Facial palsy, or facial paralysis, can be caused by lesions of the facial nerve that disrupt motor function on one side of the face. It is commonly unilateral and can result from various etiologies like Bell's palsy, tumors, trauma, or infections. Clinical features include weakness or paralysis of facial muscles on the affected side leading to issues like eyelid drooping, inability to fully close the eye, and drooping of the mouth corner. Treatment involves facial exercises and in severe cases, surgery or implants may help restore more natural movement. Prognosis is generally good with many cases recovering normal function, but some are left with minor to severe long-term weakness or contractures.
BELL'S PALSY IS AN IDIOPATHIC LMN TYPE FACIAL PALSY..THE SEMINAR TELLS YOU OF COURSE OF NERVE..FACIAL MUSCLES THEIR ACTION..HOW TO EXAMINE..THE SEQUELAE OF FACIAL PALSY...LOOK AT IT..
BELL'S PALSY IS AN IDIOPATHIC LMN TYPE FACIAL PALSY..THE SEMINAR TELLS YOU OF COURSE OF NERVE..FACIAL MUSCLES THEIR ACTION..HOW TO EXAMINE..THE SEQUELAE OF FACIAL PALSY...LOOK AT IT..
Provides information concerning gravity, rotation and acceleration
Serves as a reference for the somatosensory & visual systems
Contributes to integration of arousal, conscious awareness of the body via connections with vestibular cortex, thalamus and reticular formation
Bell's palsy is a condition in which the muscles on one side of your face become weak or paralyzed. It affects only one side of the face at a time, causing it to droop or become stiff on that side. It's caused by some kind of trauma to the seventh cranial nerve. This is also called the “facial nerve.
A detailed description of benign paroxysmal positional vertigo (BPPV): the symptoms, causes, diagnosis, and treatment methods.For more information, please visit www.everydayhearing.com
This presentation is about Bell’s palsy which is a facial paralysis of acute onset presumed to be due to non-suppurative inflammation of unknown etiology of the facial nerve within its canal above the stylomastoid foramen.
Please find the power point on Benign Paroxysmal Positional Vertigo (BPPV). I tried to present it on understandable way and all the contents are reviewed by experts and from very reliable references. Thank you
The term facial palsy generally refers to weakness of the facial muscles, mainly resulting from temporary or permanent damage to the facial nerve
Facial palsy not only cause a paresis of the target muscles, but as the nerve is responsible for a range of facial expressions, it causes serious disturbances in social life, facial expression being so important in transferring emotion.
Provides information concerning gravity, rotation and acceleration
Serves as a reference for the somatosensory & visual systems
Contributes to integration of arousal, conscious awareness of the body via connections with vestibular cortex, thalamus and reticular formation
Bell's palsy is a condition in which the muscles on one side of your face become weak or paralyzed. It affects only one side of the face at a time, causing it to droop or become stiff on that side. It's caused by some kind of trauma to the seventh cranial nerve. This is also called the “facial nerve.
A detailed description of benign paroxysmal positional vertigo (BPPV): the symptoms, causes, diagnosis, and treatment methods.For more information, please visit www.everydayhearing.com
This presentation is about Bell’s palsy which is a facial paralysis of acute onset presumed to be due to non-suppurative inflammation of unknown etiology of the facial nerve within its canal above the stylomastoid foramen.
Please find the power point on Benign Paroxysmal Positional Vertigo (BPPV). I tried to present it on understandable way and all the contents are reviewed by experts and from very reliable references. Thank you
The term facial palsy generally refers to weakness of the facial muscles, mainly resulting from temporary or permanent damage to the facial nerve
Facial palsy not only cause a paresis of the target muscles, but as the nerve is responsible for a range of facial expressions, it causes serious disturbances in social life, facial expression being so important in transferring emotion.
Ephaptic transmission of impulses between neighbouring neurons (i.e. coupling of adjacent nerve fibres due to local exchange of ions or local electric fields) leading to excessive or abnormal firing.
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
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.
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.
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.
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.
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
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Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
3. FACIAL PARALYSIS
• Commonly Unilateral
Nuclear- from destruction of the nucleus
• Central or cerebral orSupranuclear
• Peripheral- from a lesion of the nerve
• Supranuclear lesions usuallya part of hemiplegia,
only the lower part of the face is paralysed. The upper
part (frontalis and part of orbicularis oculi)escapes due to
bilateral representation in the cerebral cortex.Infranuclear
lesions- entire face is paralysed, as seen in bell’s palsy
4. Clinical features
Weakness or paralysis of the upper and lower facial muscles of the affected side
Drooping of ipsilateral eyelids
Inability to close the eye completely
Dry eye due to inability to close eyes completely
Excessive tearing of the eye (epiphora)
Drooping of the corner of the mouth
Ipsilateral impaired/loss of taste sensation
Difficulty with eating due to ipsilateral muscle weakness causing food to be
trapped on the affected side of the mouth
Dribbling of saliva
Altered sensation on the affected side of the face
Pain in or behind the ear
Increased sensitivity to sound (hyperacusis) on affected side if stapedius muscle is
involved
5. Clinical Testing of
Facial Nerve Functions
• 1. Observe patient Face
• during rest & movement for :
• • Asymmetry
• • Hemi facial spasm
• • Facial tics
• • blinking
6.
