The document provides an overview of the musculoskeletal system including its components like bones, muscles, joints, ligaments and tendons. It discusses the functions of the musculoskeletal and skeletal systems. It describes the different types of muscles, bones, and joints. The document outlines how to examine the musculoskeletal system through general observation, palpation, and assessment of individual joints like the spine, shoulder, elbow, wrist, hip, knee, ankle and foot. It also lists and describes various pathologic conditions that can affect the musculoskeletal system including congenital diseases, acquired skeletal diseases, and other soft tissue disorders.
The document discusses various oral habits and their effects on dentition and facial growth. It defines habits like thumb sucking, tongue thrusting, and mouth breathing. It describes William James' definition of habit formation in the brain and classifies habits as useful/harmful, pressure/non-pressure, and intraoral/extraoral. Specific sections provide details on the etiology, clinical effects, diagnosis and management of thumb sucking and tongue thrusting habits.
1. Congenital pseudarthrosis of the tibia (CPT) is a rare condition characterized by failure of the tibia to heal which can lead to deformity and recurrent fractures.
2. It has an unclear etiology but is often associated with neurofibromatosis type 1. Treatment aims to achieve bone union, prevent refracture, and correct limb length and ankle deformities.
3. Surgical treatment often involves vascularised fibular grafting, the Ilizarov technique using external fixation, or intramedullary nailing with bone grafting. The Ilizarov method uses corticotomy and gradual distraction to induce new bone formation.
Septicarthritis (inflammation of the joint)Hardi Hussein
A 40-year-old diabetic patient presented to the emergency department with acutely painful swelling of the right knee for 2 days. On examination, there was mild fever, tenderness over the joint, and restricted passive and active movement of the joint. The patient is likely suffering from septic arthritis, an infection and inflammation of the synovial joint caused by bacteria or other microbes. Blood tests and joint fluid analysis are needed to confirm the diagnosis and identify the causative organism. Treatment involves antibiotics, surgical drainage if needed, and immobilization of the joint. Without prompt treatment, septic arthritis can lead to permanent joint damage and disability.
This document discusses infected non-union, which occurs when the healing process stops due to mechanical or biological failure. It classifies infected non-unions based on the extent of infection and describes various classification systems. These include the Weiland, Cierny-Mader, Umiarov, G.S. Kulkarni, Gordon, and May classifications. The document also discusses the pathogenesis of infected non-union, how infection causes non-union, diagnosis, and the goals and methods of treatment, which include eradicating infection, achieving bone union, and addressing soft tissue issues. Treatment involves antibiotics, debridement, bone grafting, electrical or ultrasound stimulation, and sometimes vascularised bone gra
This document provides a summary of the stomatognathic system including its components, neurological control, and clinical importance. It discusses functional osteology including theories of bone formation and remodeling in response to functional forces. Key skeletal components like the maxilla and mandible are described along with the muscles of mastication, facial expression, the tongue, floor of the mouth, and temporomandibular joint. Mandibular positions and movements including chewing are summarized.
This document discusses polydactyly, which is the congenital duplication of fingers. It begins by describing the embryology and timeline of upper limb development. It then classifies polydactyly into preaxial, central, and postaxial types based on the duplicated digit. Preaxial polydactyly, or thumb duplication, is discussed in depth, including genetics, classification systems like the Wassel classification, clinical assessment, treatment goals and surgical techniques for different types of thumb duplication. Potential complications are also mentioned.
The document discusses various oral habits and their effects on dentition and facial growth. It defines habits like thumb sucking, tongue thrusting, and mouth breathing. It describes William James' definition of habit formation in the brain and classifies habits as useful/harmful, pressure/non-pressure, and intraoral/extraoral. Specific sections provide details on the etiology, clinical effects, diagnosis and management of thumb sucking and tongue thrusting habits.
1. Congenital pseudarthrosis of the tibia (CPT) is a rare condition characterized by failure of the tibia to heal which can lead to deformity and recurrent fractures.
2. It has an unclear etiology but is often associated with neurofibromatosis type 1. Treatment aims to achieve bone union, prevent refracture, and correct limb length and ankle deformities.
3. Surgical treatment often involves vascularised fibular grafting, the Ilizarov technique using external fixation, or intramedullary nailing with bone grafting. The Ilizarov method uses corticotomy and gradual distraction to induce new bone formation.
Septicarthritis (inflammation of the joint)Hardi Hussein
A 40-year-old diabetic patient presented to the emergency department with acutely painful swelling of the right knee for 2 days. On examination, there was mild fever, tenderness over the joint, and restricted passive and active movement of the joint. The patient is likely suffering from septic arthritis, an infection and inflammation of the synovial joint caused by bacteria or other microbes. Blood tests and joint fluid analysis are needed to confirm the diagnosis and identify the causative organism. Treatment involves antibiotics, surgical drainage if needed, and immobilization of the joint. Without prompt treatment, septic arthritis can lead to permanent joint damage and disability.
