This document discusses the musculoskeletal system in children. It notes that the high growth and bone development in children makes this system prone to issues. The goal is to study the anatomy and physiology of bones and muscles at different ages, and recognize common symptoms of problems. Key areas covered are the composition and investigation of the bone and muscle systems, common musculoskeletal issues in children, and how to objectively examine the head, chest, spine, pelvis and extremities. The student should learn examination techniques and be able to identify typical complaints and evaluate objective findings related to this system in children.
Radiation Diagnosis of Disease of Heart and Blood VesselsFaizan Siddiqui
General Principal Includes :
Ischemia testing
Maximal workload testing (VO2max)
Contractile reserve testing
Viability testing
Before the test:
Assess the pretest probability
Know sensitivity and specificity
Are there therapeutic consequences?
Atopic dermatitis is a long-term skin disease. "Atopic" refers to a
tendency to develop allergy conditions. "Dermatitis" means swelling of
the skin.
Often, the skin gets worse (flares), then it improves or clears up (remissions).
Escherichia coli species are components of the
Normal animal and human colonic flora;
Flora of a variety of environmental habitats, including long-term care facilities (LTCFs) and hospitals.
E.coli are the cause of most nosocomial infections.
Scalp Psoriasis Vs Seborrheic DermatitisAnusreeAnu12
Check our website@https://www.drpriyaskinandhairclinic.com
Check out this video to know about the difference between Scalp Psoriasis and Seborrheic Dermatitis.
To Know more about Acne scars &marks Treatment visit us @ https://www.drpriyaskinandhairclinic.com/
Contact us @https://www.drpriyaskinandhairclinic.com/contact
Follow us on:
Facebook:https://www.facebook.com/drpriyaskinandhairclinic/
Twitter:https://twitter.com/PriyaSkin
Youtube:https://www.youtube.com/channel/UCNJFmVLzhWKgHR1JinHPLrA
Linkedin:https://www.linkedin.com/company/dr.-priya%27s-skin-&-hair-clinic
Radiation Diagnosis of Disease of Heart and Blood VesselsFaizan Siddiqui
General Principal Includes :
Ischemia testing
Maximal workload testing (VO2max)
Contractile reserve testing
Viability testing
Before the test:
Assess the pretest probability
Know sensitivity and specificity
Are there therapeutic consequences?
Atopic dermatitis is a long-term skin disease. "Atopic" refers to a
tendency to develop allergy conditions. "Dermatitis" means swelling of
the skin.
Often, the skin gets worse (flares), then it improves or clears up (remissions).
Escherichia coli species are components of the
Normal animal and human colonic flora;
Flora of a variety of environmental habitats, including long-term care facilities (LTCFs) and hospitals.
E.coli are the cause of most nosocomial infections.
Scalp Psoriasis Vs Seborrheic DermatitisAnusreeAnu12
Check our website@https://www.drpriyaskinandhairclinic.com
Check out this video to know about the difference between Scalp Psoriasis and Seborrheic Dermatitis.
To Know more about Acne scars &marks Treatment visit us @ https://www.drpriyaskinandhairclinic.com/
Contact us @https://www.drpriyaskinandhairclinic.com/contact
Follow us on:
Facebook:https://www.facebook.com/drpriyaskinandhairclinic/
Twitter:https://twitter.com/PriyaSkin
Youtube:https://www.youtube.com/channel/UCNJFmVLzhWKgHR1JinHPLrA
Linkedin:https://www.linkedin.com/company/dr.-priya%27s-skin-&-hair-clinic
Skin is more than a fleshy surface for pimples, tattoos and wrinkles. Skin is the body's largest organ, and along with hair, nails, glands and nerves, is part of the integumentary system, according to Oregon State University. This system acts as a protective barrier between the outside and the inside of the body.
In this slide Structure of Skin and Hair, Hair Growth Cycle were described followed by skin related diseases such as Acne, dry skin, pigmentation, wrinkles etc.
