...D. Physical Assessment Findings VITAL SIGNS | Normal Finding | Outcome | Analysis | Body Temperature | 36.5-37.5 C | 38.1 C | Hyperthermia indicates sign of infection | Pulse Rate | 60-100 bpm | 68 bpm | Normal | Respiration | 12-20 cpm | 20 cpm | Normal | Blood Pressure | 120/80 mmHg | 160/80 mmHg | Increases Blood Pressure indicateshypertension | HEAD TO TOE ASSESSMENT Area Assessed | Normal Findings | Actual Findings | Analysis | 1. Skull A. Inspects skull for 1. size 2. shape 3. symmetry B. Palpates for tenderness of mass/nodules, depressions and tenderness | Rounded (normocephalic & symmetrical with frontal, parietal, and occipital prominences: smooth skull contour)Smooth, uniform consistency Absence of nodules or masses | My client has a rounded skull usually normocephalic & symmetrical with frontal, parietal, and occipital prominences. She also has a smooth skull contour | The skull is rounded and smooth thus it is normal. | 2. Hair and Scalp A. Inspects for 1. Color of Scalp 2. Odor 3. Presence of dandruff infection 4. Lesions B. Inspects for 1. Color of Hair 2. Distribution 3. Thickness/ Thinness 4. Texture 5. Oiliness 6. Presence of lice, nits, split ends 7. Length | Evenly distributed Thick hair Silky, resilient hair (-) infection(-) infestations | The scalp of my client is slightly...
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...MUSCLES OF RESPIRATION Muscles of the Thorax Diaphragm – dome shaped O: entire internal circumference of lower thorax; ziphoid cartilage anteriorly, cartilages and bony portion of 6 or 7 lower ribs laterally, upper lumbar vertebrae posteriorly C: muscle fibers fan centrally (up and in) I: central tendons ( umbrella shaped) A: chief muscle of respiration; elevates ribs and draws down upon the central tendon; increases vertical dimensions of thorax N: phrenic nerve from cervical nerves 3, 4, and 5 External Intercostals O: outer lip of lower border of each rib C: oblique (diagonally) I: outer lip of upper border of the rib below A: elevates ribs in inhalation N: intercostals nerves from the thoracic nerves 1-11 Internal Intercostals O: inner border and inner surface of the rib and costal cartilage C: oblique; almost at right angles to external intercostals I: upper border and inner surface of the rib and cartilage below A: elevates and may also lower ribs N: Intercostal from thoracic nerves 1-11 Transverse Thoracic O: body and zyphoid process of sternum C: some fibers vertical, some upward obliquely, and some nearly horizontally (fan) I: costal cartilages and bony ends of ribs 2-6 A: depresses ribs N: intercostal from thoracic nerves 2-6 Serratus Posterior Superior O: spines...
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...| This article needs additional citations for verification. Please help improve this article by adding citations to reliable sources. Unsourced material may be challenged and removed. (July 2012) | In the anatomy of mammals, the thoracic diaphragm, or simply the diaphragm (Ancient Greek: διάφραγμα diáphragma "partition"), is a sheet of internal skeletal muscle[2] that extends across the bottom of the rib cage. The diaphragm separates the thoracic cavity (heart, lungs & ribs) from the abdominal cavity and performs an important function in respiration: as the diaphragm contracts, the volume of the thoracic cavity increases and air is drawn into the lungs.A "diaphragm" in anatomy can refer to other flat structures such as the urogenital diaphragm or pelvic diaphragm, but "the diaphragm" generally refers to the thoracic diaphragm. Other vertebrates such as amphibians and reptiles have diaphragm-like structures, but important details of the anatomy vary, such as the position of lungs in the abdominal cavity. Contents * 1 Function * 2 Anatomy * 2.1 Innervation * 2.2 Crura and central tendon * 2.3 Openings * 2.4 Comparative anatomy and evolution * 2.5 Variations * 2.6 Pathology * 3 Development * 3.1 Clinical Relevance * 4 Additional images * 5 See also * 6 References * 7 External links | FunctionThe diaphragm functions in breathing. During inhalation, the diaphragm contracts and moves in the inferior direction, thus enlarging...