This document discusses infected non-union, which occurs when the healing process stops due to mechanical or biological failure. It classifies infected non-unions based on the extent of infection and describes various classification systems. These include the Weiland, Cierny-Mader, Umiarov, G.S. Kulkarni, Gordon, and May classifications. The document also discusses the pathogenesis of infected non-union, how infection causes non-union, diagnosis, and the goals and methods of treatment, which include eradicating infection, achieving bone union, and addressing soft tissue issues. Treatment involves antibiotics, debridement, bone grafting, electrical or ultrasound stimulation, and sometimes vascularised bone gra
This document provides a summary of the stomatognathic system including its components, neurological control, and clinical importance. It discusses functional osteology including theories of bone formation and remodeling in response to functional forces. Key skeletal components like the maxilla and mandible are described along with the muscles of mastication, facial expression, the tongue, floor of the mouth, and temporomandibular joint. Mandibular positions and movements including chewing are summarized.
This document discusses polydactyly, which is the congenital duplication of fingers. It begins by describing the embryology and timeline of upper limb development. It then classifies polydactyly into preaxial, central, and postaxial types based on the duplicated digit. Preaxial polydactyly, or thumb duplication, is discussed in depth, including genetics, classification systems like the Wassel classification, clinical assessment, treatment goals and surgical techniques for different types of thumb duplication. Potential complications are also mentioned.
Spondyloarthropathies By Dr Rekha Vankwani.pptxZOHAIB57
1. Sero-negative arthritis refers to types of inflammatory arthritis that are negative for rheumatoid factor and other autoantibodies. These include spondyloarthropathies like ankylosing spondylitis.
2. Ankylosing spondylitis is a chronic inflammatory disorder affecting the spine and sacroiliac joints. It is strongly associated with the HLA-B27 gene. Symptoms include back pain and stiffness that improves with exercise.
3. Treatment involves NSAIDs, TNF inhibitors, exercise and maintaining posture. Surgery may be used for joint replacement.
Knee clinical examination by Dr YAGNIKYagnik Bhuva
The document summarizes the anatomy and clinical evaluation of the knee joint. It describes the knee as a modified hinge joint composed of the tibiofemoral and patellofemoral joints. Key anatomical structures including the menisci, cruciate ligaments, collateral ligaments, and muscles are outlined. The clinical evaluation involves obtaining a history of pain, swelling, instability, etc and performing an examination involving inspection, palpation, range of motion testing, and special tests of ligaments and menisci.
This document provides an overview of common elbow disorders presented by Dr. Farouq Makkie Alyouzbaki. It discusses the anatomy of the elbow joint and various conditions affecting the elbow including cubitus varus, cubitus valgus, pulled elbow, osteochondritis disse cans, lateral epicondylitis (tennis elbow), medial epicondylitis (golfer's elbow), and olecranon bursitis. For each condition, it describes the causes, signs, symptoms, management options including both conservative and surgical treatments. The goal is to educate on evaluating and managing a variety of elbow disorders.
The document describes the three main types of skeletons - endoskeleton, exoskeleton, and hydrostatic skeleton. It then goes into detail about the human skeletal system, including the structure and types of bones, joints, and muscles. Key points include that humans have an endoskeleton made of bone, the skeletal system is divided into the axial skeleton and appendicular skeleton, and there are three main types of joints - fibrous, cartilaginous, and synovial joints.
1. Congenital talipes equinovarus (CTEV), also known as clubfoot, is a congenital deformity characterized by four components - cavus, adduction, varus, and equinus (CAVE).
2. Non-operative treatment involves serial casting using the Ponseti technique, which aims to correct the deformity through soft tissue manipulation and serial plaster casts over 5-6 weeks.
3. The Ponseti technique addresses each component of the deformity in order, using the head of the talus as a fulcrum to manipulate the foot into corrected position.
This document discusses various types of splints and tractions used in orthopaedics. It describes different wooden, metallic, and plaster splints used to immobilize parts of the body like the leg, arm, and spine. It also discusses types of skeletal traction used to reduce fractures or dislocations, including femoral, tibial, and calcaneal traction. Complications of splints and traction like pressure sores, nerve injuries, and infections are also outlined.
This document provides information on spinal disc herniation, including:
- Disc herniation occurs when the nucleus pulposus is pushed through tears in the annulus fibrosus into the spinal canal.
- Common causes are age-related degeneration, trauma, and straining. It progresses from internal disruption to instability.
- Diagnosis is typically made using MRI, which can identify protrusions, extrusions, and sequestrations.
- Treatment involves initial conservative measures like rest, ice, and NSAIDs. Surgery such as discectomy or microdiscectomy may be required for persistent or severe cases.
- A case study describes the successful surgical treatment of a 29-year
This document provides an overview of joints, including their definition, classification, structure, and function. It discusses the different types of joints such as fibrous joints, cartilaginous joints, and synovial joints. For synovial joints, it describes the articular cartilage, synovial fluid, articular capsule, ligaments, articular disc or meniscus, and bursa. It also classifies synovial joints based on the number of bones, axis of movement, and shape of the articular surfaces. Key joints like the knee, elbow, and wrist are referenced as examples throughout the summary.
