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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***
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.
Treatment may not be needed for an eschar if it is part of the natural healing process. However, if an eschar looks like it may have a wound infection – symptoms can include oozing fluid such as pus or blood, your clinician will likely recommend topical treatment or debridement to help control and remove the infection.
To record the sequence, Stephan Gordts and Ivo Brosens of the Leuven Institute for Fertility & Embryology in Belgium performed transvaginal laparoscopy, which involves making a small cut in the vaginal wall and observing the ovary with an endoscope.
"This allows us direct access to and observation of the tubo-ovarian structures without manipulation using forceps," says Gordts.
For the photos of ovulation, which only accidentally captured the critical moment, Jacques Donnez at the Catholic University of Louvain (UCL) in Brussels, Belgium, used gas to distend the organs for photography. However, Gordts and Brosens planned the procedure to coincide with ovulation and used saline solution to "float" the structures.
Perfect timing
Observation was timed for the day of the peak of the patient's luteal hormone cycle. Ovulation was predicted to occur on the evening of the day of the LH peak, and the endoscope introduced at 6 pm.
A small amount of saline was used to float the opening of the fallopian tube, its fimbriae (the "fingers" that sweep the egg into the tube) and the ovary itself. This gives a more natural appearance than gas, says Gordts.
In the video, the fimbriae can be seen sweeping in time with the patient's heartbeat. A mucus plug can be seen protruding from the ovary – this contains the egg.
"The ovum is not captured 'naked'," says Gordts. "There is no eruption like a volcano."
Gordts says that in clinical practice it is not easy to organise the observation of ovulation. "We were probably lucky to be successful at our first attempt," he says.
Osteomyelitis is an infection in a bone. Infections can reach a bone by traveling through the bloodstream or spreading from nearby tissue. Infections can also begin in the bone itself if an injury exposes the bone to germs. In children, osteomyelitis most commonly affects the long bones of the legs and upper arms. Adults are more likely to develop osteomyelitis in the bones that make up the spine (vertebrae). People who have diabetes may develop osteomyelitis in their feet if they have foot ulcers. Once considered an incurable condition, osteomyelitis can be successfully treated today. Most people require surgery to remove parts of the bone that have died — followed by strong antibiotics, often delivered intravenously, typically for at least four to six weeks.
This video provides a guide peforming a respiratory examination in an OSCE station, including real-time auscultation sounds of common pathology such as coarse crackles, fine crackles, wheeze and stridor.
You can access our step-by-step OSCE guide to accompany this video here: https://geekymedics.com/respiratory-examination-2/
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Chapters:
- Introduction 00:00
- General inspection 00:40
- Inspection of the hands 00:50
- Schamroth's window test 01:09
- Heart rate and respiratory rate 01:50
- Jugular venous pressure 02:02
- Face, eyes and mouth 02:13
- Anterior chest inspection 02:36
- Trachea and cricosternal distance 03:01
- Palpation of apex beat 03:16
- Chest expansion 03:28
- Lung percussion 03:50
- Auscultation of lungs 04:21
- Vocal resonance 05:03
- Lymph node palpation 05:32
- Inspection of posterior chest 06:04
- Posterior chest expansion 06:10
- Percussion of posterior chest 06:32
- Auscultation of posterior chest 06:55
- Sacral and pedal oedema 08:04
- Summary of findings 08:39
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Always adhere to your medical school/local hospital guidelines when performing examinations or clinical procedures. DO NOT perform any examination or procedure on patients based purely upon the content of these videos. Geeky Medics accepts no liability for loss of any kind incurred as a result of reliance upon the information provided in this video.
Some people have found this video useful for ASMR purposes.
Special thanks to www.easyauscultation.com and Andy Howes for providing some of the respiratory sounds.
Demystify knee pain and discover nine of the most common causes of pain in this complex joint. Join Burke Selbst PT as we work through our simple screening for the most common types of problems.
Burke is the founder and clinical director of Focus Physical Therapy in Bend Oregon.
Find him:
https://focusptbend.com
https://facebook.com/focusphysio
Intro Song Credit
Adventures by A Himitsu https://www.youtube.com/channel/UCgFw...
Creative Commons — Attribution 3.0 Unported— CC BY 3.0
http://creativecommons.org/licenses/b...
Music released by Argofox https://youtu.be/8BXNwnxaVQE
Music provided by Audio Library https://youtu.be/MkNeIUgNPQ8
A VCUG (Voiding Cystourethrogram) is a test that looks at how well your child's kidneys, ureters and bladder are working. Your child's kidneys make urine. The urine flows from the kidneys through thin tubes (called ureters) into your child's bladder.
