This document provides information about fractures of the talus bone in the foot. It begins with the osseous anatomy of the talus, describing its articulations and vascular supply. It then discusses different types of talar fractures, including fractures of the talar head, neck, and body. Classification systems and treatment options are described for each type of fracture. Complications of neck of talus fractures include osteonecrosis, post-traumatic arthritis, and malunion. The document emphasizes the importance of the blood supply to the talus in fracture healing.
Please find the power point on Fracture of Talus with well diagrammatic explanation from very reliable sources. If you need such a power point on different topics related with MBBS then please write it on comment section. Thank you
Please find the power point on Fracture of Talus with well diagrammatic explanation from very reliable sources. If you need such a power point on different topics related with MBBS then please write it on comment section. Thank you
Distraction osteogenesis is a method of producing unlimited quantities of living bone directly from a special osteotomy by controlled mechanical distraction. The new bone spontaneously bridges the gap and rapidly remodels to a normal macrostructure for the local bone.
Deformity: It’s the position of a limb/Joint, from which it cannot be brought back to its normal anatomical position.
Described as abnormalities of :
Length
Angulation
Rotation
Translation
Combination
Distraction osteogenesis is a method of producing unlimited quantities of living bone directly from a special osteotomy by controlled mechanical distraction. The new bone spontaneously bridges the gap and rapidly remodels to a normal macrostructure for the local bone.
Deformity: It’s the position of a limb/Joint, from which it cannot be brought back to its normal anatomical position.
Described as abnormalities of :
Length
Angulation
Rotation
Translation
Combination
presentation on how to manage fracture talus surgically.various fracture types fixation demonstrated by dr mohamed ashraf,HOD govt TD medical college alleppey kerala india
biomechanics of foot and ankle discusses the bony components of foot and ankle and discusses the architectural organization of the foot, and discusses the importance of ligamentous and muscular structures of foot and ankle that supports the joint and helps in locomotion.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
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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
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
2. OSSEOUS ANATOMY OF
TALUS
❖ Talus is one of the 7 tarsal bones of the foot
❖ It acts as a connecting link between the Foot and the Leg
❖ It is unique as 60% of it’s surface is articular, which articulates
with Tibial plafound, Medial malleolus, Lateral malleolus,
Calcaneum, and Navicular bones
❖ It has Ligamentous and Capsular attachments, but no
muscular attachments
3. In Greek Mythology, Talos was a giant God with single large vein coursing through his
body.Because of this vulnerable vascularity, his crucial weakness was ease of
exsanguination
❖ Talus has
A. Head
B. Neck
C. Body
D. Lateral Process
E. Posterior Process
4. ❖ Head is intra-articular
• Anteriorly : NAVICULAR bone
• Inferiorly : Sustentaculum Tali of
Calcaneum
❖ Head is supported inferiorly by
Plantar Calcaneo-navicular or
Spring ligament
❖ All three together form Talo-
Calcaneo-Navicular joint
5. ❖ NECK is non-articular
❖ It forms 15˚ angulation medially
with the body
❖ Medial - Sinus Tali corresponds
with Sinus Calcani to form
TARSAL CANAL
❖ Lateral - tarsal canal opens into
funnel shaped TARSAL SINUS
7. ❖ LATERAL PROCESS :
• Wedge shaped
• Superiorly and Laterally -
Lateral malleolus
• Inferiorly and Medially -
Calcaneum
8. ❖ POSTERIOR PROCESS :
• It has Medial and Lateral tubercle
• FHL in b/n
• Lateral : Anterior, Lateral, and
Posterior Talofibular Ligament
• Medial : Deltoid ligament
• OS TRIGONUM - seen in 50%
people, develops from separate
ossification centre posterior to
Lateral tubercle
9. VASCULAR ANATOMY OF
TALUS
❖ Talus 60% of it’s surface is articular
❖ It receives blood supply through Capsular and Ligamentous attachments, and Nutrient
foramen in the Neck
❖ Talus is supplied by
A. Anterior Tibial artery
- Dorsalis Pedis artery
B. Posterior Tibial artery
- Posterior tubercle artery
- Artery of Tarsal Canal
- Deltoid artery
