This document provides information on performing a neurological examination. It begins with an overview of the cranial nerves and methods for testing each one, including sensory function, motor function and reflexes. It then discusses examining the sensory system through tests of superficial and deep sensation. The motor system is evaluated through assessing muscle bulk, tone, power and coordination. Deep tendon reflexes are also tested. Finally, the document outlines how to examine a patient's gait. The overall summary is that this document outlines the key components and procedures for performing a full neurological examination.
Health assessment or clinical examination (more popularly known as a check-up) is the process by which a doctor investigates the body of a patient for signs of disease.
A physical examination is a routine test your primary care provider (PCP) performs to check your overall health. A PCP may be a doctor, a nurse practitioner, or a physician assistant. The exam is also known as a wellness check
Explain methods of locating acupuncture points and manipulating needles
Identify the precautions, contraindications and management of possible adverse events in acupuncture treatment.
Acupuncture
Acupuncture defined as the insertion of metallic needles in specific points of the body meridians to prevent/treat disease.
WHAT IS ACUPUNCTURE POINTS?
They are locations on the body that are the focus of acupuncture, acupressure, nonopuncture and laser acupuncture treatment.
• Several hundred acupuncture points are considered to be located along meridians
The methods commonly used to locate acupoints are :
bone length measurement,
anatomical landmarks,
Finger measurement
simple location and
searching acupoints
- MANIPULATION OF NEEDLES IN ACUPUNCTURE.
Acupuncture needles are typically made of stainless steel wire and
provided in sterilized enclosed packages. They are disposable and only used once.
• The needles are extremely thin.
• The needles are inserted into specific acupuncture points on the body, and are sometimes spun to provide additional therapeutic stimulation
NEEDLING TECHNIQUE
The skin is sterilized and the needles are inserted, frequently with a plastic guide tube. Needles may be
manipulated in various ways, e.g. spun, flicked, or moved up and down relative to the skin.
• Since most pain is felt in the superficial layers of the skin, a quick insertion of the needle is
recommended. Acupuncture can be painful. The skill level of the
acupuncturist, so it depends on the skill level and experience
Health assessment or clinical examination (more popularly known as a check-up) is the process by which a doctor investigates the body of a patient for signs of disease.
A physical examination is a routine test your primary care provider (PCP) performs to check your overall health. A PCP may be a doctor, a nurse practitioner, or a physician assistant. The exam is also known as a wellness check
Explain methods of locating acupuncture points and manipulating needles
Identify the precautions, contraindications and management of possible adverse events in acupuncture treatment.
Acupuncture
Acupuncture defined as the insertion of metallic needles in specific points of the body meridians to prevent/treat disease.
WHAT IS ACUPUNCTURE POINTS?
They are locations on the body that are the focus of acupuncture, acupressure, nonopuncture and laser acupuncture treatment.
• Several hundred acupuncture points are considered to be located along meridians
The methods commonly used to locate acupoints are :
bone length measurement,
anatomical landmarks,
Finger measurement
simple location and
searching acupoints
- MANIPULATION OF NEEDLES IN ACUPUNCTURE.
Acupuncture needles are typically made of stainless steel wire and
provided in sterilized enclosed packages. They are disposable and only used once.
• The needles are extremely thin.
• The needles are inserted into specific acupuncture points on the body, and are sometimes spun to provide additional therapeutic stimulation
NEEDLING TECHNIQUE
The skin is sterilized and the needles are inserted, frequently with a plastic guide tube. Needles may be
manipulated in various ways, e.g. spun, flicked, or moved up and down relative to the skin.
• Since most pain is felt in the superficial layers of the skin, a quick insertion of the needle is
recommended. Acupuncture can be painful. The skill level of the
acupuncturist, so it depends on the skill level and experience
A neurological examination is the assessment of sensory neuron and motor responses, especially reflexes, to determine whether the nervous system is impaired. This typically includes a physical examination and a review of the patient's medical history, but not deeper investigation such as neuroimaging.
A neurological examination is the assessment of sensory neuron and motor responses, especially reflexes, to determine whether the nervous system is impaired.
definition
indication
purpose
articles
components:
====
Level of consciousness
Mental status examination
Sensory cerebral function
Cranial nerves
Reflexes
Motor system
Sensory system
Cerebellar function
---
role of nurse
A neurological examination is the assessment of sensory neuron and motor responses, especially reflexes, to determine whether the nervous system is impaired. This typically includes a physical examination and a review of the patient's medical history, but not deeper investigation such as neuroimaging.
