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Chinese Complete Physical Clinical Exam

Electronystagmography (ENG) is a diagnostic test to record involuntary movements of the eye caused by a condition known as nystagmus. It can also be used to diagnose the cause of vertigo, dizziness or balance dysfunction by testing the vestibular system.

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.

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.

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Trigger finger, also known as stenosing tenosynovitis (stuh-NO-sing ten-o-sin-o-VIE-tis), is a condition in which one of your fingers gets stuck in a bent position. Your finger may straighten with a snap — like a trigger being pulled and released. Trigger finger occurs when inflammation narrows the space within the sheath that surrounds the tendon in the affected finger. If trigger finger is severe, your finger may become locked in a bent position. People whose work or hobbies require repetitive gripping actions are at higher risk of developing trigger finger. The condition is also more common in women and in anyone with diabetes. Treatment of trigger finger varies depending on the severity.

A video describing the procedure of colonoscopy or flexible fibre-optic examination of the colon.

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Cholestatic liver disease is a condition that results from an impairment of bile formation or bile flow to the gallbladder and duodenum (first section of the small intestine). ... The effects of cholestasis are profound and widespread, leading to worsening liver disease and systemic illness.

This video is brought to you by the Stanford Medicine 25 to teach you the common causes of shoulder pain and how to diagnose them by the physical exam.

The Stanford Medicine 25 program for bedside medicine at the Stanford School of Medicine aims to promote the culture of bedside medicine to make current and future clinicians and other healthcare provides better at the art of physical diagnosis and more confident at the bedside of their patients.

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Diagnoses covered in this video:
Rotator Cuff Pathology
Impingement Syndrome
Biceps Tendinopathy
Adhesive Capsulitis (Frozen Shoulder)
Acromioclavicular (AC) Joint Disease
Shoulder Instability
Labral Tears (SLAP Lesions)

This patient presented to the ER for umbilical pain and had a history of umbilical hernia. He was concerned about the possibility of incarceration of the hernia.

In this video we explain how the clinical exam helps to differentiate a simple painful hernia from an incarcerated one.

***Thanks to the patient for sharing his history and exam with YouTube world***

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