Detailed history and its evaluation , examination of spine in general and local with special tests in cervical , thoracic outlet syndrome , lumbar spine and SI joint with diagrams, neurological examination both sensory and motor.
Detailed history and its evaluation , examination of spine in general and local with special tests in cervical , thoracic outlet syndrome , lumbar spine and SI joint with diagrams, neurological examination both sensory and motor.
Clinical examination notes based on TU/KU curriculum of MBBS in nepal. Hope this will be very much helpful in step wise approach to you people especially during exam time.
Colles fracture is the fracture at the distal end of radius, at its
cortico cancellous junction(about 2cm from the distal articular
surface).
It is not just the fracture of distal radius but the fracture
dislocation of the inferior radio-ulnar joint.
Clinical examination notes based on TU/KU curriculum of MBBS in nepal. Hope this will be very much helpful in step wise approach to you people especially during exam time.
Colles fracture is the fracture at the distal end of radius, at its
cortico cancellous junction(about 2cm from the distal articular
surface).
It is not just the fracture of distal radius but the fracture
dislocation of the inferior radio-ulnar joint.
Knee clinical examination for orthopaedic residents.dr mohamed ashraf TD medi...drashraf369
a comprehensive and examination oriented presentation of clinical examination of knee joint.contains lot of demonstrations and tips.author is dr mohamed ashraf,professor and head of orthopaedics,govt TD medical college hospital,alleppey,kerala,india. drashraf369@gmail.com
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
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.
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.
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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.
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
Title: Sense of Smell
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 primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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.
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
2. • Adequate exposure is essential; patients must strip to their underclothes
• Examination in standing, sittting and supine examination
1. LOOK
– Gait
Front
– Posture
– Forward bending
– Lateral list
3. – Asymmetry of chest, pelvis
– Scars, sinus
– Leg shortening
– Side
– Kyphosis
– Lordosis
– Scars, sinus
4. Back
- Tufts of hair
- Café au laits spots
- Paraspinal muscle spasm
- Scars
- Muscle wasting
- scoliosis
5. 2. FEEL
a. Temperature
b. Tenderness:
– Elicit spine tenderness by 3 methods
i) Pressure over the interspinous area
ii) Twisting or pressure over the paraspinous part (facet joint) =
Spinous Rock
iii) Thumping over vertebral column
6. 3. MOVE
o Forward flexion:
- Touching toes
- Majority touches the ground
- Touching mid tibia, 7 cm above the floor
o Extension: normally 30°
o Lateral flexion: try to touch each side of leg (Average = 30°)
o Rotation: maximum 40° (first fix pelvis then only ask for rotation)
7. 4. MEASUREMENT:
o To measure the lumbar excursion
o Take any two bony points over the lumbar region 10 cm apart while
standing upright
o Measure the distance between that points when patient is asked to bend
forward fully
o The distance must be increased by at least 5 cm (i.e; lumbar excursion
= 5cm)
o If less than 3 cm, substantial pathology like ankylosing spondylitis
8. SPECIAL TESTS:
1. SLRT (Straight Leg Raising Test)/Sciatic stretch test/ Dural tension test
2. Well Leg Raise Test or Cross SLRT test
3. Bragard test
4. Lassegue’s test
5. Bowstring’s test
6. Patric test ( Faber sign) = for sacroiliac pathology
9. SLRT/ Sciatic Stretch Test/ Dural Tension Test:
Method:
o 1st do as active by patient himself
o Confirm by passive method
o Finding: test is +ve, if pain occurs between 30° – 70° of elevation
o Back pain = central disc prolapse
o Pain that radiates back to below knee, not just the thigh or back
pain = lateral protrusion
10. Well Leg Raising Test/ Cross SLRT/Contralateral SLRT:
Method:
o Definitive test for disc disease
o Perform SLRT on normal leg
o Finding: Cross over sciatic pain & parasthesia on affected leg =
large prolapse close to midline
11. Bragard Test:
Method:
o Sciatic nerve stretch test
o If SLRT +ve, leg lowered about
10° from the point of sciatic pain
o Foot is dorsiflexed to reproduce
the same pain
12. Lasegue’s Test:
Method:
o Patient supine
o Thigh bent at 90° & knee bent at 90°
o Gradually extend the knee keeping hip flexed
o Thigh pain radiates down the leg = +ve
13. Bowstring’s Test:
Method:
o SLRT +ve
o Slight flex the knee just to
relieve pain
o Then firmly press behind
lateral hamstrings to tighten
the common peroneal nerve
o Radiating pain &
parasthesia reappears
o Finding: +ve Bowstring’s
sign i.e; nerve root irritation
14. 5.NEUROLOGICAL EXAMINATION:
L4 nerve:
o Motor : grading of dorsiflexion
o Sensory: medial aspect of the leg
o Reflex: knee (normal/brisk/sluggish/absent)
L5 nerve:
o Motor: EHL (Extensor Hallucis Longus),
plantiflexion, dorsiflexion of toe
o Sensory : Anterolateral part of leg and dorsum of
foot
o Reflex: ankle jerk
S1 nerve:
o Motor: plantar
flexion
o Sensory: Lateral
aspect of the sole
o Reflex: ankle
reflex