The document discusses physical therapy interventions for cancer patients after surgery, focusing on early mobilization, lung hygiene exercises, and specific rehabilitation programs for common cancer types like breast cancer, lung cancer, and gastrointestinal cancers. Post-surgery goals include preventing complications, improving range of motion, and managing symptoms like pain, breathlessness, and bone metastasis. Precautions and considerations for different surgeries are also outlined.
This document summarizes care for breast cancer patients, including:
1. Surgical procedures like mastectomy and lumpectomy can cause complications like lymphedema and limited shoulder range of motion. Radiation therapy can also impair shoulder mobility and cause lymphedema.
2. Chemotherapy and hormonal therapy treatments have side effects like hair loss, nausea, fatigue, and menopausal symptoms.
3. Physical therapy plays an important role in managing complications through exercises, manual lymph drainage, compression garments, and lymphedema treatment. Proper exercise is important for recovery but must be done carefully.
This document discusses the anatomy, clinical presentation, diagnosis, and treatment of acute appendicitis. It notes that the appendix is considered a vestigial organ but can be important in surgery. Acute appendicitis is commonly caused by obstruction of the lumen. Clinical features include pain shifting to the lower right abdomen, anorexia, nausea, and fever. Diagnosis involves blood tests, urine analysis, and imaging like ultrasound or CT scan. Treatment is typically open or laparoscopic appendicectomy. Complications can include perforation, infection, or abscess. Conservative treatment with antibiotics may be used for appendicular masses.
This document discusses the uncertainties around the best conservative interventions for lymphedema after breast cancer surgery. It summarizes the key findings from several Cochrane reviews on this topic. While decongestive lymphatic therapy and compression therapy have been commonly used to treat lymphedema, the evidence for their effectiveness is limited due to few and small clinical trials with contradictory results. Ongoing research studies aim to provide more evidence on prevention strategies and optimal treatment approaches, but many have small sample sizes that may limit reliability. Overall, the evidence remains uncertain on the most effective conservative interventions for lymphedema after breast cancer.
1) The document discusses benign and malignant breast tumors. Benign tumors include fibrocystic changes, galactocele, and fibroadenoma. Breast cancer is the most common cancer in women.
2) Risk factors for breast cancer include genetic, hormonal, environmental factors as well as increasing age. Clinical manifestations may include breast lumps, nipple discharge, and enlarged lymph nodes.
3) Diagnostic tests for breast cancer include mammography, biopsy and laboratory tests to detect metastasis. Treatment involves surgery such as lumpectomy or mastectomy followed by radiation, chemotherapy and hormonal therapy.
1. Acute appendicitis is most commonly caused by obstruction of the appendix, usually by a faecolith. It presents with abdominal pain shifting to the right lower quadrant along with nausea, vomiting, and fever.
2. Diagnosis is made through physical exam finding tenderness over McBurney's point and confirmed through blood tests, ultrasound, or CT scan showing signs of appendiceal inflammation.
3. Treatment is an appendectomy, which can be performed through open, laparoscopic, or robotic methods to remove the inflamed appendix. Complications include wound infections, intra-abdominal abscesses, and bowel obstructions.
1. The appendix is located in the lower right portion of the abdomen and functions as part of the immune system.
2. Appendicitis is usually caused by obstruction of the appendix and results in inflammation and infection. Left untreated, it can progress to perforation or gangrene.
3. Symptoms of appendicitis include abdominal pain that starts around the navel and moves to the lower right side, nausea, vomiting, loss of appetite, and fever. A physical exam may reveal tenderness in the lower right abdomen.
This document summarizes care for breast cancer patients, including:
1. Surgical procedures like mastectomy and lumpectomy can cause complications like lymphedema and limited shoulder range of motion. Radiation therapy can also impair shoulder mobility and cause lymphedema.
2. Chemotherapy and hormonal therapy treatments have side effects like hair loss, nausea, fatigue, and menopausal symptoms.
3. Physical therapy plays an important role in managing complications through exercises, manual lymph drainage, compression garments, and lymphedema treatment. Proper exercise is important for recovery but must be done carefully.
This document discusses the anatomy, clinical presentation, diagnosis, and treatment of acute appendicitis. It notes that the appendix is considered a vestigial organ but can be important in surgery. Acute appendicitis is commonly caused by obstruction of the lumen. Clinical features include pain shifting to the lower right abdomen, anorexia, nausea, and fever. Diagnosis involves blood tests, urine analysis, and imaging like ultrasound or CT scan. Treatment is typically open or laparoscopic appendicectomy. Complications can include perforation, infection, or abscess. Conservative treatment with antibiotics may be used for appendicular masses.
This document discusses the uncertainties around the best conservative interventions for lymphedema after breast cancer surgery. It summarizes the key findings from several Cochrane reviews on this topic. While decongestive lymphatic therapy and compression therapy have been commonly used to treat lymphedema, the evidence for their effectiveness is limited due to few and small clinical trials with contradictory results. Ongoing research studies aim to provide more evidence on prevention strategies and optimal treatment approaches, but many have small sample sizes that may limit reliability. Overall, the evidence remains uncertain on the most effective conservative interventions for lymphedema after breast cancer.
