This document discusses cranial nerves XI (spinal accessory nerve) and XII (hypoglossal nerve). It provides detailed information on the anatomy and function of each nerve, how to examine them clinically, and what lesions may cause different patterns of weakness. It describes how lesions in different locations (supranuclear, nuclear, peripheral) can result in variable involvement of the muscles innervated by each nerve. Localization of lesions is discussed based on the specific muscles affected.
The document discusses cranial nerves XI and XII. CN XI is the spinal accessory nerve which has a cranial and spinal portion. The cranial portion innervates muscles of the larynx while the spinal portion innervates the sternocleidomastoid and trapezius muscles. CN XII is the hypoglossal nerve which solely innervates the muscles of the tongue. Clinical examination of both nerves involves assessing strength and movement of their respective muscles. Lesions can occur at supranuclear, nuclear or infranuclear levels and cause varying patterns of weakness depending on the location.
This document discusses various types of nerve injuries including neurapraxia, axonotmesis, and neurotmesis. It describes classifications of nerve injuries put forth by Seddon and Sunderland. Specific nerves that can be injured are discussed such as the femoral nerve, sciatic nerve, and nerves of the upper extremity. Management strategies for different types of nerve injuries are provided such as exploration and suturing of divided nerves, nerve grafting, splinting, and tendon transfers. Surgical techniques for nerve operations including nerve repair are also mentioned.
Another presentation I working on Fiverr. Please send me your RAW material if you want to create a great presentation by me. Visit my fiverr account on www.fiverr.com/dennynugroho.
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
This document discusses cervical spine injuries, their classification, mechanisms of injury, diagnosis, and management. Some key points:
1. Cervical injuries can be caused by traction, direct impact, or indirect forces like flexion, compression, or rotation. Imaging helps classify injuries and assess stability.
2. Unstable injuries with neurological deficits or multiple injuries may require urgent surgical stabilization. Otherwise, initial treatment focuses on immobilization using rigid collars, braces, halo traction, or halo vests.
3. Common injuries include fractures of C1-C2 and the odontoid process. Type II odontoid fractures are prone to displacement and non-union, so may need open reduction and fusion
This document discusses cervical spine injuries, their classification, mechanisms of injury, diagnosis, and treatment approaches. Some key points:
1. Cervical injuries can be caused by traction, direct impact, or indirect forces like flexion, compression, or rotation. Imaging helps classify injuries and assess stability.
2. Unstable injuries with neurological deficits or multiple injuries may require urgent surgical stabilization. Otherwise, treatment focuses on immobilization, reduction if needed, and rehabilitation.
3. Common injuries include fractures of C1-C2 and the odontoid process. Treatment depends on fracture type and stability but may involve traction, halo vest immobilization, or anterior/posterior fusion.
This document discusses pronator syndrome (PS), a condition where the median nerve is compressed in the forearm. It describes the anatomy of the median nerve and potential sites of compression, including the pronator teres muscle, lacertus fibrosus, and flexor digitorum superficialis. Common symptoms of PS are pain and paresthesias in the forearm and hand. Physical exam may reveal tenderness over the pronator teres. Conservative treatment includes rest, activity modification, physical therapy, and corticosteroid injections. Surgery is considered if symptoms persist after failed nonsurgical management.
The document discusses cranial nerves XI and XII. CN XI is the spinal accessory nerve which has a cranial and spinal portion. The cranial portion innervates muscles of the larynx while the spinal portion innervates the sternocleidomastoid and trapezius muscles. CN XII is the hypoglossal nerve which solely innervates the muscles of the tongue. Clinical examination of both nerves involves assessing strength and movement of their respective muscles. Lesions can occur at supranuclear, nuclear or infranuclear levels and cause varying patterns of weakness depending on the location.
This document discusses various types of nerve injuries including neurapraxia, axonotmesis, and neurotmesis. It describes classifications of nerve injuries put forth by Seddon and Sunderland. Specific nerves that can be injured are discussed such as the femoral nerve, sciatic nerve, and nerves of the upper extremity. Management strategies for different types of nerve injuries are provided such as exploration and suturing of divided nerves, nerve grafting, splinting, and tendon transfers. Surgical techniques for nerve operations including nerve repair are also mentioned.
Another presentation I working on Fiverr. Please send me your RAW material if you want to create a great presentation by me. Visit my fiverr account on www.fiverr.com/dennynugroho.
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
This document discusses cervical spine injuries, their classification, mechanisms of injury, diagnosis, and management. Some key points:
1. Cervical injuries can be caused by traction, direct impact, or indirect forces like flexion, compression, or rotation. Imaging helps classify injuries and assess stability.
2. Unstable injuries with neurological deficits or multiple injuries may require urgent surgical stabilization. Otherwise, initial treatment focuses on immobilization using rigid collars, braces, halo traction, or halo vests.
3. Common injuries include fractures of C1-C2 and the odontoid process. Type II odontoid fractures are prone to displacement and non-union, so may need open reduction and fusion
This document discusses cervical spine injuries, their classification, mechanisms of injury, diagnosis, and treatment approaches. Some key points:
1. Cervical injuries can be caused by traction, direct impact, or indirect forces like flexion, compression, or rotation. Imaging helps classify injuries and assess stability.
2. Unstable injuries with neurological deficits or multiple injuries may require urgent surgical stabilization. Otherwise, treatment focuses on immobilization, reduction if needed, and rehabilitation.
3. Common injuries include fractures of C1-C2 and the odontoid process. Treatment depends on fracture type and stability but may involve traction, halo vest immobilization, or anterior/posterior fusion.
