Case1

Demographic data
Name: - Sudhir singh
Age: - 75 years
Gander: - Male
Occupation: - farmer
Address: - Patna
Doa -: 14 aug. 2023
Chief complaint-: patient complains of headache from
last 5 days and he was also having difficulty while
swallowing the food
patient was having a feeling of sickness & sometimes
with a feeling of vomiting also.
Present history-: patient was having were headache
in the occipital region x 5 days.
. vomiting x 3 days
. nausea persistent
Past history-: no
Surgical history-: craniotomy
Family history-: no
Personal history-: . alcohol  occasionally
. smoking  no
. tobacco  no
On observation-:
. body built – ectomorph.
. posture – lying.
. muscle wasting – generalised
. deformity – no
. breathing pattern – normal
. mode of ventilation – normal ventilation
. types of respiration – abdominal – thoracic
. oedema – no
. swelling – in the left hand due to cannus
On examination-:
. general examination: patient was oriented &
conscious to place, time, people
. temperature: normal
. skin colour: brown
. external appliances – felly ‘s catheter cannula
. clubbing
. cyanosis - no
Differential diagnosis-:
. lesions may occur intentionally that can cause
hematoma
. abscess , inflammation
. stroke
. meningitis
Diagnose -: cerebral mass ( neoplastic )
Goals -:
. short term goals -:
. stop the growth or speed of tumour
. prevent recurrence
Long term goals -:
. relieve the symptoms such as headache & vomiting
. strengthen the muscles of upper & lower limb perform
balance training to improve the balance coordination
Pt management-:
1.Chest pt - . percussion
. chest wall mobilization
. vibration
2.Limb pt - . flexion
. elevation
. abduction
. adduction
. external rotation
. internal rotation
. circumduction

Case 2
Demographic data-:
Name -: Komal devi
Age -: 26 years
Gender -: female
Address -: Patna
Doa -: 24 aug 2023
Occupation -: employee
Chief complaint -: pt complains of difficulty in moving
the right arm of the body.
. pt is having the problem from year after the surgery.
Present history -: less of movement in the right
upper limb.
. pain get aggravated during passive movement
scalene while placing the arm in the arm cast.
past history -: n/a dm, no HTN.
Surgical history -: surgery of brachial plexus
On examination -:
. general examination - was conscious to time , place ,
people was oriented also.
. temperature - normal
. skin colour - honey
. cyanosis - no
. oedema - no
. tenderness – grade 2 ( deltoid , triceps , biceps )
. sensation – intact
. pain – positive in affected arm.
On observation-:
. body built – mesomorph.
. posture – sitting.
. gait – normal
. muscle wasting – positive in right arm
. oedema – no
. swelling – no
Differential diagnosis -:
. decrease arm movement due to pain.
. weakness due to lesions of nervous system outside
the brachial plexus.
. permanent nerve damage
. loss of sensation.
. uneven shoulder or arm length discrepancy.
Diagnosis-: brachial plexus injuries
Goals-:
1.short term -: leisure the adequate muscle
nutrition.
. preserve muscle function.
. promote nerve regeneration.
2.Long term -: muscle stimulator for stimulating
the affected
. strengthening arm’s
Pt management -:
1.Modalities can be applied.
2.Joint movements
. shoulder – Abd , add , flexion, extension
. elbow – flexion , extension
. wrist – flexion , extension , supination pronation
 Case3
Demographic data-:
Name-: Saloni kumari
Age-: 29 years
Gender-: female
Doa -: 8 sept. 2023
Occupation-: housewife
Chief complaint-: patient was having difficulty in
lifting the left leg.
. patient was also unable to turn in left side position.
. the patient was taking this difficulty after c- section.
Present history-: c- section surgery a week ago.
. pain in the abdominal area.
past history-: fracture in the thoracic spine 2 years
ago.
pain history-: left lower limb w/c get aggregated
during flexion of intention of hip or knee.
Family history-: no
Personal history-: no alcohol / smoking drugs
On examination-:
general examination – patient was conscious of
oriented to place , time , people
. deformity – no
. pyknosis – no
. oedema – no
. swelling – in right hand due to cannula
. tenderness – no
. external appliance – no
On observation-:
body built – endomorph
posture – lying
pattern of breathing – thoraco abdomen
deformity – no
differential diagnosis-:
. pelvic pain
. abdominal vaginal bleeding
. mensuration problem
Diagnose-:
c- section ( differentially in movement)
pt management-:
. strengthening exercises.
. shoulder ( flexion , extension)
. quadriceps stretches
. Buttocks squeezing
. ankle toe pumps
Goals-: short term goals-:
1.To reduce pain
2.To reduce swelling
Long term goals-:

1.Improve adl’s
2.Strengthening of muscles
3.Improve rom
 Case 4
Demographic data-:
Name-: Saraswati kumari
Age-: 64 years
Gender-: female
Doa-: 28 sept. 2023
Address-: Patna
Chief complaint-: patient c/o sudden fall while
walking and got injured at right side leg from last week.
Present history-: patient comes with right leg injury
+ abrasion with loss of balance in right side leg +
swelling and severe pain at hip joint.
Past history-: none
Medical history-: none
Personal history-: none
Occupational history-: married / housewife
Surgical history-: n/a
Pain history-: vas scale / moderate pain

0 1 2 3 4 5 6 7 8 9
10
Side right side
Cile – hip joint
Type of pain – acute
. duration – 1 week
. aggravating factor – during movement
. relieving factor – rest
Observation-:
Body built -: mesomorphic
Attitude of limb – right leg inverted
Skin – normal
Oedema – no
Swelling – yes
Examination-:
Vitals hr = 100bpm
Bp = 144/91mmhg
S10 = 97
Temp = 97.c
Investigations-:
1.Xray of ( rt ) side hip joint
Differential diagnosis-: . trochanteric bursitis
. avascular
neurosis
Diagnosis-: # head of femur
Pt treatment-:
. short term goals-:
1.To reduce pain
2.To reduce swelling
. long term goals-:
1.Improve rom
2.To improve bed mobility
3.Improve adls
Treatment-:
1.ATP
2.Strengthening exercises
3.SLR
4.Isometrics
 Case 5
Demographic data-:
Name-: Rakesh singh
Age-: 73 years
Gender-: male
Doa-: 18 oct 2023
Chief complaint-: patient complaints of difficulty in
breathing from 5 days.
. wet cough from 6 days.
Present history-: patient was having generalised
weakness.
. wild dysuria.
Past history-: Pneumonitis for past 1 year .
Pain history-: no
Personal history-: no
Surgical history-: no
On examination-:
. vitals – bp – 118/62
Hr – 100
Spo2 – 96
Temp – 97. 4. F
. skin colour – honey
. external appliance – . felly’s catheter
. bp cuff
On observation-:
. body built - endomorph
. posture – half lying
. oedema – pitting oedema
. respiration mode - normal
. swelling – no
Differential diagnosis-:
. COPD
. emphysema
. chronic bronchitis
Diagnosis-:
. pneumonitis
Goals-:
Short term-:
. improve ventilation
. maintain oxygenation
Long term-:
. improve airway
. breathing exercise
Pt management-:
. chest vibration
. percussion
. shaking
. spirometry

