The document outlines a group presentation focusing on posture, balance, spinal shock, and balance disorders. It details the definition and significance of good and poor posture, the phases and causes of spinal shock, as well as the types and symptoms of balance disorders. Additionally, it covers the vestibular system's role in balance and the diagnostic and treatment options for balance disorders.

1. Group Presentation
Main Topic : Posture and Balance

2. Introduction
Group Members
Abdul Manan 1158
Zain Farrukh 1157
Noor Fatima 1159
Sara Bukhari 1155
M.Aleem Ijaz 1156
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2
3
4
5

3. Next Presentator
Abdul Manan 1158
Topic: Posture

4. Static Reflexes
Posture
General static reflexes
Contents
Postural Reflexes
Statokinetic Reflexes
Statotonic reflexes
Local static reflexes

5. Posture
The particular position of our body is called posture.
Posture is the position in which we hold our bodies
while standing, sitting, or lying down.
Posture is the way our body holds itself in a
particular position.
Examples are Standing Posture, Sitting Posture,
Upright Posture etc.

6. Good posture involves body positions
where the least strain is placed on
supporting muscles and ligaments during
movement or weight-bearing activities.
Good Posture helps us to keep bones and
joints in position so that our muscles used
correctly.
Good Posture helps decrease the abnormal
wearing of joint surfaces that could result in
arthritis.
Poor posture results from certain muscles
tightening up or shortening while others
lengthen and become weak which often
occurs as a result of one's daily activities.
Poor Posture consists of
several factors:
Good Posture Bad Posture
Good Posture helps to prevent muscle
strain, backache and muscular pain.
Poor Posture occurs from repetitive motion
without frequent breaks and sustained
immobile posture for long periods of time.
Stress
Obesity
Pregnancy
Weak postural muscles.
Good Posture contribute to good
appearance.

7. Standing Posture Good & Poor
Sitting Posture Good & Poor
Normal
Posture
Lumbar
Lordosis
Swayback
Kyphosis

8. The responses that are responsible for the maintenance of the posture
are called postural reflexes.
How posture is maintained?
Postural Reflexes
Afferent impulses for the maintenance of posture arise from
proprioceptors, Vestibular apparatus, retina of eye and reach the centers
in central nervous system [CNS].
The centers, which maintain the posture, Located at different levels of
CNS particularly cerebral cortex, Cerebellum, Brain stem and spinal cord.
These centers send motor impulses to the different group of skeleton
muscles, So the appropriate movements occur to maintain the posture.

9. Posture Mechanism
Skin
Afferent Nerve
Efferent Nerve
Spinal Cord
Muscle

10. Classification of postural reflexes
Postural reflexes are classified into two groups:
Static reflexes
Statokinetic reflexes

11. Static Reflexes Statokinetic Reflexes
Static reflexes are involved in establishing
and maintaining posture when the body is
at rest.
Statokinetic reflexes allow the movement
of the body to change posture.
Static reflexes are further divided into
three types:
General static reflexes
Statotonic or attitudinal reflexes
Local static reflexes
Statokinetic reflexes, through stimulation
of the receptors in the neck muscles and
semicircular canals, brings about
movements of the limbs and eyes
appropriate to a given movement of the
head.

12. Statotonic or attitudinal reflexes2
For Example : While Standing on an inclined plane
Statotonic reflexes are initiated when the attitude of the body is
changed.
General static reflexes1
It corrects the orientation of the body when it is taken out of its normal
upright position.
General static reflexes are also called righting reflexes because these
reflexes help to maintain an upright position of the body.
It is initiated by the vestibular system, which detects that the body is not
erect and causes the head to move back into position as the rest of the
body follows

13. Local static reflexes3
The center of local static reflex are located in spinal cord.
They exert their effect on the same limb from which the stimulus was
initiated.

14. Next Presentator
Zain Farrukh 1157
Topic: Spinal Shock

15. Areflexia
Spinal Shock
Hyperreflexia,Spasticity
Contents
Phases
Initial Reflex return
Hyperreflexia
Symptoms
Causes

16. Spinal Shock
Spinal Shock is the temporary suppression of all reflex activity below the
level of injury.
It is a rare medical condition occurring as a result of a spinal cord injury
and is a combination of autonomic and motor dysreflexia
Spinal shock is presented in four phase:
Areflexia (loss of reflexes)
Initial Reflex return
Hyperreflexia
Hyperreflexia Spasticity

17. History
In 1750- Whytt first described this phenomenon.
In 1841-Hall introduced the term spinal shock.
In 1890- Bastian defined it as a complete severance of the spinal cord
that results in total loss of mortor and sensory functions below the level of
lesion.

18. Posture Mechanism

19. Phases of Spinal Shock
Spinal Shock is presented in four phases:
Areflexia (loss of
reflexes)
Initial Reflex return
Hyperreflexia,Spasticity
Hyperreflexia

20. Areflexia (0-1 days)1
Spinal concussion caused the neurons involved in various reflex arc and
the neural input from the brain become hyperpolarized and unresponsive.
A complete loss or weakening of all reflexes below the level of spinal cord
injury.
Initial Reflex return (1-3 days)2
The reason reflexes return is the hypersensitivity of reflex muscles
following denervation; more receptors for neurotransmitters are
expressed and are therefore they are easier to stimulate.
Characterized by the return of some reflexes. The first reflexes to
reappear is the bulbocavernosus reflex.

