This document provides guidance on performing an objective assessment of the lumbar spine. It outlines steps to plan the examination including identifying relevant anatomical structures and considering the patient's pain. The purpose is to interpret the patient's disability, test hypotheses, and clarify treatment options. Assessment involves observing posture, performing active physiological movements to assess pain and range of motion, and applying techniques like overpressure. Movement patterns are analyzed to identify normal and abnormal responses. Palpation and auxiliary tests complete the examination.
This is the presentation which was delivered to third year Bachelor of Physiotherapy students at Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Nepal. Different schools of thoughts in manual therapy are the part of curriculum for the undergraduate students at KUSMS.
Brian Mulligan described novel concept of the simultaneous application of therapist applied accessory mobilizations and patient generated active movements
Basic Introduction about Joint Mobilisation and Manipulation, This article gives clear notes for the students to understand the Mobilisation techniques.
This presentation will give an basic insights about the spinal mobilisation and various manual therapy techniques used on Lumbar spine especially Maitland & Mulligan techniques.
Muscle energy technique, a manual therapy technique with a long term history and 8 variations which can be used in various condition to treat muscle as well as joints. This slide show consists of detailed history, variations/types and summary of MET in detail.
This is the presentation which was delivered to third year Bachelor of Physiotherapy students at Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Nepal. Different schools of thoughts in manual therapy are the part of curriculum for the undergraduate students at KUSMS.
Brian Mulligan described novel concept of the simultaneous application of therapist applied accessory mobilizations and patient generated active movements
Basic Introduction about Joint Mobilisation and Manipulation, This article gives clear notes for the students to understand the Mobilisation techniques.
This presentation will give an basic insights about the spinal mobilisation and various manual therapy techniques used on Lumbar spine especially Maitland & Mulligan techniques.
Muscle energy technique, a manual therapy technique with a long term history and 8 variations which can be used in various condition to treat muscle as well as joints. This slide show consists of detailed history, variations/types and summary of MET in detail.
Concept given by Shacklock (modern concept) and Butler (old concept), a method of assessment as well as treatment of peripheral neurological system by physiotherapists.
Part-I: The current slideshow: theoretical aspect of neurodynamics.
Part-II: Assessment of peripheral nervous system on the basis of neurodynamic concepts: Date: 01/04/2020
Part-III: treatment part: Date: 03/04/2020
Part-IV: Self neurodynamics: 05/04/2020
There are evidence in History of treatment by Passive stretching techniques.
Over past 30-40 years many therapists have worked to identify and learn the techniques which are are more suitable and effective for the patient’s problem.
Joint mobilisations and manipulations techniques are used to safely stretch or snap structures to restore normal joint mechanics with less trauma.
A type of manual therapy in which the muscle or the joint is altered and placed in a position of comfort for certain duration after which the pain disappears completely or gets reduced. this slide show explains about the principles, mechanism and Phases of PRT
Myofascial release refers to the manual
technique for stretching the fascia and
releasing bonds between fascia and
Lintegument, musles,and bones, with the goal of
eliminating pain, increasing range of motion
and balancing the body.
This is the presentation which was delivered to third year Bachelor of Physiotherapy students at Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Nepal. Different schools of thoughts in manual therapy are the part of curriculum for the undergraduate students at KUSMS.
All manual therapist practitioner should have this basic idea about spinal manual therapy. There are lots of house of thoughts in manual therapy but everyone should have this basic idea about manual therapy.
Concept given by Shacklock (modern concept) and Butler (old concept), a method of assessment as well as treatment of peripheral neurological system by physiotherapists.
Part-I: The current slideshow: theoretical aspect of neurodynamics.
Part-II: Assessment of peripheral nervous system on the basis of neurodynamic concepts: Date: 01/04/2020
Part-III: treatment part: Date: 03/04/2020
Part-IV: Self neurodynamics: 05/04/2020
There are evidence in History of treatment by Passive stretching techniques.
Over past 30-40 years many therapists have worked to identify and learn the techniques which are are more suitable and effective for the patient’s problem.
Joint mobilisations and manipulations techniques are used to safely stretch or snap structures to restore normal joint mechanics with less trauma.
A type of manual therapy in which the muscle or the joint is altered and placed in a position of comfort for certain duration after which the pain disappears completely or gets reduced. this slide show explains about the principles, mechanism and Phases of PRT
Myofascial release refers to the manual
technique for stretching the fascia and
releasing bonds between fascia and
Lintegument, musles,and bones, with the goal of
eliminating pain, increasing range of motion
and balancing the body.
This is the presentation which was delivered to third year Bachelor of Physiotherapy students at Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Nepal. Different schools of thoughts in manual therapy are the part of curriculum for the undergraduate students at KUSMS.
All manual therapist practitioner should have this basic idea about spinal manual therapy. There are lots of house of thoughts in manual therapy but everyone should have this basic idea about manual therapy.
Introduction to musculoskeletal physical therapy principles and concepts.
MSK physical therapy is a speciality of pt. that deals with diagnosis, management and treatment of disorders and injuries of the musculoskeletal system including:
Rehabilitation after orthopedic surgery
Acute trauma such as sprains, strains
Injuries of insidious onset such as tendinopathy and bursitis.
