Biomechanics is the science of forces acting on biological structures and the effects of these forces. This document discusses the biomechanics of the normal hip joint and total hip arthroplasty (THA). It describes the anatomy of the hip joint and muscles as well as normal and abnormal biomechanics. Factors like femoral neck angle, acetabular version, and center of gravity are discussed. Principles of THA like medialization, increasing neck length, and restoring offset are aimed at decreasing joint reaction forces. Component position, design, and soft tissue function and positioning are important for stability after THA. Range of motion is influenced by prosthesis design.
Deformity: It’s the position of a limb/Joint, from which it cannot be brought back to its normal anatomical position.
Described as abnormalities of :
Length
Angulation
Rotation
Translation
Combination
Deformity: It’s the position of a limb/Joint, from which it cannot be brought back to its normal anatomical position.
Described as abnormalities of :
Length
Angulation
Rotation
Translation
Combination
Shoulder subluxation and Wilmer carrying OrthosisSmita Nayak
The patients having the problem of shoulder subluxation due to brachial plexus injury, hemiplegia or muscle weakness need a biomechanically efficient orthosis to treat the problem as well as maintain the functional position of the limb, in that case, the Wilmer carrying orthosis plays the major role by shifting the center of gravity nearer to the elbow joint that able to place the femoral head inside the acetabulum without displacing the head laterally. This orthosis is better in comparison to the conventional orthosis used for the subluxation like bobathcuff, shoulder cuff, slings, and hemislings.the design of the elbow Wilmer orthosis also varies as per the age of the patients. The design for the child case also available without a locking elbow joint but with a spring that helps the child to do different activities of daily living which enhances the growth of the child. The major problem in Erb's palsy in addition to shoulder subluxation is the associated fail elbow and wrist drop, these problems can be solved by this orthosis by modifying the design on the standard version. The lightweight feature for children which starts from 35 grams to 80 gram makes this design more comfortable and cosmetically appealing.
Shoulder joint Bio-Mechanics and Sports Specific RehabilitationFabiha Fatima
Shoulder joint Bio-Mechanics and Sports Specific Rehabilitation.
What does the PPT consists of ?
General Biomechanics of Shoulder joint as well as the Bio-mechanics of certain specific sports such as Throwing, Swimming and Racket Sports.
along with a comprehensive rehabilitation of shoulder injuries.
** Above uploaded document has been made as a study material for classroom presentation. it is powered by .gif files which may not be working in this format.**
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!
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
These 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
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
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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.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Jose Austine- Biomechanics in Total hip arthroplasty
1. Biomechanics in Total
Hip Arthroplasty
Dr. Jose Austine
Resident, Dept. of Orthopaedic surgery,
Kasturba Medical College, Mangalore
Moderators
Dr. Surendra Umesh Kamath
Dr. Sharan Mallya
1
2. “Biomechanics is the science that examines
forces acting upon and within a biological
structure and effects produced by such forces.”
- Jim Hay
2
4. • To perform the procedure properly
• To manage the problems that may arise during and after surgery
successfully.
• To select the components intelligently.
• To counsel patients concerning their physical activities.
the WHY?
4
5. ✤ Anatomy of hip joint
✤ Biomechanics of Hip- Normal & Abnormal
✤ History of biomechanics in THA
✤ Bio-mechanical considerations in THA
5
6. “Hips don’t lie”
• Strong bones
• Powerful muscles
• Strongest ligaments
• Tremendous degree of
forces acting around
• Mobile as well as stable
• “Self closed mechanism”
6
8. Neck of femur
(a) Normal femoral neck angle,
(b) a decreased femoral neck angle (coxa vara)
(c) an increased femoral neck angle (coxa valga)
Angulated in relation to the shaft in two planes - sagittal(neck shaft angle)
and coronal(ante-version).
