...D.A.C.N.B. ABSTRACT Objective: This study investigates the clinical utility of testing functional systems within the central nervous system, compared to testing individual motor nerves with manual muscle testing. Design: Private practice. Study Subjects: Patients were examined by the treating chiropractor from his existing patient pool. Methods: Chiropractic management was decided on by the treating chiropractor. A series of twelve tests were designed to discover disorders of functional systems within the CNS. The tests described were to evaluate the function of 12 systems: 1) spinal cord, 2) myelencephalon/reticular formation, 3) vagal system, 4) trigeminal motor system-muscles of mastication, 5) vestibulospinal system, and bulbo reticular area, 6) reticular formation, 7) diencephalons and gait locomotion system, 8) mesencephalon, 9) cardiac sympathetic autonomic system, 10) pyramidal system, 11) limbic system, 12) sensory system. Results: This chiropractic approach tests the nervous system after provocation of functional systems instead of sensory challenges to more discreet portions of the body. Conclusion: For chiropractic patients who are not responding to discreet treatment programs, this method of evaluation may be valuable as it tests underlying system problems within the CNS. Nearly all the functional systems have a related motor activity that results in inhibition and facilitation patterns. Case series...
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...In this case study it follows an 89-year-old man named Mr. Chestnut, who was admitted into the hospital for complaints of pain in his head. The associated system with this case study is the neurological system, which is the system in the human body that deals with a network of nerves and cells that send messages from the brain and spinal cord to the rest of the body (Mandal, 2013). Based on this case study a SOAP note, which consists of a subjective data, objective data, an assessment, and a plan, will be created to help identify and assess the condition of the patient. Subjective: The patient, Mr. Chestnut, is an 89-year-old male, who was admitted into the care facility with his caregiver/family member, complaining of pain in his head. The patient states that the pain began two days ago, and has been fluctuating...
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...Introduction Chronic low back pain (cLBP) is generally recognized as a complex musculoskeletal symptom involving dynamic, fluctuating conditions with multi-factorial etiology (Helene, 2006). Low back pain is defined as chronic after 12 weeks (3 months), since most normal connective tissues self-repair within 6-12 weeks (Anderson, 1995). Nowadays, chronic low back pain has become a serious medical and social problem in the industrial world, and a common cause of early age disability in Americans younger than 45 years old (Kelsey, 1980). From a recent review, 40% of all population around the world have low back pain sometime in their lives, and as high as 80% of people in developed countries (Hoy, et.al. 2012). Around 9% to 12% (roughly 632...
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...Chapter 1 Introduction In earlier civilizations, trepanization (drilling holes in the skull) was performed because of the belief that this would release demons that had entered into the skull and had to be released, if headache relief was to result. In the seventeenth century, it was suggested by Willis that the head pain of 'megrim' or migraine resulted from the swelling of blood vessels within the head. Interestingly, this explanation of blood vessel swelling is close to the belief today that such swelling is involved in migraine headaches (Edmeads, 1997). At the turn of the twentieth century, Sir William Osler proposed that headaches were due to 'muscular rheumatism' of the head. This was probably the first suggestion that muscle abnormalities might be involved. During the 1940s, Wolff carried out a series of experiments that showed that involuntary contraction of scalp and neck muscles could result in headache development. Other causes have been suggested; these were more serious than muscle dysfunction and would evidently require other medical interventions (Solomon, 1993). In the worldwide view, headache can be such a big health problem as evidenced by the establishment of the World Headache Alliance in 1997. The organization exists to alleviate the burden of headache worldwide, in particular, by sharing information among headache organizations and by increasing the awareness and understanding of headache as a public health concern with profound social and economic...
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...A Abstract: This case study is about the application and effectiveness of massage modalities on resolving pain and tension issues based on chronic postural imbalances. In this case study there will be assessing of the client's conditions, facilitating techniques based on the symptoms and drawing conclusions of the efficacy of the applied techniques as a protocol for the given conditions. Introduction: 1. The therapeutic concern for my client is to relieve moderate and chronic pain that stems from the neck down the shoulder blade and into the upper arm and mid-back at rest and during daily activity. With the pain and tension comes a compromised active, passive, and resisted range of motion in the actions...