This document discusses pronator syndrome (PS), a condition where the median nerve is compressed in the forearm. It describes the anatomy of the median nerve and potential sites of compression, including the pronator teres muscle, lacertus fibrosus, and flexor digitorum superficialis. Common symptoms of PS are pain and paresthesias in the forearm and hand. Physical exam may reveal tenderness over the pronator teres. Conservative treatment includes rest, activity modification, physical therapy, and corticosteroid injections. Surgery is considered if symptoms persist after failed nonsurgical management.
The document discusses the anatomy and common injuries of the elbow joint. It begins with the bones and ligaments that form the elbow joint. It then describes the muscles that flex, extend, supinate, and pronate the elbow. Common fractures discussed include fractures of the medial epicondyle, lateral epicondyle, radial head, coronoid process, olecranon, and elbow dislocations. Treatment options like splinting, open reduction internal fixation, and elbow replacement are covered. Pulled elbow, or subluxation of the radial head in children, is also summarized.
This document provides an overview of peripheral nerve injuries. It begins with the anatomy and classification of peripheral nerves. There are three main types of peripheral nerve injuries classified by Seddon: neuropraxia, axonotmesis, and neurotmesis. The document then discusses the various modes of peripheral nerve injury including stretch, laceration, compression, and ischemia. Specific peripheral nerves of the upper and lower limb that are commonly injured are then reviewed, along with their typical causes, symptoms, and treatment approaches.
This document discusses the cranial nerves, focusing on nerves VII (facial nerve) and VIII (vestibulocochlear nerve). It provides details on the anatomy and functions of these nerves, as well as clinical notes. For the facial nerve, it describes the branches that emerge from the parotid gland and innervate facial muscles. It also discusses Bell's palsy and its symptoms. For the vestibulocochlear nerve, it describes the auditory and vestibular pathways and notes that acoustic neuromas can compress this nerve. The document provides testing methods for various cranial nerves and discusses conditions like Ménière's disease.
Cervical disc prolapse occurs when a cervical disc herniates and compresses the nerve root. The cervical spine has 7 vertebrae and 6 intervertebral discs that act as shock absorbers and allow motion. A disc is composed of an inner nucleus pulposus surrounded by the outer annulus fibrosus. Common sites of prolapse are C5-C6 and C6-C7. Clinical features include neck pain radiating to the arm. Imaging like MRI or CT is used to confirm prolapse. Treatment involves rest, medications, traction and surgery like anterior cervical discectomy if non-operative measures fail.
The document discusses anatomy of the spine, including identifying vertebrae and describing their features. It covers the roles of intervertebral discs, ligaments, and muscles in load bearing and spinal movement. Common spinal abnormalities and causes of back pain are outlined. Procedures like lumbar puncture and considerations for spinal injury management are also summarized.
This document discusses torticollis (wry neck), which is a deformity where the head and neck are turned to one side. It can be permanent, temporary, or spasmodic. Congenital torticollis is a common cause of permanent torticollis. Causes include congenital tumors, infections, reflex spasms, and neurological or ocular conditions. Treatment depends on severity, but may involve stretching, splinting, or surgery to release contracted muscles. The document also discusses slipped capital femoral epiphysis, which is the displacement of the upper femoral growth plate, typically during puberty, causing coxa vara. It presents with hip or groin pain and a limp, and
Lecture occipital cervical fusion for rheumatoid arthritisSpiro Antoniades
Dr. Smith
Anesthesia: Dr. Jones
Procedure:
The patient was brought to the OR in supine position, prepped and draped in the usual sterile fashion. A midline incision was made from the inion to C7. Subperiosteal dissection was performed down to the occiput and C7. Lateral fluoroscopy was used to identify the appropriate levels. A high-speed burr was used to perform a laminectomy from C1 through C6. Pedicle screws were placed bilaterally at C2, C3, C4, C5, C6 and C7 under fluoroscopic guidance. Occipital screws were placed bilaterally under the superior n
This document discusses congenital muscular torticollis (CMT), which is the most common cause of torticollis in infants. CMT is caused by fibromatosis within the sternocleidomastoid muscle (SCM) that develops prenatally or shortly after birth. It presents as a palpable mass in the SCM that usually resolves within a year with stretching exercises, but can become permanent without treatment. Surgical release of the SCM may be needed for severe, persistent cases. Diagnosis is made by physical exam identifying the SCM mass. Treatment involves stretching exercises during infancy and possible surgery if deformity persists.
Atlantoaxial injuries can cause serious neurologic problems if not properly treated. Rotatory subluxation of C1 on C2 is the most common type and results from trauma or infection that disrupts the transverse atlantal ligament. Anterior subluxation involves displacement of C1 forward on C2 due to ligament disruption or odontoid process abnormalities. Fractures of C1 and C2 can also occur from trauma and require evaluation to assess stability and neurologic involvement. Treatment depends on the specific injury but may involve traction, immobilization, or fusion surgery to prevent further neurologic damage.
This document discusses the management of various nerve injuries. It begins by defining the peripheral nervous system and describing the different types of nerve injuries including transient ischemia, neuropraxia, axonotmesis, and neurotmesis. It then examines specific nerves that are commonly injured such as the brachial plexus, long thoracic nerve, radial nerve, median nerve, and ulnar nerve. For each nerve, it discusses anatomy, causes of injury, clinical features, treatment approaches, and prognosis. The document provides a comprehensive overview of managing different peripheral nerve injuries.
