Postural drainage involves positioning patients to drain mucus from their lungs using gravity. It combines chest percussion using cupped hands over lung segments with vibration from flat hands. This helps loosen and drain mucus into larger airways to be coughed up. Specific positions are used to target different lung lobes and segments, holding each position for 3-5 minutes while the patient takes deep breaths and coughs. Postural drainage aims to clear excess mucus from conditions like cystic fibrosis or pneumonia.
in this topic the technique of chest physiotherapy, indications, contradications of chest physiotherapy are explained. different positions used in postural drainage are briefed.
in this topic the technique of chest physiotherapy, indications, contradications of chest physiotherapy are explained. different positions used in postural drainage are briefed.
Chest physiotherapy (CPT) refers to a group of therapies used in combination to mobilize pulmonary secretions. CPT is helpful to mobilize or loosen the secretions in the lungs and respiratory tract especially for patients with large amount of secretions or ineffective cough.
this slide will help the students and other care provider to know about importance of chest physiotherapy and its practical use and able to write in exam if asked
and to improve nurses in their skills regarding chest physiotherapy as well as to teach to their colleague and students
thank you !!!!
Sitz bath is most commonly performed procedure in relevance to better wound healing through vasodilation effect. Lets see the Healing power of water
its is commonly performed to postnatal primigravida mothers for healing of perineal lacerations or tears or episiotomy.
Nurse /doctor will insert two lubricated, gloved fingers into your vagina with one hand, while the other hand presses gently on the outside of your lower abdomen. During this part of the exam, your doctor will check the size and shape of your uterus and ovaries, noting any tender areas or unusual growths.
This presentation is about positions used in postural drainage in various pulmonary disorders associated with prolonged bed rest, TBI, SCI, Covid 19, etc. This is only for education only.
Chest physiotherapy (CPT) refers to a group of therapies used in combination to mobilize pulmonary secretions. CPT is helpful to mobilize or loosen the secretions in the lungs and respiratory tract especially for patients with large amount of secretions or ineffective cough.
this slide will help the students and other care provider to know about importance of chest physiotherapy and its practical use and able to write in exam if asked
and to improve nurses in their skills regarding chest physiotherapy as well as to teach to their colleague and students
thank you !!!!
Sitz bath is most commonly performed procedure in relevance to better wound healing through vasodilation effect. Lets see the Healing power of water
its is commonly performed to postnatal primigravida mothers for healing of perineal lacerations or tears or episiotomy.
Nurse /doctor will insert two lubricated, gloved fingers into your vagina with one hand, while the other hand presses gently on the outside of your lower abdomen. During this part of the exam, your doctor will check the size and shape of your uterus and ovaries, noting any tender areas or unusual growths.
This presentation is about positions used in postural drainage in various pulmonary disorders associated with prolonged bed rest, TBI, SCI, Covid 19, etc. This is only for education only.
This presentation summarizes all breathing exercises used to rehabilitate a cardiopulmonary patient both inside and outside of a healthcare setup. It provides with the proper technique of the various exercises and conditions in which they are indicated.
CHEST MOBILIZATION EXERCISES, COUNTER-ROTATION TECHNIQUE, BUTTERFLY TECHNIQUE, BREATH CONTROL DURING WALKING. These Mobilization Techniques are useful to improve Chest Wall Mobility and Expansion in Patients with Restricted Chest wall movements and also Postoperative patients
Therapeutic Positions are used to promote comfort of the patient.
Proper turning and positioning allows the health care provider to make clients, as comfortable as possible, prevent contractures, and pressure sore, and facilitate diagnostic test for surgical intervention.
To relieve pressure to new positions every 2 hours.
Three factors significant in positioning are- Pressure, Friction and Shear
According to Annamma Jacob,
Positioning is defined as placing the patient in good body alignment as needed therapeutically.
According to nurseinfo.in,
Positioning is defined as placing the person in such a way to perform therapeutic interventions to promote the health of an individual
PURPOSE
To promote comfort
To prevent complication
To stimulate circulation
To promote normal physiologic functions.
