English-Spanish Managed Care Glossary of Terms First Edition
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Recognizing When a Child's Injury Or Illness Is Caused by Abuse
U.S. Department of Justice Office of Justice Programs Office of Juvenile Justice and Delinquency Prevention Recognizing When a Child’s Injury or Illness Is Caused by Abuse PORTABLE GUIDE TO INVESTIGATING CHILD ABUSE U.S. Department of Justice Office of Justice Programs 810 Seventh Street NW. Washington, DC 20531 Eric H. Holder, Jr. Attorney General Karol V. Mason Assistant Attorney General Robert L. Listenbee Administrator Office of Juvenile Justice and Delinquency Prevention Office of Justice Programs Innovation • Partnerships • Safer Neighborhoods www.ojp.usdoj.gov Office of Juvenile Justice and Delinquency Prevention www.ojjdp.gov The Office of Juvenile Justice and Delinquency Prevention is a component of the Office of Justice Programs, which also includes the Bureau of Justice Assistance; the Bureau of Justice Statistics; the National Institute of Justice; the Office for Victims of Crime; and the Office of Sex Offender Sentencing, Monitoring, Apprehending, Registering, and Tracking. Recognizing When a Child’s Injury or Illness Is Caused by Abuse PORTABLE GUIDE TO INVESTIGATING CHILD ABUSE NCJ 243908 JULY 2014 Contents Could This Be Child Abuse? ..............................................................................................1 Caretaker Assessment ......................................................................................................2 Injury Assessment ............................................................................................................4 Ruling Out a Natural Phenomenon or Medical Conditions -
Total HIP Replacement Exercise Program 1. Ankle Pumps 2. Quad
3 sets of 10 reps (30 ea) 2 times a day Total HIP Replacement Exercise Program 5. Heel slides 1. Ankle Pumps Bend knee and pull heel toward buttocks. DO NOT GO Gently point toes up towards your nose and down PAST 90* HIP FLEXION towards the surface. Do both ankles at the same time or alternating feet. Perform slowly. 2. Quad Sets Slowly tighten thigh muscles of legs, pushing knees down into the surface. Hold for 10 count. 6. Short Arc Quads Place a large can or rolled towel (about 8”diameter) under the leg. Straighten knee and leg. Hold straight for 5 count. 3. Gluteal Sets Squeeze the buttocks together as tightly as possible. Hold for a 10 count. 7. Knee extension - Long Arc Quads Slowly straighten operated leg and try to hold it for 5 sec. Bend knee, taking foot under the chair. 4. Abduction and Adduction Slide leg out to the side. Keep kneecap pointing toward ceiling. Gently bring leg back to pillow. May do both legs at the same time. Copywriter VHI Corp 3 sets of 10 reps (30 ea) 2 times a day Total HIP Replacement Exercise Program 8. Standing Stair/Step Training: Heel/Toe Raises: 1. The “good” (non-operated) leg goes Holding on to an immovable surface. UP first. Rise up on toes slowly 2. The “bad” (operated) leg goes for a 5 count. Come back to foot flat and lift DOWN first. toes from floor. 3. The cane stays on the level of the operated leg. Resting positions: To Stretch your hip to neutral position: 1. -
Nasolabial and Forehead Flap Reconstruction of Contiguous Alar
Journal of Plastic, Reconstructive & Aesthetic Surgery (2017) 70, 330e335 Nasolabial and forehead flap reconstruction of contiguous alareupper lip defects Jonathan A. Zelken a,b, Sashank K. Reddy c, Chun-Shin Chang a, Shiow-Shuh Chuang a, Cheng-Jen Chang a, Hung-Chang Chen a, Yen-Chang Hsiao a,* a Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taipei, Taiwan b Department of Plastic and Reconstructive Surgery, Breastlink Medical Group, Laguna Hills, CA, USA c Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital, Baltimore, MD, USA Received 4 May 2016; accepted 31 October 2016 KEYWORDS Summary Background: Defects of the nasal ala and upper lip aesthetic subunits can be Nasal reconstruction; challenging to reconstruct when they occur in isolation. When defects incorporate both Nasolabial flap; the subunits, the challenge is compounded as subunit boundaries also require reconstruc- Rhinoplasty; tion, and local soft tissue reservoirs alone may provide inadequate coverage. In such cases, Forehead flap we used nasolabial flaps for upper lip reconstructionandaforeheadflapforalarrecon- struction. Methods: Three men and three women aged 21e79 years (average, 55 years) were treated for defects of the nasal ala and upper lip that resulted from cancer (n Z 4) and trauma (n Z 2). Unaffected contralateral subunits dictated the flap design. The upper lip subunit was excised and replaced with a nasolabial flap. The flap, depending on the contralateral reference, determined accurate alar base position. A forehead flap resurfaced or replaced the nasal ala. Autologous cartilage was used in every case to fortify the forehead flap reconstruction. Results: Patients were followed for 25.6 months (range, 1e4 years). -
