harris classification for pediatric physeal fractures, and the Gustillo-Anderson classification for open fractures. Clinical presentation of fractures involves symptoms of pain, swelling, deformity, and loss of function as well as signs found on examination and imaging studies. Management principles involve stabilization, reduction, fixation, exercise, and physiotherapy.
Amputation involves the surgical removal of a limb or part of a limb. It is one of the oldest surgical procedures, historically performed without anesthesia to control bleeding from traumatic injuries or as treatment for gangrene, tumors, or other conditions. The goals of amputation are to remove dead, dangerous, or dysfunctional tissue while preserving maximum limb length and function. It requires consideration of various factors like the level of injury, adequate tissue margins, circulation, soft tissues, and infection control. Various techniques and postoperative management aim to provide a healed stump that can accommodate a prosthesis and restore mobility. Complications can include bleeding, wound healing issues, infections, phantom limb sensations and pain.
This document provides an overview of various clinical teaching and learning resources, including audiovisual aids and other materials. It defines audiovisual aids and discusses both projected aids like overhead projectors and non-projected aids such as charts, pictures, maps, and flashcards. It describes how to effectively use charts and the purposes and types of charts. The document also discusses other resources like posters, research articles, pictures, newspapers, field trips, models, microscopes, and puppets. It provides the definitions, classifications, advantages and disadvantages of each resource.
The document provides information on disaster management. It defines disaster and differentiates between hazards and disasters. It describes different types of natural and man-made disasters and their impacts. The key principles of disaster management include prevention, preparedness, response, and recovery. The disaster management cycle involves these four phases. The document outlines the roles and responsibilities of nurses before, during, and after a disaster, which includes disaster preparedness, triage and management of casualties, and coordination of resources and staff.
Presentation1 organ support technique.pptxSushilaHamal
A 31-year-old man was admitted to the hospital unconscious after a car accident. Tests show increased intracranial pressure and abnormal liver and kidney function tests. Possible medical interventions include managing increased intracranial pressure, providing organ support such as ventilation if needed, and treating any organ dysfunction through interventions like dialysis.
The document discusses consciousness and unconsciousness. It defines consciousness as awareness of oneself and one's environment, while unconsciousness is a lack of response to stimuli and can range from confusion to deep coma. Unconsciousness can be caused by lesions in the brainstem, thalamus, or hemispheres. The Glasgow Coma Scale is used to assess level of consciousness. Nursing care for unconscious patients focuses on airway protection, circulation support, skin integrity, nutrition, and safety.
This document provides an overview of Multiple Sclerosis (MS), including its definition, pathophysiology, types, symptoms, diagnostic evaluation, treatment, nursing management, complications, and references. MS is a chronic demyelinating disease of the central nervous system that results in destruction of myelin sheath. It can cause a variety of symptoms such as fatigue, numbness, vision problems, and impaired mobility. Diagnosis involves MRI, lumbar puncture, and ruling out other conditions. Treatment focuses on modifying the disease course, managing symptoms, and rehabilitation. Nursing care is aimed at promoting function and minimizing complications.
BODY –MIND COMPLEX AND PSYCHOSOMATIC(SOMATOFORM) DISORDER.pptxSushilaHamal
This document provides information about body-mind complex and psychosomatic disorders. It begins with objectives to explain body-mind complex, define psychosomatic disorders, classify somatoform disorders, and discuss causes, diagnosis, and treatment. It then reviews nervous system anatomy and physiology. Key points include the bi-directional relationship between physical and mental health, examples of mind affecting body and vice versa, and the body's stress response pathways. Causes of somatoform disorders discussed include biological, genetic, psychodynamic, learning, and social factors. Non-pharmacological treatments highlighted are relaxation techniques, yoga, fasting therapy, hypnosis, and cognitive-behavioral therapy.
Concept, Philosophy, Principle and Component of.pptxSushilaHamal
This document defines key concepts in nursing service administration including management, administration, the importance of management in nursing, levels of management, functions of management, the concept and philosophy of management, principles of management, and components of nursing service administration. It provides definitions and descriptions of these topics at a high level to explain the basic framework and elements of management as applied to nursing services.
