Rotator cuff impingement syndrome is caused by mechanical impingement of the rotator cuff between the humeral head and surrounding structures. Patients present with pain, especially with overhead activities, and during impingement tests like Hawkins and Neer. Impingement can be subacromial, subcoracoid, or involve the glenoid. MR imaging can identify tendon damage and bone abnormalities that cause narrowing. Conservative treatment includes rest, NSAIDs, and physical therapy, while surgery involves decompression or repair.
Sacroiliac(SI) Joint Dysfunction,Evaluation and Treatment Dr.Md.Monsur Rahman
Dr.MD.Monsur Rahman,PT
MPT-Musculoskeletal Disorders
Maharishi Markandeshwar Institute Of Physiotherapy And Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana - Ambala,133-207 (Haryana)
Sacroiliac(SI) Joint Dysfunction,Evaluation and Treatment Dr.Md.Monsur Rahman
Dr.MD.Monsur Rahman,PT
MPT-Musculoskeletal Disorders
Maharishi Markandeshwar Institute Of Physiotherapy And Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana - Ambala,133-207 (Haryana)
Rotator cuff tear is a very common orthopedic condition, which causes shoulder pain and stiffness. The slides are on rotator cuff tears and its management by open repair, mini open repair & by arthroscopy
Femoral Head (Superiorly, Medially, Anteriorly).
Acetabulum (Inferiorly, Laterally, Anteriorly).
Horseshoe-shaped (Acetabular Notch).
The deepest portion (Acetabular Fossa).
Labrum Acetabular:
Is a wedged fibrocartilaginous ring inserted into the acetabular rim to increase the acetabular concavity.
Tendoachilles rupture and its managementRohan Vakta
Achilles tendon is the strongest tendon of body. There are many causes of its rupture. It can be acute or chronic rupture. Management of chronic rupture by semitendinosus tendon is mentioned here.
this slideshow describes about the hip joint anatomy, biomechanics and its pathomechanics along with angles of hip joint. the slide show also briefs about the pelvic femoral rhythm in daily activities
Rotator cuff tear is a very common orthopedic condition, which causes shoulder pain and stiffness. The slides are on rotator cuff tears and its management by open repair, mini open repair & by arthroscopy
Femoral Head (Superiorly, Medially, Anteriorly).
Acetabulum (Inferiorly, Laterally, Anteriorly).
Horseshoe-shaped (Acetabular Notch).
The deepest portion (Acetabular Fossa).
Labrum Acetabular:
Is a wedged fibrocartilaginous ring inserted into the acetabular rim to increase the acetabular concavity.
Tendoachilles rupture and its managementRohan Vakta
Achilles tendon is the strongest tendon of body. There are many causes of its rupture. It can be acute or chronic rupture. Management of chronic rupture by semitendinosus tendon is mentioned here.
this slideshow describes about the hip joint anatomy, biomechanics and its pathomechanics along with angles of hip joint. the slide show also briefs about the pelvic femoral rhythm in daily activities
Shoulder Impingement Evidence Based Case Study Rumy Petkov
Used evidence based literature to compare laser therapy treatment versus corticosteroid injections, ultrasound, rehab exercises, and Kinesio taping to treat shoulder impingement.
This is a short presentation on common causes of shoulder pain, its clinical features,diagnostic methods and treatment modalities. This presentation would be helpful for general paractioners, orthopedic juniour registrars.
1.INTRODUCTION
Shoulder joint is formed by scapula and clavicle (which is also called as shoulder girdle)and proximal humerus.
2.BONES OF SHOULDER JOINT
3.Joints of the Shoulder Complex
Glenohumeral
Acromioclavicular
Sternoclavicular
Scapulothoracic
4.Muscles of the Shoulder
5.Gateways to the Posterior Scapular Region
6. Movements
step by step presentation on ultrasound evaluation of shoulder and knee joints with illustrations of probe positioning.multiple examples of pathologies also added.
Dislocation of joint is very tricky. In this presentation radiological evaluation of Dislocation of various joints will be discussed.
This is one of the best pictoral review of important joint dislocations
Anatomy, physiology and techniques of shoulder examination.
This file is a great summary of Bates' Physical Examination.
I hope this file will help you to prepare for your exams or your presentation and also having a review on this orthopedics topic.
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
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
micro teaching on communication m.sc nursing.pdfAnurag Sharma
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.
