PhysioguidebydivyaA

 A lateral (sideway) curvature of the spine which exceeds by 10° from the normal is termed as scoliosis.  Types:- it is basically of two types they are: Postural or Non - structural scoliosis Structural scoliosis.  Postural or Non-Structural Scoliosis This is Grade 1 scoliosis. This occurs without any bony changes or muscle weakness.  Causes :- Impairment of the reflex mechanism.  Wrong postural habits, eg: Standing with stress on one leg or psychological factors.  The postural scoliosis may get organized into a structural one, due to secondary soft tissue contractures in muscles and ligaments on the concave side of the curve.  Structural scoliosis:- This is Grade 2 and 3. In this type there is defect in the bone which results in contractures of the soft tissue on the concave side of the curve and reciprocal stretching on the convex side.  Classification :- Idiopathic Scoliosis Paralytic Scoliosis Congenital Scoliosis.  Idiopathic scoliosis:- this is again divided into: Infantile Scoli

 The breathing exercises are useful to loosen secretions. breathing exercises are combined with postural drainage, exercises respiratory therapy devices and medications.  Classification :-  Diaphragmatic breathing :- Aims :-  To remove gas exchange To improve oxygenation To improve ventilation To improve ascent or descent of the diaphragm To mobilize lung secretions during postural drainage To decrease work of the breathing.  Procedure :-  Position of the patient half lying supported by pillows Physiotherapist stands besides the patient.  Technique - hands should be placed on the rectus abdominis below the anterior costal margin  Initially therapist places hands on patient abdomen and ask him to inspire so that abdomen bulges out and contracts Ask the patient to breathe in through the nose and breathe out through the mouth. Practice the same 3 or 4 times then rest for brief period of time.  Train the patient to practice the on his own by keeping hands on the abdomen.  Segmental breathi

 The inhalation therapy is used to break up the mucus and to induce the relaxation in bronchial smooth muscle by using the bronchodilators This is done by:-  Aerosol Nebulizer These both can be given during intermittent positive pressure breathing  or steam inhalation.   Aerosol :-  This is the hand held device and commonly used. The patient should be trained the correct method of use of the inhalers to prevent the loss of the drug to the atmosphere. The correct technique of use of aerosol ensures the patient the maximum amount of the drugs ethers the lung.  The effectiveness of the drug can be endured by correct release. Usually only 10% of the drug reaches the bronchi and 90% of the drug is swallowed. So drug should be released at the beginning of the inspiration to ensure maximum amount of the drugs reaches the bronchi instruct the patient to hold the breathe for about 10sec and expire quietly through the nose. The patient should take a gap of one minute before starting with the nex

 It is the process in which a Human embryo/ foetus gestates during pregnancy from fertilization untill birth.  Period of the Foetus - From 9th week till Birth.  The Zygote Month - 1 Fertilized egg reaches the uterus & attaches itself to the uterus  Cell multiplication begins  Internal organs & circulatory system begins to form Cell division takes place & at the end of 2weeks the Zygote is the size of a 'pin- head'.  Heart begins to beat Small bumps show the beginning of Arms & legs.  Month - 2 (zygote)  At 5weeks, the embryo is 1/4 inch long  All major organ systems develop The placenta & umbilical cord develops.  Amniotic fluid surrounds the baby Face & limbs take stage Month - 3 (the foetus)  The foetus is about 1inch long Nostrils, Mouth, lips, teeth buds & eyelids form Fingers & toes are almost complete Eyelids are fused shut All internal organs are present but aren't ready to function The genital organs can be recognised as Male Or femal

 To remove the secretions - Effective Coughing, Huffing, Forced expiration technique, Suction Effective Coughing :- Definition : The coughing is the forced expiration technique against a closed glottis.  Aim : To clear the secretions from the trachea and bronchi.  Technique : The patient is asked to take deep breathe then tighten the abdominal muscle and cough. The air is breathed is high lung volume and deep breathe.  Effects and uses: The coughing clears the secretions from the central airways.  Huffing :  Definition : This is the forced expiration with the glottis open.  Aim : To move the secretions from the lobar and segmental bronchi.  Technique : The patient is asked to breathe in and tighten the abdominal muscle and huff through the mouth. The air is breathed in mid lung volume to breathe is medium sized.  Effects and uses : The secretions are moved from the peripheral airway.  Forced expiratory technique:  Aim:   To mobilize the secretions from the peripheral airway to the pro

