Jaw, dislocated Health Dictionary

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Jaw, Dislocated: From 1 Different Sources

Displacement of the lower jaw from one or both temporomandibular joints.

A dislocated jaw is usually due either to a blow or to yawning.

There is pain in front of the ear on the affected side or sides, and the jaw projects forwards.

The mouth cannot be fully closed, making eating and speaking difficult.

Dislocation tends to recur.

Surgery may be carried out to stabilize the joint but is often unsuccessful.

Health Source: BMA Medical Dictionary
Author: The British Medical Association

Child Health

Paediatrics is the branch of medicine which deals with diseases of children, but many paediatricians have a wider role, being employed largely outside acute hospitals and dealing with child health in general.

History Child health services were originally designed, before the NHS came into being, to ?nd or prevent physical illness by regular inspections. In the UK these were carried out by clinical medical o?cers (CMOs) working in infant welfare clinics (later, child health clinics) set up to ?ll the gap between general practice and hospital care. The services expanded greatly from the mid 1970s; ‘inspections’ have evolved into a regular screening and surveillance system by general practitioners and health visitors, while CMOs have mostly been replaced by consultant paediatricians in community child health (CPCCH).

Screening Screening begins at birth, when every baby is examined for congenital conditions such as dislocated hips, heart malformations, cataract and undescended testicles. Blood is taken to ?nd those babies with potentially brain-damaging conditions such as HYPOTHYROIDISM and PHENYLKETONURIA. Some NHS trusts screen for the life-threatening disease CYSTIC FIBROSIS, although in future it is more likely that ?nding this disease will be part of prenatal screening, along with DOWN’S (DOWN) SYNDROME and SPINA BIFIDA. A programme to detect hearing impairment in newborn babies has been piloted from 2001 in selected districts to ?nd out whether it would be a useful addition to the national screening programme. Children from ethnic groups at risk of inherited abnormalities of HAEMOGLOBIN (sickle cell disease; thalassaemia – see under ANAEMIA) have blood tested at some time between birth and six months of age.

Illness prevention At two months, GPs screen babies again for these abnormalities and start the process of primary IMMUNISATION. The routine immunisation programme has been dramatically successful in preventing illness, handicap and deaths: as such it is the cornerstone of the public health aspect of child health, with more potential vaccines being made available every year. Currently, infants are immunised against pertussis (see WHOOPING COUGH), DIPHTHERIA, TETANUS, POLIOMYELITIS, haemophilus (a cause of MENINGITIS, SEPTICAEMIA, ARTHRITIS and epiglottitis) and meningococcus C (SEPTICAEMIA and meningitis – see NEISSERIACEAE) at two, three and four months. Selected children from high-risk groups are o?ered BCG VACCINE against tuberculosis and hepatitis vaccine. At about 13 months all are o?ered MMR VACCINE (measles, mumps and rubella) and there are pre-school entry ‘boosters’ of diphtheria, tetanus, polio, meningococcus C and MMR. Pneumococcal vaccine is available for particular cases but is not yet part of the routine schedule.

Health promotion and education Throughout the UK, parents are given their child’s personal health record to keep with them. It contains advice on health promotion, including immunisation, developmental milestones (when did he or she ?rst smile, sit up, walk and so on), and graphs – called centile charts – on which to record height, weight and head circumference. There is space for midwives, doctors, practice nurses, health visitors and parents to make notes about the child.

Throughout at least the ?rst year of life, both parents and health-care providers set great store by regular weighing, designed to pick up children who are ‘failing to thrive’. Measuring length is not quite so easy, but height measurements are recommended from about two or three years of age in order to detect children with disorders such as growth-hormone de?ciency, malabsorption (e.g. COELIAC DISEASE) and psychosocial dwar?sm (see below).

