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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.
Through the hormones it produces, the thyroid gland influences almost all of the metabolic processes in your body. Thyroid disorders can range from a small, harmless goiter (enlarged gland) that needs no treatment to life-threatening cancer. The most common thyroid problems involve abnormal production of thyroid hormones. Too much thyroid hormone results in a condition known as hyperthyroidism. Insufficient hormone production leads to hypothyroidism. Although the effects can be unpleasant or uncomfortable, most thyroid problems can be managed well if properly diagnosed and treated.
A thyroid biopsy is a procedure in which a small sample of tissue is removed from the thyroid gland and looked at under a microscope for cancer, infection, or other thyroid problems. The thyroid gland is found in front of the windpipe (trachea), just below the voice box (larynx). A sample of thyroid tissue can be taken by: Fine-needle biopsy. Your doctor puts a thin needle through the skin and into the thyroid gland. Many thyroid specialists like to use a needle biopsy method rather than surgery. Open biopsy. Your doctor makes a cut (incision) through the skin to see the thyroid gland. This method is done when other tests have not found the cause of your symptoms. Core needle biopsy. Your doctor inserts a needle with a special tip and removes a sample of tissue about the size of a grain of rice.
An unnamed Russian scientist has introduced the concept of a device that attaches to the wall of the artery. It would first stop blood flow to the area to prevent breakaway plaque. A drill would then scrape the plaque from the artery wall. The procedure of treating plaque buildup could include bypass surgery, stent replacement and balloon angioplasty. Since the plaques are of different types and locations in the body, the inventor proposed using different types of cutting mills.
Hepatitis B is a serious disease caused by a virus that attacks the liver. The virus, which is called hepatitis B virus (HBV), can cause lifelong infection, cirrhosis (scarring) of the liver, liver cancer, liver failure, and death. Hepatitis B vaccine is available for all age groups to prevent HBV infection.
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 .
What is the spleen and what causes an enlarged spleen (splenomegaly)? The spleen sits under your rib cage in the upper left part of your abdomen toward your back. It is an organ that is part of the lymph system and works as a drainage network that defends your body against infection. White blood cells produced in the spleen engulf bacteria, dead tissue, and foreign matter, removing them from the blood as blood passes through it. The spleen also maintains healthy red and white blood cells and platelets; platelets help your blood clot. The spleen filters blood, removing abnormal blood cells from the bloodstream. A spleen is normally about the size of your fist. A doctor usually can't feel it during an exam. But diseases can cause it to swell and become many times its normal size. Because the spleen is involved in many functions, many conditions may affect it.
How do you know if you have pneumonia? They may include: Cough. You will likely cough up mucus (sputum) from your lungs. ... Fever. Fast breathing and feeling short of breath. Shaking and "teeth-chattering" chills. Chest pain that often feels worse when you cough or breathe in. Fast heartbeat. Feeling very tired or very weak. Nausea and vomiting.
Assuming you haven't been diagnosed with Cushing's disease by your doctor, here are steps you can take to help lower high cortisol levels naturally: Switch to a Whole Foods, Anti-inflammatory Diet. Reduce and Manage Stress. Exercise Regularly. Use Adaptogen Herbs and Superfoods. Try Essential Oils to Promote Relaxation.
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.
This video: Patent ductus arteriosus (PDA) is a persistent opening between two major blood vessels leading from the heart. The opening, called the ductus arteriosus, is a normal part of a baby's circulatory system before birth that usually closes shortly after birth. If it remains open, however, it's called a patent ductus arteriosus. A small patent ductus arteriosus often doesn't cause problems and might never need treatment. However, a large patent ductus arteriosus left untreated can allow poorly oxygenated blood to flow in the wrong direction, weakening the heart muscle and causing heart failure and other complications. Treatment options for a patent ductus arteriosus include monitoring, medications and closure by cardiac catheterization or surgery.
Patellar tendon rupture is a rupture of the tendon that connects the patella to the tibia. The superior portion of the patellar tendon attaches on the posterior portion of the patella, and the posterior portion of the patella tendon attaches to the tibial tubercle on the front of the tibia.
This video: Rhomboid muscle strain and spasm causes upper back pain between the shoulder blades. Some patients describe the muscle spasms and discomfort as knots in the back. Early treatment is important to speed healing and recovery. Ice therapy for the first few days followed by moist heat can help relieve symptoms.Oct 12, 2015
The 12-lead ECG is a vital tool for EMT’s and paramedics in both the prehospital and hospital setting. It is extremely important to know the exact placement of each electrode on the patient. Incorrect placement can lead to a false diagnosis of infarction or negative changes on the ECG.
Urinary tract infections (UTIs) are infections of the urethra, bladder, ureters, or the kidneys, which comprise the urinary tract. E. coli bacteria cause the majority of UTIs, but many other bacteria, fungi, and parasites may also cause UTIs. Females have a higher risk for UTIs than most males, probably because of their anatomy; other risk factors for UTIs include any condition that may impede urine flow (e.g., enlarged prostate, kidney stones, congenital urinary tract abnormalities, and inflammation). Patients with catheters or those who undergo urinary surgery and men with enlarged prostates are at higher risk for UTIs.
What does the placenta do? The placenta is an organ that develops in your uterus during pregnancy. This structure provides oxygen and nutrients to your growing baby and removes waste products from your baby's blood. The placenta attaches to the wall of your uterus, and your baby's umbilical cord arises from it. In most pregnancies, the placenta attaches at the top or side of the uterus.
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.
The spleen, a spongy, soft organ about as big as a person’s fist, is located in the upper left part of the abdomen, just under the rib cage. The splenic artery brings blood to the spleen from the heart. Blood leaves the spleen through the splenic vein, which drains into a larger vein (the portal vein) that carries the blood to the liver. The spleen has a covering of fibrous tissue (the splenic capsule) that supports its blood vessels and lymphatic vessels. The spleen is made up of two basic types of tissue, each with different functions: White pulp Red pulp The white pulp is part of the infection-fighting (immune) system. It produces white blood cells called lymphocytes, which in turn produce antibodies (specialized proteins that protect against invasion by foreign substances). The red pulp filters the blood, removing unwanted material. The red pulp contains other white blood cells called phagocytes that ingest microorganisms, such as bacteria, fungi, and viruses. It also monitors red blood cells, destroying those that are abnormal or too old or damaged to function properly. In addition, the red pulp serves as a reservoir for different elements of the blood, especially white blood cells and platelets (cell-like particles involved in clotting). However, releasing these elements is a minor function of the red pulp.
It's a symptom of heart disease but typically does not cause permanent damage to the heart. It is, though, a sign that you are a candidate for a heart attack at some point in the future. The chest pain may spread to your arm, shoulder, jaw, or back. It may feel like a pressure or squeezing sensation.