ARTICLES
Clean, dry, firm bed
Different types of mattress
Bed Boards
Pillows
Footboards/ Foot boot
Sandbags
Hand rolls
Trochanter rolls
Bed blocks
Over bed Table
Additional Sheets
Trapeze bar
PRINCIPLES
Maintain good body mechanics.
Obtain assistance as required.
Ensure that mattress is firm and level of bed is at working height.
Ensure that sheets are clean and dry.
Avoid placing a body part directly over another to prevent pressure.
Plan a regular position change schedule for the patient for 24 hours..
Ensure patient comfort.
Wash hand before and after procedure
TYPES OF POSITIONING
Fowler’s Position
Orthopenic Position
Prone Position
Lateral/ Side Lying Position
Sims’s Position/ Semi- Prone Position
Lithotomy Position
Trendelenburg Position
Reverse Trendelenburg Position
Supine Position
Dorsal Recumbent Position
Knee-chest Position
Rose Position
Other Position
FOWLER’S POSITION
Purpose
To relieve or minimize dyspnea
To relieve tension on abdominal sutures
ORTHOPENIC POSITION
High fowler’s position with over bed table placed in front of the client.
Client to rest with both hands on over the bed table/on pillow placed on it and lean forward. Leaning forward facilitates respiration by allowing maximum chest expansion.
Indications:
Patient with severe dyspnea
Cardiac Patients
Position for thoracentesis
Patient with chest drainage tubes
Relieve Respiratory distress
Pericarditis
ARDS
COPD
Emphysema
Asthma
PRONE POSITION
The client is in flat position only abdomen with head turned to one side. The head rest on a pillow, one or both hands beyond the head or at the sides.
Indication
Patients with pressure sores, burns, injuries, and operations on back
For patients after 24 hours of amputation of lower limbs
Position for renal biopsy
To prevents aspiration
NTD
Recovery positions after anesthesia
LATERAL POSTION
Also known as SIDE LYING POSITION.
Client lies on the side with weight on his hips, shoulder pillow support, and stabilizes. Upper most leg, arm, head and back.
In this position, trunk is right angle to bed.
Indication
To promote lung and cardiac function
During seizure attack and air embolism (Left lateral)
Patient with pyloric stenosis after meals.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
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Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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2. Postural drainage
Introduction
• Postural drainage is the positioning of a
patient with an involved lung segment such
that gravity has a maximal effect of facilitating
the drainage of bronco-pulmonary secretions
from the tracheobronchial tree.
• It is based on the concept of gravity-assisted
mobilization of secretions and transport it for
removal.
3. • The lungs consist of five lobes, three on the
right side and two on the left side of the chest
cavity. Each lobe is further divided into
segments.
• It uses a combination of chest percussion (a
clapping movement performed with cupped
hands) and vibration (a vibrating movement
done with flat hands).
4. • Postural drainage is generally performed for
three to five minutes on each segment. During
this time, the person being treated should
take slow, deep breaths followed by a vigorous
coughing to help clear mucus.
5. Purpose
• To help loosen the mucous by shaking it loose.
• To help drain mucus from each of the lobes
into the larger airways so it can be coughed up
more readily.
6. Chest percussion
• Chest percussion involves using a cupped
hand and alternately clapping both hands on
the person's chest wall. Your hand should not
be flat but cupped at all times as if you were
holding liquid in it.
• Chest percussion should be done over the
ribs, taking care to avoid the spine,
breastbone, or lower back where you can
potentially injure internal organs.
7.
8. Vibration therapy
• Vibration therapy is used along with chest percussion
helps to gently shake mucus and secretions into the
large airway passages.
• During vibration, the caregiver should place a flat hand
firmly at top the lung segment to be drained. Then,
stiffening the arm and shoulder, he or she should apply
light pressure and create a rapid, shaking movement,
similar to that of a vibrator.