7. ETIOLOGIC CLASSIFICATON OF
FACIALPALSY
• Various classification have been suggested in
this respect.
• Based on:
• Course of the nerve
• Various etiologic causes
• Degree of dysfunction observed
8. INTRACRANIAL (CENTRAL)
CAUSES
• Vascular abnormalities
• CNS degenerative diseases
• Tumours of the intracranial cavity
• Trauma to the brain
• Congenital abnormalities and agenesis
9. INTRATEMPORAL CAUSES
• Bacterial and Viral infection
• Cholesteatoma
• Trauma- blunt temporal bone trauma,
• longitudinal and horizontal fractures of the
• temporal bone and gunshot wounds.
• Tumours invading the middle ear, mastoid and
• facial nerve
• Iatrogenic causes
13. BELL’S PALSY
• First described more than a
century ago by Sir Charles Bell
Bell palsy is certainly the most common cause
of facial paralysis worldwide
14. Viruses that have been linked to
bells palsy
• Cold sores and genital herpes (herpes simplex)
Chickenpox and shingles (herpes zoster)
• Mononucleosis (Epstein-Barr)
• Cytomegalovirus infections
• Respiratory illnesses (adenovirus)
• German measles (rubella)
• Mumps (mumps virus)
• Flu (influenza B), Hand-foot-and-mouth disease
(coxsackievirus
15. EXTRACRANIAL CAUSES
• Malignant tumours of the parotid gland
• Trauma
• Iatrogenic causes
• Primary tumours of the facial nerve
• Malignant tumours of the ascending ramus of
the mandible, pterygoid region and skin
16. Traumatic facial nerve palsy
• Second most common cause of FN
paralysis
• - Represents 15% of all cases of FN
paralysis
• - Most common cause of traumatic facial
nerve injury is temporal bone fracture
21. HOUSE-BRACKMAN(1985)
CLASSIFICATION
• Grade I-normal function without weakness.
• Grade II-mild dysfunction with sligth facial
asymmetry with a minor degree of synkinesis.
• Grade III-moderate dysfunctions-obvious, but
not disfiguring, asymmetry with contracture
and/or
• hemifacial spasm, but residual forehead motion
and incomplete eye closure.
22. • • Grade IV-moderately severe dysfunction-
obvious, disfiguring asymmetry with lack of
forehead motion and incomplete eye closure.
• • Grade V-severe dysfunction-asymmetry at rest
and only slight facial movement.
• • Grade VI-total paralysis-complete absence of
tone ormotion.
23. Complications
• Irreversible damage to your facial nerve
• Misdirected regrowth of nerve fibers,
resulting in involuntary contraction of
certain muscles whenyou're trying to move
others (synkinesis) — forexample, when you
smile, the eye on the affected sidemay close
• Partial or complete blindness of the eye that
won't close, due to excessive dryness and
scratching of the cornea, the clear protective
covering of the eye
24. synkinesis
• Most distressing consequences of facial
paralysis.
• Synkinesis refers to the abnormal involuntary
facial movement that occurs with voluntary
movement of a different facial muscle group.
• •Abnormal regeneration of facial nerve fibers
to the facial muscle groups
25. ASSESSMENT AND PLANNING
• Cause of facial paralysis
• Functional deficit/extent of paralysis
• Time course/duration of paralysis
• Likelihood of recovery
• Other cranial nerve deficits
• Patient’s life expectancy
• Patient’s needs/expectations
26. Clinical Testing of
Facial Nerve Functions
• Blink test: Delay in blinking on one side
• 3. Testing facial movement
• i. Temporal branch:
• To wrinkle forehead, To elevate eye brow
• ii. Zygomatic branch: to screw up the eye
• iii. Buccal branch: to wrinkle the nose
• iv. Mandibular branch: to show the teeth,
toblow out the cheeks
• v. Cervical branch: by grimacing
27. EVALUATIONS OF NERVE
FUNCTION
• HISTORY is of vital importance to establish the
onset characteristics,duration and degree of
recovery.
• • Previous trauma, surgery or infection may help
in arriving at a diagnosis
• • Examination of the face at rest and movement.
