examination of the recturm

The examination room should be quiet, warm and well lit. After you have finished interviewing the patient, provide them with a gown (a.k.a. "Johnny") and leave the room (or draw a separating curtain) while they change. Instruct them to remove all of their clothing (except for briefs) and put on the gown so that the opening is in the rear. Occasionally, patient's will end up using them as ponchos, capes or in other creative ways. While this may make for a more attractive ensemble it will also, unfortunately, interfere with your ability to perform an examination! Prior to measuring vital signs, the patient should have had the opportunity to sit for approximately five minutes so that the values are not affected by the exertion required to walk to the exam room. All measurements are made while the patient is seated. Observation: Before diving in, take a minute or so to look at the patient in their entirety, making your observations, if possible, from an out-of-the way perch. Does the patient seem anxious, in pain, upset? What about their dress and hygiene? Remember, the exam begins as soon as you lay eyes on the patient. Temperature: This is generally obtained using an oral thermometer that provides a digital reading when the sensor is placed under the patient's tongue. As most exam rooms do not have thermometers, it is not necessary to repeat this measurement unless, of course, the recorded value seems discordant with the patient's clinical condition (e.g. they feel hot but reportedly have no fever or vice versa). Depending on the bias of a particular institution, temperature is measured in either Celcius or Farenheit, with a fever defined as greater than 38-38.5 C or 101-101.5 F. Rectal temperatures, which most closely reflect internal or core values, are approximately 1 degree F higher than those obtained orally. Respiratory Rate: Respirations are recorded as breaths per minute. They should be counted for at least 30 seconds as the total number of breaths in a 15 second period is rather small and any miscounting can result in rather large errors when multiplied by 4. Try to do this as surreptitiously as possible so that the patient does not consciously alter their rate of breathing. This can be done by observing the rise and fall of the patient's hospital gown while you appear to be taking their pulse. Normal is between 12 and 20. In general, this measurement offers no relevant information for the routine examination. However, particularly in the setting of cardio-pulmonary illness, it can be a very reliable marker of disease activity. Pulse: This can be measured at any place where there is a large artery (e.g. carotid, femoral, or simply by listening over the heart), though for the sake of convenience it is generally done by palpating the radial impulse. You may find it helpful to feel both radial arteries simultaneously, doubling the sensory input and helping to insure the accuracy of your measurements. Place the tips of your index and middle fingers just proximal to the patients wrist on the thumb side, orienting them so that they are both over the length of the vessel.

Watch that video of an Ingrown hair turned into 140-pound tumor in man’s stomach

Graphic images focusing on the reconstruction of an ear after the removal of a long-standing skin cancer that this patient allowed to slowly grow over many years because he was afraid of what the surgery to remove might entail. Go to www.skincancercentre.com to learn more about the importance of the early diagnosis of skin cancer. BTW, when you put on your sunscreen, don't forget your ears, and wear a broad brimmed hat to cover this very vulnerable area of your anatomy. www.skincancercentre.com

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/

Check out our other awesome clinical skills resources including:
• 🔥 Geeky Medics Bundles (discounted products): https://app.geekymedics.com/purchase/bundles/
• ✨ 1000+ OSCE Stations: https://app.geekymedics.com/pu....rchase/osce-stations
• 🏥 Geeky Medics OSCE Revision Book: https://app.geekymedics.com/purchase/book/
• 📝 150+ PDF OSCE Checklists: https://geekymedics.com/pdf-osce-checklists/
• 🗂️ 3000+ OSCE Flashcards: https://app.geekymedics.com/pu....rchase/flashcard-col
• 📱 Geeky Medics OSCE App: https://geekymedics.com/geeky-medics-app/
• 🩺 Medical Finals SBA Question Pack: https://app.geekymedics.com/pu....rchase/medical-stude
• 💊 PSA Question Pack: https://app.geekymedics.com/pu....rchase/prescribing-s

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

Subscribe to our newsletter to be the first to know about our latest content: https://geekymedics.com/newsletter/ ✉️

Join the Geeky Medics community: 👩‍👩‍👧‍👧
Twitter: http://www.twitter.com/geekymedics
Instagram: https://instagram.com/geekymedics
Facebook: http://www.facebook.com/geekymedics

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.

All you need to know about the Types of Female Genital Discharge

A narrowing of the major artery (the aorta) that carries blood to the body. This narrowing affects blood flow where the arteries branch out to carry blood along separate vessels to the upper and lower parts of the body. CoA can cause high blood pressure or heart damage.

In this instructional video, Director of Critical Care Nephrology, Sevag Demirjian, MD goes over the steps for in-hospital production of ultra-pure continuous hemodialysis fluid.

By using the information in this video and/or any other materials made available by Cleveland Clinic related to the dialysate solution, you agree to comply with and be bound by the terms of the Permissive Use Agreement, a copy of which is available at https://bit.ly/3f9lN4j

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.

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.

Jaw surgery, also known as orthognathic (or-thog-NATH-ik) surgery, corrects irregularities of the jaw bones and realigns the jaws and teeth to improve the way they work. Making these corrections may also improve your facial appearance. Jaw surgery may be a corrective option if you have jaw problems that can't be resolved with orthodontics alone. In most cases, you also have braces on your teeth before surgery and during recovery after surgery until healing and alignment are complete. Your orthodontist can work with your oral and jaw and face (maxillofacial) surgeon to determine your treatment plan.

Abdominal Physical Examination Lecture

This follow-along routine features stretching and strengthening exercises for before and after knee replacement surgery. Daljit, who is awaiting knee surgery, joins physiotherapist Milly Abdullah to demonstrate the exercises.

This video is part of the Surgery Toolkit, a series designed for people living with arthritis who are awaiting or recovering from joint replacement surgery. Staying active is important if you’re waiting for or recovering from surgery. Being fitter and stronger can improve the success of the operation and lead to a faster recovery time.

In the Surgery Toolkit you’ll also find tailor-made, follow-along exercise routines for hip and shoulder replacement, as well as full body workouts to help you maintain overall fitness. The series also includes advice films, personal stories and top tips on staying active before and after surgery from those living with arthritis who have been through joint replacement surgery.

This series is part of Let’s Move, a programme for people with arthritis who want more movement in their lives. Sign up today to the free newsletter to receive all the latest content to help you to get active in a way that works for you: https://action.versusarthritis.....org/page/120448/dat

Male Urethral Prostate Stent/Catheter.Removal and insertion.

Removal of pregnancy within the fallopain tube using laparoscopic keyhole surgery. A segment of the tube together with the pregnancy within is removed.

28 years old gentleman presented with huge liver abscess in the right lobe, with repeated attempts of percutaneous aspirations in the past. He was evaluated and subjected to Laparoscopic drainage. This video depicts feasibility of laparoscopy in deep seated liver abscesses. Video created by: Dr. Juneed M. Lanker Fellow Minimal Access Surgery Apollo Hospitals Chennai.

Watch that video of Super Model's Butt and Leg Implants Exploded

This video: Patent ductus arteriosus (PDA) is a persistent opening between two major blood vessels leading from the heart. The opening, called the ductus arteriosus, is a normal part of a baby's circulatory system before birth that usually closes shortly after birth. If it remains open, however, it's called a patent ductus arteriosus. A small patent ductus arteriosus often doesn't cause problems and might never need treatment. However, a large patent ductus arteriosus left untreated can allow poorly oxygenated blood to flow in the wrong direction, weakening the heart muscle and causing heart failure and other complications. Treatment options for a patent ductus arteriosus include monitoring, medications and closure by cardiac catheterization or surgery.