Physiotherapynetic

07/01/2025

13/06/2024

✍️Radiculopathy is a clinical condition which involves one or more nerves resulting in impaired function (a neuropathy).
✍️The site of injury in radiculopathy is at the level of the spinal nerve root.
✍️The result is pain (known as radicular pain), weakness in limbs, numbness/paresthesia, and difficulty in controlling specific muscles.

✍️In radiculopathy, the problem occurs at or near the site of the origin of the nerve root as it exits from the spinal cord, but the pain and accompanying symptoms usually radiate to the part of the body that is supplied by that specific nerve
❌ For example, a nerve root impingement in the cervical spine may result in pain and weakness in the forearm.
✍️Similarly, an impingement in the lumbar region can be manifested with symptoms in the foot.

12/06/2024

Toe lifts:
It uses isometric contractions to strengthen the foot muscles. To do it, press your big toe into the ground while lifting your other four digits off the ground. Hold this contraction hard for 10 seconds, then switch: Press your lateral four toes into the ground while lifting your main phalange.
Repeat this process 4-5 times, pressing and lifting the toes as hard as you can.

Even though we ask a great deal from them, neglect has relegated the feet to a strong position far removed from the rest of the body.
They need a lot of input to catch up.

12/06/2024

Lumbar puncture:
✍️It is done to withdraw cerebrospinal fluid for various diagnostic and therapeutic purposes.
The puncture should be done below the termination of the cord ie the lower border of L1.

✍️A horizontal line joining the highest points of the iliac crest passes through the spine of the 4th lumbar vertebrae. therefore the interspinous spaces immediately above and below this landmark can be used for safety. The interspinous space between L3& L4 is the most preferred site because in this region subarachnoid space is more roomy and contains only filum terminale and roots of lumbar, sacral, coccygeal nerve forming caudal equine.
✍️During this procedure, the spine must be fully flexed with the patient either lying on the side or seated. so that the interspinous space is opened up to its maximum extent and the lower end of the spinal cord is slightly raised.
✍️The needle is passed inwards and somewhat cranially exactly in the midline. the supraspinous and interspinous ligaments are transvered and then the dura mater is penetrated the latter with a distinct feel of give way.
✍️Occasionally root pain is experienced if the roots of the caudal equine are impinged upon, but usually, they float clear of the needle.

24/05/2024

Head Injury is a frequent cause of emergency department attendance, accounting for approximately 3.4% of all presentations with an incidence of around 450 cases per 100000 population per year In the UK around 500000 children with head injuries attend hospitals every year and

head injury admissions account for nearly 10%.
Head injury associated with Traumatic Brain Injury TBI occurs at an incidence of 20-40 cases per 100000 population per year. most common cause of death in young adults aged 15-24 years and more common in males than females.RTA are most common cause of TBI in the UK.
The cost of poor outcomes from TBI is measured not only in personal terms but also in socio-economic costs of neuro-rehabilitation, long-term nursing care supportive care and lost income generation.

🔬Pathophysiology:
Cerebral blood flow and autoregulation :
Normal CBF is approx 55ml 100g min, maintained by cerebral autoregulation Mean arterial pressure of b/w 50 and 150 mmHg.
Intracranial pressure and brain herniation:
The brain is confined by a rigid container, the skull, mass lesion displacement of CSF and venous blood out of the intracranial cavity.

🧪Primary vs. secondary brain injury
Primary injury occurs at the time of impact and includes injuries such as the Brainstem and hemispheric confusion, diffuse axonal injury and cortical lacerations.

The secondary injury occurs after the moment of impact and is often preventable, causes are hypoxia, hypotension, raised ICP, reduced cerebral perfusion pressure and pyrexia.

24/05/2024

Evaluation of the adult patient with a seizure :
CBC, CNS, CT, EEG,MRI

24/05/2024

Pregnancy back care :
Postural, hormonal and weight changes, ergonomic education involving sitting and working positions, bending, lifting and household activities should all be considered. ideally, no woman should go home without an individual posture check, instructions on using seatbelts during pregnancy and information regarding access to further help if she is experiencing back pain or other physical discomfort.