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...to the extent that one cannot survive without it. In this paper we will consider the role of the diaphragm through its anatomy and physiology. We will then review a congenital birth defect known as Congenital Diaphragmatic Hernia (CDH) and how it changes the anatomy and physiology of the body. We will also look at current research and prognosis of the disease in an effort to gain a better understanding of this often-fatal defect. The diaphragm is located almost centrally in the body. It is a continuous sheet of muscle that spreads across the bottom of the rib cage creating a divide between the thoracic cavity and the abdominal cavity. As detailed in the text Gray’s Anatomy, the convex upper surface of the diaphragm faces the thorax and forms the bottom of the thoracic cavity. The concave inferior surface is pointed towards the abdomen and is mostly covered in peritoneum forming the superior part of the abdominal cavity. The right side of the diaphragm is superior to the right lobe of the liver, the right kidney, and the right adrenal gland. The left side of the diaphragm lays over the left lobe of the liver, the fundus of the stomach, the spleen, the left kidney, and the left adrenal gland (Gray, 2005). The diaphragm has three parts, which are based on the regions of attachment of its outer surfaces. They are known as the sternal, the costal and the lumbar. Again, Gray’s Anatomy goes into great detail but in general, the sternal part is formed at the xiphoid...
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...Write an essay on your personal experience using tactile cues to facilitate proper breath, axial elongation, organization of head, neck and shoulders, spine articulation and alignment. Make note if you were successful in facilitating desired outcomes. How did you know whether or not you were successful? Touch can help a Pilates student to relax a muscular tension or a contracted structure. Comfortable contact can also help to move a segment or give a proprioception to expand structures like the rig cage during a breathing for example. Most people react with pleasure to the touch of the therapist if it is provided with a non invasive palpation, respectful and not abruptly. The touch should be gentle and firm at the same time. Firm in order to lead a movement, to shape a body structure. When we touch a person we must be connected and focused on the information that we want to give her. It must be a clear intention in the touch that we are given. Should have a communication between the tactile cue and the client, a good touch can lead a correct gesture while transmit a positive energy . We should take care not to force a movement with a touch overdone . We must inform the client's body and motion path with a delicate and precision tactile cue. The more the therapist is connected with the student, with a accurate intention the best will be the conduction of the gesture, facilitating the clients understanding. Excess of touches can confuse the student. Be careful not to touch...
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...#1 EQUIPMENT EQUIPMENT • • • • • • • • • • Clean Hands Stethoscope Penlight Ophthalmoscope/Otoscope Near Vision Card/ Snellen Eye Chart Tongue Blade Gloves Cotton Balls/Cotton Tipped Applicator Cup of Water Lemon Juice, Sugar, Salt TECHNIQUES OF PHYSICAL ASSESSMENT Inspection Palpation Percussion Auscultation #2 GENERAL SURVEY GENERAL SURVEY Visible skin Facial expression/Mood (Grimace, Flat Affect, Pleasant, Distress, SOB) Nutritional Status (Cachexia, Obesity, Well-nourished) Grooming/Hygiene (UnKempt, Neat, Poor Hygiene) Gross Anatomical Deformities EXAMPLES #3 SKIN SKIN • Integument • Color Pigmentation Cyanosis Jaundice Erythema • • • • Moisture Temperature Texture Turgor SKIN (CONT’D) Vascularity Edema Lesions ABCD: Asymmetry Border irregularity Color Diameter HAIR AND SCALP Hair: Color Distribution Quantity Thickness Texture Lubrication NAILS Condition of nails reflects: General health State of nutrition Occupation Level of self-care Age #4 NEUROLOGICAL SYSTEM ““ SMILE FOR ME” NEUROLOGICAL ASSESSMENT Orientation (person, place, time, purpose) 12 Cranial Nerves/Sensation Glascow Coma Scale 12 CRANIAL NERVES Olfactory Optic Oculomotor Trochlear Trigeminal Abducens Facial Auditory Glossopharngeal Vagus Spinal Accessory Hypoglossal #5 ...