Ophthalmoscopy - Eye Clinical Examination - OSCE - Dr Gill
Direct Ophthalmoscopy use of the eyes is a very challenging clinical skill, incorporating both the examiner's knowledge of the retina, but also understanding the use of the ophthalmoscope
In this clinical skills tutorial, we look at the use of the direct ophthalmoscope as part of an ophthalmic examination
it should be noted that in the ideal circumstances, the room lights will be dimmed during the examination, and dilating eye drops used to improve the visualisation of the fundus
Some people may notice an ASMR effect from this clinical examination
#DrGill #Ophthalmoscopy #ClinicalSkills #EyeExam
Lesson on clinical examination of a scaphoid fracture and assessment of the anatomic snuffbox. The scaphoid bone is one of the carpal bones of the wrist. A scaphoid fracture is important to rule out due to risk of avascular necrosis, which is a compromise of bone vasculature leading to death of the bone. Scaphoid fractures can occur with a FOOSH injury. In this lesson, we discuss the clinical assessment to rule out a scaphoid fracture, including assessing and localizing the anatomic snuffbox.
If you find this lesson helpful, please consider liking, subscribing, and clicking the notification bell to help support this channel and stay up-to-date on future lessons.
*Subscribe for more free medical lessons* https://www.youtube.com/channe....l/UCFPvnkCZbHfBvV8Ap
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Check out some of my other lessons.
Medical Terminology - The Basics - Lesson 1:
https://www.youtube.com/watch?v=04Wh2E9oNug
Fatty Acid Synthesis Pathway:
https://www.youtube.com/watch?v=WuQS_LpNMzo
Wnt/B Catenin Signaling Pathway:
https://www.youtube.com/watch?v=NGVP4J9jpgs
Upper vs. Lower Motor Neuron Lesions:
https://www.youtube.com/watch?v=itNd74V53ng
Lesson on the Purine Synthesis and Salvage Pathway:
https://www.youtube.com/watch?v=e2KFVvI8Akk
Gastrulation | Formation of Germ Layers:
https://www.youtube.com/watch?v=d6Kkn0SECJ4
Introductory lesson on Autophagy (Macroautophagy):
https://www.youtube.com/watch?v=UmSVKzHc5yA
Infectious Disease Playlist
https://www.youtube.com/playli....st?list=PLRjNoiRtdFw
Dermatology Playlist
https://www.youtube.com/playli....st?list=PLRjNoiRtdFw
Pharmacology Playlist
https://www.youtube.com/playli....st?list=PLRjNoiRtdFw
Hematology Playlist
https://www.youtube.com/playli....st?list=PLRjNoiRtdFw
Rheumatology Playlist
https://www.youtube.com/playli....st?list=PLRjNoiRtdFw
Endocrinology Playlist
https://www.youtube.com/playli....st?list=PLRjNoiRtdFw
Nephrology Playlist
https://www.youtube.com/playli....st?list=PLRjNoiRtdFw
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**MEDICAL DISCLAIMER**: JJ Medicine does not provide medical advice, and the information available on this channel does not offer a diagnosis or advice regarding treatment. Information presented in these lessons is for educational purposes ONLY, and information presented here is not to be used as an alternative to a healthcare professional’s diagnosis and treatment of any person/animal.
Only a physician or other licensed healthcare professional are able to determine the requirement for medical assistance to be given to a patient. Please seek the advice of your physician or other licensed healthcare provider if you have any questions regarding a medical condition.
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*Although I try my best to present accurate information, there may be mistakes in this video. If you do see any mistakes with information in this lesson, please comment and let me know.*
I am always looking for ways to improve my lessons! Please don't hesitate to leave me feedback and comments - all of your feedback is greatly appreciated! :) And please don't hesitate to send me any messages if you need any help - I will try my best to be here to help you guys :)
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JJ
Watch this clinical examination video to learn how to diagnose inguinal related groin pain.
This video clip is part of the FIFA Diploma in Football Medicine and the FIFA Medical Network. To enrol or to find our more click on the following link http://www.fifamedicalnetwork.com
The Diploma is a free online course designed to help clinicians learn how to diagnose and manage common football-related injuries and illnesses. There are a total of 42 modules created by football medicine experts. Visit a single page, complete individual modules or finish the entire course.
The network provides the opportunity for clinicians around the world to meet and share ideas relating to football medicine. Ask about an interesting case, debate current practice and discuss treatment strategies. Create a profile and log on to interact with other health professionals from around the globe.
This is not medical advice. The content is intended as educational content for health care professionals and students. If you are a patient, seek care of a health care professional.