This document discusses Legg-Calvé-Perthes disease, which is a degenerative condition of the hip joint that occurs primarily in young children. It involves the temporary loss of blood supply to the femoral head, which can lead to collapse of the hip joint and deformity. The document outlines the typical presentation, diagnostic imaging findings, classification systems used to assess severity, non-surgical and surgical treatment approaches, and potential long-term complications like osteoarthritis if containment of the femoral head is not achieved.
LCPD or Perthes disease - idiopathic avascular necrosis of femoral head, characterized mainly in child age 4-7 years - with a feature of limping and pain in the hip or groin
Deformities observed with Pes cavus includes :
*clawing of the toes
*posterior hind foot deformity (described as an increased calcaneal angle)
*contracture of the plantar fascia
*cock-up deformity of the great toe
Following References were used to prepare this powerpoint presentation which makes the slides accurate and relaible for studying purpose; Therapeutic Exrercise – Carolyn Kisner
Orthopaedic Physical Assessment – Magee
Orthopaedic Medicine – L. Ombregt
Campbell’s Operative Orthopaedics
Slides includes following headings;
DEFINITION
TYPES
ORTHOPAEDIC ASSESSMENT
MEDICAL MANAGGEMENT
PHYSIOTHERAPY MANAGEMENT
SURGICAL MANAGEMENT
LCPD or Perthes disease - idiopathic avascular necrosis of femoral head, characterized mainly in child age 4-7 years - with a feature of limping and pain in the hip or groin
Deformities observed with Pes cavus includes :
*clawing of the toes
*posterior hind foot deformity (described as an increased calcaneal angle)
*contracture of the plantar fascia
*cock-up deformity of the great toe
Following References were used to prepare this powerpoint presentation which makes the slides accurate and relaible for studying purpose; Therapeutic Exrercise – Carolyn Kisner
Orthopaedic Physical Assessment – Magee
Orthopaedic Medicine – L. Ombregt
Campbell’s Operative Orthopaedics
Slides includes following headings;
DEFINITION
TYPES
ORTHOPAEDIC ASSESSMENT
MEDICAL MANAGGEMENT
PHYSIOTHERAPY MANAGEMENT
SURGICAL MANAGEMENT
Clinical examination of the spine/back covering the following sections:
INSPECTION
PALPATION
MOVEMENTS
MEASUREMENTS
SPECIAL TESTS
(Neurological examination covered separately in another slideshow : SPINE EXAMINATION - PART 2)
Collapse of medial longitudinal arch, with the entire sole of the foot coming into complete or near-complete contact with the ground.
Books Refered :
Text Book Of ANATOMY - Vishram Singh
Joint Structure And Function – Cynthia Norkin
Therapeutic Exrercise – Carolyn Kisner
Orthopaedic Physical Assessment – Magee
Orthopaedic Medicine – L. Ombregt
Campbell’s Operative Orthopaedics
Deformity: It’s the position of a limb/Joint, from which it cannot be brought back to its normal anatomical position.
Described as abnormalities of :
Length
Angulation
Rotation
Translation
Combination
Clinical examination of the spine/back covering the following sections:
INSPECTION
PALPATION
MOVEMENTS
MEASUREMENTS
SPECIAL TESTS
(Neurological examination covered separately in another slideshow : SPINE EXAMINATION - PART 2)
Collapse of medial longitudinal arch, with the entire sole of the foot coming into complete or near-complete contact with the ground.
Books Refered :
Text Book Of ANATOMY - Vishram Singh
Joint Structure And Function – Cynthia Norkin
Therapeutic Exrercise – Carolyn Kisner
Orthopaedic Physical Assessment – Magee
Orthopaedic Medicine – L. Ombregt
Campbell’s Operative Orthopaedics
Deformity: It’s the position of a limb/Joint, from which it cannot be brought back to its normal anatomical position.