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...Abdelhamid Hadjahmed Drug: Metformin 1. Introduction of the medication (Case Study) A 54 year old male with obesity, and 6 year history poorly controlled type 2 diabetes. Complains of polyuria, polydipsia, fatigue, blurred vision, and headaches. Recently admitted to the hospital for diabetic ketoacidosis. He would like to get control over his diabetes so this doesn't happen again. 2. Demonstrates knowledge of the content through a teaching presentation? Actions of the medication- Metformin decreases the production of glucose or sugar in the liver, it decreases the absorption of glucose in the intestines, and it also helps increase the sensitivity of the insulin your body produces by increasing uptake and utilisation. Why is the patient taking...
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...Evidence-Based Dentistry Stabilization Splint Therapy for the Treatment of Temporomandibular Myofascial Pain: A Systematic Review Ziad Al-Ani, B.D.S., M.Sc., Ph.D.; Robin J. Gray, B.D.S., M.D.S., Ph.D., M.F.G.D.P.; Stephen J. Davies, B.D.S., M.D.Sc., D.G.D.P.; Philip Sloan, B.D.S., Ph.D., F.R.C. Path. F.D.S.; Anne-Marie Glenny, B.Sc., M.Med.Sci. Abstract: The aim of this review is to establish the effectiveness of stabilization splint (SS) therapy in reducing symptoms in patients with myofascial pain. Searching of electronic databases, handsearching of relevant key journals, and screening of reference lists of included studies were undertaken. There was no language restriction, and unpublished research was sought. The selection criteria were randomized controlled trials comparing splint therapy to either no treatment or another active treatment. Data extraction and validity assessment were carried out independently and in duplicate. Studies were grouped according to treatment type. Twenty potentially relevant Randomized Controlled Trials (RCTs) were identified. Only twelve met the inclusion criteria. There is insufficient evidence either for or against the use of stabilization splint therapy over other active interventions for the treatment of temporomandibular myofascial pain. However, it appears that stabilization splint therapy may be beneficial for reducing pain severity at rest and on palpation and depression when compared to no treatment. The authors suggested the need...
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... 2004). Fibromyalgia is a debilitating disease that attacks people of every age, race, and gender. It is a disease that may develop out of nowhere, or be brought on by a stressful event. With it comes pain, both physically and psychologically. There is hope though as there are several ways to try and alleviate the pain, or reduce the symptoms. Medications are available, and of course there is always hope for a cure. This disease does not only affect those afflicted, but their families and loved ones too. Cause Fibromyalgia can manifest in a person for many different reasons. One of the major causes of the disease is stress. It can be from simple everyday stresses, like working a tough job, or worrying about how to make ends meet. Other stresses are more physical, such as car crashes or childbirth, both of which put immense strain on the physical body. Another cause is Post- Traumatic Stress disorder. Post-Traumatic Stress can be the result of horrible events, such as war or abusive childhoods. In other cases the disease can simply manifest one day out of the blue (Fibromyalgia & Chronic Myofascial Syndrome, 1996). It is a disease that can hit any gender, but about 80% of known cases are women in their fifties (New Harvard Guide to Women's Health, 2004). Symptoms Many cases of Fibromyalgia are undocumented, mainly because some people don’t even know they have it. There are many symptoms and they can be either severe or mild depending on the person. Weight and physical condition...
