Ahmad cannot run

Ahmad cannot run

1. Anatomy

   • the foot
     • muscles
       • 4 ayers
     • nerve suplly
     • blood supply
   • ankle joint
     • ligaments
     • hinge type
     • physical examination
       • look
       • feel
       • move
         • dorsiflexion
         • inversion
         • eversion
         • plantar flexion
       • special tests
         • inversion & eversion stress test
         • thompson's test
         • tests for morton's metatarsalgia
     • physiology

2. muscles

   • Types
     • skeletal musces
       • structure
       • physiology
     • smooth muscles
     • cardiac muscle
   • grading muscular response
   • common muscle diseases
     • inflammatory myopathy
     • atrophy\hypertrophy
     • metabolic diseases
     • muscle dystrophy
       • Types
         • facioscapulohumral
         • emery-dreifuss
         • myotonic
         • becker
         • Duchenne
           • epidemiology
             • 1\3500 male children
             • 100% mortality at 20s
           • pathophysiology
             • without dystrophin, sarcolemma becomes fragile, loss Ca homeostasis, cell death occurs
               • muscle cell degeneration will outpace regeneration
                 • regeneration capacity is exhausted, fibers are replaced by connective tissue
               • dystrophin
                 • cytoplasmic protein
                 • links contractile filaments to cell membrane
                 • enables cells to contract
           • inheritance pattern
             • X linked recessive
               • genetic defect in Xp21
                 • deletion
                 • point mutation
                 • duplication
           • progression
           • investigation
             • muscle biopsy
             • electromyography
               • to assess the health of muscles and nerves
             • CK test
               • above 1000U\L
             • western plot
             • genetic tests
               • to detect genetic defects
           • complications
             • Lung failure
             • Mental impairment
             • Cardiomyopathy
             • Contractures
           • progniosis
             • poor prognosis
           • causes of death
             • Respiratory failure
             • Heart failure
             • Pneumonia
             • Aspiration
             • Airway obstruction
           • managmanet
             • corticosteroids
             • beta2-agonist
             • physical activity
             • orthopedic braces
             • respiratory support
           • clinical characterstics
         • congenital
         • depends on
           • Which muscles it affects
           • rate of progressin
           • How severe the disease is
       • inherited disorders which primarily but not exclusively effect skeletal muscles

3. neurological examination of Lower limb

   • motor function
   • sensation
   • gait
     • normal
     • abnormal
       • tip toe gait
       • due to abnormaities in
         • muscle
         • nerves
         • bones
       • tredelebreg
       • shuffling gait
   • coordanation

4. psychological effect

   • increased risk of having depression & anxiety
   • social interaction are effected

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