NAZIA SAIFI

House no.140, St. 9,

Zakir Nagar, Okhla,
New Delhi 110025
Telephone no. : 011- 26982735
Contact no. : 9891638666
E mail id : nazia.librans@gmail.com

OBJECTIVE

A challenging opportunity in the field of physical therapy that would enable me to

utilize my clinical and educational experience

EDUCATIONAL QUALIFICATI0N
Completed class Xth from St. Giri Sr. Sec. School -C.B.S.E board, Delhi
Completed class XIIth from Govt.co-ed School -C.B.S.E board,Delhi
Completed Bachelor in Physiotherapy from Santosh Medical College, Chaudhary
Charan Singh University, Meerut in 2009 by scoring 69%.

WORKSHOPS AND SEMINARS

• Attended 1ST International Conference on Orthopaedics and Sports
Physiotherapy, St. Joseph’s Academy, Dehradun, held on 2nd and 3rd
Dece,mber, 2006.

• Attended Stroke Rehabilitation, Vimhans, Delhi, held on 28th-30th November,

2008.

• Attended International Workshop on Gait analysis, ITS, Murad nagar, 6th-8th

February 2009.

• Actively participated in Physio Fest, Delhi, 22nd March, 2009.

PROJECT

Submitted a project in the final year of B.P.Th on ‘TRACTION’ in the subject of

Orthopaedics under the guidance of Dr. Deepak .

STRENGHTS

• Fast learner
• Handle patients with responsibility and care
• Good communication skill
• Good in team work
 • Fluent in enlish,hindi and urdu

PERSONAL DETAILS

Date of birth : 3rd December,1985

Sex : Female

Nationality : Indian

Marital status : Unmarried

Languages known : English, Hindi, Urdu

Permanent address : House no. 140, St. 9, Zakir nagar, Okhla,

New Delhi, 110025.

Telephone no. : 011- 26982735

Contact no. : 9891638666

Place : New Delhi

The brachial plexus is an arrangement of nerve fibers, running from the spine, formed
by the ventral rami of the lower cervical and upper thoracic nerve root, specifically from
below the fifth cervical vertebra to above the first thoracic vertebra (C5-T1). It proceeds
through the neck, the axilla (armpit region), and into the arm.

Contents
[hide]

• 1 Function
• 2 Anatomy
o 2.1 Path
• 3 Diagram
o 3.1 Specific branches
• 4 Additional images
• 5 See also
• 6 References

• 7 External links
 [edit] Function
The brachial plexus is responsible for cutaneous and muscular innervation of the entire
upper limb, with two exceptions: the trapezius muscle innervated by the spinal accessory
nerve (CN XI) and an area of skin near the axilla innervated by the intercostobrachialis
nerve.

Because the majority of the upper limb muscles are innervated by the brachial plexus,
lesions can lead to severe functional impairment.[1]

[edit] Anatomy
[edit] Path

One can remember the order of brachial plexus elements by way of the mnemonic, "Read
The Damn Cadaver Book" (Or, alternatively, Real Teenagers Drink Cold Beer") - Roots,
Trunks, Divisions, Cords, Branches[2] or - Roots, Trunks, Divisions, Cords,
Collateral/Pre-terminal Branches, and (Terminal) Branches.

• The five roots are the five anterior rami of the spinal nerves, after they have given
off their segmental supply to the muscles of the neck.

• These roots merge to form three trunks:

o "superior" or "upper" (C5-C6)
o "middle" (C7)
o "inferior" or "lower" (C8-T1)

• Each trunk then splits in two, to form six divisions:

o anterior division of the upper, middle, and lower trunks
o posterior division of the upper, middle, and lower trunks

• These six divisions will regroup to become the three cords. The cords are named
by their position with respect to the axillary artery.
o The posterior cord is formed from the three posterior divisions of the
trunks (C5-T1)
o The lateral cord is the anterior divisions from the upper and middle trunks
(C5-C7)
o The medial cord is simply a continuation of the anterior division of the
lower trunk (C8-T1)

• The branches are listed below. Most branch from the cords, but a few branch
(indicated in italics) directly from earlier structures. The five in bold are
considered "terminal branches".
[edit] Diagram

[edit] Specific branches

• One can remember the specific branches of lateral, posterior and medial cord
using the mnemonic LML ULNAR M4U respectively.
o LML - lateral pectoral nerve , musculocutaneous nerve , lateral root of the
median nerve.
o ULNAR - upper subscapular nerve , lower subscapular nerve , nerve to
latissmus dorsi (thoracodorsal nerve) , axillary nerve , radial nerve.
o M4U - medial pectoral nerve , medial root of the median nerve , medial
cutaneous nerve of the arm , medial cutaneous nerve of the forearm , ulnar
nerve.

