Waddling gait- definition|role of muscle|gait analysis|kinematic and spatiote...jasna ok
This powerpoint is about WADDLING GAIT,muscle that cause waddling gait , its causes, reasons for why this gait is called duck gait and pregnancy gait, gait analysis , and its physical therapy treatment
Waddling gait- definition|role of muscle|gait analysis|kinematic and spatiote...jasna ok
This powerpoint is about WADDLING GAIT,muscle that cause waddling gait , its causes, reasons for why this gait is called duck gait and pregnancy gait, gait analysis , and its physical therapy treatment
this is a slide show which gives in brief about anatomy and detailed description about biomechanics as well as pathomechanics of shoulder joint. various rhythms of shoulder complex are discussed as well along with the stability factors
anatomy of lumbar spine, biomechanics of lumbar spine, movements at lumbar region, muscles of lumbar region, lumbar vertebra, kinetics and kinematics of lumbar spine
this slideshow describes about the hip joint anatomy, biomechanics and its pathomechanics along with angles of hip joint. the slide show also briefs about the pelvic femoral rhythm in daily activities
Dr. Donald Corenman, M.D., D.C. (http://neckandback.com), is a Vail spine surgeon specializing in all conditions of the spine and has written countless medical articles on spine related disorders including Scheuermann’s Disease—a disease marked by a curvature of the spine and a sagittal plane deformity. This presentation focuses on Scheuermann’s Disease and provides an in-depth look at the disorder. It discusses the symptoms, classifications and treatment options. It also provides a look at what a normal sagittal plane looks like vs a sagittal plane deformity. A curvature of the spine is also a symptom of scoliosis and kyphosis.
Dr. Corenman is a renowned Vail spine surgeon and also is an expert at degenerative spinal conditions including degenerative disc disease, spinal stenosis, sciatica, and spondylolythesis. He is also a sports medicine specialist and treats athletes with traumatic sports related injuries. He recently launched his own website (http://neckandback.com) to educate patients on spine disorders and to offer second opinions to physicians and colleagues who are seeking additional information on specific spine injuries and treatment options.
Thoracic and rib cage anatomy, biomechanics, and pathomechanicsRadhika Chintamani
This slide show describes about thoracic and rib cage in detail with its anatomy, kinetics and kinematics along with force couple. the slideshow also describes about the pathology and pathomechanics related to the topic
this is a slide show which gives in brief about anatomy and detailed description about biomechanics as well as pathomechanics of shoulder joint. various rhythms of shoulder complex are discussed as well along with the stability factors
anatomy of lumbar spine, biomechanics of lumbar spine, movements at lumbar region, muscles of lumbar region, lumbar vertebra, kinetics and kinematics of lumbar spine
this slideshow describes about the hip joint anatomy, biomechanics and its pathomechanics along with angles of hip joint. the slide show also briefs about the pelvic femoral rhythm in daily activities
Dr. Donald Corenman, M.D., D.C. (http://neckandback.com), is a Vail spine surgeon specializing in all conditions of the spine and has written countless medical articles on spine related disorders including Scheuermann’s Disease—a disease marked by a curvature of the spine and a sagittal plane deformity. This presentation focuses on Scheuermann’s Disease and provides an in-depth look at the disorder. It discusses the symptoms, classifications and treatment options. It also provides a look at what a normal sagittal plane looks like vs a sagittal plane deformity. A curvature of the spine is also a symptom of scoliosis and kyphosis.
Dr. Corenman is a renowned Vail spine surgeon and also is an expert at degenerative spinal conditions including degenerative disc disease, spinal stenosis, sciatica, and spondylolythesis. He is also a sports medicine specialist and treats athletes with traumatic sports related injuries. He recently launched his own website (http://neckandback.com) to educate patients on spine disorders and to offer second opinions to physicians and colleagues who are seeking additional information on specific spine injuries and treatment options.
