Countless physicians, medical students, and therapists can describe a similar experience at one time or another during their training: a patient is behind the door in an examination room and the daily schedule has the words “shoulder pain” listed as the chief complaint. Depending on one’s experience or comfort level, many questions may immediately flood one’s mind regarding how to approach the patient: What are the various causes of shoulder pain? Is the pain really coming from the shoulder? What structures are important in the shoulder? What aspects of the physical examination will help distinguish one shoulder problem from another? The physical examination of musculoskeletal and peripheral nervous system problems is essential knowledge for broad areas of healthcare, as these problems are among the leading reasons for medical encounters. This pocket reference offers instant access to a wide array of clinical pearls to guide the physical examination and diagnosis. Whether one can choose to keep the print copy handy or use the digital version on our phone or tablet, our answer is quickly within reach. In this updated and refreshed second edition, one can search by body part or suspected diagnosis and find detailed descriptions of physical examination maneuvers, along with associated evidence of sensitivity and specificity, to help us with our diagnosis. Additionally, the reader will find all new colorized illustrations, high-resolution photos demonstrating the maneuvers, and corresponding videos that bring the examination to life. Video icons throughout chapters indicate which tests include an accompanying video. There is no substitute for excellent physical diagnosis skills. The authors hope that one will find this book useful as one develop and fine-tune their skills in order to give patients the very best care.

Ambulatory electroencephalography (aEEG) monitoring is not limited to the home environment. It is a useful diagnostic test to evaluate an individual in whom seizures or seizure-like episodes are suspected in their natural environment wherever that may be. This book reviews some of the background distinctions for the technique of aEEG and instrumentation and polygraphic aEEG recording. aEEG monitoring often yields information in the evaluation of epilepsy and in the differential diagnosis of other conditions that mimic epilepsy including psychogenic nonepileptic seizures (PNES), syncope, cardiogenic etiologies, parasomnias, migraine, and transient ischemic attacks. The book discusses the yield of aEEG and compares it with other short- and long-term monitoring techniques in epilepsy. It then provides a thorough assessment of ambulatory sleep studies. Chronic intracranial aEEG monitoring is covered with a new type of aEEG monitoring to provide not only electrocorticography but also encompass treatment using neuromodulation. The book also delivers an inside look at aEEG in the future with development of “wearables” that will allow us to learn new information that involves not only detection but prediction. The practical implications of aEEG involved in proper coding and billing are also reviewed. Case histories are included of patients evaluated with aEEG to underscore key points of practical value.

This book is devoted to a discussion of the native American Indian health system and nursing. It is divided into three parts. Part I first provides a national and historical look at the peoples of what is now the United States. This is followed by a view of pre- and postcontact indigenous America and the effects on health resulting from policies by the new dominant culture. Next to be introduced is the idea that “nursing” has been occurring in indigenous America long before icons, such as Florence Nightingale, put a face to the profession. An introduction to nursing and the Indian Health Service (IHS) is then followed by health modalities outside of the IHS that is, indigenous knowledge and traditional healing. Part II shows how these experiences are/were played out in the various cultural regions of the United States: Northeastern Woodlands; Southeastern Woodlands; Southwest tribal regions; Great Basin; Indians-habitated California; Pacific Northwest; Alaska; and Northern Great Plains. Urban has been added to the regional groups found in the 48 contiguous states and Alaska. In Part III, the reader explores funding as a major component of increasing care options and access in Indian country. Two chapters discuss the issues of Indian health funding and American Indian nursing education.

