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Sunday, June 20, 2021

Somatization

Somatization

Somatization

Somatization


Somatization is one of six major somatoform disorders identified by the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM). Other somatoform disorders include undifferentiated somatoform disorder, conversion disorder, hypochondriasis, pain disorder associated with psychologic factors, pain disorder associated with both psychologic factors and a general medical condition. Fundamentally, somatization is a constellation of physical symptoms lacking medical explanation. The DSM-IV-TR designates eight symptom requirements for diagnosis, including four bodily pain symptoms, two gastrointestinal (GI) symptoms, one neurologic symptom, and one sexual symptom, resulting in impairment in function. However, these symptoms appear to exist along a spectrum, and the current diagnostic categorization may not accurately reflect the clinical presentation. Therefore the status and characterization of somatoform disorders are being reexamined for the soon-to-be-published DSM-V, to reclassify them under the general heading of bodily distress syndrome to encompass both psychiatric and nonpsychiatric functional disorders.

Obsessive-Compulsive Disorder

Obsessive-Compulsive Disorder

Obsessive-Compulsive Disorder

Obsessive-Compulsive Disorder


Introduction. Obsessive-compulsive disorder (OCD) is diagnosed on the basis of recurrent and intrusive thoughts, referred to as obsessions, and/or compulsive behaviors or rituals. The obsessions or compulsions are recognized by the patient, at least at some point, as excessive and unreasonable, leading to marked distress or functional impairment; they may be extremely time- consuming. These symptoms are experienced as intrusive and inappropriate and are not simply excessive worries about real-world concerns.

POSTTRAUMATIC STRESS DISORDER

POSTTRAUMATIC STRESS DISORDER

POSTTRAUMATIC STRESS DISORDER

Posttraumatic stress disorder (PTSD) is a mental disorder that develops in response to a traumatic event, such as a sexual assault, military combat, natural disaster, or a serious accident. PTSD is characterized by three clusters of symptoms: (1) reexperiencing symptoms wherein the patient relives the trauma in his or her thoughts and dreams and cannot get it out of his or her mind; (2) avoidance and numbing symptoms wherein the patient avoids people, places, and anything that reminds her or him of the trauma and shuts off his or her emotional responses; and (3) hyperarousal symptoms that involve difficulty concentrating, constantly feeling on-guard and in danger, difficulty sleeping, and irritability. To be diagnosed with PTSD, the patient must report that the traumatic event was accompanied by feelings of helplessness and horror, these symptoms must occur for at least a month, and they must interfere with the patient’s ability to function in daily life.


Posttraumatic stress disorder (PTSD) is a mental disorder that develops in response to a traumatic event, such as a sexual assault, military combat, natural disaster, or a serious accident. PTSD is characterized by three clusters of symptoms: (1) reexperiencing symptoms wherein the patient relives the trauma in his or her thoughts and dreams and cannot get it out of his or her mind; (2) avoidance and numbing symptoms wherein the patient avoids people, places, and anything that reminds her or him of the trauma and shuts off his or her emotional responses; and (3) hyperarousal symptoms that involve difficulty concentrating, constantly feeling on-guard and in danger, difficulty sleeping, and irritability. To be diagnosed with PTSD, the patient must report that the traumatic event was accompanied by feelings of helplessness and horror, these symptoms must occur for at least a month, and they must interfere with the patient’s ability to function in daily life.

PANIC DISORDER

PANIC DISORDER

PANIC DISORDER

PANIC DISORDER


Patients complaining of panic often describe a dramatic presentation, including the sudden, unexpected onset of extreme fearfulness or alarm, quickly rising to a crescendo within minutes of commencement, and accompanied by a spectrum of physical, behavioral, and cognitive symptoms. These may include the bodily sensations of choking, chest pain, trembling, flushing, and rapid heart rate, which mimic a sympathetic, “fight or flight” response. The urge to escape, to find shelter, or to seek help can be overwhelming. Panic victims may believe they are dying, losing control, or going crazy and will often seek urgent medical care. The indelible, negative impression left by a panic attack often results in persistent fear of having another attack or in marked behavioral changes. Although isolated panic attacks are relatively common, it is these persistent sequelae that define the diagnosis of panic disorder. By DSM-IV criteria, this disorder may also be accompanied by agoraphobia, characterized by the phobic avoidance of situations that may be difficult or embarrassing to escape, should a panic attack recur.

SOCIAL ANXIETY DISORDER

SOCIAL ANXIETY DISORDER

SOCIAL ANXIETY DISORDER

SOCIAL ANXIETY DISORDER


Introduction and Clinical Presentation. Social anxiety disorder (SAD), or social phobia, is characterized by persistent fear of social or performance situations in which an individual will face exposure to unfamiliar people or scrutiny by others. The individual typically fears behaving in an embarrassing or humiliating fashion, or revealing symptoms of anxiety. Exposure to these situations provokes anxiety or panic symptoms, leading the individual to avoid such situations whenever possible. Physical symptoms may include diaphoresis, tachycardia, trembling, nausea, flushing, and difficulty speaking, for example.