Thoracic and rib cage anatomy, biomechanics, and pathomechanicsRadhika Chintamani
This slide show describes about thoracic and rib cage in detail with its anatomy, kinetics and kinematics along with force couple. the slideshow also describes about the pathology and pathomechanics related to the topic
USMLE RESP 05 thoracic wall anatomy medical chest .pdfAHMED ASHOUR
The thoracic wall refers to the skeletal and muscular structures that form the outer boundary of the thoracic cavity, providing protection to the organs within the chest in addition to running vessels and nerves.
The thoracic wall plays a crucial role in protecting the vital organs of the chest, including the heart and lungs. The coordinated action of the ribs, sternum, muscles, and diaphragm allows for the expansion and contraction of the thoracic cavity during respiration. The bony and muscular structures also contribute to the overall stability and integrity of the chest region.
Muscles of the axial skeleton. Pictures of the muscles, origins, insertions, actions. Does not include all the muscles we discussed in class, but includes some fun photos & side notes.
1.INTRODUCTION
Shoulder joint is formed by scapula and clavicle (which is also called as shoulder girdle)and proximal humerus.
2.BONES OF SHOULDER JOINT
3.Joints of the Shoulder Complex
Glenohumeral
Acromioclavicular
Sternoclavicular
Scapulothoracic
4.Muscles of the Shoulder
5.Gateways to the Posterior Scapular Region
6. Movements
FUNCTIONS OF THE BRONCHIOLES And it's uses PDF.pdfMaryphiri7
This talks about the the function of the bronchioles and the disorders of the function of the bronchioles so in this presentation I will talk about the importance and why it is important
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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.
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
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.
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
263778731218 Abortion Clinic /Pills In Harare ,ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group of receptionists, nurses, and physicians have worked together as a teamof receptionists, nurses, and physicians have worked together as a team wwww.lisywomensclinic.co.za/
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.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
8. 8
Sternal angle/angle of Louis corresponds to T4-T5
posteriorly.
Bifurcation of trachea
Aortic arch
9. 9
Costovertebral joint
Typical costoverterbral
joint - synovial type of
joint
2nd to 9th ribs - typical
costoverterbral joint
1st, 10th, 11th and 12th
atypical ribs articulate
only with their
corresponding vertebra
10. 10
The costovertebral joints are the articulations
that connect the heads of the ribs with the bodies
of the thoracic vertebrae. Joining of ribs to the
vertebrae occurs at two places, the head and the
tubercle of the rib. Two convex facets from the
head attach to two adjacent vertebrae. This forms a
trochoid joint, which is strengthened by the
ligament of the head and the intercapital
ligament.
11. 11
Costotransverse joint
Synovial joint
surrounded
by thin fibrous
capsule
Is present from T1
to T10 vertebra and 1st
to 10th ribs
This articulation is
reinforced by the
dorsal costotransverse
ligament
12. 12
Upper CT joints the
primary movement -
rotation
costal facet concave shape
and costal tubercle
convex shape
T7 to T10 both articular
surfaces are flat and
gliding motion
predominates
14. Costochondral joints are synchondroses with no
ligamentous support
1st through 7th ribs articulate anterolaterally with
costal cartilages forming costochondral joint
14
15. Costosternal (CS) joints
are formed by
attachment of the costal
cartilages of ribs to
sternum anteriorly
CS joints of 1st, 6th and
7th ribs are
synchondroses
CS joints of 2nd to 5th
ribs are synovial joints
15
Interchondral
joints
costosternal
16. Interchondral joints are formed when 6th through
10th costal cartilages articulate with cartilage
above them and this is only way by which 8th to
10th ribs are connected to sternum
Interchondral joints are synovial type of joints
16
17. Costovertebral and costotransverse form a joint
couple mechanically linked
Common movement - rotation about an axis
passing through centre of each joint for 1st to
10th ribs
11th and 12th ribs it passes through the CV
joints as CT is absent for these two ribs
17
18. Axis of motion - more towards frontal plane for
upper ribs and towards saggital plane for lower
ribs.
