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ost of us come across this particular sign quite often. Of course, you can just jump to the numerous investigations and one after another, rule out the possible causes, finally getting to the diagnosis. For me, that’s no fun at all. Although I still don’t know whether I am going to become a surgeon or not (embarassing for me, since I’m going to be done with med-school this year), its pretty fascinating. If I were to work in a country whether investigations aren’t that expensive, I would definitely just perform a small examination and take a short history, sending off my patient to get a myriad of investigations, reporting to me after a while, with the diagnosis in his reports.
ectal exam is an internal examination of the rectum such as by a physician or other healthcare professional.
The digital rectal examination (DRE, Latin palpatio per anum or PPA) is a relatively simple procedure. The patient is placed in a position where the anus is accessible and relaxed (lying on the side, squatting on the examination table, bent over the examination table, etc). The physician inserts a gloved and lubricated finger into the rectum through the anus and palpates the insides.
The DRE is inadequate as a screening tool for colorectal cancer because it examines less than 10% of the colorectal mucosa; colonoscopy is preferred. However, it's an important part of a general examination, as many tumors or other diseases are made manifest in the distal part of the rectum.
This examination may be used: * for the diagnosis of rectal tumors and other forms of cancer; * in males, for the diagnosis of prostatic disorders, notably tumors and benign prostatic hyperplasia; * for the diagnosis of appendicitis or other examples of an acute abdomen (i.e. acute abdominal symptoms indicating a serious underlying disease); * for the estimation of the tonicity of the anal sphincter, which may be useful in case of fecal incontinence or neurologic diseases, including traumatic spinal cord injuries; * in females, for gynecological palpations of internal organs * for examination of the hardness and color of the feces (ie. in cases of constipation, and fecal impaction); * prior to a colonoscopy or proctoscopy. * to evaluate haemorrhoids
The DRE is frequently combined with an FOBT (fecal occult blood test), which may be useful for diagnosing the etiology of an anemia and/or confirming a gastrointestinal bleed.
Sometimes proctoscopy may also be part of a rectal examination.
To facilitate the delivery of fluids during labour, obstetric anaesthetists from Coventry designed a triple IV peripheral connector with a central high-flow anti-reflux valve. This connector, now rightly known as the Coventry valve, can be used for all theatre settings and is especially useful in obstetrics, ICU, HDU and orthopaedics. More details on www.mediplus.co.uk
http://www.nucleushealth.com/ - This 3D medical animation depicts two operations, called craniotomy and craniectomy, in which the skull is opened to access the brain. The normal anatomy of the skull and tissues surrounding the brain are shown, including arteries and veins. The animation lists the common reasons for these procedures, and briefly introduces intracranial pressure.
Video ID: ANH13109
Transcript:
Your doctor may recommend a craniotomy or a craniectomy procedure to treat a number of different brain diseases, injuries, or conditions.
Your skull is made of bone and serves as a hard, protective covering for your brain. Just inside your skull, three layers of tissue, called meninges, surround your brain. The thick, outermost layer is the dura mater. The middle tissue layer is the arachnoid mater and the innermost layer is the pia mater. Between the arachnoid mater and the pia mater is the subarachnoid space, which contains blood vessels and a clear fluid called cerebrospinal fluid. Blood vessels, called bridging veins, connect the surface of your brain with the dura mater. Other blood vessels, called cerebral arteries, bring blood to your brain.
Inside your skull, normal brain function requires a delicate balance of pressure between the blood in your blood vessels, the cerebrospinal fluid that surrounds your brain, and your brain tissue. This is called normal intracranial pressure. Increased intracranial pressure may result from: brain tumors, head injuries, problems with your blood vessels, or infections in your brain or spinal cord. These conditions put pressure on your brain and may cause it to swell or change shape inside your skull, which can lead to serious brain injury.
Your doctor may recommend a craniotomy to remove: abnormal brain tissue, such as a brain tumor, a sample of tissue by biopsy, a blood clot, called a hematoma, excess cerebrospinal fluid, or pus from an infection, called an abscess.
A craniotomy may also be done to: relieve brain swelling,
stop bleeding, called a hemorrhage, repair abnormal blood vessels, repair skull fractures, or repair damaged meninges.
Finally, a craniotomy may also be done to: treat brain conditions, such as epilepsy, deliver medication to your brain, or implant a medical device, such as a deep brain stimulator.
The most common reason for a craniotomy is to remove a brain tumor.
#Craniotomy #Craniectomy #BrainSurgery