This atlas serves as a comprehensive working reference for a wide range of clinicians practicing in the field of clinical neurophysiology (CNP). It highlights the traps and pitfalls associated with artifact when interpreting studies involving CNP. Various forms of neurophysiological procedures are performed routinely at local CNP laboratories throughout the world. They are interpreted by neurologists and neurophysiologists including studies involving electroencephalography (EEG); electromyography (EMG); and nerve conductions studies (NCS), sleep, autonomic neurophysiology, evoked potentials (EP); and magnetoencephalography (MEG). It illustrates common and rare types of artifacts that may be encountered by the clinical practitioner during the course of performing CNP studies. The book provides an explanatory text with samples of artifact that emphasize essential principals existing within individual fields of CNP. It is developed in atlas form to facilitate easy interpretation for the busy clinician practitioner. The book comprises of 14 chapters. Chapter one provides an overview of CNP. Chapter two focuses on an explanation of analog recording concepts and provides explanation of important digital recording concepts. Chapter three illustrates the impact of artifact in pediatric studies involving the peripheral nervous system. Chapter four describes artifacts of neuromonitoring. Chapter five addresses continuous EEG monitoring in ICU patients. Next two chapters discuss artifacts in pediatric and adult electroencephalography. Chapter eight addresses pediatric and adult magnetoencephalography. Chapter nine reviews the difficulties encountered with artifact involved when performing EMG and NCS. Chapters ten through thirteen address artifacts in autonomic neurophysiology studies, polysomnography, evoked potential recordings, and neurophysiologic intraoperative monitoring. The final chapter discusses the most common techniques for artifact reduction.

This book is the first resource fully dedicated to quantitative EEG (QEEG) analysis, tailored for physicians or EEG technologists who work with critically ill patients. With the rise of continuous EEG monitoring in intensive care, clinicians are increasingly called on to make real-time clinical judgments with little formal guidance on how to interpret QEEG. The book is configured to meet daily practice challenges. It addresses not only technical fundamentals, but also provides numerous examples of signature QEEG patterns and artifacts to instruct both untrained and experienced eyes. The book walks the reader from essential principles all the way through to practical pattern recognition. With full-page reference samples pairing raw EEG with quantitative EEG spectrograms, brief clinical vignettes, and explanatory captions noting significant features, it provides a roadmap for understanding and applying QEEG data in critically ill patients. The book contains more than 400 full-page vivid color QEEG examples paired with raw EEG to build interpretive skills and enhance clinical decision-making. It presents thorough discussions of both normal and abnormal findings and QEEG artifacts that set the standard for effective use of quantitative electroencephalography and trend analysis in the ICU. The book is organized into three sections. Section one presents the principles of quantitative electroencephalography. Section two discusses the clinical practice of quantitative electroencephalography. Section three describes the artifacts in quantitative electroencephalography. Complete with a broad range of patterns and page after page of full-color samples, the book is designed to be the authoritative QEEG reference for neurologists, intensivists, technologists, and trainees working in critical care settings.

The practice of neonatal electroencephalography (EEG) combines clinical medicine and biomedical technology. This book consists of chapters concerning the approach to visual analysis, techniques of recording, artifacts of noncerebral origin, age-dependent normal findings, patterns of uncertain diagnostic significance, age-dependent abnormal EEG findings, and seizures. Chapters consist of explanatory text, tables, a list of figures, and the sample EEGs themselves with their legends. In presenting samples, the authors have emphasized specific components of the neonatal EEG. The basic principles of visual analysis and interpretation of the electroencephalogram (EEG) that applies to older patients also generally apply to neonates, although with some additional special considerations. The general principles of recording the EEG apply to the recording of the EEG in neonates with some important additions and exceptions. The differentiation of true brain electrical activity from extraneous artifacts is critical to the interpretation of neonatal EEG. Visual analysis of the neonatal EEG requires the recognition of the conceptional age-dependent features characteristic of specific epochs of development. The book electrographic features in four different formats: a table that lists specific elements, a narrative that describes the continuum of development, and a summary by epoch of conceptional age (CA) of the expected elements. A number of waveforms and patterns have not been reported to occur in normal infants. Sharp waves or sharp-and-slow-wave complexes are commonly recorded from the midtemporal region during sleep in apparently normal premature and term infants. Temporal sharp waves classified as normal are usually mono- or diphasic. The book also discusses disordered maturational development, maturational abnormalities and neonatal seizures.

