Elbow complex is designed to serve hand.
They provide MOBILITY for Hand in space by apparent shortening and Lengthening of upper extremity.
They provide Stability for skillful and forceful movements
GONIOMETRY FOR UPPER LIMB DISCUSSES IN CONCISE THE DIFFERENT TYPES OF GONIOMETERS AVAILABLE FOR MEASURING VARIOUS JOINT ROM, PRINCIPLES OF GONIOMETRY AND PLACEMENT OF GONIOMETER FOR MEASURING RANGE OF MOTION IN UPPER LIMB (SHOULDER, ELBOW, FOREARM AND WRIST JOINT).
Femoral Head (Superiorly, Medially, Anteriorly).
Acetabulum (Inferiorly, Laterally, Anteriorly).
Horseshoe-shaped (Acetabular Notch).
The deepest portion (Acetabular Fossa).
Labrum Acetabular:
Is a wedged fibrocartilaginous ring inserted into the acetabular rim to increase the acetabular concavity.
Elbow complex is designed to serve hand.
They provide MOBILITY for Hand in space by apparent shortening and Lengthening of upper extremity.
They provide Stability for skillful and forceful movements
GONIOMETRY FOR UPPER LIMB DISCUSSES IN CONCISE THE DIFFERENT TYPES OF GONIOMETERS AVAILABLE FOR MEASURING VARIOUS JOINT ROM, PRINCIPLES OF GONIOMETRY AND PLACEMENT OF GONIOMETER FOR MEASURING RANGE OF MOTION IN UPPER LIMB (SHOULDER, ELBOW, FOREARM AND WRIST JOINT).
Femoral Head (Superiorly, Medially, Anteriorly).
Acetabulum (Inferiorly, Laterally, Anteriorly).
Horseshoe-shaped (Acetabular Notch).
The deepest portion (Acetabular Fossa).
Labrum Acetabular:
Is a wedged fibrocartilaginous ring inserted into the acetabular rim to increase the acetabular concavity.
Seminar clinical anatomy of upper limb joints and musclesQuan Fu Gan
This is not all, there are many more clinical anatomy in terms of condition such as Popeye Deformity with are not included here and Special Test such as Neer's Impingement and Hawkins Kennedy etc... with touches on the upper limb muscles and joints. Also not forgotten Long tendon test and so forth. In general, this is just a simplified slides. Tq
1.Anatomy
a.Course
b.Motor distribution
c.Sensory distribution
2.Common sites affected
3.Level of median nerve injury
4.Clinical feature with various test performed
5.Various syndromes related to median nerve
6.Treatment
7.Summary
RADIOGRAPHIC TECHNIQUE OF UPPER LIMB BY SAGAR CHAULAGAINSagar Chaulagain
Calling all aspiring radiography professionals! Dive into the intricate world of upper limb radiography with this comprehensive guide tailored to meet the technical demands of radiography field students. From mastering essential techniques to understanding complex pathologies, this presentation equips you with the knowledge and skills necessary to excel in the radiology field.
Here's what you'll discover:
Radiographic Techniques Demystified: Unlock the secrets of acquiring clear and precise radiographic images of the upper limb. Explore a variety of positioning techniques, exposure factors, and tube-object distances to capture optimal views for diagnostic assessment.
Indications and Pathologies: Gain insight into the clinical indications and common pathologies encountered in upper limb radiography. From fractures and dislocations to degenerative joint diseases, learn to identify and interpret radiographic findings with confidence.
Radiation Protection and Safety Protocols: Prioritize patient and staff safety with rigorous adherence to radiation protection measures. Explore best practices for minimizing radiation exposure, including shielding techniques, collimation, and dose optimization strategies.
Image Characteristics and Evaluation Criteria: Develop a keen eye for assessing radiographic images of the upper limb. Understand the key characteristics and evaluation criteria essential for accurate interpretation and diagnosis.
Basic and Supplementary Views: Master the art of acquiring basic views while understanding the necessity and technique behind supplementary views. Explore the role of oblique, tangential, and special projections in revealing hidden pathologies and anatomical details.
Exposure Factors and Optimization: Delve into exposure factors and their impact on image quality and radiation dose. Learn how to manipulate exposure parameters effectively to achieve optimal results while minimizing patient exposure.
Designed as a comprehensive resource for radiography students, this presentation serves as a roadmap to navigate the complexities of upper limb radiography. Whether you're honing your skills in the classroom or preparing for clinical practice, this guide offers invaluable insights to elevate your proficiency and confidence in the radiology field.
Debridement is an important component of the wound bed preparation (WBP) management Model.
Cause of the wound and patient-centered concerns, debridement is a necessary step in local wound care.
