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Scott
23,759 Views ยท 10 months ago

The Knee Exam
Observation:
1. Make sure that both knees are fully exposed. The patient should be in either a gown or shorts. Rolled up pant legs do not provide good exposure!
2. Watch the patient walk. Do they limp or appear to be in pain? When standing, is there evidence of bowing (varus) or knock-kneed (valgus) deformity? There is a predilection for degenerative joint disease to affect the medical aspect of the knee, a common cause of bowing. Varus Knee Deformity, more marked on the left leg. 3. Make note of any scars or asymmetry. Chronic/progressive damage, as in degenerative joint disease, may lead to abnormal contours and appearance. Is there obvious swelling as would occur in an effusion? Redness suggesting inflammation? 4. Is there evidence of atrophy of the quadriceps, hamstring, or calf muscle groups? Knee problems/pain can limit the use of the affected leg, leading to wasting of the muscles.

While both legs have well developed musculature,
the left calf and hamstring are bulkier than the right. 5. Look at the external anatomy, noting structures above and below the knee itself: 1. Patella 2. Patellar tendon 3. Quadriceps/Hamstring/Calf muscles 4. Medial and lateral joint lines. 5. Femur and Tibia 6. Tibial tuberosity


Ballotment (helpful if the effusion is large) 1. Slightly flex the knee which is to be examined.
2. Place one hand on the supra-pateallar pouch, which is above the patella and communicates with the joint space. Gently push down and towards the patella, forcing any fluid to accumulate in the central part of the joint.
3. Gently push down on the patella with your thumb.
4. If there is a sizable effusion, the patella will feel as if it's floating and "bounce" back up when pushed down.

Scott
43,454 Views ยท 10 months ago

Common Benign Pain Syndromes--Symptoms and Etiology:
1. Non-specific musculoskeletal pain: This is the most common cause of back pain. Patients present with lumbar area pain that does not radiate, is worse with activity, and improves with rest. There may or may not be a clear history of antecedent over use or increased activity. The pain is presumably caused by irritation of the paraspinal muscles, ligaments or vertebral body articulations. However, a precise etiology is difficulty to identify.
2. Radicular Symptoms: Often referred to as "sciatica," this is a pain syndrome caused by irritation of one of the nerve roots as it exits the spinal column. The root can become inflamed as a result of a compromised neuroforamina (e.g. bony osteophyte that limits size of the opening) or a herniated disc (the fibrosis tears, allowing the propulsus to squeeze out and push on the adjacent root). Sometimes, it's not precisely clear what has lead to the irritation. In any case, patient's report a burning/electric shock type pain that starts in the low back, traveling down the buttocks and along the back of the leg, radiating below the knee. The most commonly affected nerve roots are L5 and S1.
3. Spinal Stenosis: Pain starts in the low back and radiates down the buttocks bilaterally, continuing along the backs of both legs. Symptoms are usually worse with walking and improve when the patient bends forward. Patient's may describe that they relieve symptoms by leaning forward on their shopping carts when walking in a super market. This is caused by spinal stenosis, a narrowing of the central canal that holds the spinal cord. The limited amount of space puts pressure on the nerve roots when the patient walks, causing the symptoms (referred to as neurogenic claudication). Spinal stenosis can be congenital or develop over years as a result of djd of the spine. As opposed to true claudication (pain in calfs/lower legs due to arterial insufficiency), pain resolves very quickly when person stops walking and assumes upright position. Also, peripheral pulses should be normal.
4. Mixed symptoms: In some patients, more then one process may co-exist, causing elements of more then one symptom syndrome to co-exist.

Scott
52,902 Views ยท 10 months ago

Function and Anatomy: The hip is a ball and socket type joint, formed by the articulation of the head of the femur with the pelvis. Normal range of motion includes: abduction 45 degrees, adduction 20-30 degrees, flexion 135 degrees, extension 30 degrees, internal and external rotation. Hip pathology can cause symptoms anywhere around the joint, though frequently pain is anterior and radiates to the groin region. Additionally, pathology outside of the hip can be referred to this region. History and exam obviously help in making these distinctions.

