Pelvic Organ Prolapse Than One Compartment at the Same Time
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Metatarsalgia
just the symptoms. What can I expect from treatment? With a proper diagnosis, and a well-rounded treatment plan including orthotics, the prog- nosis is excellent. With Sole Supports™ foot or- thotics you can expect either a dramatic loss The Truth About . of pain within the first weeks of use or a more gradual reduction of symptoms, depending Metatarsalgia on how long the problem has existed, normal body weight or how well you follow other ther- For more information and a apeutic regimens prescribed by your provider. professional consultation regarding Did you know that, with Sole whether Sole Supports may be Supports, metatarsal pads are rarely helpful for you, please contact the needed? following certified Sole Supports practitioner: What is it? Metatarsalgia is a term used to describe a pain- ful foot condition in the area just before the Arch Flattened small toes (more commonly referred to as the ball of the foot). The condition is characterized by pain and inflammation on the sole in the region of the metatarsal heads, which are the ends of the long bones in your foot. The joint This handout provides a general overview on this capsule or tendons may also be inflamed. topic and may not apply to everyone. To find out if this handout applies to you and to get more infor- mation on this subject, consult with your certified Sole Supports practitioner. Arch Restored The pain is generally aggravated by putting ments but your doctor is likely to recommend pressure off the metatarsals should also be pressure (as in walking) through the ball of a conservative approach first including: followed. -
Wound Classification
Wound Classification Presented by Dr. Karen Zulkowski, D.N.S., RN Montana State University Welcome! Thank you for joining this webinar about how to assess and measure a wound. 2 A Little About Myself… • Associate professor at Montana State University • Executive editor of the Journal of the World Council of Enterstomal Therapists (JWCET) and WCET International Ostomy Guidelines (2014) • Editorial board member of Ostomy Wound Management and Advances in Skin and Wound Care • Legal consultant • Former NPUAP board member 3 Today We Will Talk About • How to assess a wound • How to measure a wound Please make a note of your questions. Your Quality Improvement (QI) Specialists will follow up with you after this webinar to address them. 4 Assessing and Measuring Wounds • You completed a skin assessment and found a wound. • Now you need to determine what type of wound you found. • If it is a pressure ulcer, you need to determine the stage. 5 Assessing and Measuring Wounds This is important because— • Each type of wound has a different etiology. • Treatment may be very different. However— • Not all wounds are clear cut. • The cause may be multifactoral. 6 Types of Wounds • Vascular (arterial, venous, and mixed) • Neuropathic (diabetic) • Moisture-associated dermatitis • Skin tear • Pressure ulcer 7 Mixed Etiologies Many wounds have mixed etiologies. • There may be both venous and arterial insufficiency. • There may be diabetes and pressure characteristics. 8 Moisture-Associated Skin Damage • Also called perineal dermatitis, diaper rash, incontinence-associated dermatitis (often confused with pressure ulcers) • An inflammation of the skin in the perineal area, on and between the buttocks, into the skin folds, and down the inner thighs • Scaling of the skin with papule and vesicle formation: – These may open, with “weeping” of the skin, which exacerbates skin damage. -
Metatarsalgia
Metatarsalgia Definition Metatarsalgia is a generic term for pain or discomfort in the sole of the forefoot (the ball of the foot). It is an inflammatory condition of the metatarsal heads due to a drop or collapse of the metatarsal arch. The arch flattens and the bone ends (metatarsal heads) move closer together causing the soft tissue to be pinched or trapped between the bones. With every step, the arch rises and falls causing repeated stress to the area. More specific type of Metatarsalgia can be: • Morton’s Neuroma ( nerve issue) • Bursitis • Arthritic joint change • Stress Fractures Symptoms • Vague pain, ache or burning in the sole of the forefoot, during weight-bearing activities • Tingling / numbness in toes • Sharp or shooting pain in toes • Aggravated when dorsi-flexing (lifting) toes • Callousing under 2nd, 3rd and 4th toes • Feeling of “walking on pebbles” Causes Anything that puts extra stress on the forefoot can cause Metatarsalgia. Common examples are: • Use of improper footwear (i.e. high-heeled shoes and boots) • High-arched or “cavus” foot or flat arch feet “pes planus” which causes the bones in the front of the foot (metatarsals) to point down into the sole to an excessive extent, or a long metatarsal bone which takes extra pressure • Claw or hammer toes which press the metatarsals down towards the ground • A nerve problem near the 3rd and 4th toes • A stretched or irritated nerve in the ball of the foot (inter-digital neuroma) or behind the ankle (tarsal tunnel syndrome) can produce pain in the ball of the foot • A bunion or arthritis in the big toe can weaken the big toe and throw extra stress onto the ball of the foot. -