This speciality of physical therapy is most often found in the out-patient clinical setting.
Orthopedic therapists are trained in the treatment of post-operative orthopedic procedures, fractures, acute sports injuries, arthritis, sprains, strains, back and neck pain, spinal conditions, and amputations.
It is difficult to lay out the exercise prescription for low back pain. Exercise for low back pain is differ person to person. This presentation will describe about the general layout for patient with low back pain.
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.
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
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
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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
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
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MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
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.
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
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
2. MANUAL THERAPY LUMBER SPINE
OBJECTIVE ASSESSMENT
Prepared by:
MUHAMMAD IBRAHIM KHAN
BS.PT(Pak), MS.PT(Pak), NCC(AKUH)
3. PLAN THE OBJECTIVE EXAM
• List the anatomical structures that may cause pain
•
•
•
•
•
joints under the area that cause pain
joints that refer pain to the area
muscles in the area that cause pain
Consider the effect of the pain on the patient
Consider the kind of examination required
-extent and strength of the test movements
• Examination of the underlying abnormalities to find the
source of pain
4. PURPOSE OF THE OBJECTIVE EXAM
• Interpret the patient‟s concept of their disability into terms
of joints or muscles that are causing pain
• Accept/reject/modify categories of hypothesis from the
subjective evaluation
• Generate new hypothesis to be tested during the objective
evaluation and treatment
• Reproduce the Comparable Sign and/or appropriate
movement signs
• Clarify options for treatment, select techniques
• HEAR, SEE and FEEL
5. POSTURAL OBSERVATIONS
• Prior to getting your patient to move you want to observe
their resting posture
• Observe your patient in standing and sitting
• Observe from the side, back and front
• Look for obvious differences from one side to the next
7. ACTIVE PHYSIOLOGICAL MOVEMENTS
• Patient‟s provocation test movement
• „Quick Tests‟ that are spontaneous, functional active
movements
• Assessing the range and quality of movement
• Shows the level of pain
• As needed: corrected, overpressure, sustained, repeated,
distraction, compression, combined movements, quadrants,
gait
• HEAR and SEE
8. MOVE TO PAIN
• The patient is asked to move through active movements
until pain is experienced.
• Once pain (or other symptoms) is experienced the patient is
asked to return to the starting position.
MOVE TO LIMIT
• Severity of the symptoms is such that the patient is asked
to move to the limit of range.
• Whether measured to pain or to limit a second measure
should be taken.
• This measure moves beyond pain or limit to examine the
response of the symptoms
9. APPLICATION OF OVER-PRESSURE
• Where there are no symptoms the patient should be
asked to move to limit.
• At this point over-pressure is applied by the PT.
• Essential if movement appears to be full range and
normal.
• Recorded as normal if movement is full and overpressure can be applied
10. REPEATED MOVEMENTS
• Patient should move in repeated fashion so the PT
can look for disturbances of normal rhythm of IV
movement.
• If a movement is painful repeated movements
should be avoided.
• May test movement of the upper spine on the
lower or vice versa.
11. PROTECTIVE DEFORMITY
• Abnormal movement may occur because of pain or
joint stiffness which may be painless.
• Pain will be provoked by preventing the abnormality
during movement
• With stiffness no pain response will occur.
• Correct any deviation of a movement to determine if
it indicates a protective deformity.
12. COMBINED MOVEMENTS
• One movement is superimposed on another or is
applied once end range is reached for the primary
movement.
• Forward flexion followed by side flexion
• Extension followed by side flexion
• Looking for a combination that relieves or
increases a patient‟s symptoms.
14. MOVEMENT PATTERNS
• Movement of one vertebral segment involves movement of 3
joints - 2 facet joints and 1 inter-body joint
• Regular patterns are stretching or compression patterns.
• They produce similar movements at the inter-vertebral
joints, while producing similar symptoms.
REGULAR PATERNS
1. Compression Patterns
• Right lateral flexion in the lumbar spine produces right buttock pain
• Worsens when the movement is done in extension and eased when done
in flexion.
2. Stretching Patterns
• Right lateral flexion of the lumbar spine produces left buttock pain.
• Pain is increased when movement is performed in flexion and eased
when performed in extension.
15. IRREGULAR MOVEMENT PATTERNS
• All patterns that are not regular fall into the irregular
category.
• Left lateral flexion of the lumbar spine (stretching
movement) produces right buttock pain.
• Pain worsens when movement is done in extension
(compression) and eased when done in flexion
(stretching movement)
16. AUXILIARY TEST ASSOCIATED WITH ACTIVE
TESTS
• Performance of movement with the joint surfaces
compressed together.
• Tests such as the vertebrobasilar insufficiency
and neurological tests are grouped here.
• Take note of „changes‟ in neurological symptoms.
• Assess nerve roots, dermatomes and reflexes.
17. PIVM/PALPATION
•
•
•
•
•
•
Positioning joints in their mid-position
Assessing changes in temperature
Assessing soft tissue changes
Assessing bony anomalies
Checking movement anomalies (PIVM‟s)
Assessing pain responses to the above
• Postero-anteriorly on spinous process
• Postero-anteriorly on transverse process
• Transversely on lateral aspect of spinous process