Arthroscopic and Open Anatomy of the Hip 11
CHAPTER Arthroscopic and o'pen Anatomy of the Hip Michael B. Gerhardt, Kartik Logishetty, Morteza lV1eftah, and Anil S. Ranawat INTRODUCTION movements that they induce at the joint: 1) flexors; 2) extensors; 3) abductors; 4) adductors; 5) external rotators; and 6) interI12 I The hip joint is defined by the articulation between the head rotators. Although some muscles have dual roles, their primary of the femur and the aeetahulum of the pelvis. It is covered by functions define their group placem(:)nt, and they all have ullique :l large soft-tissue envelope and a complex array of neurovascu- neurovascular supplies (TIt ble 2-1). lar and musculotendinous structures. The joint's morphology The vascular supply of tbe hip stems from the external and anu orientation are complex, and there are wide anatomi c varia- internal iLiac ancries. An understanding of the course of these tions seen among individuals. The joint's deep location makes vessels is critical fo r ,lVo iding catasu"ophic vascular injury. fn both arthroscopic and open access challenging. To avoid iatro- addition, the blood supply to the fel11()ra l head is vulnerahle to genic injury while establishing functional and efficient access, both traumatic and iatrogenic injury; the disruption of this sup- the hip surgeon should possess a sound ana tomic knowledge of ply can result in avascular necrosis (Figure 2-2). the hip. T he human "hip" can be subdivided into three categories: I) the superficial surface anatomy; 2) the deep femoroacetabu- la r Joint and capsule; and 3) the associated structures, including the muscles, nerves, and vasculature, all of which directly affeet HIP MUSCULATURE its function. -
Larynx Anatomy
LARYNX ANATOMY Elena Rizzo Riera R1 ORL HUSE INTRODUCTION v Odd and median organ v Infrahyoid region v Phonation, swallowing and breathing v Triangular pyramid v Postero- superior base àpharynx and hyoid bone v Bottom point àupper orifice of the trachea INTRODUCTION C4-C6 Tongue – trachea In women it is somewhat higher than in men. Male Female Length 44mm 36mm Transverse diameter 43mm 41mm Anteroposterior diameter 36mm 26mm SKELETAL STRUCTURE Framework: 11 cartilages linked by joints and fibroelastic structures 3 odd-and median cartilages: the thyroid, cricoid and epiglottis cartilages. 4 pair cartilages: corniculate cartilages of Santorini, the cuneiform cartilages of Wrisberg, the posterior sesamoid cartilages and arytenoid cartilages. Intrinsic and extrinsic muscles THYROID CARTILAGE Shield shaped cartilage Right and left vertical laminaà laryngeal prominence (Adam’s apple) M:90º F: 120º Children: intrathyroid cartilage THYROID CARTILAGE Outer surface à oblique line Inner surface Superior border à superior thyroid notch Inferior border à inferior thyroid notch Superior horns à lateral thyrohyoid ligaments Inferior horns à cricothyroid articulation THYROID CARTILAGE The oblique line gives attachement to the following muscles: ¡ Thyrohyoid muscle ¡ Sternothyroid muscle ¡ Inferior constrictor muscle Ligaments attached to the thyroid cartilage ¡ Thyroepiglottic lig ¡ Vestibular lig ¡ Vocal lig CRICOID CARTILAGE Complete signet ring Anterior arch and posterior lamina Ridge and depressions Cricothyroid articulation -
Median Nerve Compression at Pronator Teres
1 Median Nerve Compression at Pronator Teres Surgical Indications and Considerations Anatomical Considerations: The median nerve and brachial artery travel together down the arm. Therefore, one must be very careful not to interfere with either the median nerve or the brachial artery, especially when conducting surgical procedures. In the area of the pronator teres, there are many tendons as well. It is important to identify, as much as possible, the correct site of compression. Pathogenesis: The median nerve can get entrapped or compressed by several structures in the arm. The pronator teres muscle is the most common. Others entrapment sites include the flexor digitorum superficialis arch, the lacertus fibrosis (bicipital aponeurosis), and ligament of Struthers (frequency occurs in that order). For compression of the median nerve at the pronator teres and flexor digitorum superficialis, the cause is almost always due to hypertrophy of the respected muscle. This hypertrophy is from quick, forceful and repeated movements to the involved muscle. Examples include a carpenter or a baseball batter. As the muscle hypertrophies, the signal from the median nerve is diminished resulting in paresthesias in the median nerve distribution (lateral arm and hand) distal to the site of compression. Pain in the volar part of the forearm, often aggravated by repetitive supination and pronation, is a common symptom of pronator involvement. Another indicator is forearm pain with the compression of muscle such as pain in the volar part of the forearm implicating pronator teres. Onset is typically insidious and diagnosis is usually delayed 9 months to 2 years. Epidemiology: Pronator teres syndrome is the second most common cause of median nerve compression behind carpal tunnel syndrome. -