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.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- 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
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
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.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of 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 leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
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. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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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3. WHAT IS IT?
• Rotator cuff impingement syndrome is a clinical diagnosis that
caused by mechanical impingement of the rotator cuff by its
surrounding structures.
• Patients with impingement syndromes may present
with various signs and symptoms on physical
examination depending on the degree of pathology and
the structures involved.
4. CLINICAL FEATURES
Pain
nocturnal + +
overhead activities
unaple to sleep on involved side
Painful arch
(70 – 120)
Impingement signs
neer test
hawkins test
5. Hawkins' test
Hawkins test – “patient reports pain when the arm is flexed at 90° and
passively positioned in internal rotation” Hawkins Test - ThePainSource.com -
YouTube.FLV
6. Neer's test
pain during passive arm elevation Neer's Impingement Test -
ThePainSource.com - YouTube.FLV
7. STATIC FACTORS
activity pain haw neer
Oa of Ac joint Overhead+abd ac j - +
Hooked acromion Over h lateral + +
Ossificatin of Over h ant lateral + -
coracoacromial lig
Os acromiale Over h fibrous union + -
Coracoid change add+internal anterior - -
8. DYNAMIC FACTORS
act pain haw/neer
• Weak muscles over h ant/pos + +
ant laxity fatigue
• Tight post throw post + -
capsule
• Glenoid abduction post - -
( internal ext rotation
impingment) throwing
11. SUBACROMIAL IMPINGEMENT
Neer proposed that 95% of rotator cuff tears are due to chronic
impingement
between the humeral head and the coracoacromial arch.
12. SUBACROMIAL IMPINGEMENT
Stage 1 disease consists of edema and hemorrhage ofthe tendon
due to occupational or athletic overuse, and is reversible under
conservative treatment .
13. SUBACROMIAL IMPINGEMENT
Stage 2 disease shows progressive inflammatory changes of the
rotator cuff tendons and the subacromial-subdeltoid bursa, and
can be treated by removing the bursa and dividing the
coracoacromial ligament after failed conservative management.
14. SUBACROMIAL IMPINGEMENT
Stage 3 disease manifests as partial or complete tears of the
rotator cuff and secondary bony changes at the anterior acromion,
the greater tuberosity or the acromioclavicular joint.
16. SUBACROMIAL IMPINGEMENT
FACTORS
acromial shape
Ac joint subacromial
osteophytes osteophytes
thickened os acromiale
coracoacromial lig
17. • Morrison and Bigliani described three types of
• acromion based on dried cadaver specimens and
• conventional outlet view radiographs.
• Type 1 acromion has a flat undersurface and is
• considered the physiologic shape.
• Type 2 acromion has a curved undersurface.
• Type 3 acromion has a hooked undersurface.
18. Both type 2 and 3 acromion are considered abnormal
variants that predispose individuals to impingement of
supraspinatus beneath the acromion, and increase the
likelihood of developing rotator cuff tear.
26. SUBCORACOID IMPINGEMENT
The coracoid process may cause anterior impingement
when the coracohumeral distance is decreased.
This distance must be large enough to accommodate the
articular cartilage of the humerus, the subscapularis
tendon, the subscapularis bursa and the rotator interval
tissue, and portions of the insertions of the
coracoacromial ligament and the conjoint tendon.
27. SUBCORACOID IMPINGEMENT
Gerber’s study in normal subjects with conventional CT of
the shoulder demonstrates average distance between
medially rotated humeral head (the lesser tuberosity) and
the coracoid tip is 8.6 mm.
Forward flexion combined with medial rotation reduced
the coracohumeral distance to an average of 6.7 mm (30).
A coracohumeral space of less than 6 mm was
considered diagnostic of subcoracoid stenosis.
29. SUBCORACOID IMPINGEMENT
1. Idiopathic – anatomic abnormality of the coracoid process such as
longitudinally or laterally displaced coracoid process, or developmental
enlargement of the coracoid process.
2. Iatrogenic – surgical procedures involving the coracoid process, such as
bone block procedures for anterior instability of
the shoulder, posterior glenoid neck osteotomies for posterior instability of the
shoulder, and acromionectomies for rotator cuff tears.
3. Traumatic – fractures of the lesser tuberosity or the coracoid process, and
subsequent malunion that leads to decreased subcoracoid space.
4. space-occupying lesions in the subcoracoid space such as ganglions,
calcifications, and amyloid deposits.