C. Peroneal artery
- Artery of Tarsal Sinus
13. ❖ Head and Neck - by DPA
❖ Body
- Medial 1/3 - Deltoid lig
- Middle 1/3 - Artery of Tarsal
Canal
- Lateral 1/3 - Artery of Tarsal
Sinus
❖ Posterior tubercle
- Branches from Posterior
Tibial artery
14. ❖ Crucial Anastomotic Sling is formed in
the Tarsal canal b/n Artery of Tarsal
canal and Artery of Tarsal Sinus
❖ It gives branches to the Body of Talus
from Distal to Proximal
❖ In # Neck of Talus, this is disrupted
leading to Osteonecrosis of Body of
Talus
16. CLINICAL EXAMINATION
❖ Patients presents with h/o trauma
❖ Followed by c/o Pain and swelling of the hind foot
❖ Restriction of movements of the ankle
❖ O/E : Tenderness over Talus and Subtalar joint
: Restriction of Ankle and Subtalar movements
18. ❖ CT SCAN - required to detect the fracture pattern
❖ MRI SCAN - may be done to identify the soft tissue
injury
19. CLASSIFICATION
❖ TALAR HEAD FRACTURES
❖ TALAR NECK FRACTURES
❖ TALAR BODY FRACTURES
❖ LATERAL PROCESS FRACTURES
❖ POSTERIOR PROCESS FRACTURES
20. TALAR HEAD FRACTURES
❖ MECHANISM OF INJURY:
• Fall from ht, with Foot in plantar
flexion and compression force
along the long axis of the
forefoot
Talo-Calcaneo-Navicular jt
disruption
Shortening of the medial column
Loss of the Medial longitudinal
arch
23. TALAR NECK FRACTURES
❖ Most common type of Talar
Fractures
❖ It is so called, if # inferior line is
distal to Lateral process of
Talus
❖ AVIATORS ASTRAGALUS :
Pilots resting the sole of the
foot on the rudder bar in crashing
plane at the point of impact
causes Hyperdorsiflexion of ankle
causing Talar neck #
24. MECHANISM OF INJURY
With Hyperdorsiflexion, Posterior capsular ligament of Subtalar jt
rupture and Neck of Talus impacts against Anterior edge of Tibia,
leading to TALAR NECK #
With continuation of dorsiflexion force, Calcaneus with rest of foot
subluxate forward, leading to Subtalar Subluxation
With continuation of dorsiflexion force, Posterior capsular ligaments of
ankle jt, Posterior Talo-fibular lig, and Deltoid lig rupture
Body of Talus is the wedged Postero-medially out of Tibial mortise, b/n
Medial malleolus and Tendo-achilles, leading to Subluxation of ankle jt
With further dorsiflexion, Talo-navicular jt subluxation occurs
25. HAWKIN’S CLASSIFICATION
❖ Type I : Nondisplaced
❖ Type II : Displaced with Subtalar
Subluxation
❖ Type III : Ass with Subtalar and Ankle
subluxation
❖ Type IV : Ass with Subtalar, Ankle and
Talo-Navicular subluxation
AVN
TYPE I 0-25%
TYPE II 25-50%
TYPE III 50-75%
TYPE IV 75-100%
28. SURGICAL APPROACH
❖ Type II, III, IV are difficult to obtain anatomical reduction by closed reduction
29.
30.
31. TALAR BODY FRACTURES
❖ It is so called, if # line is proximal to Lateral process of
Talus
❖ Incidence of AVN is same in Neck and Body #, but Post-
traumatic arthritis is more with Body #
32. MECHANISM OF INJURY
❖ Axial compression of Talus b/n Tibial Plafound and
Calcaneum
❖ Occurs due to fall from height or Motor vehicular
accidents
35. CALCANEOTIBIAL FUSION
BLAIR TIBIO-TALAR SLIDING GRAFT
ARTHRODESIS
Antero-lateral incision Antero-lateral incision
Talectomy done Comminuted # fragments are removed
Posterior Displacement of navicular to
come in contact with Tibia
Sliding graft from anterior surface Tibia
used to fill the gap
Painless and stable No Posterior displacement of navicular
Decrease in Height and length of foot Foot is not shortened
Ankle and Subtalar jt are lost Subtalar and Talo-navicular jt are intact
Compensatory Midtarsal movements are
present
Subtalar and Midtarsal movements are
present
36.
37.
38.
39. LATERAL PROCESS OF
TALUS #
❖ Lateral process # occurs on EVERSION OF DORSIFLEXED AND
AXIALLY LOADED FOOT
❖ Seen in Snowboarding injuries
❖ Lateral process has attachments to Anterior, Lateral and Posterior
Talo-fibular ligaments
❖ V-sign for Radiographic diagnosis
44. POSTERIOR PROCESS OF
TALUS #
❖ Posterior process of Talus has
Medial and Lateral tubercles with
FHL passing in the groove
❖ Medial tubercle - Deltoid Lig
❖ Lateral tubercle - Posterior
Talofibular lig
45. MECHANISM OF INJURY
❖ Medial tubercle of Posterior process # - Forceful
eversion of the ankle
❖ Lateral tubercle of Posterior process # - Forceful
inversion of the ankle
48. 1. OSTEONECROSIS of Body of Talus :
in # neck of Talus, Due to loss of blood supply
- TALECTOMY + TIBIOCALCANEAL FUSION
- BLAIR TIBIO-TALAR SLIDING GRAFT ARTHRODESIS
2. Post-traumatic Arthritis
3. Malunion of Neck of Talus
- CORRECTIVE OSTEOTOMY OF NECK
4. Skin necrosis