Molecular Signatures of Tissue-Specific
Developmental Cell Resource Molecular Signatures of Tissue-Specific Microvascular Endothelial Cell Heterogeneity in Organ Maintenance and Regeneration Daniel J. Nolan,1,6 Michael Ginsberg,1,6 Edo Israely,1 Brisa Palikuqi,1 Michael G. Poulos,1 Daylon James,1 Bi-Sen Ding,1 William Schachterle,1 Ying Liu,1 Zev Rosenwaks,2 Jason M. Butler,1 Jenny Xiang,4 Arash Rafii,1,7 Koji Shido,1 Sina Y. Rabbany,1,8 Olivier Elemento,3 and Shahin Rafii1,5,* 1Department of Genetic Medicine, Howard Hughes Medical Institute 2Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine 3HRH Prince Alwaleed Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine 4Genomics Resource Core Facility Weill Cornell Medical College, New York, NY 10065, USA 5Ansary Stem Cell Institute, New York, NY 10065, USA 6Angiocrine Bioscience, New York, NY 10065, USA 7Weill Cornell Medical College-Qatar, Stem Cell and Microenvironment Laboratory, Education City, Qatar Foundation, Doha 24144, Qatar 8Bioengineering Program, Hofstra University, Hempstead, NY 11549, USA *Correspondence: srafi[email protected] http://dx.doi.org/10.1016/j.devcel.2013.06.017 SUMMARY been appreciated. Capillary ECs of the blood brain barrier (BBB) form a restrictive environment for passage between the Microvascular endothelial cells (ECs) within different brain tissue and the circulating blood. Many of the trafficking pro- tissues are endowed with distinct but as yet unrecog- cesses that are passive in other vascular beds are tightly nized structural, phenotypic, and functional attri- controlled in the brain (Rubin and Staddon, 1999). As opposed butes. We devised EC purification, cultivation, to the BBB, the capillary ECs of the kidney glomeruli are fenes- profiling, and transplantation models that establish trated for the filtration of the blood (Churg and Grishman, tissue-specific molecular libraries of ECs devoid of 1975). -
How the Larynx (Voice Box) Works
How the Larynx (Voice Box) Works Charles R. Larson, PhD If you love opera, or if you admire the voices of pop singers such as Celine Dion or Barbra Streisand, you may have wondered how it is these marvelous singers are able to create such beautiful music with this instrument we call the human voice. You may also know of someone who has a bad voice or has had to have their voice box, or larynx, removed because of illness or injury. The larynx is a critical organ of human speech and singing, and it serves important biological functions as well. Let's have a look at the larynx to understand its functions, what it looks like and how it works. It is thought that the same factors that favored the evolution of air‐breathing animals on earth led to the evolution of the larynx. Lungs are comprised of very delicate tissues that must be maintained within strict biological limits, that is, temperature, humidity and freedom from foreign particles. Thus, along with the first air‐breathing animals, there appeared a primitive sort of larynx, whose one and only function was protection of the lung. This function remains the most important of those the larynx has assumed in subsequent evolutionary developments. Now, of course we recognize that the larynx is critical for human speech and singing. But we also should realize that the larynx is important for swallowing, coughing, vomiting and eliminating contents of the abdomen. If you have ever felt your 'Adam's Apple', then you know where the larynx is. -
AIH Chapter 2: Human Behavior
Aviation Instructor's Handbook (FAA-H-8083-9) Chapter 2: Human Behavior Introduction Derek’s learner, Jason, is very smart and able to retain a lot of information, but has a tendency to rush through the less exciting material and shows interest and attentiveness only when performing tasks that he finds to be interesting. This concerns Derek because he is worried that Jason will overlook many important details and rush through procedures. For a homework assignment Jason was told to take a very thorough look at Preflight Procedures and that for his next flight lesson they would discuss each step in detail. As Derek predicted, Jason found this assignment to be boring and was not prepared. Derek knows that Jason is a “thrill seeker” as he talks about his business, which is a wilderness adventure company. Derek wants to find a way to keep Jason focused and help him find excitement in all areas of learning so that he will understand the complex art of flying and aircraft safety. Learning is the acquisition of knowledge or understanding of a subject or skill through education, experience, practice, or study. This chapter discusses behavior and how it affects the learning process. An instructor seeks to understand why people act the way they do and how people learn. An effective instructor uses knowledge of human behavior, basic human needs, the defense mechanisms humans use that prevent learning, and how adults learn in order to organize and conduct productive learning activities. Definitions of Human Behavior The study of human behavior is an attempt to explain how and why humans function the way they do. -
