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This is a diabetic foot ulcer. The patient reportedly went on vacation and noticed this ulcer upon their return. Debridement (removal of damaged tissue) to the level of healthy bleeding tissue is medically necessary as damaged tissue acts an impediment to wound healing. Due to their diabetic neuropathy, they did not feel any pain or indication that a wound was forming. This ulcer appeared to have penetrated to the level of subcutaneous tissue or even fascia, but turned out to be much deeper than that. These are serious wounds and are the beginnings of what lead to foot and leg amputations if they are not treated promptly by your healthcare provider, AKA Podiatrist.
Urinary incontinence isn't a disease, it's a symptom. It can be caused by everyday habits, underlying medical conditions or physical problems. A thorough evaluation by your doctor can help determine what's behind your incontinence. Temporary urinary incontinence Certain drinks, foods and medications can act as diuretics — stimulating your bladder and increasing your volume of urine. They include: Alcohol Caffeine Decaffeinated tea and coffee Carbonated drinks Artificial sweeteners Corn syrup Foods that are high in spice, sugar or acid, especially citrus fruits Heart and blood pressure medications, sedatives, and muscle relaxants Large doses of vitamins B or C Urinary incontinence also may be caused by an easily treatable medical condition, such as: Urinary tract infection. Infections can irritate your bladder, causing you to have strong urges to urinate, and sometimes incontinence. Other signs and symptoms of urinary tract infection include a burning sensation when you urinate and foul-smelling urine. Constipation. The rectum is located near the bladder and shares many of the same nerves. Hard, compacted stool in your rectum causes these nerves to be overactive and increase urinary frequency. Persistent urinary incontinence Urinary incontinence can also be a persistent condition caused by underlying physical problems or changes, including: Pregnancy. Hormonal changes and the increased weight of the uterus can lead to stress incontinence. Childbirth. Vaginal delivery can weaken muscles needed for bladder control and also damage bladder nerves and supportive tissue, leading to a dropped (prolapsed) pelvic floor. With prolapse, the bladder, uterus, rectum or small intestine can get pushed down from the usual position and protrude into the vagina. Such protrusions can be associated with incontinence. Changes with age. Aging of the bladder muscle can decrease the bladder's capacity to store urine. Menopause. After menopause women produce less estrogen, a hormone that helps keep the lining of the bladder and urethra healthy. Deterioration of these tissues can aggravate incontinence. Hysterectomy. In women, the bladder and uterus are supported by many of the same muscles and ligaments. Any surgery that involves a woman's reproductive system, including removal of the uterus, may damage the supporting pelvic floor muscles, which can lead to incontinence. Enlarged prostate. Especially in older men, incontinence often stems from enlargement of the prostate gland, a condition known as benign prostatic hyperplasia. Prostate cancer. In men, stress incontinence or urge incontinence can be associated with untreated prostate cancer. But more often, incontinence is a side effect of treatments for prostate cancer. Obstruction. A tumor anywhere along your urinary tract can block the normal flow of urine, leading to overflow incontinence. Urinary stones — hard, stone-like masses that form in the bladder — sometimes cause urine leakage. Neurological disorders. Multiple sclerosis, Parkinson's disease, stroke, a brain tumor or a spinal injury can interfere with nerve signals involved in bladder control, causing urinary incontinence.
This patient presented to the ER for umbilical pain and had a history of umbilical hernia. He was concerned about the possibility of incarceration of the hernia.
In this video we explain how the clinical exam helps to differentiate a simple painful hernia from an incarcerated one.
***Thanks to the patient for sharing his history and exam with YouTube world***
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
Vasectomy is a minor surgical procedure wherein the vasa deferentia of a man are severed, and then tied or sealed in a manner such to prevent sperm from entering the seminal stream (ejaculate). Typically done in an outpatient setting, a traditional vasectomy involves numbing (local anesthetic) of the scrotum after which 1 (or 2) small incisions are made, allowing a surgeon to gain access to the vas deferens.
Watch this clinical examination video to learn how to diagnose inguinal related groin pain.
This video clip is part of the FIFA Diploma in Football Medicine and the FIFA Medical Network. To enrol or to find our more click on the following link http://www.fifamedicalnetwork.com
The Diploma is a free online course designed to help clinicians learn how to diagnose and manage common football-related injuries and illnesses. There are a total of 42 modules created by football medicine experts. Visit a single page, complete individual modules or finish the entire course.
The network provides the opportunity for clinicians around the world to meet and share ideas relating to football medicine. Ask about an interesting case, debate current practice and discuss treatment strategies. Create a profile and log on to interact with other health professionals from around the globe.
This is not medical advice. The content is intended as educational content for health care professionals and students. If you are a patient, seek care of a health care professional.
Shoulder Clinical Examination - Medical School Clinical Skills - Dr Gill
Personally, I find the shoulder examination the most complex examination possibly as there are so many variations and special tests. Some of which overlap and some will relate specifically to a patients presentation.
Often in a medical school syllabus, only select special tests will be used. In this shoulder exam demonstration, we include the Hawkins-Kennedy Test looking for impingement. This is dovetailed with examination for bicipital tendonitis as this is another possible cause of impingement type symptoms.
This shoulder upper limb exam follows the standard "Look, Feel, Move" orthopaedic exam approach, and overall order as set out in MacLeods Clinical Examination
Watch further orthopaedic examinations for your OSCE revision:
The Spine Examination:
https://youtu.be/pJxMHa6SCgU
Knee Examination
https://youtu.be/oyKH4EYfJDM
Hip Joint Clinical Examination
https://youtu.be/JC9GKq5nSdQ
________
Please note that there is no ABSOLUTE way to perform a clinical examination. Different institutions and even clinicians will have differing degrees of variations - the aim is the effectively identify medically relevant signs.