From Nerve Roots Muscles Cutaneous

rhomboid muscles and

roots dorsal scapular nerve C5 -
levator scapulae

C5, C6,
roots long thoracic nerve serratus anterior -
C7

superior nerve to the

C5, C6 subclavius muscle -
trunk subclavius

superior supraspinatus and

suprascapular nerve C5, C6 -
trunk infraspinatus

pectoralis major (by

lateral C5, C6,
lateral pectoral nerve communicating with the -
cord C7
medial pectoral nerve)

lateral musculocutaneous C5, C6, coracobrachialis, becomes the lateral

cord nerve C7 brachialis and biceps cutaneous nerve of the
 brachii forearm

lateral lateral root of the C5, C6, fibres to the median

-
cord median nerve C7 nerve

posterior upper subscapular subscapularis (upper

C5, C6 -
cord nerve part)

thoracodorsal nerve
posterior C6, C7,
(middle subscapular latissimus dorsi -
cord C8
nerve)

posterior lower subscapular subscapularis (lower part

C5, C6 -
cord nerve ) and teres major

anterior branch: deltoid

and a small area of posterior branch
posterior overlying skin becomes upper lateral
axillary nerve C5, C6
cord posterior branch: teres cutaneous nerve of the
minor and deltoid arm
muscles

triceps brachii, supinator, skin of the posterior

C5, C6,
posterior anconeus, the extensor arm as the posterior
radial nerve C7, C8,
cord muscles of the forearm, cutaneous nerve of the
T1
and brachioradialis arm

medial pectoralis major and

medial pectoral nerve C8, T1 -
cord pectoralis minor

portions of hand not

medial medial root of the fibres to the median
C8, T1 served by ulnar or
cord median nerve nerve
radial

medial medial cutaneous C8, T1 - front and medial skin

cord nerve of the arm of the arm

medial medial cutaneous medial skin of the

C8, T1 -
cord nerve of the forearm forearm

the skin of the medial

flexor carpi ulnaris, the
medial 2 bellies of flexor
medial
ulnar nerve C8, T1 digitorum profundus,
cord
most of the small
muscles of the hand
side of the hand and
medial one and a half
fingers on the palmar
side and medial two
and a half fingers on
the dorsal side

[edit] Additional images

Brachial plexus with areas of roots, trunks, divisions and cords marked.
Mind map showing branches of Brachial plexus

Superficial dissection of the Diagram of segmental

The axillary Cutaneous
right side of the neck, distribution of the
artery and its nerves of right
showing the carotid and cutaneous nerves of the
branches. upper extremity.
subclavian arteries. right upper extremity.

The right sympathetic chain Side of neck,

and its connections with the showing chief
thoracic, abdominal, and surface
pelvic plexuses. markings.

[edit] See also

The acute respiratory distress syndrome is a severe and acute form of respiratory
failure precipitated by a wide range of catastrophic events- including shock,
septicaemia, major trauma, or aspiration or inhalation of noxious substances.

The aims of physiotherapy are:

Removal of retained secreations

Passive/Active movements

Chest Physiotherapy in this case involve four principal manoeuvers:

Positioning to enhance the removal of secretions and to improve gas exchange

Manual Hyperinflation

Endotracheal suction

Manual techniques which include shakings and vibrations

Passive and active exercises need to be performed regularly whilst the patient
mobility remain restricted during the critical stages of their disease, in order to
maintain the mobility of joints and extensibility of soft tissues (e.g. muscles, tendons
and ligaments).

Physio treatment goes according to the pathophysiological stage of ARDS which is

multifactorial.

If in the exudative phase (caused due to DAD(Diffuse alveolar damage)),

characterizing pulmonary edema, positioning to avoid further V/Q mismatch (prone
or lateral - more appropriate wud be prone, recent trend even head end elevated),
ET suction - airway clearance, concomitant ventilatory support (Low Vt, High PEEP
strategy, PCV), alveolar recruitment maneuvers, CPAP
Excessive passive movements can lead to further distress, if pt is extremly
tachycardic, tachypneic.. Ankle toe and slow movemnts ideal. Monitor ABG

With due reasoning - proceed for the fibroproliferative phase.. - excessive secretion
retention - Bronchial hygeine and remodelling phase..

ARDS can lead to ILD due to excess fibrosis in interstitium.. -further rehab..

YYG

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Physiotherapy in Intensive Care*

Table 1.

Summary of Evidence and Evidence-Based Recommendations for

Physiotherapy in the ICU

Strong evidence that:

Physiotherapy is the treatment of choice for patients with acute lobar
atelectasis
Prone positioning improves oxygenation for some patients with severe
acute respiratory failure or ARDS
Positioning in side lying (affected lung uppermost) improves
oxygenation for some patients with unilateral lung disease
Hemodynamic status should be monitored during physiotherapy to
detect any deleterious side effects of treatment
Sedation before physiotherapy will decrease or prevent adverse
hemodynamic or metabolic responses
Preoxygenation, sedation, and reassurance are necessary before
suction to avoid suction-induced hypoxemia
Continuous rotational therapy decreases the incidence of pulmonary
complications
Moderate evidence that:
Multimodality physiotherapy has a short-lived beneficial effect on
respiratory function
MH may have a short-lived beneficial effect on respiratory function, but
hemodynamic status, airway pressure, or VT should be monitored to
detect any deleterious side effects of treatment
ICP and CPP should be monitored on appropriate patients during
physiotherapy to detect any deleterious side effects of treatment
Very limited or no evidence that:
Routine physiotherapy in addition to nursing care prevents pulmonary
complications commonly found in ICU patients
Physiotherapy is effective in the treatment of pulmonary conditions
commonly found in ICU patients (with the exception of acute lobar
atelectasis)
Physiotherapy facilitates weaning, decreases length of stay in the ICU
or hospital, and reduces mortality or morbidity
Positioning (with the exception of examples cited above), percussion,
vibrations, suction, or mobilization are effective components of
physiotherapy for ICU patients
Limb exercises prevent loss of joint range or soft-tissue length, or
improve muscle strength and function, for ICU patients
•