Nerve injuries ,fracture bone and dislocations in newborn part IITheShraddha
This document discusses nerve injuries, fractures, and dislocations that can occur in neonates during birth. It begins by defining different types of nerve injuries such as facial palsy and brachial palsy. Common sites of fracture in newborns are then described, along with clinical features and management. Dislocations during birth, including of the hips, are also covered. Finally, preventive measures for minimizing birth injuries are discussed.
This document provides an overview of spinal anatomy and common spinal conditions presented by Dr. Tarek ElHewala. It describes the basic anatomy of the spine and discusses lumbar disc herniation, spinal stenosis, and lumbar spondylolisthesis. For each condition, it outlines symptoms, diagnostic imaging, non-surgical and surgical treatment options. Diagrams and radiological images are provided to illustrate spinal anatomy and various pathologies. The document serves as an educational guide on orthopaedic conditions of the spine.
This document provides information on supracondylar fractures of the humerus in children. It discusses the anatomy and mechanisms of injury, classification, clinical presentation, management including closed and open reduction techniques, complications, and outcomes. Key points include:
- Supracondylar fractures most commonly result from a fall onto an outstretched hand with the elbow hyperextended.
- Gartland classification divides fractures into non-displaced (type I), displaced with intact posterior cortex (type II), displaced with rotational deformity (type III), and unstable fractures (type IV).
- Closed reduction under fluoroscopy and percutaneous pinning is the standard treatment, with crossed pins providing more stability
The document provides information about brachial plexus anatomy and different approaches for brachial plexus block, including interscalene, supraclavicular, infraclavicular, and axillary approaches. It discusses the anatomy relevant to each approach, positioning and needle placement techniques, methods for localizing nerves, injection procedures, expected durations and volumes of local anesthetic, and potential complications.
Do it-yourself-paeds-ortho (Paediatric Orthopaedics for beginners)Jonathan Cheah
This is a powerpoint developed by the consultants from the mater children's hospital brisbane emergency department (which has now amalgamated with the royal children's hospital to create the brand new Lady Cilento Children's Hospital LCCH)
This is ideal for medical students/ residents to use to learn paediatrics orthopaedics.
Easy and fun to go through.
The brachial plexus is formed by the ventral rami of cervical and thoracic nerve roots. It divides into trunks, cords and branches that innervate the muscles and skin of the upper limb. Injuries to different parts of the brachial plexus result in characteristic patterns of muscle weakness and sensory loss. Erb's palsy involves the upper trunk and causes weakness of shoulder muscles. Klumpke's palsy involves the lower trunk, affecting hand muscles. Specific nerves like the radial and median nerves can also be injured.
This document provides an overview of spinal injury, including embryology, anatomy, mechanisms of injury, assessment, management, and complications. It begins with the early development of the nervous system from the ectoderm and formation of the neural tube. Key points include the layers of the meninges surrounding the spinal cord, arterial supply, and biomechanics of the spinal column. Common mechanisms of injury, assessment of neurologic function, and initial management including stabilization and use of steroids are discussed. Surgical intervention criteria and ongoing studies are also summarized.
This document defines key concepts and characteristics related to information and communication technology (ICT). It explains that a computer is an electronic device that can store and process large amounts of data. A process refers to how a computer works on data according to a program. Computers have characteristics like speed, accuracy, storage, and versatility. The document also discusses applications of computers in various fields. It defines the internet as a global network connecting computers, and describes common internet uses like email, searching, and file sharing. ICT is defined as technologies used for information processing and communication. Examples of ICT tools include computers, radio, television, and mobile phones. The document outlines how ICT impacts fields like education, agriculture, and the environment.
The pentose phosphate pathway (PPP), also known as the phosphogluconate pathway or hexose monophosphate shunt, occurs in the cytosol and is a metabolic pathway parallel to glycolysis. The PPP generates NADPH and pentoses like ribose-5-phosphate. NADPH production is important for biosynthesis of fatty acids and reducing oxidized glutathione. Insufficient NADPH and glutathione due to glucose-6-phosphate dehydrogenase deficiency can lead to hemolytic anemia when red blood cells are exposed to oxidative stress.
The document discusses the anatomy and common injuries of the elbow joint. It begins with the bones and ligaments that form the elbow joint. It then describes the muscles that flex, extend, supinate, and pronate the elbow. Common fractures discussed include fractures of the medial epicondyle, lateral epicondyle, radial head, coronoid process, olecranon, and elbow dislocations. Treatment options like splinting, open reduction internal fixation, and elbow replacement are covered. Pulled elbow, or subluxation of the radial head in children, is also summarized.
This document provides an overview of peripheral nerve injuries. It begins with the anatomy and classification of peripheral nerves. There are three main types of peripheral nerve injuries classified by Seddon: neuropraxia, axonotmesis, and neurotmesis. The document then discusses the various modes of peripheral nerve injury including stretch, laceration, compression, and ischemia. Specific peripheral nerves of the upper and lower limb that are commonly injured are then reviewed, along with their typical causes, symptoms, and treatment approaches.
This document discusses the cranial nerves, focusing on nerves VII (facial nerve) and VIII (vestibulocochlear nerve). It provides details on the anatomy and functions of these nerves, as well as clinical notes. For the facial nerve, it describes the branches that emerge from the parotid gland and innervate facial muscles. It also discusses Bell's palsy and its symptoms. For the vestibulocochlear nerve, it describes the auditory and vestibular pathways and notes that acoustic neuromas can compress this nerve. The document provides testing methods for various cranial nerves and discusses conditions like Ménière's disease.