Debridement is the removal of necrotic tissue, exudate, bacteria, and metabolic waste from a wound in order to improve or facilitate the healing process
Chest pain or discomfort
Common presenting symptom of cardiovascular disease
May be cardiac or noncardiac in origin.
Cardiac – angina, MI, pericarditis, mitral valve prolapse, dissecting aortic aneurysm
Non cardiac – anemia (physical exertion), cervical disc disease, anxiety, trigger points etc
Follows pattern of ulnar nerve distribution (heart supplied by C3-T4 spinal segments)
Radiating pain to neck, jaw, upper trapezius, upper back, shoulder or arms (commonly left
Biologist & gerontologist used concept of senescence to explain biological aging
Senescence or normal aging refers to a gradual, time related to biological process that takes places as degenerative processes overtake regenerative or growth processes.
or
senescence: a change in the behavior of an organism with age leading to a decreased power of survival and adjustment
Immunology plays a very important role in homeostasis but it possesses two edge sword actions. Either hypo or hyperimmunity both can cause systemic diseases which will manifest in the oral cavity.
Immunomodulators are the agents which modulate the body immunity according to
the need.
There are natural and synthetic immunomodulatory agents .
Endocrinology is a specialty of medicine; some would say a sub-specialty of internal medicine, which deals with the diagnosis and treatment of diseases related to hormones. Endocrinology covers such human functions as the coordination of metabolism, respiration, reproduction, sensory perception, and movement
non-skeletal mesodermal tissues: adipose tissue, fibrous tissue, muscle, blood vessels and peripheral nerves (despite neuroectodermal origin)
benign, malignant and intermediate (low-grade malignant – locally aggressive, can recur, no metastatic potential)
originate from primitive mesenchymal stem cells
classification according to differentiation lines (e.g. liposarcoma is not a tumor arising from adipose tissue but exhibiting lipoblastic differentiation)
Down syndrome (DS or DNS), also known as trisomy 21, is a genetic disorder caused by the presence of all or part of a third copy of chromosome 21. It is typically associated with physical growth delays, characteristic facial features and mild to moderate intellectual disability. The average IQ of a young adult with Down syndrome is 50, equivalent to the mental ability of an 8- or 9-year-old child, but this can vary widely.
Facial pain is pain felt in any part of the face, including the mouth and eyes.
It’s normally due to an injury or a headache, occasionally facial pain may also be due to neurological or vascular causes, but equally well may be dental in origin.
The lymphatic system is responsible for the production, transport and filtration of lymph fluid throughout the body. In addition to its important circulatory functions, the lymphatic system also has important immunological functions
The pressure of the blood in the circulatory system, often measured for diagnosis since it is closely related to the force and rate of the heartbeat and the diameter and elasticity of the arterial walls.
Eating a diet high in vegetables, fruits, whole grains, and legumes.
Choosing lean, low-fat sources of protein.
Limiting sweets, soft drinks, and foods with added sugar.
Including proteins, carbohydrates, and a little good fat in all meals and snacks.
Vectors are organisms that transmit pathogens and parasites from one infected person (or animal) to another, causing serious diseases in human populations
She has a wonderful personality.”“He has no personality.”“He has a charming personality.”“We seem to have a personality conflict.”“It’s just her personality.”“She has her mother’s personality.”“He’s a real personality.”
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.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
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.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
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.
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Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
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
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2. Outline
Introduction of hand
Types of grasp
Arches of the hand
Functional position of the hand
Joints of the hand
Mechanism for finger flexion
Mechanism for finger extension; the extensor mechanism
Muscles that transmit force to the extensor mechanism
How does the extensor mechanism work?
Clinical appearance of peripheral nerve injuries in the hand
Internet links related to the hand
3. Movements of the Wrist
Sagittal and frontal plane movements
Rotary motion
Flexion
Extension and Hyperextension
Radial Deviation
Ulnar Deviation
4. Joint Structure of the Hand
Carpometacarpal (CM)
Metacarpophalangeal (MP)
Interphalangeal (IP)
5. Common Injuries of the Wrist and Hand
Sprains and strains fairly common
Metacarpal fractures and football
Ulnar collateral ligament and hockey
Wrist fracture and skate/snowboarding
Wrist in non-dominant hand for golfers
Carpal tunnel syndrome
6. Types of grasp
Two types of grasp are differentiated according
to the position and mobility of the thumb's CMC
and MP joints.
1. Power grasp
2. Precision grasp
7. POWER GRASP
(The adductor pollicis stabilizes an object against the palm; the hand's
position is static.)
cylindrical grip (fist grasp is a small diameter cylindrical grasp)
spherical grip
hook grip (MP extended with flattening of transverse arch; the person
may or may include the thumb in this grasp)
lateral prehension (this can be a power grip if the thumb is adducted,
a precision grip if the thumb is abducted).
