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http://www.highimpact.com - This brain surgery animation was used to demonstrate a young girl's craniotomy, cranioplasty, and reconstructive skull surgery after her vehicle was struck by a tractor-trailer. The procedures included the evacuation of a large epidural hematoma, the draining of the epidural space, and the reassembly of bone fragments to repair the skull.
More Brain Surgery Animations: https://tinyurl.com/y6m4lkdf
WHAT HAPPENED
A teenage girl was riding home with her parents and boyfriend from a Wednesday night church service when a tractor-trailer struck the back driver’s side of their car as they were traveling through an intersection. The impact sent the car spinning into oncoming traffic where it struck another vehicle. When paramedics arrived, the 17-year-old was unresponsive with bleeding from her left ear and a laceration from behind her left ear.
She was rushed to the hospital where she underwent a series of CT scans that showed a severely comminuted open skull fracture with an underlying 1.1 cm subdural hematoma. She was taken to the operating room where an emergency craniotomy was performed to evacuate the hematoma and reassemble the skull fragments. The patient gradually began to wake up and was discharged six days later, after she showed she could maneuver up and down the hallway.
The biggest challenge in a traumatic brain injury case like this - where most of the damages are deeply underlying and undetectable on the surface - is that the only visual evidence is in the form of 2D black-and-white radiographic films. This can look ambiguous to the typical juror because it’s often difficult to discern where these snapshots are located inside the person’s skull. Tony Seaton, Esq., and Robert Bates, Esq., needed to reinforce this 2D radiographic evidence with maximum 3D context.
We equipped them with a custom Diagnostic Slice Chooser: an interactive presentation that presents radiographic slides within a three-dimensional model of the patient’s head. We also designed the model accurately to the patient’s likeness and colorized the films to highlight key areas of damage. The attorneys could show the complete depth and magnitude of his client’s injuries at every level both before and after the surgery. After establishing the full extent of damages, we also created an animation to walk viewers through the surgical experience the patient would undergo as a result of her injuries.
The visual presentation helped jurors understand the destructive impact this collision had on this young teenager’s life, and Mr. Seaton and Mr. Bates, Esq., were able to acquire a $4.5M settlement for his client.
Read the Full Case Study: https://tinyurl.com/yy4v2dyh
Alzheimer's is the most common form of dementia, a general term for memory loss and other intellectual abilities serious enough to interfere with daily life. Alzheimer's disease accounts for 60 to 80 percent of dementia cases. Alzheimer's is not a normal part of aging, although the greatest known risk factor is increasing age, and the majority of people with Alzheimer's are 65 and older. But Alzheimer's is not just a disease of old age. Up to 5 percent of people with the disease have early onset Alzheimer's (also known as younger-onset), which often appears when someone is in their 40s or 50s.
A breech birth is the birth of a baby from a breech presentation. In the breech presentation the baby enters the birth canal with the buttocks or feet first as opposed to the normal head first presentation.
There are either three or four main categories of breech births, depending upon the source:
* Frank breech - the baby's bottom comes first, and his or her legs are flexed at the hip and extended at the knees (with feet near the ears). 65-70% of breech babies are in the frank breech position.
* Complete breech - the baby's hips and knees are flexed so that the baby is sitting crosslegged, with feet beside the bottom.
* Footling breech - one or both feet come first, with the bottom at a higher position. This is rare at term but relatively common with premature fetuses.
* Kneeling breech - the baby is in a kneeling position, with one or both legs extended at the hips and flexed at the knees. This is extremely rare, and is excluded from many classifications.
As in labour with a baby in a normal head-down position, uterine contractions typically occur at regular intervals and gradually cause the cervix to become thinner and to open. In the more common breech presentations, the baby’s bottom (rather than feet or knees) is what is first to descend through the maternal pelvis and emerge from the vagina.
