Catheters can be placed in veins in the neck (internal jugular vein), chest (subclavian vein or axillary vein), groin (femoral vein), or through veins in the arms (also known as a PICC line, or peripherally inserted central catheters).

The examination room should be quiet, warm and well lit. After you have finished interviewing the patient, provide them with a gown (a.k.a. "Johnny") and leave the room (or draw a separating curtain) while they change. Instruct them to remove all of their clothing (except for briefs) and put on the gown so that the opening is in the rear. Occasionally, patient's will end up using them as ponchos, capes or in other creative ways. While this may make for a more attractive ensemble it will also, unfortunately, interfere with your ability to perform an examination! Prior to measuring vital signs, the patient should have had the opportunity to sit for approximately five minutes so that the values are not affected by the exertion required to walk to the exam room. All measurements are made while the patient is seated. Observation: Before diving in, take a minute or so to look at the patient in their entirety, making your observations, if possible, from an out-of-the way perch. Does the patient seem anxious, in pain, upset? What about their dress and hygiene? Remember, the exam begins as soon as you lay eyes on the patient. Temperature: This is generally obtained using an oral thermometer that provides a digital reading when the sensor is placed under the patient's tongue. As most exam rooms do not have thermometers, it is not necessary to repeat this measurement unless, of course, the recorded value seems discordant with the patient's clinical condition (e.g. they feel hot but reportedly have no fever or vice versa). Depending on the bias of a particular institution, temperature is measured in either Celcius or Farenheit, with a fever defined as greater than 38-38.5 C or 101-101.5 F. Rectal temperatures, which most closely reflect internal or core values, are approximately 1 degree F higher than those obtained orally. Respiratory Rate: Respirations are recorded as breaths per minute. They should be counted for at least 30 seconds as the total number of breaths in a 15 second period is rather small and any miscounting can result in rather large errors when multiplied by 4. Try to do this as surreptitiously as possible so that the patient does not consciously alter their rate of breathing. This can be done by observing the rise and fall of the patient's hospital gown while you appear to be taking their pulse. Normal is between 12 and 20. In general, this measurement offers no relevant information for the routine examination. However, particularly in the setting of cardio-pulmonary illness, it can be a very reliable marker of disease activity. Pulse: This can be measured at any place where there is a large artery (e.g. carotid, femoral, or simply by listening over the heart), though for the sake of convenience it is generally done by palpating the radial impulse. You may find it helpful to feel both radial arteries simultaneously, doubling the sensory input and helping to insure the accuracy of your measurements. Place the tips of your index and middle fingers just proximal to the patients wrist on the thumb side, orienting them so that they are both over the length of the vessel.

Idiopathic thrombocytopenic purpura (ITP) is a disorder that can lead to easy or excessive bruising and bleeding. The bleeding results from unusually low levels of platelets — the cells that help blood clot. Idiopathic thrombocytopenic purpura, which is also called immune thrombocytopenia, affects children and adults. Children often develop ITP after a viral infection and usually recover fully without treatment. In adults, the disorder is often long term. If you don't have signs of bleeding and your platelet count isn't too low, you may not need any treatment. In rare cases, the number of platelets may be so low that dangerous internal bleeding occurs. Treatment options are available.

For this surgery, your doctor makes a large incision in the abdomen to expose the aorta. Once he or she has opened the abdomen, a graft can be used to repair the aneurysm. Open repair remains the standard procedure for an abdominal aortic aneurysm repair. Endovascular aneurysm repair (EVAR).

The shoulder joint is formed where the humerus (upper arm bone) fits into the scapula (shoulder blade), like a ball and socket. Other important bones in the shoulder include: The acromion is a bony projection off the scapula. The clavicle (collarbone) meets the acromion in the acromioclavicular joint.

Renal artery stenosis is the narrowing of one or more arteries that carry blood to your kidneys (renal arteries). Narrowing of the arteries prevents normal amounts of oxygen-rich blood from reaching your kidneys. Your kidneys need adequate blood flow to help filter waste products and remove excess fluids. Reduced blood flow may increase blood pressure in your whole body (systemic blood pressure) and injure kidney tissue.

During the examination, the doctor gently puts a lubricated, gloved finger of one hand into the rectum. He or she may use the other hand to press on the lower belly or pelvic area. A digital rectal exam is done for men as part of a complete physical examination to check the prostate gland .

With inner ear disorders, your brain receives signals from the inner ear that aren't consistent with what your eyes and sensory nerves are receiving. Vertigo is what results as your brain works to sort out the confusion. These self-help acupressure points works with meridians to help the body regain normal healing and homeostasis.

