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Identify the anatomy and explain the physiology of the breast on diagrams and sonograms.
Describe and demonstrate the protocol for sonographic scanning of the breast, including the clock and quadrant methods, and targeted examinations based on mammographic findings.
Describe the various diagnostic pathways that may lead to a sonographic breast examination, and explain how the ultrasound findings are correlated with other imaging modalities.
Identify and describe sonographic images of benign and malignant features and common breast pathologies.
Explain biopsy techniques for breast tumors.
Define and use related medical terminology.
Explain the Patient Privacy Rule (HIPAA) and Patient Safety Act (see reference
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.
What Is an Appendectomy? An appendectomy is the surgical removal of the appendix. It’s a common emergency surgery that’s performed to treat appendicitis, an inflammatory condition of the appendix. The appendix is a small, tube-shaped pouch attached to your large intestine. It’s located in the lower right side of your abdomen. The exact purpose of the appendix isn’t known. However, it’s believed that it may help us recover from diarrhea, inflammation, and infections of the small and large intestines. These may sound like important functions, but the body can still function properly without an appendix. When the appendix becomes inflamed and swollen, bacteria can quickly multiply inside the organ and lead to the formation of pus. This buildup of bacteria and pus can cause pain around the belly button that spreads to the lower right section of the abdomen. Walking or coughing can make the pain worse. You may also experience nausea, vomiting, and diarrhea. It’s important to seek treatment right away if you’re having symptoms of appendicitis. When the condition goes untreated, the appendix can burst (perforated appendix) and release bacteria and other harmful substances into the abdominal cavity. This can be life-threatening, and will lead to a longer hospital stay. Appendectomy is the standard treatment for appendicitis. It’s crucial to remove the appendix right away, before the appendix can rupture. Once an appendectomy is performed, most people recover quickly and without complications. Why Is an Appendectomy Performed? An appendectomy is often done to remove the appendix when an infection has made it inflamed and swollen. This condition is known as appendicitis. The infection may occur when the opening of the appendix becomes clogged with bacteria and stool. This causes your appendix to become swollen and inflamed. The easiest and quickest way to treat appendicitis is to remove the appendix. Your appendix could burst if appendicitis isn’t treated immediately and effectively. If the appendix ruptures, the bacteria and fecal particles within the organ can spread into your abdomen. This may lead to a serious infection called peritonitis. You can also develop an abscess if your appendix ruptures. Both are life-threatening situations that require immediate surgery. Symptoms of appendicitis include: stomach pain that starts suddenly near the belly button and spreads to the lower right side of the abdomen abdominal swelling rigid abdominal muscles constipation or diarrhea nausea vomiting loss of appetite low-grade fever Although pain from appendicitis typically occurs in the lower right side of the abdomen, pregnant women may have pain in the upper right side of the abdomen. This is because the appendix is higher during pregnancy. Go to the emergency room immediately if you believe you have appendicitis. An appendectomy needs to be performed right away to prevent complications. What Are the Risks of an Appendectomy? An appendectomy is a fairly simple and common procedure. However, there are some risks associated with the surgery, including: bleeding infection injury to nearby organs blocked bowels It’s important to note that the risks of an appendectomy are much less severe than the risks associated with untreated appendicitis. An appendectomy needs to be done immediately to prevent abscesses and peritonitis from developing. How Do I Prepare for an Appendectomy? You’ll need to avoid eating and drinking for at least eight hours before the appendectomy. It’s also important to tell your doctor about any prescription or over-the-counter medications you’re taking. Your doctor will tell you how they should be used before and after the procedure. You should also tell your doctor if you: are pregnant or believe you may be pregnant are allergic or sensitive to latex or certain medications, such as anesthesia have a history of bleeding disorders You should also arrange for a family member or friend to drive you home after the procedure. An appendectomy is often performed using general anesthesia, which can make you drowsy and unable to drive for several hours after surgery. Once you’re at the hospital, your doctor will ask you about your medical history and perform a physical examination. During the exam, your doctor will gently push against your abdomen to pinpoint the source of your abdominal pain. Your doctor may order blood tests and imaging tests if appendicitis is caught early. However, these tests may not be performed if your doctor believes an emergency appendectomy is necessary. Before the appendectomy, you’ll be hooked up to an IV so you can receive fluids and medication. You’ll likely be put under general anesthesia, which means you’ll be asleep during surgery. In some cases, you’ll be given local anesthesia instead. A local anesthetic numbs the area, so even though you’ll be awake during the surgery, you won’t feel any pain. How Is an Appendectomy Performed? There are two types of appendectomy: open and laparoscopic. The type of surgery your doctor chooses depends on several factors, including