Cervical disc prolapse occurs when a cervical disc herniates and compresses the nerve root. The cervical spine has 7 vertebrae and 6 intervertebral discs that act as shock absorbers and allow motion. A disc is composed of an inner nucleus pulposus surrounded by the outer annulus fibrosus. Common sites of prolapse are C5-C6 and C6-C7. Clinical features include neck pain radiating to the arm. Imaging like MRI or CT is used to confirm prolapse. Treatment involves rest, medications, traction and surgery like anterior cervical discectomy if non-operative measures fail.
The document discusses anatomy of the spine, including identifying vertebrae and describing their features. It covers the roles of intervertebral discs, ligaments, and muscles in load bearing and spinal movement. Common spinal abnormalities and causes of back pain are outlined. Procedures like lumbar puncture and considerations for spinal injury management are also summarized.
This document discusses torticollis (wry neck), which is a deformity where the head and neck are turned to one side. It can be permanent, temporary, or spasmodic. Congenital torticollis is a common cause of permanent torticollis. Causes include congenital tumors, infections, reflex spasms, and neurological or ocular conditions. Treatment depends on severity, but may involve stretching, splinting, or surgery to release contracted muscles. The document also discusses slipped capital femoral epiphysis, which is the displacement of the upper femoral growth plate, typically during puberty, causing coxa vara. It presents with hip or groin pain and a limp, and
Lecture occipital cervical fusion for rheumatoid arthritisSpiro Antoniades
Dr. Smith
Anesthesia: Dr. Jones
Procedure:
The patient was brought to the OR in supine position, prepped and draped in the usual sterile fashion. A midline incision was made from the inion to C7. Subperiosteal dissection was performed down to the occiput and C7. Lateral fluoroscopy was used to identify the appropriate levels. A high-speed burr was used to perform a laminectomy from C1 through C6. Pedicle screws were placed bilaterally at C2, C3, C4, C5, C6 and C7 under fluoroscopic guidance. Occipital screws were placed bilaterally under the superior n
This document discusses congenital muscular torticollis (CMT), which is the most common cause of torticollis in infants. CMT is caused by fibromatosis within the sternocleidomastoid muscle (SCM) that develops prenatally or shortly after birth. It presents as a palpable mass in the SCM that usually resolves within a year with stretching exercises, but can become permanent without treatment. Surgical release of the SCM may be needed for severe, persistent cases. Diagnosis is made by physical exam identifying the SCM mass. Treatment involves stretching exercises during infancy and possible surgery if deformity persists.
Atlantoaxial injuries can cause serious neurologic problems if not properly treated. Rotatory subluxation of C1 on C2 is the most common type and results from trauma or infection that disrupts the transverse atlantal ligament. Anterior subluxation involves displacement of C1 forward on C2 due to ligament disruption or odontoid process abnormalities. Fractures of C1 and C2 can also occur from trauma and require evaluation to assess stability and neurologic involvement. Treatment depends on the specific injury but may involve traction, immobilization, or fusion surgery to prevent further neurologic damage.
This document discusses the management of various nerve injuries. It begins by defining the peripheral nervous system and describing the different types of nerve injuries including transient ischemia, neuropraxia, axonotmesis, and neurotmesis. It then examines specific nerves that are commonly injured such as the brachial plexus, long thoracic nerve, radial nerve, median nerve, and ulnar nerve. For each nerve, it discusses anatomy, causes of injury, clinical features, treatment approaches, and prognosis. The document provides a comprehensive overview of managing different peripheral nerve injuries.
Nerve injuries ,fracture bone and dislocations in newborn part IITheShraddha
This document discusses nerve injuries, fractures, and dislocations that can occur in neonates during birth. It begins by defining different types of nerve injuries such as facial palsy and brachial palsy. Common sites of fracture in newborns are then described, along with clinical features and management. Dislocations during birth, including of the hips, are also covered. Finally, preventive measures for minimizing birth injuries are discussed.
This document provides an overview of spinal anatomy and common spinal conditions presented by Dr. Tarek ElHewala. It describes the basic anatomy of the spine and discusses lumbar disc herniation, spinal stenosis, and lumbar spondylolisthesis. For each condition, it outlines symptoms, diagnostic imaging, non-surgical and surgical treatment options. Diagrams and radiological images are provided to illustrate spinal anatomy and various pathologies. The document serves as an educational guide on orthopaedic conditions of the spine.
This document provides information on supracondylar fractures of the humerus in children. It discusses the anatomy and mechanisms of injury, classification, clinical presentation, management including closed and open reduction techniques, complications, and outcomes. Key points include:
- Supracondylar fractures most commonly result from a fall onto an outstretched hand with the elbow hyperextended.
- Gartland classification divides fractures into non-displaced (type I), displaced with intact posterior cortex (type II), displaced with rotational deformity (type III), and unstable fractures (type IV).
- Closed reduction under fluoroscopy and percutaneous pinning is the standard treatment, with crossed pins providing more stability
The document provides information about brachial plexus anatomy and different approaches for brachial plexus block, including interscalene, supraclavicular, infraclavicular, and axillary approaches. It discusses the anatomy relevant to each approach, positioning and needle placement techniques, methods for localizing nerves, injection procedures, expected durations and volumes of local anesthetic, and potential complications.
Do it-yourself-paeds-ortho (Paediatric Orthopaedics for beginners)Jonathan Cheah
This is a powerpoint developed by the consultants from the mater children's hospital brisbane emergency department (which has now amalgamated with the royal children's hospital to create the brand new Lady Cilento Children's Hospital LCCH)
This is ideal for medical students/ residents to use to learn paediatrics orthopaedics.