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...Pancoast tumors represent short of what 5% of all bronchogenic carcinomas. These tumors are situated in the summit of the lung and include through tissue contiguity the apical midsection divider and/or the structures of the thoracic channel. The tumors get to be clinically obvious with the trademark side effects of the "Pancoast-Tobias disorder" which incorporates Claude-Bernard Horner disorder, serious torment in the shoulder transmitting around the axilla and/or scapula and along the ulnar appropriation of the upper arm, decay of hand and arm muscles and block of the subclavian vein bringing about edema of the upper arm. This regularly dangerous neoplasm frequently goes unrecognized in its initial stages. Yet recognition with its excellent indications, determination, and treatment can raise the possibilities of cure. Pancoast tumors show a troublesome and particular issue. Their clinical indications may be extrapulmonary. The judgment will be made by the blend of the trademark clinical side effects with the radiographic discoveries of a mass or obscurity in the summit of the lung penetrating the first and/or second ribs. A tissue analysis of the tumor by means of CT-guided FNA/B ought to dependably be accessible before the start of treatment. Bronchoscopy, thoracoscopy and biopsy of discernable supraclavicular hubs are option approaches to get a tissue finding. Adenocarcinomas represent 2/3 of all Pancoast tumors, while whatever remains of the tumors are squamous cell and extensive...
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...Insanity Insanity runs deep within one’s veins; it travels at such a fast speed that one does not realize. It claws and screams from within, begging to be freed, begging to be released so it can corrupt. So it can corrupt and destroy and simply ruin the beauty in the world. You see, if Insanity was left loose into the world, then Insanity would ruin even the most innocent of things. For example, imagine Insanity to be a person. A person with two arms, two legs, hands and feet; a person with blood pulsing through thick veins and capillaries and breathing life into lungs—a person with a beating heart, eyes like the darkest oceans in this world as this person stares and stalks. Do you see that person? Can you picture that person perfectly? Can you picture that person standing tall in the falling, peaceful snow dressed in black, watching carefully? Can you? Can you feel the person’s breath tickling down your throat as they step closer, as fingers wrap around your throat and slowly but surely squeeze. Like I said, slowly at first… so slow, so gentle, you can’t really notice it; you don’t panic, you relax. Your lips part and your head tips back a little, eyes locking with theirs, question filling your irises. But then you feel it, you feel the hatred running through your veins, intoxicating your mind and your heart and ruining every single cell in that what was once innocent body of yours. You feel Insanity taking over and you cannot stop it because the rush, the taste, the...
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...Describe the role of muscles in the breathing process The intercostal muscles are tiny muscles located in between each rib. There are 12 sets of ribs and these muscles are located between each rib and on each side. In between each rib there is two bands of muscles, one called the internal intercostal muscles and the other called the external intercostal muscles. In between each of these muscles is the nerve and blood supply. The most important muscle to breathing is the diaphragm. The diaphragm has its own nerve supply and can operate as a voluntary muscle or involuntary muscle, thus allowing us to hold our breath or slow our breathing if we wish to. When the diaphragm contracts, it moves down towards the stomach, this creates a vacuum in the cavity containing the lungs. This vacuum causes the lungs to expand and pull air down and in. When we breathe out and the diaphragm relaxes and moves up again, it no longer causes a vacuum. This in combination with the rib bones relaxing to their normal position help to push air back out of the lungs. The involuntary act of breathing is driven by carbon dioxide sensors in the body. These carbon dioxide sensors will send a message directly to the brain to force the body to breathe again, (i.e., make the diaphragm and intercostal muscles contract.) During times of stress, injury or just difficulty breathing, other muscles will kick in to help out. These muscles are called accessory muscles and are not used during normal breathing...
