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Peritoneal dialysis (per-ih-toe-NEE-ul die-AL-uh-sis) is a way to remove waste products from your blood when your kidneys can no longer do the job adequately. A cleansing fluid flows through a tube (catheter) into part of your abdomen and filters waste products from your blood. After a prescribed period of time, the fluid with filtered waste products flows out of your abdomen and is discarded. Peritoneal dialysis differs from hemodialysis, a more commonly used blood-filtering procedure. With peritoneal dialysis, you can give yourself treatments at home, at work or while traveling. Peritoneal dialysis isn't an option for everyone wit
The goal of a decompression surgery is usually to relieve pain caused by nerve root pinching. There are two common causes of lumbar nerve root pressure: from a lumbar herniated disc or lumbar spinal stenosis. This type of pain is usually referred to as a radiculopathy, or sciatica. A decompression surgery involves removing a small portion of the bone over the nerve root and/or disc material from under the nerve root to relieve pinching of the nerve and provide more room for the nerve to heal. The most common types of decompression surgery are microdiscectomy and laminectomy.
During normal sleep, you cycle through REM and four stages of non-REM (NREM) sleep numerous times a night. Stage 1 of NREM sleep is the lightest, while stage 4 is the deepest. When you're repeatedly interrupted and can't cycle normally through these types and stages of sleep, you may feel tired, fatigued, and have trouble concentrating and paying attention while you're awake. Sleepiness puts you at greater risk for car wrecks and other accidents.
A successful cardiovascular exam includes visual examination, palpation of the apical impulse, auscultation of Erb's point, auscultation of the carotids, and auscultation over the four different heart valve locations (aortic, pulmonic, tricuspid, and mitral). Additionally, the radial pulse is palpated while auscultating to distinguish whether a murmur is diastolic or systolic.
Video Index:
0:13 - Inspection of the thorax
0:29 - Palpation of the apex heart beat
0:59 - Auscultation of the heart
1:16 - Auscultation of the Erb’s point
1:33 - Using Erb’s point to check the heart rate
1:45 - Systolic and diastolic heart sound identification
2:01 - Ascultating individual valves: aortic, pulmonary, tricuspid, mitral
2:41 - Ascultation of the carotids
2:54 - Ascultating the pulmonary and aortic valves
3:04 - Ascultation of the mitral valve
3:16 - Mitral valve murmurs
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This video: Polycystic ovary syndrome (PCOS) is a common endocrine disorder among women of reproductive age. Women with PCOS may have enlarged ovaries that contain small collections of fluid — called follicles — located in each ovary as seen during an ultrasound exam. Infrequent or prolonged menstrual periods, excess hair growth, acne, and obesity can all occur in women with polycystic ovary syndrome. In adolescents, infrequent or absent menstruation may raise suspicion for the condition. The exact cause of polycystic ovary syndrome is unknown. Early diagnosis and treatment along with weight loss may reduce the risk of long-term complications, such as type 2 diabetes and heart disease.
Neurogenic shock is a distributive type of shock resulting in low blood pressure, occasionally with a slowed heart rate, that is attributed to the disruption of the autonomic pathways within the spinal cord. It can occur after damage to the central nervous system such as spinal cord injury.
Most intact aortic aneurysms do not produce symptoms. As they enlarge, symptoms such as abdominal pain and back pain may develop. Compression of nerve roots may cause leg pain or numbness. Untreated, aneurysms tend to become progressively larger, although the rate of enlargement is unpredictable for any individual. Rarely, clotted blood which lines most aortic aneurysms can break off and result in an embolus. They may be found on physical examination. Medical imaging is necessary to confirm the diagnosis. Symptoms may include: anxiety or feeling of stress; nausea and vomiting; clammy skin; rapid heart rate. In patients presenting with aneurysm of the arch of the aorta, a common symptom is a hoarse voice as the left recurrent laryngeal nerve (a branch of the vagus nerve) is stretched. This is due to the recurrent laryngeal nerve winding around the arch of the aorta. If an aneurysm occurs in this location, the arch of the aorta will swell, hence stretching the left recurrent laryngeal nerve. The patient therefore has a hoarse voice as the recurrent laryngeal nerve allows function and sensation in the voicebox. Abdominal aortic aneurysms, hereafter referred to as AAAs, are the most common type of aortic aneurysm. One reason for this is that elastin, the principal load-bearing protein present in the wall of the aorta, is reduced in the abdominal aorta as compared to the thoracic aorta (nearer the heart). Another is that the abdominal aorta does not possess vasa vasorum, hindering repair. Most are true aneurysms that involve all three layers (tunica intima, tunica media and tunica adventitia), and are generally asymptomatic before rupture. The most common sign for the aortic aneuysm is the Erythema nodosum also known as leg lesions typically found near the ankle area. The prevalence of AAAs increases with age, with an average age of 65–70 at the time of diagnosis. AAAs have been attributed to atherosclerosis, though other factors are involved in their formation. An AAA may remain asymptomatic indefinitely. There is a large risk of rupture once the size has reached 5 cm, though some AAAs may swell to over 15 cm in diameter before rupturing. Before rupture, an AAA may present as a large, pulsatile mass above the umbilicus. A bruit may be heard from the turbulent flow in a severe atherosclerotic aneurysm or if thrombosis occurs. Unfortunately, however, rupture is usually the first hint of AAA. Once an aneurysm has ruptured, it presents with a classic pain-hypotension-mass triad. The pain is classically reported in the abdomen, back or flank. It is usually acute, severe and constant, and may radiate through the abdomen to the back. The diagnosis of an abdominal aortic aneurysm can be confirmed at the bedside by the use of ultrasound. Rupture could be indicated by the presence of free fluid in potential abdominal spaces, such as Morison's pouch, the splenorenal space (between the spleen and left kidney), subdiaphragmatic spaces (underneath the diaphragm) and peri-vesical spaces. A contrast-enhanced abdominal CT scan is needed for confirmation. Only 10–25% of patients survive rupture due to large pre- and post-operative mortality. Annual mortality from ruptured abdominal aneurysms in the United States alone is about 15,000. Another important complication of AAA is formation of a thrombus in the aneurysm.
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The video is about the evolution of the anatomic UCLA laparoscopic technique over 1325 cases and demonstrates the key steps of our operation to improve patient safety and outcomes.
Learn more at http://urology.ucla.edu