Overview : The vulva is a part of the female reproductive system and is also part of the external genitalia. The vulva consists of labia minora, labia majora, mons pubis, clitoris, vestibular bulb, vulval vestibule, urinary meatus the vaginal opening, hymen, and Bartholin's glands. other parts of the vulva include sebaceous glands, urogenital triangle, and pudendal cleft. Pelvic floor muscles support the structures of the vulva and vulva including the entrance to the vagina. Vulva goes through changes during childhood, puberty, menopause, and post-menopause. Structure: A) Mons pubis: it is present in both sexes and act as a cushion during sexual intercourse and is more pronounced in female. the mons pubis is a soft fatty tissue at the front of the vulva in the pubic region covering the pubic bone. the lower part of the mons pubis is divided by a fissure called pudendal cleft. it separates mons pubis and labia majora, the mons pubis, and labia majora get covered by pubic hair at pu...
Rotator cuff tear - symptoms | Diagnosis | Treatment - Sentelhealth
Your shoulders do a lot of things that you might take for granted. The shoulder joint is one of the most important joints in the body and has a maximum range of motion. Movements at the shoulder joints are especially important in sports like tennis, baseball, and swimming and to perform such activities the joint has to be very stable and has to be well supported and that is the rotator cuff's function. It is a group of muscles that provides stability and strength to the shoulder joint. Injury or a tear to such a group of muscles can cause a significant effect on the quality of a life.
Rotator cuff tear can be caused by acute injuries related to falling on an outstretched hand or pulling on the shoulder. It can also be caused by repetitive overhead activities and lifting. The most commonly affected tendon in rotator cuff tear is the supraspinatus tendon.Rotator cuff tears can be classified as :
1) Partial-thickness rotator cuff tear - it is when the muscles of the rotator cuff are partially torn and is the most common cause of shoulder impingement syndrome.
2) Full-thickness rotator cuff tear - when the muscles are completely torn and are treated surgically in most cases.
Symptoms of a rotator cuff tear :
The severity of the symptoms depends on the type of tear and the tendon affected. However, a detailed history should be taken to know that how it affected the quality of life of a patient for eg. an athlete with a small partial tear can have severe symptoms while a 60 yr old with a full-thickness tear can present with no symptoms. Clinical findings of rotator cuff tear are those of the impingement syndrome except with the full-thickness rotator cuff tear there may be more obvious weakness noted with light resistance. Common symptoms of rotator cuff tear include:
1) Pain with overhead movement
2) weakness in the affected area
3) Night pain with sleeping on the shoulder.
4) Pain and weakness with internal rotation of the shoulder.
Diagnosis of the rotator cuff tear :
A rotator cuff tear can be suspected by your doctor after a complete physical examination. Your doctor may press on different parts of your shoulder and move your arm in different positions to check for the range of motion. After an examination, your doctor may recommend some tests such as :
1) X-ray: Although an x-ray can not show you the rotator cuff tear it can be useful to visualize the bone spurs or other causes of pain such as arthritis.
2) Ultrasound: Ultrasound can be used for dynamic testing and assessing the structures of your shoulder as they move. It is also useful in comparing the affected shoulder with the normal shoulder. Ultrasound is also used to differentiate between a partial thickness tear from a full-thickness tear.
3) MRI (Magnetic resonance imaging): MRI is considered the best method to diagnose the rotator cuff tear as it examines the shoulder in multiple sections. The images obtained display all the structures in great detail. This test uses radio waves and magnets for imaging. It is considered superior to the USG in differentiating partial-thickness tears from full-thickness tears.
Treatment of rotator cuff tear :
Treatment of the rotator cuff tear depends on the type of tear. However, initially, all cases are treated conservatively with ice and physical therapy. Oral pain medications can be given to alleviate pain as an initial effort to reduce pain. However, if no response is obtained then the patient must be shifted on to injectable pain medications which mostly include steroid injections.
These medications should be given under medical supervision as they can lead to weakness of the muscles further worsening the situation.
Physical therapy is directed mainly at strengthening the muscle groups affected and can help in partial rotator cuff tears. Exercises tailored to specific muscles can help restore the flexibility and strength of your shoulder. Physical therapy can also be an option for older sedentary patients.
In the case of full-thickness rotator cuff tear is the best treatment as delayed surgical intervention can lead to accelerated progression of fatty infiltration which is considered as the bad prognostic sign. Physical therapy is advised after the surgery for faster recovery.
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