Ventilators are the device used for artificial ventilation, (Helps you breathing) breathing machine. It is attached to a computer with knobs and buttons which is controlled by a therapist, nurse or doctor.  Types of ventilators:- Negative pressure: The whole body below neck is kept in a large negative tank and a negative pressure is set in tank and this induces pressure.  Positive pressure: Air is sent into the lungs with pressure more than atmospheric pressure, i.e. supra atmospheric pressure is set up and air is driven through trachea.  High frequency positive: This is of two types:  Jet High frequency positive: 350breathes/min Oscillator High frequency positive:1300breathes/min. Modes of ventilation:- This is of two types. They are: Full ventilatory support Partial ventilatory support The following provides both of the above  Controlled Mandatory ventilators: This is the fixed ventilation for definite time intervals, no provision for spontaneous ventilatory effort, limited to intra-

 It is the sudden and temporary loss of consciousness due to inadequate cerebral flow.  Types :-  Emotional syncope This is due to emotional fainting, Decreased cardiac output, decreased cerebral flow, suppression of myocardium, severe vasodilation caused by the parasympathetic division of the autonomic nervous system.  Postural Syncope This   is due to prolonged standing causes pooling of blood in lower limbs.  Micturition Syncope This is due to low blood pressure while standing or orthostatic hypotension causes micturition syncope.  Neurocardiogenic Syncope This is due to cardiac arrhythmia, decrease in cardiac output, bradycardia, and heart block.  Effort Syncope This is due to stenosis of semilunar valves, increased cardiac output because of the exercise strain.  Cough Syncope This is due to increased intra- thoracic pressure, decreased venous return cardiac output results in fainting.  Carotid Sinus Syncope This is due to tight collar dress cause decrease in heart rate and vasodil

 This is the condition that results from a developmental defect in the vertebral column resulting in a lack of fusion of the vertebral arches and so the vertebral canal is not closed. There may or may not be defects of the spinal cord and meninges, and in some cases there are little or no symptoms.  Pathology:- There are two main types of this abnormalities, spina bifida occulta and spina bifida cystica. Spinal bifida Occulta:- This is the mildest form of defect and is observed in only a small percentage of children with spina bifida. The actual number may be larger because there may not be any obvious defect or abnormality externally. There is a defect in the fusion of the laminal arch but this may only be evident in X-ray. There is a dimple in the skin over the vertebrae, and sometimes there may be small tuft of hair over the area. A common feature of this type of lesion is abnormality of bladder control with either enuresis or urine retention. Spina bifida Cystica:- Meningocele:-  T

 Compression of the median nerve as it passes beneath the flexor retinaculum. Causes :- General  - Inflammatory due to joint disease - eg., rheumatoid arthritis. Endocrine - hypothyroidism, diabetes mellitus, menopause, pregnancy, etc., Metabolic - Gout Local causes - Crowding of the space, Malunited Colles' fracture, ganglion in the carpal region, Osteoarthritis of the carpal bones, and wrist contusions, haematoma, etc., Clinical features :- S tage 1 In this stage, pain is usually the presenting complain and the patient complains of discomfort in the hand but there is no precise localization to the median nerve. There may be history of morning stiffness in the hand.  Stage 2 In this stage, symptoms of tingling and numbness, pain paraesthesia, etc., are localized to areas supplied by the median nerve. Stage 3 Here the patient complains of clumsiness in the hand and impairment of digital function, etc., Stage 4 In this stage sensory loss in the median nerve distribution area can be