8
9. Ante-version
• Angle between the neck and shaft in the
coronal plane(viewed from above)
• Axis of the neck and the trans-condylar
axis
• 15-20 degrees anterior to coronal plane
9
14. Joint reaction force
• Defined as force generated within a joint in response to forces acting on the joint
• In the hip, it is the result of the need to balance the moment arms of the body weight and
abductor tension
• Maintains a level pelvis
14
16. ✤ First order lever
✤ While standing 1/3rd of the body weight passes through both hips
✤ In swing phase 4 times the weight passes through the hip
✤ Forces acting on the hip
- Body weight
- Abductor muscle force
- Joint reaction force
16
18. Bi-pedal stance
✤ Body weight is equally
distributed across both
hips
✤ Each hip supports
4/6th or 1/3rd the BW
✤ Little or no muscle
force required to
maintain equilibrium
BW
R R
18
22. Coxa Valga
✤ GT is lower than
normal
✤ Reduced
abductor lever
arm
✤ Increased joint
reaction force
22
23. Coxa Vara
✤ GT is higher than
normal
✤ Increased abductor
lever arm
✤ Decreased joint
reaction force
✤ But…abductor
inefficiency
23
24. Cane
&
Limp
✤ Both decrease the force exerted by the BW on the loaded hip
✤ Cane transmits part of BW to the ground and also provides a counter acting
force thereby decreasing the muscular force required for balancing
✤ Limping shortens the body lever arm by shifting the centre of gravity to the
loaded hip
24
29. Applied biomechanics in THA
Principle- To decrease joint reaction force
Centralisation of the femoral head by deepening of acetabulum
- decreases BW lever arm
29
30. Increase in neck length and lateral reattachment of trochanter
- lengthens abductor lever arm
30
31. Decreased BW lever arm Lengthened abductor lever arm
Reduced wear of implants
31
33. Four important variables determine the stability of
total hip arthroplasty-
1. Component design
2. Component position
3. Soft tissue positioning (restoration of offset)
4. Soft tissue function
33
34. Offset
Medial or horizontal offset
Centre of the head to the axis of the
stem.
Vertical offset(height)
Determined by the base length of
the prosthetic neck and length
gained by head.
The depth the implant is inserted
into the femoral canal alters the
vertical height.
34
37. ✤ Adjustment of neck length is important as it has effect
on both medial and horizontal offset
✤ Joint reaction forces are minimal if hip centre placed in
anatomical position.
37
39. ✤ Principle of medialization has given way to preserving subchondral
bone in the pelvis and to deepening the acetabulum only as much as
necessary to obtain bony coverage for the cup.
✤ Most total hip procedures are now done without osteotomy of the
greater trochanter, the abductor lever arm is altered only relative to the
offset of the head to the stem.
✤ These compromises in the original biomechanical principles of total hip
arthroplasty have evolved to obtain beneficial tradeoffs of a biologic
nature; to preserve pelvic bone, especially subchondral bone; and to
avoid problems related to reattachment of the greater trochanter.
39
43. Component orientation
..”probably the most important biomechanical aspect for
the tribological and functional success of a THA procedure.”
-M.M. Morlock et al
Biomechanics of Hip arthroplasty
43
46. • To perform the procedure properly
• To manage the problems that may arise during and after surgery succ
• To select the components intelligently.
• To counsel patients concerning their physical activities.
46
47. 47
References
✤ Campbell’s operative orthopaedics 13th Ed Vol 1
✤ Biomechanical considerations of total hip replacement- Michael P
Kowaleski
✤ Anatomy and Biomechanics of the hip- Damien P Bryne et al- The open
sports medicine journal, 2010
✤ Biomechanics of hip arthroplasty- Michael M Morlock
✤ The history of biomechanics in total hip arthroplasty- Jan Van Houcke et
al- Indian journal of orthopaedics
Acetabulum
cup-shaped acetabulum is formed by the innominate
bone with contributions from the ilium (approximately 40%
of the acetabulum), ischium (40%) and the pubis (20%)
Labrum
Attached to the rim of the acetatelum. Although it makes less of a contribution to joint stability than the glenoid labrum it plays a role in normal joint development and in distribution of forces around the joint. Also, helps in exerting a negative pressure effect within the joint.
Femoral head
>1/2 sphere and covered by hyaline cartilage
Femoral neck
head of the femur is attached to the femoral shaft by the femoral neck, which varies in length depending on body size.
Long neck which is narrower than the diameter of the head contributes towards mobility.