This document provides an overview of the Müller AO Classification system for fractures of long bones. It describes the alphanumeric structure used to classify fractures according to location on the bone and fracture type. Fractures are classified based on their anatomical location, morphology (type), and the force that caused the fracture. The system divides long bones into three segments - proximal, diaphyseal, and distal. Fracture types are categorized as extra-articular, partial articular, or complete articular. Additional details on classifying diaphyseal and end segment fractures are also provided.
Elbow is the most common joint to dislocate in children. Posterior dislocation is most common.
Simple dislocations are those without fracture.
Complex dislocations are those that occur with an associated fracture
Supracondylar humerus fracture & complication for MBBS studentsYash Oza
Fracture classification, xray, complication, reduction method, surgery, cast, vascular injury, nerve injury, all the Undergraduate students should know is included
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Elbow is the most common joint to dislocate in children. Posterior dislocation is most common.
Simple dislocations are those without fracture.
Complex dislocations are those that occur with an associated fracture
Supracondylar humerus fracture & complication for MBBS studentsYash Oza
Fracture classification, xray, complication, reduction method, surgery, cast, vascular injury, nerve injury, all the Undergraduate students should know is included
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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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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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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
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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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.
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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
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7. 8- Foot
4- Tibia/fibula
3- Femur/patella
7- Hand
9- Craniomaxillofacial bones
1- Humerus
2- Radius/
ulna
5- Spine
15- Clavicula
91-
92-
44-
43-
42-
41-
33-
32-
31-
23-
22-
21-
13-
12-
11-
51-
53-
52-
6- Pelvis/acetabulum
61-
62-
15-
14-
14- Scapula
34-
AO/OTA system for numbering the anatomical location of a fracture
in three bone segments (proximal = 1, diaphyseal = 2, distal = 3)
Bone
1 2 3 4
Segment
1 2 3 (4)
Type
A B C
Group
1 2 3
Subgroup
.1 .2 .3
4 long bones 3 or 4
segments
3 types 3 groups 3 subgroups
Diagnosis = “essence” of the fracture
MorphologyLocalization
-
Anatomical location of the fracture. Anatomical location is designated by two
numbers: one for the bone and one for its segment (ulna and radius as well as
tibia and fibula are regarded as one bone). The malleolar segment (44-) is an
exception. The proximal and the distal segments of long bones are defined by
a square whose sides have the same length as the widest part of the epiphysis
(exceptions 31- and 44-).
Alphanumeric structure of the Müller AO Classification of Fractures—Long
Bones for adults
11-
13-
12-
21-
23-
22-
31-
33-
32-
41-
43-
42-
44-
Example 32-B2
3
femur
2
diaphyseal
B
wedge
fracture
2
bending
wedge
-
8. Definitions of fracture types for long-bone fractures in adults
Exception to this are fractures of the proximal humerus (11-), proximal femur (31-), malleoli (44-), subtrochanteric fractures (32-)
Segment Type
A B C
1 Proximal
Extraarticular Partial articular Complete articular
No involvement of displaced fractures
extending into the articular surface
Part of the articular component is involved,
leaving the other part attached to the
meta-/diaphysis
Articular surface involved, metaphyseal
fracture completely separates articular
component from the diaphysis
2 Diaphyseal
Simple Wedge Complex
One fracture line, cortical contact between
fragments exceeds 90% after reduction
Three or more fragments, main fragments
have contact after reduction
Three or more fragments, main fragments
have no contact after reduction
3 Distal
Extraarticular Partial articular Complete articular
No involvement of displaced fractures
extending into the articular surface
Part of the articular component is involved,
leaving the other part attached to the
meta-/diaphysis
Articular surface involved, metaphyseal
fracture completely separates articular
component from the diaphysis
9. Diaphyseal fracture
Step Question Answer
1 Which bone? Specific bone (X)
2 Is the fracture at the end or in
the middle segment of the bone?
Middle segment (X2)
3 Type: Is the fracture a simple or
multifragmentary one (does it
have >2 parts)?
Simple (X2-A)
If it is multifragmentary, go to
step 3a
3a Is there contact between both
fracture ends or not?
If there is contact it is a wedge
(X2-B)
If there is no contact it is
complex (X2-C)
4 Group: Is the fracture pattern
caused by a twisting (spiral) or
bending force?
Spiral or twisting forces will
result in a simple spiral (X2-A1),
a spiral wedge
(X2-B1), or a spiral fragmented
complex fracture (X2-C1)
Bending forces produce simple
oblique (X2-A2), simple
transverse (X2-A3), bending
wedge (X2-B2), fragmented
wedge (X2- B3), or complex (X2-
C3) fractures
C2 fractures are segmental by
definition
Steps in identifying diaphyseal fractures
Type Group
1 2 3
A
Simple
Spiral Oblique Transverse
B
Wedge
Spiral Bending Multifragmentary
C
Complex
Spiral Segmental Irregular
Classification of fractures of the diaphysis into the three fracture groups.
10. End segment fracture
Step Question Answer
1 Which bone? Specific bone (X)
2 Is the fracture at the end or
middle segment of the bone?
End segment
3 Is the fracture through the
proximal or distal end segment?
Proximal (X1)
Distal (X3)
4a Type: Does the fracture enter the
articular surface?
If it does not enter it is
extraarticular (XX-A), go to step 6
If it enters it is articular, go to
step 4b
4b Type: Is it partial or total
articular?
If part of the joint is still attached
to the meta-/diaphysis it is
partial articular (XX-B)
If it is not attached to the
diaphysis it is complete articular
(XX-C)
5 Group: How many fracture lines
cross the joint surface?
If there is one line it is simple
If there are >2 lines it is
multifragmentary
6 Group: How is the metaphysis
fractured?
Simple: extraarticular (XX-A1),
or simple articular (XX-C1)
Wedge: extraarticular (XX-A2)
Complex: extraarticular (XX-A3),
or simple articular (XX-C2),
or complex articular (XX-C3)
Steps in identifying end segment fractures
Type Group
1 2 3
A
Extraarticular
Simple Wedge Complex
B
Partial
articular
Split Depression Split-depression
C
Articular
Simple articular,
simple
metaphyseal
Simple articular,
complex
metaphyseal
Complex
articular,
complex
metaphyseal
Classification of fractures of the end segment into the three fracture
groups