This document summarizes information about Achilles tendon injuries. It describes the anatomy and blood supply of the Achilles tendon. It discusses the populations most at risk for injury and the mechanisms of injury. Common presentations are outlined for Achilles tendonitis and rupture. Diagnostic investigations and various treatment approaches are also summarized, including prognosis. A case presentation is then provided of a 42-year old male patient with a calcaneal tuberosity avulsion fracture and Achilles tendon rupture from a volleyball injury.
The document discusses clubfoot, a congenital foot deformity. It describes the anatomy of the normal foot and characteristics of clubfoot including equinus, varus, adduction, and cavus deformities. It covers etiologies such as neuromuscular, fibrotic, and vascular theories. Treatment approaches include serial casting and surgery. The document provides details on the classification, presentation, and evaluation of clubfoot through history, examination, and radiography.
Describe about the chief complaints , gait assessment, special test and local examination of hip joint.
includes the special tests like thomas test, tredenlenberg test, DDH test etc..
This document discusses sacroiliac joint dysfunction. It begins by describing the anatomy of the sacroiliac joint, including its ligaments, muscles that stabilize it, and typical movements. It then discusses causes of sacroiliac dysfunction like trauma, mechanics issues, and systemic diseases. Common clinical signs are described along with examination tests like the Faber test. Various types of sacroiliac dysfunctions are outlined such as rotational issues, sacral torsions, and shearing. Treatment approaches mentioned include manual therapy, exercises, and in severe cases, surgery. Proper sleeping position is also recommended for sacroiliac joint pain.
This document discusses sacroiliac joint dysfunction. It covers anatomy of the sacrum, sacral motions including nutation and counter nutation, and types of sacral somatic dysfunction. Diagnosis involves history, physical exam including special tests like Faber, Gillett and Yeoman's tests, and sacroiliac joint injections which are the gold standard. Management can include soft tissue techniques, muscle energy techniques, counterstrain and other osteopathic manipulative medicine.
This document discusses seronegative arthritis, specifically focusing on spondyloarthropathies. It defines spondyloarthropathies as a group of inflammatory arthropathies that share clinical, radiographic, and genetic features, including ankylosing spondylitis, reactive arthritis, psoriatic arthritis, and enteropathic arthritis. It then provides detailed information on the pathogenesis, clinical manifestations, diagnostic findings, and treatment approaches for ankylosing spondylitis and reactive arthritis. Psoriatic arthritis is also briefly discussed.
Case discussion of perthes disease-Dr. Siddharth Deshwal PG OrthopaedicsSIDDHARTHDESHWAL3
This document discusses the case of a child with Perthes disease. Key points include:
- Perthes disease typically affects children ages 4-10 years old and presents with limping or hip/groin pain.
- Imaging shows stages of the disease from initial involvement to reossification. Staging systems like Caterall and Salter-Thompson are used to classify the extent of epiphyseal involvement.
- Treatment aims to contain the femoral head in the acetabulum during healing to promote a spherical head shape and prevent deformity. Containment is usually only beneficial in the early revasularization stage.
Deformities of hand in rheumatoid arthritisorthoprince
Rheumatoid arthritis can cause deformities of the fingers including intrinsic plus, swan neck, and buttonhole deformities. Swan neck deformity involves flexion of the distal interphalangeal joint and hyperextension of the proximal interphalangeal joint. Buttonhole deformity is the reverse, with flexion of the proximal interphalangeal joint and hyperextension of the distal interphalangeal joint. Both deformities result from muscle imbalance and can be caused by synovitis, tendon damage, or capsular changes within the finger joints. Surgical correction may involve synovectomy, tendon releases or reconstructions, and joint mobilization or fusion depending on the severity and chronicity of the
The document discusses disorders of the upper limb, including the shoulder, elbow, wrist, and hand. It provides details on anatomy, common conditions such as frozen shoulder, lateral epicondylitis, carpal tunnel syndrome, and treatments including injections, physical therapy, and surgery. It comprehensively covers the assessment and management of various musculoskeletal issues in the upper extremity.
Join us for an enlightening seminar delving into the intricate world of Ankylosing Spondylitis (AS). This event aims to provide a deep understanding of AS, a chronic inflammatory arthritis primarily affecting the spine and pelvis.
Seminar Highlights:
Introduction to Ankylosing Spondylitis:
Definition, prevalence, and demographic insights.
Clinical Features and Diagnosis:
Recognizing early symptoms and the diagnostic journey.
The role of imaging and laboratory tests.
Understanding the Pathophysiology:
In-depth exploration of the immune system's role.
Genetic factors and their impact on AS.
Treatment Modalities:
Current pharmacological interventions.
Physical therapy and lifestyle management.
Quality of Life and Mental Health:
Addressing the holistic impact of AS on daily life.
Strategies for maintaining mental and emotional well-being.
Research Advances and Future Directions:
Overview of cutting-edge research in AS.
Promising avenues for future treatments and interventions.