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...Myofascial Pain Syndrome: Alternative Therapies Myofascial pain, characterized by chronic pain affecting connective tissue of muscles is often chronic and the most common symptom is trigger points. Trigger points are areas of highly sensitive muscle tissue prone to spasm and pain (sometimes referred) upon palpation. Myofascial pain is related to strains or injuries to the muscle tissue or strenuous use of muscles after a period of sedentary activity such as after having a stroke or breaking a bone. (Webmd.com, 2013) Most often, myofascial pain affects areas of the spine; lower back, shoulders, and neck. Myofascial pain is identified or diagnosed by a physician upon completion of a physical exam involving questions surrounding the onset of the symptoms. Which include tender muscles, pain that happens with pressure on a trigger point, weakness in the affected area and sometimes limitation to the range-of-motion of the affected area. (Cleveland Clinic, 2013) Causes are suspect related to stress; stress is probably the biggest factor. Poor posture combined with overuse of muscles is also suspected contributors to the cause of myofascial pain and trigger point sensitivities. Conventional treatment for myofascial pain and trigger points include physical therapy, which focusses on strengthening, stretching and posture improvement exercises. Medications can also be used like Non-Steroidal-Anti-Inflammatory (NSAIDs) drugs, analgesics like Tramadol® for mild-to-severe pain and benzodiazepines...
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...causing the desired change either in behaviour, emotionally, physically and psychologically. Hypnosis has become essential in the clinical aspects, mainly in the pain management with positive results . This is due to the success of many laboratory studies and research, and the ability to observe the behaviour of the client, reinforcing the theory of hypnosis. HISTORY Modern Hypnosis began with Franz Anton Mesmer (1734-1815) an Austrian doctor who used magnets and the view of transferring fluid in order to cure illness without medicine or surgery. As there was no scientific evidence to his work, Mesmer’s believed that it was magnetism, rather than the patient's own mind that determined the outcome. His first attempt to test his theory and practice in 1774 was with Franziska Osterlin and in 1777 he restored a blind girl’s sight. His method of fluid transfer was disregarded and declared as individual fantasy by King Louis in 1785. However, Mesmer’s theory had stirred interest even after he died, a result of which saw other theories emerge. James Braid in 1840 pioneered the first scientific study and named the theory hypnosis, and concluded that the previous cures were due to suggestion and not magnetism power. Research shows that hypnosis continued to be applied and proved effective like in the cases of Dr. James Esdaile who used hypnosis to surgically operate 400 people which was a success. A further evidence was with Dr. John...
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...Running head: PAIN CASE STUDY Case Study: Pain Amit Dhir, Omeid Heidari, Sean Mayer, Ololade Ikuomola & Adam Boyce NR110.542 Physiological/Pathophysiological Basis for Advanced Nursing Practice I 09/29/2015 Johns Hopkins University School of Nursing On our honor, we pledge that we have neither given nor received any unauthorized assistance on this assignment. 1 Running head: PAIN CASE STUDY CASE STUDY Pain Use this document in documenting your response to the Patient Case Questions. CHIEF COMPLAINT “My back is killing me. The pain is mostly sharp and stabbing, and sometimes it’s a dull ache. You’ve got to do something. Those Tramadol pills aren’t cutting it and they’ve bound me up.” “I am not sleeping because of the pain.” MEDICAL HISTORY P.M. is a retired, 81yearold male being seen for a routine health maintenance visit. He has a history of lower back pain, morbid obesity, hypertension, hypothyroid, occipital lobe stroke, bilateral total knee arthroplasty, GERD and sleep apnea. Now reporting pain in feet. He has been a smoker for the past 64 years, reporting 12 ppd. He is accompanied by his wife of 62 years. CURRENT MEDICATIONS Tramadol 50100 mg p.o. Q 12 hrs prn back pain Atenolol 25 mg p.o. Q a.m. Levothyroxine sodium 125 mcg p.o. Q a.m. Clopidogrel 75 mg p.p. Q a.m. Ibuprofen 600 mg ii p.o. prn knee pain Aspirin 650 mg p.o. prn “when I can’t get to sleep” ...
