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The most reliable clinical sign to detect ascites is checking for bilateral flank dullness. If a patient with ascites is lying supine, fluid accumulates in the flank regions, leading to dullness on percussion. At the same time, the air-filled bowel loops are forced upwards by the free fluid due to buoyancy, resulting in tympanitic percussion. To locate specifically where dullness shifts to tympany, or the air-fluid level, percussion should be performed from the sides towards the middle. To confirm that the dullness is caused by ascites, ask the patient to switch to a lateral decubitus position. If ascites is present, the air-filled bowel loops will shift accordingly and remain at the surface of the fluid. As a result, the air-fluid level will shift as well. This is known as shifting dullness.
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Transgender Man Gives Birth to Healthy Baby, Talks Navigating Pregnancy as a Man Trystan Reese is a transgender man who just gave birth to a healthy baby boy. He told us about his pregnancy—and why his story isn't so out of the ordinary.
A VCUG (Voiding Cystourethrogram) is a test that looks at how well your child's kidneys, ureters and bladder are working. Your child's kidneys make urine. The urine flows from the kidneys through thin tubes (called ureters) into your child's bladder.
Sex reassignment surgery for male-to-female involves reshaping the male genitals into a form with the appearance of, and, as far as possible, the function of female genitalia. Prior to any surgeries, patients usually undergo hormone replacement therapy (HRT), and, depending on the age at which HRT begins, facial hair removal. There are associated surgeries patients may elect to, including facial feminization surgery, breast augmentation, and various other procedures.
This medical animation shows laparoscopically assisted gallbladder removal surgery, or cholecystectomy. The animation begins by showing the normal anatomy of the liver and gallbladder. Over time, gallstones form within the gallbladder, blocking the cystic duct, and causing the gallbladder to become enlarged and inflamed. The procedure, sometimes called a "lap-chole", begins with the insertion of four trocar devices, which allow the physician to see inside the abdomen without making a large incision. Air is added to the abdominal cavity to make it easier to see the gall bladder. Next, we see a view through the laparascope, showing two surgical instruments grasping the gallbladder while a third severs the cystic duct. After the gallbladder is removed, the camera pans around to show that the cystic artery and vein, have already been clipped to prevent bleeding.
Item #ANIM026
Majority of patients these days prefer PCNL ( Minimal Invasive Telescopic removal of kidney stones broken with lithoclast, removed through a button hole incision ). This patient with a big stone in the pelvis of the kidney wanted it open only so I did an open pyelolithotomy for this patient after a long time as I use to do it in routine in the past. Except for the long incision and scar as compared to PCNL the recovery time was the same and patient went home third day happily walking and eating.
Pelvic examinations during labor are used for several purposes, among them assessment of cervical dilatation, effacement, station of the presenting part, presentation, position, and pelvic capacity.Instruction in these techniques is particularly important for those health care providers involved in labor management, including physicians, nurses, midwives, paramedics and EMT personnel.
Hysteroscopy is a procedure that allows your doctor to look inside your uterus in order to diagnose and treat causes of abnormal bleeding. Hysteroscopy is done using a hysteroscope, a thin, lighted tube that is inserted into the vagina to examine the cervix and inside of the uterus.
ACL tears are treatable using arthroscopy and minimally-invasive surgical techniques. The surgical success rates for ACL reconstruction exceed 95%. The anterior cruciate ligament is one of the major supportive ligaments in the knee
Identify the anatomy and explain the physiology of the scrotum on diagrams and sonograms.
Describe and demonstrate the protocol for sonographic scanning of the scrotum.
Identify and describe sonographic images of congenital abnormalities of the scrotum.
Identify and describe sonographic images of pathologies of the scrotum.
Identify and describe sonographic images of extratesticular disease processes.
Identify the anatomy and explain the physiology of the prostate on diagrams and sonograms.
Describe and demonstrate the protocol for transabdominal and endorectal sonographic scanning of the prostate.
Identify and describe sonographic images of benign and malignant pathologies of the prostate, including benign hyperplasia, prostatitis, carcinoma, and calculi.
Explain the technique for prostate biopsy.
Define the criteria for an ultrasound appearance of prostate tumor staging.
Explain the technique for radiation seed implantation.
Explain the Patient Privacy Rule (HIPAA) and Patient Safety Act (see reference).
This video is brought to you by the Stanford Medicine 25 to teach you the common causes of shoulder pain and how to diagnose them by the physical exam.
The Stanford Medicine 25 program for bedside medicine at the Stanford School of Medicine aims to promote the culture of bedside medicine to make current and future clinicians and other healthcare provides better at the art of physical diagnosis and more confident at the bedside of their patients.
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Diagnoses covered in this video:
Rotator Cuff Pathology
Impingement Syndrome
Biceps Tendinopathy
Adhesive Capsulitis (Frozen Shoulder)
Acromioclavicular (AC) Joint Disease
Shoulder Instability
Labral Tears (SLAP Lesions)