Let the learning begin…

If you have been following my blog you will be aware that over the past five years I have been studying for a bachelors (hons) degree in osteopathic medicine. I am very pleased to announce that this has finally come to an end and my qualification will be awarded this summer.

It has been a hard but very enlightening five years where I have learned so much about my own health, both mental and physical. This has caused me to adopt new attitudes towards maintaining both and I hope to be able to pass on what I have learned to my future patients in order to help them take control of their own well-being.

Currently I am working under supervision with a very good friend of mine at Streatham Osteopaths, South London. The clinic is an integrated health clinic with various styles of Osteopathy as well as Chinese medical practitioners, Hypnotherapists, Psychologists and Massage Therapists. I feel honoured to be given the chance of being part of something like this and would highly recommend the service provided by these professionals.

If you are one of my followers or happen to be in the London area of a weekend, get in touch to book an appointment with us!

 

Advertisements

orthopedic tests

Rather than listing and describing regional orthopedic tests, I’d like to share a few videos I found. The anatomy and test are well described so I found them easy to follow. I hope these help you the way they have helped me. Corrections are welcome!

**NB the thomas test displayed is done incorrectly. Patient should be supine with both knees and hips flexed initially, extending one leg to test. The shown test can give false positive results**

Female Gynaecology Red Flags

Symptom Causes
Menorrhagia Uterine Fibroids

Uterine polyps

Pelvic inflammatory disease

Adenomyosis

Intrauterine Device (IUD)

Anti-coagulant medications

Anti-inflammatory medications

Miscarriage
Uterine Cancer

Amenorrhea Pregnancy

Breast feeding

Menopause
Contraceptives
Polycystic ovary syndrome
Uterine scarring
Hyper/hypothyroidism

Stress
Pituitary tumour

Irregular menses Stress

Polycystic ovary syndrome

Endometriosis

PID
Birth control pills

Intermenstrual bleeding Recent contraceptive change < 3/12

– IUD

– Birth control pill
– Implant
– Injection
– Patch

Miscarriage

Ectopic pregnancy

Uterine fibroids

PID

Foreign object

Cervical/Uterine Cancer

Post coital bleeding Infections

Cervical ectropion

Cervical/uterine polyps

Trauma

Vagina/cervical cancer

Dyspareunia Trauma

PID

Vaginismus (spasm)

Congenital abnormality

Endometriosis

Uterine prolapse

Ovarian cysts

Fibroids

Retroverted uterus

Uterine cancer

Postmenopausal bleeding Uterine polyps

Endometrial atrophy (thinning of inner layer)

Endometrial hyperplasia (thickening)

Endometrial cancer

Osteopathic syndrome

An insidious neurological disorder often presenting with voluntary auditory nerve palsy, egotism and sharp pain in surrounding colons

Aetiology
Osteopathic syndrome (OS) is closely associated to those who have began tutoring within 1-3 years of qualifying as an osteopathic practitioner. The initial sense of self importance and authority is more prevalent in those less capable of a genuine income and manifests as a complete neurological deficit in reality perception during tutoring.

Pathophysiology
The physiological origins of OS is thought to be associated with sexless lives of boredom by the previously bullied but this is yet to be confirmed via trials.

Symptoms
Initial presentation of OS is displayed by a variable voluntary auditory nerve palsy with a continued vocal stimulation. Progression varies but can present with preferential attitudes, expectation of hot beverage delivery, excessive sense of self importance, narcissism and willful ignorance.
If left untreated, OS can lead to a cranio-rectal fusion and eventual complete self absorption.

Diagnosis
The symptoms of OS are to be differentiated from similar conditions such as DJitis and autotheism. A clear case history displaying a previously undertaken osteopathic degree can prevent misdiagnosis.

Treatment
Initial stages of OS can be treated with considerable doses of Shutthefuckupamol. In rare cases an additional course of fuckyoucilin can assist with complete eradication.
Once this disorder has progressed past the excessive self importance phase it is advised to treat the patient’s pineal gland with a lead bullet.

Signs of gastrointestinal disease.

There are various symptoms which can indicate gastrointestinal disorders.

Primarily abdominal pain can present as somatic pain, but is often unrelated to activity or joint movements. It can be relived or aggravated by food, and can also be constant in nature.