HIV discrimination among health providers in Malaysia by Dr RubzDr. Rubz
Although doctors took oath that they will treat everyone the best they can and without judging anyone but discrimination still exist especially in HIV affected people. Due to this issue, Pertubuhan Advokasi Masyarakat Terpinggir Malaysia has taken a step to engage with doctors at government sector and desensitize them and find the line to stand together.
Testicular cancer for public awareness by Dr RubzDr. Rubz
A presentation prepared for Charity Dinner with Fun Charity. All the profits of the event will go to FReHA (a NGO which supports women's and reproductive health.)
Prostate cancer for public awareness by DR RUBZDr. Rubz
A presentation prepared for Charity Dinner with Fun Charity. All the profits of the event will go to FReHA (a NGO which supports women's and reproductive health.)
Breast Cancer for public awareness by Dr RubzDr. Rubz
A presentation prepared for Charity Dinner with Fun Charity. All the profits of the event will go to FReHA (a NGO which supports women's and reproductive health.)
This is the first phase (qualitative) of the current project we are working on with the supervision of University Malaya and Yale School of Medicine.It will be publish as IBBS 2013 by end of the year. This slide is just a rough picture of what we are doing at the moment. This is copyright protected!
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.
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
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.
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.
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.
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/
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
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
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.
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.
Couples presenting to the infertility clinic- Do they really have infertility...
Bohomolets Pediactric Skin and subcutaneous fat
1. SKIN AND SUBCUTANEOUS FAT
The current relevance of a research: Due to its anatomic and physiological
peculiarities concerning children subcutaneous fat and skin take an active part in all the
exchange and immune processes, they are treated as tissues that are characterized by the
fast development in childhood. That is why skin and subcutaneous fat affections may be
the evidences of the affected organism.
The aim of the lesson: To study the anatomic and physiological peculiarities of
skin and subcutaneous fat among children of different ages, as well as with symptoms of
their affection.
As the result of the self-training the student must know the following:
1. Anatomic and physiological peculiarities of skin and subcutaneous fat.
2. The skin and subcutaneous fat functions in age aspect.
3. The peculiarities of skin and subcutaneous fat for newborns, physiological and
transitory states of skin and subcutaneous fat within the period of newborns.
4. The methods of skin and subcutaneous fat investigation.
5. The skin and subcutaneous fat affection semiotics.
As the result of topic covering the student must be able to:
1. Collect the anamnesis, to analyse the complaints typical for the skin and subcutaneous
fat affection.
2. Evaluate the skin colour, its humidity, temperature, the skin fold thickness, skin
elasticity, dermatographism, the state of capillaries; in case of eruption pserence one
must be able to find out its nature.
3. Evaluate the skin and subcutaneous fat state (turgor, oedemata, infiltration, tha state of
development).
Skin glands in age aspect:
Oil glands may be found on all the skin districts, except for palms, feet and dorsal
side of feet. Their ducts open to the hair follicle, except for lips skin, preputial bags and
2. small (lower) lips of pudendum, where they open on the surface directly. The oil glands
activity depends on androgenic stimulation (the mother’s androgens stimulation for
foetus).
Apocrine glands are located at axillary sockets, perianal and privy parts districts,
near umbilicus. They produce the milk-like odourless secret. It is pushed out under the
androgen stimulators action to the surface. Under the influence of bacteria it becomes
smelly, this smel is connected with perspiration. These glands are “sleeping” up to the
pubertal period.
Eccrine (merocrine) glands are spread over the whole body’s surface. They
response to the temperature on hair districts and regulate the body’s temperatutre by
means of water transportation to the skin surface where it is turned into a vapour. Their
ducts are opened to the skin surface. The glands are provided with sympathetic nerve
endings.
Skin eruption elements:
Primary: appear in visually unchanged skin.
Spot (makula) – primary non-cavernous skin eruption element which changes
the skin colour only, it disappears when pressed. May be of inflammation and non-
inflammation genesis. According to its size is divided into roseolas (less than 5 mm in
size), proper spots and erythema (more than 20 mm in size). Among the spots of non-
inflammation genesis hemorrhagic ones are the most frequent to meet; they are divided
into petechia, purpura (2-5 mm in size), linear (vibices), ecchimozes (“bruises” >5 mm),
big formless spots – sugilation (???),haematoma. The spots can be dypigmented (vitiligo,
albinism), hyper pigmented (freckles, chloasma, birthmarks). Typhoid maculopapular
rash is present in case of typhoid, syphilis, measles and German measles. Punctate (finely
papular) rash is typical for scarlet fever and measles. Telangiectasia (vessels units having
the star form) are also treated as spots. They are the evidence of liver affection.
