18ECO124T - HUMAN ASSIST DEVICES UNIT 4 & 5 - 12M


12M:


SET 1:


Write in detail about the pediatric orthosis with a diagram

Pediatric orthosis:

  • There are several respects in which a child's orthotic requirements differ from those of an adult and these may extend beyond treatment of the obvious abnormality.

  • Accordingly, before considering specific hardware and research activities, the criteria affecting the performance of an orthosis will be discussed.

  • A child is a particularly dynamic person in terms both of his activity and of his developing personality. 

  • It is important that there is a full appreciation of these factors so that prescription of an orthosis can be made sympathetically and in harmony with his development

Human factors:

  • Many physical and emotional factors can affect the success of an orthosis

  • Physical factors can be considered under the headings of deformity, growth and activity

Deformity: 

  • Frequently an orthosis is fitted to prevent the development of a deformity, particularly during periods of rapid growth

  • For instance, knee and hip flexion contractures may develop rapidly if the child is wheelchair-bound but may be prevented if he is provided with an orthosis which permits an upright stance and mobility for at least a part of each day

Growth: 

  • The prime reason for including adjustability within the orthosis is to accommodate the growth, although at certain sites growth cannot be handled in this way

  • A weight penalty, from the adjustable components is inevitable and this option should be balanced against the replacement of certain parts

Activity level:

  • A child’s natural desire to participate in games and to move from one place to another rapidly, provided there is motivation for doing so, as exemplified by the able-bodied child who runs, hops, skips and jumps whilst out for a 'walk'.

  • As far as possible, the orthosis should permit the handicapped child to achieve the highest possible level of activity compatible with his disability and it should not represent an additional handicap in itself

Change of attitude/location:

  • An orthosis should be unobtrusive both in appearance and in its effect on daily living activities

  • Ideally a child should be able to stand up/ sit down, transfer to/from a wheelchair or road vehicle, go to the toilet, attend school, without having to remove his orthosis

  • The emotional and physical effort of such maneuvers should be minimal if the child is going to achieve his maximum potential 


Elaborate in detail about the Intermittent positive pressure breathing (IPPB) assistance for lungs

  • Intermittent Positive Pressure breathing (IPPB) is an assisted breathing technique used to provide short term or intermittent mechanical ventilation via mouthpiece or mask for the purpose of augmenting lung expansion and delivering aerosol medication

  • IPPB is inspiration using a non-invasive ventilator such as the Bird and Bennett with pressure boost

  • The Bird Mark 7 ventilator is a pressure cycled device convenient to use for providing IPPB

Indication for IPPB:

  • To improve lung expansion

  • To clear secretions

  • To relieve bronchospasm

Procedure for IPPB:

  • Explain procedure to patient

  • Attach circuit tubing, valve line and nebulizer tubing to IPPB machine

  • Block the mouthpiece with sterile gauze

  • Aseptically prepare medication and insert in the IPPB

  • Purse lips around mouthpiece

  • Breathe through the mouth only

  • Inspire slowly and deeply

  • After patient is comfortable, treatment can begin

  • Set sensitivity control according to patient

  • Adjust inspiratory pressure accordingly

  • Adjust nebulizer controls accordingly

  • Monitor the patient throughout

  • When treatment is complete, detach circuit from IPPB machine

Frequency for use of IPPB:

  • Critical care: every 1 to 6 hrs for IPPB is tolerated. IPPB order should be re-evaluated at least every 24 hours

  • Acute/ home care patients: common strategies for IPPB vary from b.i.d to q.i.d

  • For acute care patients: order should be re-evaluated at least every 72 hrs

  • Home care patients: should be re-evaluated periodically

Contra indication of IPPB:

  • Hiccups

  • Nausea

  • Hemodynamic instability

  • Recent facial, oral or skull surgery

  • Recent esophageal surgery

  • Increased intracranial pressure

  • Tracheoesophageal fistula

Limitations:

  • All the effects are short lived, only lasting for an hour after treatment

  • Based on available literature, MDI or compressor driven nebulizers should be considered as best choice, not IPPB

  • The dose of IPPB is tenfold compared to MDIs

  • Efficacy of the device is technique dependent


SET 2:


Explain briefly about the Foot Orthosis with a neat Diagram

  • Foot orthosis is a medical device employed to support and align the foot, in order to prevent or correct foot deformities and to improve the function of foot

  • Foot orthoses aim at 

  • correcting static and dynamic disorders of the foot

  • Relieving painful overloaded areas by distributing bearing forces

  • Protecting and preventing trophic risks

  • Accommodating fixed lesions

  • Stimulating anatomic parts of the foot

  • Foot orthosis is the fundamental component of any lower limb orthotic system

  • Functions: 

  • Reduce stress and strain on ankle, foot, knee, hip and spine

  • Correct abnormal foot position

  • Support arches of foot

  • Equalize limb length discrepancies

  • Protect the foot from injurious stimuli

  • Foot orthosis includes:

  • Foot wear (shoe, chappal, sandal)

  • Footwear modifications (external modification and internal modification)

  • Shoe inserts (rigid, semi rigid, soft)

  • Commonly used in:

  • Heel pain

  • Toe pain

  • Club foot

  • Insensitive foot

  • Limb length discrepancy

Different types of foot orthosis:

  • Corrective orthoses

  • Accommodation orthoses

  • Stimulatory orthoses

  • Preventive orthoses

Types of materials used:

  • Leather and leatherwork derived from animal hides

  • Glues

  • Materials composing orthotic inserts

Types of lower limb orthosis:

  • Foot Orthosis (FO)

  • Ankle Foot Orthosis (AFO)

  • Knee Ankle Foot Orthosis (KAFO)

  • Hip Knee Ankle Foot Orthosis (HKAFO)

  • HKAFO with spinal support

Knee orthosis:

  • Enclose the knee joint extending as far as mid-thigh and mid-calf

  • Types: 

  • Soft

  • Rigid 

AFO:

  • Most commonly used orthosis

  • AKA below knee brace, below knee iron, short caliper

  • Frequently described for patients with gait deviations resulting muscle dysfunction around ankle and foot

KAFO:

  • Are for individuals who have significant weakness or deformity in the lower extremities

  • Are made from metal and leather

HKAFO:

  • Combine componentry at the hip and pelvis as well as the knee and foot and ankle

  • Usually prescribed for:

  • Paraplegia

  • Paraparesis

  • Paralysis 




Summarize the working of Intra-Aortic Balloon Pump with a neat diagram.

