This tutorial explains the difference in mechanisms between the 2 palsies. Bulbar palsy is a lower motor neuron condition and pseudobulbar palsy is an upper motor neuron condidtion.

Scalpel Blade Handling

Cricothyroidotomy NEJM

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

Acute aortic dissection can be treated surgically or medically. In surgical treatment, the area of the aorta with the intimal tear is usually resected and replaced with a Dacron graft. Emergency surgical correction is the preferred treatment for Stanford type A (DeBakey type I and II) ascending aortic dissection. It is also preferred for complicated Stanford type B (DeBakey type III) aortic dissections with clinical or radiologic evidence of the following conditions: Propagation (increasing aortic diameter) Increasing size of hematoma Compromise of major branches of the aorta Impending rupture Persistent pain despite adequate pain management Bleeding into the pleural cavity Development of saccular aneurysm

Optimal blood pressure typically is defined as 120 mm Hg systolic — which is the pressure as your heart beats — over 80 mm Hg diastolic — which is the pressure as your heart relaxes. For your resting heart rate, the target is between 60 and 100 beats per minute (bpm)

Using models and actual patient video, the aspiration of a traumatically injured knee joint is demonstrated.

Paracentesis is a procedure to take out fluid that has collected in the belly (peritoneal fluid). This fluid buildup is called ascites camera.gif. Ascites may be caused by infection, inflammation, an injury, or other conditions, such as cirrhosis or cancer. The fluid is taken out using a long, thin needle put through the belly. The fluid is sent to a lab and studied to find the cause of the fluid buildup. Paracentesis also may be done to take the fluid out to relieve belly pressure or pain in people with cancer or cirrhosis.

Whereas it is true that no operation has been profoundly affected by the advent of laparoscopy than cholecystectomy has, it is equally true that no procedure has been more instrumental in ushering in the laparoscopic age than laparoscopic cholecystectomy has. Laparoscopic cholecystectomy has rapidly become the procedure of choice for routine gallbladder removal and is currently the most commonly performed major abdominal procedure in Western countries.[1] A National Institutes of Health consensus statement in 1992 stated that laparoscopic cholecystectomy provides a safe and effective treatment for most patients with symptomatic gallstones and has become the treatment of choice for many patients.[2] This procedure has more or less ended attempts at noninvasive management of gallstones. The initial driving force behind the rapid development of laparoscopic cholecystectomy was patient demand. Prospective randomized trials were late and largely irrelevant because advantages were clear. Hence, laparoscopic cholecystectomy was introduced and gained acceptance not through organized and carefully conceived clinical trials but through acclamation. Laparoscopic cholecystectomy decreases postoperative pain, decreases the need for postoperative analgesia, shortens the hospital stay from 1 week to less than 24 hours, and returns the patient to full activity within 1 week (compared with 1 month after open cholecystectomy).[3, 4] Laparoscopic cholecystectomy also provides improved cosmesis and improved patient satisfaction as compared with open cholecystectomy. Although direct operating room and recovery room costs are higher for laparoscopic cholecystectomy, the shortened length of hospital stay leads to a net savings. More rapid return to normal activity may lead to indirect cost savings.[5] Not all such studies have demonstrated a cost savings, however. In fact, with the higher rate of cholecystectomy in the laparoscopic era, the costs in the United States of treating gallstone disease may actually have increased. Trials have shown that laparoscopic cholecystectomy patients in outpatient settings and those in inpatient settings recover equally well, indicating that a greater proportion of patients should be offered the outpatient modality

Repair of an indirect inguinal hernia

This video shows management of rupture of the posterior capsule post blunt trauma in a child aged 8. Pre-operative suspicion of PCR was strong because of a flat anterior. So we were careful in our approach from the very beginning. CCC was performed and then dry aspiration of lens matter initiated. Sice vitreous showed, so anterior vitrectomy was done along with systematic removal of the lens matter. An acrysof multi-component lens was implanted into the sulcus and optic captured into the CCC.Outcome was very good.

Laparotomy : opening the abdomen

Paramedian Thoracic Epidural Anaesthesia

Scientists Create Artificial Womb

Neck Examination - Cervical Spine Assessment - Clinical Skills - Dr Gill

Compose a new pain within athletes is cervical spine discomfort, thankfully in the vast majority of cases when the neck is examined the cause of the neck pain is found to be muscular.

However, pain can also refer from the neck to the arm, in which case it is important to be able to assess for cervical radiculopathy prior to gaining more information which may indicate an MRI is needed

We assess for radiculopathy by doing Spurling's test, an often overlooked part of the neck examination, but it should be included for completeness and reassurance of the patient - not forgetting the athlete or not, neck pain can be a considerable source of distress, so it's vital to be able to get information from the neck examination which allows you to safely reassure a patient when appropriate, or comment that neck exam found evidence that needs further investigation

#DRGill #neck #asmr

A detailed discussion of the causes, diagnosis and management of the causes of Meningitis and Encephalitis. Includes bacterial, viral, fungal and autoimmune conditions as well as treatment of these conditions. Includes antivirals such as Aciclovir and Ganciclovir as well as IVIG and plasma exchange for autoimmune encephalitis.

A very funny video

Deuk Laser Disc Repair vs Traditional Spinal Fusion Comparison, Laser versus Fusion

Harvesting and prepare fat for grafting

Dr. Kathryn Baerman is a Board Certified General Surgeon specializing in Women's Health and Breast Care. She shares with us that in women, hernias present differently than in men. If you are experiencing groin pain, it may be a hernia.

To visit Dr. Baerman in Apex, Chapel Hill, or Durham, North Carolina, call 919-281-1699 to schedule an appointment with her at EmergeOrtho.