During inspiration - ribs elevate, in upper ribs
motion simulates that of pump handle due to
frontal plane orientation of axis of motion, this
increases the anteroposterior diameter of
ribcage
18
19. Axis of motion lying nearly in the saggital plane,
movement takes place more in lateral part in the
lower ribs
Movement of 11th and 12th ribs varies from the
rest of the ribs
Quadratus Lumborum muscle depresses and
fixes these ribs to provide adequate
diaphragmatic muscle tension
19
24. Muscles of the ribcage - ventilatory muscles
Increased fatigue capacity and contract
rhythmically throughout life rather than
episodically
Act primarily against the elastic properties of
lungs and airway resistance rather than
gravitational forces
24
25. Neurological control of ventilatory muscles is
both voluntary and involuntary
Recruitment of these muscles for ventilation
depends on the type of ventilation required
Primary muscles of ventilation - Diaphragm,
Intercostals and scalenes
25
28. Diaphragm - accounts for 70% to 80% of quiet
breathing
Functionally, muscle portion of diaphragm can be
divided as Costal and Crural parts
Costal part - sternum, ribs (lower 6) and costal
cartilages
Crural part - vertebral bodies (L1-L3)
28
30. Diaphragm contracts and pulls central tendon down
increasing vertical diameter of thorax
Decrease in the pleural pressure
Decrease in intrapulmonary pressure responsible for inspiration
30
31. Costal fibers of diaphragm run vertically from
their origin close to the ribcage before getting
inserted into central tendon
Portion of diaphragm which is close to inner wall
of lower ribcage - “ZONE OF APPOSIOTION”
During tidal breathing, descent of dome of
diaphragm causes only slight change in its
shape, maintaining most of zone of apposition
31
33. Crural portion has an indirect effect on
inspiration, it helps central tendon to descend
thus increasing pressure which is transmitted
through apposed diaphragm thus helping lower
ribcage to expand
33
35. Diaphragm increases all three diameters of the
ribcage
Vertical diameter by contraction of central
tendon
Transverse diameter by elevating the lower ribs
Anteroposterior diameter by elevating the upper
ribs with the help of sternum
35
36. 36
Intercostals
Intercostal muscles - internal and external
intercostals
Act as splints during inspiration and expiration, by
maintaining a constant tone
Internal intercostal muscles run caudally and
posteriorly continuing dorsally where they become
posterior intercostal membrane at angle of the ribs
37. 37
External intercostals run caudally and at an
oblique angle to internal intercostals till
costochondral junction where they become
anterior intercostal membrane
39. Anteriorly portion where only internal intercostals
are present - parasternal muscles
Posteriorly only external intercostals are present
from the tubercle of ribs to the angle of ribs
Laterally both external and internal intercostals
are present and are referred to as interosseous
or lateral intercostals
39
40. Both set of intercostal muscles may be activated
during phases of respiration as minute ventilation
increases
Activation of intercostals is from cephalic to
caudal end
40
42. Parasternal muscles - primary inspiratory
muscles during quiet breathing and
stabilizers of ribcage
Scalene are one of the primary muscles of quiet
respiration, their activity begins with onset of
inspiration and increases as inspiration gets
closer to total lung capacity
42
44. Accessory muscles of ventilation
When thorax is fixed, accessory muscles of
inspiration move vertebral column, arm or head on
the trunk
Reverse muscle action
44
46. Sternocleidomastoid flexes the cervical spine
when acting bilaterally
When cervical spine is fixed the muscle moves
the ribcage superiorly, which expands upper
ribcage in pump handle mechanism
46
47. Pectoralis major elevates upper ribcage when
shoulders and humerus are fixed. It can act both
as an inspiratory and an expiratory muscle
Pectoralis minor can help raise third, fourth and
fifth ribs during a forced respiration
47
48. Upper Trapezius can be helpful in active
inspiration in fixing the head so that
sternocledomastoid can act as a muscle of active
inspiration
Subclavius is between the clavicle and first rib,
when acting in reverse action it can assist in
raising upper chest for inspiration
48
52. 52
Antagonismand synergismof diaphragm
and abdominal muscles :
During inspiration – with diaphragmatic
contraction the central tendon descends down
increasing vertical thoracic diameter but this is
opposed by elongation of mediastinal elements
and also resistance of abdominal viscera.