It is thought to be an autoimmune disease involving the synovium, often affecting several joints at the same time. The joints are affected symmetrically and eventually there is destruction of articular cartilage, capsule, ligaments and tendons, leading to deformity. Eventually joints are destroyed, fibrosed, ankylosed. eighty percent affected are women. Male : Female ratio - 1:3. Etiology:- The exact cause is unknown but malfunction of the cellular and humoral arms of the immune system are cited as the probable cause. Pathology:- Due to synthesis of auto-antibodies, against unknown antigenic agents in the synovium, primary synovitis sets in. This primary synovitis gets rise to pannus, which in turn forms the villus. This villus migrates towards the joint causing its degeneration and ankylosis, fibrous in the early stages followed by ankylosis in the late stages.  Clinical features:- Pain, swelling, stiffness, of small joints of hands  and feet. history of weight loss, lethargy and depr

 It is a deformity with hyperextension of the metacarpophalangeal joints and flexion of the interphalangeal joints of the fingers. Types and Causes: two varieties are described: one is a true claw hand involving both median and ulnar nerves(Syringomyelia, muscle atrophy, leprosy, peripheral neuritis, anterior poliomyelitis etc.,)  the second an ulnar claw hand or claw-like hand ( here only ulnar nerve is involved) due to ulnar nerve injury Clinical features:- these include the classical deformity loss of sensation along the ulnar nerve distribution  wasting of the hypothenar muscles intrinsic muscles of the hand leading to hallow intermetacarpal spaces on the dorsum of the hand  if high lesions above the level of elbow entire nerve function is lost however the clinical features vary depending upon the level of lesion. Clinical tests: - for ulnar nerve injury Froment's sign :- Three muscles (first palmar interossei, adductor pollicis and flexor pollicis longus) are required to hold

Fracture is a break in the surface of a bone, either across its cortex or through its articular surface. Dislocation is a complete and persistent displacement of a joint in which at least part of the supporting joint capsule and some of its ligaments are disrupted. Subluxation is a partial dislocation of a joint. Sprain is the temporary subluxation of a joint and the articular surfaces return to normal alignment. Strain is a tear in the muscle. This bone can break within its soft tissue envelope and may not communicate to the exterior (simple or closed fracture), exposing the bone to the external atmosphere (compound or open fracture) Types of fracture:- Simple or compound these have been already explained. Based on the extent of fracture line                                                                                              Incomplete fractures - it involves only one surface or cortex of the bone.                          Complete fracture - here the fracture involves

 Torticollis is defined as the rotational deformity of the cervical spine that causes turning and tilting deformity of the head and neck. Causes :- Congenital  Infective Tuberculosis of the cervical spine, acute respiratory tract infection, etc.., Traumatic Sprain, dislocation and fracture of the cervical spine. Myositis or fibromyositis of sternocleidomastoid, exposure to cold causes myositis. Spasmodic painful, persistent or intermittent sternomastoid muscle contraction. Unilateral muscle paralysis, eg:-polio. Neuritis of spinal accessory nerve. Ocular disturbances Child turns head to one side to compensate for defective vision. Among the acquired causes of torticollis, spasmodic muscle contraction of the sternocleidomastoid is the most common cause. Clinical features:- Head of the patient is tilted towards the affected side while the chin points to the other side. Sternocleidomastoid muscle is prominently seen. In the later stages, the patient may develop facial asymmetry and macula

 The cervical region consists of seven cervical vertebrae with their intervening disks. The disk is made up of central nucleus pulpsus and annulus fibrosus at the periphery. The disk functions as an effective shock absorber and also gives the cervical spine more mobility. If the disk material herniates because of trauma or old age it gives rice to cervical dick syndrome. More than 90% of the disk lesions in the cervical spine occur at the C5 and C6 levels as these are the most mobile segments. Types:- Soft disk lesion It is common in young adults and is usually following trauma. In this there is only a nuclear herniation through the wide annulus fibrosus of the disk. Hard disk lesions This is more common than the First, seen in older age group, gradual in onset and is usually due to cervical spondylosis. Rarely large posterior osteophytes may cause pressure on the anterior portion of the spinal cord produces mixed symptoms of the upper limb nerve root pain and lower extremity weakness