Hildegard Peplau developed the theory of interpersonal relations, which views nursing as an interpersonal process focused on the nurse-client relationship. The theory outlines phases of the relationship - orientation, identification, exploitation, and resolution - and roles for nurses, such as stranger, teacher, and counselor. Peplau believed the relationship and roles help clients address problems, gain independence, and terminate the relationship successfully. The document provides an overview of Peplau's theory and concepts, and explains their application in nursing assessment, diagnosis, and care planning using an example client case.
Hildegard Peplau developed the theory of interpersonal relations, which views nursing as an interpersonal process focused on the nurse-client relationship. The theory outlines phases of the relationship - orientation, identification, exploitation, and resolution - and roles for nurses, such as stranger, teacher, and counselor. Peplau believed the relationship and roles help clients address problems, gain independence, and terminate the relationship successfully. The document provides an overview of Peplau's theory and concepts, and explains their application in nursing assessment, diagnosis, and care planning using an example client case.
Hildegard Peplau developed the theory of interpersonal relations, which views nursing as an interpersonal process between nurse and patient. The theory outlines phases of the nurse-patient relationship including orientation, identification, exploitation, and resolution. It also describes Peplau's seven nursing roles and four major concepts. Peplau's theory emphasizes therapeutic communication and can guide nursing assessments, diagnoses, interventions, and evaluations through each phase of the nurse-patient relationship.
Concept, Philosophy, Principle and Component of.pptxSushilaHamal
This document defines key concepts in nursing service administration including management, administration, the importance of management in nursing, levels of management, functions of management, the concept and philosophy of management, principles of management, and components of nursing service administration. It provides definitions and descriptions of these topics at a high level to explain the basic framework and elements of management as applied to nursing services.
Hildegard Peplau developed the theory of interpersonal relations, which views nursing as an interpersonal process focused on the nurse-client relationship. The theory outlines phases of the relationship - orientation, identification, exploitation, and resolution - and roles for nurses, such as stranger, teacher, and counselor. Peplau believed the relationship and roles help clients address problems, gain independence, and terminate the relationship successfully. The document provides an overview of Peplau's theory and concepts, and explains its application in nursing assessment, diagnosis, and assisting a client with back pain.
Rheumatic fever is an autoimmune condition that occurs after a Group A streptococcal infection, typically affecting the heart, joints, and brain. It causes inflammation of the heart valves, which can lead to scarring and deformity known as rheumatic heart disease. Symptoms of rheumatic heart disease include shortness of breath, palpitations, and swelling from fluid buildup. Treatment involves antibiotics to prevent initial and recurrent streptococcal infections, along with medications, surgery, and lifestyle changes to manage valve damage and heart failure. Complications can include arrhythmias, valve stenosis, heart failure, and endocarditis if left untreated.
Mitral stenosis and regurgitation sushilaSushilaHamal
This document provides information on mitral regurgitation and mitral stenosis. Mitral regurgitation involves blood flowing back from the left ventricle to the left atrium during systole due to issues with the mitral valve closing properly. Causes include degenerative valve changes, ischemia, and rheumatic heart disease. Symptoms include fatigue, dyspnea, and palpitations. Mitral stenosis is a narrowing of the mitral valve opening, usually caused by rheumatic fever which thickens the valve leaflets. It presents with dyspnea, orthopnea, palpitations, and hemoptysis. Both conditions are investigated using echocardiography and ECG and treated medically
This document discusses infective endocarditis, which is a microbial infection of the heart's endothelial surface. It can affect the heart valves and is characterized by vegetations that form on the valves. There are two main classifications: acute bacterial endocarditis and subacute bacterial endocarditis. Risk factors include invasive procedures, weakened valves, and immunosuppression. Symptoms may include fever, heart murmurs, and embolic complications affecting organs. Diagnosis involves blood cultures, echocardiography, and other tests. Treatment involves parenteral antibiotics for several weeks as well as surgery in some cases. Nursing care focuses on monitoring for complications and educating patients.
