Ahmad cannot run

Description

Mind Map on Ahmad cannot run, created by Nadeen Adi on 20/04/2017.
Nadeen Adi
Mind Map by Nadeen Adi, updated more than 1 year ago
Nadeen Adi
Created by Nadeen Adi about 7 years ago
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Resource summary

Ahmad cannot run
  1. Demographics
    1. Ahmad
      1. 5 years old
      2. Anatomy of the foot & ankle
        1. Bones
          1. Muscles
            1. Ligaments
              1. Arteries
                1. Nerves
                2. Muscular Dystrophy
                    1. Pathophysiology OF DMD
                      1. Absence of Dystrophin
                        1. Mechanically induced damage through eccentric contractions
                          1. Loss of stability of sarcolemma and loss of calcium homeostasis
                            1. Regeneration, inflammation, impaired vascular adaptation, and fibrosis
                              1. Cell Death
                      2. Function of dystrophin
                        1. Natural history of DMD
                          1. Early phase
                            1. gross motor skills (sitting, standing) maybe mildly delayed
                              1. Poor head control is usually the first sign
                              2. Transitional phase
                                1. Toddler
                                  1. By the 2nd year have hip girdle weakness
                                    1. Delayed walking, falling, toe walking and trouble running or walking upstairs
                                      1. Lordotic posture
                                      2. In 3-9 yrs
                                        1. Early Gowers sign
                                          1. Pseudohypertrophy of calf muscles
                                            1. Contractures mostly of ankles, knees hips and elbows
                                          2. Late stage
                                            1. 15yrs+
                                              1. Cardiomyopathies
                                                1. Respiratory problems
                                                  1. learning disability
                                                2. Loss of ambulation
                                                  1. In 10-14yrs
                                                    1. Children are using wheelchair
                                                      1. Scoliosis due to sitting and back weakness
                                                        1. Upper limb weakness and difficult to retain use of fingers
                                                    2. Learning issues of DMD
                                                      1. attention focusing
                                                        1. verbal learning and memory
                                                          1. emotional interaction
                                                          2. Neurological Examination of the Lower Limb
                                                            1. Scale of muscle strength
                                                              1. Gower's sign
                                                                1. Normal Gait
                                                                  1. Abnormal Gaits
                                                                    1. Lateral trunk bending (Trendelenburg gait)
                                                                      1. Anterior trunk bending
                                                                        1. Posterior trunk bending
                                                                          1. Insufficient push off
                                                                            1. Functional leg discrepancy
                                                                              1. Swing-out
                                                                                1. Hip hiking
                                                                                  1. Steppege gait
                                                                                    1. Vaulting
                                                                                    2. Antalgic gait
                                                                                      1. Ataxic gait
                                                                                      2. Investigations for Diagnosis of Muscle Problems
                                                                                        1. Serum Creatine Kinase Test
                                                                                          1. Electromyography
                                                                                            1. TFT Test
                                                                                              1. Muscle biopsy
                                                                                              2. Genetic counseling
                                                                                                1. patients at risk of an inherited disorder are advised of the consequences of the disorder, the probability of transmitting it, and the options open to them in family planning
                                                                                                2. Duchenne Muscular Dystrophy Inheritance
                                                                                                  1. Treatment of DMD
                                                                                                    1. physical therapy
                                                                                                      1. positioning aids
                                                                                                        1. braces and splints
                                                                                                          1. nutritional counseling
                                                                                                            1. Medications
                                                                                                              1. Eteplirsen (Exondys 51)
                                                                                                                1. Steroids (such as prednisone)
                                                                                                                  1. oral corticosteroid deflazacort
                                                                                                                2. Basics of gene therapy
                                                                                                                  1. approaches
                                                                                                                    1. Viral delivery
                                                                                                                      1. Complications
                                                                                                                        1. Short Lived
                                                                                                                          1. Immune Response
                                                                                                                            1. Viral Vectors
                                                                                                                              1. Multigene Disorders
                                                                                                                                1. Tumor formation
                                                                                                                              2. Psychosocial aspects of muscular dystrophy
                                                                                                                                1. Difficulty with social interactions
                                                                                                                                  1. social isolation
                                                                                                                                    1. anxiety or depression
                                                                                                                                    2. History taking for children with walking abnormalities
                                                                                                                                      1. General and developmental history
                                                                                                                                        1. Signs and symptoms history
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