All babies have their head circumference measured at birth, and again at the eight-week check. A too rapidly growing head implies that the infant might have HYDROCEPHALUS – excess ?uid in the hollow spaces within the brain. A too slowly growing head may mean failure of brain growth, which may go hand in hand with physically or intellectually delayed development.

At about eight months, babies receive a surveillance examination, usually by a health visitor. Parents are asked if they have any concerns about their child’s hearing, vision or physical ability. The examiner conducts a screening test for hearing impairment – the so-called distraction test; he or she stands behind the infant, who is on the mother’s lap, and activates a standardised sound at a set distance from each ear, noting whether or not the child turns his or her head or eyes towards the sound. If the child shows no reaction, the test is repeated a few weeks later; if still negative then referral is made to an audiologist for more formal testing.

The doctor or health visitor will also go through the child’s developmental progress (see above) noting any signi?cant deviation from normal which merits more detailed examination. Doctors are also recommended to examine infants developmentally at some time between 18 and 24 months. At this time they will be looking particularly for late walking or failure to develop appropriate language skills.... child health

Hip-joint

The joint formed by the head of the thigh bone and the deep, cup-shaped hollow on the side of the pelvis which receives it (acetabulum). The joint is of the ball-and-socket variety, is dislocated only by very great violence, and is correspondingly di?cult to reduce to its natural state after dislocation. It is enclosed by a capsule of ?brous tissue, strengthened by several bands, of which the principal is the ilio-femoral or Y-shaped ligament placed in front of the joint. A round ligament also unites the head of the thigh bone to the margin of the acetabulum.

For hip-joint disease, see under JOINTS, DISEASES OF.... hip-joint

Cast

A rigid casing applied to a limb or other part of the body to hold a broken bone or dislocated joint in position as it heals.

Most casts are made of bandages, impregnated with plaster of Paris, which are applied wet and harden as they dry.... cast

Lens Dislocation

Displacement of the crystalline lens from its normal position in the eye. Lens dislocation is almost always caused by an injury that ruptures the fibres connecting the lens to the ciliary body. In Marfan’s syndrome, these fibres are particularly weak and lens dislocation is common.A dislocated lens may produce severe visual distortion or double vision, and sometimes causes a form of glaucoma if drainage of fluid from the front of the eye is affected. If glaucoma is severe, the lens may need to be removed. (See also aphakia.)... lens dislocation

Marfan’s Syndrome

A rare genetic disorder of connective tissue (material that holds body structures together) that results in skeletal, heart, and eye abnormalities. Features of Marfan’s syndrome usually appear after age 10. Affected people are very tall and thin, with long, spidery fingers and weak ligaments and tendons. The chest and spine are often deformed and the lens of the eye may be dislocated. The heart or aorta is often abnormal.... marfan’s syndrome

Dislocations

Injuries to joints of such a nature that the ends of the opposed bones are forced more or less out of connection with one another. Besides displacement of the bones, there is bruising of the tissues around them, and tearing of the ligaments which bind the bones together.

Dislocations, like fractures (see BONE, DISORDERS OF), are divided into simple and compound, the bone in the latter case being forced through the skin. This seldom occurs, since the round head of the bone has not the same power to wound as the sharp end of a broken bone. Dislocations are also divided according to whether they are (1) congenital, i.e. present at birth in consequence of some malformation, or (2) acquired at a later period in consequence of injury, the great majority falling into the latter class. The reduction of a dislocated joint is a skilled procedure and should be done by an appropriately trained professional.... dislocations

Knee

The joint formed by the FEMUR, TIBIA and patella (knee-cap). It belongs to the class of hinge-joints, although movements are much more complex than the simple motion of a hinge, the condyles of the femur partly rolling, partly sliding over the ?at surfaces on the upper end of the tibia, and the acts of straightening and of bending the limb being ?nished and begun, respectively, by a certain amount of rotation. The cavity of the joint is very intricate: it consists really of three joints fused into one, but separated in part by ligaments and folds of the synovial membrane. The ligaments which bind the bones together are extremely strong, and include the popliteal and the collateral ligaments, a very strong patellar ligament uniting the patella to the front of the tibia, two CRUCIATE LIGAMENTS in the interior of the joint, and two ?brocartilages which are interposed between the surfaces of tibia and femur at their edge. All these structures give to the knee-joint great strength, so that it is seldom dislocated. The cruciate ligaments, although strong, sometimes rupture or stretch under severe physical stress such as contact sports or athletics. Surgical repair may be required, followed by prolonged physiotherapy.

