Ear Examination ENT is often a challenging examination, crossing over with the cranial nerve examination of the vestibular cochlear exam as well at other neurological assessments of balance

Here we will review the ear examination, looking both at the use of the otoscope, but also the Dix-Hallpike Manoeuvre, along with HINTS assessment. the Webers and Rinne's test is also included to determine types of hearing loss.

Often these ear examination techniques are performed separately, depending on the patients presenting complaint

#EARExamination #DrGill #ClinicalSkills

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Most intact aortic aneurysms do not produce symptoms. As they enlarge, symptoms such as abdominal pain and back pain may develop. Compression of nerve roots may cause leg pain or numbness. Untreated, aneurysms tend to become progressively larger, although the rate of enlargement is unpredictable for any individual. Rarely, clotted blood which lines most aortic aneurysms can break off and result in an embolus. They may be found on physical examination. Medical imaging is necessary to confirm the diagnosis. Symptoms may include: anxiety or feeling of stress; nausea and vomiting; clammy skin; rapid heart rate. In patients presenting with aneurysm of the arch of the aorta, a common symptom is a hoarse voice as the left recurrent laryngeal nerve (a branch of the vagus nerve) is stretched. This is due to the recurrent laryngeal nerve winding around the arch of the aorta. If an aneurysm occurs in this location, the arch of the aorta will swell, hence stretching the left recurrent laryngeal nerve. The patient therefore has a hoarse voice as the recurrent laryngeal nerve allows function and sensation in the voicebox. Abdominal aortic aneurysms, hereafter referred to as AAAs, are the most common type of aortic aneurysm. One reason for this is that elastin, the principal load-bearing protein present in the wall of the aorta, is reduced in the abdominal aorta as compared to the thoracic aorta (nearer the heart). Another is that the abdominal aorta does not possess vasa vasorum, hindering repair. Most are true aneurysms that involve all three layers (tunica intima, tunica media and tunica adventitia), and are generally asymptomatic before rupture. The most common sign for the aortic aneuysm is the Erythema nodosum also known as leg lesions typically found near the ankle area. The prevalence of AAAs increases with age, with an average age of 65–70 at the time of diagnosis. AAAs have been attributed to atherosclerosis, though other factors are involved in their formation. An AAA may remain asymptomatic indefinitely. There is a large risk of rupture once the size has reached 5 cm, though some AAAs may swell to over 15 cm in diameter before rupturing. Before rupture, an AAA may present as a large, pulsatile mass above the umbilicus. A bruit may be heard from the turbulent flow in a severe atherosclerotic aneurysm or if thrombosis occurs. Unfortunately, however, rupture is usually the first hint of AAA. Once an aneurysm has ruptured, it presents with a classic pain-hypotension-mass triad. The pain is classically reported in the abdomen, back or flank. It is usually acute, severe and constant, and may radiate through the abdomen to the back. The diagnosis of an abdominal aortic aneurysm can be confirmed at the bedside by the use of ultrasound. Rupture could be indicated by the presence of free fluid in potential abdominal spaces, such as Morison's pouch, the splenorenal space (between the spleen and left kidney), subdiaphragmatic spaces (underneath the diaphragm) and peri-vesical spaces. A contrast-enhanced abdominal CT scan is needed for confirmation. Only 10–25% of patients survive rupture due to large pre- and post-operative mortality. Annual mortality from ruptured abdominal aneurysms in the United States alone is about 15,000. Another important complication of AAA is formation of a thrombus in the aneurysm.

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What Happens During an Erection?
In order to attain an erection, messages from the brain and other sense organs trigger the arteries of the penis to dilate. This allows an increased amount of blood to flow into three columns of spongy tissue in the penis.

As the arteries supplying blood to the corpus spongiosum and to the two larger columns, the corpus cavernosa, become filled with blood; the penis grows and becomes rigid. Pressure of the engorged tissue against the veins in the penis effectively traps blood within the penis until climax is reached or the sensation wanes.