Treatment of Spastic Foot Deformities
TREATMENT OF SPASTIC FOOT DEFORMITIES penn neuro-orthopaedics service Table of Contents OVERVIEW Severe loss of movement is often the result of neurological disorders, Overview .............................................................. 1 such as stroke or brain injury. As a result, ordinary daily activities Treatment ............................................................. 2 such as walking, eating and dressing can be difficult and sometimes impossible to accomplish. Procedures ........................................................... 4 The Penn Neuro-Orthopaedics Service assists patients with Achilles Tendon Lengthening .........................................4 orthopaedic problems caused by certain neurologic disorders. Our Toe Flexor Releases .....................................................5 team successfully treats a wide range of problems affecting the limbs including foot deformities and walking problems due to abnormal Toe Flexor Transfer .......................................................6 postures of the foot. Split Anterior Tibialis Tendon Transfer (SPLATT) ...............7 This booklet focuses on the treatment of spastic foot deformities The Extensor Tendon of the Big Toe (EHL) .......................8 under the supervision of Keith Baldwin, MD, MSPT, MPH. Lengthening the Tibialis Posterior Tendon .......................9 Care After Surgery .................................................10 Notes ..................................................................12 Pre-operative right foot. Post-operative -
Gynecological-DBQ
INTERNAL VETERANS AFFAIRS USE GYNECOLOGICAL CONDITIONS DISABILITY BENEFITS QUESTIONNAIRE IMPORTANT - THE DEPARTMENT OF VETERANS AFFAIRS (VA) WILL NOT PAY OR REIMBURSE ANY EXPENSES OR COST INCURRED IN THE PROCESS OF COMPLETING AND/OR SUBMITTING THIS FORM. PLEASE READ THE PRIVACY ACT AND RESPONDENT BURDEN INFORMATION ON REVERSE BEFORE COMPLETING FORM. NAME OF PATIENT/VETERAN PATIENT/VETERAN'S SOCIAL SECURITY NUMBER NOTE TO PHYSICIAN - Your patient is applying to the U.S. Department of Veterans Affairs (VA) for disability benefits. VA will consider the information you provide on this questionnaire as part of their evaluation in processing the claim. VA reserves the right to confirm the authenticity of ALL DBQs completed by private health care providers. IS THIS DBQ BEING COMPLETED IN CONJUNCTION WITH A VA21-2507, C&P EXAMINATION REQUEST? YES NO If no, how was the examination completed (check all that apply)? In-person examination Records reviewed Other, please specify: Comments: ACCEPTABLE CLINICAL EVIDENCE (ACE) INDICATE METHOD USED TO OBTAIN MEDICAL INFORMATION TO COMPLETE THIS DOCUMENT: Review of available records (without in-person or video telehealth examination) using the Acceptable Clinical Evidence (ACE) process because the existing medical evidence provided sufficient information on which to prepare the DBQ and such an examination will likely provide no additional relevant evidence. Review of available records in conjunction with a telephone interview with the Veteran (without in-person or telehealth examination) using the ACE process because the existing medical evidence supplemented with a telephone interview provided sufficient information on which to prepare the DBQ and such an examination would likely provide no additional relevant evidence. -
The Indications for Toe Transfer After ''Minor
ARTICLE IN PRESS Invited personal view article THE INDICATIONS FOR TOE TRANSFER AFTER ‘‘MINOR’’ FINGER INJURIES F DEL PINAL* From the Institute for Hand and Plastic Surgery, Private Practice, and Mutua Montan*esa, Santander, Spain Toe-to-hand transfer is widely considered to be unjustified for ‘‘minor’’ finger injuries. In this invited personal view article the indications for toe-to-hand transfer for finger amputation and neurocutaneous and major pulp defects are discussed, and a classification of multidigital injury that has both prognostic and decision-making value is presented. In the author’s opinion a toe transfer should always be considered as an option when reconstructing ‘‘minor’’ finger injuries, as it can reproduce significant long-term benefit to the hand and the patient’s sense of well being. The procedure should be carried out in the acute period, not only because it is technically easier and better for hand function, but above all because the surgeon can save structures that will be lost if the transfer is delayed. Journal of Hand Surgery (British and European Volume, 2004) 29B: 2: 120–129 Keywords: microsurgery, toe-to-hand, finger amputation Since the hand is always naked and exposed, even if reconstruction. In this personal view article only the only the fingertip is lost, it presents a very large most ‘‘typical’’ indications will be discussed. The handicap for the patient. (Hirase! et al., 1997) metacarpal hand (Tan et al., 1999; Wei et al., 1997, 1999; Yu and Huang, 2000), congenital reconstruction There was a time when only loss of the thumb was (Kay and Wiberg, 1996; Shibata et al., 1998; Van Holder considered an acceptable indication for toe-to-hand et al., 1999), joint transfer (Dautel and Merle 1997; transfer (Buncke et al., 1973; Cobbett, 1969). -
