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The cardiac examination is one of the earliest clinical skills that medical students learn. As a junior doctor, the examination of the cardiovascular system can be almost a dreaded examination, as cardiac murmurs can literally take years of exposure in order to gain confidence with their identification through cardiac auscultation.
This video demonstrates not merely the examination of the heart, but the complete cardiovascular system including peripheries.
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Pulmonary embolism symptoms can vary greatly, depending on how much of your lung is involved, the size of the clots, and whether you have underlying lung or heart disease. Common signs and symptoms include: Shortness of breath. This symptom typically appears suddenly and always gets worse with exertion. Chest pain. You may feel like you're having a heart attack. The pain may become worse when you breathe deeply (pleurisy), cough, eat, bend or stoop. The pain will get worse with exertion but won't go away when you rest. Cough. The cough may produce bloody or blood-streaked sputum. Other signs and symptoms that can occur with pulmonary embolism include: Leg pain or swelling, or both, usually in the calf Clammy or discolored skin (cyanosis) Fever Excessive sweating Rapid or irregular heartbeat Lightheadedness or dizziness
Pulmonary edema is almost always treated in the emergency room or hospital. You may need to be in an intensive care unit (ICU). Oxygen is given through a face mask or tiny plastic tubes are placed in the nose. A breathing tube may be placed into the windpipe (trachea) so you can be connected to a breathing machine (ventilator) if you cannot breathe well on your own. The cause of edema should be identified and treated quickly. For example, if a heart attack has caused the condition, it must be treated right away. Medicines that may be used include: Diuretics that remove excess fluid from the body Medicines that strengthen the heart muscle, control the heartbeat, or relieve pressure on the heart
Closed Reduction of Distal Radius Fractures - Discussion: (distal radius fracture menu) - closed reduction & immobilization in plaster cast remains accepted method of treatment for majority of stable distal radius frx; - unstable fractures will often lose reduction in the cast and will slip back to the pre-reduction position; - patients should be examined for carpal tunnel symptoms before and after reduction; - carpal tunnel symptoms that do not resolve following reduction will require carpal tunnel release; - cautions: - The efficacy of closed reduction in displaced distal radius fractures. - Technique: - anesthesia: (see: anesthesia menu) - hematoma block w/ lidocaine; - w/ hematoma block surgeon should look for "flash back" of blood from hematoma, prior to injection; - references: - Regional anesthesia preferable for Colles' fracture. Controlled comparison with local anesthesia. - Neurological complications of dynamic reduction of Colles' fractures without anesthesia compared with traditional manipulation after local infiltration anesthesia. - methods of reduction: - Jones method: involves increasing deformity, applying traction, and immobilizing hand & wrist in reduced position; - placing hand & wrist in too much flexion (Cotton-Loder position) leads to median nerve compression & stiff fingers; - Bohler advocated longitudinal traction followed by extension and realignment; - consider hyper-extending the distal fragment, and then translating it distally (while in extended position) until it can be "hooked over" proximal fragment; - subsequently, the distal fragment can be flexed (or hinged) over the proximal shaft fragment; - closed reduction of distal radius fractures is facilitated by having an assistant provide counter traction (above the elbow) while the surgeon controls the distal fragment w/ both hands (both thumbs over the dorsal surface of the distal fragment); - flouroscopy: - it allows a quick, gentle, and complete reduction; - prepare are by prewrapping the arm w/ sheet cotton and have the plaster or fibroglass ready; - if flouroscopy is not available, then do not pre-wrap the extremity w/ cotton; - it will be necessary to palpate the landmarks (outer shaped of radius, radial styloid, and Lister's tubercle, in order to judge success of reduction; - casting: - generally, the surgeon will use a pre-measured double sugar sugar tong splint, which is 6-8 layers in thickness; - more than 8 layers of plaster can cause full thickness burns: - reference: Setting temperatures of synthetic casts. - position of immobilization - follow up: - radiographs: - repeat radiographs are required weekly for 2-3 weeks to ensure that there is maintenance of the reduction; - a fracture reduction that slips should be considered to be unstable and probably require fixation with (pins, or ex fix ect.) - there is some evidence that remanipulation following fracture displacement in cast is not effective for these fractures; - ultimately, whether or not a patient is satisfied with the results of non operative treatment depends heavily on th
how do you know if I have a clogged duct or mastitis? You'll always have a clogged duct before you have mastitis and sometimes mastitis can be prevented if you jump on it fast enough. A clogged duct may be red, it can be a tender lump on one side or the other, just feel a little bit painful in one area when you nurse, and the best thing to do is apply warm compresses especially before nursing, massage the area from your armpit down towards the nipple, and then nurse your baby. The goal is to unclog that duct, get your baby to fully empty the breast, and hopefully it will prevent an infection. An infection or mastitis develops if the clogged duct isn't unclogged and bacteria start to harbor and grow and then you have an infection. Symptoms can be the same as a clogged duct as far as how the breasts feel. You might notice a red tender area or a lump. In addition to that you usually do have a fever or flu-like symptoms or just have generalized malaise, and fatigue, and aches. If you feel this way, call your doctor as soon as possible because it requires treatment. An antibiotic is the treatment as well as drinking lots of fluids and nursing your baby as frequently as possible. The milk that comes from the clogged duct is not harmful for your baby but sometimes it tastes a little extra salty and babies refuse it. If that's the case be sure to pump so that you're emptying your breast frequently. The more frequently you empty your breast the quicker you'll get over the infection. Also, of course, taking the antibiotics your doctor has prescribed and be sure to finish the entire course. If you have any other questions for me in the future feel free to ask them on our Facebook page at Facebook.com/IntermountainMoms and recommend us to your friends and family too.
Preeclampsia is a pregnancy complication characterized by high blood pressure and signs of damage to another organ system, often the kidneys. Preeclampsia usually begins after 20 weeks of pregnancy in a woman whose blood pressure had been normal. Even a slight rise in blood pressure may be a sign of preeclampsia. Left untreated, preeclampsia can lead to serious — even fatal — complications for both you and your baby. If you have preeclampsia, the only cure is delivery of your baby. If you're diagnosed with preeclampsia too early in your pregnancy to deliver your baby, you and your doctor face a challenging task. Your baby needs more time to mature, but you need to avoid putting yourself or your baby at risk of serious complications.
Pelvic inflammatory disease (PID) is an infection of the female reproductive organs. It usually occurs when sexually transmitted bacteria spread from your vagina to your uterus, fallopian tubes or ovaries. Many women who develop pelvic inflammatory disease either experience no signs or symptoms or don't seek treatment. Pelvic inflammatory disease may be detected only later when you have trouble getting pregnant or if you develop chronic pelvic pain.
Dr. Eric Janssen of SportsMED Orthopaedic Surgery & Spine Center in Huntsville, Alabama demonstrates a total knee replacement using dry bones model. In this demonstration he uses the Wright Medical Evolution Knee implant. This demonstrations does not include soft tissue.
Scientists have found that every baby has genius potential, a child's education must begin early in order to develop the potential it has. Pregnancy is not too early to start, as evidence indicating that the developing fetus can learn is ever mounting.