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The most reliable clinical sign to detect ascites is checking for bilateral flank dullness. If a patient with ascites is lying supine, fluid accumulates in the flank regions, leading to dullness on percussion. At the same time, the air-filled bowel loops are forced upwards by the free fluid due to buoyancy, resulting in tympanitic percussion. To locate specifically where dullness shifts to tympany, or the air-fluid level, percussion should be performed from the sides towards the middle. To confirm that the dullness is caused by ascites, ask the patient to switch to a lateral decubitus position. If ascites is present, the air-filled bowel loops will shift accordingly and remain at the surface of the fluid. As a result, the air-fluid level will shift as well. This is known as shifting dullness.
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Intrauterine insemination (IUI) is a fertility treatment that involves placing sperm inside a woman's uterus to facilitate fertilization. The goal of IUI is to increase the number of sperm that reach the fallopian tubes and subsequently increase the chance of fertilization
With ECT, electrodes are placed on the patient's scalp and a finely controlled electric current is applied while the patient is under general anesthesia. The current causes a brief seizure in the brain. ECT is one of the fastest ways to relieve symptoms in severely depressed or suicidal patients.
With keratoconus, the clear, dome-shaped tissue that covers the eye (cornea) thins and bulges outward into a cone shape. Its cause is unknown. Symptoms first appear during puberty or the late teens and include blurred vision and sensitivity to light and glare. Vision can be corrected with glasses or contact lenses early on. Advanced cases may require a cornea transplant.
A hematoma is a common complication of surgical procedures. A large, expanding hematoma can result in necrosis of the overlying skin (1,2) or adjacent subcutaneous fat, increased incidence of infection, scarring, skin hyperpigmentation, tissue edema and a prolonged convalescence.
Colorectal surgeon Conor Delaney, MD, explains laparoscopic surgery for colon cancer, including how it works and what patients can typically expect before, during, and after the procedure.
Learn more about colon cancer at http://cancer.org/coloncancer
An animated description of the composition of bones.
Visit www.orthofilms.com for more videos and info.
This title in the new Surgical Techniques Atlas series presents state-of-the-art updates on the full range of pediatric surgical techniques performed today. Expand your repertoire and hone your clinical skills thanks to the expert advice, procedural videos, and online access at expertconsult.com. For more information, please visit http://www.us.elsevierhealth.com/product.jsp?sid=EHS_US_BS-SPE-59&isbn=9781416046899&dmnum=null&elsca1=CriticalCare&elsca2=soc_med&elsca3=null&elsca4=youtube_ELSpromovideos