1) The document discusses benign and malignant breast tumors. Benign tumors include fibrocystic changes, galactocele, and fibroadenoma. Breast cancer is the most common cancer in women.
2) Risk factors for breast cancer include genetic, hormonal, environmental factors as well as increasing age. Clinical manifestations may include breast lumps, nipple discharge, and enlarged lymph nodes.
3) Diagnostic tests for breast cancer include mammography, biopsy and laboratory tests to detect metastasis. Treatment involves surgery such as lumpectomy or mastectomy followed by radiation, chemotherapy and hormonal therapy.
1. Acute appendicitis is most commonly caused by obstruction of the appendix, usually by a faecolith. It presents with abdominal pain shifting to the right lower quadrant along with nausea, vomiting, and fever.
2. Diagnosis is made through physical exam finding tenderness over McBurney's point and confirmed through blood tests, ultrasound, or CT scan showing signs of appendiceal inflammation.
3. Treatment is an appendectomy, which can be performed through open, laparoscopic, or robotic methods to remove the inflamed appendix. Complications include wound infections, intra-abdominal abscesses, and bowel obstructions.
1. The appendix is located in the lower right portion of the abdomen and functions as part of the immune system.
2. Appendicitis is usually caused by obstruction of the appendix and results in inflammation and infection. Left untreated, it can progress to perforation or gangrene.
3. Symptoms of appendicitis include abdominal pain that starts around the navel and moves to the lower right side, nausea, vomiting, loss of appetite, and fever. A physical exam may reveal tenderness in the lower right abdomen.
This document discusses reconstructive breast surgery options after mastectomy or breast conservation therapy. It describes the multidisciplinary approach required and covers timing considerations for reconstruction. The two main types of reconstruction - prosthetic devices and autologous tissue reconstruction - are outlined. Autologous techniques discussed include pedicled and free TRAM flaps, latissimus dorsi flap, and various perforator flaps. Future directions like supramicrosurgery and tissue regeneration are also mentioned.
Appendicitis is characterized by inflammation of the appendix. it is most common abdominal emergency encountered in children. most common symptom is pain., vomiting and low - grade fever. Here, nurses play an important role in managing the problem before the doctor arrives. so read this out and it will help you in the future.
Right iliac fossa mass is a common clinical presentation and has a range of differentials that need to be excluded.
In this presentation will discuss RIF masses in briefly.
contact me / dr.3shaq@gmail.com
The document provides information about the anatomy, blood supply, function, pathology, clinical features, investigations, differential diagnosis, treatment and complications of acute appendicitis. It discusses the common retrocecal position of the appendix and describes obstructive and non-obstructive types of acute appendicitis. It also outlines the conservative and surgical management of appendicular masses and perforated appendicitis.
This updated encyclopaedia of anaesthesia and intensive care medicine covers aspects relating to Anesthesia & critical care medicine. With extensive line diagrams & topic descriptions, this is a reference title that every post graduate should own.
If you would like to purchase this title, please visit Elsevier Asia Bookshop.
The document discusses common post-operative complications in horses including gastrointestinal issues like adhesions and infections, as well as orthopedic complications involving casts and implants. It provides details on the pathophysiology, risk factors, prevention, and treatment options for various complications that can arise after surgery in horses such as adhesions, incisional infections, dehiscence, hernias, and rectal tears.
1) Appendicitis is caused by a blocked appendix, often due to stool, a foreign object, or cancer. It most commonly occurs between ages 10-30 and symptoms include abdominal pain that starts around the belly button and moves to the lower right side.
2) While an appendectomy was traditionally used to treat appendicitis, a recent study found that 80% of non-perforated cases can be treated successfully with antibiotics alone without increased risk of complications from delayed surgery.
3) For cases treated with antibiotics, 27% ultimately required an appendectomy within a year for recurring symptoms. However, no major complications occurred due to the initial delayed surgery.
This document discusses appendicitis during pregnancy. It covers the epidemiology, anatomical changes, pathophysiology, complications, diagnosis, differential diagnosis, and surgery of appendicitis in pregnant patients. The key points are that appendicitis occurs in about 1 in 1500 pregnancies, symptoms can be more difficult to diagnose due to pregnancy-related changes, ultrasound and CT scan are used for diagnosis but have limitations during late pregnancy, and prompt surgical treatment is indicated to prevent complications of perforation for both the mother and fetus.
The document provides information on the appendix, including its history, anatomy, embryology, physiology, acute appendicitis, neoplasms, and variants. Some key points include: the appendix was first depicted by Leonardo da Vinci in 1492; acute appendicitis is caused by obstruction leading to distention and infection, with symptoms like migrating right lower quadrant pain; imaging like CT can help diagnose appendicitis; complications include perforation; and neoplasms like carcinoid tumors or adenocarcinomas can rarely affect the appendix.