It is the abnormality of the proximal end of the femur, which is characterized by decreased neck shaft angle (Normal angle is 125-132degrees) It can be either congenital (present at birth) Developmental (manifests clinically during early childhood and progresses with growth) or Acquired (mal-united and non-united fractures, a slipped upper femoral epiphysis, Perthes' disease and bone softening  eg.., osteomalacia , Paget's disease). Classification :- congenital  Congenital coxa vara  Congenital short femur with coxa vara  Congenital bowed femur with coxa vara. Acquired (according to the site of disturbance)  Capital coxa vara this is seen in perthes disease ,chondro osteodystrophy, cretinism, septic arthritis , of hip .,etc.  Epiphyseal coxa vara Slipped capital femoral epiphysis.  Cervical coxa vara this is seen in malunited trochanteric fracture, pathological hip conditions like             ---Children --Rickets,bony dystrophies,etc.,             ---Adult--Osteomyelitis, Oste

 Patient present with a variety of conditions, and assessment need to be adapted to suit their needs. This section provides a basic framework for the subjective and objective neurological assessment of patient. Database: History of present condition past medical history drug history Results of specific investigation (X- ray, CT scan ,blood tests,etc..,) Subjective Examination:  Social situation:    --Family Support    --accommodation    --employment    --leisure activities    --social service support. Normal daily routine Indoor and outdoor mobility Continence Vision  Hearing Swallowing Fatigue Pain Other ongoing treatment Past physiotherapy and response to treatment Perceptions of own problem/main concern  Expectations of treatment Objective examination: posture and balance   Alignment   Neglect   Sitting balance    Standing balance       --Romberg's test. Voluntary movements  Range of movement  Strength  Coordination     --finger-nose test      --heel-shin test     --rapidly alte

 Painful elbow syndromes encompass(to contain) lateral, medial and posterior elbow syndromes. The one commonly encountered is the lateral tennis elbow which is known as the classical tennis elbow and is the pain and tenderness on the lateral side of the elbow, some well defined and some vague that results from repetitive stress. It is a lesion affecting the tendinous origin of common wrist extensors from the lateral epicondyle  Causes:- • Epicondylitis this is due to single or multiple tears in the common extensor origin, periosteitis, angiofibroblastic proliferation of extensor carpi radialis brevis(ECRB). Etc.  • Inflammation of adventitious bursa Between the common extensor origin and radio humeral joint.  • Calcified deposits Within the common extensor tendon.   • Painful annular ligament is due to hypertrophy of synovial fringe between the radial head and the capitulum's. • Pain of neurological origin, for example, cervical spine affection, radial nerve  entrapment, etc.  • Ca

Joint is a junction between two or more bones or cartilages.it is a device to permit movement.  however immovable joints are primarily meant for growth. Primary cartilaginous joints of long bones increase length of bone. A newborn baby is about 15'' long and length increases to 60-70'' in an adult due to growth at these joints. Fontanelles of skull may permit moulding during childbirth. There are more joints in a child than in an adult because as growth proceeds some of the bones fuse together, e.g. the ischium and pubis to fuse form the pelvic bone. The two halves of the infant frontal bone, and of the infant mandible also fuse to form single frontal and mandible bone respectively. The five sacral vertebrae fuse to form sacrum and the four coccygeal vertebrae joint to form coccyx.  joint help to form cavities like cranial, thoracic, abdominal and pelvic cavities where the respective organs are safely kept. Joints of thoracic cage help in increasing transverse and verti

 The physical therapist assists the patient in movement restoration. He is a very important member of the rehabilitation team. He has to perform a thorough muscle strength evaluation and quantification, spasticity assessment, and measurement of joint range. On the therapeutic side he would have to perform exercises to maintain and increase joint range of motion, train sitting and standing balance, or increase strength, endurance, and coordination for specific muscle groups or the entire body.  During the course of therapy he would have to use various therapy modalities, such as heat and cold, as well as hydrotherapy techniques, electrical stimulation, traction and massage for pain relief. For those confined to home he would visit them and aid in home evaluation to make the environment barrier free and accessible. The use of various mobility aids including the wheelchair and it's maintenance has to be taught to the patient. For those who are not ambulant the physiotherapist does pro