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
Spondyloarthropathies By Dr Rekha Vankwani.pptxZOHAIB57
1. Sero-negative arthritis refers to types of inflammatory arthritis that are negative for rheumatoid factor and other autoantibodies. These include spondyloarthropathies like ankylosing spondylitis.
2. Ankylosing spondylitis is a chronic inflammatory disorder affecting the spine and sacroiliac joints. It is strongly associated with the HLA-B27 gene. Symptoms include back pain and stiffness that improves with exercise.
3. Treatment involves NSAIDs, TNF inhibitors, exercise and maintaining posture. Surgery may be used for joint replacement.
Knee clinical examination by Dr YAGNIKYagnik Bhuva
The document summarizes the anatomy and clinical evaluation of the knee joint. It describes the knee as a modified hinge joint composed of the tibiofemoral and patellofemoral joints. Key anatomical structures including the menisci, cruciate ligaments, collateral ligaments, and muscles are outlined. The clinical evaluation involves obtaining a history of pain, swelling, instability, etc and performing an examination involving inspection, palpation, range of motion testing, and special tests of ligaments and menisci.
This document provides an overview of common elbow disorders presented by Dr. Farouq Makkie Alyouzbaki. It discusses the anatomy of the elbow joint and various conditions affecting the elbow including cubitus varus, cubitus valgus, pulled elbow, osteochondritis disse cans, lateral epicondylitis (tennis elbow), medial epicondylitis (golfer's elbow), and olecranon bursitis. For each condition, it describes the causes, signs, symptoms, management options including both conservative and surgical treatments. The goal is to educate on evaluating and managing a variety of elbow disorders.
The document describes the three main types of skeletons - endoskeleton, exoskeleton, and hydrostatic skeleton. It then goes into detail about the human skeletal system, including the structure and types of bones, joints, and muscles. Key points include that humans have an endoskeleton made of bone, the skeletal system is divided into the axial skeleton and appendicular skeleton, and there are three main types of joints - fibrous, cartilaginous, and synovial joints.
1. Congenital talipes equinovarus (CTEV), also known as clubfoot, is a congenital deformity characterized by four components - cavus, adduction, varus, and equinus (CAVE).
2. Non-operative treatment involves serial casting using the Ponseti technique, which aims to correct the deformity through soft tissue manipulation and serial plaster casts over 5-6 weeks.
3. The Ponseti technique addresses each component of the deformity in order, using the head of the talus as a fulcrum to manipulate the foot into corrected position.
This document discusses various types of splints and tractions used in orthopaedics. It describes different wooden, metallic, and plaster splints used to immobilize parts of the body like the leg, arm, and spine. It also discusses types of skeletal traction used to reduce fractures or dislocations, including femoral, tibial, and calcaneal traction. Complications of splints and traction like pressure sores, nerve injuries, and infections are also outlined.
This document provides information on spinal disc herniation, including:
- Disc herniation occurs when the nucleus pulposus is pushed through tears in the annulus fibrosus into the spinal canal.
- Common causes are age-related degeneration, trauma, and straining. It progresses from internal disruption to instability.
- Diagnosis is typically made using MRI, which can identify protrusions, extrusions, and sequestrations.
- Treatment involves initial conservative measures like rest, ice, and NSAIDs. Surgery such as discectomy or microdiscectomy may be required for persistent or severe cases.
- A case study describes the successful surgical treatment of a 29-year
This document provides an overview of joints, including their definition, classification, structure, and function. It discusses the different types of joints such as fibrous joints, cartilaginous joints, and synovial joints. For synovial joints, it describes the articular cartilage, synovial fluid, articular capsule, ligaments, articular disc or meniscus, and bursa. It also classifies synovial joints based on the number of bones, axis of movement, and shape of the articular surfaces. Key joints like the knee, elbow, and wrist are referenced as examples throughout the summary.
This document summarizes information about Achilles tendon injuries. It describes the anatomy and blood supply of the Achilles tendon. It discusses the populations most at risk for injury and the mechanisms of injury. Common presentations are outlined for Achilles tendonitis and rupture. Diagnostic investigations and various treatment approaches are also summarized, including prognosis. A case presentation is then provided of a 42-year old male patient with a calcaneal tuberosity avulsion fracture and Achilles tendon rupture from a volleyball injury.
The document discusses clubfoot, a congenital foot deformity. It describes the anatomy of the normal foot and characteristics of clubfoot including equinus, varus, adduction, and cavus deformities. It covers etiologies such as neuromuscular, fibrotic, and vascular theories. Treatment approaches include serial casting and surgery. The document provides details on the classification, presentation, and evaluation of clubfoot through history, examination, and radiography.
Describe about the chief complaints , gait assessment, special test and local examination of hip joint.
includes the special tests like thomas test, tredenlenberg test, DDH test etc..
This document discusses sacroiliac joint dysfunction. It begins by describing the anatomy of the sacroiliac joint, including its ligaments, muscles that stabilize it, and typical movements. It then discusses causes of sacroiliac dysfunction like trauma, mechanics issues, and systemic diseases. Common clinical signs are described along with examination tests like the Faber test. Various types of sacroiliac dysfunctions are outlined such as rotational issues, sacral torsions, and shearing. Treatment approaches mentioned include manual therapy, exercises, and in severe cases, surgery. Proper sleeping position is also recommended for sacroiliac joint pain.