Non surgical mimics of appendicitis on imagingSumiya Arshad
This document discusses non-surgical conditions that can mimic appendicitis. Several gastrointestinal conditions are described, including mesenteric adenitis, bacterial ileocecitis, Crohn's disease, right-sided colonic diverticulitis, epiploic appendagitis, and omental infarction. These conditions can present with similar symptoms to appendicitis but are not caused by appendiceal inflammation and usually resolve with conservative treatment. Imaging plays an important role in differentiating these mimics from true appendicitis in order to avoid unnecessary surgery.
Plastic Surgery for obese, lower body lifts
Cosmetic and body reshape surgery liposuction...Dr Junaid Ahmad (MBBS FCPS) is the best plastic surgeon in Lahore. He is a well known, trained and expert in his field. He is MBBS and FCPS in Plastic and Recosntructive Surgery. He is a post graduate of the College of Physicians and Surgeons Pakistan which is oldest and best institute for post graduation in this area of the world. He is doing his practice in Lahore, Pakistan. He is always kind to the patients and listens them carefully as it is part of modern clinical skill and training. He is expert in both cosmetic as well as reconstructive surgery. He is also skin cancer and burn expert. A few of Dr Junaid Ahmad expertise are listed here..... call 03104037071
Thank you for the summary. Acute appendicitis is a common surgical emergency that requires timely diagnosis and management to prevent complications. A high index of suspicion is needed given its varied presentations.
The document discusses appendicitis, including:
- The blood and lymph drainage of the appendix, supplied by the appendicular artery.
- The symptoms of appendicitis include colicky abdominal pain shifting to the right lower quadrant, fever, nausea and vomiting.
- The diagnosis is clinical, using tests like the Alvarado score, and may include ultrasound or CT scans.
- Treatment is usually an appendectomy, which can be open or laparoscopic. Complications include wound infections, intra-abdominal abscesses, and adhesive bowel obstructions. Rarely, appendicitis can be treated non-operatively with antibiotics.
Colorectal cancer begins in the colon or rectum. It is the third most common cancer globally and incidence increases with age. Risk factors include family history, diet high in red meat, and certain medical conditions. Symptoms include changes in bowel habits, blood in stool, and abdominal discomfort. Diagnosis involves tests like colonoscopy, biopsy, and blood tests. Treatment depends on stage and location of cancer and may include surgery, chemotherapy, and radiation. Nursing care focuses on managing pain, nutrition, and educating patients. Prevention includes exercise, limiting red meat, and screening to detect and remove precancerous polyps.
The document summarizes the history and current practices of surgical management of breast cancer. It discusses:
1) The evolution from radical mastectomy to more conservative breast-conserving surgery and modified radical mastectomy based on evidence that removal of all breast tissue did not improve survival outcomes.
2) The types of breast surgery now commonly used including lumpectomy, quadrantectomy, mastectomy, and reconstructive surgeries using tissue expanders, implants, or flaps.
3) The indications and contraindications for different surgical procedures based on tumor size and location.
1. Acute appendicitis is caused by obstruction of the appendix lumen, leading to increased intraluminal pressure, edema, and bacterial invasion.
2. The classic presentation includes initially vague periumbilical pain that later localizes to the right lower quadrant, accompanied by anorexia, nausea, and low-grade fever.
3. On examination, tenderness is elicited over McBurney's point with guarding and rebound tenderness. Diagnosis is suggested by clinical scoring systems and confirmed by ultrasound or CT scan showing a thick-walled, inflamed appendix.
This document summarizes blunt abdominal trauma evaluation. It outlines the anatomy of the abdomen, common injury mechanisms and patterns including injuries to solid organs like the liver and spleen from deceleration forces. Assessment involves history of the traumatic mechanism and physical exam noting signs like abdominal tenderness. Diagnostic tools discussed include labs, plain films, diagnostic peritoneal lavage, focused assessment with sonography for trauma (FAST) exam, and CT scanning. Algorithms are provided for managing unstable versus stable patients based on exam and test findings.
This document discusses physiotherapy approaches for various abdominal surgeries including appendicectomy, hernia repair, nephrectomy, and operations on the small and large intestine. It outlines common indications, surgical procedures, complications, and post-operative physiotherapy protocols for mobilization and rehabilitation. The physiotherapy aims to safely progress exercises away from the incision site and address any postoperative problems like pain, reduced lung function, or risk of blood clots through techniques like chest physiotherapy, positioning, early mobilization, and pain relief measures.
Cancer Exercise Specialist Sample Of Breast Cancer Sectionleonardandrea
The document provides information about breast cancer and breast cancer treatments. It discusses the different types of breast cancer and how they are staged. It then describes various surgical procedures for breast cancer like lumpectomy, mastectomy, and lymph node dissection. It explains the potential side effects of these procedures. Finally, it discusses options for breast reconstruction after mastectomy like implants, tissue expanders, and latissimus dorsi flaps along with their potential complications.
This document discusses reconstructive breast surgery options after mastectomy or breast conservation therapy. It describes the multidisciplinary approach required and covers timing considerations for reconstruction. The two main types of reconstruction - prosthetic devices and autologous tissue reconstruction - are outlined. Autologous techniques discussed include pedicled and free TRAM flaps, latissimus dorsi flap, and various perforator flaps. Future directions like supramicrosurgery and tissue regeneration are also mentioned.