the severity of your appendicitis and your medical history. Open Appendectomy During an open appendectomy, a surgeon makes one incision in the lower right side of your abdomen. Your appendix is removed and the wound is closed with stiches. This procedure allows your doctor to clean the abdominal cavity if your appendix has burst. Your doctor may choose an open appendectomy if your appendix has ruptured and the infection has spread to other organs. It’s also the preferred option for people who have had abdominal surgery in the past. Laparoscopic Appendectomy During a laparoscopic appendectomy, a surgeon accesses the appendix through a few small incisions in your abdomen. A small, narrow tube called a cannula will then be inserted. The cannula is used to inflate your abdomen with carbon dioxide gas. This gas allows the surgeon to see your appendix more clearly. Once the abdomen is inflated, an instrument called a laparoscope will be inserted through the incision. The laparoscope is a long, thin tube with a high-intensity light and a high-resolution camera at the front. The camera will display the images on a screen, allowing the surgeon to see inside your abdomen and guide the instruments. When the appendix is found, it will be tied off with stiches and removed. The small incisions are then cleaned, closed, and dressed. Laparoscopic surgery is usually the best option for older adults and people who are overweight. It has fewer risks than an open appendectomy procedure, and generally has a shorter recovery time. What Happens After an Appendectomy? When the appendectomy is over, you’ll be observed for several hours before you’re released from the hospital. Your vital signs, such your breathing and heart rate, will be monitored closely. Hospital staff will also check for any adverse reactions to the anesthesia or the procedure. The timing of your release will depend on: your overall physical condition the type of appendectomy performed your body’s reaction to the surgery In some cases, you may have to remain in the hospital overnight. You may be able to go home the same day as the surgery if your appendicitis wasn’t severe. A family member or friend will need to drive you home if you received general anesthesia. The effects of general anesthesia usually take several hours to wear off, so it can be unsafe to drive after the procedure. In the days following the appendectomy, you may feel moderate pain in the areas where incisions were made. Any pain or discomfort should improve within a few days. Your doctor may prescribe medication to relieve the pain. They might also prescribe antibiotics to prevent an infection after surgery. You can further reduce your risk for infection by keeping the incisions clean. You should also watch for signs of infection, which include: redness and swelling around the incision fever above 101°F chills vomiting loss of appetite stomach cramps diarrhea or constipation that lasts for more than two days Although there’s a small risk of infection, most people recover from appendicitis and an appendectomy with little difficulty. Full recovery from an appendectomy takes about four to six weeks. During this time, your doctor will probably recommend that you limit physical activity so your body can heal. You’ll need to attend a follow-up appointment with your doctor within two to three weeks after the appendectomy.
What is hemodialysis, and why would someone need it? How does hemodialysis work? Can people perform hemodialysis at home? John Kevin Tucker, M.D., Nephrologist at Brigham and Women's Hospital and Vice President for Education at Mass General Brigham, discusses hemodialysis and how it helps people who have lost their kidney function to maintain normal lives.
Subscribe Link: https://www.youtube.com/channe....l/UCYrLjATd88gPwIKnt
0:00 - Intro
0:26 - The Condition
2:06 - Hemodialysis: How It Works
4:37 - In-Center Hemodialysis Care Team
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Kidney Failure: Signs, Dialysis Options, and Hemodialysis Explained | Mass General Brigham
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Thoracic outlet syndrome affects the space between the collarbone and first rib (thoracic outlet). Common causes include trauma, repetitive injuries, pregnancy, and anatomical defects, such as having an extra rib. Symptoms include pain in the shoulders and neck and numbness, weakness, and coldness in the fingers. Treatment involves physical therapy and pain relief. In rare cases, surgery may be needed to relieve the compression.
The average time from symptom onset to diagnosis has been reported to be approximately 2 years. Despite recent attempts at increasing the awareness of pulmonary arterial hypertension (PAH), especially associated PAH (APAH), this delay in diagnosis has not changed appreciably in recent years. Early symptoms are nonspecific. Often, neither the patient nor the physician recognizes the presence of the disease, which leads to delays in diagnosis. Complicating matters, idiopathic PAH (IPAH) requires an extensive workup in an attempt to elucidate an identifiable cause of the elevated pulmonary artery pressure. The most common symptoms and their frequency, reported in a national prospective study, are as follows: Dyspnea (60% of patients) Weakness (19%) Recurrent syncope (13%) Additional symptoms include fatigue, lethargy, anorexia, chest pain, and right upper quadrant pain. Cough, hemoptysis, and hoarseness are less common symptoms. Women are more likely to be symptomatic than men.
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.
Cytoplasmic organelles are "little organs" that are suspended in the cytoplasm of the cell. Each type of organelle has a definite structure and a specific role in the function of the cell. Examples of cytoplasmic organelles are mitochondrion, ribosomes, endoplasmic reticulum, golgi apparatus, and lysosomes.