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...“The Broken Heart” Analysis In John Donne’s poem, “The Broken Heart”, Donne shows the predacious nature of love and the true faintness of the heart through the use of metaphors. This poem sets a mood of despair and sorrow; moods that reveal the regret of love. It opens the reader’s eyes to realize just how vulnerable the heart can be when dealing with love. Donne associates love with the negative; he portrays it as some evil entity that overtakes people without warning and, if not careful, destroys them from the inside, out. In the first stanza of Donne’s poem, he describes how long the oh-so-terrible phenomenon of love lasts. He compares it to the plague and claims it has stuck with him for an entire year. He states that anyone who claims to have only been in love an hour, or a short duration at all, “is stark mad.” Donne makes a clear point that love simply cannot decay so soon. He compares the duration of love to a flask of powder burning in one day. I assume that it would take quite some time to use an entire flask of powder given the context of the text [small amounts of gun powder was used in the 1700’s and 1800’s for guns each time they were to be fired, and unless one of the soldiers chambered every round as fast as a sub-machine gun, it is very unlikely that they would have gone through an entire flask in one day]. Stanza two reveals Donne’s ideas about the characteristics of love and the heart. He says that once the heart has fallen into the hands of love, it...
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...Muscle | Proximal Attachment | Distal Attachment | Action/Function | Nerve Supply | THORACIC CAGE | THORACIC CAGE | THORACIC CAGE | THORACIC CAGE | THORACIC CAGE | Diaphragm | Lumbar vertebraeBodies and intervening discs L1-L3Inner surface of lower six ribs and their costal cartilagesposterior surface of xiphoid process of sternum | Central tendon | Inspiration and assists in raising intra-abdominal pressure | Left and right phrenic nerves (C3/4/5) | Intercostal muscles | Upper border of rib | Lower border of rib above | Rib elevation (externals)Rib depression (internals)Stablise the chest wall | Anterior primary rami of adjacent intercostal nerves | Levator costarum | Transverse processes of vertebrae C7 to T11 | Upper border of the rib below | Rib elevationTrunk rotation (slight)Trunk lat flexion (slight) | Dorsal rami of the adjacent thoracic nerves | Subcostals | Upper border of rib | Inner surface of the rib (2-3 ribs below) near the angle | Rib depression | Anterior primary rami of the adjacent thoracic nerves | ANT. ABDOMINAL WALL | ANT. ABDOMINAL WALL | ANT. ABDOMINAL WALL | ANT. ABDOMINAL WALL | ANT. ABDOMINAL WALL | Rectus abdominis | Xiphoid process of sternumCostal cartilages of ribs 5, 6, 7 | Pubic crest and pubic symphysis | Trunk flexionCompresses abdomen | Anterior primary rami of T7-T12 | External oblique | Outer border lower 8 ribs and costal cartilages | Iliac crest Linea alba | Trunk flexionTrunk lateral flexionTrunk rotationCompresses...
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...Clinical research The SYNTAX Score: an angiographic tool grading the complexity of coronary artery disease Georgios Sianos1, MD, PhD; Marie-Angèle Morel2, BSc; Arie Pieter Kappetein3, MD, PhD; Marie-Claude Morice4, MD; Antonio Colombo5, MD; Keith Dawkins6, MD; Marcel van den Brand7, MD, PhD; Nic Van Dyck8, RN; Mary E Russell9, MD; Friedrich W. Mohr10, MD; Patrick W Serruys1* MD, PhD 1. Department of Interventional Cardiology, Erasmus Medical Center, Thoraxcenter Rotterdam, The Netherlands 2. Cardialysis BV, Rotterdam, The Netherlands 3. Department of Cardiothoracic Surgery, Erasmus Medical Center, Thoraxcenter, Rotterdam, The Netherlands 4. Institut Cardiovasculaire Paris Sud, Massy, France 5. San Raffaele Hospital, Milano, Italy 6. Southampton General Hospital, Southampton, UK 7. Ouderkerk aan den ijssel, The Netherlands 8. Boston Scientific Corporation, Maastricht, The Netherlands 9. Boston Scientific Corporation, Natick Massachusetts, USA 10. Herzzentrum, Leipzig, Germany Introduction Optimal revascularization strategy in patients with coronary artery disease remains a subject of debate between interventional cardiologists and surgeons. Numerous large scale randomized trials addressed this issue comparing coronary artery bypass grafting (CABG) with percutaneous coronary intervention (PCI) in patients with multivessel disease (MVD). Initially these trials compared multivessel balloon angioplasty with CABG1-6 and in a later period multivessel stenting...