At the beginning of labour, the baby is generally in an oblique position, facing either the right or left side of the mother's back. As the baby's bottom is the same size in the term baby as the baby's head. Descent is thus as for the presenting fetal head and delay in descent is a cardinal sign of possible problems with the delivery of the head.
In order to begin the birth, internal rotation needs to occur. This happens when the mother's pelvic floor muscles cause the baby to turn so that it can be born with one hip directly in front of the other. At this point the baby is facing one of the mother's inner thighs. Then, the shoulders follow the same path as the hips did. At this time the baby usually turns to face the mother's back. Next occurs external rotation, which is when the shoulders emerge as the baby’s head enters the maternal pelvis. The combination of maternal muscle tone and uterine contractions cause the baby’s head to flex, chin to chest. Then the back of the baby's head emerges and finally the face.
Due to the increased pressure during labour and birth, it is normal for the baby's leading hip to be bruised and genitalia to be swollen. Babies who assumed the frank breech position in utero may continue to hold their legs in this position for some days after birth.
The sinus is a hollow area in the back part of the mouth, when people lost thier teeth in this area, the bone will quickly resorbed, One way we can place implant into this area is by put graft materials in the sinus and hoped that the bone will take and allow us to place implant into the grafted bone. The grafting increases the time and the risk of successful implantation.
A c-section, or cesarean section, is the delivery of a baby through a surgical incision in the mother's abdomen and uterus. In some circumstances, a c-section is scheduled in advance. In others, the surgery is needed due to an unforeseen complication. If you or your baby is in imminent danger, you'll have an emergency c-section. Otherwise, it's called an unplanned section. According to the U.S. Centers for Disease Control, about 32 percent of American women who gave birth in 2015 had a cesarean delivery.
Possible complications include: Cardiovascular disease. ... Nerve damage (neuropathy). ... Kidney damage (nephropathy). ... Eye damage (retinopathy). ... Foot damage. ... Skin conditions. ... Hearing impairment. ... Alzheimer's disease.
Overbite is a type or malocclusion or an overjet. A lot of people don’t realize that they have an overbite, as they believe their condition is not serious enough to obtain dental attention. This could also for the reason that other cases of overbites are so minor to be noticeable. However, others have serious overbite condition that can make the person’s top jaw look much larger or the bottom jaw significantly smaller. But one thing to remember, overbite can actually cause some dental problems. This condition can change the structure of your face and affect the way you talk. The most popular form of overbite correction is orthodontic treatment. Your dentist will fix the overbite with the help of rubber bands and dental braces to pull the upper teeth back. Tooth extraction may be suggested if overcrowding complicates the overbite so as to provide room for your front teeth. In extreme conditions, overbite surgery may be needed to place your jaw backwards or forwards. Furthermore, if severe overbite is not corrected during adulthood, the teeth may continue to shift and trigger dental issues such as gum disease.
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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This video illustrates an IM injection for deltoid muscle.
Note that vaccines and other medications can be administered through the deltoid muscle. I will give you some tips through this video.
It is important to check your client’s details such as their medication, time, dose, and the route to be used. Different research works are subject to change the protocols for insertion thus, it is necessary to be up to date with the current changes.
Assemble all the supplies and conduct hand sanitation. Usually, I wear gloves before giving any injection in as much as the CDC may state it is optional unless the patient has an open lesion and contact of body fluids is likely to happen.
Use the acromion process landmark to locate the deltoid muscle. Move your fingers about two widths below the landmark. The patient’s adipose tissue determines the choice of needle length. Note that the needle gauge is determined by the type of medication you plan to give to the patient.
The Z-track technique is recommended rather than pinching the patient’s skin. Pull the patient’s skin to the side using one hand. Use a 90 degree angle to insert the needle to the patient’s skin. At the rate of 10 seconds per mL gently depress the plunger.
Remove the needle carefully and engage the safety precautions then dispose of the needle appropriately in the sharps container. Gauzing helps to cover the injection site.
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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?
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