Easy and fun to go through.
The brachial plexus is formed by the ventral rami of cervical and thoracic nerve roots. It divides into trunks, cords and branches that innervate the muscles and skin of the upper limb. Injuries to different parts of the brachial plexus result in characteristic patterns of muscle weakness and sensory loss. Erb's palsy involves the upper trunk and causes weakness of shoulder muscles. Klumpke's palsy involves the lower trunk, affecting hand muscles. Specific nerves like the radial and median nerves can also be injured.
This document provides an overview of spinal injury, including embryology, anatomy, mechanisms of injury, assessment, management, and complications. It begins with the early development of the nervous system from the ectoderm and formation of the neural tube. Key points include the layers of the meninges surrounding the spinal cord, arterial supply, and biomechanics of the spinal column. Common mechanisms of injury, assessment of neurologic function, and initial management including stabilization and use of steroids are discussed. Surgical intervention criteria and ongoing studies are also summarized.
This document defines key concepts and characteristics related to information and communication technology (ICT). It explains that a computer is an electronic device that can store and process large amounts of data. A process refers to how a computer works on data according to a program. Computers have characteristics like speed, accuracy, storage, and versatility. The document also discusses applications of computers in various fields. It defines the internet as a global network connecting computers, and describes common internet uses like email, searching, and file sharing. ICT is defined as technologies used for information processing and communication. Examples of ICT tools include computers, radio, television, and mobile phones. The document outlines how ICT impacts fields like education, agriculture, and the environment.
The pentose phosphate pathway (PPP), also known as the phosphogluconate pathway or hexose monophosphate shunt, occurs in the cytosol and is a metabolic pathway parallel to glycolysis. The PPP generates NADPH and pentoses like ribose-5-phosphate. NADPH production is important for biosynthesis of fatty acids and reducing oxidized glutathione. Insufficient NADPH and glutathione due to glucose-6-phosphate dehydrogenase deficiency can lead to hemolytic anemia when red blood cells are exposed to oxidative stress.
This document discusses white blood cells and immunity. It begins by outlining the learning outcomes which are to categorize white blood cells, describe platelets and hemostasis, and distinguish innate and adaptive immunity. It then defines leukocytes and their types, including granulocytes and agranulocytes. Specific white blood cell types such as neutrophils, lymphocytes, and monocytes are examined in terms of their structures and functions. The roles of platelets and the three phases of hemostasis are also summarized. Finally, it distinguishes between innate nonspecific immunity and adaptive specific immunity.
There are 12 pairs of cranial nerves that supply structures in the head, neck, and upper body. The document proceeds to describe each cranial nerve in detail, including its function, origin, opening in the skull, attachments, and effects of damage. The cranial nerves described are the olfactory nerve, optic nerve, oculomotor nerve, trochlear nerve, trigeminal nerve, abducent nerve, facial nerve, vestibulocochlear nerve, glossopharyngeal nerve, vagus nerve, accessory nerve, and hypoglossal nerve.
This document provides details on the cranial nerves V, VII, IX, and X, including their nuclei, branches, areas of innervation, and connections. It discusses the first, second, and third branches of the trigeminal nerve (V), their innervation areas, and connections with ganglia. It also describes the facial nerve (VII) including its nuclei and course through the facial canal, as well as its branches like the chorda tympani. Details are given on the glossopharyngeal nerve (IX) and its fibers.
The Nevada-Semipalatinsk movement was an international anti-nuclear movement formed in 1989 in response to Soviet nuclear testing in Kazakhstan. The movement aimed to end the testing and raise awareness of its health and environmental impacts. It gained global support and led to the closure of the Semipalatinsk nuclear test site in 1991. Today, the movement continues advocating for nuclear nonproliferation and supporting the people of Kazakhstan affected by Soviet nuclear testing.
Hemostasis is the body's natural reaction to stop bleeding from an injury by forming a blood clot. It is a multi-step process involving platelet clotting to form a temporary plug, coagulation factors that stabilize the plug through a cascade, and fibrin clots that permanently seal the damage. Homeostasis maintains stable conditions in the body through feedback loops, but can fail due to diseases like diabetes that disrupt regulation of blood glucose. Tissues also have natural surface fluctuations driven by cell dynamics of rearrangement, division and death that help maintain homeostasis.
This particular slides consist of- what is hypotension,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
Here is the summary of hypotension:
Hypotension, or low blood pressure, is when the pressure of blood circulating in the body is lower than normal or expected. It's only a problem if it negatively impacts the body and causes symptoms. Normal blood pressure is usually between 90/60 mmHg and 120/80 mmHg, but pressures below 90/60 are generally considered hypotensive.
Chandrima Spa Ajman is one of the leading Massage Center in Ajman, which is open 24 hours exclusively for men. Being one of the most affordable Spa in Ajman, we offer Body to Body massage, Kerala Massage, Malayali Massage, Indian Massage, Pakistani Massage Russian massage, Thai massage, Swedish massage, Hot Stone Massage, Deep Tissue Massage, and many more. Indulge in the ultimate massage experience and book your appointment today. We are confident that you will leave our Massage spa feeling refreshed, rejuvenated, and ready to take on the world.
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Trauma Outpatient Center is a comprehensive facility dedicated to addressing mental health challenges and providing medication-assisted treatment. We offer a diverse range of services aimed at assisting individuals in overcoming addiction, mental health disorders, and related obstacles. Our team consists of seasoned professionals who are both experienced and compassionate, committed to delivering the highest standard of care to our clients. By utilizing evidence-based treatment methods, we strive to help our clients achieve their goals and lead healthier, more fulfilling lives.