As the field of intensive care unit (ICU) electroencephalogram (EEG) monitoring evolves, the use of continuous EEG monitoring (cEEG) is expanding beyond seizure detection. EEG provides continuous and noninvasive monitoring of brain function and, coupled with quantitative EEG, enables clinicians to monitor for signs of acute and evolving cerebral injury. Early identification of these electroencephalographic biomarkers may, in turn, offer targets for therapeutic neuroprotective interventions. This book provides a contemporary and concise summary of important principles ranging from seizure identification and encephalopathy grading to advanced techniques of quantitative EEG and multimodality monitoring. These principles are important for current clinical care and advancement of the field. It includes 12 core chapters, each of which begins with text, tables, and figures and ends with a series of EEG images illustrating the concepts and principles discussed in the text. Each chapter is written by experts in the field. In addition, case-based approaches to common scenarios focus on EEG pattern recognition, diagnostic evaluation, and management. The cases not only build upon EEG skills learned in the chapters but also cover additional diagnostic and management principles. The book also includes chapter-based board-style multiple-choice questions and videos available online to elucidate important concepts. This atlas will benefit an audience ranging from novices to experts in the fields of neurology, epilepsy, neurophysiology, neurocritical care, neonatology, and cardiac and pediatric critical care medicine.

Botulinum toxin (BoNT) therapy involves as much art as it does science. Prescription and injection of a BoNT product requires that clinicians be familiar with the unique properties of each product, including its dosage range for a seemingly ever-expanding list of approved or published medical indications. This quick reference guide provides detailed dosage information for the four BoNT products available in the USA (abobotulinumtoxinA, incobotulinumtoxinA, onabotulinumtoxinA, and rimabotulinumtoxinB) which are approved for both cosmetic and medical indications. Included in this abbreviated manual are updated regulatory agency approved medical indications for both adults and children and recommended dosage ranges in the USA (Food and Drug Administration), Canada (Health Canada), the United Kingdom (Medicines & Healthcare products Regulatory Agency), and the European Union (European Medicines Agency). Detailed BoNT dosage information for each of these BoNT products is presented in an easy-to-navigate table format. The tables are organized by clinical indication along with each agency-approved dosage where available and the published dosage ranges per treatment session and per structure injected. Providing this information in a single reference manual allows clinicians to quickly calculate the dosage of a given BoNT product for a given indication and/or structure. The anatomical illustrations provided in this manual serve as a reference guide for clinicians to enhance the localization of muscles and other target structures during the injection planning process. The authors hope this information will be useful for clinicians and for the patients to whom they provide care.

This third edition provides a review of developmental, ecosystemic, and career theories to inform relevant P–12 career and college readiness interventions. It reviews numerous developmental theories and assists readers in using them as a foundation to design sequential and developmentally appropriate career and college readiness curricula and interventions. The book help readers understand the ecosystemic influences (e.g., family, school, community, society) on career development and college readiness, and discusses both why it is important to involve various stakeholders in career and college readiness initiatives and how to involve them. It starts with six foundational chapters in which it reviews (a) current data and issues related to college and career readiness, (b) information to assist with postsecondary planning and career and college advising, (c) professional preparation standards for individuals who will provide career and college readiness interventions, (d) cultural considerations in career and college readiness, (e) career and college readiness assessment, and (f) career and college readiness curriculum development. It addresses career development and college readiness needs by grade level. The focus in each grade level chapter is to identify common tasks that occur at that level and to help readers apply knowledge of ecosystems, developmental theories, and career theories, and identify ways that multiple stakeholders can become involved in career and college readiness interventions. This third edition has been revised and includes: updated workforce statistics; work-based learning opportunities for secondary students; the impact of social media on student development; career and technical education pathways; gap year information; enhanced instructor's manual, including project-based activities, discussion prompts, and related online activities, games, and apps. This book helps both preserves and practicing school counselors to identify career and college readiness needs and design developmentally appropriate interventions that are grounded in theory and research.