A troublesome condition often found in the knee – and common among athletes, footballers and other energetic sportspeople – consists of the loosening of one of the ?bro-cartilages lying at the head of the tibia, especially of that on the inner side of the joint. The cartilage may either be loosened from its attachment and tend to slip beyond the edges of the bones, or it may become folded on itself. In either case, it tends to cause locking of the joint when sudden movements are made. This causes temporary inability to use the joint until the cartilage is replaced by forcible straightening, and the accident is apt to be followed by an attack of synovitis, which may last some weeks, causing lameness with pain and tenderness especially felt at a point on the inner side of the knee. This condition can be relieved by an operation

– sometimes by keyhole surgery (see MINIMALLY INVASIVE SURGERY (MIS)) – to remove the loose portion of the cartilage. Patients whose knees are severely affected by osteoarthritis or rheumatoid arthritis which cause pain and sti?ness can now have the joint replaced with an arti?cial one. (See also ARTHROPLASTY; JOINTS, DISEASES OF.)... knee

Dislocation, Joint

Complete displacement of the 2 bones in a joint so that they are no longer in contact, usually as a result of injury. (Displacement that leaves the bones in partial contact is called subluxation.) It is usually accompanied by tearing of the joint ligaments and damage to the membrane that encases the joint. Injury severe enough to cause dislocation often also causes bone to fracture. Dislocation restricts or prevents the movement of the joint; it is usually very painful. The joint looks misshapen and swells. In some cases, dislocation is followed by complications, for example, paralysis.A dislocated joint should only be manipulated by medical personnel. First- aid treatment consists of applying a splint or, in the case of a dislocated shoulder, a sling. Sometimes, an operation is necessary to reset the bones.... dislocation, joint

Facial Pain

Pain in the face may be due to a variety of causes, of which injury is the most obvious. Facial pain is also commonly due to infection, particularly in sinusitis and mumps. Problems with the teeth and jaws are another common cause of facial pain. They include severe caries (see caries, dental), an abscess (see abscess, dental), impacted wisdom teeth (see impaction, dental), or partial dislocation of the jaw (see jaw, dislocated). Damage to a nerve that supplies the face can produce severe pain, including the knife-like pain that precedes the one-sided rash in herpes zoster and the intermittent shooting pain of trigeminal neuralgia.

A disorder elsewhere in the body may result in referred pain in the face. For example, in angina, pain may be felt in the jaw. In migraine, pain may occur on one side of the face. Facial pain that occurs for no apparent reason may be a symptom of depression.

Analgesic drugs can provide temporary relief, but severe or persistent facial pain requires medical attention.... facial pain

Barlow Manoeuvre

a test for *congenital dislocation of the hip that detects whether or not a hip can be readily dislocated. With the baby lying supine and the pelvis steadied with one hand, the hip being tested is gently adducted and backward pressure is applied to the head of the femur. If the hip is dislocatable, a clunk will be felt and sometimes heard (Von Rosen’s sign). If the hip is gently abducted, it will usually relocate. [T. Barlow (1845–1945), British physician]... barlow manoeuvre

Extension

n. 1. the act of extending or stretching, especially the muscular movement by which a limb is straightened. 2. the application of *traction to a fractured or dislocated limb in order to restore it to its normal position.... extension