GENERALIZED ANXIETY DISORDER

GENERALIZED ANXIETY DISORDER

GENERALIZED ANXIETY DISORDER

GENERALIZED ANXIETY DISORDER


Generalized anxiety disorder (GAD) is characterized by excessive, uncontrollable, and often irrational worry, about everyday things that is disproportionate to the actual source of worry. To diagnose GAD, excessive worry must be present for at least 6 months, the person finds it difficult to control the worry, and the anxiety and worry are associated with three (or more) out of six symptoms. These include (1) restlessness or feeling keyed up or on edge, (2) being easily fatigued, (3) difficulty concentrating or mind going blank, (4) irritability, (5) muscle tension, and (6) sleep disturbance (difficulty falling or staying asleep, or restless unsatisfying sleep). As with other axis I diagnoses, the symptoms must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning and are not due to the direct physiologic effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hyperthyroidism), and do not occur exclusively during a mood disorder, psychotic disorder, or a pervasive developmental disorder.

Friday, June 18, 2021

FROZEN SHOULDER

FROZEN SHOULDER


FROZEN SHOULDER

FROZEN SHOULDER
The clinical and anatomic pathology in frozen shoulder is derived from an acute inflammatory synovitis followed by an intracapsular soft tissue fibrosis, resulting in contracture of  the capsule. Some  have  made an analogy of frozen shoulder to Dupuytren contraction in the palmar fascia of the hand. Dupuytren contracture has been associated with myofibroblasts present within the fibrous tissues, and these same cells can be found in the shoulder capsule with frozen shoulder. Frozen shoulder is commonly seen in association with thyroid disorders as well as diabetes. Patients with these associated systemic diseases often have a more severe and refractory clinical course. When associated with thyroid and diabetic changes, the treatment of frozen shoulder is often more difficult. The recovery phase is longer and protracted, and the recurrence rate and the number of treatment failures are higher with both surgical and nonsurgical treatment.
EXERCISES FOR RANGE OF MOTION AND STRENGTHENING OF SHOULDER

EXERCISES FOR RANGE OF MOTION AND STRENGTHENING OF SHOULDER


EXERCISES FOR RANGE OF MOTION AND STRENGTHENING OF SHOULDER
BASIC, PASSIVE, AND ACTIVE-ASSISTED RANGE-OF-MOTION EXERCISES

Basic, Passive, And Active-Assisted Range-Of-Motion Exercises
The rehabilitation exercises shown in this section are applicable to both nonoperative and postoperative treatment for all of the shoulder conditions discussed in this book. The specific exercises used, their progression, and their coordination with other treatment modalities are specific to the diagnosis, the severity of the pathologic process, and many other patient and surgical factors. A detailed discussion for each of these conditions is beyond the scope of this book.
SCROTAL SKIN DISEASES I: CHEMICAL AND INFECTIOUS

SCROTAL SKIN DISEASES I: CHEMICAL AND INFECTIOUS


SCROTAL SKIN DISEASES I: CHEMICAL AND INFECTIOUS

SCROTAL SKIN DISEASES I: CHEMICAL AND INFECTIOUS
Many skin diseases of infectious, allergic, or metabolic origin can involve the scrotum. Among many yeasts, molds, and fungi, only a few are infectious and are termed dermatophytes (“skin fungi”). Skin fungi live only on the dead layer of keratin protein on the skin surface. They rarely invade deeper and cannot live on mucous membranes. Infections by the fungus tinea cruris (ring-worm) are very common in the groin and scrotum. It involves desquamation of the scrotal skin and contiguous surfaces of the inner thighs and itches (“jock itch”). Tinea begins with fused, superficial, reddish-brown, well-defined scaly patches, which extend and coalesce into large, symmetrical, inflamed areas. The margins of the lesions are characteristically distinct. The initial lesion may become macerated and infected and is painful and itches. Sweating, tight clothing or obesity favor development and recurrence of this fungal infection, derived mainly from the genera Trichophyton and Microsporum. These same organisms cause tinea pedis or “athlete’s foot.”
Homologues of External Genitalia Anatomy

Homologues of External Genitalia Anatomy

Homologues of External Genitalia Anatomy

Homologues of External Genitalia Anatomy
Glans area, Epithelial tag, Urogenital fold, Urogenital groove, Lateral part of tubercle, Anal tubercle, Anal pit, Undifferentiated, Genital tubercle, Male Female, Glans, Epithelial tag, Coronal sulcus, Site of future origin of prepuce, Urethral fold, Urogenital groove, 

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