This document discusses cardiomyopathy, a heart muscle disease associated with cardiac dysfunction. It is classified according to structural and functional abnormalities and includes dilated cardiomyopathy, hypertrophic cardiomyopathy, restrictive cardiomyopathy, and arrhythmogenic right ventricular cardiomyopathy. Dilated cardiomyopathy causes ventricular enlargement and decreased contractility. Hypertrophic cardiomyopathy causes ventricular wall thickening and decreased filling. Restrictive cardiomyopathy impairs ventricular filling and causes muscle stiffness. Clinical manifestations include heart failure symptoms. Diagnosis involves echocardiogram, ECG, chest x-ray, and biopsy. Treatment includes medications, diet, exercise, devices, and transplantation. Nursing focuses on improving perfusion, managing activity and symptoms, and addressing anxiety.
This document discusses dysrhythmias, which are disorders of the heart's electrical conduction or rhythm. Dysrhythmias can be diagnosed by electrocardiogram and may cause changes in blood pressure or pumping of the heart. Common types of dysrhythmias discussed include normal sinus rhythm, sinus bradycardia, sinus tachycardia, premature atrial complexes, atrial flutter, and atrial fibrillation. Nursing management focuses on treating the underlying cause, controlling heart rate, and preventing complications like stroke.
Myocarditis and pericarditis are inflammatory conditions of the heart. Myocarditis involves inflammation of the myocardium/heart muscle, and can lead to dilation of the heart chambers, thrombus formation on the heart wall, and infiltration of blood cells between muscle fibers. Pericarditis is inflammation of the pericardium, the sac surrounding the heart. It often begins as an acute condition but can become chronic with scarring. Both conditions have various infectious and non-infectious causes and can cause chest pain and other symptoms. Diagnosis involves ECG, blood tests, imaging modalities and biopsy. Treatment focuses on managing symptoms and underlying causes.
Myocarditis is an inflammation of the myocardium that can be caused by viruses, bacteria, fungi, or other infectious agents. It involves inflammation and damage to cardiac myocytes that can lead to dilated cardiomyopathy and heart failure over time. Symptoms may include fever, fatigue, chest pain, abnormal heart sounds, and changes on electrocardiogram or elevated cardiac markers. Diagnosis involves history, physical exam, imaging, and endomyocardial biopsy. Treatment focuses on managing symptoms and underlying cause.
Rheumatic fever is an autoimmune condition that occurs after a Group A streptococcal infection, typically affecting the heart, joints, and brain. It causes inflammation of the heart valves, which can lead to scarring and deformity known as rheumatic heart disease. Symptoms of rheumatic heart disease include shortness of breath, palpitations, and swelling from fluid buildup. Treatment involves antibiotics to prevent initial and recurrent streptococcal infections, along with medications, surgery, and lifestyle changes to manage valve damage and heart failure. Complications can include arrhythmias, valve stenosis, heart failure, and endocarditis if left untreated.
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- 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
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
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the 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 lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
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. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...Donc Test
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Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Thyroid Gland- Gross Anatomy by Dr. Rabia Inam Gandapore.pptx
amputation final ppt (1).pptx
1. Supervised by: Presenter:
Prof. Dr.Ram Sharan Mehta Sushila Hamal
Medical Surgical Nursing M.Sc. Nursing 1st year
BPKIHS BPKIHS
2. At the end of this session, the participant will be
able to;
Introduce amputation
State the epidemiology and incidence
Describe the causes of amputation
List down the indication of amputation
Explain the types of amputation
3. State the diagnostic evaluation
List out the principle of amputation
List the complication of amputation
Explain management (pharmacological ,nursing
management , rehabilitation)
4. Introduction:
The word amputation is derived from the Latin
word amputare, “to cut away”. An amputation
usually refers to the removal of the whole or part
of an arm/hand or leg/foot.
Amputation is a procedure where a part of the
limb is removed through one or more bones.
It should be distinguished from disarticulation
where a part is removed through a joint.