Case 6

Demographic data-:
Name -: Kamal chand
Age -: 60 years
Gender -: male
Doa -: 23 0ct. 2023
Chief complaint-: patient come to er with fever on
and off from 10 days also abdominal pain.
Present history-: patient c/o decrease appellate and
weakness increase wine from one week , constipation
and chills morning.
History of past illness-:
. surgical history – hip replacement x 24 weeks ago.
. pain history – site grain area
Side : ( rt ) side
Mild lain
l___l___l___l___l___l___l___l___l___l___l
0 1 2 3 4 5 6 7 8 9 10
. personal history – n/a
. medical history – n/a
On observation-:
. wasting – n/a
. oedema – n/a
. body built – ectomorphic.
. type of skin – n/a
. swelling – n/a
On examination-:
Vital signs -: Rr – 186 / m
Pr – 107 6pm
Bp – 115 / 67 mm / hg
Spo2 – 96 %
Rbs – 87 mg
Temp – 98 . f
Other -: wine catheter
Investigation -: . chest x ray
. urine test
Differential diagnosis -: renal tb
Fungal infection
Diagnosis-: Uti
Pt management-:
Short term
. To lese pain
. Improve rom
Long term
. To remove strength
. Improve adls
. To prevent contracture
Treatment-: pelvic floor muscle gaining
. Kegel & exercise
. child pose
. side plank exercises.
. squats exercise
. triangular pose
. prodigy
 Case 7
Demographic data-:
Name -: Bhawan singh
Age -: 54 years
Gender -: male
Address -: Patna
Doa -: 2 nov. 2023
Occupation -: farmer
Chief complaint -: patient c/o since 6 – 7 years b / l
knee pain.
Present history -: knee pain 7 years , slightness
swelling in both knees.
Past history -: dm ( 11 ) , HTN
Present surgical history -: TKR b / l
Pain history -: site – knee
Side – b / l knee
Aggravating factor – during movement relieving rest
. Vas -4/0
4 / 10
l___l___l___l___l___l___l___l___l___l
1 2 3 4 5 6 7 8 9
10
Personal history -: n/a
Medical history -: HTN medication
Calcium channel bluchers
Propranolol
On observation -:
Body built – mesomorphic.
Watery – n/a
Oedema – n/a
Bandage scar
On palpation -:
. tanners – grade ( 1 )
. type of skin – dry
Examination -:
Vital signs
Temp - 98.2 f
P r – 72 6pm
External appliances -:
. Foley & catheter
. cannula
Range of motion -:
15 – 20 degree knee flexion
Investigation -: x-ray , c t scan
Differential diagnosis -: gov.t septic
Diagnosis -: o a b / l knee
Pt management -:
Short term : to decrease the pain , to decrease the
swelling
Long term : improve rom , improve strength
Day – 1
. maintain limb in extension by placing sell below heel
or amble.
. isometries.
. hip abduction of adduction.
. dynamic quants.
. s l r neigh hold.
Day 2 – 3
. assisted s l r.
. transfer in bed.
. standing and walking.
. passive knee bending.
Day 4 – 6
. heel drag in supine.
. active knee flexion of extension.
. s l r with hold.
Day 7 – 14
.work up to 90 degree of knee flexion.
. Hams strengthening in prove.
. knee flexion exercise.
 Case 8
Name -: Sandeep singh
Age -: 20 years
Gender -: male
Occupation -: farmer
Doa -: 14 dec. 2023
Chief complain -: patient come to hospital with r s a
while riding bike and another bike in conscious state &
normal bleeding & vomiting on 20 oct. 2023.
Present history -: patient come to hospital with
history of road traffic accident he was riding his bike &
get hit by another bike he got injured when he was
returning home from his coaching he was unconscious ,
when they brought him to the hospital blood was
coming out of the nose & he was vomiting continuously
and got fracture of normal bone & left side metacarpal
bone ( right finger ) patient is having symptoms of
headache & pain in left firearm & left thigh. Swelling
over left eye multiple abrasions over body.
Past history -: no
Surgical history -: ORIF + plating
Pain assessment -: NPRS – 2/10
Personal history -: no
Family history -: no
Symptoms -:
Side – left
Lite – forehead , hand , leg
Onset – from six days
Duration – constant
Aggravating factor – during movement
Relieving factor – rest
Vitals -:
Bp – 120/60 mm/g
Pulse – 72 bpm
Temp – 98 deg. F
Rr – 16 bpm
Observation-:
Body built – mesomorphic.
Oedema – no
Any bandage -yes
Attitude of limb – internal rotation of elbow
Type of joint-: do not check the gait because patient
bedridden.
Deformity-: do not check the deformity because
patient is bedridden.
On palpation-:
Tenderers – Positive ( 3 )
Stain – multiple abrasions over face , leg , hand
swelling + blush discoloration eye.
Swelling – Positive ( hand , eye , face , leg )
On examination -:
Rom shoulder ( left )
( right )
Flexion 0 – 160 degree
0 – 180 degree
Extension 0 – 70 degree
0 – 60 degree
Abduction 0 – 18 degree
0 – 180 degree
Elbow
Flexion 0 – 120 degree
0 – 170 degree
Extension 0 – 10 degree
0 – 10 degree
Wrist
Flexion 0 – 10 degree
0 – 80 degree
Extension 0 – 60 degree
0 – 70 degree
Radial 0 – 10 degree
0 – 30 degree
Hip joint
Flexion 0 – 60 degree
0 – 90 degree
Extension _
_
Knee joint
Flexion 0 – 120 degree
0 – 130 degree
Extension 110 – 0 degree
130 – 0 degree
Investigation -: meta carpal fracture ( ring
finger )type commented fracture.
Diagnosis -: meta carpal fracture ( surgery )
Pt management -:
Short term goals -:
1.To reduce pain
2.To reduce swelling
3.To prevent dvt
4.Prevent chest complications
5.To prevent pressure sures
6.To strength the muscle
Long term goals -:
1.To increase rom of joint
2.To make patient functionally independent
Pt management -:
Strengthening exercise of upper limb
Shoulder – flexion , extension
Abduction , abduction
Elbow – flexion , extension
Lower limb – hip flexion
Knee flexion
Knee extension
 Ankle to pump

