Abdominal Physical Examination Lecture

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Please remember that this video is to be used for educational purposes. You must follow your facility or colleges' policies and procedure checklists to ensure you are completing the skill satisfactorily. Thanks for watching!

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A complete organized library of all my videos, digital slides, pics, & sample pathology reports is available here: https://kikoxp.com/posts/5084 (dermpath) & https://kikoxp.com/posts/5083 (bone/soft tissue sarcoma pathology)

Topics discussed:

Epidermis:
Layers of epidermis: 0:10
Melanocytes vs Keratinocytes: 5:16
Langerhans cells: 10:10 & 33:30 & 57:30

Dermis:
Papillary and reticular dermis: 11:50
Three types of white empty spaces on a slide: vessels, glands/ducts/cysts, or artifact: 15:25
Blood vessels & nerves: 18:24 & 48:50 & 58:59
Arrector pili & other dermal smooth muscle: 20:00

Adnexal:
Sebaceous gland: 21:10
Hair follicle 23:14
Eccrine sweat glands and ducts 24:45 & 50:00
Gland/duct vs blood vessel 27:20 & 48:50
Apocrine glands: this video https://kikoxp.com/posts/7837 (at 12:30)
Acrosyringium: this video https://kikoxp.com/posts/7837 (at 10:00)

Three types of pink bundles: smooth muscle, nerve, dense connective tissue: 27:50

Acral skin (palm sole) with contact dermatitis 29:37
Parakeratosis 30:00
Perivascular lymphocytes 30:40
Eosinophils vs neutrophils 31:20
Spongiosis with desmosome keratinocyte spines 32:10
Spongiotic vesicles with Langerhans cells 33:30
Normal acral skin (palm & sole) with stratum lucidum 34:20
Normal glomus body/apparatus (canal of Sucquet-Hoyer) 35:40
Nerve 36:46 & 51:50
Adipose tissue (white fat cells) in subcutis with Lochkern 37:55
Normal scalp skin with large anagen hair follicles: 39:30
Hair follicle anatomy (bulb/matrix, inner root sheath, outer root sheath, hair shaft, isthmus, infundibulum): 40:55 (labeled images):
https://kikoxp.com/posts/3661 & https://kikoxp.com/posts/7899
Pacinian corpuscle 50:40
Meissner corpuscle 1:02:28

Dense regular connective tissue (Fascia/Tendon/Ligament) vs Smooth Muscle 53:00

Basic Normal Skin Immunohistochemistry:
-cytokeratin in epidermis: 55:33
-S100 in melanocytes and Langerhans cells and adipocytes: 57:30
-Desmin in smooth muscle (arrector pili and blood vessels): 58:59
-CD31 in endothelial cells of blood vessels: 59:33
-SOX-10 in melanocytes: 1:00:40

Digit/Finger/Toe histology (amputation for subungual acral melanoma) 1:04:10 & 1:08:30
-bone 1:05:40
-glomus body 1:05:15
-tendon/ligament 1:06:10
-artery 1:06:58
-fingernail/toenail 1:08:54
-acrosyringium 1:10:45

Solar elastosis (what wrinkles look like microscopically!) 1:11:50

Other videos you might like:
Tendon vs Nerve Histology Made Simple with the Ramen Noodle Sign (of Fulton) video: https://kikoxp.com/posts/4466
Melanocytes vs Keratinocytes made easy video: https://kikoxp.com/posts/3802
Blood Vessel vs Gland vs Artifact Made Easy video: https://kikoxp.com/posts/4808

The basic normal structures of the skin discussed and described by a dermatopathologist. This material is intended for use by medical students, junior pathology or dermatology residents, or for anyone else studying normal human histology. Special thanks to two of my medical students at UAMS for helping make this video possible. Miki Lindsey convinced me that I really needed to sit down and record this video. Akash Patel took time to edit the video and make it ready for YouTube. My sincere thanks to both of them for helping me overcome procrastination.

Huge thanks to Abigail Cline, a medical student at Medical College of Georgia, for volunteering to type a transcript of this ENTIRE video (over 14,000 words!) so that I could provide closed caption subtitles for those with hearing impairments and for those who may need assistance in understanding spoken English (particularly given how quickly I speak!). You can access a text version of her transcript of my video here: https://kikoxp.com/posts/5390

Correction - I made a mistake in the video. I said that sebaceous gland secretions are turned into smelly substances by bacteria and that this makes body odor. That is incorrect. That is actually true of APOCRINE gland secretions not sebaceous secretions.