This document discusses sacroiliac joint dysfunction. It covers anatomy of the sacrum, sacral motions including nutation and counter nutation, and types of sacral somatic dysfunction. Diagnosis involves history, physical exam including special tests like Faber, Gillett and Yeoman's tests, and sacroiliac joint injections which are the gold standard. Management can include soft tissue techniques, muscle energy techniques, counterstrain and other osteopathic manipulative medicine.
This document discusses seronegative arthritis, specifically focusing on spondyloarthropathies. It defines spondyloarthropathies as a group of inflammatory arthropathies that share clinical, radiographic, and genetic features, including ankylosing spondylitis, reactive arthritis, psoriatic arthritis, and enteropathic arthritis. It then provides detailed information on the pathogenesis, clinical manifestations, diagnostic findings, and treatment approaches for ankylosing spondylitis and reactive arthritis. Psoriatic arthritis is also briefly discussed.
Case discussion of perthes disease-Dr. Siddharth Deshwal PG OrthopaedicsSIDDHARTHDESHWAL3
This document discusses the case of a child with Perthes disease. Key points include:
- Perthes disease typically affects children ages 4-10 years old and presents with limping or hip/groin pain.
- Imaging shows stages of the disease from initial involvement to reossification. Staging systems like Caterall and Salter-Thompson are used to classify the extent of epiphyseal involvement.
- Treatment aims to contain the femoral head in the acetabulum during healing to promote a spherical head shape and prevent deformity. Containment is usually only beneficial in the early revasularization stage.
Deformities of hand in rheumatoid arthritisorthoprince
Rheumatoid arthritis can cause deformities of the fingers including intrinsic plus, swan neck, and buttonhole deformities. Swan neck deformity involves flexion of the distal interphalangeal joint and hyperextension of the proximal interphalangeal joint. Buttonhole deformity is the reverse, with flexion of the proximal interphalangeal joint and hyperextension of the distal interphalangeal joint. Both deformities result from muscle imbalance and can be caused by synovitis, tendon damage, or capsular changes within the finger joints. Surgical correction may involve synovectomy, tendon releases or reconstructions, and joint mobilization or fusion depending on the severity and chronicity of the
The document discusses disorders of the upper limb, including the shoulder, elbow, wrist, and hand. It provides details on anatomy, common conditions such as frozen shoulder, lateral epicondylitis, carpal tunnel syndrome, and treatments including injections, physical therapy, and surgery. It comprehensively covers the assessment and management of various musculoskeletal issues in the upper extremity.
Join us for an enlightening seminar delving into the intricate world of Ankylosing Spondylitis (AS). This event aims to provide a deep understanding of AS, a chronic inflammatory arthritis primarily affecting the spine and pelvis.
Seminar Highlights:
Introduction to Ankylosing Spondylitis:
Definition, prevalence, and demographic insights.
Clinical Features and Diagnosis:
Recognizing early symptoms and the diagnostic journey.
The role of imaging and laboratory tests.
Understanding the Pathophysiology:
In-depth exploration of the immune system's role.
Genetic factors and their impact on AS.
Treatment Modalities:
Current pharmacological interventions.
Physical therapy and lifestyle management.
Quality of Life and Mental Health:
Addressing the holistic impact of AS on daily life.
Strategies for maintaining mental and emotional well-being.
Research Advances and Future Directions:
Overview of cutting-edge research in AS.
Promising avenues for future treatments and interventions.
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the 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 lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
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. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...Donc Test
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8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
Does Over-Masturbation Contribute to Chronic Prostatitis.pptxwalterHu5
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
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Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
2. INTRODUCTION
MUSCULOSKELETAL SYSTEM COMPRISES OF:
1. BONES - SKELETON – AXIAL AND APPENDICULAR
2. MUSCLES
3. JOINTS
4. LIGAMENTS – BONE TO BONE ATTACHMENT
5. TENDONS – MUSCLES TO BONE ATTACHMENT
6. CARTILAGES
LIGAMENT
CARTILAGE
3. FUNCTIONS OF
MUSCLES:
WORKS WITH SKELETAL
SYSTEM TO PRODUCE
VOLUNTARY MOVEMENT
HELPS TO CIRCULATE
BLOOD
MOVE FOOD THROUGH
DIGESTIVE SYSTEM
FUNCTIONS OF
SKELETAL SYSTEM:
SUPPORT
PROTECTION
MOVEMENTS
STORAGE OF MINERALS
PRODUCTION OF BLOOD
CELLS
FUNCTIONS OF
MUSCULOSKELETAL SYSTEM
8. BONES ARE ONE OF THE TYPE OF CONNECTIVE TISSUE.
THERE ARE SIX TYPE OF BONES:
SKELETAL SYSTEM
LONG
BONES
SHORT
BONES
FLAT BONES
SESAMOID
BONES
IRREGULAR
BONES
PNEUMATIC
BONES
10. STRUCTURAL CLASSIFICATION
FIBROUS JOINTS: SUTURES, SYNDESMOSIS.