Case 9
Demographic data -:
Name -: Asha singh
Age -: 77 years
Gender -: Female
Address -: patna
Doa -: 9 jan. 2024
Occupation -: housewife
Chief complaint -: patient complain of pain is knee
while doing walking.
Present history -: pain in knee joint while moving or
in weight bearing position assistive device ( stick ) are
needed during walking.
Past medical -: no HTN
History – No Dm
Hepatitis c
Personal history -: no
Surgical – implant in left tibia.
History – Hysterectomy x 26 years
NPRS – 7 / 10
Pain assessment –: state of pain (knee joint )
On observation -:
Body built – endomorphic.
Attitude of limb / deformity – bow leg
Assistive device – stick
On palpation –:
Swelling – yes ( +ve )
Tenderness – +ve ( 3+ )
Investigation -: x- ray wallowing of space b/w joints
Diagnosis -: OA knee
Differential diagnosis -: OA knee , inflammatory
arthritics
Pt management -:
Short term goals – to reduce swelling , to reduce pain
Long term goals – to improve muscle strength ,
improve ADLs
Treatment -: Icing – 15 min ,

Exercise -: SLR 5 Rep with 5 sec. hold knee flexion 10

– 15 rep isometric of hems , VMO – 10 rep.
Stretching – quadriceps
Home – no stairs
Advice – Icing daily , exercise daily.

Case 10
Demographic data -:
Name -: Saloni kumari
Age -: 67 years
Gender -: female
Occupation -: housewife
Doa -: 2 feb. 2024
Chief complain -: patient c/o sudden fall at home
while walking & got leg injury at right side last week.
Present history -: patient come with right side injury
with help obsession with loss of balance at right side
leg+ swelling & serve paint at left joint.
Past history – no
Medical history – no
Personal history – no
Surgical history – no
Occupational history – housewife
Marital status – married
Pain history -: NPRS – 5/10 ( moderate pain )
________________________
1 2 3 4 5 6 7 8 9 10

Type of pain -: constant

Duration -: 1 week
Aggravating factor -: during movement
Relieving factor -: Rest
On observation -:
Body built – mesomorphic.
Muscle wasting – no
Attitude of limb – right leg extended.
Skin – normal
Swelling – yes
On palpation -:
Tenderness - yes ( 3 + )
Tone – normal
Oedema – yes
Vitals -:
Bp – 177 191 mm\hg
Rr – 25 bpm
Spo – 97 percent.
Hr – 100 bpm
Temp. – 97 degree C
External applicators -:
Bp cuff
Foley catheter
Pulse oximeter.
DVT preventer pump

Cannula
Central live
Investigation -:
x- ray right side hip, ap view
diagnosis -:
femur bone fracture ( head )
pt management -:
short term goals – to reduce pain, reduce swelling ,
increase muscle strength.
Long term goals – to increase rom, to increase bed
mobility , to increase ADLs , to make functionally
independent.
Treatment -: 10 min twice / day ankle toe pumps
Statement -: excess – SLR, Hip abduction , adduction
Isometric exercise of hamstring.
Name: - Raunak kishore
Roll: - G30219045
Collage: - PDM University
Session: - 2019-2023

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