5. Amputation should only be considered if
the limb is non-viable (gangrenous or
grossly ischemic, dangerous malignancy or
infection), or non-functional .
Amputation is always a last resort and it
will not be done unless it is absolutely
necessary for a person’s health.
6. In 2017, 57.7 million people were living with limb
amputation due to traumatic causes worldwide. (GBD 2017)
Leading traumatic causes of limb amputation were falls
(36.2%), road injuries (15.7%), other transportation injuries
(11.2%), and mechanical forces (10.4%).
Approximately 150000 patients per year undergo a lower
extremity amputation in the United States.
The most common leading causes to amputation are diabetes
mellitus, peripheral vascular disease, neuropathy and trauma.
(Cesar S. Molina 2022)
7. In India every year 23,500 amputees are added to the
amputee population in India, of which 20,200 are males
and 3,300 are females.
There was a 54.1% increase in major amputations noted
in the pandemic period more than the pre pandemic period.
(COVID19 Pandemic in South India, 2021)
In Nepal the average age of amputees was 33 years (7 to
90 years) 22% female and 78 % were males. 53 % were
between 20 to 40 years.
Most common level of amputation was below knee
amputation (60.33%) followed by above knee (33.6 %)
and through knee amputation (6%). Only 46 % of all
amputees used a prosthesis. (BBMed,2019)
8. Age:
Common in 50-75 yrs of age
Sex:
Appro.75% in male 25% in female
Involvement of limb:
85% in lower limb 25% in upper limb
Age VS Indication
Children- congenital anomalies
Young adults- Injuries
Elderly- Peripheral vascular disease (DM)
9. Circulatory disorders : Diabetic foot infection or
gangrene
Neoplasm: Cancerous bone or soft tissue tumors
Trauma
Deformities : Deformities of digits and/or limbs, Extra
digits and/or limbs
Infection: Bone infection (osteomyelitis)
Legal punishment: Amputation is used as a legal
punishment in a number of countries, among them Iran,
Yemen, Saudi Arabia, Sudan, and Islamic regions of
Nigeria
10. The Seven d’s for amputation are as follows.
A dead limb: e.g. vascular gangrene.
A dying limb: e.g. TAO, frost bite, Burn etc.
A destroyed limb: e.g. crush injury.
A denervated limb: e.g. hereditary sensory neuropathy,
brachial plexus injury.
A dangerous limb: e.g. malignant bone tumor, gas gangrene.
A deformed limb: abnormalities in growth and development
A damned nuisance: loss of function, gross deformity,
deformities of digits/limbs
11. Guillotine or Open Amputation:
An amputation after which the stump is left unsutured
(without skin flap closure) for several weeks while debrid-
ement and antibiotic therapy are carried out.
Closing the stump before the wound is free from bacteria
or debris increases the risk of infection and compromises
healing.
13. Closed Amputation :
Amputation in which flaps are made from skin
and subcutaneous tissue and sutured over the
bone end of the stump; called also flap
amputation.
15. Forequarter amputation: Scapula + lateral 2 /3
of clavicle + amputation of whole upper limb
Shoulder disarticulation: Removal through the
glenohumeral joint
Above elbow amputation: Through the arm
Elbow disarticulation: Through the elbow joint.
16. Below elbow amputation: Through the forearm
bones
Wrist disarticulation: Through the radiocarpal
joint
Ray amputation: Removal of a finger with
respective metacarpal from carpometacarpal joint
Krukenburg's amputation: Making 'forceps'
with two forearm bones
20. Hindquarter amputation: Whole of the lower
limb with one side amputation of the Ilium being
removed
Hip disarticulation: Through the hip joint
Above knee amputation: Through the femur
Knee disarticulation : Through the knee joint
21. Below knee amputation: Through the tibia-fibula
Syme's amputation : Through the ankle joint
Chopart's amputation: Through talonavicular
joint
Lisfranc's amputation: Through intertarsal joints
27. History collection
Physical examination
The diagnostic assessments include the usual
preoperative blood studies and radiographs to
determine the level of amputation.
28. Arteriography may be done to determine the level of
blood flow in the extremity.
