T.W. initial assessment and to stabilize him will be the priority following ABCs. The neurologic assessment every hour will provide T.W. general condition and information that can determine any changes. Oxygen will be given at 4 L per nasal cannula. The next will be stabilization of spine by immobilize the cervical spine to protect the spine and from causing more trauma. The preparation to administer fluid to maintain hemodynamic stability therefore, initiate two large bore IVs. An ECG monitor will be connected to record and detect heart conduction, disturbances or hyperkalemia. Also, a Foley catheter will be inserted that will assist T.W. with voiding and lastly, apply warm blanked as needed to prevent hypothermia and to maintain his temperature.…
Findings: Ct scan of the chest was performed in 7 mm axial sections with no intrrveous contrast enhancement. Comparison is made to previous ct scans made during his admission last year. There is interval resolution of the previously noted cavitary lesions in both upper lobes. However, there is evidence of chronic residual infultrates or scarring in both upper lobes as well as in the mid- and lower-lung fields posteriorly. Heart again appears enlarged. There is evidence of mild bilateral pleural thickening. No interval pulmonary parynchimal or pleural based mass lesions. No mediastynal or hylar masses. No lymphadenopethy, no pleural effusions, and no significant lesions of the boney thorax.…
11/16/15 Progress note indicated that the patient has constant pain. He has burning, stabbing pain in the right lateral elbow. He has difficulty in making a full fist. It takes a long time to release with the use of hot water, if he does make a fist. The pain radiates from his shoulder down to his right thumb, index and middle fingers. Pushing, pulling, reaching and turning doorknob aggravate the pain. Pain medications…
Patient was diagnosed with cervical disc displacement C3-C7 and C7-T1 and sprain thoracic spine ligaments.…
PROCEDURE: The patient was given a general anesthetic. The right arm was free draped, and she was prepped and draped in this position. We marked our superior and inferior skin incisions, and then we developed our superior flap and went down to the chest wall. We then developed the inferior flap and went down to the chest wall. We then removed the breast going from medial to lateral. We then marked it for pathological orientation. I then opened up the clavipectoral fascia. There was an easily palpable node in an area where I had felt palpable nodes before her neoadjuvant chemotherapy. I dissected this node out. This could be a sentinel node, but I obviously do not know that for sure. However, it is in the area where I felt palpable nodes, and I elected to send it for frozen section with the idea that if I saw tumor within the node, then I would consider being more aggressive with my axillary dissection. We sent this for frozen section, and it came back with no tumor. It could be that there was tumor in this node and chemotherapy dealt with it. Either way, we continued with our axillary dissection, but we elected not to go after level II nodes, because this was negative. We identified the axillary vein, the long thoracic nerve, and the thoracodorsal vessels and nerves, and then we did a formal axillary dissection going from below the axillary vein all the way down. We sent this for pathology. We had excellent hemostasis. We clipped multiple small vessels and lymphatics. We irrigated out the wound with fluid that had Ancef in it. We then put a Hemovac drain through a separate wound laterally…
A patient is performing a Phase I (inpatient) cardiac rehabilitation exercise session. The physical therapist should terminate low-level activity if which of the following changes occurs? 1. The diastolic blood pressure increases to 120 mm Hg. 2. The respiratory rate increases to 20 breaths per minute. 3. The systolic blood pressure increases by 20 mm Hg. 4. The heart rate increases by 20 bpm. A patient is being evaluated for possible carpal tunnel syndrome, and a nerve conduction velocity test is performed. Which of the following findings would MOST strongly support the diagnosis? 1. Decreased latency at the elbow. 2. Decreased latency at the carpal tunnel. 3. Increased latency at the carpal tunnel. 4. Increased latency at the forearm. When examining a patient with a history of alcohol abuse, a physical therapist notes that the patient demonstrates fine resting tremors and hyperactive reflexes. The patient reports frequent right upper quadrant pain. Which of the following additional signs is MOST likely? 