GOMPHOSIS
CARTILAGINOUS: PRIMARY/SYNCHONDROSIS,
SECONDARY/SYMPHYSIS/AMPHIARTHROSIS
SYNOVIAL JOINTS: BALL AND SOCKET JT, SADDLE JT,
CONDYLAR JT,ELLIPSOID JT, HINGE JT, PIVOT JOINT,
PLANE JT.
TYPES OF JOINTS:
11. BALL AND SOCKET JT.
HINGE JOINT
SADDLE JOINT
ELLIPSOID JOINT
PIVOT JOINT
12. 1. PAIN
2. STIFFNESS
3. REDNESS
4. SWELLING
5. WEAKNESS
6. LOCKING AND TRIGERRING
7. DEFORMITY
8. EXTRA-ARTICULAR MANIFESTATIONS
COMMON SIGN AND SYMPTOMS
13. ORIGINATES FROM JOINTS (ARTHALGIA),
MUSCLES (MYALGIA) OR OTHER SOFT
TISSUES
LOCALISED – EX. GOUT
DIFFUSE PAIN – OSTEOMALACIA, PAGET’S
DISEASE
AGGRAVATES AT MOVEMENT - FRACTURES
PAIN PRESENT AT REST – INFLAMMATION,
INFECTION, TUMOR
PAIN AFTER INJURY
EPISODIC PAIN
FLITTING JOINT PAIN
PAIN
14. EXAMINATION CAN BE DONE IN TWO PARTS
1. GENERAL OBSERVATION
2. EXAMINATION OF INDIVIDUAL JOINTS
EXAMINATION
1. GAIT AND POSTURE
2. MOBILITY
3. INDEPENDENCE
4. MUSCLE WASTING – Primarily due to muscle disease
as in Polymyositis and Secondarily due to disuse,
either due to joint pain or nerve root compression or
peripheral neuropathy.
5. LONG BONES
6. FRACTURES
7. JOINTS
8. TENDONS
GENERAL OBSERVATION
15. BONES:
1. ALTERATION IN SHAPE OR OUTLINE, SHORTENING.
2. DEFORMITY OF CHEST
3. LOCALISED SWELLING OF LONG BONES
EXAMINATION – GENERAL PRINCIPLES
16. EXAMINATION – GENERAL PRINCIPLES
PALPATION
TENDERNESS OF BONES IS FOUND IN LOCAL LESIONS
WHEN THERE IS A DESTRUCTIION, ELEVATION OR
IRRITATION TO PERIOSTEUM AS IN OSTEITIS FIBROSA
CYSTICA, MYELOMATOSIS, INFECTION OF BONES AND
RARELY IN LEUKAEMIA
17. 1. COMMON, PAINFUL AND DISTRESSING.
2. CAN INVOLVE ANY BONE.
3. FRACTURES IN HEALTHY BONES ARE DUE TO
TRAUMA.
4. FRACTURES OF RIBS, VERTEBRAE, SKULL ARE
MOST FREQUENTLY DUE TO COMPLICATIONS OF
BONE DISEASE.
5. MULTIPLE RIB FRACTURES ARE DUE TO FALLS.
6. FRACTURES WITHOUT TRAUMA WHEN A BONE IS
WEAKENED BY DISAESE ARE PATHOLOGICAL
FRACTURES.
7. PRESENTS WITH PAIN, SWELLING AND LOSS OF
MOVEMENT.
FRACTURES
18. LOOK IF IT IS OPEN/CLOSE?
DEFORMITY ( dinner fork deformity in colles’
fracture)
LOCALISED TENDERNESS AND SWELLING
(swelling may be not found if the overlying muscle
mass is large)
CREPITUS (due to abnormal motion of bone
ends)
EVALUATE NERVE SUPPLY TO LIMB DISTAL TO THE
SITE OF FRACTURE (ask to voluntarily move ankle
joint in fracture of femur, if absent, nerve injury
must be suspected)
WHAT TO EXAMINE?
19. INSPECTION:
IMPORTANT TO DECIDE WHETHER IT IS INFLAMMATORY OR
NON-INFLAMATORY.
LOOK FOR SWELLING OR DEFORMITY OF JOINT.
INFLAMMATION ASSOCIATED WITH REDNESS, TENDERNESS
AND WARMTH.
WHETHER THE INVOLVEMENT IS SYMMETRICAL
(RHEUMATOID ARTHRITIS) OR ASYMMETRICAL (PSORIATIC
ARTHROPATHY)
EXAMINATION OF JOINTS:
20. •PALPATION:
•TENDERNESS
•DETERMINE WHETHER THE SWELLING IS DUE TO BONY
ENLARGEMENT, OSTEOPHYTES OR EFFUSION
EXAMINATION OF JOINTS
ASSESSMENT OF TENDERNESS
GRADE - 1 PATIENT SAYS THE JOINT IS TENDER
GRADE - 2 PATIENT WINCES
GRADE - 3 PATIENT WINCES & WITHDRAWS THE
AFFECTED PART
GRADE - 4 PATIENT WILL NOT ALLOW TO TOUCH
THE JOINT
21. CREPITUS:
THIS CAN BE FEEL BY
PLACING ONE HAND
OVER THE JOINT WHILE
IT IS MOVED PASSIVELY
WITH OTHER.