30. Most patients complain of pain and tenderness in the anterior aspect of the
shoulder, which is exacerbated by various degrees of flexion, adduction, and
rotation.
The pain is thought to be caused by impingement of the subscapularis tendon
between the lesser tuberosity and coracoid process.
MR axial and oblique sagittal images are used to evaluate the coracohumeral
space and subcoracoid impingement.
Subscapularis tendon partial or full thickness tear and biceps tendon instability
has been reported in patients with clinical diagnosis of subcoracoid
impingement.
31. SECONDARY EXTRINSIC IMPINGMENT
In these patients the coracoacromial outlet is usually normal.
Overhead-throwing athletes can develop glenohumeral joint instability
secondary to fatigue and overloading of the rotator cuff muscles caused by
chronic microtrauma and weakening of the anterior capsule.
This instability will cause abnormal superior translation of the humeral head and
lead to dynamic narrowing of the coracoacromial outlet.
Instability can also occur in the scapulothoracic joint, and cause abnormal
scapular motion and result in dynaminc narrowing of the coracoacromial outlet.
32. MR images will show
undersurface degeneration
and partial tears of the rotator
cuff tendons.
Labral abnormality is also
described in patients
with secondary extrinsic
impingement.
33. POSTEROSUPERIOR GLENOID
IMPINGEMENT
Posterosuperior glenoid impingement syndrome was first
described by Walch et al in athletes who participate in
recurrent overhead activities, such as throwing, tennis
playing, and swimming.
During the late cocking phase of throwing motion, the arm
is maximally abducted and maximally externally rotated.
This extreme ABER position will cause contact between
the undersurface fibers on the supraspinatus and
infraspinatus and posterosuperior glenoid rim.
34.
35. This contact is commonly seen in asymptomatic
individuals and non-throwers during ABER;
Repetitive impaction of these structures in competitive
athletes can lead to degeneration and tearing of the
articular surface fibers at the infraspinatus and
supraspinatus tendon junction with associated
degeneration and tearing of the posterosuperior glenoid
labrum.
36. The diagnosis of internal impingement can be made on
physical examination when abduction and external
rotation of the shoulder elicits posterosuperior
glenohumeral joint pain.
Relocation test of Jobe can be done to further confirm
this diagnosis, when a posteriorly directed force to the
humeral head while shoulder in ABER position relieves
the pain.
37. MR image findings include partial-thickness undersurface
tearing of the posterior fibers of the supraspinatus and anterior
fibers of the infraspinatus tendons;
Fraying and tearing of the posterosuperior glenoid labrum;
Paralabral cyst formation;
Cystic changes in the greater tuberosity of the humeral head
38. Some of these findings may simply represent normal
adaptive changes from the repetitive motion, however
they are considered pathologic in symptomatic patients.
MR imaging can also demonstrate the contact between
the rotator cuff tendons, the greater tuberosity, and the
posterosuperior glenoid labrum when arm is placed in
ABER position.
39.
40.
41. ANTEROSUPERIOR GLENOID IMPINGEMENT
Impingement of the
undersurface of the
reflective pulley system and
of the subscapularis tendon
against the anterosuperior
glenoid rim, when the arm is
anteriorly elevated,
horizontally adducted, and
internally rotated.
42. The shoulder pulley system is
composed of coracohumeral ligament
(CHL), the superior glenohumeral
ligament (SGHL ), and fibers of the
spupraspinatus and subscapularis
tendon.
the function of the pulley system is to
protect the long head of the biceps
tendon against anterior shearing
stress, and stabilize this tendon in its
intraarticular position.
43. Gerber and Sebesta proposed that in patients with
anterosuperior impingement syndrome, repetitive and
forceful anterior elevation, horizontal adduction and
internal rotation of the arm will cause impingement of the
reflective pulley between the subscpularis tendon and the
anterosuperior glenoid rim, and leads to frictional
damages in these structures.
44. A torn reflective pulley, either secondary to trauma or degenerative
process, can cause instability of the long head of the biceps (LHB)
in its intraarticular course, results in medial subluxation of LHB.
45. The medially subluxed LHB will lead to anterior translation and
superior migration of the humeral head, which will cause
anterosuperior impingement.
46. The combination of a partial articular-side subscapularis
and supraspinatus tendon tear in addition to the pulley
lesion increases the risk of the incidence of ASI;
and gender are not influencing factors for
Age
the development of the ASI.