Our mission is to provide a safe and supportive environment where our clients can receive the highest quality of care. We are dedicated to assisting our clients in reaching their objectives and improving their overall well-being. We prioritize our clients' needs and individualize treatment plans to ensure they receive tailored care. Our approach is rooted in evidence-based practices proven effective in treating addiction and mental health disorders.
Unlocking the Secrets to Safe Patient Handling.pdfLift Ability
Furthermore, the time constraints and workload in healthcare settings can make it challenging for caregivers to prioritise safe patient handling Australia practices, leading to shortcuts and increased risks.
Deep Leg Vein Thrombosis (DVT): Meaning, Causes, Symptoms, Treatment, and Mor...The Lifesciences Magazine
Deep Leg Vein Thrombosis occurs when a blood clot forms in one or more of the deep veins in the legs. These clots can impede blood flow, leading to severe complications.
International Cancer Survivors Day is celebrated during June, placing the spotlight not only on cancer survivors, but also their caregivers.
CANSA has compiled a list of tips and guidelines of support:
https://cansa.org.za/who-cares-for-cancer-patients-caregivers/
KEY Points of Leicester travel clinic In London doc.docxNX Healthcare
In order to protect visitors' safety and wellbeing, Travel Clinic Leicester offers a wide range of travel-related health treatments, including individualized counseling and vaccines. Our team of medical experts specializes in getting people ready for international travel, with a particular emphasis on vaccines and health consultations to prevent travel-related illnesses. We provide a range of travel-related services, such as health concerns unique to a trip, prevention of malaria, and travel-related medical supplies. Our clinic is dedicated to providing top-notch care, keeping abreast of the most recent recommendations for vaccinations and travel health precautions. The goal of Travel Clinic Leicester is to keep you safe and well-rested no matter what kind of travel you choose—business, pleasure, or adventure.
Empowering ACOs: Leveraging Quality Management Tools for MIPS and BeyondHealth Catalyst
Join us as we delve into the crucial realm of quality reporting for MSSP (Medicare Shared Savings Program) Accountable Care Organizations (ACOs).
In this session, we will explore how a robust quality management solution can empower your organization to meet regulatory requirements and improve processes for MIPS reporting and internal quality programs. Learn how our MeasureAble application enables compliance and fosters continuous improvement.
Can coffee help me lose weight? Yes, 25,422 users in the USA use it for that ...nirahealhty
The South Beach Coffee Java Diet is a variation of the popular South Beach Diet, which was developed by cardiologist Dr. Arthur Agatston. The original South Beach Diet focuses on consuming lean proteins, healthy fats, and low-glycemic index carbohydrates. The South Beach Coffee Java Diet adds the element of coffee, specifically caffeine, to enhance weight loss and improve energy levels.
INFECTION OF THE BRAIN -ENCEPHALITIS ( PPT)blessyjannu21
Neurological system includes brain and spinal cord. It plays an important role in functioning of our body. Encephalitis is the inflammation of the brain. Causes include viral infections, infections from insect bites or an autoimmune reaction that affects the brain. It can be life-threatening or cause long-term complications. Treatment varies, but most people require hospitalization so they can receive intensive treatment, including life support.
About this webinar: This talk will introduce what cancer rehabilitation is, where it fits into the cancer trajectory, and who can benefit from it. In addition, the current landscape of cancer rehabilitation in Canada will be discussed and the need for advocacy to increase access to this essential component of cancer care.
PrudentRx's Function in the Management of Chronic Illnesses
Cranial nerves.pptx
1. D R . N I S H T H A J A I N
S E N I O R R E S I D E N T ,
D E PA R T M E N T O F N EU R O L O GY ,
GM C , K O T A .
CRANIAL NERVES XI AND XII
2. The Spinal Accessory Nerve
⚫The spinal accessory (SA) nerve - two nerves that run
together in a common bundle for a short distance.
⚫The smaller cranial portion (ramus internus) is a
special visceral efferent (SVE) accessory to the vagus.
⚫The cranial root runs to the jugular foramen and unites
with the spinal portion, traveling with it for only a few
millimeters to form the main trunk of CN XI.
3. ⚫ The cranial root communicates with the jugular ganglion of
the vagus, and then exits through the jugular foramen
separately from the spinal portion.
⚫ It passes through the ganglion nodosum and then blends
with the vagus.
⚫ Distributed principally with the recurrent laryngeal nerve to
sixth branchial arch muscles in the larynx except there is
no XI contribution to the cricothyroid muscle.
4. ⚫ The major part of CN XI is the spinal portion (ramus
externus).
⚫ The fibers of the spinal root arise from SVE motor cells in
the SA nuclei in the ventral horn from C2 to C5, or even C6.
⚫ The supranuclear innervation of CN XI arises from the
lower portion of the precentral gyrus.
5. ⚫ The bulk of current evidence indicates that both the SCM
and trapezius receive bilateral supranuclear innervation.
⚫ The input to the SCM motor neuron pool - ipsilateral and
that to the trapezius motor neuron pool - contralateral.
6.
7. ⚫ Somatotopic arrangement present : cord levels C1 and C2
innervate the ipsilateral sternocleidomastoid muscle, and
levels C3 and C4 innervate primarily the ipsilateral
trapezius.
⚫ The corticobulbar fibers to the sternocleidomastoid are
located in the brainstem tegmentum, whereas fibers to the
trapezius are located in the ventral brainstem.
