The patient appeared to be a healthy 64 year old white male. The patient’s past surgical history included a right ankle fracture with fixation 23 years ago. The patient reported hypertension that was well controlled with medication as his only medical condition.
System’s Review
Integumentary System
Upon examining the integumentary system, swelling was found in bilateral knees. Bilateral swelling was measured by taking the circumference at the superior and inferior patella on both knees. Left knee swelling was measured at 44.5 cm and 41.0 cm at the superior and inferior patella, respectively. Right knee swelling was measured at 43.5 cm and 39.0 cm respectively. The incisions on both knees were closed and nicely healed. The patient didn’t report any numbness or tingling in bilateral lower extremities, therefore sensation was not tested. All other systems were insignificant.
Gait
The patient stated before his surgery he was not using an assistive device. He reported he only needed to use the cane when walking long distances for increased balance and stability. He stated his legs would fatigue after long periods of walking.
When examining gait, the patient ambulated without the cane. He presented with a mild antalgic gait, leaning to the right with decreased weight bearing on the left lower extremity. Other than having a mild antalgic gait, the patient presented with normal, coordinated, movement patterns. When measuring gait speed, the patient walked safely at 263 ft/min. The patient’s balance was tested by having the patient stand in tandem. The patient was able to stay in tandem stance longer than 30 seconds with both the left and right foot in front, indicating the patient had good balance.
Pain
The patient’s pain was rated ...
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...and endurance, manual therapy for decreasing pain and increasing range of motion, augmented soft tissue mobilization (ASTYM) to break up scar tissue and help regenerate healthy new tissue, neuromuscular re-education to increase balance and proprioception, and a home exercise program. The patient was scheduled to be seen at the outpatient clinic two times a week for four weeks. At four weeks the patient was re-evaluated, and the surgeon approved the patient to continue with therapy two times a week for three more weeks.
Interventions
During the patient’s six weeks of treatment by the physical therapy student, general bilateral lower extremity strengthening and stretching exercises were introduced in the clinic along with manual therapy to both lower extremities. Each treatment session lasted 60 minutes. A home exercise program was also established for the patient.
In this paper I will clarify the relation between the integumentary system and the skeletal system. During this paper I will address how the two systems work together to maintain homeostasis and what occurs when balance is not maintained between the integumentary and skeletal system. During this paper I will explain how osteoporosis is directly linked between both the integumentary and skeletal system and ways to prevent or yield this disease.
Per AME report dated 05/02/12 by Dr. Perelman, the IW is P & S 8-12 months post injury. Future medical care includes orthopedic evaluations, PT, chiropractic care, and acupuncture to the cervical spine. The patient underwent a cervical ESI at C5-6 per procedure report dated 02/10/12 with no benefit.
After receiving an artificial leg, he was able to walk after several weeks of therapy
What? The patient is 65-year-old man Mr. John Douglas who is suffering from dysphagia and have been admitted to the surgical ward for insertion of a percutaneous endoscopic gastrostomy (PEG). Apart from that, he is a Type 1 diabetes patient and has weakness in his right leg and arm because of right-sided hemiplegia. He is thin in appearance and has stage 1 pressure sore on his right heel.
J.P. was positive for dyspnea and a productive cough. She also was positive for dysuria and hematuria, but negative for flank pain. After close examination of her integumentary and musculoskeletal system, the examiner discovered a shiny firm shin on the right lower extremity with +2 edema complemented by severe pain. A set of baseline vitals were also performed, revealing a blood pressure of 124/80, pulse of 87 beats per minute, oxygen saturation of 99%, temperature of 97.3 degrees Fahrenheit, and respiration of 12 breaths per minute. The blood and metabolic panel exposed to several abnormal labs.
Mr. Barta continues to have a very slow recovery and pain. After discussion with physical therapist Bo and speaking with Mr. Barta a second opinion was explored. I made several calls and provided medical records to Orthopedic Surgeon Dr. Lilly. Dr. Lilly reviewed the records and recommended waiting for some time yet before exploring a second opinion.
Since we will be going to the nursing home, it is imperative that we know how to correctly assist a client with their ambulation. To begin with, Ms. D demonstrated how to use a wheelchair, cane, and walker. We all practiced assisting each other with standing, sitting, and falling.