A neurological examination is the assessment of sensory neuron and motor responses, especially reflexes, to determine whether the nervous system is impaired.
definition
indication
purpose
articles
components:
====
Level of consciousness
Mental status examination
Sensory cerebral function
Cranial nerves
Reflexes
Motor system
Sensory system
Cerebellar function
---
role of nurse
Introduction:
RNA interference (RNAi) or Post-Transcriptional Gene Silencing (PTGS) is an important biological process for modulating eukaryotic gene expression.
It is highly conserved process of posttranscriptional gene silencing by which double stranded RNA (dsRNA) causes sequence-specific degradation of mRNA sequences.
dsRNA-induced gene silencing (RNAi) is reported in a wide range of eukaryotes ranging from worms, insects, mammals and plants.
This process mediates resistance to both endogenous parasitic and exogenous pathogenic nucleic acids, and regulates the expression of protein-coding genes.
What are small ncRNAs?
micro RNA (miRNA)
short interfering RNA (siRNA)
Properties of small non-coding RNA:
Involved in silencing mRNA transcripts.
Called “small” because they are usually only about 21-24 nucleotides long.
Synthesized by first cutting up longer precursor sequences (like the 61nt one that Lee discovered).
Silence an mRNA by base pairing with some sequence on the mRNA.
Discovery of siRNA?
The first small RNA:
In 1993 Rosalind Lee (Victor Ambros lab) was studying a non- coding gene in C. elegans, lin-4, that was involved in silencing of another gene, lin-14, at the appropriate time in the
development of the worm C. elegans.
Two small transcripts of lin-4 (22nt and 61nt) were found to be complementary to a sequence in the 3' UTR of lin-14.
Because lin-4 encoded no protein, she deduced that it must be these transcripts that are causing the silencing by RNA-RNA interactions.
Types of RNAi ( non coding RNA)
MiRNA
Length (23-25 nt)
Trans acting
Binds with target MRNA in mismatch
Translation inhibition
Si RNA
Length 21 nt.
Cis acting
Bind with target Mrna in perfect complementary sequence
Piwi-RNA
Length ; 25 to 36 nt.
Expressed in Germ Cells
Regulates trnasposomes activity
MECHANISM OF RNAI:
First the double-stranded RNA teams up with a protein complex named Dicer, which cuts the long RNA into short pieces.
Then another protein complex called RISC (RNA-induced silencing complex) discards one of the two RNA strands.
The RISC-docked, single-stranded RNA then pairs with the homologous mRNA and destroys it.
THE RISC COMPLEX:
RISC is large(>500kD) RNA multi- protein Binding complex which triggers MRNA degradation in response to MRNA
Unwinding of double stranded Si RNA by ATP independent Helicase
Active component of RISC is Ago proteins( ENDONUCLEASE) which cleave target MRNA.
DICER: endonuclease (RNase Family III)
Argonaute: Central Component of the RNA-Induced Silencing Complex (RISC)
One strand of the dsRNA produced by Dicer is retained in the RISC complex in association with Argonaute
ARGONAUTE PROTEIN :
1.PAZ(PIWI/Argonaute/ Zwille)- Recognition of target MRNA
2.PIWI (p-element induced wimpy Testis)- breaks Phosphodiester bond of mRNA.)RNAse H activity.
MiRNA:
The Double-stranded RNAs are naturally produced in eukaryotic cells during development, and they have a key role in regulating gene expression .
Observation of Io’s Resurfacing via Plume Deposition Using Ground-based Adapt...Sérgio Sacani
Since volcanic activity was first discovered on Io from Voyager images in 1979, changes
on Io’s surface have been monitored from both spacecraft and ground-based telescopes.
Here, we present the highest spatial resolution images of Io ever obtained from a groundbased telescope. These images, acquired by the SHARK-VIS instrument on the Large
Binocular Telescope, show evidence of a major resurfacing event on Io’s trailing hemisphere. When compared to the most recent spacecraft images, the SHARK-VIS images
show that a plume deposit from a powerful eruption at Pillan Patera has covered part
of the long-lived Pele plume deposit. Although this type of resurfacing event may be common on Io, few have been detected due to the rarity of spacecraft visits and the previously low spatial resolution available from Earth-based telescopes. The SHARK-VIS instrument ushers in a new era of high resolution imaging of Io’s surface using adaptive
optics at visible wavelengths.