⚫ Thus, a ventral pontine lesion can cause supranuclear
paresis of the trapezius with sparing of the
sternocleidomastoid muscle.
8. ⚫ To assess SCM power, have the patient turn the head fully
to one side and hold it there, then try to turn the head back
to midline, avoiding any tilting or leaning motion.
⚫ The muscle usually stands out well, and its contraction can
be seen and felt.
⚫ Significant weakness of rotation can be detected if the
patient tries to counteract firm resistance.
9. ⚫ The two sternocleidomastoid muscles can be examined
simultaneously by having the patient flex his neck while the
examiner exerts pressure on the forehead, or by having the
patient turn the head from side to side.
⚫ Flexion of the head against resistance may cause deviation
of the head toward the paralyzed side.
10. ⚫ With unilateral paralysis, the involved muscle is flat and
does not contract or become tense when attempting to turn
the head contralaterally or to flex the neck against
resistance.
⚫ Weakness of both SCMs causes difficulty in anteroflexion
of the neck, and the head may assume an extended
position.
11.
12.
13. ⚫ With trapezius atrophy the outline of the neck changes,
with depression or drooping of the shoulder contour and
flattening of the trapezius ridge.
⚫ The strength of the trapezius is traditionally tested by
having the patient shrug the shoulders against resistance.
⚫ To examine the middle and lower trapezius, place the
patient's abducted arm horizontally, palm up, and attempt
to push the elbow forward.
14.
15. ⚫ Weakness of the trapezius disrupts the normal scapulohumeral
rhythm and impairs arm abduction.
⚫ Impairment of upper trapezius function causes weakness of
abduction beyond 90 degrees.
⚫ Weakness of the middle trapezius muscle causes winging of the
scapula.
⚫ The winging due to trapezius weakness is more apparent on
lateral abduction in contrast to the winging seen with serratus
anterior weakness, which is greatest with the arm held in front.
16. ⚫ When the trapezius is weak, the arm hangs lower on the
affected side, and the fingertips touch the thigh at a lower
level than on the normal side.
⚫ Placing the palms together with the arms extended
anteriorly and slightly below horizontal shows the fingers on
the affected side extending beyond those of the normal
side.
17. ⚫ The two trapezius muscles can be examined
simultaneously by having the patient extend his neck
against resistance.
⚫ Bilateral paralysis causes weakness of neck extension.
⚫ The patient cannot raise his chin, and the head may tend to
fall forward (dropped head syndrome).
⚫ The shoulders look square or have a drooping, sagging
appearance due to atrophy of both muscles.
18. ⚫ Weakness of the muscles supplied by CN XI may be
caused by supranuclear, nuclear, or infranuclear lesions.
⚫ Supranuclear involvement usually causes at worst
moderate loss of function since innervation is partially
bilateral.
⚫ In hemiplegia there is usually no head deviation, but
testing may reveal slight, weakness of the SCM, with
difficulty turning the face toward the involved limbs.
⚫ There may be depression of the shoulder resulting from
trapezius weakness on the affected side.
19. ⚫ Irritative supranuclear lesions may cause head turning
away from the discharging hemisphere.
⚫ This turning of the head (or head and eyes) may occur as
part of a contraversive, ipsiversive, or jacksonian seizure,
and is often the first manifestation of the seizure.
⚫ Extrapyramidal lesions may also involve the
sternocleidomastoid and trapezius muscles, causing
rigidity, akinesis, or hyperkinesis.
20. ⚫ Lesions of the lower brainstem or upper cervical spinal cord
may cause dissociated weakness of the SCM and
trapezius muscles depending on the exact location.
⚫ Nuclear involvement of the SA nerve may occur in motor
neuron disease, syringobulbia, and syringomyelia.
⚫ In nuclear lesions, the weakness is frequently accompanied
by atrophy and fasciculations.
21. Localisation
⚫ Weakness of the trapezius on one side associated with
weakness of the sternocleidomastoid on the other side
(dissociated weakness) indicates an upper motor neuron
lesion ipsilateral to the weak sternocleidomastoid.
⚫ Weakness of the trapezius on one side with sparing of the
sternocleidomastoid muscles indicates a ventral brainstem
lesion, a lower cervical cord lesion, or a lower spinal
accessory root lesion.
22. ⚫ Weakness of the sternocleidomastoid with trapezius
sparing indicates a lesion of the lower brainstem
tegmentum or upper cervical accessory roots.
⚫ Weakness of the sternocleidomastoid and the trapezius
muscles on the same side indicates a contralateral
brainstem lesion, an ipsilateral high cervical cord lesion, or
an accessory nerve lesion before the nerve divides into its
sternocleidomastoid and trapezius branches.
23. The Hypoglossal Nerve
⚫ The hypoglossal nerve (CN XII) - a pure motor nerve,
supply the tongue.
⚫ The branches of the hypoglossal nerve are the meningeal,
descending, thyrohyoid, and muscular.
⚫ The meningeal branches send filaments derived from
communicating branches with C1 and C2 to the dura of the
posterior fossa.
24. ⚫ The descending ramus sends a branch to the omohyoid,
and then joins a descending communicating branch from
C2 and C3 to form the ansa hypoglossi which supplies the
omohyoid, sternohyoid, and sternothyroid muscles.
⚫ The thyrohyoid branch supplies the thyrohyoid muscle.
⚫ The descending and thyrohyoid branches carry
hypoglossal fibers but are derived mainly from the cervical
plexus.
25. ⚫ CN XII supplies the intrinsic muscles, all of the extrinsic
muscles of the tongue except the palatoglossus, and
possibly the geniohyoid muscle.
