In this video, Dr. Robert Rozbruch, chief of Limb Lengthening and Complex Reconstruction at Hospital for Special Surgery performs an osseointegration after a primary amputation. The patient, a 40 year old woman, had chronic nerve pain and compromised function of her residual limb.

For more information, visit: https://www.limblengthening.com/

https://www.hss.edu/limblengthening
https://www.hss.edu/LSARC
https://www.facebook.com/limblengtheningNYC
https://www.instagram.com/limblengthening
https://www.twitter.com/limblengthen
https://www.youtube.com/channe....l/UC-JL_X6ALjZXiXtcP

key words: Osseointegration, Amputee, Amputation, Limb Replacement, Tibia, Osseointegration

Multiple strains put your children and teens at risk of meningococcal meningitis. How-to ensure they are fully protected.

Breast Massage Technique For Good Breast Health

Dr. Debbie Song at Gillette Children's describes in detail selective rhizotomy surgery.

A selective dorsal rhizotomy is an operation performed to treat spasticity. It is thought that high tone and spasticity arise from abnormal signals that are transmitted through sensory or dorsal nerve roots to the spinal cord. In a selective dorsal rhizotomy we identify and cut portions of the dorsal nerve roots that carry abnormal signals thereby disrupting the mechanisms that lead to spasticity. Potential patients go through a rigorous assessment that includes an in-depth gait and motion analysis as well as a physical therapy evaluation.

They are evaluated by a multidisciplinary team that includes a pediatric rehabilitation doctor, a neurosurgeon, and an orthopedist, Appropriate patient selection is vital. Ideal candidates for selective dorsal rhizotomy are children who are between four and ten years of age, have a history of being born prematurely, and have a diagnosis of diplegia cerebral palsy. These patients usually walk independently or with the assistance of crutches or a walker. They typically function at a level one, two, or three in the gross motor function classification system or gmfcs. A selective dorsal rhizotomy involves the coordinated efforts of the neurosurgery, physiatry, anesthesia and nursing teams. The operation entails making an incision in the lower back that is approximately six to eight inches long. We perform what we call a laminoplasty in which we remove the back part of the spinal elements from the lumbar one or l1 to l5 levels. At the end of the procedure the bone is put back on. We identify and open up the Dural sac that contain the spinal fluid spinal cord and nerve roots. Once the Dural sac is opened ,we expose the lumbar and upper sacral nerve roots that transmit information to and from the muscles of the lower extremities.

At each level we isolate the dorsal nerve root, which in turn is separated into as many as 30 smaller thread light fruitlets.

Each rootlet is then electrically stimulated. Specialized members of the physiatry team look for abnormal responses in the muscles of the legs as each rootless is being stimulated. If an abnormal response is observed then the rootlet is cut.

If a normal response is observed, then the rootlet is not cut. We usually end up cutting approximately 20 to 40 percent of the rootlets. The Dural sac is sutured closed and the l1 through l5 spinal elements are put back into anatomic position, thus restoring normal spinal alignment. The overlying tissues and skin are then closed and the patient is awoken from surgery. The entire operation takes between four and five hours. A crucial component to the success of our rhizotomy program is the extensive rehabilitation course following surgery. With their tone significantly reduced after a rhizotomy, patients relearn how to use their muscles to walk more efficiently through stretching, strengthening, and gait training. Approximately one to two years after a rhizotomy patients undergo repeat gait and motion analysis. The orthopedic surgeons assess the need for interventions to correct bone deformities, muscle contractures, poor motor control, impaired balance, or other problems related to cerebral palsy.

At Gillette we work closely with patients and families to ensure that our selective dorsal rhizotomy program meets their goals for enhancing their function and improving their quality of life.

VISIT https://www.gillettechildrens.org/ to learn more

0:00 Why choose selective dorsal rhizotomy?
0:56 Who is a good candidate for selective dorsal rhizotomy?
1:31 What does a selective dorsal rhizotomy entail?
3:26 What is recovery from selective dorsal rhizotomy like?

Detailed examination of the joints is usually not included in the routine medical examination. However, joint related complaints are rather common, and understanding anatomy and physiology of both normal function and pathologic conditions is critically important when evaluating the symptomatic patient. By gaining an appreciation for the basic structures and functioning of the joint, you'll be able to "logic" your way thru the exam, even if you can't remember the eponym attached to each specific test!

Resection of sigmoid colostomy prolapse

Ellis demonstrates how to perform a sterile wound dressing change. It would be appropriate to perform hand hygiene between glove changes.

Our Critical Nursing Skills video tutorial series is taught by Ellis Parker MSN, RN-BC, CNE, CHS and intended to help RN and PN nursing students study for your nursing school exams, including the ATI, HESI and NCLEX.

#NCLEX #ClinicalSkills #woundcare #HESI #Kaplan #ATI #NursingSchool #NursingStudent⁠ #Nurse #RN #PN #Education #LVN #LPN #nurseeducator

00:00 What to expect
00:51 Prepping for wound dressing change
1:15 Removing the old wound dressing
1:40 Assessing a wound
2:05 Setting up sterile field
2:49 Sterile gloving
4:02 Preparing equipment for wound dressing change
5:09 Cleaning a wound
6:13 Drying a wound
6:28 Packing a wound
7:19 Covering a wound
7:47 Labeling a wound dressing

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A video showing the examination of femoral hernia.

a video of abdominal physical examination including all the required items:
-Inspection
-Palpation
-Percussion
-Auscultation

Funny Video from hospital waiting room

Here's how female-to-male gender reassignment surgery works.

A patient suffering from Diabetic gangrene and maneged by "myiasis"

Watch that video of Virginity Hymen Repair Plastic Surgery

Watch that video of Male Catheter Insertion Procedure

Breast Exam Demonstration

exam

If you could stand in someone else's shoes...Hear what they hear See what they see Feel what they fell Would you treat them differently?

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).

A video showing clinical examination of the thyroid gland

To record the sequence, Stephan Gordts and Ivo Brosens of the Leuven Institute for Fertility & Embryology in Belgium performed transvaginal laparoscopy, which involves making a small cut in the vaginal wall and observing the ovary with an endoscope.

"This allows us direct access to and observation of the tubo-ovarian structures without manipulation using forceps," says Gordts.

For the photos of ovulation, which only accidentally captured the critical moment, Jacques Donnez at the Catholic University of Louvain (UCL) in Brussels, Belgium, used gas to distend the organs for photography. However, Gordts and Brosens planned the procedure to coincide with ovulation and used saline solution to "float" the structures.
Perfect timing

Observation was timed for the day of the peak of the patient's luteal hormone cycle. Ovulation was predicted to occur on the evening of the day of the LH peak, and the endoscope introduced at 6 pm.

A small amount of saline was used to float the opening of the fallopian tube, its fimbriae (the "fingers" that sweep the egg into the tube) and the ovary itself. This gives a more natural appearance than gas, says Gordts.

In the video, the fimbriae can be seen sweeping in time with the patient's heartbeat. A mucus plug can be seen protruding from the ovary – this contains the egg.

"The ovum is not captured 'naked'," says Gordts. "There is no eruption like a volcano."

Gordts says that in clinical practice it is not easy to organise the observation of ovulation. "We were probably lucky to be successful at our first attempt," he says.