Appendicitis is characterized by inflammation of the appendix. it is most common abdominal emergency encountered in children. most common symptom is pain., vomiting and low - grade fever. Here, nurses play an important role in managing the problem before the doctor arrives. so read this out and it will help you in the future.
Right iliac fossa mass is a common clinical presentation and has a range of differentials that need to be excluded.
In this presentation will discuss RIF masses in briefly.
contact me / dr.3shaq@gmail.com
The document provides information about the anatomy, blood supply, function, pathology, clinical features, investigations, differential diagnosis, treatment and complications of acute appendicitis. It discusses the common retrocecal position of the appendix and describes obstructive and non-obstructive types of acute appendicitis. It also outlines the conservative and surgical management of appendicular masses and perforated appendicitis.
This updated encyclopaedia of anaesthesia and intensive care medicine covers aspects relating to Anesthesia & critical care medicine. With extensive line diagrams & topic descriptions, this is a reference title that every post graduate should own.
If you would like to purchase this title, please visit Elsevier Asia Bookshop.
The document discusses common post-operative complications in horses including gastrointestinal issues like adhesions and infections, as well as orthopedic complications involving casts and implants. It provides details on the pathophysiology, risk factors, prevention, and treatment options for various complications that can arise after surgery in horses such as adhesions, incisional infections, dehiscence, hernias, and rectal tears.
1) Appendicitis is caused by a blocked appendix, often due to stool, a foreign object, or cancer. It most commonly occurs between ages 10-30 and symptoms include abdominal pain that starts around the belly button and moves to the lower right side.
2) While an appendectomy was traditionally used to treat appendicitis, a recent study found that 80% of non-perforated cases can be treated successfully with antibiotics alone without increased risk of complications from delayed surgery.
3) For cases treated with antibiotics, 27% ultimately required an appendectomy within a year for recurring symptoms. However, no major complications occurred due to the initial delayed surgery.
This document discusses appendicitis during pregnancy. It covers the epidemiology, anatomical changes, pathophysiology, complications, diagnosis, differential diagnosis, and surgery of appendicitis in pregnant patients. The key points are that appendicitis occurs in about 1 in 1500 pregnancies, symptoms can be more difficult to diagnose due to pregnancy-related changes, ultrasound and CT scan are used for diagnosis but have limitations during late pregnancy, and prompt surgical treatment is indicated to prevent complications of perforation for both the mother and fetus.
The document provides information on the appendix, including its history, anatomy, embryology, physiology, acute appendicitis, neoplasms, and variants. Some key points include: the appendix was first depicted by Leonardo da Vinci in 1492; acute appendicitis is caused by obstruction leading to distention and infection, with symptoms like migrating right lower quadrant pain; imaging like CT can help diagnose appendicitis; complications include perforation; and neoplasms like carcinoid tumors or adenocarcinomas can rarely affect the appendix.
Non surgical mimics of appendicitis on imagingSumiya Arshad
This document discusses non-surgical conditions that can mimic appendicitis. Several gastrointestinal conditions are described, including mesenteric adenitis, bacterial ileocecitis, Crohn's disease, right-sided colonic diverticulitis, epiploic appendagitis, and omental infarction. These conditions can present with similar symptoms to appendicitis but are not caused by appendiceal inflammation and usually resolve with conservative treatment. Imaging plays an important role in differentiating these mimics from true appendicitis in order to avoid unnecessary surgery.
Plastic Surgery for obese, lower body lifts
Cosmetic and body reshape surgery liposuction...Dr Junaid Ahmad (MBBS FCPS) is the best plastic surgeon in Lahore. He is a well known, trained and expert in his field. He is MBBS and FCPS in Plastic and Recosntructive Surgery. He is a post graduate of the College of Physicians and Surgeons Pakistan which is oldest and best institute for post graduation in this area of the world. He is doing his practice in Lahore, Pakistan. He is always kind to the patients and listens them carefully as it is part of modern clinical skill and training. He is expert in both cosmetic as well as reconstructive surgery. He is also skin cancer and burn expert. A few of Dr Junaid Ahmad expertise are listed here..... call 03104037071
Thank you for the summary. Acute appendicitis is a common surgical emergency that requires timely diagnosis and management to prevent complications. A high index of suspicion is needed given its varied presentations.
The document discusses appendicitis, including:
- The blood and lymph drainage of the appendix, supplied by the appendicular artery.
- The symptoms of appendicitis include colicky abdominal pain shifting to the right lower quadrant, fever, nausea and vomiting.
- The diagnosis is clinical, using tests like the Alvarado score, and may include ultrasound or CT scans.
- Treatment is usually an appendectomy, which can be open or laparoscopic. Complications include wound infections, intra-abdominal abscesses, and adhesive bowel obstructions. Rarely, appendicitis can be treated non-operatively with antibiotics.