• It is important for the person being treated to inhale
deeply and exhale slowly but forcefully. This should be
done without straining to stimulate a productive
cough.
9.
10. Assessment
• The following should be assessed and reported to
establish a need for postural drainage:-
• A recent radiograph or bronchogram if available,
is a useful adjunct in isolating the affected areas.
• Pulmonary Function Test
• excessive sputum production
• effectiveness of cough
• history of pulmonary problems treated
successfully with PDT (e.g., bronchiectasis, cystic
fibrosis, Lung Abscess)
11. • decreased breath sounds or crackles or
rhonchi suggesting secretions in the airway
• change in vital signs
• abnormal chest x-ray consistent with
atelectasis, mucus plugging, or infiltrates
• deterioration in arterial blood gas values or
oxygen saturation
12. Procedure
The patient is tilted or propped at an angle
required and chest percussion is performed to
loosen the secretions.
Frames, tilt tables, and pillows may be used to
support patients in these positions.
A foot end elevation of 14-18 inches is requires
for the drainage of middle and lower lobes.
Each position consists of placing the target lung
segment(s) superior to the carina. Positions
should generally be held for 3 to 15 minutes
13. In critical care patients, including those on
mechanical ventilation, Postural Drainage
should be performed from every 4 to every 6
hours as indicated.
PDT order should be re-evaluated at least
every 48 hours based on assessments from
individual treatments.
14.
15. • To drain mucus from the upper lobe apical
segment, have the person sit in a comfortable
position on a bed or flat surface, leaning
against a pillow on the headboard or the
caregiver for support.
• The caregiver will then percuss and vibrate the
muscular area between the collarbone and
very top of the shoulder blades on both sides
for around three to five minutes.
• Encourage the person to take deep breaths
and to cough during the percussion.
16.
17. • The person will next sit comfortably in a chair
or on the side of the bed and lean over a
pillow with his or her arms dangling.
• As before, percuss and vibrate with both
hands over the upper back on both the right
and left sides.
18.
19. • In this position, the person will lie flat on a
bed or table with a pillow situated
comfortably under the head and legs.
• The caregiver will then percuss and vibrate
the right and left sides of the front portion of
the chest between the collarbone and nipple.
20.
21. • The person will then lie on the right side, face
down toward the foot of the bed, with the
hips and legs propped on pillows. The body
should be rotated about a quarter-turn
towards the back.
• A pillow can also be placed behind the
person. The legs should be slightly bent with
another pillow placed between the knees. The
caregiver will then percuss and vibrate just
outside the nipple area.
22.
23. • For the middle lobe position, the person will
lie face-down on his or her left side, a quarter-
turn toward the back with the right arm up
and out of the way. The legs and hips should
be elevated as high as possible.
• A pillow may be placed on the back and
between slightly bent legs. The caregiver will
percuss and vibrate just outside the right
nipple area.
24.
25. • In this position, the person will lie on the right
side, face down facing the foot of the bed,
with a pillow propped behind the back.
• The hips and legs should be elevated as high
as possible on pillows. The knees should be
slightly bent with a pillow placed in between.
• The caregiver will percuss and vibrate over the
lower ribs on the left side and repeat the right
side.
26.
27. • For this position, the person will lie on his or
her stomach with hips and legs elevated on
pillows.
• The caregiver will percuss and vibrate the
lower part of the back over the left and right
sides of the spine, taking care to avoid the
spine and lower ribs.
28.
29. • For these positions, the person will lie on the
right side, leaning forward about one-quarter
of a turn with hips and legs elevated on
pillows. The top leg may be flexed over a
pillow for support and comfort.
• The caregiver will percuss and vibrate the
uppermost portion of the lower part of the
left ribs, repeating on the right side.
30.
31. • For this final position, the patient will lie flat
his or her stomach on a bed or table. Two
pillows should be placed under the hips.
• The caregiver will percuss and vibrate the
bottom part of the shoulder blades on both
the right and left sides of the spine, taking
care to avoid the spine itself.