(OSTEOARTHRITIS,
CARTILAGINOUS
FRAGMENTS IN THE
JOINT SPACES
RANGE OF MOVEMENT:
ESTIMATE THE DEGREE
OF LIMITATION BASED
ON THE COMPARISON
WITH NORMAL SIDE.
BOTH ACTIVE AND
PASSIVE MOVEMENT
SHOULD BE ASSESED.
LIMITATION OF
MOVEMENT MAY BE DUE
TO PAIN,
INFLAMMATION,
CONTRACTURES,
MUSCLE
SPASM,EFFUSION, BOMY
OVERGROWTH ETC.
CREPITUS AND RANGE OF MOVEMENT
22. EXAMINATION OF INDIVIDUAL JOINTS
SPINE:
INSPECTION
LOOK FOR DEFORMITY
(SCOLIOSIS,KYPHOSIS,LORDOISIS,GIBBUS)
23. CERVICAL SPINE:
• THE FOLLOWING MOVEMENTS SHOULD BE TESTED
1. FLEXION ( TOUCH CHIN TO CHEST)
2. FLEXION ( LOOK UPTO THE CEILING)
3. ROTATION ( LOOK OVER THE SHOULDERS ONE AFTER
OTHER)
4. LATERAL BENDING (TOUCH THE SHOULDER WITH
EAR)
• ANY PAIN OR PARAESTHESIA IN ARM, SUGGESTS
NERVE ROOT INVOLVEMENT.
• IN CERVICAL NERVE INJURY, NEVER ELICIT ROM.
EXAMINATION OF INDIVIDUAL JOINTS
24. THORACIC SPINE AND LUMBAR SPINE:
•THE FOLLOWING MOVEMENTS ARE TO BE TESTED:
1. FLEXION (TOUCH THE TOES WITHOUT BENDING
KNEES)
2. EXTENSION (BEND BACKWARDS)
3. LATERAL BENDING (RUN THE HANDDOWN THE SIDE
OF THIGH AS FAR AS POSSIBLE)
4. THORACIC ROTATION (SIT WITH ARMS CROSSED,
TWIST ROUND TO THE LEFT AND RIGHT AS FAR AS
POSSIBLE)
Examination of individual joints
25. • PAINFUL RESTRICTED SPINAL MOVEMENTS
IMPORTANT SIGN OF CERVICAL AND LUMBAR
LORDOISIS, ALSO BE FOUND IN VERTEBRAL DISC
DISEASE.
• SPINAL MOVEMENTS VIRTUALLY ABSENT IN
ANKYLOSING SPONDYLITIS.
• PAIN AND LIMITATION OF SLR (Straight Leg Raising)
IN PROLAPSED INTERVERTEBRAL DISC WHERE
IRRITATION OR COMPRESSION OF ONE OF THE
ROOTS OF SCIATIC NERVE.
• SAME CONDITION IN TIGHTNESS OF HAMSTRINGS.
• LASEGUE’S SIGN
Examination of individual joints
26. •NEUTRAL POSITION – ARM TO SIDE, ELBOW FLEXED
AT 90 DEGREE AND FOREARMS POINTING FORWARD.
•SCAPULA IS MOBILE, SO THE EXAMINATION CAN BE
DONE AFTER HOLDING THE SCAPULA BETWEEN
FINGER AND THUMB ON THE POSTERIOR CHEST
WALL.
•MOVEMENTS TO BE EXAMINE:
1. FLEXION
2. EXTENSION
3. ABDUCTION
4. ROTATION IN ABDUCTION
5. ROTATION IN NEUTRAL POSITION
• SUPRASPINATOUS TENDINITIS: FULL ROM + , BUT
PAINFUL ARC ON ABDUCTION
• SUBACROMIAL IMPINGEMENT: (due to bursitis or
rotator cuff abnormality) PRODUCES SEVERE PAIN
AT THE END OF ABDUCTION.
EXAMINATION OF SHOULDER:
27. THE ELBOW
• NEUTRAL POSITION IS
FOREARM EXTENDED.
• MOVEMENTS TO BE
EXAMINED
1. FLEXION
2. HYPEREXTENSION
• GOLFER’S ELBOW –
PAIN ON WRIST FLEXION
• TENNIS ELBOW – PAIN
ON WRIST EXTENSION
FOREARM:
• NEUTRAL POSITION IS
ARM BY THE SIDE,
ELBOW FLEXED TO 90
DEGREE WITH THUMB
UPPERMOST.