Colorectal cancer begins in the colon or rectum. It is the third most common cancer globally and incidence increases with age. Risk factors include family history, diet high in red meat, and certain medical conditions. Symptoms include changes in bowel habits, blood in stool, and abdominal discomfort. Diagnosis involves tests like colonoscopy, biopsy, and blood tests. Treatment depends on stage and location of cancer and may include surgery, chemotherapy, and radiation. Nursing care focuses on managing pain, nutrition, and educating patients. Prevention includes exercise, limiting red meat, and screening to detect and remove precancerous polyps.
The document summarizes the history and current practices of surgical management of breast cancer. It discusses:
1) The evolution from radical mastectomy to more conservative breast-conserving surgery and modified radical mastectomy based on evidence that removal of all breast tissue did not improve survival outcomes.
2) The types of breast surgery now commonly used including lumpectomy, quadrantectomy, mastectomy, and reconstructive surgeries using tissue expanders, implants, or flaps.
3) The indications and contraindications for different surgical procedures based on tumor size and location.
1. Acute appendicitis is caused by obstruction of the appendix lumen, leading to increased intraluminal pressure, edema, and bacterial invasion.
2. The classic presentation includes initially vague periumbilical pain that later localizes to the right lower quadrant, accompanied by anorexia, nausea, and low-grade fever.
3. On examination, tenderness is elicited over McBurney's point with guarding and rebound tenderness. Diagnosis is suggested by clinical scoring systems and confirmed by ultrasound or CT scan showing a thick-walled, inflamed appendix.
This document summarizes blunt abdominal trauma evaluation. It outlines the anatomy of the abdomen, common injury mechanisms and patterns including injuries to solid organs like the liver and spleen from deceleration forces. Assessment involves history of the traumatic mechanism and physical exam noting signs like abdominal tenderness. Diagnostic tools discussed include labs, plain films, diagnostic peritoneal lavage, focused assessment with sonography for trauma (FAST) exam, and CT scanning. Algorithms are provided for managing unstable versus stable patients based on exam and test findings.
This document discusses physiotherapy approaches for various abdominal surgeries including appendicectomy, hernia repair, nephrectomy, and operations on the small and large intestine. It outlines common indications, surgical procedures, complications, and post-operative physiotherapy protocols for mobilization and rehabilitation. The physiotherapy aims to safely progress exercises away from the incision site and address any postoperative problems like pain, reduced lung function, or risk of blood clots through techniques like chest physiotherapy, positioning, early mobilization, and pain relief measures.
Cancer Exercise Specialist Sample Of Breast Cancer Sectionleonardandrea
The document provides information about breast cancer and breast cancer treatments. It discusses the different types of breast cancer and how they are staged. It then describes various surgical procedures for breast cancer like lumpectomy, mastectomy, and lymph node dissection. It explains the potential side effects of these procedures. Finally, it discusses options for breast reconstruction after mastectomy like implants, tissue expanders, and latissimus dorsi flaps along with their potential complications.
This document discusses physiotherapy treatment for various pulmonary surgeries. It describes different types of thoracotomy incisions and their indications. It also discusses postoperative physiotherapy protocols for procedures like pneumonectomy, lobectomy, wedge resection and others. The goals of physiotherapy are to clear secretions, retain lung expansion, prevent complications and restore mobility. It covers management of chest drains and tubes as well as potential complications of pulmonary surgeries.
This document outlines different types of thoracic incisions used in cardiothoracic surgery. It begins with an historical perspective and then describes general workup, types of incisions like sternotomy, thoracotomy, and their variations. Complications are discussed. Current trends favor minimally invasive techniques like VATS, but open incisions remain important. The conclusion expresses hope for continued advancement while acknowledging current limitations.
1. Anesthesia for spine surgery presents several challenges including patient positioning, increased blood loss, and spinal cord protection.
2. Pre-operative assessment focuses on airway evaluation, neurological and cardiovascular status, and determining risk factors for complications.
3. During surgery, careful positioning, maintenance of stable anesthesia and hemodynamics, and monitoring for changes like abnormal SSEPs are important considerations.
4. Post-operative care involves managing pain, monitoring for complications, and addressing issues like respiratory function, neck edema, and injury risks from prolonged prone positioning.
This document summarizes upper abdominal surgery, including common procedures like splenectomy, gastric surgery, cholecystectomy, herniotomy, and hepatic surgery. It describes the definition, incisions, causes, diagnosis, and complications for each procedure. Postoperative rehabilitation is discussed over three stages: the first two days focusing on pain management and respiratory care; days three to four adding circulatory exercises and abdominal muscle strengthening; and from day five until discharge addressing any lingering pulmonary issues as well as posture and gait training.
Maternal injuries following childbirth are common and can lead to morbidity or death if not properly managed. Injuries often occur in the vulva, perineum, and cervix during delivery. Prevention focuses on proper conduct during the second stage of labor and taking care of the perineum. Risk factors for serious third degree tears include high birth weight babies, first births, narrow pelvis, and instrument-assisted deliveries. Injuries are usually repaired immediately but some tears may need to wait 3 months for repair. Complications include hemorrhage, infection, and problems with the pelvic floor later in life if not addressed properly.