Iridodonesis

n. tremulousness of the iris seen when the eye is moved. It is due to absence of support from the lens, against which the iris normally lies, and occurs when the lens is absent or dislocated from its normal position.... iridodonesis

Kocher Manoeuvre

a method for *reduction of an anteriorly dislocated shoulder by manipulation. Longitudinal traction is applied to the elbow, pulling down the shoulder, then the forearm, bent at the elbow, is externally rotated to 90°. [E. T. Kocher (1841–1917), Swiss surgeon]... kocher manoeuvre

Spinal Cord

A cylinder of nerve tissue that runs from the brain, down the central canal in the spine to the 1st lumbar vertebra. Below that, the nerve roots continue within the canal as cauda equina.

Grey matter, the spinal cord’s core, contains the cell bodies of nerve cells. Areas of white matter (tracts of nerve fibres running lengthwise) surround the grey matter. Sprouting from the cord on each side at regular intervals are the sensory and motor spinal nerve roots. The small nodule (ganglion) in each sensory root comprises nerve cell bodies. Nerve roots combine to form the spinal nerves that link the spinal cord to all regions of the trunk and limbs. The entire spinal cord is bathed in cerebrospinal fluid and surrounded by the meninges.

The nerve tracts in the white matter act mainly as highways for sensory information passing up to the brain or motor signals passing down. However, the cord processes some sensory information itself and provides motor responses without involving the brain. Many reflex actions are controlled in this way.

The spinal cord may be injured by trauma (see spinal injury); spinal-cord infections such as poliomyelitis are rare but can cause serious damage.spinal fusion Major surgery to join 2 or more adjacent vertebrae. It is performed if abnormal movement between adjacent vertebrae causes severe back pain or may damage the spinal cord. spinal injury Damage to the spine and sometimes to the spinal cord. Spinal injury is most often the result of falling from a height or of a road traffic accident. Damage to the vertebrae and their ligaments usually causes severe pain and swelling of the affected area. Damage to the spinal cord results in paralysis and/or loss of sensation below the site of injury.

X-rays of the spine are carried out to determine the extent of damage. If the bones are dislocated, surgery is needed to manipulate them back into position. Treatment with the drug methylprednisolone within a few hours of an injury aids recovery from spinal-cord damage. Surgery may be needed to remove any pressure on the cord, but damaged nerve tracts cannot be repaired. Physiotherapy may stop joints locking and muscles contracting as the result of paralysis.

If there is no spinal-cord damage, recovery is usually complete.

In cases of spinal-cord damage, some improvement may occur for up to 12 months.... spinal cord

Congenital Dislocation Of The Hip

(CDH) an abnormality present at birth in which the head of the femur is displaced or easily displaceable from the acetabulum (socket) of the ilium, which is poorly developed; it frequently affects both hip joints. CDH occurs in about 1.5 per 1000 live births, being more common in first-born girls, in breech deliveries, and if there is a family history of the condition. The leg is shortened and has a reduced range of movement, and the skin creases may be asymmetrical. All babies are routinely screened for CDH at birth and at developmental check-ups by gentle manipulation of the hip causing it to be reduced and dislocated with a clunk (see Barlow manoeuvre; Ortolani manoeuvre). The diagnosis is confirmed by X-ray or ultrasound scan. Treatment is with a special harness holding the hip in the correct position. If this is unsuccessful, the hip is reduced under anaesthetic and held with a plaster of Paris cast or the defect is corrected by surgery. Successful treatment of an infant can give a normal hip; if the dislocation is not detected, the hip does not develop normally and osteoarthritis develops at a young age.... congenital dislocation of the hip

Ortolani Manoeuvre

a test for *congenital dislocation of the hip in which, with the baby lying supine and the pelvis steadied with one hand, the examiner attempts to relocate a dislocated hip by gently abducting the hip while simultaneously pushing upwards on the greater trochanter. If the hip is dislocated, it will relocate with a detectable and sometimes audible clunk. [M. Ortolani (20th century), Italian orthopaedic surgeon]

os1 n. (pl. ossa) a bone.

