Porcelain gallbladder is a condition characterized by calcium salt deposits in the wall of a chronically inflamed gallbladder. The calcifications can be thin or faintly visible, or may be amorphous, patchy, and thick. The gallbladder is generally large, but its size can vary considerably. Most porcelain gallbladders are associated with gallstones. A plain radiograph generally detects these, but computed tomography (CT) has a higher specificity; therefore, a CT scan is performed to confirm the diagnosis. Due to their high risk of gallbladder carcinoma, all patients with porcelain gallbladder should have an elective cholecystectomy.

Neck Examination - Cervical Spine Assessment - Clinical Skills - Dr Gill

Compose a new pain within athletes is cervical spine discomfort, thankfully in the vast majority of cases when the neck is examined the cause of the neck pain is found to be muscular.

However, pain can also refer from the neck to the arm, in which case it is important to be able to assess for cervical radiculopathy prior to gaining more information which may indicate an MRI is needed

We assess for radiculopathy by doing Spurling's test, an often overlooked part of the neck examination, but it should be included for completeness and reassurance of the patient - not forgetting the athlete or not, neck pain can be a considerable source of distress, so it's vital to be able to get information from the neck examination which allows you to safely reassure a patient when appropriate, or comment that neck exam found evidence that needs further investigation

#DRGill #neck #asmr

Top 10 Shocking Before And After Drug Use Photos

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This video, created by Nucleus Medical Media, shows the function of white blood cells in normal immunity. It also portrays how the human immunodeficiency virus (HIV) affects the immune system and causes acquired immunodeficiency syndrome (AIDS). Common types of antiretroviral medications used to treat HIV and AIDS are also shown.

#HIV #AIDS #HumanImmunodeficiencyVirus
ANH13111

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This shows a full Abdominoplasty surgery performed by Dr. Art Foley in Olympia Washington. Abdominoplasty is also commonly referred to as a "Tummy Tuck." Tummy tuck is a surgical procedure also known as abdominoplasty to remove excess skin and fat from the middle and lower abdomen and to tighten the muscles of the abdominal wall. The procedure can dramatically reduce the appearance of a protruding abdomen. But bear in mind, it does produce a permanent scar.

Common causes of the knee pain
Knee pain is very common and in this video we will present the most common problems that can cause pain in the knee. (Patella) itself, which is in front of the knee, or from the tendons that are attached to the kneecap (patellar tendon and quadricep tendon). One of the most common problems is patellar chondromalacia which is chronic pain due to the softening of the cartilage beneath the kneecap. The cartilage of the kneecap will have some erosions, defects, or holes from mild to complete inside the joint (exactly in the back of the kneecap).
• Pain in the front of the knee
• Occurs more in young people
• Becomes worse from climbing up stairs and going downstairs
Treatment is usually nonsteroidal anti-inflammatory medication, physical therapy, and surgery is very rare. Also in front of the kneecap, the patient may get pain due to prepatellar bursitis.
When there is prepatellar bursitis, the patient will see that the swelling, the inflammation, and the pain is located over the front of the kneecap. The bursa becomes inflamed and fills with fluid at the top of the knee, causing pain, swelling, tenderness and a lump in that area on top of the kneecap. If the pain is in front of the knee but below or above the patella, this may indicate that the patient has tendonitis. Patellar tendonitis is an overuse condition that often occurs in athletes who perform repetitive jumping activities. Patellar tendonitis is a knee pain that is associated with focal patellar tendon tenderness and it is usually activity related. It is located below the kneecap and is called "jumper's knee". Patellar tendonitis affects approximately 20% of jumping athletes. There will be tenderness to palpation at the distal pole of the patella in extension and not in flexion. Quadriceps inflexibility, atrophy and hamstring tightness are predisposing factors for this condition. Treatment is rest, anti-inflammatory medication, stretching and strengthening of the hamstrings and quadriceps. Use an eccentric exercise program. The early stages of patellar tendonitis will respond well to nonoperative treatment. Another important cause of knee pain is a meniscal tear. The meniscus is the cushion that protects the cartilage in the knee. Injury will cause pain on the medial or the lateral side of the knee exactly at the level of the joint. The patient will complain of a history of locking, instability and swelling of the knee. McMurray test will be positive. A painful pop or click is obtained as the knee is brought from flexion to extension with either internal or external rotation of the knee. Arthritis of the knee Knee arthritis is very common. The cartilage cells die with age and its repair response decreases in the joint collapses with increased breakdown of the framework of the cartilage. The patient will have progressive blurring away of the cartilage of the joint with decreased joint space as seen on x-rays. Another source of pain is the Baker's cyst. The cyst is in the back of the knee between the semimembranosus yes and the medial gastrocnemius muscles. Another important source of knee pain is a ligament injury. Here is a normal knee without a ligament injury. Here you can see from the front, you can see the lateral and medial collateral ligament. You can see the ACL and PCL from the side view. These ligaments are usually injured as a result of a sports activity. Here is an example of a sports knee injury. Here is an example of the medial collateral ligament injury. This is the most commonly injury knee ligament injury to this ligament is on the inner part of the knee. Here is an example of an injury of the anterior cruciate ligament. It involves a valgus stress to the knee. Lachman test is usually positive, and MRI is diagnostic. Another important cause of knee pain is iliotibial band syndrome of the knee. Inflammation of the thickening of the iliotibial band results from excessive friction as the iliotibial band slides over the lateral femoral condyle. The iliotibial band is a thick band of fascia that extends along the lateral thigh from the iliac crest to the knee. And as the knee moves, the IT band was repeatedly shifted forwards and backwards across the lateral femoral condyle. The patient will complain of swelling, tenderness, and crepitus over the lateral femoral condyle. The condition occurs in the ITB S occurs in runners, cyclist and athletes that require repeated knee flexion and extension. The pain may be reproduced by doing a single-leg squat. The Ober's test is used to at assess tightness of the iliotibial band. MRI may show edema in the area of the ITB. Treatment is usually nonoperative with rest and ice, physical therapy, with stretching, proprioception, and improvement in neuromuscular coordination. Training modification and injections may be helpful. Surgery is a last resort. Surgical excision of the scarred inflamed part of the iliotibial band.

