Routine pelvic exams are important for good reproductive health. A woman should have her first GYN exam when she first thinks about becoming sexually active, when she becomes sexually active or when she turns 18.

At the gynecologist, you will have a short general physical exam, including a breast exam. You will wear a hospital gown and nothing else. For the actual pelvic examination, you will lie down on an examination table with your feet resting in elevated “stirrups” (props that support your legs in the air). Stirrups might look a little scary, but they are there to keep you comfortable. Your legs will be spread apart, with your knees falling to each side so that your vagina is exposed. You may feel uncomfortable, but relax and realize that everyone goes through this.

External Exam
The practitioner will visually examine your vulva for discoloration, irritation, swelling and other abnormalities, and will gently feel for glands.

Internal Exam
There are two parts to the internal exam. The first involves a speculum, a metal or plastic instrument that the practitioner inserts into the vagina. The speculum is shaped like a duck’s bill, and once it is inserted into the vaginal canal, it is gently widened to spread the interior vaginal walls (this is not painful). As the vaginal walls are spread, the practitioner is able to see the walls of the vagina itself, and up the vaginal canal to the cervix. When viewing the vaginal canal and the cervix, the practitioner can look for discoloration, abnormal discharge, lesions, growths and signs of infection. It is possible for you to look at your own cervix during this process by propping yourself up on your elbows and using a mirror. Some practitioners ask if you would like to do this, but feel free to ask to if she doesn’t mention it first.

Pap Smear
Next the practitioner will take a pap smear. She/he uses a long-stemmed cotton swab to collect a sample of cells in the cervix. Some women feel a slight cramping sensation when their cervix is touched. The collected cells are smeared onto a slide and sent to a lab for testing and examination. The pap smear is extremely important for spotting abnormalities in the cervix which may indicate infection or disease.

STD Testing
If you are sexually active, the practitioner will test for STDs. The gynecologist will swab the inside of the cervix with a long cotton swab. The speculum is then taken out of the vagina. The samples are sent to a laboratory for various STD testing. The tests will probably take a couple days. Ask when your results will be available so you can call. If you want to be tested for HIV, syphilis, genital herpes or hepatitis you need to have blood taken. They can do that as well, but you will need to ask since it is not usually routine.

Manual Exam
The second part of the pelvic exam is called the manual or bi-manual exam. The practitioner will insert one or two fingers into your vagina and press with her/his other hand on the outside of your lower abdomen. They will use a lubricant on their fingers so it is more comfortable. The person can then feel the uterus, fallopian tubes and ovaries, and check for any swelling or tenderness. Once the doctor is finished checking your uterus and ovaries, the exam is complete. The entire pelvic exam (the parts involving your vagina, cervix, uterus, and ovaries) takes 3 to 5 minutes to complete.

https://www.youtube.com/watch?v=Uc6ZotU5mxA

Watch that Female Recto-vaginal Exam Video

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ACE Inhibitor Mechanisms. Angiotensin converting enzyme (ACE) inhibitors are agents used to relax blood vessels and lower blood pressure. They prevent an enzyme from producing angiotensin II, which narrows blood vessels and raises blood pressure, meaning the heart has to work harder to pump blood around the body.

Orgasmic childbirth is a new variant of water birth delivery.

Surgeon performs a dissection of the transverse process during spine surgery, explaining the benefits of including the AQUAMANTYS System from Salient Surgical Technologies during the procedure. The AQUAMANTYS System uses Salient's patented TRANSCOLLATION technology, which has been clinically shown to reduce blood loss and lower blood transfusion rates when used during surgery.

http://www.hypodermic-injection.com This is a demonstration of an IM hypodermic injection administered in the gluteus maximus muscle. The patient is in the prone position.

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http://www.proctoscopeexam.com This is a demonstration of a proctoscope examination of the rectum.

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.

Foreceps Delivery Birth Video

An animation showing vaginal childbirth (delivery)

Microcalcifications in the breast can be the first sign of cancer. They are, as the name says, very small and clustered. A precise biopsy without pain under stereotactic guidance is the standard procedure. What makes this Spirotome different from the vacuum assisted biopsies is that only a few biopsies are needed and that the approach of the needle towards the microcalcifications is direct and frontal. There is no damage to the surrounding tissues making this procedure rather painfree and with minimal bleeding.

A video describing the procedure of colonoscopy or flexible fibre-optic examination of the colon.

http://www.hypodermic-injection.com This is a demonstration of an IM injection being administered in the patient's buttocks while bending over the edge of the exam table.

Alexandra J. Golby, MD, Director, Image-guided Neurosurgery at Brigham and Women’s Hospital, discusses technological advancements to improve the precision of surgery to remove brain tumors.

It’s estimated that each year nearly 80,000 people are diagnosed with primary brain tumors and 100,000 with metastatic brain tumors. Nearly everybody is at risk for developing a brain tumor. Brain tumors can affect people from childhood to the last years of their lives. Men are slightly more affected than women and the causes of most brain tumors are not known.

There are a number of unique challenges in treating brain tumors. One challenge is that primary tumors can have indistinct margins that are difficult to see. Another challenge is that the tissue around a brain tumor is uniquely important and may impact things like language, visual and motor function.

The AMIGO Suite, opened in 2011 at Brigham and Women’s Hospital, is the Advanced Multimodality Image Guided Operating Suite. It's an NIH-funded national center which was developed with the goal of translating technological advances into improvements in surgical and interventional care for patients. In the AMIGO Suite, there is an intraoperative MRI scanner which can be brought in and out of the operating room during surgery to help surgeons visualize a patient’s tumor better.

Image-guided surgery uses the information obtained from advanced imaging and translates that into the planning and execution of surgery by acquiring high resolution and specialty structural images of the brain and also functional images of the brain. These images can be registered to one another and then to the patient's head during surgery. This allows surgeons to pinpoint the location of the tumor as well as the areas that we would like to preserve, areas that serve critical brain functions are located.

One of the big challenges, even with image-guided surgery, is that as we perform the surgery, the configuration of the brain is changing, and we call that brain shift. And it's due to changes in the brain itself and also as we remove tissue, things are constantly shifting and moving. When we're talking about doing brain tumor surgery, a few millimeters of movement can be a big difference. How to measure and track brain shift is an important area of research and a number of technologies are being studied to understand how to measure brain shift during surgery.

The development of various intraoperative imaging technologies allows surgeons to provide the most accurate surgical treatment for each individual patient.

Learn more about precision brain surgery at Brigham and Women’s Hospital:
https://www.brighamandwomens.o....rg/neurosurgery/brai

it's a 8 years old boy with previous medical history of Sickle cell disease presented with gall stone and repeat abdominal pain. A laparoscopic cholecystectomy is performed. The cystic duct is controlled with 2 stiches of absorbable suture. The cystic artery is simply cauterized with the hook cauter...y. the specimen is removed through the umbilical port using an 10mm endobag.

This video shows how to insert a catheter in a baby girl