Papule (papula) - is the vessel knit, non-cavernous element which changes the
skin consistence and relief. Appears as the result of different pathological processes
taking place in epidermis and skin upper layers (infiltrate skin accumulation, skin tissues
hypertrophy, protein products precipitations. Depending on the size the following types
3. are distinguished: miliary, lenticularis (up to 0, 5 cm), numeral (???) (1-2 cm). they may
be of inflammation and non-inflammation (warts) genesis. Papule is most frequent in
case of scab, lichen pilaris, measles, German measles and purpura rheumatica).
Hunch (tuberculum) - is the non-cavernous element located in a gauze layer of
derma, up to 1 cm in diameter, prominent on the skin surface. May be of inflammation
and non-inflammation nature. Is noticed in case of syphilis, wolfish herpes, leprosy and
leishmaniasis.
Nodule (nodus) - is the non-cavernous element located in derma. May be of
non-inflammation (atheroma, lipoma) and inflammation (strophuloderma, leprosy,
rubber, furuncle, carbuncle, nodal eryterma).
Vial (vesicula) – is the primary non-cavernous element having a bottom, cover
and content. If it is less than 1 cm in size, it is vial; if it is more than 1 cm in size, it is
bulb (bulla). The content may be serum, hemorrhagic and purulent. May be located either
in epidermis ar below epidermise. It is typical for eczema, chicken pox, shingles. The
bulb is typical for burns.
Pustule (pustula) – is the non-cavity element with the purulent content located in
epidermis, derma or subcutaneous. May be connected (osteofolliculitis, folliculitis, acne
and hydradenitis) and disconnected (impetigo) with the skin appendages; deep and
superficial.
Bulb (urtica) – is the non-cavernous element (stands between the cavernous and
non-cavernous ones), form as the result of temporary surface blood vessels widening and
liquid blood components release. The examples: nettle-rash, insects bites, nettle burns,
allergic dermatosis).
Secondary: is the stage of primary and secondary elements development.
Secondary pigmentation: - the skin colour change on the place of the previously
existing element.
Peel (squama) – the element consisting of the surface epidermis layers, skin fat,
dust and bacteria.
Erosion (erosio) – the defect in the epithelium boundaries. Ulcer (uslus) – is the
deep defect of skin which reaches the cellar layer, is formed of the deep primary
elements.
4. Excoriation (excoriatio) – scratch, abrasion. Is the linear skin defect caused in
mechanic way.
Crack (rhagades) – is the linear skin defect formed as the result of the skin
wholeness and elasticity.
Crust (crustae) – exudation which is dry; appears on the places of all the
cavernous lements or at the places of secondary elements accompanied by the skin
wholeness affection.
Cicatrice (cicatrix) - conjunctive tissue replaces skin.
Atrophy – all the skin layers get thinner.
Lichenification (lichenificatio) – all the skin layers get thicker, the underlined
picture is present (neurodermatitis, eczema). The skin is wholeness, coarse, the picture is
enforced, there is a lot of furrows, practically cannot be taken to folds.
The ambiguity of skin eruption elements is called polymorphism. The real (true)
polymorphism is represented by several different primary elements, while the false one is
represented by the one primary element on different stages of its development.
The normotrophia, hypotrophy and paratrophy finding out and the
sequence of precipitation and disappearance for children:
Normotrophy – is the normally developed subcutaneous fat.
Paratrophy – is overdeveloped subcutaneous fat among infants. As for eldery
children, the same symptoms stand for adiposity.
Hypotrophy – is the disappearing or lowering of subcutaneous fat (SCF). There
are three detected grades of hypotrophy:
I grade – SCF disappears on stomach, lowers on body and extremities. The body
mass compromise stands for 11-20%.