Grading Pelvic Prolapse and Pelvic Floor Relaxation Using Dynamic Magnetic Resonance Imaging
ADULT UROLOGY GRADING PELVIC PROLAPSE AND PELVIC FLOOR RELAXATION USING DYNAMIC MAGNETIC RESONANCE IMAGING CRAIG V. COMITER, SANDIP P. VASAVADA, ZORAN L. BARBARIC, ANGELO E. GOUSSE, AND SHLOMO RAZ ABSTRACT Objectives. With significant vaginal prolapse, it is often difficult to differentiate among cystocele, enterocele, and high rectocele by physical examination alone. Our group has previously demonstrated the utility of magnetic resonance imaging (MRI) for evaluating pelvic prolapse. We describe a simple objective grading system for quantifying pelvic floor relaxation and prolapse. Methods. One hundred sixty-four consecutive women presenting with pelvic pain (n ϭ 39) or organ prolapse (n ϭ 125) underwent dynamic MRI. The “H-line” (levator hiatus) measures the distance from the pubis to the posterior anal canal. The “M-line” (muscular pelvic floor relaxation) measures the descent of the levator plate from the pubococcygeal line. The “O” classification (organ prolapse) characterizes the degree of visceral prolapse beyond the H-line. Results. The image acquisition time was 2.5 minutes per study. Each study cost $540. In the pain group, the H-line averaged 5.2 Ϯ 1.1 cm versus 7.5 Ϯ 1.5 cm in the prolapse group (P Ͻ0.001). The M-line averaged 1.9 Ϯ 1.2 cm in the pain group versus 4.1 Ϯ 1.5 cm in the prolapse group (P Ͻ0.001). Incidental pelvic pathologic features were commonly noted, including uterine fibroids, ovarian cysts, hydroureter, urethral diverticula, and foreign body. Conclusions. The HMO classification provides a straightforward and reproducible method for staging and quantifying pelvic floor relaxation and visceral prolapse. -
How to Self-Bandage Your Leg(S) and Feet to Reduce Lymphedema (Swelling)
Form: D-8519 How to Self-Bandage Your Leg(s) and Feet to Reduce Lymphedema (Swelling) For patients with lower body lymphedema who have had treatment for cancer, including: • Removal of lymph nodes in the pelvis • Removal of lymph nodes in the groin, or • Radiation to the pelvis Read this resource to learn: • Who needs self-bandaging • Why self-bandaging is important • How to do self-bandaging Disclaimer: This pamphlet is for patients with lymphedema. It is a guide to help patients manage leg swelling with bandages. It is only to be used after the patient has been taught bandaging by a clinician at the Cancer Rehabilitation and Survivorship (CRS) Clinic at Princess Margaret Cancer Centre. Do not self-bandage if you have an infection in your abdomen, leg(s) or feet. Signs of an infection may include: • Swelling in these areas and redness of the skin (this redness can quickly spread) • Pain in your leg(s) or feet • Tenderness and/or warmth in your leg(s) or feet • Fever, chills or feeling unwell If you have an infection or think you have an infection, go to: • Your Family Doctor • Walk-in Clinic • Urgent Care Clinic If no Walk-in clinic is open, go to the closest hospital Emergency Department. 2 What is the lymphatic system? Your lymphatic system removes extra fluid and waste from your body. It plays an important role in how your immune system works. Your lymphatic system is made up of lymph nodes that are linked by lymph vessels. Your lymph nodes are bean-shaped organs that are found all over your body. -
Hammer Toe Information Sheet
Fitter Feet For Life Hammer toe information sheet. (ref. A15) A hammer toe is a deformity of the first small toe joint with in toes. (proximal inter-phalangeal joint) This deformity can occur in the second, third, fourth or fifth (relatively rare) toes, causing it to be permanently bent, resembling a hammer. This abnormality can create pressure on the foot when wearing shoes and cause discomfort and problems walking. The joints themselves can be arthritic and painful. There is a choice of different procedures to straighten a hammer toe. This information sheet has been written to help you choose which procedure is best for you. Fig 1 Hammer toe . Fig 2 Arthrodesis with K wires . Fig 3. Smart toe implant An arthrodesis is a surgical procedure to treat hammer toes. The deformed joint is fully removed and the apposing bone ends fused together in a corrected position. The joint will no longer move. The joint closer to the end of the toe will still move. The joint where the toe joins the foot will also continue to move. 1 Fitter Feet For life. 34 North Street. London SW40HD 0207 627 4901 Fitter Feet For Life 1. K-Wire Arthrodesis. Traditionally hammer toe correction is performed by arthrodesis surgery using K-Wires. The procedure is successful in most cases and has been performed for many years. The deformed joint is removed and the bone ends are secured together with a K-wire which protrudes though the tip of the toe. The foot must be kept dry, dressed and the k-wire protected in a post operative shoe for six weeks after the operation. -
