Emergency Medicine Review of Extremity Injuries *not medical advice, not official, prepared as review material, personal slides not those of my employer
HyProCure is an internal talar stabilization device. Through a minimally invasive procedure HyProCure is sized and inserted. Instantly the ankle bone is stabilized which realigns the hindfoot.
Patient's Guide to HyProCure - Minimally Invasive Solution to Misaligned Feet.GraMedica
The stability and alignment of the ankle bone (talus) on the heel bone (calcaneus) is extremely important. Ankle bone misalignment will lead to a variety of symptoms within the foot and will also negatively affected the knees, hips, and back. HyProCure is the proven solution to internally realign and stabilize the ankle bone while still allowing a natural range of motion.
This slide show illustration is designed to give a brief introduction into injury assesment and immediate action splinting as it pertains to injuries involving school-aged children from elementry to high school. This slide show is part of a visual training utilized for the purpose of educating school coaches in the "out of the box" injury assesment and splinting methods when commercially manufactured splinting material is unavailable.
HyProCure is an internal talar stabilization device. Through a minimally invasive procedure HyProCure is sized and inserted. Instantly the ankle bone is stabilized which realigns the hindfoot.
Patient's Guide to HyProCure - Minimally Invasive Solution to Misaligned Feet.GraMedica
The stability and alignment of the ankle bone (talus) on the heel bone (calcaneus) is extremely important. Ankle bone misalignment will lead to a variety of symptoms within the foot and will also negatively affected the knees, hips, and back. HyProCure is the proven solution to internally realign and stabilize the ankle bone while still allowing a natural range of motion.
This slide show illustration is designed to give a brief introduction into injury assesment and immediate action splinting as it pertains to injuries involving school-aged children from elementry to high school. This slide show is part of a visual training utilized for the purpose of educating school coaches in the "out of the box" injury assesment and splinting methods when commercially manufactured splinting material is unavailable.
Risks and Potential Complications of EOTTS TreatmentGraMedica
EOTTS has been proven to be a safe and effective treatment option for talotarsal displacement. This presentation provides a critical look at the possible risks and complications.
Hammer Toes: American college of foot and ankle surgeons. An insight into what a hammertoe is and possible treatments for hammertoes including hammertoe correction surgery. via American College of Foot and Ankle Surgeons
Risks and Potential Complications of EOTTS TreatmentGraMedica
EOTTS has been proven to be a safe and effective treatment option for talotarsal displacement. This presentation provides a critical look at the possible risks and complications.
Hammer Toes: American college of foot and ankle surgeons. An insight into what a hammertoe is and possible treatments for hammertoes including hammertoe correction surgery. via American College of Foot and Ankle Surgeons
Common Running Injuries & What's the long term fix?GraMedica
Running is a beloved activity for millions of people, however many are sidelined because of injuries. Many continue to run despite the pain until they destroy a body part. Take a look at this presentation to find out the top injuries and to find a real solution to keep you running.
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.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
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.
Title: Sense of Smell
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 primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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.
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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.
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
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
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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
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
4. What is it, what do you do next
• 1 yo baby crying more
than normal after an
afternoon at grandmas
house
• You notice she seems to
wince more when you
squeeze her R knee
6. Consider child abuse for ANY fx, in particular
• Bucket handle aka
metaphyseal corner fx
• From whiplash
• (often tib / femur)
• Mid shaft ( requires sig
force)
• Humerus
• Tibia
• Vertebral compression
• Rib fx (lat or posterior)
7. What’s going on? Whats the ED treatment?
• 32 M playing football and was tackled, jammed finger on ground
8. Boutonniere deformity:
• extensor tendon central slip
• could also be from arthritis
• splint in Proximal PIP EXTENSION
• (if you dont, could become permanent )
9. What is it, what to do
• 14 yr old playing basketball and it jammed him in the hand
10. Mallet finger-
• extensor tendon rupture or avulsion fx at base distal phalanx, forced
flexion of DIP
• Splint Distal DIP extension
12. What is it? What to do?
• 45 M drunk, assaulted, signed
out to you as a sobriety then
reassess
• 8 hours later he complains his
hand hurts and doesn’t work
• PE: Cant flex 4th finger DIP , can
feel a lump in volar palm
•
13. Jersey finger- Surgery!
• avulsion of the FDP at DIP joint
• Depending on how bad the injury is, may need prompt repair within 7
days – few weeks
• tendon retracts to palm and can be palpated, needs within 7 – 10 days
• If its palpated PIP/ DIP can wait a few weeks, if theres a fx that needs pining
first
14. What to do now?
• 38 M smashed his finger in the car door 3
days ago, it still hurts but is getting better
• What do do?