This pdf is about the Schizophrenia.
For more details visit on YouTube; @SELF-EXPLANATORY;
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Slide 1: Title Slide
Extrachromosomal Inheritance
Slide 2: Introduction to Extrachromosomal Inheritance
Definition: Extrachromosomal inheritance refers to the transmission of genetic material that is not found within the nucleus.
Key Components: Involves genes located in mitochondria, chloroplasts, and plasmids.
Slide 3: Mitochondrial Inheritance
Mitochondria: Organelles responsible for energy production.
Mitochondrial DNA (mtDNA): Circular DNA molecule found in mitochondria.
Inheritance Pattern: Maternally inherited, meaning it is passed from mothers to all their offspring.
Diseases: Examples include Leber’s hereditary optic neuropathy (LHON) and mitochondrial myopathy.
Slide 4: Chloroplast Inheritance
Chloroplasts: Organelles responsible for photosynthesis in plants.
Chloroplast DNA (cpDNA): Circular DNA molecule found in chloroplasts.
Inheritance Pattern: Often maternally inherited in most plants, but can vary in some species.
Examples: Variegation in plants, where leaf color patterns are determined by chloroplast DNA.
Slide 5: Plasmid Inheritance
Plasmids: Small, circular DNA molecules found in bacteria and some eukaryotes.
Features: Can carry antibiotic resistance genes and can be transferred between cells through processes like conjugation.
Significance: Important in biotechnology for gene cloning and genetic engineering.
Slide 6: Mechanisms of Extrachromosomal Inheritance
Non-Mendelian Patterns: Do not follow Mendel’s laws of inheritance.
Cytoplasmic Segregation: During cell division, organelles like mitochondria and chloroplasts are randomly distributed to daughter cells.
Heteroplasmy: Presence of more than one type of organellar genome within a cell, leading to variation in expression.
Slide 7: Examples of Extrachromosomal Inheritance
Four O’clock Plant (Mirabilis jalapa): Shows variegated leaves due to different cpDNA in leaf cells.
Petite Mutants in Yeast: Result from mutations in mitochondrial DNA affecting respiration.
Slide 8: Importance of Extrachromosomal Inheritance
Evolution: Provides insight into the evolution of eukaryotic cells.
Medicine: Understanding mitochondrial inheritance helps in diagnosing and treating mitochondrial diseases.
Agriculture: Chloroplast inheritance can be used in plant breeding and genetic modification.
Slide 9: Recent Research and Advances
Gene Editing: Techniques like CRISPR-Cas9 are being used to edit mitochondrial and chloroplast DNA.
Therapies: Development of mitochondrial replacement therapy (MRT) for preventing mitochondrial diseases.
Slide 10: Conclusion
Summary: Extrachromosomal inheritance involves the transmission of genetic material outside the nucleus and plays a crucial role in genetics, medicine, and biotechnology.
Future Directions: Continued research and technological advancements hold promise for new treatments and applications.
Slide 11: Questions and Discussion
Invite Audience: Open the floor for any questions or further discussion on the topic.
A brief information about the SCOP protein database used in bioinformatics.
The Structural Classification of Proteins (SCOP) database is a comprehensive and authoritative resource for the structural and evolutionary relationships of proteins. It provides a detailed and curated classification of protein structures, grouping them into families, superfamilies, and folds based on their structural and sequence similarities.
Nutraceutical market, scope and growth: Herbal drug technologyLokesh Patil
As consumer awareness of health and wellness rises, the nutraceutical market—which includes goods like functional meals, drinks, and dietary supplements that provide health advantages beyond basic nutrition—is growing significantly. As healthcare expenses rise, the population ages, and people want natural and preventative health solutions more and more, this industry is increasing quickly. Further driving market expansion are product formulation innovations and the use of cutting-edge technology for customized nutrition. With its worldwide reach, the nutraceutical industry is expected to keep growing and provide significant chances for research and investment in a number of categories, including vitamins, minerals, probiotics, and herbal supplements.
10. Orientation-
• It refers to patient’s awareness of time,place
and person.