Described as abnormalities of :
Length
Angulation
Rotation
Translation
Combination
1- Why isn't Jamie allowed unlimited use of aspirin for pain- 2- Why d.docxKevinjrHWatsono
1. Why isn't Jamie allowed unlimited use of aspirin for pain? 2. Why does Jamie's pain subside after a period of inactivity? 3. Why is Sever disease more likely to occur in a child who is active than in one who is sedentary? 4. Why does Sever disease occur in children rather than adults? 5. Describe the pattern of pain appearance and remission that can be expected if Jamie uses heel pads only intermittently. 6. Why are Jamie's X rays normal? If Jamie had calcaneal spurs, how would the X rays have differed? 7. In craniosynostosis, why would premature closure of the sagittal suture restrict the lateral growth of the skull? 8. If you were a pediatrician, what measurements of the skull would you take to distinguish different forms of craniosynostossis from each other? 9. About 50% of children with cranioynostossi exhibit mental retardation. Explain the probable connection between the skeletal deformity and the neurological effect. 10. Explain why Paget disease could cause abnormal pressure on a spinal nerve. Objectives In this chapter we will study - foor developmental disorders of the skull-microcephaly, macrocephaly, acrania, and craniosynostosis; - two developmental disorders of the face and jaw-cleft palate and mandible disorders: - developmental disorders of the vertebral column, incloding spina bifida and aboormal spine curvatures; - some of the causes of lower back pain later in life; and - two disorders of the pelvis-rachitic pelvis and pelvis asyametry. - three disorders of the legs - congenital short fenur, genu varum, and genu valgum: - skeletal disorders of the foet, specifically foot deformities and heel pain. Diagnosing Skeletal Disorders Craniosymosiosis This chapter focuses on disonders of some of the groups of booes Normal human babies are born with unfused e that compose the skeletoa, and examines skeletal problems at the able to shift enough to allow their heads to organ and system level as opposed to the tissue level treated in canal. The cranial booes become rigidly joi the previous chapter. You may find it helpfal to refer to a buman 2 years after birth. Craniosynostonis oecurs asatomy textbook to review the skeleton. The methods used to di- of the cranial sutures fuses prematurely durin agnose the disorders diseussed in this chapter are largely the same months of life. It occurs in about 5 out of 100 as those deseribed in the previous chapter. twice as often in males as in females. Developmental Disorders of the Skull Premature closure of a suture results in I Developmental defects that occur daring the formation of the tures that remain open. For example, if the o bones of the skull can be so minor that they have little or no effect prematurely, the head cannot grow normally or so major that they cause death. This discussion focuses ce two direction but shows excessive promth in a la defects of the skull: acrania and crasiosynostosis. pendicular to the sagittal suture. As a result, Acrania mally wide (left to right) and sh.
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.
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
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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.
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These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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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.
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Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
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Legg calvé-perthes disease
1.
2. Degenerative disease of the hip joint
growth/loss of bone mass some degree of
collapse of the hip joint and deformity of the
head of the femur and acetabulum.
3. Typically found in young children, may lead
to OA in adults.
Syn: Ischemic necrosis of the hip, coxa plana,
osteochondritis and avascular necrosis of the
femoral head, Legg–Perthes Disease.
4. Idiopathic capital femoral epiphyseal
ischaemia temporary cessation of
epiphyseal growth epiphyseal
revascularization occurs from periphery
resumption of growth.
Potential form (no subchondral #).:- no
epiphyseal resorption, no subluxation, no
deformity, asymptomatic, good range of hip
movements, x-ray shows head within head
appearance.
5. True form (subchondral #) :- trauma and
vigorous. Characteristic clinical and
radiographic features.
6. Genetic aspect.
Abnormal growth and development.
Poor socio economic class
80% are males
Trauma.
7. Capital femoral epiphysis
Epiphyseal growth plate
Metaphysis :- adipose tissue,osteolytic
lesions,disorganised ossification and
extrusion of growth plate.
8. Altered longitudinal growth of proximal
femur.
Coxa vara and coxa magna.
High greater trochanter and short femoral
neck results in functional coxa vara.
Shortening by 1-2cm
Trendelenberg gait.
9. 4-8yr old boys.
If older than 12-not true perthes.
10. Painless limp
Mild pain in the hip or anterior thigh or knee.
h/o trauma.
Pain may be a/c or c/c.
11. Antalgic gait.
Muscle spasm.
Proximal thigh atrophy.
Limitation of abduction and internal rotation.
Short stature.
12. Internal rotation test.
Trendelenberg test.
Abduction test.
Roll test.
Thomas test-15 degree flexion deformity.
13. Cessation of growth of the capital femoral
epiphysis.
Subchondral #.
Resorption
Re-ossification.
14.
15. Group I
Antero-medial portion of the head and no
collapse.
Epiphyseal plate not involved.
No metaphyseal change
Heals without significant sequelae.
16. Group II
More head involved and fragmentation of the
involved segment.