Doppler studies are used to measure blood flow
viscosity.
Transcutaneous oxygen level may also be measured.
29. Tourniquet is always used except in a case of vascular
disease.
Flaps are marked properly before the skin incision is
made.
Designing equal antero-posterior flaps is desirable.
The procedure should aim at designing an ideal
stump.
Skin division is the farthest, followed by fascia,
muscle and the bone.
30. Sharp spikes of bone are trimmed and made round.
Skin flap: good skin coverage is important to helps in
preventing from edema or swelling . Skin should be
mobile and sensitive.
Method of muscle suture:
1. Myodesis: muscle is suture to bone through drill holes
2. Myoplasty: The muscle is sutured to other muscle
and then placed over the end of the bone .
31. The major vessels are to be perfectly ligated.
Tourniquet is always released before closure
and hemostasis achieved.
Wound always closed over a drain.
Regular stump exercises are to be done to
prevent joint contractures
Level of amputation: efforts should be made to
preserve all the possible limb length, keeping
in mind the prosthesis to be fit.
32. Haematoma
Infection
Skin flap necrosis
Deformities of the joints
Neuroma
Pantom sensation
33. Phantom sensation are feelings that the amputated
part is still present. Although these sensation are
often referred to as phantom pain , not all of the
sensation are painful.
The patient may describe unusual sensations, such
as numbness,, warmth, cold, itching as well as a
feeling that the extremity is present, crushed,
cramped, or twisted in an abnormal position
34. Phantom sensation are caused by intact peripheral nerves
proximal to the amputation site that carried messages
between the brain and the now amputated part.
Amputees may experience phantom limb pain soon after
surgery or 2 to 3 months after amputation. It occurs
more frequently in above-knee amputations. Phantom
sensations diminish over time. It gradually decreases
over the next 2 years.
35. Pain is usually burning, cramping, squeezing, or
shooting in nature.
May occur in large number of clients.
It is thought to be caused by combination of
physiologic and psychological components.
Phantom pain occurs most often in clients who had
pain in the limb before the amputation.
Distraction techniques and activity are helpful.
36.
37. There are numerous theories about the causes of
phantom limb pain including peripheral, central and
spinal theories:
Peripheral Theories
Remaining nerves in the stump grow to form
neuromas, which generate impulses. These impulses
are perceived as pain in the limb which has been
removed.
After changes in the severity of phantom limb pain
were noted in different temperatures, another theory
says that cooling of the nerve endings increases the
rate of firing of the nerve impulses, which are
perceived by the patient as phantom limb pain
38. Central Theories
Melzack proposed that the body is represented in the
brain by a matrix of neurons. Sensory experiences
create a unique neuromatrix, which is imprinted on the
brain. When the limb is removed, the neuromatrix tries
to reorganise, but the neurosignature remains due to the
chronic pain experienced prior to the amputation. This
causes phantom limb pain after amputation.
Spinal Theories
When peripheral nerves are cut during amputation,
there is a loss of sensory input from the area below the
level of amputation. This reduction in neurochemicals
alters the pain pathway in the dorsal horn
41. The extremity of limb left after amputation.
The distal end of a limb left after AMPUTATION; called
residual limb.
42. In below-knee amputations: 10.0–12.5 cm from the Tibial
tuberosity.
In above-knee amputations: 22.5–25.0 cm from the
greater trochanter.
In above and below elbow amputations: 20.0 cm from the
Acromion process and the Olecranon process respectively.
These stump lengths recommended, are not constant.
The length varies depending on the length of the limb. It is
useful in determining the length of prosthesis
43. Conical shape
Ideal length
Good muscle power
Non-adherent scar
No fixed deformity
Absence of neuroma
Bone well covered by
muscles
Muscular and not
flabby
Free of infection
44. Stump care
Keep the skin on the surface of stump clean to reduce
the risk of it becoming irritated or infected.
Gently wash your stump at least once a day (more
frequently in hot weather) with mild unscented soap
and warm water, and dry it carefully.
If you have a prosthetic limb, you should also regularly
clean the socket using soap and warm water.