TIME- Ask the patient to tell the
year,season,date,day and month.
PLACE- Ask for the
state,country,town,hospital and floor in which
he is admitted.
PERSON- Ask for the identify of his nearby
relatives or neighbours.
11. MEMORY-
1. Immediate – Eg. Repeat a sequence of
5,6,7.
2. Short term/Recent- Weeks to months-
Eg. – Ask patient to describe present
illness,duration of hospital stay etc.
3. Long term/Remote-month- years.-Eg.
Date and place of birth,date of
marriage,no.of siblings,etc.
14. LANGUAGE AND SPEECH
• It is the expressions of thought by production of articulate
sound, bearing a definite meaning.
• When a sound is produced verbally, it is called SPEECH.
Nervous control of speech-
MOTOR AREA-
Broca’s area-Lower
frontal area(44,45).
It controls the
movement of
structure(tongue,lips
and larynx) involved in
vocalization.
SENSORY AREA-
Wernicke’s area-Upper part
of temporal lobe(22).
It is reponsible for
understanding the auditory
info. About any word and
sending the info.to Broca’s
area.
17. CRANIAL NERVES
I. Olfactory
II. Optic
III. Occulomotor
IV. Trochlear
V. Trigeminal
VI. Abducent
VII. Facial
VIII.Vestibulocochlear
IX. Glossopharyngeal
X. Vagus
XI. spinal accessory
XII. Hypoglossal
20. • TESTING:
Sense of smell is tested by asking the patient
to sniff various non-irritating substances (like
tea, coffee, clove oil, peppermint oil,etc)
Seperately each nostrils should be tested.
Avoid irritating substances like ammonia.
28. VISUAL FIELDS
• The visual field refers to the total area in
which objects can be seen in the
side(peripheral) vision while you focus your
eyes on a central point.
• Test is done by CONFRONTATION method
29.
30. • PERIMETRY-
o It is the measurement of visual functions of
eye at topographically defined loci in the
visual field.
o Usually each eye is tested seperately, however
when both eyes are tested together it is
binocular field of vision
34. COLOUR VISION
• Best tested by pseudoisochromatic plates of
ISHIHARA.
• The plates are so constructed that a person
with normal color vision will be able to read a
number which a person with defective color
vision will not.
• The most common defect of color vision is
red-green deficiency, inherited as a sex linked
recessive condition.
39. Method-
The patient is asked to look at a distant object
and then at the examiner’s finger which is
gradually brought within 5cms of the eyes.
When the gaze is directed from a distant to a
near object, contraction of the medial recti
brings about a convergence of the occular
axes and along with this, accomodation occurs
by contraction of the cilliary muscles and
pupils contrict as a part of associated
movement.
42. Functions:
• Controls the extraoccular muscles and
elevators of eye lids.
• Also regulates the pupillary muscles.
43. Testing:
Inspect the pupils to rule out local disease,
peripheral lesions or a nuclear involvement.
Examine eye movements and determine if
defect is muscular origin or neural
involvement
To detect nystagmus.
44. Method:
• Observation
- presence or absence of squint
-whether unilateral or bilateral
-constant or variable
-size, shape, equality and regularity of pupil
45. • Reaction to light- the pupil should constrict
briskly
• Reaction to convergence and accomodation
for near vision-
- fix vision on a distant object and instruct to
look in a near object
-place finger tip in front of bridge of nose
-then return to the far object.
-observe pupillary reaction in both
55. Taste- it may be tested by using sugar, tartaric acid
or sodium chloride. A small quantity of each
substance is placed on the appropriate side of the
protruded tongue.
69. SENSORY SYSTEM EXAMINATION
• Superficial sensations
1. Touch
2. Pain
3. Temperature
4. Pressure
• Deep Sensations
1. Proprioception
2. Vibration
• Combine or cortical sensations
1. Tectile location
2. Two point discrimination.
3. Stereognosis.
4. Barognosis.
5. Graphesthesia
70. • Touch - Tested with cotton wisp / camel hair brush.Compare one side
other (check in each dermatome).
CAUTION-cotton wool/pin should be discarded after
use with one patient.
71. • Pain – sharp and dull end of safety pin.
Ask the patient to close the eyes.All the areas of the body is
stimulated.Ask the patient to indicate when the stimulus is
felt by responding YES/NO.