Comparison of the Upper and Lower Limbs-A Phylogenetic Concept
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 14, Issue 8 Ver. I (Aug. 2015), PP 14-16 www.iosrjournals.org Comparison of the Upper and Lower Limbs-A Phylogenetic Concept Dr.Vandana Sinam1, Dr.Thonthon Daimei2, I Deven Singh3, N Damayanti Devi4 1.Medical officer,2. Senior Resident,3. Assistant Proffessor,4. Professor and Head, Department of Anatomy Regional Institute of Medical Sciences, Imphal, Manipur Abstract: The upper and lower limbs of the human body are phylogenetically homologues of the forelimbs and hind limbs of the quadrupeds. Primates started lifting of the forelimbs off the ground for various functional adaptations as evolution progressed and this led to the deviation of the forelimbs from lower limbs. With the gradual diversification of the functions, morphological evolution of the two limbs follows closely leading to the differences in upper and the lower limbs in the human. Since the inception of the Anatomy as one of the curriculum in medical subjects, the anatomical position has been termed as one that the body stand erect with the eyes looking straight forward and the two upper limbs hanging by the side of the body with the palm facing forward. Therefore in this position the upper limb looked forward with the palm also accordingly faced forward too whilst with the thumb on the lateral side whilst in the lower limb, the big toe which is homologous to the thumb, is placed on the medial side. The anatomical position in the upper limb is not normally a comfortable position as it is kept in this position with effort. -
TRUFORM Classic Medical Closed Toe 20-30 Mmhg Thigh High
TRUFORM Classic Medical Closed Toe 20-30 mmHg Thigh High Stockings Measuring Guide for Compression Stockings Measuring your legs for compression stockings, support socks, support hose, and gradient compression hosiery: • For knee-highs: measure around your ankle and calf. Then, measure the distance from the floor to the back of your knee. • For thigh-high and pantyhose: measure around your ankle, calf, and upper thigh. Then, measure the distance from the floor to your upper thigh (bottom of your buttocks). An Important Measuring Tip... If swelling is an issue with you, measure your legs, first thing in the morning, after you get out of bed. This is when swelling is at a minimum, and the size of your legs should remain once the swelling is eliminated. Each of our compression products has a sizing chart on the product page. ANKLE CALF LENGTH Measure Measure Measure from around the around the the floor to the ankle at the calf muscle bend behind the narrowest at the knee. point, widest part. generally above the ankle bone. THIGH THIGH Measure LENGTH around the Measure thigh the distance approx. 3" from the below the bottom of gluteal fold your (crease of buttocks to buttocks). the floor. Sizes may differ between various brands of support stockings. Keep in mind that each manufacturer of support hose has their own sizing chart. A medium size in one brand of circulation stockings, may not be a medium in another. Some brands of compression stockings offer petite (shorter) lengths, while others do not. Knowing your measurements will ensure you get compression hosiery that fits properly and comfortably. -
Turf Toe Affects Everyone
Plateau Footnotes Newsletter Turf Toe Affects Everyone– Not Just Athletes Here’s what you need to know to treat it 1 Volume 2 Tis foot injury with the funny name is particularly com- If your symptoms are indicative of turf toe, then you may mon among athletes who play on artifcial turf, hence the be able to relieve the pain and swelling with the following name “turf” toe. When athletes play sports on turf or other self-treatment. hard surfaces, the foot can stick to the ground, resulting in jamming of the big toe joint. Typically with turf toe the • Ice the injury injury is sudden, but it can also occur after sustaining mul- tiple injuries, such as pushing of repeatedly when running • Apply a compression bandage or jumping. • Rest and temporarily Turf toe is actually a sprain of the discontinue any phys- joint just below the big toe, also ical activity known as the frst metatarsopha- langeal (MTP) joint. Although • Wear a brace to pro- it’s a condition most commonly tect the toe and to associated with dancers, soccer limit bending players, wrestlers, gymnasts and football players, you don’t have For more severe cases of to be an athlete to get it. turf toe, visit our ofce. Dr Schaengold will take a look and can easily diagnose turf Symptoms of turf toe range from mild to severe, and toe through an evaluation that includes range of motion may gradually worsen with continued movement. Te and joint stability tests. Ten, we will design a treatment most common symptoms of turf toe include: plan that works best for you.