The Epley Maneuver for Vertigo can be very effective at relieving vertigo symptoms, but it’s a procedure that should be performed by a physical therapist or other health care professional. This video is for demonstration purposes only. See Doctor Jo’s blog post about the Epley

A hernia occurs when an organ or fatty tissue squeezes through a weak spot in a surrounding muscle or connective tissue called fascia. The most common types of hernia are inguinal (inner groin), incisional (resulting from an incision), femoral (outer groin), umbilical (belly button), and hiatal (upper stomach).

Chronic angina is a prevalent manifestation of cardiovascular disease and is most commonly due to insufficient oxygen supply from fixed epicardial lesions in the coronary arteries.

A pheochromocytoma (fee-o-kroe-moe-sy-TOE-muh) is a rare, usually noncancerous (benign) tumor that develops in cells in the center of an adrenal gland. You have two adrenal glands, one above each kidney. Your adrenal glands produce hormones that give instructions to virtually every organ and tissue in your body. If you have a pheochromocytoma, an adrenal gland releases hormones that cause persistent or episodic high blood pressure. If left untreated, a pheochromocytoma can result in severe or life-threatening damage to other body systems, especially the cardiovascular system. Most people with a pheochromocytoma are between the ages of 20 and 50, but the tumor can develop at any age. Surgical treatment to remove a pheochromocytoma usually returns blood pressure to normal.

Hypertrophic cardiomyopathy (HCM) is very common and can affect people of any age. It affects men and women equally. It is a common cause of sudden cardiac arrest in young people, including young athletes. Hypertrophic cardiomyopathy occurs if heart muscle cells enlarge and cause the walls of the ventricles (usually the left ventricle) to thicken. The ventricle size often remains normal, but the thickening may block blood flow out of the ventricle. If this happens, the condition is called obstructive hypertrophic cardiomyopathy. Sometimes the septum, the wall that divides the left and right sides of the heart, thickens and bulges into the left ventricle. This can block blood flow out of the left ventricle. Then the ventricle must work hard to pump blood. Symptoms can include chest pain, dizziness, shortness of breath, or fainting. Hypertrophic cardiomyopathy also can affect the heart's mitral valve, causing blood to leak backward through the valve. Sometimes, the thickened heart muscle doesn't block blood flow out of the left ventricle. This is referred to as non-obstructive hypertrophic cardiomyopathy. The entire ventricle may thicken, or the thickening may happen only at the bottom of the heart. The right ventricle also may be affected. In both obstructive and non-obstructive HCM, the thickened muscle makes the inside of the left ventricle smaller, so it holds less blood. The walls of the ventricle may stiffen, and as a result, the ventricle is less able to relax and fill with blood.

What is peripheral neuropathy? Your peripheral nervous system connects the nerves from your brain and spinal cord, or central nervous system, to the rest of your body. This includes your: arms hands feet legs internal organs mouth face The job of these nerves is to deliver signals about physical sensations back to your brain.

Triglycerides are a type of fat (lipid) found in your blood. When you eat, your body converts any calories it doesn't need to use right away into triglycerides. The triglycerides are stored in your fat cells. Later, hormones release triglycerides for energy between meals. If you regularly eat more calories than you burn, particularly "easy" calories like carbohydrates and fats, you may have high triglycerides (hypertriglyceridemia).

Stapling is used to treat prolapsed hemorrhoids. A surgical staple fixes the prolapsed hemorrhoid back into place inside your rectum and cuts off the blood supply so that the tissue will shrink and be reabsorbed. Stapling recovery takes less time and is less painful than recovery from a hemorrhoidectomy.

A ventricular septal defect (VSD) is an opening or hole in the wall that separates the two lower chambers of the heart. This wall is called the ventricular septum. The hole causes oxygen-rich blood to leak from the left side of the heart to the right side. This causes extra work for the right side of the heart, since more blood than necessary is flowing through the right ventricle to the lungs. The hole is usually closed with surgery. However, in certain situations, your child's cardiologist and surgeon may think it is best to close the hole with a special device. This procedure is done in the heart catheterization lab.

Pelvic ureter. The ureter enters the pelvis, where it crosses anteriorly to the iliac vessels, which usually occurs at the bifurcation of the common iliac artery into the internal and external iliac arteries. Here, the ureters are within 5 cm of one another before they diverge laterally.

Your egg usually lives for just 12 to 24 hours, but sperm will live inside you for anything from a few hours to seven days, with one to three days the optimum time. ... But because a small number of sperm are long-living, having sex up to six days before ovulation can also result in pregnancy.

The lumps may be hard or rubbery and can appear as a single breast lump that may be large or small. Fibrocystic changes also can appear as thickening of the breast tissue. Fibrocystic changes can occur in one or both breasts and are the most common cause of benign breast lumps in women age 35 to 50.