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.

exam

Physical Examination of the abdomen

A wet mount is the suspension of a small amount of vaginal discharge in a liquid medium. Two liquids are commonly used, normal saline and potassium hydroxide. Each has it's own unique properties that make it useful in this setting

How to remove the Intra Uterine Device (IUD)

The examination consists of three portions: Inspection, Palpation, and Synthesis of data from these techniques In addition to palpating for size, also note the gland texture, mobility, tenderness and the presence of nodules. Inspection Inspection: Anterior Approach The patient should be seated or standing in a comfortable position with the neck in a neutral or slightly extended position. Cross-lighting increases shadows, improving the detection of masses. To enhance visualization of the thyroid, you can: Extending the neck, which stretches overlying tissues Have the patient swallow a sip of water, watching for the upward movement of the thyroid gland. quicktime video 251KB video demo from Return to the Bedside Inspection: Lateral Approach After completing anterior inspection of the thyroid, observe the neck from the side. Estimate the smooth, straight contour from the cricoid cartilage to the suprasternal notch. Measure any prominence beyond this imagined contour, using a ruler placed in the area of prominence. Palpation Note: There is no data comparing palpation using the anterior approach to the posterior approach so examiners should use the approach that they find most comfortable. Palpation: Anterior Approach placement of hands for palpatation of thyroid in anterior approach The patient is examined in the seated or standing position. Attempt to locate the thyroid isthmus by palpating between the cricoid cartilage and the suprasternal notch. Use one hand to slightly retract the sternocleidomastoid muscle while using the other to palpate the thyroid. Have the patient swallow a sip of water as you palpate, feeling for the upward movement of the thyroid gland. quicktime video 454KB video demo from Return to the Bedside. Palpation: Posterior Approach placement of hands for palpatation of thyroid in posterior approach The patient is examined in the seated or standing position. Standing behind the patient, attempt to locate the thyroid isthmus by palpating between the cricoid cartilage and the suprasternal notch. Move your hands laterally to try to feel under the sternocleidomstoids for the fullness of the thyroid. Have the patient swallow a sip of water as you palpate, feeling for the upward movement of the thyroid gland.

Watch that video of Creation and Pathway of Sperm During Ejaculation

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.

Loyola Full Thorax Exam Part 1 A video from Loyola Medical School, Chicago showing the medical and clinical examination of the respiratory system.

Ganglion Cyst Volar Wrist Removal Ganglion cysts are noncancerous lumps that most commonly develop along the tendons or joints of your wrists or hands. They also may occur in the ankles and feet. Ganglion cysts are typically round or oval and are filled with a jellylike fluid. Small ganglion cysts can be pea-sized, while larger ones can be around an inch (2.5 centimeters) in diameter. Ganglion cysts can be painful if they press on a nearby nerve. Their location can sometimes interfere with joint movement. If your ganglion cyst is causing you problems, your doctor may suggest trying to drain the cyst with a needle. Removing the cyst surgically also is an option. But if you have no symptoms, no treatment is necessary. In many cases, the cysts go away on their own.

Watch that video of Tying The Sperm Canal to Avoid Ejaculation

Level of fundus and exam

Shut the front door: Scientists have finally found the perfect breasts. No, they weren't hiding in the Amazon or roving solo across the Sahara (although we have no doubt there are women in both the Amazon and the Sahara who have magnificent mammaries); it turns out these perfect breasts were hiding in a plastic surgeon's office this whole time! Now, before you get all worked up, the American Society of Plastic Surgeons (ASPS) would like you to know that the super-fake looking plastic breasts of yore are not actually what people think are most attractive now. According to a study published in the Journal of Plastic and Reconstructive Surgery—which involved asking over 1,300 people to look at pictures of naked boobies and rank them by hotness (stop laughing, this is serious research!)—people preferred a more "real" and "normal" look from their silicone, with the ideal breast shape having a 45:55 ratio. People said the best chests have 45 percent of the fullness above the nipple line and 55 percent of the fullness below, in a slightly teardrop shape. Researchers noted this preference remained consistent across gender, racial, and ethnic groups with the 45:55 ratio favored by 87 percent of women in their 30s, 90 percent of men, and 94 percent of plastic surgeons.

Identify the anatomy and explain the physiology of the scrotum on diagrams and sonograms.

Describe and demonstrate the protocol for sonographic scanning of the scrotum.

Identify and describe sonographic images of congenital abnormalities of the scrotum.

Identify and describe sonographic images of pathologies of the scrotum.

Identify and describe sonographic images of extratesticular disease processes.

Identify the anatomy and explain the physiology of the prostate on diagrams and sonograms.

Describe and demonstrate the protocol for transabdominal and endorectal sonographic scanning of the prostate.

Identify and describe sonographic images of benign and malignant pathologies of the prostate, including benign hyperplasia, prostatitis, carcinoma, and calculi.

Explain the technique for prostate biopsy.

Define the criteria for an ultrasound appearance of prostate tumor staging.

Explain the technique for radiation seed implantation.

Explain the Patient Privacy Rule (HIPAA) and Patient Safety Act (see reference).

Watch that Human Baby Medical Abortion Surgery

Endoscopic Nasal Polypectomy

Lumpectomy means that a focal area of cancer is going to be removed. A lot of patients with a lumpectomy don’t need any specific breast reconstruction, explains Dr. Miguel Angel Medina, Director of Microsurgery with Miami Cancer Institute.
Al the end of surgical treatment, all those patients go on to need radiation therapy. For patients who have large breasts, physicians have to take a larger lumpectomy than normal.

A 3D animated explanation of the circumcision procedure. Educational only — not personal medical advice.

Testicular sperm aspiration (TESA) is a procedure performed for men who are having sperm retrieved for in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI). It is done with local anesthesia in the operating room or office and is coordinated with their female partner's egg retrieval.