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Heart sounds are the noises generated by the beating heart and the resultant flow of blood through it. Specifically, the sounds reflect the turbulence created when the heart valves snap shut. In cardiac auscultation, an examiner may use a stethoscope to listen for these unique and distinct sounds that provide important auditory data regarding the condition of the heart. In healthy adults, there are two normal heart sounds often described as a lub and a dub (or dup), that occur in sequence with each heartbeat. These are the first heart sound (S1) and second heart sound (S2), produced by the closing of the atrioventricular valves and semilunar valves, respectively. In addition to these normal sounds, a variety of other sounds may be present including heart murmurs, adventitious sounds, and gallop rhythms S3 and S4.
The examination consists of three portions: Inspection, Palpation, and Synthesis of data from these techniques In addition to palpating for size, also note the gland texture, mobility, tenderness and the presence of nodules. Inspection Inspection: Anterior Approach The patient should be seated or standing in a comfortable position with the neck in a neutral or slightly extended position. Cross-lighting increases shadows, improving the detection of masses. To enhance visualization of the thyroid, you can: Extending the neck, which stretches overlying tissues Have the patient swallow a sip of water, watching for the upward movement of the thyroid gland. quicktime video 251KB video demo from Return to the Bedside Inspection: Lateral Approach After completing anterior inspection of the thyroid, observe the neck from the side. Estimate the smooth, straight contour from the cricoid cartilage to the suprasternal notch. Measure any prominence beyond this imagined contour, using a ruler placed in the area of prominence. Palpation Note: There is no data comparing palpation using the anterior approach to the posterior approach so examiners should use the approach that they find most comfortable. Palpation: Anterior Approach placement of hands for palpatation of thyroid in anterior approach The patient is examined in the seated or standing position. Attempt to locate the thyroid isthmus by palpating between the cricoid cartilage and the suprasternal notch. Use one hand to slightly retract the sternocleidomastoid muscle while using the other to palpate the thyroid. Have the patient swallow a sip of water as you palpate, feeling for the upward movement of the thyroid gland. quicktime video 454KB video demo from Return to the Bedside. Palpation: Posterior Approach placement of hands for palpatation of thyroid in posterior approach The patient is examined in the seated or standing position. Standing behind the patient, attempt to locate the thyroid isthmus by palpating between the cricoid cartilage and the suprasternal notch. Move your hands laterally to try to feel under the sternocleidomstoids for the fullness of the thyroid. Have the patient swallow a sip of water as you palpate, feeling for the upward movement of the thyroid gland.
Visualization of the larynx by direct or indirect means is referred to as laryngoscopy and is the principal aim during airway management for passage of a tracheal tube. This paper presents a brief background regarding the development and practice of laryngoscopy and examines the equipment and techniques for both direct and indirect methods. Patient evaluation during the airway examination is discussed, as are predictors for difficult intubation. Laryngoscope blade design, newer intubating techniques, and a variety of indirect laryngoscopic technologies are reviewed, as is the learning curve for these techniques and devices.
The patient has spasticity in the lower extremities greater than the upper extremities. The hips and knees are flexed and adducted with the ankles extended and internally rotated. When the patient walks both lower extremities are circumducted and the upper extremities are held in a mid or low guard position. This type of gait is usually seen with bilateral periventricular lesions. The legs are more affected than the arms because the corticospinal tract axons that are going to the legs are closest to the ventricles.
-Rectocele is a relatively common condition in older women and is characterized by the displacement of the rectum through posterior vaginal wall defect(s). The condition is typically caused by damage to the rectovaginal septum incurred during vaginal childbirth and is exacerbated by periodic increases in intraabdominal pressure (e.g., when laughing or coughing) and the effects of gravity. Women with symptomatic rectoceles who are poor surgical candidates may be treated with pessaries, which are structures designed to support the vaginal wall. Pessaries should only be used in conjunction with vaginal
Emphysema gradually damages the air sacs (alveoli) in your lungs, making you progressively more short of breath. Emphysema is one of several diseases known collectively as chronic obstructive pulmonary disease Smoking is the leading cause of emphysema. Your lungs' alveoli are clustered like bunches of grapes. In emphysema, the inner walls of the air sacs weaken and eventually rupture — creating one larger air space instead of many small ones. This reduces the surface area of the lungs and, in turn, the amount of oxygen that reaches your bloodstream. When you exhale, the damaged alveoli don't work properly and old air becomes trapped, leaving no room for fresh, oxygen-rich air to enter. Treatment may slow the progression of emphysema, but it can't reverse the damage.
