SRIKUMARAN PHYSIOTHERAPY & FITNESS CENTRE ( ஶ்ரீகுமரன் ‌‌‌‌பிசியோதெரபி & உடற்பயிற்சி மையம் )

NEBULISER Nebulization is the process of medication administration via inhalation. It utilizes a nebulizer which transports medications to the lungs by means of mist inhalation. TYPES OF NEBULISER- There is a huge market for different types of nebulizers and each of them have some unique features although they all function in a similar way. Here are the two basic types of nebulizers available in the market: STATIONARY NEBULISER  – these are the nebulizers that are sturdy, rest on top of the table and they can provide durability as most of them come with a longer warranty period. They are cheaper than the mobile nebulizers and serve as a good aid for usage for children or elderly patients. Stationery nebulizers are mostly for indoor use only and are seldom used outdoors. MOBILE NEBULISER  – these nebulizers provide most mobility as they can be hand held and carried with the patient wherever they go. They have alternative power sources like batteries or auto adapters which enable them wi

 COUGHING AND HUFFING Coughing is a forced expiration against a closed glottis causing a rise in intrathoracic pressure. As the glottis opens, there is a difference in pressure between the smallest airways and the upper trachea, causing a rapid flow of air. This rapid flow, combined with the narrowing of the airways, increases the force of the air, which dislodges mucus and foreign particles into the pharynx. Since a high intrathoracic pressure diminishes the return of blood to the heart, a prolonged bout of coughing may cause a fall in the cardiac output and the patient may faint (cough syncope). Patients must be taught to avoid this. A forced expiratory manoeuvre (cough or huff) produces compression and narrowing within the airways from a point dependent on lung volume. The compression point is adjacent to the equal pressure point, where the pressure within the airways is equal to the pleural pressure. At high-lung volume this point lies in the trachea and main bronchi, and secretion

 INTRODUCTION: Acute disseminated encephalomyelitis  ( ADEM ), or  acute demyelinating encephalomyelitis , is a rare autoimmune disease marked by a sudden, widespread attack of inflammation in the brain  and spinal cord. As well as causing the brain and spinal cord to become inflamed, ADEM also attacks the nerves of the central nervous system and damages their myelin insulation, which, as a result, destroys the  white matter . It is often triggered by a  viral   infection  or (very rarely) specific non-routine  vaccinations . ADEM's symptoms resemble the symptoms of multiple sclerosis (MS), so the disease itself is sorted into the classification of the multiple sclerosis borderline diseases. However, ADEM has several features that distinguish it from MS. Unlike MS, ADEM occurs usually in children and is marked with rapid fever, although adolescents and adults can get the disease too. ADEM consists of a single flare-up whereas MS is marked with several flare-ups (or relapses), over

 INTRODUCTION Humans have used fire since the dawn of history and burn injuries have presumably occurred ever since. Burns affect skin directly and all other organ systems indirectly, causing a chain of events with implications far beyond skin loss. Rehabilitation of the burn patient may be considered in 2 phases: • Acute • Postacute and longterm. Assessment Initially after eliciting a history, the rehabilitation team conducts a physical exam to document the type and extent of burns, neuromuscular and musculoskeletal damage, associated medical conditions, presence of other injuries and social problems. The pediatric burns patient differs from an adult patient in many ways. Since the body surface area is different, dehydration is greater, temperature control is more difficult and hypertrophic scarring is more severe. In the pediatric patient, mortality is higher and rehabilitation more challenging. The assessment of burns in the acute phase is governed by the rule of 9 (given below) and

 RANGE The word range may be used in two senses. First, it may refer to the amount of movement which occurs in a joint. Secondly, it may refer to the amount of shortening or lengthening of a muscle as it acts to produce or control movement. Range of movement at a joint This is the total quantity of movement when a joint is moved to its full extent.  The names of the movements are those anatomical names which are normally applied (see Chapter 3) and the method of recording range is well laid down in the book Joint Motion published by the American Orthopaedic Association. One may measure and record the amount of range of movement in a certain direction, e.g. the range of abduction of the shoulder joint is 90°. The range of adduction of the shoulder joint is 90°. This is normal range. If, however, the range is limited the available range can be recorded when a zero starting point is necessary and the recording could be from 10° of abduction to 80° of abduction, i.e. the first 10° and last

 GROUP ACTION OF MUSCLES Muscles do not work in isolation. They must, for smooth co-ordinated movement to occur, operate in one of the following roles. Prime Movers or Agonists In this case they are those muscles which initiate and perform movement. Antagonists These can produce the opposite movement to that produced by the agonists. When the agonists work the antagonists must relax reciprocally, i.e. exactly an equal amount. The tension of the agonist contraction is equalled by the relaxation of the opposing muscles in order to allow smooth movement to occur. Synergists These are muscles which contract in order to bring about a joint position to make the action of the agonists stronger. They most frequently may be observed in action when the agonists are bi- or multi-axial muscles, e.g. the wrist extensors. Synergists also contract to prevent extra or additional movements that the agonists might otherwise perform. They operate from unconscious levels. Fixators These muscles also opera

 TYPES OF MUSCLE WORK There are two main ways in which a muscle may work naturally. It may contract and produce no movement, called isometric contraction, or it may produce movement during contraction, called isotonic contraction. Both these types of contraction may be used therapeutically, but a third type of muscle action may be applied to muscles to strengthen them. This uses isokinetic or accommodative resistance to achieve. Isotonic Contraction When a muscle works isotonically it contracts and the part of the body to which it is attached will move. There are two types of isotonic contraction. Isotonic Shortening. When a muscle performs a contraction and its two attachments are approximating to one another, the contraction is known as an isotonic shortening, e.g. when the arm is raised from the side and the abductors of the shoulder contract, the contraction is one of isotonic shortening. Isotonic Lengthening When the attachments of a muscle move slowly away from one another and th

INTRODUCTION: Cystic fibrosis (CF) is the most common lethal genetic disease in Caucasians, affecting 1 in 2500 births. It is caused by mutations of a gene (on chromosome 7) coding for a chloride channel – cystic fibrosis transmembrane conductance regulator (CFTR). The carrier rate of CF mutations is 1 in 25 and inheritance is autosomal recessive. The most common mutation is ΔF508 but > 1000 mutations have been identified. The genetic defect causes increased sodium and chloride in sweat, and depletion of airway lining fluid, leading to chronic bacterial infection in the airways. The gut epithelium, pancreas, liver and reproductive tract are also affected.  Neonatal screening for CF is now routine in the UK. The diagnosis is confirmed by genetic testing and sweat electrolyte measurements. CLINICAL FEATURES: The lungs are normal at birth, but bronchiectasis develops in childhood. Staph. aureus is the most common childhood organism; however, in adulthood, increasing numbers are colonis

 INTRODUCTION: Chronic obstructive pulmonary disease (COPD) is a preventable and treatable disease characterized by persistent progressive airflow limitation associated with chronic inflammation in response to noxious particles or gases. Related diagnoses include chronic bronchitis (cough and sputum on most days for at least 3 mths, in 2 consecutive yrs) and emphysema (abnormal permanent enlargement of the distal air spaces, with destruction of alveolar walls). Extrapulmonary manifestations include weight loss and skeletal muscle dysfunction, and COPD is associated with cardiovascular disease, cerebrovascular disease, the metabolic syndrome, osteoporosis and depression. The prevalence of COPD is related to the prevalence of tobacco smoking and, in low- and middle income countries, exposure to biomass fuel smoke. Approximately 80 million people worldwide suffer from moderate to severe disease. In 2005, COPD contributed to over 3 million (5%) deaths globally but it is forecast to become