At this time the abdominals relax allowing the abdomen
to bulge.
This shows the synergistic activity of abdominals
53. During expiration – diaphragm relaxes and
contraction of abdominal muscles lowers the
thoracic floor thereby decreasing simultaneously
the transverse and anteroposterior diameters of
thorax
Also by pushing the viscera up abdominals
raise the central tendon
This shows the antagonistic activity of
abdominals
53
54. 54
In normal breathing the respiratory muscles
should use less than 5% of the O2 taken in the
breath. If the diaphragm not working it is much
more.
56. 56
Differencesassociated with neonates
Healthy new born has an extremely compliant
chest wall because it is primarily cartilaginous
Primary responsibility of ribcage stability on
ribcage muscles to counteract negative pleural
pressure of diaphragm during inspiration
Ribs are also more horizontally placed this alters
angle of insertion of costal fibers of diaphragm
57. Increased tendency of diaphragm fibers to pull
lower ribs inwards, thereby decreasing efficiency
of ventilation
Only 20% of fibers of diaphragm are fatigue
resistance as compared to 50% in adults
Accessory muscles are also at a disadvantage
57
58. 58
Differencesassociated with elderly
Pulmonary changes that occur may
affect pulmonary function
Costal cartilages ossify, which interferes with
their axial rotation
Many articulations undergo fibrosis with
advancing age
Synovial joints undergo morphological changes
reducing mobility
59. 59
Chest wall compliance also reduces with age
Lung tissue decreases in elasticity, thus
affecting elastic recoil property of lung and
outward pull of ribcage
Results of these skeletal and tissue changes are
increase in functional residual capacity and
decrease in inspiratory capacity of thorax
60. Loss of strength of skeletal muscles of
respiration
Ventilatory muscles become more energy
expensive
Resting position of diaphragm becomes less
domed with decrease in tone of abdominal
muscles
60
61. 61
Scoliosis
In scoliosis, if the curve is structural it
affects chest wall biomechanics and hence ventilation
Lumbar and cervical curves cause minimal
change in chest wall biomechanics but a thoracic
curve causes restriction in ventilatory capacity,
restriction proportional to severity of curve
62. 62
3 Types:
1. Nonstructural scoliosis
2. Transient structural scoliosis
3. Structural scoliosis (idiopathic accounts for 70–
80% of cases of scoliosis)
64. 64
Kyphosis
An exaggeration of the normal posterior curve of the
spine.
Results from change in structure and shape in
spine or posture.
Fracture of anterior aspect of vertebral body –
Osteoporosis (OP).
Scheuermann’s disease – Hereditary disorder that
results in kyphosis.
65. 65
COPD
In COPD, major manifestation is hyperinflation of
lungs due to destruction of alveolar walls
Resting position of thorax in more of inspiratory
cycle against the normal resting position in
expiration
This leads diaphragm to adapt a more flattened
configuration in its resting state rather than
acquiring its usual dome shape
66. Flattened diaphragm will pull lower rib cage
inward, actually working against lung inflation
This also decreases the zone of apposition
Majority of inspiration performed by accessory
muscles, particularly the parasternal and scalene
66
67. Pectuscarinatum
67
Some patients develop a
rigid chest wall, in which
the AP diameter is
almost fixed in full
inspiration.
In these patients,
respiratory efforts are
less efficient.
68. 68
Vital capacity is reduced
Residual air is increased
Alveolar hypoventilation may ensue, with arterial
hypoxemia and the development of cor pulmonale.
As the lungs lose compliance, incidence of
emphysema and frequency of infection are
increased.
