The cervical spine consists of 7 vertebrae that give rise to 8 cervical nerves and two plexuses - the cervical and brachial plexuses. The document then provides details on the history, physical examination, and investigations for cervical, thoracic, and lumbar spine conditions. It lists the nerves associated with each region and describes red flags, movements tested, and special tests like Schober's test and straight leg raise test in the physical examination.
Clinical examination notes based on TU/KU curriculum of MBBS in nepal. Hope this will be very much helpful in step wise approach to you people especially during exam time.
references:
Campbell’s operative orthopaedics 11th edition
Text book of orthopaedics & fractures 5th edition Dr B. Aalami Harandi
Gray’s anatomy 2nd edition
Clinical anatomy Richard S. Snell
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
Clinical examination notes based on TU/KU curriculum of MBBS in nepal. Hope this will be very much helpful in step wise approach to you people especially during exam time.
references:
Campbell’s operative orthopaedics 11th edition
Text book of orthopaedics & fractures 5th edition Dr B. Aalami Harandi
Gray’s anatomy 2nd edition
Clinical anatomy Richard S. Snell
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
Clinical examination of the spine/back covering: NEUROLOGICAL EXAMINATION -
-MOTOR
-SENSORY
-REFLEXES
-AUTONOMOUS
-BOWEL AND BLADDER
(Upper and Lower Limbs)
Covering separately:
The Vertebral level
The pathological process : Extradural or Intradural
The extent of deficit: The Neurological level
The type of deficit: UMN or LMN
UPPER & LOWER LIMBS
The presentation investigates the following characteristics of the meniscus;
Role of the Meniscus
Material Properties
Structural Limitations / Failure Limits
Mechanism & Treatment of Injuries
Detailed history and its evaluation , examination of spine in general and local with special tests in cervical , thoracic outlet syndrome , lumbar spine and SI joint with diagrams, neurological examination both sensory and motor.
Clinical examination of the spine/back covering: NEUROLOGICAL EXAMINATION -
-MOTOR
-SENSORY
-REFLEXES
-AUTONOMOUS
-BOWEL AND BLADDER
(Upper and Lower Limbs)
Covering separately:
The Vertebral level
The pathological process : Extradural or Intradural
The extent of deficit: The Neurological level
The type of deficit: UMN or LMN
UPPER & LOWER LIMBS
The presentation investigates the following characteristics of the meniscus;
Role of the Meniscus
Material Properties
Structural Limitations / Failure Limits
Mechanism & Treatment of Injuries
Detailed history and its evaluation , examination of spine in general and local with special tests in cervical , thoracic outlet syndrome , lumbar spine and SI joint with diagrams, neurological examination both sensory and motor.
Some slides are taken from different textbooks of medicine like Davidson, Kumar and Clark and Oxford, and some from other presentations made by respected tutors. I'm barely responsible for compilation of various resources per my interest. These resources are free for use, and I do not claim any copyright. Hoping knowledge remains free for all, forever.
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
USMLE MSK L013 Upper 02 Muscles of scapular, pectoral and deltoid regions.pdfAHMED ASHOUR
The muscles in the scapular, deltoid, and pectoral regions play a crucial role in the movements and stability of the shoulder complex.
These muscles work in coordination to provide stability to the scapula, enable a wide range of shoulder movements, and contribute to the overall function of the upper limb.
Proper functioning of these muscles is essential for activities involving the shoulder complex, such as reaching, lifting, and throwing.
LOWER LIMB EXAMINATION.pptxThe neurologic examination is typically divided in...Awais irshad
LOWER LIMB EXAMINATION ,INSPECTION,PALPATION,TONE ,POWER, The neurologic examination is typically divided into eight components: mental status; skull, spine and meninges; cranial nerves; motor examination; sensory examination; coordination; reflexes; and gait and station.
The Gram stain is a fundamental technique in microbiology used to classify bacteria based on their cell wall structure. It provides a quick and simple method to distinguish between Gram-positive and Gram-negative bacteria, which have different susceptibilities to antibiotics
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
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
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.
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
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
- 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
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
- 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
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
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
spine Orthopedic
1.
2. Cervical spine
Consist of 7 vertebra
8 nerves
Give two plexuses
Cervical plexus ( C1-C5)
brachial plexus ( C5-T1)
Phernic ( C3,C4,C5)
mucocutanous n (C5-C7)
Lesser occipital (C2)
axillary n (C5-C6)
Supraclaviclular ( C3,C4)
median n (C5-T1)
radial N (C5-T1)
ulnar n (C8-T1)
3. Cervical spine
History
*
acute trauma
History of Falling down , vehicle accident .
Any patient unconious form after heard injury you should assumed it as cervical
spine injury.
ABC, WAIT FOR help , x –ray frontal & lateral
4. Cervical spine
History
* PAIN
:- analysis of pain
Acute ,sub acute ,chronic
Onset ,duration , character , severity ,radiation ,reliving ,aggravating factor
At end of day /at night , other joint affected
*Weakness in upper limb
*Paraesthesia
5. Cervical spine
History
Pain and difficulty turning the head and neck, examples are:
→ Disease of atlanto-occipital joints produces pain radiating to the occiput.