What Are Penile Implants?
Impotence, or the inability to attain or maintain an erection, can be caused by a disruption at any stage in this process. Several types of penile implants are available that create an artificial erection. Two common types of implants are the semi-rigid malleable rod and the inflatable implant.

•The semirigid malleable rod is usually made of plastic with a core of flexible wire. These rods can be bent down to conceal the penis under clothing or raised to form an artificial erection.


•The inflatable implant is more complex and involves several working parts: a reservoir of fluid that is implanted into the abdomen, a pump system located in the scrotal sac near the testes, and two inflatable cylinders.
How Penile Implants Help Erectile Fuctioning
In order to attain an erection, the scrotal pump must be squeezed repeatedly to propel fluid into the penile cylinders. When an erection is no longer desired, a release valve is pressed on the side of the pump and the cylinders deflate.
Before Having Penile Implant Surgery
Persons considering these types of implants should speak with their physician or healthcare professional about possible risks and complications.

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Recommended range without diabetes is 70 to 130mg/dL. (The standard for measuring blood glucose is "mg/dL" which means milligrams per deciliter.) If your blood glucose level is above 130mg/dL, that's fasting hyperglycemia. Fasting hyperglycemia is a common diabetes complication.

Rhabdomyolysis is a condition in which damaged skeletal muscle (Ancient Greek: rhabdomyo-) tissue breaks down rapidly (Greek –lysis). This damage may be caused by physical (e.g. crush injury), chemical, or biological factors. Breakdown products of damaged muscle cells are released into the bloodstream; some of these, such as the protein myoglobin, are harmful to the kidney and may lead to kidney dysfunction. The severity of the symptoms (which may include muscle pains, vomiting and confusion) depends on the extent of the muscle damage, and whether kidney failure develops. The mainstay of treatment is generous intravenous fluids, but could include dialysis or hemofiltration.

Rhabdomyolysis and its complications are significant problems for those injured in disasters such as earthquakes and bombing. Relief efforts in areas struck by earthquakes often include medical teams with skills and equipment for treatment of survivors with rhabdomyolysis. The disease and its mechanisms were first fully elucidated during the Blitz of London in 1941.

A voice prosthesis (plural prostheses) is an artificial device, usually made of silicone that is used to help laryngectomized patients to speak. During a total laryngectomy, the entire voice box (larynx) is removed and the windpipe (trachea) and food pipe (esophagus) are separated from each other.

In this video, we show a sports hernia self treatment we give many of our clients. It is not the only part of treatment. Grabbing the skin around the region of the groin strain can reduce pain and stiffness with turning and twisting. Sports hernias are often misdiagnosed with hip labrum tears, hip impingement, adductor tendonitis and abdominal strains.

Option 1: Groin On-Demand Webinar https://bit.ly/37thtNF
Option 2: eBook Unveiling The Mystery Behind Groin Pain in Athletes https://www.p2sportscare.com/p....roduct/understanding
Option 2: Video Guide https://bit.ly/33aLIqC
Option 3 (the best): Work With Us https://www.p2sportscare.com/

Sports Hernia Diagnosis

What Is A Sports Hernia?

A sports hernia is tearing of the transversalis fascia of the lower abdominal or groin region. A common misconception is that a sports hernia is the same as a traditional hernia. The mechanism of injury is rapid twisting and change of direction within sports, such as football, basketball, soccer and hockey.

The term “sports hernia” is becoming mainstream with more professional athletes being diagnosed. The following are just to name a few:

Torii Hunter
Tom Brady
Ryan Getzlaf
Julio Jones
Jeremy Shockey
If you follow any of these professional athletes, they all seem to have the same thing in common: Lingering groin pain. If you play fantasy sports, this is a major headache since it seems so minor, but it can land a player on Injury Reserve on a moments notice. In real life, it is a very frustrating condition to say the least. It is hard to pin point, goes away with rest and comes back after activity, but is hardly painful enough to make you want to stop. It lingers and is always on your mind. And if you’re looking for my step-by-step sports hernia rehab video course here it is.