II grade – SCF disappears on stomach, lowers on body and extremities, but
remains on a child’s face. The body mass compromise stands for 21-30%.
III grade – SCF disappears even on face. The body mass compromise stands for
more than 30%.
SCF precipitation: face, neck and shoulders, body, extremities, stomach.
SCF disapearance: stomach, hip internal surface, body, extremities, cheeks
(Bish’s heaps).
5. Sclerema, scleredema:
Sclerema (focal or diffusive) – is the process of SCF infiltration. Is noticed
among the prematurely born and weak full-term children. Most frequently appears on
cheeks, hips, buttocks, body with the following spread on the neighbouring sound skin
zones. The skin of these zones is cold, tense, pale or with hyperemia.
Scleredema is the process of infiltration or oedema of the definite SCF zone
which spreads over the neighbouring body zones.
Tests:
1. The following elements are treated as the primary skin eruption elements except for:
1.1. Spot;
1.2. Papule;
1.3. Vial;
1.4. Hunch;
1.5. Ulcer;
1.6. Pustule.
2. The following elements are treated as the secondary eruption elements except for:
2.1. Cicatrice;
2.2. Peel;
2.3. Atrophy;
2.4. Hunch;
2.5. Lichenification.
3. Point out the skin zones free of oil glands:
3.1. Lips;
3.2. Palms;
3.3. Neck;
3.4. Shoulders;
3.5. Stomach.
4. What of the given below is not typical for the child’s skin epidermis?
4.1. Epidermis is thin, delicate and light;
6. 4.2. The glittering epidermis layer is noticed on palms and feet only;
4.3. The melanin pigment is absent in growth layer up to the age of 6 months;
4.4. The cambial layer where the epithelium cellars growth takes place is almost
undeveloped.
4.5. All the intercellar connections are very weak, that is why the superfacial
layer cells are easily pilled and traumas are usual.
5. “Thrush” is the following:
5.1. The patch on tonsil as the result of diphtheria;
5.2. The white pellicle in the infant’s mouth cavity left after feeding;
5.3. The fungus affection of the mouth cavity, mostly among infants;
5.4. White dots often appearing on the infants’ faces, the result of the temporary
oil glands ducts closing.
6. The following statements have nothing to do with the childrens’ derma peculiarities:
6.1. The quantity of collagenous (white) fibers is small, they are thin and joined
into the light fascicle.
6.2. The elastic derma fibres are well developed, they are the prevaling ones
during the childish age;
6.3. The papillary derma layer is not enough exposed;
6.4. The water quantity in derma is sufficiently biger for children than for adults;
6.5. The derma’s biochemical composition helps the increased skin penetration.
7. Which of the given below skin peculiarities helps the newborns pemphigus
development:
7.1. Collagenous (white) fibers are thin and joined into the light fascicle;
7.2. Children’ skin contains more water than that of adults;
7.3. Child’s skin is delicate and easilly injured;
7.4. The basic (basement) membrane is undeveloped;
7.5. All given above.
8. Dermatographism is:
8.1. The corresponding skin vessels response on mechanic stimulation by the
blunt item;
7. 8.2. The skin response on the environment temperature change;
8.3. One of the SCF characteristics;
8.4. All given above.
9. What do the jam syndrome positive reaction says:
9.1. Of the increased skin vessels fragility;
9.2. Of the periferal vessels hypo tonus;.
9.3. Of the periferal vessels hyper tonus;
9.4. Of the skin lowered turgor;
9.5. This is the physiological state for the newborn’s skin.
10. The following substances sre prevailing in children’ skin:
10.1. Croton and oleic acids;
10.2. Stearic and arachidonic fat acids;
10.3. Oleic and palmitinic fat acids;
10.4. Capric and linoleic fat acids;
10.5. Palmitinic and stearic fat acids.
Answers: 1.5; 2.4; 3.2; 4.4; 5.3; 6.2; 7.4; 8.1; 9.1; 10.3;
MUSCULOSKELETAL (APPARATUS) SYSTEM
The current relevance of a research: the high growth and bone stock (bone
tissue) reconstruction tempo which take place while a lot of organs and systems are
functionally imperfect, especially for children of early age, may lead to the high
frequency of apparatus affection.