15. Subungal hematomas
• Subungal hematoms with pain can be trephinated if injury Under 48
hr, after the hematoma probably already clotted
• if theres small nailbed lac, if the nail is intact you dont have to remove
the nail
16. What to do? How to fix?
• 23 M punched someone
face, co R hand pain, there is
open skin on his fourth
knuckle
• PE: bent fist shows
17. Boxer fracture with rotational deformity
• How to reduce?
• place finger parallel to
ground, Flex MCP 90
degrees, press down on
metacarpal shaft and upward
on the phalange
• You give him TDAP and
unasyn
18. What to do?
• 79 year skiing in the Alps
complaining thumb pain
• He also went hunting and
twisted the necks of many a
poor fowl
• PE: ttp ulnar thumb MCP,
bends over 20%
19. UCL tear, game keepers thumb
• Torn Ulnar Collateral ligament
• Thumb spica splint
• If > 20 degrees valgus varus instability, or if lesion
as shown in xr, will also need OR
20. Ah, continuity of care….what to do next?
• Our upstanding
gentleman did not fill
his augmentin rx and
now comes back 5
days later complaining
of finger pain
• PE: flexed, sausage-
like, pain w extension,
tenderness along volar
surface
27. Triquetrum fx
• Triquetrum is second most frequently fx!
• put in volar splint
• ALSO…..
• Scaphoid is first most commonly fx
• Snuff box ttp even if neg xr
• What splint do you put it in?
31. Perilunate dislocation
• Progression of scapholunate
dissociation
• Pie sign (due to rotation)
• High energy w poor functional
outcomes
• Perilunate- lunate stays but all carpal
bones are displaced
• Median nerve injured in 25% pt (
lunate dislocates into carpal tunnel)
• NEEDS OPERATIVE MANAGEMENT!!!
44. Tibial plateau fx
• Assess deep peroneal nerve
• big toe dorsal webspace
sensation,
• foot drop
• Watch for compartment
syndrome
• Check for ACL/ meniscal tears
• ORIF (usually)
46. Maisonneuve fx
• Squeeze calf of every ankle injury pt
• eversion injury --> proximal fibula and medial mal
• tear of the distal tibiofibular syndesmosis and the interosseous
membrane
• usually splinting is enough, if syndesmosis needs realignment then
ORIF is needed
48. Pilon/ plafond fracture
• comminuted distal tibia fx from axial force, talus pushes onto tibial
plafond.
• High energy--Check for associated injuries ( fibia, calcaneus, vert
body, pelvis)
• usually ORIF
49. What is it? What to do?
• Twist foot going down stairs
50. Jones fx
• Jones fx high risk for complication if
untreated, many require ORIF, after
ortho consult may discharge home w
NWB and splint
• if over 15mm then its metatarsal shaft
fx not jones
• if its just avulsion at base its pseudo
jones (hard sole shoe /WBAT)
55. Lisfranc fx
• Lisfranc joint base 1-2 metatarsal and
cuneiform
• Most require ORIF
• Initial xr often normal (get WB XR)
• CT also helpful
• Often missed! Delayed dx = deformity,
function loss
• CHECK DP PULSE (could be transected)
• Posterior splint, NWB w likely ORIF in 7d
56. SLR notes…
• When doing SLR, pt complains of pain to mid thigh, is this + SLR?
• NO ( only past knee)
• SLR on opposite leg causes pain in effected leg, is this + SLR?
• YES, even more specific
• SLR causes pain at <30 degrees what should you think of?
• Spondylolishtesis, tumor, abscess
57.
58.
59.
60.
61.
62.
63.
64.
65.
66.
67. • Femoral-
• hip flexion, knee
extension
• patellar reflex
• Sensation- Ant thigh