Breast cancer is the most common cancer in women, affecting about 1 in 8 women over their lifetime. Risk factors include age, family history, certain genetic mutations, reproductive history, obesity, and alcohol use. Screening mammography can detect breast cancer early when treatment is most effective. Treatment may involve surgery such as lumpectomy or mastectomy, radiation, chemotherapy, hormone therapy, and breast reconstruction. Side effects of treatment can include pain, lymphedema, fatigue, and changes in body image. Long term follow up focuses on monitoring for recurrence and managing side effects.
This document provides information on medical terminology, anatomy, pathology, diagnostic procedures, imaging procedures, surgical procedures, and therapeutic procedures related to the female reproductive system. It defines anatomical structures, pathological conditions, diagnostic tests, imaging techniques, surgeries, and a contraceptive method. Key topics covered include the organs and tissues of the reproductive system, common infections and cancers, procedures like colposcopy and mammography, and surgeries such as hysterectomy and breast reconstruction.
This document summarizes evaluation and management of blunt abdominal trauma. It defines the abdominal anatomy, describes common injury patterns from compression or deceleration mechanisms. The assessment involves history of the traumatic mechanism and physical exam findings. Diagnostic tools discussed include peritoneal lavage, FAST ultrasound, and CT scan. Algorithms are provided for management of hemodynamically unstable versus stable patients based on EAST guidelines.
This document provides an overview of the abdominoperineal resection (APR) procedure for rectal cancer. It discusses the historical background, indications for APR, preoperative planning including imaging and marking of the stoma site. The document describes the surgical techniques for both the abdominal and perineal components of APR. It also reviews postoperative care, management of complications, and reported outcomes of APR.
1. Esophagectomy is a complex surgery that carries significant risks of postoperative complications, especially pulmonary complications which have a reported rate of 10-25%.
2. Factors that increase the risk include preexisting pulmonary disease, smoking history, advanced age, and comorbidities. Intraoperative risks include one-lung ventilation and postoperative risks include anastomotic leaks.
3. Careful preoperative optimization including nutrition support and screening for risk factors can help reduce complications. Goal-directed fluid management and lung protective ventilation strategies during surgery also aim to prevent postoperative pulmonary issues.
1. Pectus excavatum and pectus carinatum are the most common anterior chest wall deformities, with pectus excavatum occurring more frequently.
2. The Ravitch procedure and Nuss procedure are two common surgical techniques used to repair pectus excavatum, with Ravitch being an open resection and Nuss being minimally invasive.
3. Chest wall tumors can be either benign or malignant, with malignant tumors like fibrous histiocytoma and chondrosarcoma requiring wide resection for treatment.
This document provides information on the anatomy, pathologies, investigations, staging, and treatment of breast cancer. It describes the breast anatomy and lymphatic drainage. Common breast pathologies include discharges, duct ectasia, fibroadenomas, and breast cancer. Breast cancer is evaluated using triple assessment involving clinical examination, radiology, and histology. Treatment involves surgery such as mastectomy or breast-conserving surgery, along with chemotherapy, radiation therapy, and hormone therapy depending on the cancer stage.
- Congenital diaphragmatic hernia (CDH) and diaphragmatic eventration (DE) are congenital diaphragmatic malformations that result from abnormal development of the diaphragm. DE involves an abnormally thin diaphragm while CDH is a defect or abnormal attachment.
- For newborns with CDH, the current standard of care is delayed surgical repair after stabilization along with therapies like nitric oxide and ECMO. Surgery is rarely needed for asymptomatic DE in children.
- In adults, an elevated diaphragm is attributed to a congenital cause only after ruling out other etiologies, and surgery may be indicated for symptomatic DE or when it
Lecture by PROF.DR. AISHA ELBAREG {common gynecologic surgical-procedures}.Dr. Aisha M Elbareg
This document provides an overview of common gynecological surgical procedures and includes the following key points:
1. It describes procedures like dilation and curettage (D&C), endometrial ablation, and cervical cerclage - outlining their indications, techniques, and potential complications.
2. Endometrial ablation is presented as a minimally invasive option for abnormal uterine bleeding that does not require hysterectomy. Non-hysteroscopic methods like balloon and thermal ablation are discussed.
3. Cervical cerclage is explained as a surgical technique used to prevent cervical insufficiency and recurrent mid-trimester pregnancy loss, with prophylactic cerclage placed electively at 14 weeks
The document contains 24 numbered sections, each containing only a date of 2013/10/13 and a section label from I-1 to I-24. It appears to be a log or record of items from October 13, 2013 but provides no other context or descriptive information for the numbered sections.
The document discusses palliative care, which aims to relieve suffering and improve quality of life for patients with serious illnesses. It provides an overview of palliative care goals, processes, interventions, symptoms addressed, and tools used to assess patients' physical functioning and set functional goals. The document also outlines examples of physical therapy interventions for common issues like pain, dyspnea, and fatigue in cancer patients.
This document summarizes treatment for breast cancer, including surgery, radiation therapy, chemotherapy, hormone therapy, and targeted therapy. It discusses different types of breast surgery including mastectomy, breast-conserving surgery, lymph node surgery, and breast reconstruction. It also covers common side effects of chemotherapy and hormone therapy. Physical therapy exercises for breast cancer recovery are proposed in four phases focusing on range of motion, strength, flexibility, and endurance.