• • Radiolologic evaluations
• • Nerve excitability tests.
28. Pathophysiology of
nerve injury
• Neuropraxia : Blocks flow of axoplasm
from stoma to distal axon.
• Axonotemesis : Wallerian
degeneration with intact endoneural tubules.
Neurotemesis : Wallerian
degeneration with loss of endoneural tubules .
• Transection : Complete division of the nerve .
29. Minimal
excitability test
Compare the minimal current necessary to elicit
minimal muscle contraction when applied
tobranch of facial nerve on normal side to paralyze
• Difference of 3.5mA Or greater between 2
side→ degeneration→surgical decompression
30. ELECTRICAL TESTING OF
FACIAL NERVE
• MAXIMUM STIMULATION TEST
• Pulsed electric current is delivered through a
cutaneous electrode
• Short pulse will stimulate an intact nerve & elicit
a muscular twitch.
• In paralysed facial nerve, this indicates that
lesion is neuropraxia & distal neurons have not
undergone degeneration Hence differentiates
between neuropraxia & axonotmesis:prognostic
value.
31. • No value for 1st 72 h
• Equal response
• Reduced response
• Absent response
• Frequent testing
• shows progressive ↑
• threshold →continuing
• degeneration
32. NERVE EXCITABILITY TEST
• Current required for stimulation on normal side
is compared with paralysed side.
• Disadv: even few intact fibres can elicit a
response when rest in
• undergoing degeneration.
• Muscle twitch response is subjective
• Uncomfortable procedure
• Requires patient co-operation
33. ELECTRONEUROGRAPHY
• Measures compound action potential in facial
muscles in response to facial nerve stimulation.
• Compare compound action potential of facial n.
after Supramaximal stimulation of bothsides
• The degree of degeneration is directly
proportional to the amplitude loss of measured
summation potential
• Not useful during 1st72 h,90% or more
degeneration indicate decompression within3
weeks
34. ELECTROMYOGRAPHY
• The recording of
spontaneous and voluntary muscle potentials by
needles introduced into the muscle is called
electromyography(EMG).
• Records motor unit potentials of the orbicularis
oculi & orbicularis oris muscle during rest
&voluntary contraction
35. • EMG can be used to determine:-
• 1.If a nerve in question is in fact in
continuity(volitional activity recorded)
• 2.Evidence of degenration ( fibrillation after 10-
14 days)
• 3.If there are early sign of reinnervation
(polyphasic innervation potentials after 4-6
weeks)
36. • Fibrillation potentials typically arises 2-3 weeks
following injury
• With regeneration of nerve after injury,
polyphasic
• reinnervation potential replaces fibrillation
potential
• Reinnervation potentials may precede clinical
signs of recovery by 6-12 weeks
37. Limitation of electophysiological
testing
• Electric impulse can stimulate only normal/
neuropraxic fibres and can’t distinguish b/w
axonotemesis or neurotemesis
• Provides no useful information in cases of
incomplete facial paralysis
• It fails to provide information on the
immediate post paralysis period( first 72 hours)
38.
39. • Types of physical therapy interventions for
facial palsy
• Facial exercises, such as
• – Strengthening and Stretching,
• – Endurance,
• – Therapeutic and facial mimic exercises ("mime
• therapy")
40. • • Electrotherapy,
• • Biofeedback,
• • Transcutaneous electrical nerve stimulation
(TENS)
• • Thermal methods or massage, alone or in
• combination with any other therapy
41. Exercise therapy
• Simple movement retraining
• • Expression training- mime
• • Functional training
• • PNF
• • Massage-Efflureage,circular&fine thumb
kneading improve circulation and prevent
contracture
• Active exercise in front of mirror prevent
contracture
43. Electrotherapy
• May have an adverse effect on recovery
• • Avoid in acute stage
• • Poor evidence to show it may be helpful in
• chronic facial paralysis.
45. Prognosis
• The Copenhagen Facial Nerve Study
found that around 71% of patients recover normal
function without treatment. Around 13% are left with
slight weakness and around 4% with severe weakness
resulting in major facial dysfunction. Contracture of
the facial muscles on the affected side was found in
17% and associated movements were found in 16%.6
48. BIONIC FACE
• An implantable neuroprosthetic device may one
day provide a new approach to restoring more
natural facial movement in patients with one-
sided facial paralysis (hemifacial palsy)
• Initial experiments in animals show promising
results with a "bionic face" approach to facial
reanimation -- using electrical signals from the
uninjured side of the face to trigger muscle
movement on the paralyzed side.
49. House-Brackmann scale of facial
nerve weakness
• 1-Normal
• 2-Mild Weakness
• 3-Weak but eye closes
• 4-weak with incomplete eye closure
• 5-Flicker of movement
• 6-No movement