Abdominal examination is composed of observation, auscultation, percussion and palpation.

Observation.

Abdominal distention – ascites, portal hypertension
Jaundice – liver dysfunctions, gallstones.
Pallor – anaemia.
Clubbed fingers – ulcerative collitis, crohns, chronic heart failure, auto-immune.
Dupytren’s contracture – alcoholism.
Spider naeviLiver disease (if excessive)
Distended veins – portal hypertension, cirrhosis, irritable bowel syndrome.

clubbed nails ascites jaundice spider naevi

Case presentation indicators:

Dysphagia – damaged CN IX or CN X, space occupying lesion, inflammation.
Dyspepsia – indigestion, heart burn, intolerance to fats.
Reflux – weak spincter muscle, hiatus hernia, increased acid production.
Weight loss – malnutrition, malabsorbtion, deliberate, anorexia.
Flatus – lactose/wheat/gluten intolerance, coeliac disease, gut fermentation.
Pain – unrelated to movement, food aggravates or relieves.

Faeces.
Gall bladder: pale, foul smelling, floating.
Crohns/ulcerative collitis: bloody diarrhoea, mucus.
anal fissure: fresh blood.
Gastrointestinal bleeding: melena (if higher up tract), can also present with anaemia.

 

Presenting symptoms and differentials.

For my diagnostic studies class I will have to look at individual symptoms and the differentials that they are more likely to suggest. So in revers of looking at a pathology I have compiled short lists of non mechanical differentials associated with a presented symptom. I will be expanding on this as I continue my studies so don’t assume that the published article is the final draft!

Dyspnoea:
– Pneumothorax: Trauma, emphysema, cystic fibrosis, tuberculosis (TB).
– Pulmonary oedema: Left sided heart failure.
– Myocardial infarction:
– Pulmonary embolism: Deep vein thrombosis (DVT).
– Asthma: Non steroidal anti-inflammatory drugs (NSAIDs), smoking, infections, anxiety.
Chronic obstructive pulmonary disease (COPD) – chronic bronchitis or emphysema.

Clubbed nails:
clubbed nails
Congenital cyanotic heart disease: right ventricle under developed.
– Infective endocarditis (IE): Infection of inner heart lining.
– Empyema (pyothorax): pus in the lungs, secondary to lung infection.
– Bronchiectasis: widened bronchi, caused from genetics, obstructions or infections, cystic fibrosis.
– Liver disease – Cirrhosis, alcoholism, viral hepatitis, bile duct obstruction (cholestasis or gallstones), chronic heart failure, autoimmune.
– Ulcerative colitis or Crohns: Congenital, childhood history of antibiotics (prolonged), auto-immune diseases.

Neck pain:
– TB (of the cervical spine): weakens vertebrae.
– Cervical spondylosis: degeneration.
– Cervical disk lesion: Trauma.
– Myocardial infarction (MI): Feeling of impending death.
– Angina: occurs on exertion.
– Thoracic outlet syndrome: neurovascular compression.

Chest pain:
– Angina: Exertion related.
– MI: deathly feeling.
– Pericarditis or IE: inflammation of the heart muscles or lining.
– Rheumatic fever:
– Heart failure: pulmonary oedema, cor pulmonale.
– Lung patholgies: Pneumonia, pneumothorax, pulmonary embolism, TB. Dyspnoea, cough.

Leg pain:
– Rheumatoid arthritis (RA): Autoimmune, symmetrical joint inflammation.
– Ankylosing spondylitis: Morning stiffness relieved by activity.
– Intermittent claudication: spinal stenosis, oedema, DVT.
– DVT: oedema, visible superficial veins, low grade fever, calcium channel blockers, oestrogen, high dose of opiods, venous hypertension – right side heart failure.
– Gout: swelling, warmth, redness, fever, pain progressively worse, decreased renal excretion.
– Osteoarthritis: bony end feel.

Oedema:
– Cardiac failure: dyspnoea, lethargy, ascites, cough.
– Liver disease: jaundice, viral hepatitis, alcoholism.
– Renal disease: diabetes, proteinuria.
– DVT: unilateral, female, smoker, immobile, obese, surgery within three months prior, oestrogen therapy, contraceptives.
– Lymphatic flow obstruction: allergens, drug use.
– Trauma/local infection: heat, redness.