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...BIOS255 Week 2 Lab 2 Bios 225 Week 2 Lab Exercise Review of the Arteries 1. Right Internal Carotid | 2. Right Vertebral | 3. Right Common Carotid | 4. Right Subclavian | 5. Brachiocephalic trunk | 6. Ascending Aorta | 7. Right Brachial | 8. Abdominal Aorta | 9. Celiac Trunk | 10. Common Hepatic | 11. Right Radial | 12. Right Renal | 13. Right Ulnar | 14. Right Deep Femoral | 15. Right External Carotid | 16. Left Common Carotid | 17. Left Subclavian | 18. Arch of Aorta | 19. Left Axillary | 20. Thoracic Aorta | 21. Diaphragm | 22. Left Gastric | 23. Splenic | 24. Left Renal | 25. Superior Mesenteric | 26. Left Gonadal (testicular or ovarian) | 27. Inferior Mesenteric | 28. Left Common Iliac | 29. Left External Iliac | 30. Left Internal Iliac | 31. Left Femoral | 32. Left Deep Femoral | 33. Left Popliteal | 34. Left Anterior Tibial | 35. Left Posterior Tibial | 36 Left Fibular (peroneal) | 37. Left Dorsal Artery of foot (dorsalis pedis) | Review of the Veins 1. Superior Sagittal Sinus | 2. Right Internal Jugular | 3. Right External Jugular | 4. Right Subclavian | 5. Right Brachiocephalic | 6. Superior Vena Cava | 7. Right Axillary | 8. Right Cephalic | 9. Right Hepatic | 10. Right Brachials | 11. Right Median Cubital | 12. Right Basilic | 13. Right Radial | 14. Right Median Antebrachial | 15. Right Ulnar | 16. Great...
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...The sampling done in the research article took place in a high school in Halifax, Nova Scotia, Canada, using 7th, 8th and 9th grade students. This was so that the study was able to get a range of adolescent aged people. A criteria was set for the people that could participate within the study, this was: All participants were to be able to speak and read fluent English, as well as not having any development disabilities. This was so that people who met the criteria could be selected randomly, therefore allowing the study to be generalised amongst the population (Fampra). They then sent 350 letters out to people who met the criteria, however only 24 responded and participated in the study. With qualitative research, the studies should be carried out in a neutral place, so that the researcher is able to watch the participant’s behaviour and reactions closer. Therefore allowing the researcher to get the most accurate results (bmj.com). In the articles case the data collection took place in facilities in the local mall or the participant’s school. The participants were then separated up into same sex focus groups. The researcher decided to do same sex focus groups so that people who were participating in the study were not discriminated against as well as focus groups being more likely to encourage quieter people to speak out about their opinions (bmj.com/content/311/7000/299.extract). The article also refers to this as the “Peacock effect ( tendency for males to speak more frequent...
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...diaphragm. Exhalation occurs due to a sudden stop in impulses along the inspiratory nerves. Our lungs are prevented from excess inspiration due to stretch receptors within the bronchi and bronchioles which send impulses to the Medulla Oblongata when stimulated. INSPIRATION Inspiration occurs when the chest cavity enlarges. As the thorax enlarges, the lungs expand along with it, and air rushes into them and down the alveoli. Muscles of respiration that are classified as inspiratory muscles include the diaphragm and the external intercoastals. The diaphragm is the dome shaped muscle separating the abdominal cavity from the thoracic cavity. The diaphragm flattens out when it contracts during inspiration. Instead of protruding up into the chest cavity, it moves down towards the abdominal cavity. Thus the contraction or flattening of the diaphragm makes the chest cavity longer from the top to bottom. The diaphragm is the most important muscle of inspiration. Nerve impulses passing through the phrenic nerve stimulate the diaphragm to contract. The external intercoastal muscles are located between the ribs. When they contract, they enlarge the thorax by...
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