→ Spondylosis of the middle and lower cervical spines causes pain radiating to
the upper border of trapezius, interscapular region, and the arms.
→ Irritation of the C6 & C7 nerve roots can give rise to referred pain in the
interscapular region, radial fingers, and thumb.
→ Irritation of C8 can cause pain on the ulnar side of forearm, ring, and little
fingers.
6.
7. Cervical spine
Physical examination:
Look
Observe the posture of the head and neck and note any abnormality and
deformity, e.g. loss of lordosis.
Feel
→ The midline spinous processes
→ The paraspinal soft tissues
→ The supraclavicular fossae – for cervical ribs or enlarged lymph nodes
→ The anterior neck structures including the thyroid
8. Move:
→ Assess active movements:
o forward flexionPut your
chin on your chest
o Extensionlook upwards
at the ceiling as far back
as you can
o Lateral flexionPut your
ear onto your shoulder
o Lateral
rotationLook
over
your
right/left
shoulder
9. →occiput to wall test
→ Gently perform passive movements if there are
reduced active movements and see if the end of the
range has a sudden or gradual resistance and whether
it is pain or stiffness that restricts movements
11. Thoracic spine( T1-T12)
History
→ Commonly, localized spinal pain, examples are:
Ankylosing spondylitis produces pain in the thoracolumbar region
Acute thoracic spinal pain may be due to vertebral prolapse due to
malignancy, or infection; especially if there was systemic upset or fever
is present
→ Less commonly, symptoms of paraparesis including sensory loss,
leg weakness, and loss of bladder or bowel control
12. Thoracic spine
Physical examination:
Look
With the patient standing, inspect posture from behind, the side and the
front, noting any deformity, e.g. rib hump or abnormal curvature.
Feel
→ The midline spinous processes
→ The paraspinal soft tissues
→ If there is increased prominence of one or more spinous processes
implying anterior wedge-shaped collapse of the vertebral body – often
related to osteoporosis.
Move
Ask the patient to sit with arms crossed, and to twist round and look at you.
14. Lumbar spine
SCITICA :- PAIN extend from buttock , poster-lateral of leg , lateral aspect of foot
Common risk factor :-
1-Herniated disc
2- pregnancy
3-osteoarthritis
4- wrong IM INJECTION
15. Lumbar spine
History
→ Low back pain is an extremely common complaint
→ Sacroilitis produces pain that is referred down both legs to knees
→ Consider abdominal and retroperitoneal pathology, e.g. abdominal
aortic aneurysm, pancreatitis, peptic ulcer, renal pathologies.
16. Lumbar spine
Red flag features for acute low back pain:
→ In History:
Age < 20 yrs or > 55 years
Recent significant trauma (fracture)
Pain:
Thoracic (dissecting aneurysm)
Non-mechanical (infection/ tumor/pathological fracture)
Fever ( infection)
Difficult micturition
Fecal incontinence
Motor weakness
Saddle anesthesia
Sexual dysfunction
Gait change ( cauda equina syndrome)
Bilateral sciatica
17. Lumbar spine
Red flag features for acute low back pain:
→ In Past medical History:
Cancer ( metastasis.)
Previous steroid use (osteoporotic collapse)
→ In Systemic review:
Weight loss/malaise without obvious cause (e.g. cancer)
18. Lumbar spine
Physical examination:
Look
Examine the patient standing. Look for obvious abnormality such as
decreased/increased lordosis, obvious scoliosis soft tissue abnormalities
such as a hairy patch or lipoma that overlie spina bifida.
Feel
Palpate the spinous processes and the paraspinal tissues. The L4/L5
interspinous space is palpable at the level of iliac crests.
19. Move
→ Flexion: ask the patient to
try to touch his toes with his
legs straight
→ Extension: ask the patient to
straighten up and lean back as
far as possible
→ Lateral flexion: ask the
patient to reach down to each
side touching the outside of the
leg as far down as possible
while keeping the legs straight
21. Lumbar spine
Physical examination-Cont.:
Special tests:
Schober’s test for forward flexion
Root compression tests:
Straight leg raise
Tibial nerve stretch test
Femoral nerve stretch test
Flip test
Sacroiliac joints test
22. Lumbar spine
Schober’s test for forward flexion
1- Erect position.
2- Select 2 bony points,10cm apart and mark it.
3-Maximum flexion on lumbar with fix knee.
4-the two points should separate by at least a further 5cm.
24. Straight –Leg raising test
-knee straight,slowly lifted the leg.
-note for any tightness and pain in
the buttock (around 80-90 )
-passive dorsiflexion,increase the
pain.
-bow-string sign : bending the knee
slightly,release the pain.then
apply firm pressure behind
lateral hamstring,pain will recur.
-
25. • Hematological : erythrocyte sedimentation rate, complete
•
•
•
•
•
•
•
blood count
Biochemical : C-Reactive protein , Ca level , ALP
Serological : RF , ANA
X- ray
CT scan
MRI
Isotope bone scan
Ultrasound