9. PRECISION
(Muscles are active that abduct or oppose the thumb; the
hand's position is dynamic.)
palmar prehension (pulp to pulp), includes 'chuck' or
tripod grips
tip-to-tip (with FDP active to maintain DIP flex)
lateral prehension (pad-to-side; key grip)
10. Three arches balance stability and
mobility in the hand.
The proximal transverse arch is
rigid, but the other two arches are
flexible, and are maintained by
activity in the hand's intrinsic
muscles.
11. 1. PROXIMAL TRANSVERSE ARCH
a stable bony arch that forms the posterior border of the carpal
tunnel.
The arch's integrity is maintained by a soft tissue "strut" formed by
the flexor retinaculum or transverse carpal ligament (also called
the volar carpal ligament). This ligamentous strut connects the
scaphoid and
trapezium on the arch's radial side with the
hamate on its ulnar side, and forms the
anterior border of the carpal tunnel.
12. 2. DISTAL TRANSVERSE ARCH
It is also call metacarpal arch, because it is formed
by the metacarpal heads; metacarpals 2 and 3 are
stable while 4 and 5 are relatively mobile. You can
observe the arch's combination of "radial" stability
and "ulnar" mobility by loosely closing your fist, then
squeezing more tightly, when you will observe
movement in the more mobile fourth and fifth
metacarpals.
13. 3. LONGITUDINAL ARCH
Observe this arch's behavior as you loosely close your fist.
The arches provide a balance between stability and mobility
for grasping. For instance, we produce the so-called "chuck
grasp" by using the more stable second and third
metacarpals, instead of the more mobile fourth and fifth
metacarpals.
Therapeutic splints must support these three arches.
14. Functional position of the hand
•Wrist
• extended 20 degrees
• ulnarly deviated 10 degrees
•Digits 2 through 5
• MP joints flexed 45degrees
• PIP joints flexed 30-45 degrees
• DIP joints flexed 10-20 degrees
•Thumb
• first CMC joint partially abducted and opposed
• MP joint flexed 10 degrees
• IP joint flexed 5 degrees
15. When therapists immobilize a patient's hand,
they often position it this way. During a
period of immobilization, the resting lengths
of the hand's ligaments and muscles
change. This hand position provides the
best balance of resting length and force
production so the hand can function when
the patient mobilizes it again.
16. JOINT STRUCTURE AXIS MOTION
CLOSE-PACKED
POSITION
Metacarpo-
phalangeal (MP)
biaxial
(condylar)
lateral
A-P
flexion/extension
abduction/adductio
n
first: extension
2nd-5th: flexion
Proximal
Interphalangeal
(PIP)
uniaxial lateral flexion/extension extension
Distal
Interphalangeal
(DIP)
uniaxial lateral flexion/extension extension
Joints of the hand
17. Mechanism for finger flexion
FDP: flexor digitorum profundus (the deeper of the two)
FDS: flexor digitorum superficialis (the more superficial muscle)
Although the FDP is deep to the FDS over most of its course, it
attaches to the skeleton more distally, because it passes through a
'split' in the FDS tendon.
18. Mechanism for finger extension
We can extend the PIP and DIP joints without also extending the MP
joints.
But we can't extend the PIP joint without extending the DIP joint at the
same time.
Flexing only the DIP joint without also flexing the PIP joint is difficult.
Full (active or passive) flexion of the PIP joint prevents active
extension of the DIP joint.
19. Force Transmission
• 80-90% through Radius & 10-20% - Ulna
• Peak pressures are higher through Scaphoid fossa than
lunate fossa
• 50% of load applied through distal Carpus is transmitted
through the Capitate to the scaphoid & lunate
20. Force Transmission
Pattern of force transmittal depends on:
• Wrist position
• Capsuloligamentous integrity
• Articular surface
• Congruity
21.
22. PERIPHERAL NERVE INJURIES IN
THE HAND
Median nerve:
Often due to carpal tunnel syndrome.
Wasting of thenar eminence
Decreased thumb function, especially
opposition.
Thumb moves into plane of palm.
23. Ulnar nerve
Damage to ulnar nerve can occur with trauma to elbow region.
Ulnar neuropathy is a frequent complication of diabetes mellitus
Wasting of web space and interosseous spaces.
Affects strength of intrinsic muscles of hand, so person can't hold
a piece of paper between extended but adducted fingers
Affects adductor pollicis and ulnar head of FPB. A person who
lacks strength in these muscles cannot grasp with the thumb
unless he or she flexes the IP joint by substituting with the flexor
pollicis longus.
24.
25. Radial nerve injury
Associated with gunshot or stab wounds, fracture of
humerus, "Saturday night palsy."
person demonstrates a "dropped wrist," and cannot
reposition thumb.
lack of wrist extension may cause hand grip to be
weak.