45. When taking a bath, avoid leaving your stump
submerged in water for long periods because the water
will soften the skin on your stump, making it more
vulnerable to injury.
Skin becomes dry, use a moisturizing cream before
bedtime or when wearing your prosthesis.
Wearing one or more socks around their stump helps
absorb sweat and reduces skin irritation.
46. The size of your stump may change as the swelling goes
down, so the number of socks you need to use may vary.
Socks should be changed every day.
Check your stump carefully every day for signs of
infection, such as:
warm, red and tender skin
discharge of fluid or pus
increasing swelling
48. Medications that may be used to help relieve pain include:
Non-steroidal anti-inflammatory drugs (NSAIDs): such
as ibuprofen
Anticonvulsants : such as carbamazepine or gabapentin
Antidepressants : such as amitriptyline or nortriptyline
(these medications work directly on the nerves in your leg)
Opioids : such as codeine or morphine
Corticosteroid
49. Pre-operative management:
Before surgery, the nurse must evaluate: the neurovascular
and functional status of the extremity through history and
physical assessment.
If the patient has experienced a traumatic amputation, the
nurse assesses the function and condition of the residual limb.
The circulatory status and function of the unaffected extremity.
Build the patient's strength by implementing muscular exercise
50. Exercises for the unaffected limbs.
Improve the patient's nutritional status by encouraging a
balanced diet high in vitamins and minerals and with adequate
protein to enhance wound healing.
Maintain adequate hydration.
Follow the physician's orders for therapeutic measures used
to stabilize any chronic medical conditions such as diabetes,
hypertension, that may interfere with surgery or rehabilitation.
51. If ordered, arrange preoperative counseling with the
physical therapist.
If a mobilization aid such as a walker or crutches is to be
used postoperatively, it is easier to provide instruction in
the preoperative period.
The physical therapist will also inform the patient about
his postoperative rehabilitation program.
If authorized by the physician, schedule a visit from the
prosthetic specialist
52. . This may help to alleviate some of the patient's anxieties
about the fitting and wear of prosthetic devices.
Hemodynamic evaluation is performed through testing:
angiography, arterial blood flow
Cultural and sensitivity test of draining wounds: to assist in
control of infection preoperatively
Evaluation of any concurrent health problems (eg:
dehydration, anemia)
53. NURSING DIAGNOSIS :
Acute pain related to amputation.
Impaired physical mobility related to loss of
extremity.
Situational Low Self-Esteem related to loss of body
part/change in functional abilities.
Disturbed body image related to amputation of body
part
Impaired skin integrity related to surgical amputation
54. Self-care deficit: feeding, bathing/hygiene,
dressing/grooming, or toileting, related to loss of
extremity .
Risk for Infection related to post-operative
procedure.
Risk for disturbed sensory perception: phantom
limb pain related to amputation .
Risk for anticipatory and/or dysfunctional
grieving related to loss of body part .
55. Nursing diagnosis:
Acute pain related to amputation
Nursing intervention:
Assess the level of pain, intensity and duration.
Keep patient in comfort position .
Keep stump elevated .
Measure stump size in every shift.
Provide patient with diversional therapy.
Administer analgesic as prescribed and patients need.
56. Nursing diagnosis:
Impaired Physical Mobility related to loss of extremity
Expected outcome:
Client will demonstrate techniques/behaviors that
enable resumption of activities
Nursing intervention:
Demonstrate and assist with transfer techniques and use
of mobility aid like crutches/walker
Provide stump care on a routine basis
57. Rewrap stump immediately with an elastic
bandage, elevate if “immediate or early” cast is
accidentally dislodged. Prepare for reapplication
of the cast.
Encourage active and isometric exercises for
unaffected limbs.
Provide trochanter rolls as indicated.
Assist with ambulation.
58. Nursing diagnosis:
Situational Low Self-Esteem related to loss of body
part/change in functional abilities.
Expected outcome:
Client will develop realistic plans for adapting to new
role/role modifications.
Nursing intervention:
Assess and consider patients preparation for and view of
amputation.
