The exam should be performed in an orderly fashion as follows: 1. Have the patient stick out their tongue so that you can examine the posterior pharynx (i.e. the back of the throat). Ask the patient to say "Ah", which elevates the soft palate, giving you a better view. If you are still unable to see, place the tongue blade � way back on the tongue and press down while the patient again says "Ah," hopefully improving your view. This causes some people to gag, particularly when the blade is pushed onto the more proximal aspects of the tongue. It may occasionally be important to determine whether the gag reflex is functional (e.g. after a stroke that impairs CNs 9 or 10; or to determine if a patient with depressed level of consciousness is able to protect their airway from aspiration). This is done by touching a q-tip against the posterior pharynx, uvula or tongue. It is not necessary to do this during your routine exam as it can be quite noxious!
2. Note that the uvula hangs down from the roof of the mouth, directly in the mid-line. With an "Ah," the uvula rises up. Deviation to one side may be caused by CN 9 palsy (the uvula deviates away from the affected side), a tumor or an infection. CN9 Pasly Cranial Nerve 9 Dysfunction: Patient has suffered stroke, causing loss of function of left CN 9. As a result, uvula is pulled towards the normally functioning (ie right) side. 3. The normal pharynx has a dull red color. In the setting of infection, it can become quite red, frequently covered with a yellow or white exudate (e.g. with Strep. Throat or other types of pharyngitis).
4. The tonsils lie in an alcove created by arches on either side of the mouth. The apex of these arches are located lateral to and on a line with the uvula. Normal tonsils range from barely apparent to quite prominent. When infected, they become red, are frequently covered by whitish/yellow discharge. In the setting of a peritonsilar abscess, the tonsils appear asymmetric and the uvula may be pushed away from the affected side. When this occurs, the tonsil may actually compromise the size of the oral cavity, making breathing quite difficult.
5. Look carefully along the upper and lower gum lines and at the mucosa in general, which can appear quite dry if the patient is dehydrated.
6. Examine the teeth to get a sense of general dentition, particularly if the patient has a dental complaint. Pain produced by tapping on a tooth is commonly caused by a root abscess. Tooth Abscess: Tooth abscess involving left molar region. Associated inflammation of left face can clearly be seen. 7. Have the patient stick their tongue outside their mouth, which allows evaluation of CN 12. If there is nerve impairment, the tongue will deviate towards the affected side. Any obvious growths or abnormalities? Ask them to flip their tongue up so that you can look at the underside. If you see something abnormal, grasp the tongue with gauze so that you can get a better look. Left CN 12 Dysfunction: Stroke has resulted in L CN 12 Palsy. Tongue therefore deviates to the left.
8. Make note of any growths along the cheeks, hard palate (the roof of the mouth between the teeth), soft palate, or anywhere else. In particular, patients who smoke or chew tobacco are at risk for oral squamous cell cancer. Any areas which are painful or appear abnormal should also be palpated. Put on a pair of gloves to better explore these regions. What do they feel like? Are they hard? To what extent does a growth involve deeper structures? If the patient feels something that you cannot see, try to get someone else to hold the light source, freeing both your hands to explore the oral cavity with two tongue depressors.

Research from Mayo Clinic finds that half of elderly patients who start dialysis after age 75 will die within one year.

Lead study author and a health care delivery scholar with the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Dr. Bjorg Thorsteinsdottir says many elderly patients and their families feel that they have no choice but to start dialysis, with several expressing regret from having initiated therapy.

The findings were presented at the American Society of Nephrology's Kidney Week 2013 in Atlanta.

A salivary gland stone -- also called salivary duct stone -- is a calcified structure that may form inside a salivary gland or duct. It can block the flow of saliva into the mouth. The majority of stones affect the submandibular glands located at the floor of the mouth.

Move the person beyond striking distance of the snake. Have the person lie down with wound below the heart. Keep the person calm and at rest, remaining as still as possible to keep venom from spreading. Cover the wound with loose, sterile bandage

Preeclampsia is a pregnancy complication characterized by high blood pressure and signs of damage to another organ system, often the kidneys. Preeclampsia usually begins after 20 weeks of pregnancy in a woman whose blood pressure had been normal. Even a slight rise in blood pressure may be a sign of preeclampsia. Left untreated, preeclampsia can lead to serious — even fatal — complications for both you and your baby. If you have preeclampsia, the only cure is delivery of your baby. If you're diagnosed with preeclampsia too early in your pregnancy to deliver your baby, you and your doctor face a challenging task. Your baby needs more time to mature, but you need to avoid putting yourself or your baby at risk of serious complications.

Sectioned Heart

Symptoms of depression in women include: Persistent sad, anxious, or "empty" mood. Loss of interest or pleasure in activities, including sex. Restlessness, irritability, or excessive crying. Feelings of guilt, worthlessness, helplessness, hopelessness, pessimism. Sleeping too much or too little, early-morning awakening.

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 case of replantation of a completely amputated arm

Hemodialysis is a process that uses a membrane (dialyzer) to: Remove wastes, such as urea, from the blood. Restore the proper balance of electrolytes in the blood. Eliminate extra fluid from the body.

The primary goal of treatment for each patient is to help relieve pain and other symptoms resulting from the herniated disc. To achieve this goal, each patient’s treatment plan should be individualized based on the source of the pain, the severity of pain and the specific symptoms that the patient exhibits.

Is that knee pain just a sprain or a more serious ACL injury? Orthopedic surgeon Paul Fadale, M.D., offers tips on how to tell the difference. http://www.orthopedicsri.org/

A Chinese hospital in the process of creating a human ear almost entirely through the human anatomy alone.

Brushing flossing and rinsing -the winning combination for preventing gingivitis

Examination of a patient with post-enucleation socket syndrome.

Eye tests are important for the detection of many common eye infections and diseases. Eyes are also an important indicator to detect chronic systemic diseases like Hypertension and Diabetes.  Must after maxillofacial trauma to rule out any near and late complications emerging for the eyes. 2. There are two perspectives for examining the eyes : 1. Ophthalmic Perspective – because eyes are prone to many infections, diseases and conditions. 2. Maxillofacial Perspective – because the eyes and the orbit forms an integral component of facial and mid-facial fractures and trauma.

Histology of GastroDuodenal Junction

Histology of Heart Endocardium Pericardium Epicardium

An U/S showing first trimesteric scan

Histology of Mucles Skeletal Smooth Cardiac