After miles and miles of use, a runner's legs take a beating. Running coach, John Henwood, explains the proper way to train so that runners can avoid painful knees.

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A surgeon creates an arteriovenous fistula by making a connection between an artery (which carries blood away from the heart) and a vein (which carries blood back to the heart). This artificial connection allows the vein to become larger and for the walls of the vein to thicken, a process termed maturation. A mature fistula makes it easier for the vein to be punctured repeatedly for dialysis. Maturation typically takes three to six months to occur, but in rare cases, can take up to a year. This makes advance planning for an arteriovenous fistula important. When a patient is felt to be approximately a year away from requiring dialysis, the patient should be referred for evaluation for possible creation of an arteriovenous fistula.

⁣Endovascular Coiling of Unruptured Ophthalmic Artery Aneurysm

the technique of insertion of a tube into the pericardial sac to remove fluid or blood, improving cardiac function

Baby Delivery

What Happens During an Erection?
In order to attain an erection, messages from the brain and other sense organs trigger the arteries of the penis to dilate. This allows an increased amount of blood to flow into three columns of spongy tissue in the penis.

As the arteries supplying blood to the corpus spongiosum and to the two larger columns, the corpus cavernosa, become filled with blood; the penis grows and becomes rigid. Pressure of the engorged tissue against the veins in the penis effectively traps blood within the penis until climax is reached or the sensation wanes.

What Are Penile Implants?
Impotence, or the inability to attain or maintain an erection, can be caused by a disruption at any stage in this process. Several types of penile implants are available that create an artificial erection. Two common types of implants are the semi-rigid malleable rod and the inflatable implant.

•The semirigid malleable rod is usually made of plastic with a core of flexible wire. These rods can be bent down to conceal the penis under clothing or raised to form an artificial erection.


•The inflatable implant is more complex and involves several working parts: a reservoir of fluid that is implanted into the abdomen, a pump system located in the scrotal sac near the testes, and two inflatable cylinders.
How Penile Implants Help Erectile Fuctioning
In order to attain an erection, the scrotal pump must be squeezed repeatedly to propel fluid into the penile cylinders. When an erection is no longer desired, a release valve is pressed on the side of the pump and the cylinders deflate.
Before Having Penile Implant Surgery
Persons considering these types of implants should speak with their physician or healthcare professional about possible risks and complications.

This video demonstrates a boatload of excellent teaching points on how to perform a peritoneal tap to remove ascites fluid from the peritoneum.

Neurological Examination

Going to the dentist is not a very fun experience for most. In fact, let's face it, most of us dread it.
http://www.dentistmaps.com/

Root canal is a treatment to repair and save a badly damaged or infected tooth instead of removing it. The term "root canal" comes from cleaning of the canals inside a tooth's root. Decades ago, root canal treatments often were painful. With dental advances and local anesthetics, most people have little if any pain with a root canal. In fact, it's probably more painful living with a decayed tooth. Root canal alternatives include extracting the damaged tooth and replacing it with a dental implant, bridge or removable partial denture.

Certain high-surgical-risk patients with severe degenerative mitral regurgitation (DMR) now have a minimally invasive treatment option. MitraClip® therapy is a minimally-invasive transcatheter mitral valve repair (TMVr) procedure that has been established as a proven option with demonstrated safety and clinically important improvements. Used in more than 25,000 patients worldwide, MitraClip® is a well-established therapy. The MitraClip® device received CE Mark approval in Europe in 2008 and U.S. FDA approval in 2013, and has been approved for commercial use in 50 countries throughout the world.

USMLE Step 2 CS - LOC This is just preview video. To get full access please visit our website : www.usmletutoring.com

A step by step approach to Hypokalaemia including causes, diagnosis and management.