NEUOROLOGY



علم الأعصاب من أكثر العلوم إلي حبيتها بشكل خيالي ..... هل العلاج الطبيعي له تأثير في حالات أمراض الأعصاب .... أكيد وهو من أهم الأشياء بعد العمليات أو بعض الحالات المرضية مثل أمراض الشلل النصفي أو شلل الرعاش وغيرها و غيرها
بأذن الله من بعد كل فترة وفترة راح انزل مواضيع تخص تخصص الأعصاب وكيفية علاجها

موضوعي هنا راح اكتب عن كيف نعمل تقيم لمريض الأعصاب وكيف نعالج المريض في بعض الحالات وأيضاً في أخر الموضوع فيه ملفات فديو تقدرون تخزنونها عندكم وهي عبارة عن كيفية تطبيق بعض الاختبارات ...... والموضوع انجليزي اللغة

ملحوظة

انا مصغر احجامهن علشان تقدرون تحملونهن كمان في اجهزة الجوالات .... يشترط وجود برنامج Quick Time علشان تقدرون تشفون الملفات

قبل لا ابدأ الموضوع طويل

يعني إلي يمل بسرعة لا يقرا من هالحين




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في البداية المعلومات التي تكتب في ملف المريض تكون من مصدرين:

Patient Profile الملف الطبي للمريض

من المريض نفسه أو المرافق له

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Diagnosis



Write the diagnosis which written by the doctor who diagnosis first time

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1-Personal History:

Write his/here Name, Age, Sex (male – female), Martial Status (single- married-
divorcee), Occupation, and smoking or no smoking

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2- Past History PMHx:

Write the what patient have ( diseases (hypertension –diabetes…est.) – any surgery in the past – any thing about past history for the patient

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3- Present History:

Write the complaint the patient

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انتهينا من القسم الأول وهو ما يسمى بــ

Subjective

Any information patient gives us: complaints of pain, weakness, pins , needles or numbness, fatigue, dizziness, etc



القسم الثاني وهو ما يسمى بــ

Objective

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1-Observation:

Patients appearance
Dressing, skin color- cyanosis, lips, weight loss, coma

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2- Palpation

To Diagnosis the Oedem, Tenderness, and Hotness

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3- Orientation time and palace

By ask the patient or through talk to him/here .. it is important to mental state of the patient, and Severity of injury , e.g. stroke patient doesn't know time and place.


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4- Level of consciousness G.C.S :

To know the patient is co-operative or not

There are there tests to know the consciousness

a- Motor response



b- Verbal Response



c- Eye Response



In the normal person the total of consciousness is 15/15

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5- Sensory assessment

It is very important when you give to patient thermotherapy or electrotherapy to avoid burn and to know if he/she can known his/here position in space or no

Divided into

1- Superficial subdivided into

a- Pain

The sharp end of a broken wooden cotton tip applicator can be used then discarded. It is important for the patient to be able to identify the sensation as sharp and then compare between dermatomes, distal versus proximal and right versus left for the upper extremities.


mild/ moderate/ sever



b- Temperature :

Tubes or vials of hot and cold water can be used but this is usually impractical. Using a tuning fork, which is normally perceived as cool or cold to the touch, compare between dermatomes and right versus left.


c-Light pressure

Is used as a screening test for touch. A cotton tip applicator or fine hair brush is used. Select areas from different dermatomes and peripheral nerves and compare right versus left


2- Deep subdivided into

a- Movement sense: let the patient movement and be sure to put him/here in safety position.

b- Position sense :

Is tested by holding the most distal joint of a digit by its sides and moving it slightly up or down. First, demonstrate the test with the patient watching so they understand what is wanted then perform the test with their eyes closed. The patient should be able to detect 1 degree of movement of a finger and 2-3 degrees of movement of a toe. If the patient can't accurately detect the distal movement then progressively test a more proximal joint until they can identify the movement correctly.


