By F. Abe. University of Phoenix.
Massage therapy is con- traindicated both pre and post surgical unless per- formed under the supervision of a physician effective 40mg propranolol. Swedish massage: A vigorous system of treatment designed to energize the body by stimulating circula- tion generic propranolol 80 mg online. Five basic strokes propranolol 40 mg generic, all flowing toward the heart buy propranolol 40mg with amex, are used to manipulate the soft tissues of the body. Swedish gymnastics: A form of treatment by move- ments and exercises in which systematized movements of the body and limbs are regulated by the resistance made by an attendant. Massage of swollen area is contraindicat- ed to prevent damage to the inflamed tissues. Although each division may be considered a whole in and of itself, with mul- tiple subsystems interlocking to form its entire divi- sion, each major component or division influences and is influenced by all others, and thus the totality of the CNS is based on the summation of interactions, not individual function. A sensory integrative dysfunction character- ized by tactile sensations that cause excessive emo- tional reactions, hyperactivity, or other behavioral problems. Tara approach: A holistic system for the critical trans- formation of psychological, physical, and emotional shock and trauma. This work combines the ancient ori- ental healing art of jin shin with therapeutic dialogues. T cell: A heterogeneous population of lymphocytes comprising helper/inducer T cells and cytotoxic/sup- pressor T cells. Massage therapy is contraindicated for tendon injuries due to the potential for increased injury to tissues. TENS (transcutaneous electrical nerve stimulation): Application of mild electric stimulation to skin elec- trodes placed over region of pain to cause interference with the transmission of painful stimuli. Tera-Mai Seichem: A complete energy system, incor- porating all the basic elements of life—air, water, spir- it, earth, and fire. Tera-Mai Seichem focuses on the patient’s mental, physical, emotional, and spiritual well being. Thai massage (Nuad Bo Rarn): A form of complimen- tary and integrative medicine based on ancient yoga and ayurvedic sciences. It utilizes yoga positions, yoga therapeutic practices, reflexology, and Thai foot mas- sage. A broad range of activities intended to improve strength, range of motion (including muscle length), cardiovascular fitness, or flexibility or to otherwise increase a person’s functional capacity. Practitioners feel or sense energy imbalances in the client and use laying on of hands to disperse blocks and channel healing forces to the client’s body. Massage therapy is con- traindicated due to the potential for loosening blood clots. Tibetan point holding: As many as 5 practitioners are used to hold points for up to 2 hours. The long period of holding allows time for the client to address internal thoughts as they arise. The spasm of the muscles is often painful and this condition may be caused by a birth injury to the sternocleidomastoid muscle. The method of treatment requires a second person who per- forms muscle testing. Touch Research Institute: A facility at Miami University in Florida dedicated to studying the effects of touch therapy. Trager: An approach to bodywork developed in the 1920s by American medical practitioner Dr. It makes extensive use of touch-contact and encourages the client to experience the freeing-up of different parts of the body. A procedure in which electrodes are placed on the surface of the skin over specific nerves and electrical stimula- tion is done in a manner that is thought to improve CNS function, reduce spasticity, and control pain. TIAs have many symptoms, such as dizziness, weakness, numbness, or paralysis of a limb or half of the body. TIA may last only a few minutes or up to 24 hours, but does not have any persistent neurologic deficits. A transudate, in contrast to an exudate, is characterized by high fluidity and a low content of protein, cells, or solid materials derived from cells.