Coarctation of the aorta (CoA[1][2] or CoAo), also called aortic narrowing, is a congenital condition whereby the aorta is narrow, usually in the area where the ductus arteriosus (ligamentum arteriosum after regression) inserts. The word “coarctation” means narrowing. Coarctations are most common in the aortic arch. The arch may be small in babies with coarctations. Other heart defects may also occur when coarctation is present, typically occurring on the left side of the heart. When a patient has a coarctation, the left ventricle has to work harder. Since the aorta is narrowed, the left ventricle must generate a much higher pressure than normal in order to force enough blood through the aorta to deliver blood to the lower part of the body. If the narrowing is severe enough, the left ventricle may not be strong enough to push blood through the coarctation, thus resulting in lack of blood to the lower half of the body. Physiologically its complete form is manifested as interrupted aortic arch
Ankle and Foot Clinical Examination - Clinical Skills - Dr Gill
When it comes to joints of the body, the ankle is one of the joints most commonly injured. This is vitally important to be able to effectively examine a patient who is complaining of pain in the ankle and foot.
In this video we will perform a demonstration of the ankle and foot examination.
Examination of the foot, and the ankle joint, follows the standard orthopaedic approach of look, feel, move.
There is a connected video to the foot and ankle examination, on the causes of carpal tunnel syndrome - here
https://youtu.be/aXx6NfBWDSs
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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 Macleod's Clinical Examination - a recognized standard textbook for clinical skills.
#footpain #clinicalexamination #DrGill
We will show how to know if you have a sports hernia. These are a few tests you can do on your own. Lower abdominal pain and tightness that increases with twisting and kicking. Stretching and exercises tend to make the discomfort increase.
Want more info? We have a free webinar that covers hip, groin, adductor, lower abdominal strains and sports hernia diagnosis in detail. Use this link to get access. https://bit.ly/37thtNF
#sportshernia #hernia #hippain
To work with us, contact us using this link https://bit.ly/3zCBnzZ or call us 714-502-4243. We have online programs, virtual and in-person options.
Costa Mesa, CA www.p2sportscare.com
Option 1: Groin On-Demand Webinar https://bit.ly/37thtNF
Option 2: Video Guide https://bit.ly/33aLIqC
Option 3 (the best): Work With Us https://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.
How To Stop Hair Loss Naturally, Hair Regrowth Shampoo, Tips For Hair Regrowth, Hair Loss Stop--- http://how-to-regrow-your-hair.info-pro.co/ --- Natural Hair Regrowth Treatment, Looking for ideas on natural hair regrowth treatment? There are actually a lot of safe and effective natural methods that you can try in order to reverse hair loss. So what are those natural methods? Here are some of them: Eat your way to better hair: Hard to believe isn’t it? To think that what you’re actually eating can affect your hair in so many ways, positively and negatively. Want to slow down the process of hair loss and get your hair back to the healthy original state you always remembered it in? Then you might want to start transitioning over to a low fat high fiber diet. Aside from this, you’ll also want to concentrate on foods that contain biotins, which play an essential role in maintaining healthy hair. Fish, cooked eggs, whole milk, and various nuts and fruits – all of these are good sources of biotins so it’s best that you take note of them. Drink plenty of water: It’s not only that gets thirsty, as even your hair requires the moisture that water provides. Dehydration can lead to symptoms like constipation, eczema, thick dandruff, wrinkly skin, foul breath and hair loss. Remember that your body is made up of 98% water and you need to maintain it at optimum levels if you want to keep your hair in place. An easy way to quickly replenish and establish enough water in your body is to routinely drink at least 8 ounces of water immediately after you urinate. You’ll know you’re getting enough water when you observe that you are urinating more frequently. Supplements: The fact that you are experiencing hair loss is a surefire indication that something is amiss in the nutrition department. If you are however looking for a definitive guide on the products that will be available, one useful source you can use will be found at http://how-to-regrow-your-hair.info-pro.co/
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.
The jaw thrust is a method of opening the airway of a patient. The airway is very important in first aid! It consists of the structures in the back of the throat and upper neck. A patient who is unconscious is not able to maintain their own airway as it can become blocked by the tongue (see picture). Normally, first aid courses teach the head tilt – chin lift technique to open an airway. However, this airway manoeuvre involves significant movement of the patient’s neck. Therefore if there is any suspicion of a spinal (neck) injury it may cause further damage.
it's a 8 years old boy with previous medical history of Sickle cell disease presented with gall stone and repeat abdominal pain. A laparoscopic cholecystectomy is performed. The cystic duct is controlled with 2 stiches of absorbable suture. The cystic artery is simply cauterized with the hook cauter...y. the specimen is removed through the umbilical port using an 10mm endobag.