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The procedure was performed under wrist block regional anesthesia with tourniquet control. A single Chinese finger trap was used on the thumb with 5 to 8 lb of ongitudinal traction. The arm was held down with wide tape around the tourniquet securing it to the hand table to serve as countertraction. A shoulder holder, rather than a traction tower, was used to facilitate fluoroscopic intervention more easily. The Trapeziometacarpal joint was detected by palpation. Joint distension was achieved by injecting 1 to 3 mL of normal saline (Fig. 1). It is important to distally direct the needle approximately 20 degrees to clear the dorsal flare of the metacarpal base and enter the joint capsule. This course should be reproduced upon entering with arthroscopic sleeve/ trocar assembly to minimize iatrogenic cartilage injury. Fluid distention is important to facilitate this. The incision for the 1-R (radial) portal, used for proper assessment of the dorsoradial ligament, posterior oblique ligament, and ulnar collateral ligament, was placed just volar to the abductor pollicis longus tendon. The incision for the 1-U (ulnar) portal, for better evaluation of the anterior oblique ligament and ulnar collateral ligament, was made just ulnar to the extensor pollicis brevis tendon. A short-barrel, 1.9-mm, 30- degree inclination arthroscope was used for complete visualization of the CMC joint surfaces, capsule, and ligaments, and then appropriate management was done, as dictated by the stage of the arthritis detected (Fig. 2A). A full-radius mechanical shaver with suction was used in all the cases, particularly for initial debridement and visualization. Most of the cases were augmented with radiofrequency ablation to perform a thorough synovectomy and radiofrequency was also used to perform chondroplasty in the cases with focal articular cartilage wear or fibrillation. Chondroplasty refers to thedebridement of the fibrillated cartilage to improve vascularity of the cartilage and enhance the growth of fibrocartilage. Ligamentous laxity and capsular attenu- ation were treated with thermal capsulorraphy using a radiofrequency shrinkage probe. We were careful to avoid thermal necrosis; hence, a striping technique was used to tighten the capsule of the lax joints. The striping technique refers to thermal shrinkage performed in longitudinal stripes on the lax capsule, so as to leave vascular zones between the stripes; hence, thermal necrosis is prevented. Arthroscopic stage I disease was characterized by synovitis without any cartilage wear, wherein a synovectomy coupled with thermal capsulor- raphy as described was performed.
How to Improve Sexual Health or Stamina part 4 All Solution of Male Disorder Male Infertility Diagnostic and Treatment Re-Slim Care Latest Technology in Pakistan Dr. Aslam Naveed is a well known sexologist in Pakistan. He has treated more than 1 Lac patients since last 30 years of clinical Practice in sexology, he knows how to help the people facing sexual disorders. Contact: 02134965050, 03432821919 www.sexologistpakistan.com https://www.facebook.com/menssexcareclinic/ https://youtu.be/_fRbtwWtLoE Part 1 https://youtu.be/S17bCnwCLuI Part 2 https://youtu.be/CPAXxkdz7mM Part 3 https://youtu.be/YlsdBZJ4prg Part 4 https://youtu.be/fylxbK4azvs Part 5 https://youtu.be/Zb8TcdgJ7Io Part 6 https://youtu.be/0wbDDNAwsmo Part 7 https://youtu.be/gHDmwfsMgTw Part 8 https://youtu.be/IasXoRKUlV4 Part 9 ADDRESS: Men’s Care Modern Hospital, Opposite, Safari Park, University Road, Karachi, Pakistan.
Flexible bronchoscopy is a procedure that allows a clinician to examine the breathing passages (airways) of the lungs (figure 1). Flexible bronchoscopy can be either a diagnostic procedure (to find out more about a possible problem) or a therapeutic procedure (to try to treat an existing problem or condition).
Sinus infections caused by viruses can use home (over-the-counter, OTC) treatments such as pain and fever medications (acetaminophen [Tylenol]), decongestants, and mucolytics. In addition, some health-care professionals suggest nasal irrigation or a sinus rinse solution to help relieve symptoms of sinus infections, even chronic sinusitis symptoms.
Duke Sports Medicine Specialists Jocelyn Wittstein, MD, Janna Fonseca, ATC, and Michael Messer ,PT, present on Soccer Injury Prevention including Concussion Management and the 11+ program that significantly reduces ACL tear rates in soccer.