The involved segment show increased
density, but the uninvolved pillar of the
normal bone prevent its significant collapse.
The metaphyseal reaction is localized.
Regeneration occurs without much loss of the
height and the result is usually good.
17. Group III
More of the head involvement, collapse
occurs as the un-involved pillars are not large
enough to prevent collapse.
May show head-with-in head appearance
(Crescent sign).
Metaphyseal involvement is usually
widespread
Result is poorer.
18. Group IV
Severe collapse
Extensive metaphyseal changes
Epihyseal plate often involved – abnormal
growth occurs - coxa magna, coxa vara or
coxa valga may occur.
19. Group A (Catterall Gr I and Gr II) :- < half of
the capital femoral epiphysis is involved.
Group B (Catterall Gr III and Gr IV):- > half of
the capital femoral epiphysis involved.
20. A.- No collapse of lateral pillar
B.- Lateral pillar margin - more than 50% of
original height is maintained
C.- Laterall pillar - collapse of more than
50%.
21. 1. Lateral subluxation of head from
acetabulum
2. Speckeled calcification lateral to the capital
epiphysis
3. Diffuse metaphyseal reaction (Met cysts)
4. Horizontal growth plate
5. Gage’s sign – radiolucent V shaped defect in
the lateral epiphysis and adjacent
metaphysis.
22.
23. Arthrography – early resorption stage of the
disease.
Radionuclide bone scan-potential form of
perthes’.
MRI-epiphyseal infarction and femoral head
contour.
24. Primary aim Containment of femoral head
within the acetabulum.
If this is achieved, femoral head can reform
(Biological plasticity- Salter)
Prognosis cannot be estd: accurately all
children with total head involvement must be
Rx actively.
Colter recommended that surgery be reserved
for children of age > 6 yrs with at least 2
head at risk signs except those who refuse to
wear casts due to psycho-social reasons.
29. Advantages
Anterolateral coverage of
femoral head
Lengthening of extremity
(possibly shortened by
avascular process)
Avoidance of second
operation for plate
removal
Disadvantages
Possibility of inability to
attain proper
containment of femoral
head
Increase in acetabular
and hip joint pressure
resulting in further
avascular changes in the
femoral head
Increase in limb length
on operated side which
may lead to relative
adduction of the hip and
femoral head uncovering.
30. Saw cut made horizontally and anteriorly
through illeum as close as possible to the
capsular attachment of the acetabulum.
Graft placed on osteotomy site; stabilise with
threaded pins
31.
32. Immobilization 10-12 weeks in spica cast
Range of motion exercises and full weight
bearing ambulation are then started.
33. Advantages
Ability to obtain
maximum coverage of
femoral head
Ability to correct
excessive femoral
anteversion at the same
osteotomy
Disadvantages
Excessive varus
angulation which may
not correct with growth
Further shortening of
already shortened limb
Possibility of gluteal
lurch due to decrease in
length of the lever arm of
gluteal musculature
Possibility of non union
of the osteotomy
Requirement of a second
operation to remove the
internal fixation.
35. Containment of the femoral head cannot be
achieved for psychosocial reasons
Child is from 8-10yrs old
Without leg length inequality,
On arthrogram a majority of the femoral head
is uncovered
Significant amount of femoral anteversion.
36.
37. Cheilectomy- head is mushroom shaped,hip
is painful and lack of abduction or clicking
sensation on abduction.
Chiari osteotomy- head is mushroom shaped
as in coxa plana and subluxating from the
acetabulum,hip is painful.
Greater trochanter advancement.
38. Malformed femoral head in late groupIII or
residual group IV for which cheilectomy may
be used.
A large malformed femoral head with
subluxation laterally for which chiari’s
osteotomy considered.
Capital femoral growth plate arrest for which
trochanteric advancement may be performed.
39. 1. Coxa Magna
2. Hanging rope sign. - indicative of severe
epiphyseal disturbance, seen on x-ray as line
present in neck droping down distally.
3. Coxa Brevis: Short neck with overgrowth of the
trochanter as a result of premature physeal
arrest.
4. Coxa irregularis : collapse and lateral extrusion
of the femoral head, forming a groove under the
lateral edge of the acetabulum.
5. Osteochondritis dessicans.
40. Female sex
Age of clinical onset >6yrs.
Catterall grp III and IV.
Loss of femoral head containment.
Persistant loss of motion.
Premature epiphyseal growth plate closure.