Help the amputee cope with his altered body image.
59. Encourage expression of fears, negative feelings and grief
over the loss of body part.
Provide psychological support to patient.
Ascertain individual strengths and identify previous
positive coping behaviors.
Encourage and provide for a visit by another amputee
especially one who is successfully rehabilitating.
Note withdrawn behavior, negative self talk, use of denial.
60. Nursing diagnosis:
Risk for Infection related to post-operative procedure.
Expected outcome:
Achieve timely wound healing; be free of purulent drainage
or erythema, and be afebrile.
Nursing intervention:
Monitor vital signs, clean the wound and give tetanus
prophylaxis and antibiotics as order
Flush the wound with sterile saline solution, apply a sterile
pressure dressing.
61. Maintain aseptic technique when changing dressing
and caring for the wound.
Inspect dressings and wound, note characteristics of
drainage, and send for culture and sensitivity.
Maintain patency and routinely empty drainage device.
Expose stump to air; wash with mild soap and water
after dressing are discontinued.
Administer antibiotics as indicated.
62. Nursing diagnosis:
Risk for Ineffective Tissue Perfusion related to reduced arterial/venous
blood flow.
Expected outcome:
Client will maintain adequate tissue perfusion as evidenced by
palpable peripheral pulses, warm/dry skin, and timely wound healing.
Nursing intervention:
Monitor vital signs, palpate peripheral pulse,assess neurovascular
function
Inspect dressings and drainage device ,noting amount and
characteristics of drainage.
63. Apply direct pressure to the bleeding site if
hemorrhage occurs.
If the patient experience throbbing after the stump is
wrapped the bandage may be too tight.
Check the bandage regularly
Report persistent or unusual pain in the operative site.
Evaluate for homan’s signs
Monitor PT and activated partial thromboplastin time.
Encourage and assist with early ambulation.
Administer low dose anticoagulant as indicated.
64. PROSTHESIS:
Prosthetics is a unit of rehabilitation medicine dealing
with the replacement of whole or a part of a missing
extremity with an artificial device.
69. Prosthesis care:
Remove sweat and dirt from the prosthesis socket daily
by wiping the inside of the socket with damp soapy
cloth and dry thoroughly.
Never attempt to adjust or mechanically alter the
prosthesis. If problems develop, consult the prosthesist.
Schedule a yearly appointment with the prosthesist.
70. A Functional Outcome Study was conducted on, “Lower
Extremity Amputations Around the Knee Joint” in
2019. A complete enumeration method was used, and all
the amputees between 2005 and 2017 were included in the
study. Of the 520 amputees, 275 trauma related amputees
were available for interview. Structured questionnaire and
SF-36 was used for the general information and functional
outcome respectively. Telephone conversation was done to
know the functional outcome and some of the participants
were called to our center for the face to face interview.
71. Only above knee, through knee and the below knee
amputation cases were included in the study. Of the 275
study participants 214 were male, 166 had below knee,
92 had above knee and 17 had through knee amputation.
The result showed that the average age of amputees was
33 years (7 to 90 years) 22% female and 78 % were
males. 53 % were between 20 to 40 years.
Most common level of amputation was below knee
amputation (60.33%) followed by above knee (33.6 %)
and through knee amputation (6%). Only 46 % of all
amputees used a prosthesis. Main reason for not using
prosthesis was no access and poor economic status.
Main complain among the prosthesis user was difficulty
in walking for long distance.
72. 78% of prosthesis users were involved in farming whereas
13% had their own business. 65% amputees belonged to
literate group.
The study concluded that trauma was found to be the most
common cause of amputation around the knees. More than
half the patients were not using prosthesis. Amputees using
prosthesis, had better physical and mental health functional
outcomes.
(Nitesh K Karn, Ishor Pradhan, Bibek Banskota. B & B Hospital,
Gwarko, Lalitpur, Nepal and Hospital and Rehabilitation Centre for
Disabled Children (HRDC), Janagal, Kavre, Nepal in 2019)
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Maheshwari ,J. and Mhaskar V. (2015) Essential
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