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Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation01:21

Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation

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Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
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Assessment of the Cardiovascular System III: Palpation01:27

Assessment of the Cardiovascular System III: Palpation

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Palpation involves feeling the body to evaluate texture, size, consistency, and tenderness for assessing cardiovascular health. The following steps are organized in a head-to-toe order:
Jugular Venous Pressure (JVP) Measurement
Position the patient at a thirty- to forty-five-degree angle or in a semi-fowler's position. Look for the highest point of pulsation in the internal jugular vein and measure the vertical distance to the angle of Loius or sternal angle. A normal JVP is 3-4 cm above...
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Peripheral Artery Disease IV: Nursing Management01:26

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 The nursing management of a patient with peripheral artery disease (PAD) begins with a thorough assessment of the patient’s health history and clinical manifestations.AssessmentHealth History: Evaluate the patient’s history of hypertension, hyperlipidemia, family history of cardiovascular issues, and lifestyle factors such as dietary patterns, smoking, and physical activity.Physical Examination:Assess the affected extremity for decreased or absent peripheral pulses,...
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Spinal Nerves: Plexus I01:22

Spinal Nerves: Plexus I

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Nerve plexuses are networks of interlacing nerves that serve as communication hubs to distribute and organize nerve action across various body regions. The nerve plexuses are organized into the cervical plexus located in the neck region, brachial plexus in the shoulder area, lumbar plexus found in the lower back, sacral plexus situated in the pelvis, and coccygeal plexus located in the coccygeal region.
The Cervical Plexus
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Peripheral artery disease (PAD) predominantly results from atherosclerosis, which involves the accumulation of fatty deposits, or plaques, within the walls of arteries. This causes them to narrow and harden, significantly reducing blood flow. PAD predominantly affects the legs but also impacts other areas, such as the arms, thereby impairing overall circulation and organ function.Etiology of PAD:The principal cause of PAD is atherosclerosis, which results from fatty deposits inside the arterial...
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Function and strength declines in a client with radiation-induced brachial plexopathy: a case report.

Susan R Harris1, Mara A R Nalewajek2,3, Marie E G Brown4

  • 1Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.

Physiotherapy Theory and Practice
|September 30, 2024
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Summary

Radiation-induced brachial plexopathy (RIBP) causes progressive disability. This case study shows significant, measurable declines in grip strength, pinch strength, and dexterity in a breast cancer survivor over three years, highlighting the condition's worsening nature.

Keywords:
Brachial plexopathybreast cancercancer rehabilitationcase reportradiation-induced brachial plexopathyradiotherapy

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Area of Science:

  • Neurology
  • Oncology
  • Rehabilitation Medicine

Background:

  • Radiation-induced brachial plexopathy (RIBP) is a debilitating complication of radiotherapy.
  • It can significantly impair upper extremity function and quality of life.
  • Late-onset RIBP can present years after cancer treatment.

Purpose of the Study:

  • To document the progressive decline in upper extremity function in a patient with very late-onset RIBP.
  • To quantify functional deficits using standardized assessments.
  • To highlight the lack of effective interventions for muscle strength recovery in RIBP.

Main Methods:

  • A case report detailing a breast cancer survivor diagnosed with stage IIIA breast cancer.
  • Radiotherapy included bilateral mastectomy, chemotherapy, and 25 sessions of radiation to the right chest wall, supraclavicular, and axillary lymph nodes.
  • Standardized neurological examinations, nerve conduction tests, grip/pinch strength measurements, and functional dexterity assessments were performed over time.

Main Results:

  • Significant decreases in grip strength (28.1%), lateral pinch strength (67%), and key/three-point pinch strength (95%) were observed.
  • Functional dexterity declined, with astereognosis noted.
  • These deficits worsened over a three-year period, indicating progressive functional loss.

Conclusions:

  • This is the first report to document progressive functional decline in RIBP using standardized measures.
  • RIBP leads to irreversible muscle strength loss and functional impairment.
  • Further research is needed to explore potential management strategies for progressive RIBP.