Also, in the past I used "keratinocyte" and "squamous cell" interchangeably (this is because in dermatopathology, we see and talk about squamous cell carcinomas all the time, and those tumors are composed of keratinocytes). But technically, in normal skin histology, "squamous cell" refers only to the flattened keratinocytes in the superficial epidermis. Thankfully, a histology PhD colleague pointed this out to me and corrected my lazy nomenclature!

Please check out my Soft Tissue Pathology & Dermatopathology survival guide textbooks: http://bit.ly/2Te2haB ‬

This video is geared towards medical students, pathology or dermatology residents, or practicing pathologists or dermatologists. Of course, this video is for educational purposes only and is not formal medical advice or consultation.

Presented by Jerad M. Gardner, MD. Please subscribe to my channel to be notified of new pathology teaching videos.

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The dentin is a hard tissue that forms the bulk of the tooth. It is similar to bone but is slightly harder, although softer than enamel. The dentin has numerous dentinal tubules that run across its length. Each dentinal tubule houses the cytoplasmic process of an odontoblast (odontoblastic process).
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📖Question Bank: https://www.hackdentistry.com/bundles/question-bank
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References and further reading:
💡Berkovitz BKB, Hollan GR, Moxham BJ. Oral Anatomy, Histology and Embryology. 4th ed. Mosby Elsevier; 2009.
💡Nanci A. Tencate’s Oral Histology. Development, Structure and Function. 8th ed. Elsevier; 2013.
💡Kumar GS. Orban’s Oral Histology and Embryology.13th ed. Elsevier; 2011.
💡Avery JK. Oral development and Histology. 3rd ed. Thieme Medical Publishers; 2002.

Log in to https://www.hackdentistry.com and get access to:
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Most babies will move into delivery position a few weeks prior to birth, with the head moving closer to the birth canal. When this fails to happen, the baby’s buttocks and/or feet will be positioned to be delivered first. This is referred to as “breech presentation.”

Dealing with Anxiety and Panic Attacks

A tummy tuck is a surgical process that removes excess fat and skin. Learn more about the procedure by watching this video!

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Un tummy tuck es un procedimiento quirúrgico que elimina el exceso de grasa y piel. ¡Aprenda más sobre este procedimiento viendo este video!

¿Quiere agendar una consulta? Llame a Zuri Plastic Surgery ahora al 786-804-1603 o envíenos un DM hoy para programar una consulta gratuita con el Dr. Z.

Symptoms Burning stomach pain Feeling of fullness, bloating or belching Fatty food intolerance Heartburn Nausea The most common peptic ulcer symptom is burning stomach pain. Stomach acid makes the pain worse, as does having an empty stomach. The pain can often be relieved by eating certain foods that buffer stomach acid or by taking an acid-reducing medication, but then it may come back. The pain may be worse between meals and at night. Nearly three-quarters of people with peptic ulcers don't have symptoms. Less often, ulcers may cause severe signs or symptoms such as: Vomiting or vomiting blood — which may appear red or black Dark blood in stools, or stools that are black or tarry Trouble breathing Feeling faint Nausea or vomiting Unexplained weight loss Appetite changes

A video describing the procedure of colonoscopy or flexible fibre-optic examination of the colon.

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Watch that IUD Female Birth Control Insertion Surgery

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.

Want more information? We have a more detailed free webinar on our page here. https://bit.ly/37thtNF

Want some treatment or suggestions of exercises or stretches? Contact us! We have in-person and virtual sessions.
Costa Mesa CA 715-502-4243 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
Common sports: soccer, hockey, tennis, football, field hockey
Motions involved: cutting, pivoting, kicking and sharp turns
Gradual onset

How A Sports Hernia Develops
Chronic groin pain typically happens over time, which is why with sports hernias, we do not hear many stories of feeling a “pop” or a specific moment of injury. It is the result of “overuse” mechanics stemming from a combination of inadequate strength and endurance, lack of dynamic control, movement pattern abnormalities, and discoordination of motion in the groin area.

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Rectal Examination

Big Butt Abscess Drainage

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.

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Guest: Dr. Vicente Santos Jr., Ophthalmologist/President - Fatima University Medical Center
Date Aired: August 14, 2015

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