The document provides information about lymphedema including its causes, stages, treatments, and skin complications. It discusses conservative therapies like decongestive lymphatic therapy (DLT) which involves manual lymphatic drainage, compression therapy, skin care, and self drainage exercises. DLT is an effective treatment for lymphedema of various degrees by reducing lymphatic load and improving transport capacity. The document also covers bandaging techniques and compression garments.
The document discusses exercise for cancer patients across the cancer care trajectory. It covers goals of cancer rehabilitation including prevention, restoration, support, and palliation. It then discusses exercise for prevention, detection, coping with treatment, rehabilitation after treatment, survival, health promotion, and palliation. Specific benefits of exercise discussed include reducing cancer risk and recurrence, managing treatment side effects, and improving physical and psychological well-being.
This document discusses physical therapy approaches for cancer patients experiencing common symptoms like fatigue, pain, and breathing difficulties. It covers:
1. Definitions and screening tools for cancer-related fatigue and pain. Fatigue is graded on a scale and can interfere with daily activities. Pain is also assessed for intensity.
2. Non-pharmacological treatments for fatigue and pain including energy conservation, exercise, massage, heat/ice therapy, and electrotherapy. Exercise is recommended for patients during and after cancer treatment.
3. Cancer pain has multiple causes and classifications. The WHO pain ladder provides guidance on pain management strategies from non-opioid to opioid approaches. Physical therapy can help address pain through techniques like
This document discusses bone and soft-tissue tumors. It provides information on different types of bone tumors like osteosarcoma, chondrosarcoma, and Ewing's sarcoma. It also discusses approaches to musculoskeletal tumors including history, imaging, biopsy, and differential diagnosis. Surgical treatment options for bone cancers include resection, reconstruction, and prosthesis replacement. Limb salvage is preferred over amputation when possible. Follow-up care after treatment is also covered.
Radiation therapy can cause complications and side effects. Common early side effects include mucositis, dermatitis, and hair loss affecting areas receiving radiation. Late effects include xerostomia, osteoradionecrosis, brain necrosis, myelitis, fibrosis, and endocrine changes. Trismus, a limited opening of the mouth, is a complication for head and neck cancers. Physiotherapists can help with trismus management and pulmonary rehabilitation. Precautions and symptom management strategies are needed depending on the radiation site and timeline.
2. Goal of surgery
2
Debulking a tumor:表示腫瘤已無法完全切除,因此開
刀時只將較大,較易切除的腫塊拿掉
Diagnosing a tumor(biopsy)
Removing precancerous(癌前期) lesions
Resecting a tumor
Correction of life-threatening conditions caused by
cancer
Palliation
3. Theme for postsurgery physical therapy
3
Early mobilization
Prevention of complications: pneumonia, ileus, DVT, loss of lean
body mass
Lung hygiene
Splinting cough, diaphragm/deep breathing exercise, posture
education
Gait training
Weight bearing restriction? pain?
ADL training
4. Management of some common cancer
4
Breast cancer
Head and neck cancer
Lung cancer
Colorectal cancer
Gastrointestinal cancer
5. Breast cancer
5
Introduction of surgery type
Post op programs
7. Lumpectomy or partial mastectomy
7
removal of the breast tumor
(the "lump") and some of
the normal tissue
Lumpectomy : Tumor size<4
cm
8. Mastectomy
8
Removal of the whole breast
Simple/ total mastectomy
Modified radical mastectomy
Radical mastectomy
Partial mastectomy
Subcutaneous (nipple-sparing) mastectomy.
9. Simple Mastectomy
9
removes the entire
breast, skin, nipple
No muscles are
removed from
beneath the breast
10. Modified Radical Mastectomy
10
removal of both breast
tissue and lymph nodes:
優點:維持胸部肌肉及
手臂肌肉的張力,
手臂腫脹的情形較施行
乳房根除術輕微
乳房重建較易。
11. Radical Mastectomy
11
Most extensive type of mastectomy
Removes :
the entire breast,
Levels I, II, and III of the
underarm lymph (B, C, and D in
illustration),
chest wall muscles under the
breast.