The examples are innumerable cheap 40 mg propranolol visa, palpable mass diagnosed as a hematoma should be including jumper’s knee (patellar tendon) order propranolol 80mg on-line, tennis leg followed clinically to maturation or resolution discount propranolol 40mg on line. If plain films are normal discount propranolol 40mg overnight delivery, MRI will provide the necessary soft CHRONIC SEQUELA TO TRAUMA tissue contrast for diagnosis. The spectrum of findings range from mild edema to hematoma, partial tear, and Areas of prior hemorrhage, hematoma, or inflamma- complete disruption. Ultrasound is gaining popularity tion may undergo transformation into mature bone. The former name is preferred, Bursae are fluid filled structures with synovial linings since this is not an inflammatory process of the mus- that act as cushions at foci of increased motion or fric- cles. They are classically found between bones and role in recognizing this entity. The finding of peripheral tendons or muscles and skin, but can form anywhere calcification around a soft tissue mass is the hallmark 110 SECTION 2 EVALUATION OF THE INJURED ATHLETE of this entity. This is contrary to osteogenic sarcoma, HAND/WRIST where the osteoid is situated centrally. With Posteroanterior, lateral, and oblique views usually con- maturation, the mineralization of heterotopic ossifica- stitute a hand series. The basic wrist series consists of tion will often completely ossify with marrow induc- four projections, those above as well as a navicular tion. An area of heterotopic ossification immediately (scaphoid) view to lay the bone out on its long axis. These calcifications are usually hydroxyapetite bound, and have a pasty appearance. Depending on the location of the symptoms, radiographs, CT or ultra- Anteroposterior and lateral views are the basic series, sound may be utilized for diagnosis. In the cervical spine, the open SITE SPECIFIC PLAIN RADIOGRAPHY: mouth view shows alignment of the first two vertebral STANDARD AND SPECIAL VIEWS segment lateral masses and the odontoid base. The swimmer’s Each institution has its own set of plain film series and view shows the lower cervical and upper thoracic seg- as such, it is useful to know what views are included ments that may be obscured by shoulder soft tissues in a given radiologic examination. A coned lateral physician may then request a specific view that may view of the L5-S1 disc is often useful, and this level is be crucial for the diagnosis of the suspected pathol- subject to distortion from beam angulation on the ogy, or the radiologist may add or vary the study standard lateral lumbar film. In the setting of acute joint trauma, a three view minimum is usually required. Two perpendicular THORACIC SPINE views suffice for the long bone shafts, and two views are usually adequate for fracture follow-up. A swimmer’s view is frequently obtained to evaluate the upper thoracic segments. Axillary or trans-scapular-Y view are common third projections obtained, needed for a perpendicular The most common view of the pelvis is the AP pro- view of the glenoid. Inlet/outlet and bilateral Judet (lateral scapular) and West Point views may be obtained for oblique) views may also be obtained, but these are evaluation of the glenohumeral joint space, anterior usually reserved for significant acute pelvic trauma. The lateral view should be obtained with the elbow in 90° Anteroposterior and frog-leg lateral views are stan- of flexion. While these provide two views of the proximal soft tissue calcification or acute fracture, and an angu- femur, they show the acetabulum in only one projec- lated radial head view may show a nondisplaced frac- tion. CHAPTER 19 ELECTRODIAGNOSTIC TESTING 111 KNEE Farooki S, Seeger LL: Magnetic resonance imaging in the evalu- ation of ligament injuries. Except in the setting of acute trauma where frac- Imhof H, Fuchsja¨ger M: Traumatic injuries: Imaging of spinal ture is of clinical concern, these should be obtained in the injuries. In acute trauma, the lateral view should Lin J, Fessell DP, Jacobson JA, et al: An illustrated tutorial of be positioned in a cross-table manner to allow demon- musculoskeletal sonography: Part I, Introduction and general stration of a lipohemarthrosis, a sign of fracture. The flexed PA view gives insight musculoskeletal sonography: Part II, Upper Extremity. Am J into the intercondylar notch, and is more sensitive than Roentgenol 175:1071–1079, 2000b.