os2 n. (pl. ora) the mouth or a mouthlike part.... ortolani manoeuvre

Reduction

n. (in surgery) the restoration of a displaced part of the body to its normal position by manipulation or operation. The fragments of a broken bone are reduced before a splint is applied; a dislocated joint is reduced to its normal seating; or a hernia is reduced when the displaced organ or tissue is returned to its usual anatomical site.... reduction

Jasmine

Jasminum officinale

FAMILY: Oleaceae

SYNONYMS: Jasmin, jessamine, common jasmine, poet’s jessamine.

GENERAL DESCRIPTION: An evergreen shrub or vine up to 10 metres high with delicate, bright green leaves and star-shaped very fragrant white flowers.

DISTRIBUTION: Native to China, northern India and west Asia; cultivated in the Mediterranean region, China and India (depending on the exact species). The concrete is produced in Italy, France, Morocco, Egypt, China, Japan, Algeria and Turkey; the absolute is mainly produced in France.

OTHER SPECIES: There are many species of jasmine used for medicine and perfumery work. Apart from the common jasmine, the most widespead varieties are the royal or Italian jasmine (J. grandiflorum) which is grown in the Mediterranean region, and its Eastern counterpart J. officinale var. grandiflorum or J. auriculatum. See the Botanical Classification section for a more comprehensive list.

HERBAL/FOLK TRADITION: In China the flowers of J. officinale var. grandiflorum are used to treat hepatitis, liver cirrhosis and dysentery; the flowers of J. sambac are used for conjunctivitis, dysentery, skin ulcers and tumours. The root is used to treat headaches, insomnia, pain due to dislocated joints and rheumatism.

In the West, the common jasmine was said to ‘warm the womb ... and facilitate the birth; it is useful for cough, difficulty of breathing, etc. It disperses crude humours, and is good for cold and catarrhous constitutions, but not for the hot.’ It was also used for hard, contracted limbs and problems with the nervous and reproductive systems.

ACTIONS: Analgesic (mild), antidepressant, anti-inflammatory, antiseptic, antispasmodic, aphrodisiac, carminative, cicatrisant, expectorant, galactagogue, parturient, sedative, tonic (uterine).

EXTRACTION: A concrete is produced by solvent extraction; the absolute is obtained from the concrete by separation with alcohol. An essential oil is produced by steam distillation of the absolute.

CHARACTERISTICS: The absolute is a dark orange-brown, viscous liquid with an intensely rich, warm, floral scent and a tealike undertone. It blends well with rose, sandalwood, clary sage, and all citrus oils. It has the ability to round off any rough notes and blend with virtually everything.

PRINCIPAL CONSTITUENTS: There are over 100 constituents in the oil including benzyl acetate, linalol, phenylacetic acid, benzyl alcohol, farnesol, methyl anthranilate, cis jasmone, methyl jasmonate, among others.

SAFETY DATA: Non-toxic, non-irritant, generally non-sensitizing. (An allergic reaction has been known to occur in some individuals.)

AROMATHERAPY/HOME: USE

Skin care: Dry, greasy, irritated, sensitive skin.

Circulation muscles and joints: Muscular spasm, sprains.

Respiratory system: Catarrh, coughs, hoarseness, laryngitis.

Genito-urinary system: Dysmenorrhoea, frigidity, labour pains, uterine disorders.

Nervous system: Depression, nervous exhaustion and stress-related conditions. ‘It ... produces a feeling of optimism, confidence and euphoria. It is most useful in cases where there is apathy, indifference or listlessness.’.

OTHER USES: Extensively used in soaps, toiletries, cosmetics and perfumes, especially high-class floral and oriental fragrances. The oil and absolute are employed in a wide range of food products, alcoholic and soft drinks. The dried flowers of J. sambac are used in jasmine tea.... jasmine


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