M_Nabil
14,572 Views ยท 10 months ago

Laparoscopic Tubal Reversal of fallopian tubes after ligation

M_Nabil
35,392 Views ยท 10 months ago

Tubal ligation using Fallope Ring

M_Nabil
13,273 Views ยท 10 months ago

laparoscopy for repair of rupture of urinary bladder

Mohamed
34,331 Views ยท 10 months ago

Bladder and prostate injection- Botox

Mohamed
15,211 Views ยท 10 months ago

Endoscopic crushing of a bladder stone

Mohamed
15,508 Views ยท 10 months ago

Catheters and Long Lines are introduced in Neonates to administer fluid and Total Parentral Nutrition. The proceedure is not easy to perform and is prone to get infections.
Strict Aseptic technique is mandatory

Mohamed
20,462 Views ยท 10 months ago

Cystoscopy

Mohamed
19,683 Views ยท 10 months ago

New York Plastic Surgery ,Dr. Robert Vitolo ,board certified plastic surgeon , brings you into the operating room for a glimpse at how his transumbilical breast augmentation procedure is performed. Dr. Vitolo, a pioneer in the 'no visible scar' breast enlargement surgery, has been using this technique since 1994. Dr. Vitolo use Allergan Natrelle saline breast implants and Mentor saline implants. Dr. Vitolo also performs a removal of silicone gel implants and replacement with saline implants using the transumbilical method.

Mohamed
23,495 Views ยท 10 months ago

Minimally invasive kidney and ureteral stone surgery using holmium laser performed at El Camino Urology Medical Group,

Mohamed
38,020 Views ยท 10 months ago

Microsurgical varicocelectomy is performed for patients with a varicocele and impaired semen parameters, testicular atrophy or pain due to the varicocele.

Dr.Neelesh Bhandari
19,397 Views ยท 10 months ago

Basic Surgical Instruments- Forceps, scissors.

Mohamed
17,428 Views ยท 10 months ago

This is a educational video for the prostate cancer patient and their family. Depending on the individual patient, a radical prostatectomy, might a procedure that your urologist could recommend as treatment.

Mohamed
18,076 Views ยท 10 months ago

HoLEP (Holmium laser enucleation of prostate)

Mohamed
15,437 Views ยท 10 months ago

Incision of the bladder neck for a small prostate

Mohamed El-Rouby
22,855 Views ยท 10 months ago

Gynecomastia means enlargement of male breast to resample female breast that is a common problem between males and causes many psychological problem
Dr. Mohamed El-Rouby
Consltant of Plastic surgery - Faculty of Medicine - Ain Shams University

Mohamed El-Rouby
21,570 Views ยท 10 months ago

ุชุถุฎู… ุงู„ุซุฏู‰ ุนู†ุฏ ุงู„ุฑุฌุงู„ ู…ู† ุงู„ู…ุดุงูƒู„ ุงู„ู…ู†ุดุฑุฉ ุฌุฏุง ุจูŠู† ุงู„ุดุจุงุจ ูˆ ุชุณุจุจ ุงู„ูƒุซูŠุฑ ู…ู† ุงู„ู…ุดุงูƒู„ ุงู„ู†ูุณูŠุฉ ูˆ ุงู„ุตุญูŠุฉ
ุฏ. ู…ุญู…ุฏ ุงู„ุฑูˆุจู‰
ุงุณุชุดุงุฑู‰ ุฌุฑุงุญุงุช ุงู„ุชุฌู…ูŠู„ - ุฌุงู…ุนุฉ ุนูŠู† ุดู…ุณ

Mohamed El-Rouby
19,770 Views ยท 10 months ago

ุนู…ู„ูŠุฉ ุชุฌู…ูŠู„ ุฃูˆ ุงุนุงุฏุฉ ุดูƒู„ ุงู„ุงู†ู
ุฏ. ู…ุญู…ุฏ ุงู„ุฑูˆุจู‰
ุงุณุชุดุงุฑู‰ ุฌุฑุงุญุงุช ุงู„ุชุฌู…ูŠู„ - ุฌุงู…ุนุฉ ุนูŠู† ุดู…ุณ




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