缺點:會留下很長的疤痕,胸部也
會凹陷,可能導致淋巴水腫、手臂
無力、痲痹、疼痛、肩膀活動受限
制等,
12. Post op programs
12
Progressive shoulder ROM exercise:
Begin after removal of the drains
http://www.breastcf.org.tw/bloom/personal.php
Postural exercise
Lymphedema education
13. Head and neck cancer
13
Site: Lip, tongue, floor of mouth, gum, salivary gland,
oropharynx, nasopharynx, larynx, nose and sinuses,
ear, thyroid
Surgery type
Radical neck dissection:
Modified radical neck dissection
Selective neck dissection
14. Head and neck cancer
14
Reconstruction: TMJ dysfunction
Pectoralis flap:
Fibular flap:
reconstruct the mandible bone; non-weight bearing for 4-7 days
Vascular integrity, peroneal nerve function
Transfer skill, bed mobility
Radical forearm flap:
no weight bearing activity on donor site,
ROM limited to 90 degree before drains removed
15. Head and neck cancer
15
Post op care in acute phase
Maintain airway, Lung hygiene and tracheotomy care
Monitor circulation
Prevent infection
Control pain
Postural training
Cervical and shoulder ROM exercise
16. Airway management and tracheostomy care
16
Aim of care
Ensure a patent airway
Maintain comfort
Ensure regular breathing rhythm, depth, and pattern
Complication
Bleeding
Tracheoesophageal fistula
Infection
Obstruction or displacement of tracheostomy tube
PT programs
Breathing exercise, cleaning of tracheostomy q2-3h(suction),
humidification
17. Lung cancer
17
Small cell lung cancer
High growth rate
Worse progonosis
Non small cell lung cancer
Squamous cell carcinoma
Adenocarcinoma
Large-cell carcinoma
19. Reduced respiratory capacity after lung surgery
19
↓25-30%functioning lung tissue after lobectomy or
bilobetomy
↓40% after left pneumonectomy
↓60% after right pneumonectomy
Indicators for post-op lung function
%FEV1
Diffusion capacity of the lung for carbon monoxide
Maximal oxygen uptake during exercise
Provide oxygen
21. Lung cancer
21
Post op care
Symmetrical movement of the thoracic cage
ROM of shoulder
Breathing training: pursed lip and diaphragmatic
breathing
Drainage of secretions/ percussion, use of
nebulizers
Splinting cough
Reconditioning: early ambulation, functional
independent
22. Symptoms and signs of Radiation pneumonitis
22
Dyspnea
Non-productive cough
Tachypnea
Low grade fever
Fullness in the chest
↑ESR
Treatment: corticosteroids,
24. Possible organ displacement after right
pneumonectomy
24
Displacement of the tracheal to the right side
Displacement of esophagus
Mediastinal displacement to the empty pleural space
Elevation of diaphragm and liver
Deviation of the vertebral column
25. Superior vena cava obstruction
25
Tumor compress
Neck swelling
Distended veins over chest
Swelling of one or both arms
Dyspnea
Hoarse voice
Stridor
Headache
27. PT intervention for SVCO
27
Elevate the patient‘s head
Oxygen therapy
Modified chest care skill
Avoid compression therapy
28. Colon cancer
28
Ileostomy: after removal of colon and rectum,
externalized ileum
Colostomy: rectum removed, distal colon attached to
abdominal
Ileo-anal reservoir surgery
30. Precautionary measures to prevent abdominal wall
hernia
30
Caution in lifting and carrying heavy loads
Loads should never lifted suddenly
Excess weight should be avoided
Abdominal bandage
31. Example of physical therapeutic interventions for
abdominal surgery
31
Breathing exercise
Deep breathing/ inspiratory holds
Incentive spirometry
Huffing/ directed cough
Chest percussion/vibration
Early mobilization
Log-rolling /bracing with pillow
Transfer/ gait training
Progressive ambulation
33. Pre/post upper abdominal and thoracic surgery
33
Pre op assessment: FEV1
Post op increased risk of respiratory complication:50%
Disruption of abdominal and diaphragmatic muscles
↓30%FRC for days
Impaired mucociliary function
PT programs
Breathing exercise, Deep breathing, Incentive spirometry,
Huffing, Chest percussion/vibration
Early mobilization
34. Precaution for PT programs after upper abdominal
and thoracic surgery
34
Avoid head down postural drainage:
Suction ??
Drips and drains
Shoulder ROM
35. The environment and patient support/non-
intravenous equipment after GI sugery
35
IV fluid
TPN
Enteral nutrition: PEG (percutaneous enteral
gastrostomy), J-tube (jejonostomy), NG
PRBC (paced red blood cell): ↑the O2 carrying
capacity of blood
FFP(fresh frozen plasma): ↑blood volume
Stop PT
JP (Jackson-Pratt) drain
Sump drain
Foley
36. Breathlessness management
36
Breathing exercise
Positions
High side lying
Sitting upright in a chair with feet, back, and arm support
Forward lean sitting with arm resting on pillows on a table
37. Bone metastasis
37
Location of metastatic bone disease
Vertebrae 69%
Pelvis 40%
Femur 25%
Ribs 25%
Humerus 20%
38. Pain characteristics that may indicate fracture
or impending fracture
38
Pain with weightbearing
Pain in the groin
Pain with hip external rotation and abduction
Pain with deep breathing
Pain in a ban around the chest wall
Increased pain with supine
Increased pain with valsava
39. Goal of Surgery for pathological fracture
39
Excision of tumor
Cure
Stabilization of bone
Prevention sequela from bed rest
Palliation
40. Reference
40
Physical therapy in acute care : a clinician's guide .
Edited by Daniel Malone Thorofare, NJ : Slack, 2006.
Rehabilitation in cancer care. edited by Jane Rankin
Chichester, UK ; Ames, Iowa : Wiley-Blackwell, 2008.