C a p i t i s T 4 a n d T 5 a n d c e r v i c i s p r o c e s s ( d e e p t o s a m e s i d e a n d l o w e r ( b r a n c h e s ) a n d a r t i c u l a r p r o c e s s e s s p l e n i u s c a p i t u s a n d s a m e s i d e c e r v i c a l n ( s ) purchase propranolol 40mg without prescription. C 4 discount 80mg propranolol with visa, C 5 order propranolol 40 mg on-line, C 6 buy propranolol 80mg free shipping, a n d C 7 S C M ) O b l i q u u s C a p i t u s A r i s e s f r o m a p e x o f I n f & d o r s a l t r a n s v e r s e s a m e s i d e B r a n c h d o r s a l S u b c l a v i a n a. I n f e r i o r s p i n o u s p r o c e s s o f a x i s p r o c e s s o f a t l a s p r i m a r y d i v i s i o n ( b r a n c h ) s u b o c c i p i t a l n. O b l i q u u s C a p i t i s T e n d i n o u s f i b e r s f r o m O c c i p i t a l b o n e b e t w e e n / h e a d B r a n c h d o r s a l S u b c l a v i a n a. S u p e r i o r s u p s u r f a c e t r a n s v e r s e s u p & i n f n u c a l l i n e s p r i m a r y d i v i s i o n ( b r a n c h ) p r o c e s s o f a t l a s ( l a t t o s e m i s p i n a l i s s u b o c c i p i t a l n. P o s t e r i o r M a j o r a x i s o f o c c i p i t a l b o n e a n d s a m e s i d e p r i m a r y d i v i s i o n ( b r a n c h ) s u r f a c e i m m e d i a t e l y s u b o c c i p i t a l n. P o s t e r i o r M i n o r p o s t a r c h o f a t l a s n u c h a l l i n e o f p r i m a r y d i v i s i o n ( b r a n c h ) o c c i p i t a l b o n e & s u r f a c e s u b o c c i p i t a l n. A r i s e s u p p e r t h o r a c i c b r a n c h s p i n a l a o r t a f r o m s p i n o u s p r o c e s s e s v e r t e b r a e n e r v e s ( b r a n c h ) o f T 1 1 , T 1 2 , L 1 , & L 2 S e m i s p i n a l i s T r a n s v e r s e p r o c e s s e s S p i n o u s p r o c e s s e s o f / s p i n e D o r s a l p r i m a r y T h o r a c i c T h o r a c i s o f T 6 t o T 1 0 C 6 , C 7 , T 1 , T 2 , T 3 , & o p p s i d e b r a n c h s p i n a l a o r t a T 4 n e r v e s ( b r a n c h ) I l i o c o s t a l i s F l a t t e n e d t e n d o n s f r o m I n f b o r d e r s o f a n g l e s / s p i n e D o r s a l p r i m a r y T h o r a c i c L u m b o r u m u p p e r p o r t i o n o f e r e c t o r o f l a s t 6 o r 7 r i b s l a t b r a n c h s p i n a l a o r t a s p i n a e ▼ r i b s n e r v e s ( b r a n c h ) M u s c l e O r i g i n I n s e r t i o n A c t i o n N e r v e A r t e r y S a c r o s p i n a l i s A r i s e s f r o m b r o a d S p l i t s i n t o l o n g i s s i m u s , / s p i n e S p i n a l n e r v e s T h o r a c i c ( E r e c t o r S p i n a e ) t e n d o n a t t a c h e d t o m i d i l i o c o s t a l i s , s p i n a l i s , s p i n e a o r t a c r e s t o f s a c r u m ; a n d s e m i s p i n a l i s ▼ r i b s s p i n o u s p r o c e s s e s T 1 1 m u s c l e s ( s e e r e s p e c t i v e l a t t o T 1 2 a n d l u m b a r m u s c l e s ) v e r t e b r a e ; s u p r a s p i n a l l i g - m e n t t o l i p o f i l i a c c r e s t s a n d l a t c r e s t o f s a c r u m M u l t i f i d u s S p i n o u s p r o c e s s e s o f E a c h a s c e n d s o b l i q u e l y / s p i n e B r a n c h e s o f d o r s a l T h o r a c i c e a c h v e r t e b r a e f r o m c r o s s i n g o v e r 2 t o 4 o p p s i d e p r i m a r y s p i n a l a o r t a s a c r u m t o a x i s. A r i s e s v e r t e b r a e a n d i n s e r t e d n e r v e s f r o m b a c k o f s a c r u m i n t o s p i n o u s p r o c e s s o f f r o m a p o n e u r o s i s o f v e r t e b r a f r o m l a s t l u m b a r s a c r o s p i n a l i s , f r o m m e d t o a x i s s u r f a c e o f p o s t s u p i l i a c s p i n e a n d p o s t s a c r o i l i a c l i g a m e n t s R o t a t o r e s T r a n s v e r s e p r o c e s s o f R o t a t o r e s l o n g i c r o s s / s p i n e B r a n c h e s o f d o r s a l T h o r a c i c o n e v e r t e b r a a n d i n s e r t o n e v e r t e b r a i n t h e i r o p p s i d e p