1. Jaundice 2. Hyperhidrosis 3. Hypotension 4. Nocturnal cough Which of the following examination findings would be expected in a patient who also had sustained ankle clonus? 1. An upgoing great toe when the sole of the foot is stroked 2. Weakness of ankle plantar flexors with one-repetition strength testing 3. Absence of sensation to sharp/dull testing over the posterior lower leg 4. Hyporeflexia when deep tendon reflexes are elicited in the lower leg Which of the following sensory testing locations corresponds to the C 7 nerve root? 1. Volar aspect of the little finger (5th digit) 2. Dorsal aspect of the middle finger (3rd digit) 3. Lateral aspect of the upper arm 4. Medial aspect of the upper arm A 3-month-old infant has poor midline head control. During evaluation, the physical therapist notes facial asymmetry and observes that the infant has limitation of cervical rotation to the left and cervical lateral flexion to the right.…
Thoracic Outlet Syndrome is a complex disorder characterized by a constellation of signs and symptoms resulting from a compression of blood vessels and nerves in the thoracic outlet region where they exit the chest. The thoracic outlet is a space located between the thorax (rib cage) and the clavicle (collarbone) which contains major blood vessels and nerves. The thoracic outlet is the area through which nerves and blood vessels travel to and from the arm. Thoracic Outlet syndrome is considered a “syndrome” since it involves multiple systems, including neural complexes, vascular structures, and musculoskeletal systems. This paper will analyze, discuss, and inform you on what Thoracic Outlet Syndrome is; parts of the body that are affected…
HISTORY OF PRESENT ILLNESS: The patient is an elderly mail who fell 4 days prior to admission. He noted immediate pain and swelling in the area just below his left elbow. He was presented to the emergency room for treatment.…
HISTORY OF PRESENT ILLNESS: The patient is an elderly male, who fell four days prior to admission. He noted immediate pain and swelling in the area just above his left elbow. He presented to the emergency room for treatment.…
IW reports constant neck pain as aching with exacerbations and radiation to bilateral shoulders/upper extremities. IW notes intermittent numbness and tingling to bilateral hands/fingers. IW reports major weakness in the upper extremities, not being able to grasp items and involuntarily drop items. IW reports being able to tolerate right wrist pain. IW reports exacerbation of pain due to change in weather. IW complains of headaches with dizziness and nausea. She attempts to avoid any exacerbating activities. The IW has tried pain medications and therapy which helps some. Her sleep quality is poor secondary to pain. She has a history of epidural injections with no change. She has been doing PT 3 days a week since her last visit with some improvement of symptoms. On examination of the cervical spine, bilateral paracervical and trapezius tenderness is noted. Bilateral palpable spasm is noted. Range of motion (ROM) shows flexion of 35 degrees, extension of 20 degrees, and bilateral rotation to 55 degrees, all with pain. On examination of the lumbar spine, bilateral paralumbar tenderness is noted with palpable spasm. Sacroiliac joint tenderness is noted, right greater than the left. ROM demonstrates flexion of 45 degrees and extension of 0 degrees, all with pain. Straight leg raise is positive bilaterally. Sensory…
The 1800s brought many new technological advances that helped transform American life. These advances led to an economic and physical growth. Inventions brought a continuous growth in the population. New modes of transportation created a highly affective trading system. The three most important technological advances were the Erie Canal, Railroads, and the cotton gin.…
HISTORY OF PRESENT ILLNESS: The patient is an elderly female who fell four days prior to admission. He noted immediate pain and swelling in the area just below his left elbow. He presented to the emergency room for treatment.…
Our case illustrates that TCM mimicks AMI. Although casualty cannot be concluded if there is association. Among the physical stressors known to be related with TCM are intracranial occasions, infection, surgical injury and respiratory disease. For our situation, the respiratory disease may have contributed to the development of…
As per Ehow web and Nursing Times.net, the following table compares the neurological and neurovascular observations.…
Proximal Attachment: base of skull, occipital bone, posterior ligament of neck and spinous process of the last cervical and all the thoracic vertebrae…