23/05/2024

♦Gout: It is a type of inflammatory arthritis that causes pain and swelling in your joints, usually as flares that last for a week or two, and then resolve.
Gout flares often begin in your big toe or a lower limb. Gout happens when high levels of urate build up in your body over a long period, which can then form needle-shaped crystals in and around the joint.
This leads to inflammation and arthritis of the joint. When the body makes too much urate or removes too little, urate levels build up in the body. However, many people with high levels of serum urate will not develop gout.

🖍Areas of the body that can be affected by gout include:

Joints.

Bursae, are cushion-like sacs between bones and other soft tissues.

Tendon sheaths are membranes that surround tendons.

Kidneys, because the high uric acid levels can lead to stones.

Gout is a disease that can move through several stages:

Hyperuricemia is when you have elevated levels of urate in your blood over a long period and even crystals in the joint, but you do not have symptoms.

Gout flares, when you have periodic attacks of intense pain and swelling in your joints.

Interval or intercritical gout is the time between gout attacks when you do not have any symptoms.

Tophi is a late stage of gout when crystals build up in the skin or other areas of the body. Depending on their location, tophi can permanently damage your joints and other internal organs such as the kidneys. Proper treatment can prevent the development of tophi.

21/03/2024

Cardiomyopathy:
🖍Cardiomyopathy is a disease that affects the myocardium (heart muscle).
make heart stiffen, enlarge or thicken and can cause scar tissue. As a result, the heart can’t pump blood effectively to the rest of your body.

🖍Types of cardiomyopathy include:

Dilated cardiomyopathy.
Hypertrophic cardiomyopathy.
Ischemic cardiomyopathy.
Arrhythmogenic right ventricular dysplasia (ARVD).
Restrictive cardiomyopathy.
Transthyretin amyloidosis cardiomyopathy (ATTR-CM).
Broken heart syndrome (stress-induced or takotsubo cardiomyopathy).
Chemotherapy-induced cardiomyopathy.
Alcohol-induced cardiomyopathy.
Left ventricular non-compaction (LVNC).
Peripartum cardiomyopathy.

✏️Cardiomyopathy can affect anyone of any age, s*x or race. The most common inherited cardiomyopathy, hypertrophic, affects about 1 in 500 people in the world. Other genetic types occur in 1 in 2,000 or 2,500 people.
✏️ symptoms include:

Fatigue.
Heart palpitations.
Chest pain.
Arrhythmia.
Shortness of breath (dyspnea).
Swelling (edema) in your legs or ankles.

03/03/2024

Aphasia: It is a communication disorder caused by brain damage and characterized by an impairment of language comprehension formulation.

✍️It affects the sounds and vocabulary or expression and reception (understanding ).
Aphasic patients may have difficulty reading (dyslexia) and writing (agraphia) and( acalculia)
Types:
✔️Global aphasia
✔️Isolation aphasia
✔️Broca aphasia
✔️Transcortical motor aphasia
✔️Wernicke’s aphasia
✔️Transcortical sensory aphasia
✔️Conduction aphasia
✔️Anomic aphasia

Some tests are MinneapolisTestfor differential diagnosis for Aphasia(MTDDA)
The porch index of communicative ability (PICA)

12/02/2024

Systemic inflammatory response syndrome:
SIRS is a non-specific widespread inflammatory reaction which takes place in response to a pathological event (ischemia, trauma, infection)
This inflammatory process results in a disorder of microcirculation, a decrease in organ perfusion and finally organ dysfunction.
is defined as SIRS-caused by infections and severe sepsis with evidence of organ dysfunction.
Septic shock is associated with hypotension unresponsive to fluids or requires inotropes for its management.

Sources of sepsis in the postoperative period:
Wound infection
Urinary tract infection
Ventilator-associated Pneumonia (VAP)
Intravenous line-related infection
Sinusitis
Prosthesis infection
Gastrointestinal Infection

12/02/2024

In renal failure increased interval between doses (CrCl 10-50 mL/min:q8 -12h, CrCl