The aim of the lesson: to study the composition peculiarities and functions of
bones and muscles of children of different ages, to evaluate the state of this system and to
recognize the most spread symptoms of its affection in childish age.
As the result of the self-training the student must know the following:
1. The peculiarities of histological composition and chemical composition of children’
bone tissue.
2. The peculiarities of skull, backbone, chest and extremities among children.
8. 3. The most frequent skeleton affection semiotics.
4. The order of teeth coming out.
5. The methods of bone system investigation.
6. The peculiarities of histological composition and muscles tonus for children of
different ages.
7. The muscles affection semiotics for children.
8. The methods of muscular system investigation.
As the result of topic covering the student must be able to:
1. Point out complaints typical for musculoskeletal system affection; collect the
family and individual anamnesis.
2. Conduct the objective bones and muscles investigation for children of different
ages.
3. Evaluate the data obtained as the result of the objective investigation of the given
system.
4. Work out the plan for the laboratory and instrumental musculoskeletal system
investigation and evaluate the data obtained.
The methodology of the musculoskeletal system investigation for children.
During the children’ investigation it is necessary to exinine the anamnesis data
which have the importance for the musculoskeletal system, static and motility
development (mother’s state of health within the pregnancy period, the character of her
feeding, the child’s state of health, the child’s feeding and the brining up regime); as well
as the typical complaints (pain in bones, muscles and joints; joints configuration change
and mobility limiting).
During the examination one must pay attention on the following aspects: the
head’s form and size changes (microcephalia, macrocephaly, acrocephaly, buttocks-like,
saddle-like, scaphocephaly, steeple (tower) skull, flat occiput); the upper and lower laws
development, the peculiarities of occlusion, teeth quantity, their character (milk
(deciduous, baby, first, primary, temporary) teeth, permanent (succedaneous) teeth); the
chest form (conical, cylindric, flat) and its form (Harrison’s trench, keeled chest, funnel
9. breast, barrel (emphysematous) chest, cardiac hump, one side flattening or one side
outpouching); the backbone form (the pathological kyphosis presence, lordosis, scoliotic
angulation) and child’s pelvis (plano- rachitic, Otto’s pelvis); extremities configuration
(acromegalia, bradydaktylia, adactylia, aphalangia, etc.); the joints form (edema,
deformation), their mobility and the skin and surronding tissues state (eruption presence,
knots and other formations); muscles trophism (weak, middle and best state of
development, atrophy, hypertrophy, hypotrophy); the state of muscles tonus (hypo tonus
and hyper tonus).
By means of musculoskeletal system palpation the wholeness of skull bones,
sutures state and crown is detected (craniotabes, crown sides pliability, crown’s size); the
breaks and deformation presence; osteoid tissue hyperplasia signs (rickety thickening of
wrists and ankles, rachitic rosaries, “beads”); the skin temperature over the joints, pain in
bones, muscles and joints; the muscles power and tonus; the infiltration presence.
The muscles trophism and power finding out.
The muscles trophism which characterises the level of exchange (metabolism)
processes is detected by the degree and symmetry of the development of certain muscles
groups. The evaluation is made in the state of calm and in the state of physical loading.
The following development states are distinguished: low, middle, good. In case of a low
body and extremeties muscles development they are not well exposed in the state of
calm, in case of physical loading their volume is not significanly changed, the lower part
of stomach is drooping, the shoulder-blades lower corners are separated from the chest.
In case of a middle development, the body muscles mass is moderately exposed
in the state of calm, the same of extremities are well exposed, their volume andform are
changed when physically loaded. In case of a good state of development the body and
extremities muscles are well developed, and their relief enlargement is visually noticed
when physically loaded.
The muscles power evaluation is made according to the special scale by 5
points’ system: 0 points – movements are absent; 1 point – active mopvements are
absent, but muscular tension is detected by means of palpation; 2 points – passive
movements are possible in case of slight resistance overcoming; 4 points – passive
10. movements are possible in case of moderate resistance overcoming; 5 points – the
muscles power is within the normal indexes.