However during OSCE assessments. Different medical schools, nursing colleges, and other health professional courses will have their own preferred approach to a clinical assessment - you should concentrate on THEIR marks schemes for your assessments.
The examination demonstrated here is derived from Macleods Clinical Examination - a recognized standard textbook for clinical skills.
#ShoulderExamination #ClinicalSkills #DrGill
Transurethral resection of the prostate (also known as TURP, plural TURPs and as a transurethral prostatic resection TUPR) is a urological operation. It is used to treat benign prostatic hyperplasia (BPH). As the name indicates, it is performed by visualising the prostate through the urethra and removing tissue by electrocautery or sharp dissection. This is considered the most effective treatment for BPH. This procedure is done with spinal or general anesthetic. A large triple lumen catheter is inserted through the urethra to irrigate and drain the bladder after the surgical procedure is complete. Outcome is considered excellent for 80-90% of BPH patients. Because of bleeding risks associated with the surgery, TURP is not considered safe for many patients with cardiac problems. As with all invasive procedures, the patient should first discuss medications they are taking with their doctor, most especially blood thinners or anticoagulants, such as warfarin (Coumadin), or aspirin. These may need to be discontinued prior to surgery. Postop complications include bleeding (most common), clotting and hyponatremia (due to bladder irrigation).
Additionally, transurethral resection of the prostate is associated with low but important morbidity and mortality.
Lesson on clinical examination of a scaphoid fracture and assessment of the anatomic snuffbox. The scaphoid bone is one of the carpal bones of the wrist. A scaphoid fracture is important to rule out due to risk of avascular necrosis, which is a compromise of bone vasculature leading to death of the bone. Scaphoid fractures can occur with a FOOSH injury. In this lesson, we discuss the clinical assessment to rule out a scaphoid fracture, including assessing and localizing the anatomic snuffbox.
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Check out some of my other lessons.
Medical Terminology - The Basics - Lesson 1:
https://www.youtube.com/watch?v=04Wh2E9oNug
Fatty Acid Synthesis Pathway:
https://www.youtube.com/watch?v=WuQS_LpNMzo
Wnt/B Catenin Signaling Pathway:
https://www.youtube.com/watch?v=NGVP4J9jpgs
Upper vs. Lower Motor Neuron Lesions:
https://www.youtube.com/watch?v=itNd74V53ng
Lesson on the Purine Synthesis and Salvage Pathway:
https://www.youtube.com/watch?v=e2KFVvI8Akk
Gastrulation | Formation of Germ Layers:
https://www.youtube.com/watch?v=d6Kkn0SECJ4
Introductory lesson on Autophagy (Macroautophagy):
https://www.youtube.com/watch?v=UmSVKzHc5yA
Infectious Disease Playlist
https://www.youtube.com/playli....st?list=PLRjNoiRtdFw
Dermatology Playlist
https://www.youtube.com/playli....st?list=PLRjNoiRtdFw
Pharmacology Playlist
https://www.youtube.com/playli....st?list=PLRjNoiRtdFw
Hematology Playlist
https://www.youtube.com/playli....st?list=PLRjNoiRtdFw
Rheumatology Playlist
https://www.youtube.com/playli....st?list=PLRjNoiRtdFw
Endocrinology Playlist
https://www.youtube.com/playli....st?list=PLRjNoiRtdFw
Nephrology Playlist
https://www.youtube.com/playli....st?list=PLRjNoiRtdFw
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**MEDICAL DISCLAIMER**: JJ Medicine does not provide medical advice, and the information available on this channel does not offer a diagnosis or advice regarding treatment. Information presented in these lessons is for educational purposes ONLY, and information presented here is not to be used as an alternative to a healthcare professional’s diagnosis and treatment of any person/animal.
Only a physician or other licensed healthcare professional are able to determine the requirement for medical assistance to be given to a patient. Please seek the advice of your physician or other licensed healthcare provider if you have any questions regarding a medical condition.
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*Although I try my best to present accurate information, there may be mistakes in this video. If you do see any mistakes with information in this lesson, please comment and let me know.*
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JJ
You may have heard that some positions, such as your partner on top (missionary position), are better than others for getting pregnant. In fact, there's no evidence to back these theories up. Experts just haven't done the research yet. What experts have done, though, is use scanning to show what's going on inside when you're doing the deed. The research looked at two positions: the missionary position and doggy style. (Doggy style being when you're on all fours, and your partner enters you from behind). Common sense tells us that these positions allow for deep penetration. This means that they're more likely to place sperm right next to your cervix (the opening of your uterus). The scans confirm that the tip of the penis reaches the areas between the cervix and vaginal walls in both of these positions. The missionary position allows the penis to reach the area at the front of the cervix. The rear entry position reaches the area at back of the cervix. It's amazing what some experts spend their time doing, isn't it! Other positions, such as standing up, or woman on top, may be just as good for getting sperm right next to the cervix. We just don't know yet. So, in the meantime, enjoy some variety in your sex life and keep it fun while you're trying for a baby. And talk to others who are hoping to get pregnant by joining our Actively trying group. Do I have to have an orgasm to conceive? Obviously, it's very important for your partner to reach orgasm if you are trying for a baby. There is no evidence, however, that you need to orgasm to conceive. The female orgasm is all about pleasure and satisfaction. It doesn't really help to get the sperm to the egg. Gentle contractions in your uterus can help the sperm along, but these happen without you having an orgasm. So, it's really not vital for you to reach orgasm after your partner, or even to reach orgasm at all, for you to conceive.