One the best definitions of Sport hernias is the following by Harmon:
The phenomena of chronic activity–related groin pain that it is unresponsive to conservative therapy and significantly improves with surgical repair.”

This is truly how sports hernias behave in a clinical setting. It is not uncommon for a sports hernia to be unrecognized for months and even years. Unlike your typical sports injury, most sports medicine offices have only seen a handful of cases. It’s just not on most doctors’ radar. The purpose of this article is not only to bring awareness about sports hernias, but also to educate.

Will you find quick fixes in this article for sports hernia rehab?
Nope. There is no quick fix for this condition, and if someone is trying to sell you one, they are blowing smoke up your you-know-what.

Is there a way to decrease the pain related to sports hernias?
Yes. Proper rehab and avoidance of activity for a certain period of time will assist greatly, but this will not always stop it from coming back. Pain is the first thing to go and last thing to come. Do not be fooled when you become pain-free by resting it. Pain is only one measure of improvement in your rehab. Strength, change of direction, balance and power (just to name a few) are important, since you obviously desire to play your sport again. If you wanted to be a couch potato, you would be feeling better in no time. Watching Sports Center doesn’t require any movement.

Why is this article so long?
There is a lot of information on sports hernias available to you on the web. However, much of the information is spread out all over the internet and hard for athletes to digest due to complicated terminology. This article lays out the foundational terminology you will need to understand what options you have with your injury. We will go over anatomy, biomechanics, rehab, surgery, and even the fun facts. The information I am using is from the last ten years of medical research, up until 2016. We will be making updates overtime when something new is found as well. So link to this page and share with friends. This is the best source for information on sports hernias you will find.

Common Names (or Aliases?) for Sports Hernias
Sportsman’s Hernia
Athletic Pubalgia
Gilmore’s Groin
How Do You Know If You Have A Sports Hernia?
Typical athlete characteristics:
Male, age mid-20s

#sportsherniadiagnosisselftreatment #sportshernia #california

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Causes are chronic inflammation due to infection, allergies, drug sensitivity, or immune disorders. Symptoms may include a runny nose, stuffiness, or post-nasal drip. In some cases, there may be no symptoms. The condition can be treated with corticosteroids, other medications, or surgery.

Is your vertigo or dizziness BPPV or autoimmune?

Welcome to the latest episode of HT Physio Quick Tips!

In this episode, Farnham's leading over-50's physiotherapist, Will Harlow, reveals the most common knee injuries that can be sustained from a fall. You'll learn the 5 most common knee injuries from falls, how to differentiate between them and the key signs to look for before getting help.

To register your interest for the upcoming Optimum Knee Health course and to be among the first to know when it is released, reach out to Will@ht-physio.co.uk

To get a copy of Will's new book, Thriving Beyond Fifty, you can find it on Amazon below:
UK link: https://amzn.to/3mAISFv
US link: https://amzn.to/43TE5Q8
(Amazon Affiliate links)

If you're suffering from nagging knee pain that hurts in the morning and stops you from walking as far as you'd like, you can take our free knee pain guide - which will give you 5 expert tips to put a stop to knee pain at home - by visiting here: https://ht-physio.co.uk/knee-pain-guide-download/

If you're over-50 with a painful problem in the Farnham, Surrey area, you can learn more about how Will Harlow and HT Physio can help you overcome a painful problem here: https://ht-physio.co.uk/

**Any information in this video should not be used as a substitute for individual medical advice. Please seek advice from your local healthcare professional before taking action on the information in this video.**

Craniectomy is neurosurgical procedure that involves removing a portion of the skull in order to relieve pressure on the underlying brain. This procedure is typically done in cases where a patient has experienced a very severe brain injury that involves significant amounts of bleeding around the brain or excessive swelling of the brain.

Male Foley Catheterization Technique

Fetal heart sound by sonique

Abdominal Aorta Palpation

Medical examination of the abdomen from Loyola University, Chicago

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