Position Sense



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6- Motor Assessment:

Divided into :

A- Muscle Tone
B- Muscle strength

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A- Muscle Tone

Muscle tone is the continuous and passive partial contraction of the muscles. It helps maintain posture in the Right and Left side. The muscle tone important to know if the injury in the Upper Motor Neuron Lesion (UMNL) or Lower Motor Neuron Lesion LMNL
In UMNL the tone will be Hypertonia ( increase the Tone in muscle
In LMNL the tone will be Hypotonia ( decrease the Tone in muscle
Through the tone you can also know which the stage he/she now e.g. patient of Hemiplegia or Quadriplegia
Muscle tone is assessed by putting selected muscle groups through passive range of motion


B- Muscle strength:

Muscle strength is tested from the proximal to the distal part of the extremity so that all segmental levels for the extremity are tested

Technique: Place the muscle in an active position and ask the patient to resist movement

Muscle Strength Grading

0 – No contraction
1 – Slight contraction, no movement
2 – Full range of motion without gravity
3 – Full range of motion with gravity
4 – Full range of motion , some resistance
5 – Full range of motion, full resistance

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7-Deep Tendon Reflex D.T.R:

DTR Tonic contraction of the muscles in response to a stretching force, due to stimulation of muscle proprioceptors. When reflex responses are absent this could be a clue that the spinal cord, nerve root, peripheral nerve, or muscle has been damaged. When reflex response is abnormal, it may be due to the disruption of the sensory (feeling) or motor (movement) nerves or both. A brisk tap to the muscle tendon using a reflex hammer produces a stretch to the muscle that results in a reflex contraction of the muscle. The muscles tested, segmental level.


Grading DTR's

0 – Absent
1 – Decreased but present
2 – Normal
3 – Brisk and excessive
4 – With clonus

How can I applied this test?

Biceps Reflex



Triceps Reflex



Brachioradialis Reflex



Knee Reflex & Ankle Reflex





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8-Functional Assessment:

Divided to

A- Bed Mobility Rolling

B- Transfers from bed to chair & from chair to bed

C- Site to Standing

The Grades

Independent : the patient can do it without in assistance

Supervision : the patient can do it without in assistance but you must be their
whit patient

Close guarding : the patient can do it without in assistance but you must be close to the patient

Contact Guarding : the patient can do it without in assistance but you must be hold or grab the patient

Minimum assistance : the patient can do it but with minimal assistance

Moderate assistance :the patient can do it but with Moderate assistance.

Maximum assistance:the patient can do it but with Maximum assistance applied by tow physiotherapy

D- Sitting and Standing Balance

It is subdivided into static balance and dynamic balance for each of sitting and standing



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9- Gait Assessment

Gait assessment it is important to not only watch the lower extremities but also the upper extremities for normal associated movements

You must be tests

a- Step length
b- Base of support
c- Weight shifting
d- Arm swing
e- Stance phase/ Swing phase/ heel strike/ toe off
f- Circumduction

There are pathological gaits that should be recognized by their characteristic pattern. These pathological gaits are:

Hemiplegic

Spastic diplegic

Parkinson

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FinallyYou should be know the Key muscles and the Key Sensory Points of the body, it is very important restriction the area of lesion.










للمعلومية تراه مجهود شخصي فيه بعض الإضافات البسيطة جدا من موقع سبتا

Press Here

اللغة يعني لا تدققون كثير يعني لكم عليها بس أهم شي إنكم تستفيدون منها و أتمنى إلي عنده أي استفسار بس يكتبه هنا و أنا على استعداد كامل للرد
والله يوفق الجميع


هذه هي ملفات الفديو للي يبي يحملها

وتبون الصراحة وربي انها مفيده و اكيد ان شاء الله تدعون لي



NEURO 1



NEURO 2



NEURO 3


اخوي KaZbObO
لك كل شكري واحترامي

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