69. Pectusexcavatum
69
Unless severe does not
cause restriction in
breathing , but due to
altered biomechanics
–shallow breathing
and dyspnea on
exertion may be
present
71. 71
The characteristic paradoxical motion of the flail
segment occurs due to pressure changes associated
with respiration that the rib cage normally resists:
During normal inspiration, the diaphragm
contracts and intercostal muscles push the rib cage
out. Pressure in the thorax decreases below
atmospheric pressure, and air rushes in through
the trachea. However, a flail segment will not resist
the decreased pressure and will appear to push in
while the rest of the rib cage expands.
72. 72
During normal expiration, the diaphragm and
intercostal muscles relax, allowing the abdominal
organs to push air upwards and out of the thorax.
However, a flail segment will also be pushed out
while the rest of the rib cage contracts.
The constant motion of the ribs in the flail
segment is painful, and, untreated, the sharp
broken edges of the ribs are likely to eventually
puncture the pleural sac and lung, possibly
causing a pneumothorax.
76. 76
Impaired Muscle Performance
Sources:
Neurologic impairment or pathology
Muscle strain or injury
Disuse resulting in atrophy and general
deconditioning
Length-associated changes resulting in altered
length-tension properties
77. 77
Treatment
• Neural input must be restored for muscle performance
to improve.
• Protect weakened muscles from overstretch with
proper support.
• Stretch short muscles to maintain extensibility and
prevent contracture.
• For example: Impaired respiration – Stretch short
muscles and apply manual or elastic band resistance to
facilitate strength.
79. 79
Muscle Strain or Injury
Address posture and movement patterns.
Improve performance of underused synergists.
For example, in the case of overuse of anterior
scalene during breathing, reduce anterior scalene
use by improving performance of deep anterior
cervical flexors and instruct in proper pump and
bucket handle diaphragmatic breathing.
80. 80
Disuse Resulting in Atrophyand General
Deconditioning
Caused by illness, immobilization, sedentary
lifestyle, subtle shifts in muscle balance.
Progressive resistive exercises for the upper body.
Initially, weight of limb is ample stimulus.
Progress in small increments.
Address balance between abdominal and spinal
extensors as well as thoracic multifidii.
81. 81
Length-Associated Changes
Subtle imbalances in muscle length lead to length-
associated strength changes and positional
weakness of one synergist compared with agonist
or antagonist.
• Strengthen weak overstretched muscle groups in
shortened range.
• Stretch adaptively shortened muscles.
• Supportive taping adjunctive.
• Correction of posture and movement patterns.
83. 83
Impaired ROM, Muscle Length, and Joint
Mobility/Integrity
Optimal function of the thoracic region requires
full symmetrical cardinal plane motion and full
rib motion.
Consider symmetrical breathing patterns.
Diagnose restrictions that are joint versus soft
tissue origin.
86. 86
Exercise Managementof Scoliosis
• Avoid symmetrical and spine flexibility exercises.
• Strengthen overstretched antagonist/synergist in
shortened range.
• Promote strength of the relatively weak muscle or
groups of muscles in the anterior thoracolumbar
region and the pelvic-hip complex.
• Trunk curl exercises or sit-ups are not indicated
methods of strengthening anterior thoracolumbar
muscles.
87. 87
Thoracic Outlet Syndrome
• Characteristically young, slender women with
drooping shoulders and poor posture
• Treatment aimed at improving muscle
performance and reducing stretch to upper and
middle trapezius
• Supportive taping to elevate scapula
88. 88
• Correct posture and movement relative to
neurovascular compression or stretching (i.e.,
depressed or anterior tilt scapula)
• Tape scapula into elevation to relieve compression
• Alter sleeping habits
• Improve diaphragmatic breathing
• Address associated physiologic/psychological
impairments
The costovertebral joints are the articulations that connect the heads of the ribs with the bodies of the thoracic vertebrae. Joining of ribs to the vertebrae occurs at two places, the head and the tubercle of the rib. Two convex facets from the head attach to two adjacent vertebrae. This forms a trochoid joint, which is strengthened by the ligament of the head and the intercapital ligament. Articulation of the tubercle is to the transverse process of the adjacent vertebrae. This articulation is reinforced by the dorsal costotransverse ligament.
Add flail chest and symmetric and asymmetric chest wall abnormalities