⚫ The cerebral center regulating tongue movements lies in
the lower portion of the precentral gyrus near and within the
sylvian fissure.
⚫ Supranuclear control to the genioglossus muscle is
primarily crossed; supply to the other muscles is bilateral
but predominantly crossed.
26.
27. ⚫ The clinical examination of hypoglossal nerve function
consists of evaluating the strength, bulk, and dexterity of
the tongue—looking especially for weakness, atrophy,
abnormal movements (particularly fasciculations), and
impairment of rapid movements.
⚫ After noting the position and appearance of the tongue at
rest in the mouth, the patient is asked to protrude it, move it
in and out, from side to side, and upward and downward,
both slowly and rapidly.
28. ⚫ Motor power can be tested by having the patient press the
tip against each cheek as the examiner tries to dislodge it
with finger pressure.
⚫ The normal tongue is powerful and cannot be moved.
⚫ When unilateral weakness is present, the tongue deviates
toward the weak side on protrusion because of the action
of the normal genioglossus.
29. ⚫ The patient cannot push the tongue against the cheek on
the normal side, but is able to push it against the cheek on
the side toward which it deviates.
30.
31. ⚫ Unilateral weakness may cause few symptoms; speech
and swallowing are little affected.
⚫ With severe bilateral weakness the tongue cannot be
protruded or moved laterally; the first stage of swallowing is
impaired, and there is difficulty with articulation, especially
in pronouncing linguals.
⚫ Rarely, the tongue tending to slip back into the throat may
cause respiratory difficulty.
32. Supranuclear Lesions
⚫ Lesions of the corticobulbar tract anywhere in its course
from the lower precentral gyrus to the hypoglossal nuclei
may result in tongue paralysis.
⚫ A lesion of the corticobulbar fibers above their decussation
result in weakness of the contralateral half of the tongue.
⚫ A supranuclear lesion is not accompanied by atrophy or
fibrillations of the tongue.
33. ⚫ Sudden isolated dysarthria may occur with lacunar infarcts
affecting the contralateral corona radiata or internal
capsule, which interrupt in isolation the cortico-lingual
pathways to the tongue (central monoparesis of the
tongue).
⚫ The main decussation of supranuclear projections to the
hypoglossal nucleus in the brainstem is located close to the
pontomedullary junction.
34. ⚫ Pontine lesions at the ventral paramedian base close to the
midline affect the contralateral cortico-hypoglossal
projections, whereas lateral lesions at the pontine base
affect ipsilateral projections.
35. Nuclear Lesions and Intramedullary
Cranial Nerve XII Lesions
⚫ Unilateral lesions of the hypoglossal nucleus or nerve result
in paresis, atrophy, furrowing, fibrillations, and
fasciculations that affect the corresponding half of the
tongue.
⚫ Because of the close proximity of the two hypoglossal
nuclei, dorsal medullary lesions (e.g., multiple sclerosis,
syringobulbia) often result in bilateral lower motor neuron
lesions of the tongue.
36. ⚫ A rare but characteristic syndrome that affects the
hypoglossal nerve in its intramedullary course is the medial
medullary syndrome (Dejerine's anterior bulbar syndrome).
⚫ This syndrome results from occlusion of the anterior spinal
artery or its parent vertebral artery.
37. ⚫ The anterior spinal artery supplies the ipsilateral pyramid,
medial lemniscus, and hypoglossal nerve; its occlusion
therefore results in three main signs:
⚫ Ipsilateral paresis, atrophy, and fibrillations of the tongue
(due to affection of cranial nerve XII).
⚫ Contralateral hemiplegia (due to involvement of the
pyramid) with sparing of the face.
⚫ Contralateral loss of position and vibratory sensation (due
to involvement of the medial lemniscus).
38. Peripheral Lesions of Cranial Nerve XII
⚫ With neck lesions, the cervical sympathetic chain may be
involved, resulting in an ipsilateral Horner syndrome
(miosis, anhidrosis, and ptosis).
⚫ Isolated hypoglossal nerve palsy has been described due
to compression by a kinked vertebral artery (hypoglossal-
vertebral entrapment syndrome).
⚫ Skull metastases to the clivus may cause bilateral
hypoglossal nerve palsies.
39. ⚫ Combined abducens nerve and hypoglossal nerve palsies
are rare. This ominous combination may be seen with
nasopharyngeal carcinoma (Godtfredsen's syndrome) and
with other clival lesions, especially tumors (three-fourths of
which are malignant).
⚫ Lesions, usually tumors or chronic inflammatory lesions, of
the occipital condyle may cause occipital pain associated
with an ipsilateral hypoglossal nerve injury (occipital
condyle syndrome).
40. ⚫ The hypoglossal nerve may be injured in isolation in the
neck or in its more distal course near the tongue.
⚫ The causes of this peripheral involvement include
⚫ carotid aneurysms,
⚫ aneurysms of a persistent hypoglossal artery,
⚫ vascular entrapment,
⚫ spontaneous dissection of the extracranial internal carotid
artery,
41. ⚫ local infections,
⚫ tuberculosis of the atlantoaxial joint,
⚫ rheumatoid arthritis,
⚫ surgical (e.g., carotid endarterectomy) or
⚫ accidental trauma,
⚫ birth injuries,
⚫ neck radiation, and
⚫ tumors of the retroparotid or retropharyngeal spaces, neck,
salivary glands, and base of the tongue.
42. ⚫ Unilateral or bilateral hypoglossal neuropathy may occur in
patients with hereditary neuropathy with liability to pressure
palsy.