ZF Teaches

20/08/2025

Nine main pulse points with brief explanations:

1. Temporal Pulse
Location: At the temple, just above and to the side of the eyes
Use: Checking circulation in the head or during CPR

2. Carotid Pulse
Location: On either side of the neck, beside the windpipe
Use: Commonly used in emergencies; strong and easy to find

3. Apical Pulse
Location: At the apex of the heart, left side of the chest, 5th intercostal space midclavicular line
Use: Most accurate for infants and for auscultation with a stethoscope

4. Brachial Pulse
Location: Inside of the upper arm, between the biceps and triceps
Use: Commonly used for blood pressure measurement and in infants

5. Radial Pulse
Location: On the wrist, thumb side
Use: Most commonly used pulse point for checking heart rate

6. Ulnar Pulse
Location: On the wrist, little finger side
Use: Less commonly used; helps assess blood flow to the hand

7. Femoral Pulse
Location: In the groin area where the thigh meets the pelvis
Use: Checking circulation to the leg and during emergencies

8. Popliteal Pulse
Location: Behind the knee
Use: Assesses blood flow to the lower leg

9. Dorsalis Pedis Pulse
Location: On the top of the foot
Use: Checks circulation to the foot, important for diabetic patients

20/08/2025

30/01/2025

20/01/2025

Piriformis syndrome

🗣️Examination

A complete neurological history and physical assessment of the patient is essential for an accurate diagnosis.

The physical assessment should include the following points:

👉an osteopathic structural examination with special attention to the lumbar spine, pelvis and sacrum, as well as any leg length discrepancies.
👉diagnostic tests.
👉deep-tendon reflex testing, strength and sensory testing.

🗣️Palpation

👉The patient reports sensitivity during palpation at the greater sciatic notch, in the region of sacroiliac joint or over the piriformis muscle belly. It is possible to detect the spasm of the PM by careful, deep palpation.

👉With deep digital palpation in the gluteal and retro-trochanteric area, there may be tenderness and pain with an exacerbation of tightness and leg numbness.

🗣️Observation:

👉Patients with piriformis syndrome may also present with gluteal atrophy, as well as shortening of the limb on the affected side.In chronic cases, muscle hypotrophy is present in the affected extremity.

🗣️Special test:

👉Lasèque sign / Straight Leg Raise Test.
👉FAIR test.
👉Hughes test.
👉Hip Abduction Test.
👉Trendelenburg Test.
👉Beatty’s Manoeuver
👉Freiberg Sign
👉Pace sign

16/09/2024

*Weakness of wrist extension* ✅
C5-C6 (C6 nerve root): Pain, tingling, and/or numbness may be felt in the thumb side of the hand. Weakness may also be experienced in the biceps (muscles in the front of the upper arms) and wrist extensor muscles in the forearms. The C5-C6 disc is one of the most common to herniate.

*Myotome*
A myotome (greek: myo=muscle, tome = a section, volume) is defined as a group of muscles which is innervated by a single spinal nerve root. Myotome testing is an essential part of neurological examination when suspecting radiculopathy. Myotomes are much more complex to test then dermatomes, since each skeletal muscle is innervated by nerves derived from more than one spinal cord level.

Myotomes are a part of the somatic nervous system and the somatic nervous system is a part of the peripheral nervous system.

*There are 31 spinal nerves, each vertebrae has a spinal nerve. The nerves are categorized by the vertebra which house them. There are 8 cervical nerves, 12 thoracic nerves, 5 lumbar nerves, 5 sacral nerves,1 coccygeal nerve. 16 of these 31 nerves has a specific myotome that controls voluntary muscle movement.*

*Upper Extremity Myotomes*

C5 : Shoulder Abduction

C6 : Elbow Flexion
Wrist Extension

C7 : Elbow Extension

C8 : Thumb Extension
Ulnar Deviation

T1 : Finger Abduction

*Lower Extremity Myotomes*

L2 : Hip Flexion
L3 : Knee Extension
L4 : Ankle Dorsiflexion
L5 : Big Toe Extension
S1 :Ankle Plantarflexion
S2 : Knee Flexion

*Purpose*
Testing of myotomes, in the form of isometric resisted muscle testing, gives information about the level in the spine where a lesion may be present. During myotome testing, you are looking for muscle weakness of a particular group of muscles. Results may indicate lesion to the spinal cord nerve root, or intervertebral disc herniation pressing on the spinal nerve roots. The muscle strength grading scale, which assigns a rating to the degree of muscle weakness, is often used.

15/09/2024

*Diminished Achilles Tendon Reflex* ✅. In the posterolateral disc herniation at L5-S1 level, the S1 root will be involved. Achilles reflex is S1 so Option C is the correct answer.

15/09/2024

*React Accordingly*
A. ❤️
B. 👍🏻
C. 😮
D. 😂

01/05/2024

Dr.Zfabbasi:
Hepatitis B is a viral infection that affects the liver, causing inflammation and damage. Here are some key points about Hepatitis B:

*Causes:*

- Hepatitis B virus (HBV) is transmitted through:
- Blood and bodily fluids
- Mother-to-child during pregnancy or childbirth
- Contaminated needles or medical equipment
- Sexual contact
- Organ transplantation

*Symptoms:*

- Fatigue
- Loss of appetite
- Nausea and vomiting
- Abdominal pain
- Dark urine and pale stools
- Yellowing of the skin and eyes (jaundice)

*Types:*

- Acute Hepatitis B: Lasts less than 6 months
- Chronic Hepatitis B: Lasts more than 6 months
- Fulminant Hepatitis B: Severe and life-threatening

*Complications:*

- Liver cirrhosis
- Liver failure
- Liver cancer
- Kidney disease

*Diagnosis:*

- Blood tests (HBsAg, HBcAb, HBeAg)
- Liver function tests (LFTs)
- Liver biopsy

*Treatment:*

- Antiviral medications (e.g., lamivudine, adefovir)
- Interferon therapy
- Liver transplantation (in severe cases)

*Prevention:*

- Vaccination (recommended for all newborns and high-risk individuals)
- Safe s*x practices
- Avoid sharing needles or personal care items
- Proper sterilization of medical equipment

If you have any specific questions or concerns about Hepatitis B, feel free to ask!