r i m a r y s p i n a l a o r t a a t b a s e o f s p i n o u s o b l i q u e c o u r s e. R o t a t o r e s n e r v e s p r o c e s s o f v e r t e b r a e b r e v e s i n s e r t i n n e x t a b o v e f r o m t h e s a c r u m s u c c e e d i n g v e r t e b r a t o t h e a x i s a n d r u n h o r i z o n t a l M u s c l e O r i g i n I n s e r t i o n A c t i o n N e r v e A r t e r y Q u a d r a t u s S u p b o r d e r s o f t h e I n f b o r d e r o f l a s t ▼ l a s t r i b 1 2 t h t h o r a c i c n. I l i a c c i r c u m - L u m b o r u m t r a n s v e r s e p r o c e s s e s r i b a n d t r a n s v e r s e l a t 1 s t l u m b a r n. S u p r a - p r o t u b e r a n c e ; m e d 1 / 3 c l a v i c l e ; m e d m a r g i n A b d s a m e s i d e C 3 & C 4 s c a p u l a r s u p n u c h a l l i n e ; s p i n o u s a c r o m i o n ; s p i n e o f t h e o p p s i d e s p i n a l n e r v e s p r o c e s s C 7 , T 1 t o T 1 2 s c a p u l a R e t r a c t i o n ▲ g l e n f o s s a ▲ g l e n o i d f o s s a L e v a t o r T r a n s v e r s e p r o c e s s e s M e d b o r d e r s c a p u l a E l e v a t i o n D o r s a l s c a p u l a r n. S u p e r f i c i a l S c a p u l a e C 1 t o C 4 b e t w e e n s u p P r o t r a c t i o n C 3 & C 4 s p i n a l c e r v i c a l a. A b d s a m e s i d e s a m e s i d e R o m b o i d e u s S p i n o u s p r o c e s s o f M e d b o r d e r s c a p u l a E l e v a t i o n D o r s a l s c a p u l a r n. D e s c e n d i n g M i n o r C 7 a n d T 1 a t l e v e l o f t h e s p i n e R e t r a c t i o n s c a p u l a r a. D e s c e n d i n g M a j o r T 2 t o T 5 b e t w e e n s p i n e a n d R e t r a c t i o n s c a p u l a r a. S u b s c a p u l a r D o r s i s p i n o u s p r o c e s s e s o f i n t e r t u b e r c u l a r g r o o v e A b d s h o u l d e r C 6 t o C 8 s p i n a l a. T 6 t o T 1 2 , L 1 t o L 5 , o f h u m e r u s M e d n e r v e s & s a c r a l v e r t e b r a e E l e v a t i o n R e t r a c t i o n P e c t o r a l i s A n t s u r f a c e s t e r n a l 1 / 2 C r e s t o f g r e a t e r s h o u l d e r M e d a n d l a t T h o r a c o - M a j o r c l a v i c l e ; v e n t r a l s u r f a c e t u b e r c l e o f h u m e r u s A d d s h o u l d e r p e c t o r a l n. P e c t o r a l i s E x t s u r f a c e s o f r i b s C a r a c o i d p r o c e s s o f P r o t r a c t i o n M e d p e c t o r a l n. T h o r a c o - M i n o r 3 , 4 , a n d 5 n e a r t h e i r s c a p u l a D e p r e s s i o n a c r o m i a l a. L a t t h o r a c i c A n t e r i o r r i b s 1 t o 9 b o r d e r o f s c a p u l a f r o m D e p r e s s i o n a. C i r c u m f l e x f o s s a ; i n f 2 / 3 g r o o v e o n h u m e r u s & / s c a p u l a r a. S u p r a - f o s s a g r e a t e r t u b e r c l e o f L a t ( w e a k ) s c a p u l a r h u m e r u s ( w e a k ) I n f r a s p i n a t u s M e d 2 / 3 i n f r a s p i n a t u s M i d i m p r e s s i o n o f L a t S u p r a s c a p u l a r n. S u p r a - f o s s a g r e a t e r t u b e r c l e o f A b d a n d a d d s c a p u l a r h u m e r u s T e r e s M i n o r D o r s a l s u r f a c e o f I n f i m p r e s s i o n o f L a t B r a n c h o f a x i l l a r y n. P o s t h u m e r a l a x i l l a r y b o r d e r o f g r e a t e r t u b e r c l e o f A d d c i r c u m f l e x a. P r o f u n d a t u b e r o s i t y o f s c a p u l a ; o f o l e c r a n o n / s h o u l d e r c o l l a t e r a l a. M u s c l e O r i g i n I n s e r t i o n A c t i o n N e r v e A r t e r y L a t h e a d : p o s t s u r f a c e o f A d d s h o u l d e r I n f u l n a r h u m e r u s ; M e d h e a d : p o s t s u r f a c e o f h u m e r u s d i s t a l t o r a d i a l g r o o v e B r a c h i a l i s D i s t a l 1 / 2 o f a n t a s p e c t T u b e r o s i t y o f u l n a ; e l b o w M u s c u l o c u t a n e o u s B r a c h i a l a. I n f u l n a r t o m e d e p i c o n d y l e o f m i d o f l a t s u r f a c e c o l l a t e r a l a. R a d i a l i s h u m e r u s m e t a c a r p a l b o n e R a d i a l P a l m a r i s L o n g u s M e d e p i c o n d y l e o f P a l m a r a p o n e u r o s i s w r i s t M e d i a n n. F l e x o r C a r p i H u m e r a l h e a d : m e d P i s i f o r m b o n e w r i s t U l n a r n.