• MOVEMENTS TO
EXAMINE:
1. SUPINATION
2. PRONATION
EXAMINATION OF ELBOW, FOREARM
28. THE WRIST:
NEUTRAL
POSITION IS
HAND IN THE
LINE OF
FOREARM AND
PALM DOWN
MOVEMENTS TO
BE TESTED
1. DORSIFLEXION
2. PALMAR
FLEXION
3. ULNAR
DEVIATION
4. RADIAL
DEVIATION
THE FINGERS:
NEUTRAL
POSITION IS
WITH FINGERS
EXTENSION
TEST FLEXION
AT:
1. METACARPOPH
ALANGEAL
JOINT
2. PROXIMAL
INTERPHALAN
GEAL JOINT
3. DISTAL
INTERPHALAN
GEAL JOINT
THE THUMB:
NEUTRAL
POSITION IS
THUMB
ALONGSIDE
FOREFINGER
AND
EXTENDED.
MOVEMENTS
TO BE TESTED:
1. EXTENSION
2. FLEXION
3. OPPOSITION
4. ABDUCTION
EXAMINATION OF WRIST, FINGERS AND
THUMB
29. HEBERDEN’S NODES AND BOUCHARD’S NODES
SWAN NECK DEFORMITY
PSORIATIC PIITING DEFORMITY
EXAMINATION OF HAND:
30. ULNAR NERVE LESION – CLAW HAND
MEDIAN NERVE LESION - HAND OF BENEDICT
DEFORMITY
EXAMINATION OF HAND:
31. THE HIP:
•NEUTRAL POSITION IS HIP
IN EXTENSION WITH
PATELLA POINTING
FORWARDS.
•MOVEMENTS TO BE TESTED:
1. FLEXION
2. ABDUCTION
3. ADDUCTION
4. ROTATION IN FLEXION
5. ROTATION IN EXTENSION
6. EXTENSION
• ADDITIONAL
EXAMINATION
1. TRENDELENBURG TEST
2. MEASUREMENT OF TRUE
AND APPARENT
SHORTENING.
THE KNEE
• NEUTRAL PSITION IS
COMPLETE EXTENSION
1. OBSERVE ANY VALGUS
(LATERAL ANGULATION
OF TIBIA) OR VARUS
(MEDIAL ANGULATION)
ON STANDING.
2. LOOK FOR MUSCLE
WASTING
3. SWELLING
4. TENDERNESS
EXAMINATION OF HIP AND KNEE
32. THE ANKLE:
•NEUTRAL POSITION IS
OUTER BORDER OF FOOT AT
AN ANGLE OF 90 DEGREES
WITH LEG AND MIDWAY
BETWEEN INVERSION AND
EVERSION.
•LOOK FOR VALGUS AND
VARUS DEFORMITY
•CALF MUSCLE WASTING IN
LONG STANDING ANKLE
DISEASES
•MOVEMENTS TO BE TESTED
•DORSIFLEXION
•PLANTAR FLEXION
•THE FOOT:
•THERE MAY BEABNORMAL
SPREAD OF 2 ADJACENT
WOSIF THERE IS
INTERPHALANGEAL BURSA
IN BETWEEN. (Daylight sign)
•CHECK FOR HALLUX
VALGUS (Lat. Deviation of
big toe), CLAW TOES
(Abnormal curvatures)
•MOVEMENTS TO BE
TESTED:
1. SUBTALAR INVERSION
AND EVERSION
2. METATARSOPHALANGEAL
AND INTERPHALANGEAL
FLEXION/EXTENSION
EXAMINATION OF ANKLE AND FOOT:
33. CONGENITAL DISEASES:
1. SPINA BIFIDA - Neural tube defect, spine and spinal
cord doesn’t form properly.
2. OSTEOGENESIS IMPERFECTA (BRITTLE BONE DISEASE)
– Inherited connective tissue disorder. Triad – blue
sclera, osseous fragility, conductive hearing loss.
3. ARTHROGRYPOSIS MULTIPLEX – Involves variety of
conditions involving multiple joint contractures.
4. MARFAN SYNDROME – Inherited disorder that affects
connective tissues. Mutation in gene FBN1.
5. FIBROUS DYSPLASIA – It is a benign, non-cancerous
condition in which scar tissue in grows in place of
normal bone.
6. DUCCHENE MUSCULAR DYSTROPHY – It is a genetic
disorder- progressive muscle degeneration and
weakness due to alteration of protein called
‘Dystrophin’.
PATHOLOGIC CONDITIONS OF
MUSCULOSKELETAL SYSTEM
35. 5. CERVICAL SPONDYLOSIS: Age related, wear and tear
affecting the spinal disks of neck.
6. ANKYLOSING SPONDYLITIS: Inflammatory disease that
causes some of bones to fuse and makes them less
flexible and hunched posture.
7. OSTEOMYELITIS:
ACQUIRED SKELETAL DISEASES
36. 8. KOCH’S SPINE: Tuberculosis of spine
9. OSTEOMALACIA: Nutritional disease, caused due
to long standing deficiency of vitamin D that
results in less resorption of calcium and weakens
the bones.
10.RICKETS: same as osteomalacia but occurs in
children
11.OSTEOPOROSIS