72. • Temperature – 2 laboratory test tubes – one containing
hot H20(40o-45oc)& other crushed ice(5o-10oc) – place on all
parts of the body.
73. • Pressure – Tested by pressure algometer/ by pressure on
deep structure (muscle, tendon, nerves) using finger pressure
/ blunt object.
74. • Proprioception– This test examines’’joint position sense and
awareness of joint at rest.’’
Patient’s extremity//joint is held in a static position,patient is then asked
to describe the position verbally/to duplicate the position of extremity or
joint with the contralateral extremity.
76. • Vibration – A low frequency tuning fork of 128 Hz is used to
test the vibration sense.
Firstly, patient is asked to close his/her eyes then
vibrating tuning fork is placed over the bony
prominences,Patient is asked to say “Yes” when he feels the
vibration.
77. Two point discrimination-
Randomly apply one/two points of the tool(5mm,4mm,3mm
apart),starting with the greater distance first.
Patient is then asked to report whether they feel either one point or two
points..
Record the distances at which the patient is able to discriminate two
points.
78. • Sterognosis –
Ability to identify an object by feeling it.
Place familiar object in patient’s hand and ask patient to identify it
with eyes closed.
Familiar objects such as coin, keys,comb,paperclip,etc.
79. • Graphaesthesia – It is the ability to recognize
letter/no/ designs traced on the skin with a pencil,
dull pin or similar object.
Ask the patient to close their eyes and identify the no. or
letter you will write with the back of the pen on their
palm.Repeat on the other hand with a different no./letter.
80. • Barognosis –Ability to recognize different
weights.
Ask the patient to close their eyes and objects are placed in both the
hands simultaneously the patient is then asked to compare the weight of
two objects.The patient responds by indicating whether the object is
heavier/lighter.
84. Muscle bulk
• Full exposure of the limb to be tested.
• Look for asymmetry, inspecting both
proximally and distally. (Girth measurement)
• Wasting or hypertrophy, fasciculation and
involuntary movement.
85. Tone
• It is the resistance felt by the examiner when
moving a joint passively through its range of
motion
86. • Hypotonia(flaccidity)- It is characterized by
flabby muscles, which offer less resistance to
passive movements and the limb is unable to
maintain posture.
Causes-
1. LMN disease- poliomyelitis, peripheral neuritisetc.
2. Cerebellar disease
3. Rheumatic chorea
87. • Hypertonia- it is increased resistance to
passive movements, a heightened salience of
the muscles and increased firmness on
palpation
Causes-
1. Pyramidal disorders
2. Extrapyramidal disorders
3. Tetanus
4. Tetany
88. Types of hypertonia-
o Clasp knife spasticity (SPASTICITY): There is increased tone in
the flexors of upper limbs. The resistance is increased at the
beginning and end of the passive movement. This is seen in
pyramidal lesions.
o Lead-pipe rigidity: There is increased tone in both flexor and
extensors. The resistance is present throughout the entire
range of movement. This is seen in extrapyramidal lesion
o Cog wheel rigidity (RIGIDITY): The increased resistance is
throughout the entire range of passive movement and is
rhythemically jerky. It is also seen in extrapyramidal lesion.
93. Picture showing direction of
contractions while stroking
over the abdomen.
The umbilicus will shift
towards the direction of
stoke and retract.
94. Absent abdominal response:
1. Lesion of local reflex arch of T6-T12
2. Pyramidal lesion
3. Marked obesity and abdominal distention
4. Multiparous women with lax abdomen
95. • Cremasteric reflex(L1)-
- Stroking the skin on the upper, inner aspect of
the thigh, from above downwards with a blunt
point.
- Response- contraction of the cremasteric
muscle with homolateral elevation of the
testicles.
- Absent response-
1. Lesion of local reflex arch of L2
2. Pyramidal lesion
3. Hydrocele
4. Hernia
97. • Bulbocavernous reflex(S3,S4)- stroking over
the dorsum of the glans penis, contraction of
bulbocavernous will be seen.
• Anal reflex(S4,S5)- on stroking over the
perineal region contraction of the anal
sphincter will be seen.
105. POWER
• The power of all the muscles should be tested
at each joint in both upper limb and lower
limb against gravity and against resistance .
Power of individual muscles is graded as
follows:
