The musculoskeletal system consists of bones, joints, and muscles that work together to enable movement and protect internal organs. The skeleton provides structure and support, while joints allow bones to articulate and muscles to contract, producing movement. There are over 200 bones in the human body that form the framework for this system. Joints are where two or more bones connect, and can be immovable or freely movable. Muscles make up 40-50% of body weight and attach to bones via tendons, allowing motions like flexion, extension, and rotation when contracted. Landmarks, range of motion, and strength are assessed during a physical exam of this complex anatomical system.
Palpation of knee joint can be done in various positions based on the comfort of the patient and therapist. If the patient is sitting, high sitting is a good position to start. If not, supine is an alternative position where the patient is most relaxed; as shown by Hutchinson in the BJSM video.
Practice is the key to master the examination. The students should be aware of the location of the structures in such a way that you should be able to see through the skin and locate the structures underneath. Practice by marking the skin for various structures under the skin.
Palpation of knee joint can be done in various positions based on the comfort of the patient and therapist. If the patient is sitting, high sitting is a good position to start. If not, supine is an alternative position where the patient is most relaxed; as shown by Hutchinson in the BJSM video.
Practice is the key to master the examination. The students should be aware of the location of the structures in such a way that you should be able to see through the skin and locate the structures underneath. Practice by marking the skin for various structures under the skin.
Biomechanics of Ankle joint- intended to share the powerpoint with first year undergraduate students at Kathmandu University School of Medical Sciences, Nepal.
Knee clinical examination for orthopaedic residents.dr mohamed ashraf TD medi...drashraf369
a comprehensive and examination oriented presentation of clinical examination of knee joint.contains lot of demonstrations and tips.author is dr mohamed ashraf,professor and head of orthopaedics,govt TD medical college hospital,alleppey,kerala,india. drashraf369@gmail.com
Biomechanics of Ankle joint- intended to share the powerpoint with first year undergraduate students at Kathmandu University School of Medical Sciences, Nepal.
Knee clinical examination for orthopaedic residents.dr mohamed ashraf TD medi...drashraf369
a comprehensive and examination oriented presentation of clinical examination of knee joint.contains lot of demonstrations and tips.author is dr mohamed ashraf,professor and head of orthopaedics,govt TD medical college hospital,alleppey,kerala,india. drashraf369@gmail.com
Lower limb neurological examination frequently appears in OSCEs. You’ll be expected to pick up the relevant clinical signs using your examination skills. This lower limb neurological examination OSCE guide provides a clear, concise, step-by-step approach to performing a neurological examination of the lower limb
Food hygiene is more than cleanliness ......
Protecting food from risk of contamination, including harmful bacteria, poison and other foreign bodies.
Preventing any bacteria present multiplying to an extent which would result in the illness of consumers or the early spoilage of the food.
Destroying any harmful bacteria in the food by thorough cooking
or processing.
Discarding unfit or contaminated food.
T-Cell Activation
• Concept of immune response
• T cell-mediated immune response
• B cell-mediated immune response
I. Concept of immune response
• A collective and coordinated response to the introduction of foreign substances in an individual mediated by the cells and molecules in the immune system.
II. T cell-mediated immune response
• Cell-mediated immunity is the arm of the adaptive immune response whose role is to combat infection of intracellular pathogens, such as intracellular bacteria (mycobacteria, listeria monocytogens), viruses, protozoa, etc.
Major Histocompatibility Complex
MHC:
• Major Histocompatibility Complex
– Cluster of genes found in all mammals
– Its products play role in discriminating self/non-self
– Participant in both humoral and cell-mediated immunity
• MHC Act As Antigen Presenting Structures
• In Human MHC Is Found On Chromosome 6
– Referred to as HLA complex
• In Mice MHC Is Found On Chromosome 17
– Referred to as H-2 complex
• Genes Of MHC Organized In 3 Classes
– Class I MHC genes
• Glycoproteins expressed on all nucleated cells
• Major function to present processed Ags to TC
– Class II MHC genes
• Glycoproteins expressed on macrophages, B-cells, DCs
• Major function to present processed Ags to TH
– Class III MHC genes
• Products that include secreted proteins that have immune functions. Ex. Complement system, inflammatory molecules
Antigen Processing and Presentation MID
Antigens and “foreignness”
• Antigens (or, more properly, immunogens) have a series of features which confer immunogenicity.
• One of these features is “foreignness.”
• So, we can infer that – most often – antigens – ultimately – originate externally.
• (There are exceptions, of course. Some cells become transformed by disease [e. g., cancer] or by aging. In such instances, the antigens have an internal origin.)
Extinction of a particular animal or plant species occurs when there are no more individuals of that species alive anywhere in the world - the species has died out. This is a natural part of evolution. But sometimes extinctions happen at a much faster rate than usual. Natural Causes of Extinction.
Difference between In-Situ and Ex-Situ conservation
Conservation of biodiversity and genetic resources helps protect, maintain and recover endangered animal and plant species. There are mainly two strategies for the conservation of wildlife: In-situ conservation and Ex-situ conservation. Although, both the strategies aim to maintain and recover endangered species, they are different from each other. Let us see how they differ from each other!
Evolution Of Bacteria
Bacteria have existed from very early in the history of life on Earth. Bacteria fossils discovered in rocks date from at least the Devonian Period (419.2 million to 358.9 million years ago), and there are convincing arguments that bacteria have been present since early Precambrian time, about 3.5 billion years ago. Bacteria were widespread on Earth at least since the latter part of the Paleoproterozoic, roughly 1.8 billion years ago, when oxygen appeared in the atmosphere as a result of the action of the cyanobacteria. Bacteria have thus had plenty of time to adapt to their environments and to have given rise to numerous descendant forms.
Impact of Environment on Loss of Genetic Diversity and Speciation
Genetic variation describes naturally occurring genetic differences among individuals of the same species. This variation permits flexibility and survival of a population in the face of changing environmental circumstances. Consequently, genetic variation is often considered an advantage, as it is a form of preparation for the unexpected. But how does genetic variation increase or decrease? And what effect do fluctuations in genetic variation have on populations over time?
GENE ENVIRONMENT INTERACTION
Subtle differences in one person’s genes can cause them to respond differently to the same environmental exposure as another person. As a result, some people may develop a disease after being exposed to something in the environment while others may not.
As scientists learn more about the connection between genes and the environment, they pursue new approaches for preventing and treating disease that consider individual genetic codes.
How to store food in hot
The Good News
To maximize benefit of preservation, keep your food as fresh as possible for as long as possible. You can do this, even in the heat, by creating a “cooler” made from two basic terra cotta pots, one larger than the other. Put the smaller pot in the larger one, fill the gap with sand, and saturate the sand with water. Then cover it with a cloth. To add additional insulation from the heat, bury the pot up to its rim. The evaporation of moisture from the wet sand will cool the air around the food and help keep it fresh.
What is IUPAC naming?
In order to give compounds a name, certain rules must be followed. When naming organic compounds, the IUPAC (International Union of Pure and Applied Chemistry) nomenclature (naming scheme) is used. This is to give consistency to the names. It also enables every compound to have a unique name, which is not possible with the common names used (for example in industry). We will first look at some of the steps that need to be followed when naming a compound, and then try to apply these rules to some specific examples.
IUPAC Nomenclature
IUPAC nomenclature uses the longest continuous chain of carbon atoms to determine the basic root name of the compound. The root name is then modified due to the presence of different functional groups which replace hydrogen or carbon atoms in the parent structure.
Hybridization describes the bonding atoms from an atom's point of view. For a tetrahedral coordinated carbon (e.g. methane CH4), the carbon should have 4 orbitals with the correct symmetry to bond to the 4 hydrogen atoms.
INTRODUCTION:
Hybrid Orbitals
Developed by Linus Pauling, the concept of hybrid orbitals was a theory created to explain the structures of molecules in space. The theory consists of combining atomic orbitals (ex: s,p,d,f) into new hybrid orbitals (ex: sp, sp2, sp3).
1. Why Firefly give light during night?
2. Why atomic mass and Atomic numbers are given to elements ?
3. Why elements have been characterized and classified into different groups?
4. What is the transition of elements and what they play their role in elements stability?
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
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Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
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
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
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.
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
Pharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptx
Musculoskeletal System
1. Musculoskeletal System
Introduction
- its consist of bon’s, joints& muscles
Functions:
1- support to stand erect
2- For movement
3- encase & protect inner vital organs (brain, spinal cord, heart)
4- produce RBC in bone marrow (hematopoiesis)
5- a reservoir for storage essential minerals as Ca & Ph in bones
Component of M.S system
Skeleton is the bony framework of body , it has 206 bones, bone hard, continually
turnover . Joints is the place of union of 2 or more bones, its permit permeability.
Nonsynovial or Synovial Joints:
In non Synovial joints bones are united by fibrous tissue or cartilage & immovable
(vertebra). Synovial joints frely movable, cavity filled with a lubricant or synovial fluid.
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2. It has a layer of cartilage covers the surface of opposing bones, cushions the bones &
gives a smooth surface to facilitate movement.
Joints surrounded by ligaments.
Muscles: 40-50% of body weight, when they contract produce movement.
3 types: skeletal, smooth, cardiac .skeletal is voluntary muscles.
Skeletal muscles are attached to bones by a tendon: producing the following
movements:
1- flexion: bending a limb at a joint
2- Extension: straightening a limb at a joint
3- Abduction: moving a limb away from midline
4- Adduction: moving a limb toward midline.
5- pronation: turning the forearm so that palm is down
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3. 6- Supination: turning forearm so palm up.
7- Circumduction: moving arm in a circle around the shoulder
8- Inversion: moving sole of foot inward at ankle
9- Eversion: moving sole of foot outward at ankle
10- Rotation: moving head around a central axis
11- protraction: moving a body part forward & parallel to ground.
12- Retraction: moving a body part backward& parallel to ground.
13- Elevation: raising a body part
14- Depression: lowering a body part.
Landmarks
Temporomandibular joint: articulation of mandible & temporal bone
Spine:
1- C7& T1 prominent
2- inferior angle of scapula between T7& T8.
3- line of iliac crest crosses L4
4- line of posterior iliac spines crosses sacrum
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4. Shoulder: 1- acromion process; at the top of shoulder 2- greater tubercle of humerus
Elbow: 1- medial & lateral epicondyles of humerus 2- olecranon process of ulna
Wrist & carpals:
1- radiocarpal joint: articulation of radius & a row of carpal bones permit flexion&
extension& side to side deviation
2- midcarpal joint : between 2 rows of carpal bones. Allows flexion , extension & rotation
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7. Subjective Data:
1) Joints: pain-stiffness-swelling-heat-redness-limitation of movement
2)muscles: pain (cramps)- weakness
3) bones: pain- deformity- trauma
4) functional assessment (ADL): bathing- toileting -grooming-eating…..etc
5) self care behaviors
* preparation: 1- make him comfortable before & throughout exam
2- take an orderly approach _head to toe, proximal to distal
3- joints examined should be supported at rest
4- use firm support gentle movement & return to a relaxed
5- compare corresponding paired joints (symmetry)
Order of exam
*Inspection; note the size& contour of joint, inspect skin for color, swelling, masses or
deformity
* Palpation: palpate each joint, skin, muscles, note the heat, tenderness, swelling or
masses
* ROM: range of motion:
Ask for active ROM if you see a limitation attempt passive motion.
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8. Muscle testing
Test the strength of muscle for each joint ask person to flex& hold as you apply opposing
force.
Temporomandibular joint:
Inspect area anterior to ear, place tips of your first 2 fingers in front of each ear & ask
person to open & close mouth. an audible & palpable click occur normally.
Palpate contracted temporalis & masseter muscles as person clenches teeth. Compare Rt
& Lt for size, strength. Ask him to move the jaw forward & laterally against your
resistance & to open mouth against your resistance (CN V)
Cervical spine:
Inspect alignment of head & neck .should be straight & head erect
Palpate spinous processes & sternomastoid, trapezius& paravertebral muscles, should feel
firm, no spasm or tenderness, ask him to follow the motions:
Extension -flexion
Lateral bending
Rotation
Repeat motions while applying opposing force( CN XI)
Upper Extremities: shoulder
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9. Inspect & compare both shoulders post &ant.
Check size & contour of joint & compare shoulders for equality of bony landmarks,
normally no redness, muscular atrophy, deformity or swelling.
If reports pain, ask to point spot, it may from local causes or referred pain to hiatal hernia
or cardiac or pleural condition
Palpate both shoulders noting any muscular spasm or atrophy, swelling, heat, or
tenderness.
Shoulders
Start at clavicle then acromioclavicular joint, scapula, greater tubercle of humerus&
glenohumeral joint.
Palpate axilla no adenopathy or masses .
Test ROM;
Forward flexion -hyperextension
Abduction-adduction
Internal rotation
External rotation
Test the strength of shoulder muscles, ask him to shrug shoulders flex forward &up.
abduct against your resistance (CN XI)
Elbow
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10. Inspect size & contour of elbow in both flexed & extended positions. Look for deformity,
redness or swelling. Check olecranon bursa
Palpate with elbow flexed about 70 degrees & relaxed as possible, use Lt hand to support
Lt forearm & palpate olecranon process & medial & lateral epicondyles of humerus, with
Rt thumb& fingers in medial groove, normally feel fairly solid, check for synovial
thickening, swelling, nodules or tenderness.
Palpate for heat, swelling, tenderness or nodules.
ROM
Flexion -extension
Pronation - supination
Test muscle strength: flex elbow against your resistance, then ask him to extend elbow
against your resistance.
Wrist & hand:
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11. Inspect on dorsal & palmar sides, noting position, contour& shape. Normal position
shows wrist in slight extension. Fingers lie straight in same axis a forearm, no swelling or
redness, deformity or nodules.
Skin smooth with knuckle wrinkle present & no swelling or lesions.
Palpate joint in wrist & hands, support hand with your fingers under it & palpate the wrist
firmly with both your thumbs on its dorsum. Move your palpating thumbs side to side to
identify the normal depressed areas that overlie the joint space normally feel smooth, no
swelling, nodules or tenderness
Palpate metacarpopharyngeal joints with your thumbs. use your thumb& index finger in a
pinching motion to palpate the sides of interphangeal joints. Normally no synovial
thickening, tenderness, warmth, or nodules
ROM: Extension -flexion
Hyperextension- flexion
Ulnar deviation- radial deviation
Test muscle strength: position forearm supinated on table, stabilize by holding your hand at
the person’s midforarm. ask to flex wrist against your resistance at the palm
Knee: inspection
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12. Remain Supine with leg extended, or flex knee & dangling for inspection, skin normally
looks smooth, even , no lesions.
Lower leg should extend in same axis as thigh.
Inspect knee’s shape & contour. Normally hollows present on either side of patella, check
for swelling, check quadriceps muscle in anterior thigh for atrophy its important for joint
stability during weight –bearing.
Palpation
(supine position), start on anterior thigh,10 cm above patella, palpate with your Lt thumb
& fingers in a grasping fashion, exploring supra patellar pouch. Note consistency of
tissues. Muscles & soft tissues feel solid& joint should feel smooth, no warmth,
tenderness, thickening, or nodularity. When swelling occurs, to distinguish between
tissues swellings or fluids in joints, use the 2 tests:
THE END
Do Good
to
Have Good
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