Intra-aortic balloon pump:

  • Intra-aortic balloon pump (IABP) remains the most widely used circulatory assist device in critically ill patients with heart disease

  • The primary goal of IABP is to improve the ventricular performance of the failing heart by facilitating an increase in myocardial oxygen supply and a decrease in myocardial oxygen demand

  • The IABP catheter is inserted percutaneously into the femoral artery through an introducer sheath using the modified Seldinger technique

History: 

  • Kantrowitz described augmentation of coronary blood flow in 1952

  • In 1958, Harken suggested diastolic augmentation

  • 4 years later, Moulopoulos and colleagues developed an experimental prototype of an IABP

Principles of Intra-Aortic Balloon Pump (IABP)

  • Mechanical Assistance: The IABP is a mechanical device designed to help the heart pump blood; It is inserted into the aorta

  • Counterpulsation: The principle of counterpulsation is central to the IABP's function. The balloon inflates and deflates in sync with the cardiac cycle

  • Inflation and Deflation Timing:

   - Diastole (Inflation): During diastole, when the heart is at rest, the balloon inflates

   - Systole (Deflation): Just before systole, the balloon deflates

  • Helium Gas: Helium is used to inflate and deflate the balloon

  • Synchronization with ECG: The IABP is synchronized with the patient's electrocardiogram (ECG) to ensure precise timing of inflation and deflation.

Physiological effects:

  • Enhancement of LV function

  • Improve RV function

  • Reduces RV afterload

  • Reduction in LA and pulmonary vascular pressures

The magnitude of these effects depends upon:

  • Balloon volume

  • Heart rate

  • Aortic compliance

Indications for IABP:

  • Cardiogenic shock

  • In association with CABG

  • In association with nonsurgical revascularization

  • Stabilization of cardiac transplant recipient before insertion of VAD

Problems Associated with Intra-Aortic Balloon Pump (IABP)

  • Vascular Complications

  • Thrombosis and Embolism

  • Balloon Rupture

  • Infection Risk

  • Malposition

  • Mechanical Failure


Comments

Post a Comment

Popular posts from this blog

18CSC305J - Artificial Intelligence UNIT 4 & 5

Image
 I have only updated some answers...The ppt is not clear and many contents are missing, so you can say we have to refer online only for the answers. So please make do with these. 4M: Supervised vs Unsupervised SUPERVISED LEARNING UNSUPERVISED LEARNING Requires labeled data Uses unlabeled data Predicts output based on input-output relationships Extracts patterns or relationships from the input data Classification and regression Clustering and association Receives feedback during training to adjust parameters Does not receive explicit feedback during training More complex More simple What is adaptive network? Adaptive learning brings human analysts into the process at every step. This is in contrast to rule-based, simple machine learning and deep learning approaches, where the humans only create rules and label data at the start of the process.  Adaptive learning systems require the least human effort because they only require human input when it matters most and continually exp...
Read more

18CSC303J - Database Management System UNIT 4 & 5 - 12 MARKS

Image
12M: 2) 2NF and 3NF with examples Second Normal Form (2NF): For a table to be in the Second Normal Form, It should be in the first normal form It should not have partial dependency 1 column primary key (Basically no 2 rows have the same primary keys) Example: Here the course code is unique and can be taken as primary key SUBJECT NAME COURSE CODE DBMS CS101 CD CS152 AI CS154 Storing student enrollment in various courses. Here, both the columns are not unique, but the tuple (student name, course code) is unique since a student cannot enroll in the same course more than once). But this is not the second normal form. STUDENT NAME COURSE CODE A CS152 B CS101 A CS154 C CS101 To convert to 2NF, we need to break it into 2 tables. In the first table, the second column is unique and we can attach each of these with the course codes in the second table STUDENT NAME ENROLLMENT NUMBER A 1 B 2 C 3 COURSE CODE ENROLLMENT NUMBER CS101 2 CS101 3 CS152 1 CS154 1 These 2 tables together provide u...
Read more

18CSC303J - Database Management System UNIT 4 & 5 - 4 MARKS

Image
TOTALLY THERE WERE 10 4M GIVEN. 5 FROM SET A  AND 5 FROM SET B. I HAVE TAKEN 4 FROM EACH SET   4M: 1) Design goals of relational database design & 6) paraphrase the pitfalls occurring in relational database design Relational database design requires that we find a ‘good’ collection of relation schemas. A bad design may lead to Repetition of information inability to represent certain information Design goals: Avoid redundant data Ensure that relationships among attributes are represented Facilitate the checking of updates for violation of database integrity constraints Redundancy: Wastes space Complicates updating, introducing possibility of inconsistency Null values Can use, but difficult to handle Cannot store information if value does not exist 2) attribute closure of functional dependency with example The closure of functional dependency means the complete set of all possible attributes that can be functionally derived from given functional dependency using the inferenc...
Read more