21. Hyperreflexia(1-4 days), Spasticity (1-12 Months)3
4
In these phases neurons below the injury attempt to reestablish the
synapses.
This is characterized by hyperreflexia.

22. Spinal Cord injury leads to spinal shock which can occur as a result of:
Motor vehicle accidents
Penetrating injuries and accident at work place
Domestic accidents
Causes of Spinal Shock

23. If the level of spinal cord injury is at the Neck
Entire spinal cord is not functioning or is paralyzed.
Severe hypotension and bradycardia observed.
Abnormal reflexes (dysreflexia) are observed in all four extremities.
All four extremities are paralyzed also known as Quadriplegia.
Dilatation of bladder.
hypotension
Symptoms of Spinal Shock

24. If the level of spinal cord injury is at the Chest and Abdomen:
Spinal cord in neck is intact and functions normal
Entire spinal cord in chest and abdomen is not functioning.
Moderate hypotension since blood vessels in chest, abdomen and lower
leg are dilated.
Heart rate is increased
Lower extremity is paralyzed also known as paraplegia.
Symptoms of Spinal Shock

25. If the level of spinal cord injury is at Sacral Segment then spinal shock
signs:
Spinal cord injury in sacral segment causes injuries to sacral autonomic
nerves.
Vasoconstriction of blood vessels of legs dominated by sympathetic
action resulting in hypertension and dilatation of urinary bladder.
The reflexes are normal in all four extremities.
Symptoms of Spinal Shock

26. Next Presentator
Noor Fatima 1159
Topic: Balance

27. Symptoms
Balance
BPPV
Contents
Balance Disorders
Causes
Labyrinthitis
Meniere's disease
Vestibular neuronitis

28. Balance
It is an even distribution of weight enabling someone or something to
remain upright and steady.
It is the ability of a body or object to move or to remain in a position
without losing control or falling.
The state of having your weight spread equally so that you do not fall.

29. Balance BalanceBalance

30. A condition that makes unsteady or dizzy, if you are moving, spinning,
floating, standing still or lying down.
Symptoms
Balance Disorder
If you have a balance disorder, you may stagger when you try to walk, or
teeter or fall when you try to stand up. You might experience symptoms
such as:
Dizziness or vertigo (a spinning sensation)
Lightheadedness, faintness, or a floating sensation
Falling or feeling as if you are going to fall
Blurred vision
Confusion or disorientation.

31. Other Symptoms
Other symptoms might include:
Nausea
Diarrhea
Vomiting
Fear
Anxiety
panic
Changes in heart rate and blood pressure

32. Fear
Blurred Vision
Dizziness/Vertigo
Panic
Anxiety
Disorientation

33. Causes of Balance Disorder
Balance disorders can be caused by:
Change in health conditions
Ear infection
Medication
A head injury
Low blood pressure
Arthritis or eye muscle imbalance
Age Factor
Blood circulation disorder

34. Types of Balance Disorder
Balance Disorder is classified into four types:
Benign paroxysmal
positional vertigo
(BPPV)
Labyrinthitis
Vestibular neuronitis
Meniere's disease

35. Benign paroxysmal positional vertigo (BPPV)1
BPPV occurs when loose otoconia tumble into one of the semicircular
canals and weigh on the cupula. The cupula doesn't flex properly and
sends wrong information about your head’s position, causing vertigo
A brief, intense episode of vertigo triggered by a specific change in the
position of the head.
BPPV can result from a head injury, or can develop just from getting
older.

37. Labyrinthitis2
It is often associated with an upper respiratory infection such as the flu.
An infection or inflammation of the inner ear that causes dizziness and
loss of balance.
Meniere's disease3
It may be associated with a change in fluid volume within parts of the
labyrinth, but the cause or causes are still unknown.
Continuity of Dizziness, hearing loss, tinnitus (TIN-nih-tuss, a ringing or
buzzing in the ear), and a feeling of fullness in the ear

38. Vestibular neuronitis4
An inflammation of the vestibular nerve that can be caused by a virus.

39. Next Presentator
Sara Bukhari 1155
Topic: Diagnosis & Treatment of Balance Disorder

40. Balance
Contents
Balance Disorders
Diagnosis Treatment

41. Diagnosis of Balance Disorder
Diagnosis of a balance disorder is difficult. To find out if you have a
balance problem, your doctor may suggest that you see an
otolaryngologist.
An otolaryngologist is a physician and surgeon who specializes in
diseases and disorders of the ear, nose, neck, and throat.
The otolaryngologist may ask you to have a:
Hearing examination
Blood test
Electronystagmogram
Posturography

42. Electronystagmogram(ENG)
It is a test that measures normal eye movement and involuntary
rapid eye movements called nystagmus. It also checks the muscles that
control eye movements. ENG checks how well the eyes, inner ears ,
and brain help you keep your balance and position (such as when you
change from lying down to standing).
ENG is done to help see whether there is damage or a problem in how
the inner ear, brain, or nerves connecting them work. These problems
may cause dizziness, vertigo, or loss of balance.
During ENG, electrodes are attached to the face near the eyes to record
eye movements. The movements are recorded on graph paper. A series
of recordings is done.