Additional methods of investigation: a) calcium, phosphorus, alkaline
phosphatase content finding out in blood serum; b) X-ray examination of cells; c)
electromyography; d) chronaximetry; e) for eldery children the dynamometry; f) muscles
biopsy; g) densitometry.
Osteoid tissue hyperplasia signs
Rickety thickening of wrists and ankles, rachitic rosaries, “beads”, frontal tubers
enlargement.
Osteomalacia signs
Craniotabes (occipital bone’s softening), Краніатабес (пом’якшення
потиличної кістки), back of the head’s flattening, Harrison’s trench, X-like and O-like
shanks (genu varum).
The normal rate of Ca and P in blood serum (Doskin V.A., 1997).
Usual calcium in blodd cerum 2,5 – 2,87 milli gram-molecule per liter
ммоль/л
Ionized calcium 1,25 – 1,37 milli gram-molecule per liter
Phosphorus inorganic in blood serum 0,65 – 1,62 milli gram molecule per liter
Arthritis symptoms.
There is a skin oedema, it aches: edemas of the surrounding tissues near joints,
the mobility is limited in joints as well as the active movements are also limited.
Muscles tonus violation types.
Hypotonia – is the muscles tonus lowering (as the result of rachits, hypotrophy,
chorea, congenital acromicria (trisomy 21 (Down's) syndrome, mongolism, Down's
disease), hypothyroidism, Hoffmann's muscular atrophy, peripheral paralysis).
11. Hypertension – the muscles tonus increasing (it is typical for the sound child for
the first 3-4 months of life, central paralysis, meningitis, correcting).
Muscles trophism violation types.
Atrophy – is the muscles extreme degree of the low development or
undevelopment (simple form) or degeneration (degenerative form).
The simple form is met in cases of cerebral palsy, muscles diseases (muscles
progressive dystrophy, inborn myodystrophy) and joints (juvenile rheumatoid arthritis,
tuberculous coxitis). Degenerative form is the result of peripheral paralysis,
poliomyelitis, and others.
Hypertrophy – is the process of muscles thickening and mass enlargement. Most
frequently is found among children going infor sports or practicing physical labour. In
case of pseudohypertrophy fat accumulation simulates the well exposed muscles.
Tests:
1. The big parietal region of a sound child is closed at the age of:
1.1. 4 - 6 months
1.2. 6 - 8 months
1.3. 9 - 11 months
1.4. 1 - 1,5 years
2. The newborn’s chest is of the following form:
2.1. Cylindrical
2.2. Barrel
2.3. Funnel
2.4. Conical
3. Which of the given below symptoms is not the sign of rachitis?
3.1. Craniotabes
3.2. Crown sides pliability
3.3. Rachitic rosaries
3.4. Bandy (boomerang) legs
4. Which of the given below signs is not the evidence of osteomalacia?
12. 4.1. Craniotabes
4.2. Caput quadratum
4.3. Genu varum
4.4. Back of the head’s flattening
5. Which of the given below symptoms is not the sign of osteoid tissue hyperplasia?
5.1. Rachitic rosaries
5.2. Rickety thickening of wrists and ankles
5.3. Harrison’s trench
5.4. Frontal tubers enlargement
6. Flat feet is the physiological state for children up to the age of:
6.1. Before 6 months
6.2 First 2-3 years of life
6.3. Up to 5 years
6.4. Up to 7 years
7. Physiological chest kyphosis is formed for :
7.1. 2 - 3 months
7.2. 6 - 7 months
7.3. 10 - 12 months
7.4. 1,5 - 2 years
8. The flexors hypertonus of the upper extremities is preserved for children up to:
8.1. 1 month
8.2. 2 - 3 months
8.3. 3 - 4 months
8.4. 4 - 5 months
9. The flexors hypertonus of the lower extremities disappears at the age of:
9.1. 1 month
9.2. 2 - 3 months
9.3. 3 - 4 months
9.4. 4 - 5 months
10.Which of the given below additional methods is used for the muscular system
investigation?