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...A heart attack occurs when the blood supply to a portion of the heart muscle is severely reduced or stopped. This happens when one of the arteries that supply blood to the heart muscle is blocked by an obstruction. This blockage can be due to a condition called atherosclerosis (a buildup of fatty like substance along the wall of the artery), a blood clot or a coronary vessel spasm along with a total obstruction. If the blood supply to a portion of the heart stops, that area of the heart will no longer receive the oxygen or nutrients needed to carry out its function and will die. If it is a very small part of the heart involved, it will be able to work without it. If a large portion is damaged, irreversible damage will happen which can lead to death. Damage to the heart muscle may be so severe that it may cause abnormal heart rhythm, called arrhythmias. Most people who are of a myocardial infraction or a heart attack do so within a few hours due to a type of arrhythmia. The heart attack victim will complain of pressure, discomfort or a squeezing sensation in the center of the chest. There may be pain radiating to the arms or the neck. There may also be shortness of breath, weakness, fatigue, nausea, vomiting and or indigestion. The pain that occurs is the result of heart tissue ischemia (decreased blood supply). The area that is not receiving enough blood is literally crying out for help. When a person complains of any of the symptoms mentioned, they should be transported...
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...Case Studies on Cardiac Function Case 1 A.O. is an 89-year-old woman with a long history of systolic heart failure secondary to a large left ventricular infarct when she was in her 70s. She had poor activity tolerance and required assistance with activities of daily living. Even minimal activity was associated with moderately severe dyspnea and exertional chest pain, which was relieved by rest. A.O. also exhibited marked pedal edema bilaterally. She is being treated with digitalis, furosemide (Lasix), KCl, and sublingual nitroglycerin. Discussion Questions 1. Which type of heart failure (left or right sided) is usually associated with dyspnea? Left-sided What other clinical findings are likely to be present with left-sided heart failure? Signs of pulmonary congestion are orthopnea or basilar crackles. Possible cough. Increased heart rate and S3 heart sound with auscultation. 2. What compensatory mechanisms are likely to be operative in A.O. to enhance cardiac output? Baroreceptors will detect a low blood pressure and carbon monoxide levels, which would excite the sympathetic system resulting in an increased heart rate. During this mechanism the beta receptors will down regulate leaving this mechanism less effective. Prolonged stretch on the myocardium will result in myocardial hypertrophy. 3. What is the most likely cause of A.O.’s pedal edema? Right sided failure causes pedal edema. 4. What is the cause of A.O.’s exertional...
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...mutation that affects the dystrophin proteins of the muscles. Dystrophin is the largest gene known to man. (Tennyson, Klamut, Warton 1995). Hundreds of genes are responsible for producing the proteins that protect these muscle fibers from damage. In DMD, the dystrophin gene is defective. Where most forms of muscular dystrophy worsen slowly over time, Duchenne grows worse quite rapidly. Duchenne muscular is linked to the X-chromosome so the mother carries the disease and the defective gene but will likely never show symptoms. Their sons will each have a 50% chance of getting the disease and their daughters will each have a 50% chance of being carriers of the disease (Bushby, Finkel, Birnkrant, Case, Clemens, Cripe, Kaul, Kinnett, McDonald, Pandya, Poysky, Shapiro, Tomezsko, Constantin, 2010). The women who are carriers will pass the gene onto their children. One in every 3,500 live male births are diagnosed with Duchenne muscular dystrophy (Chen, Ma, Zhang, Chen, Xing, Wang, Zhang, Luo, 2014). Most of these diagnoses have a line of family history with Duchenne muscular dystrophy that they were unaware of because it had not shown up in several generations. Females who are diagnosed with Duchenne muscular dystrophy and show symptoms tend to have very mild cases compared to those cases of males. Symptoms of this condition are usually noticed before the age of five years old and can even be seen as early as infancy in some cases (Bushby, et al. 2010). These symptoms are fatigue...
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...Introduction: Total hip replacements (THR) happen for a multitude of reasons. Patient’s requiring a THR are in pain within the hip joint from a specific cause. For example, a THR could be done to relieve arthritis pain, repair a break in the bone, or repair the joint from a traumatic injury or disease. The hip joint is a ball and socket joint, made up of the head of the femur (ball) which moves within the acetabulum (socket) in the pelvis (Hasan & Akbar). Functionally, this joint allows movement of the lower body in relation to the trunk in a circumduction motion. At the time of the repair, usually patient’s have decreased function of that lower extremity because of pain. The joint itself does not have nerve endings, but bone does....
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