43. Posturography
This test is used to quantify postural control in upright stance in either
static or dynamic conditions.
During this test you have to stand on a special movable platform in front
of a patterned screen. The doctor measures how your body responds to
movement of the platform, the patterned screen, or both.

44. Treatment of Balance Disorder
The first thing a doctor will do if you have a balance problem is determine
if another health condition or a medication is to blame. If so, your doctor
will treat the condition, suggest a different medication, or refer you to a
specialist if the condition is outside his or her expertise.
BPPV:
If you have BPPV, your doctor might recommend a series of simple
movements, such as the Epley maneuver, which can help dislodge the
otoconia from the semicircular canal. In many cases, one session works;
other people need the procedure several times to relieve their dizziness.
Meniere’s Disease:
If you are diagnosed with Meniere's disease, your doctor may
recommend that you make some changes to your diet and, if you are a
smoker, that you stop smoking. Anti-vertigo or anti-nausea medications
may relieve your symptoms, but they can also make you drowsy

45. Treatment of Balance Disorder
Anti-vertigo or anti-nausea medications may relieve the symptoms of
Meniere's disease, but they can also make us drowsy. Other
medications, such as gentamicin (an antibiotic) or corticosteroids may be
used
In some severe cases of Meniere's disease, surgery on the vestibular
organs may be needed.

46. Treatment Precautions
To reduce your risk of injury from dizziness you should :
Avoid walking in the dark
Wear low-heeled shoes or walking shoes outdoors
If necessary, use a cane or walker
Modify conditions at your home and workplace, such as by adding
handrails

47. Next Presentator
M.Aleem Ijaz 1156
Topic: Vestibular System

48. Vestibular System
A system that control our body balancing is called as vestibular system.
It consist of all the parts in inner ear except Cochlea.
It consists of two main parts:
Semicircular
Canals
Utricle and Saculla

49. Posture Mechanism

50. Semicircular Canals1
These Canals contain a fluid called Endolymph.
These Canals are Sensitive to Rotational motion (contain Hair cells).
These are three in number.
These Canals are orientated in Three Dimensional Space.
Horizontally:
One which lies in X-axis (allow motion as we move left and right)
Vertically:
One which lies in Y-axis (allow motion as we move up and down).
In Space:
One which lies in Z-axis (allow motion as we move forward and
backward)

51. Semicircular Canals Directions

52. Semicircular Canals
Movement of Endolymph
cause the bending of hair
cells that help in rotational
perception.
Bending of the Hair cells
cause Action potential in
Nerves of Vestibular system.
Our clockwise movement
cause the fluid to move in
clockwise direction and vice
versa. Semicircular Canals

53. Motion of Brain & VBS
When we are looking
Forward and our Head is in
static condition.
Our vestibular nerves are
beating continuously and
regularly.
This condition of continuous
nerve propagating or beating
is called Tonically Active
Condition. Semicircular Canals

54. Motion of Brain & VBS
When we move our head first
time then change in
frequency of beating or
propagation of nerve impulse
take place.
In this condition movement of
endolymph cause the motion
of hair cells that cause
change in nervous signals .
In this condition frequency of
nerve propagation decrease
Semicircular Canals

55. Motion of Brain & VBS
When we move our head
second time then change in
frequency of beating or
propagation of nerve impulse
occurs.
In this condition our
frequency of beating of
nerves increase.
Semicircular Canals

56. Utricle and Saccule2
They are orientated
Horizontally and Vertically
(have an angle of 900C with
each other).
They are involve in
perception of Gravitational
Pull, Acceleration and
Deacceleration.
These are ''Otolith Organs''
which means ''Ear Stone'' so
are called Little Rock Organs.
Semicircular Canals

57. Utricle and Saccule Anatomy & Action Process
In Saccule and Utricle,
Gravitational force pull the
stone toward itself which
cause a force on hair cells
present in it.
These hair cell are further
connected with Nerves that
transmit impulse to our brain.
In Space this stone lie in
center which cause no Action
Potential to brain via
vestibular nerve.
i.e. tilting our head, motion in
Elevator, up side down etc.
Semicircular Canals

58. Transmission of Nerve Impulse from Inner ear to Brain1
Nerve fibers relay into the Vestibular Reflex center of Medulla
Oblongata.
Nerve fibers then relay into Thalamus and then relay to primary sensory
area located in Parietal Lobe of the Cerebral Cortex.
Nerve Fibers in Vestibulocochlear Nerve Vlll.

59. Posture Mechanism
Skin
Afferent Nerve
Efferent Nerve
Spinal Cord
Muscle

60. T H A N SK
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