Minimally Invasive Surgery (MIS) Hip Joint Replacement is an advancement in hip replacement that offers important advantages over standard surgical procedures. Stryker has partnered with surgeons worldwide to develop MIS procedures and surgical instruments that are designed to help your surgeons do their very best to help you recover your lifestyle. These techniques bring together a wide variety of hip implants, new minimally invasive surgical techniques, and new instrumentation. The direct anterior approach is one of the minimally invasive techniques used in hip replacement surgery. Continuing orthopaedic experience suggests that this procedure may offer several advantages over the more traditional surgical approaches to hip replacement.1 Traditional hip replacement techniques involve operating from the side (lateral) or the back (posterior) of the hip, which requires a significant disturbance of the joint and connecting tissues and an incision approximately 8-12 inches long. In comparison, the direct anterior approach requires an incision that is only 3-4 inches in length and located at the front of the hip.1 In this position, the surgeon does not need to detach any of the muscles or tendons.
This 25 year young female wanted her split earlobe hole to be repaired.Ear lobe ring hole usually elongated due to continuous use of fancy heavy ear rings.most young ladies suffer from this problem, subsequently this get converted to complete split ear lobe.This needs surgical repair only.This is a cosmetic repair .watch the video , how this repair is done.Usually the split is completely closed with suture.After healing new hole to be done little distance from the repair site.
How to approach histology for Human Anatomy students. Using a key will help get you through it! Add some penguin fairy dust will help too!
Please note: I mis-spoke and said "striated" instead of "stratified epithelium" a couple of times... apologies!
There are lots of histology keys out there, but the one I showed in the video is here: http://www.penguinprof.com/upl....oads/8/4/3/1/8431323
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Tissue in the human body:
Epithelial: Is made of cells arranged in a continuous sheet with one or more layers, has apical & basal surfaces.
A basement membrane is the attachment between the basal surface of the cell & the underlying connective tissue.
Two types of epithelial tissues: (1) Covering & lining epithelia and (2) Glandular Epithelium.
The number of cell layers & the shape of the cells in the top layer can classify epithelium.
Simple Epithelium - one cell layer
Stratified epithelium - two or more cell layers
Pseudostratified Columnar Epithelium - When cells of an epithelial tissue are all anchored to the basement Membrane but not all cells reach the apical surface.
Glandular Epithelium -- (1) Endocrine: Release hormones directly into the blood stream and (2) Exocrine - Secrete into ducts.
Connective: contains many different cell types including: fibroblasts, macrophages, mast cells, and adipocytes. Connective Tissue Matrix is made of two materials: ground substance - proteins and polysaccharides, fiber -- reticular, collagen and elastic.
Classification of Connective Tissue:
Loose Connective - fibers & many cell types in gelatinous matrix, found in skin, & surrounding blood vessels, nerves, and organs.
Dense Connective - Bundles of parallel collagen fibers& fibroblasts, found in tendons& ligaments.
Cartilage - Cartilage is made of collagen & elastin fibers embedded in a matrix glycoprotein & cells called chondrocytes, which was found in small spaces.
Cartilage has three subtypes:
Hyaline cartilage -- Weakest, most abundant type, Found at end of long bones, & structures like the ear and nose,
Elastic cartilage- maintains shape, branching elastic fibers distinguish it from hyaline and
Fibrous Cartilage - Strongest type, has dense collagen & little matrix, found in pelvis, skull & vertebral discs.
Muscle: is divided into 3 categories, skeletal, cardiac and smooth.
Skeletal Muscle -- voluntary, striated, striations perpendicular to the muscle fibers and it is mainly found attached to bones.
Cardiac Muscle -- involuntary, striated, branched and has intercalated discs
Smooth Muscle -- involuntary, nonstriated, spindle shaped and is found in blood vessels & the GI tract.
Nervous: Consists of only two cell types in the central nervous system (CNS) & peripheral nervous system (PNS):
Neurons - Cells that convert stimuli into electrical impulses to the brain, and Neuroglia -- supportive cells.
Neurons -- are made up of cell body, axon and dendrites. There are 3 types of neurons:
Motor Neuron -- carry impulses from CNS to muscles and glands,
Interneuron - interpret input from sensory neurons and end responses to motor neurons
Sensory Neuron -- receive information from environment and transmit to CNS.
Neuroglia -- is made up of astrocytes, oligodendrocytes, ependymal cells and microglia in the CNS, and schwann cells and satellite cells in the PNS.
Rheumatoid arthritis is a chronic inflammatory disorder that can affect more than just your joints. In some people, the condition also can damage a wide variety of body systems, including the skin, eyes, lungs, heart and blood vessels. An autoimmune disorder, rheumatoid arthritis occurs when your immune system mistakenly attacks your own body's tissues. Unlike the wear-and-tear damage of osteoarthritis, rheumatoid arthritis affects the lining of your joints, causing a painful swelling that can eventually result in bone erosion and joint deformity. The inflammation associated with rheumatoid arthritis is what can damage other parts of the body as well. While new types of medications have improved treatment options dramatically, severe rheumatoid arthritis can still cause physical disabilities.