Signs to Help the Deaf Included in This Packet
Signs to help the Deaf Included in this packet: Medical Signs Color Signs People Signs This is made by: Deanna Zander, I am a parent of a deaf son. Here is my email address: [email protected], if you have any questions, please email your question, Please put in the Subject box- RE: Medical Signs. For more information, or to obtain a hospital kit for Deaf or Hard of Hearing, please contact Pam Smith, Adult Outreach Coordinator @ 701-665-4401 Medical Signs (Medicine) Medical Medicine- Tip of bent middle finger rubs circle on left palm Sign- Palm-out indexes circle Signs alternately Made By: Deanna Zander Hi, Hello, Howdy Good-Bye, Yes, Yep Bye Right “S” hand & head nods (both head & hand nod) No, Nope Flat hand, Touch forehead, Just wave First two fingers close onto move forward slightly right thumb, & shake your head Appointment Schedule Fingertips of the right palm- out “5” draws down left palm; then turn palm-in & draws across palm The right “S” hand palm down, is postitioned above the left “S” hand, also palm- down. The right hand circels above the left in a clockwise manner & is brought on the back of left hand. Your Name, My Name Birthday My, Mine- Your- The right middle finger touches the chin, Palm of flat Vertical flat palm moves then moves down to touch the chest hand on chest toward person Fingerspell- The right hand, palm- out, is move left to right, fingers wiggling up & Name- Right “H” touches left “H” at right angles MM/DD/YYYY down Call, phone Left “Y” hand, thumb near ear, little finger near mouth The upturned thumbs -
Calf Stretching and Strengthening Exercises
Julie Dass Injury Clinic 108 Milton Road Phone: 01234349464 Clapham Email: [email protected] Bedford MK416as Exercise plan: Patient: Date: Calf Stretches and Strengthening Mrs Julie Dass 31st Mar 2017 Exercises Eccentric calf strengthening exercise Stand with your toes on the edge of a step or a box. Hold onto something stable for support if required. We will assume the leg you are trying to strengthen is your left leg (the injured side). Lift your left leg off the step, and go onto your toes on your right leg. Now place your left foot beside the right, and place all your weight on your left leg. Drop your heels downwards below the level of the step. Use your right leg (non-injured leg) to lift yourself back to the start position. Make sure you keep your leg straight during the exercise. This exercise can help strengthen the calf muscle and may be useful for treating Achilles tendinopathy. Full squat single leg Stand on one leg, and bend your knee to the full squat (90 degrees) position. Make sure when you squat you keep the middle of your knee cap in line with the middle toes of your foot. Do not let your knee drift off to one side. Also keep your hips and pelvis level as you squat, so you go down in a straight line. Be careful not to slump forwards as you squat, maintain good posture. Always keep your foot flat on the ground, do not let your heel raise up. Video: http://youtu.be/afJNrDNonAc Full wall squat Open your legs slightly wider than shoulder width, stand with your back resting against a wall, and bend your knees to the full squat position (90 degrees). -
Birth Cont R Ol Fact Sheet
VAGINAL RING FACT SHEET What is the Vaginal Ring (Nuvaring®)? The Vaginal Ring is a clear, flexible, thin, plastic ring that you place in the vagina where it stays for one cycle providing a continuous low dose of 2 hormones (estrogen and progestin). It prevents pregnancy by stopping the release of an egg (ovulation), thickening the cervical fluid, and changing the lining of the uterus. How effective is the Vaginal Ring? The ring is a very effective method of birth control. The ring is about 93% effective at preventing pregnancy in typical use, which means that around 7 out of 100 people who use it as their only form of birth control will get pregnant in one year. With consistent and correct use as described in this fact sheet, it can be over 99% effective. How can I get the Vaginal Ring? You can visit a clinic to get the ring or a prescription for it and talk with a healthcare provider about whether the ring is right for you. Advantages of the Vaginal Ring Disadvantages of the Vaginal Ring Periods may be more predictable/regular and lighter Must remember to remove and replace the ring once a Less period cramping month Decreased symptoms of Premenstrual Syndrome Some users may experience mild side effects such as: (PMS) and perimenopause spotting, nausea, breast tenderness, headaches, or Can be used to skip or shorten your periods dizziness (usually these improve in the first few months Less anemia/iron deficiency caused by heavy periods of use) Does not affect your ability to get pregnant in the Possibility of high blood pressure