My patient was a twenty-two year old female and she suffers from bunions on both of her feet. Only the left foot was treated, because the severity level was higher. After her diagnosis, she was taken to surgery and had the first metatarsal operated on. Type of surgery that was performed is called a bunionectomy. This surgery requires a small piece of bone to be removed and repositioned by a piece of hardware (UPMC, 2014). My patient had a screw inserted from the lateral border of her first metatarsal. After the surgery, she came to x-ray to get post operation images. The order called for a left foot series, which includes the anterior posterior (AP), oblique, and lateral views. After the surgery she had a cast on, which meant techniques were increased on each view accordingly. The AP view was done with the tube angled about ten degrees cephalic with a technique set at 65 kVp and 3.2 mAs. Next the oblique was done by rolling her foot medially about thirty degrees with no angle on and using the same technique as the AP. After she was placed in a lateral position and increasing the mAs to 4.
"Chapter 37." Operative Techniques in Orthopaedic Surgery. Ed. Sam Wiesel. 4th ed. Vol. 2. Lippincott Williams & Wilkins, 2011. eBook.
The patient must understand the capabilities and limitations for a better adaptation. Additionally, endurance and cardio vascular activities must be address. Also specific muscles strength as the hamstring, gluts and quads. Furthermore, gait training and stair step negotiating. Moving forward on specific interventions we can start training going up/down a 1 inches’ block using parallel bars to increase confidence, progress to higher height of block 2->4->6 inches. To work on endurance and cardio vascular fitness we can start just by walking and assess gait and impairments in the process. Also, to increase intensity UE ergometry can be used, this will help with cardiovascular and endurance. These different and simple exercises will give the patient the confident necessary to progress to more functional activities like using the stairs, and walking on different surfaces. Also, working on weight shifts will allow the patient to get to know his boundaries and how to approach different situations, weight shits might prevent falls. Additionally, working on strengthening quads, gluts and hamstring must be done. AROM with proper body mechanics might be a good starting point and assess the strength of those possible weak muscles. Progress to MREs followed by T-bands-and some cuff weights after endurance and cardio vascular fitness has been
Initially we will start with static balance by having the patient stand in the parallel bars without the use of her AD for 30 seconds. To progress, the patient will stand on one leg without the use of her AD while duration to up to 1 minute. To progress even further, the patient can stand on an uneven surface and balance without the AD using both legs initially and then just one leg for balance. Next, we will work on dynamic balance. The patient will stand in the parallel bars without her AD and balance while performing a ball toss. To progress, the patient can stand on an uneven surface and a smaller ball can be used with greater ranges requiring the patient to reach further. In addition to balance training, the physical therapy intervention will include ambulation training without the AD. Since the patient has no major gait deviations, it is important that she not become dependent on the cane. Ambulation training can begin in the parallel bars to ensure safety (Kisner and Colby,
By having physiotherapy this will help to achieve and restore movement and function to the injured area of the body. To allow movement and function to occur an individual would complete a range of different exercise which, their therapist will show them how to do. This overall, would improve the ranges of movements and by improving the movements overall, it will help to heal the injured area so that, an individual would be able to do normal movements once again. Also, by attending physiotherapy it will reduce the chance of experiencing long-term injuries occurring like this happening again within a certain area of the
• If you have trouble walking or keeping your balance, try using a cane for stability. Sit down right away if you feel dizzy or unstable.
Physical therapy is a fun and exciting healthcare profession that helps people. It is all about helping other people who have problems with their body, muscles, joints and other parts of their body. Patients includes accident victims and individuals with disabling conditions such as low back pain, arthritis, heart disease, fractures, head injuries, and cerebral palsy. Physical therapy will perform an evaluation of your problem or difficulty. They evaluate your problem by performing tests and measures to assess the problem. These tests includes muscle strength, joint motion, sensory and neurological, coordination, balance, observation, palpation, flexibility, postural screening, movement analysis, and special tests are designed for a particular problem. Next, they develop a treatment plan and goals and then manage the appropriate treatment to aid in recovery of a problem or dysfunction. Physical therapists are able to treat their patients by using many different treatments depending on the type of injury. Some of the treatments are electrical stimulation, hot and cold packs, infrared and ultrasound to reduce swelling or relieve pain. These treatments are used to help decrease pain and increase movement and function. Therapeutic exercises instructions will help restore strength, movement, balance, or skill as a guide towards full functional recovery. Physical therapy provides "hands on techniques" like massage or joint mobilizations skills to restore joint motion or increase soft tissue flexibility. They will focus on basic skills such as getting out of bed, walking safely with crutches or a walker, moving specific joints and muscles of the body. Physical therapists treatment includes patient education to teach them how to deal with a current problem and how to prevent the problem in the future. Such documentation is used to track the patient's progress, and identify areas requiring more or less attention. They encourage patients to use their own muscles. Their main goal is to improve how an individual functions at work and home.
Orthopedic surgery covers a wide area of expertise. Depending on age and condition, a certain surgery might be