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OB_A_1013
3D animation depicting the operating room and initial procedure preparing the patient for a laparoscopic hysterectomy. The patient is prepped and draped in the usual fashion and surrounded by the surgeon and surgical assistants. The skin is elevated, an infraumbilical incision is made, a trocar port is inserted through the incision and the abdomen is insufflated. Finally, a laparoscope is inserted into the port to allow for direct visualization of the uterus and the surgery can begin.
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An inguinal hernia occurs when tissue, such as part of the intestine, protrudes through a weak spot in the abdominal muscles. The resulting bulge can be painful, especially when you cough, bend over or lift a heavy object. However, many hernias do not cause pain.
An inguinal hernia isn't necessarily dangerous. It doesn't improve on its own, however, and can lead to life-threatening complications. Your doctor is likely to recommend surgery to fix an inguinal hernia that's painful or enlarging. Inguinal hernia repair is a common surgical procedure.
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.
Are most spiders poisonous? The majority of the 3,000 spiders in the United States aren’t poisonous. Even if most spiders did bite, their fangs are too small or weak to puncture human skin. Their bites may leave itchy, red wounds that heal within a week or so. The spiders that do manage to bite through our skin and insert toxic venom can cause serious health complications. Read on to learn what spider bites look like, what spider varieties leave certain bites, and how to treat spider bites. What do spider bites look like? Identifying a spider bite is easier if you saw the spider that bit you, but it’s possible that you won’t notice the wound until hours later. Look for things like: swelling a red welt skin damage any troubling symptoms that accompany the bite Other possible symptoms that may accompany a spider bite include: itching or rash pain around the area of the bite muscle pain or cramping blister that’s red or purple in color sweating difficulty breathing headache nausea and vomiting fever chills anxiety or restlessness rashes swollen lymph glands high blood pressure Spider bites often take longer to heal than other insect bites, and they may affect skin tissues. It’s important to keep the bite clean to reduce the risk of infection. How to treat a spider bite at home In some cases, you can treat spider bites at home. For nonvenomous spider bites, follow these steps: Apply an ice pack on and off the bite for 10 minutes at a time. Elevate the area to reduce swelling. Take an antihistamine, such as diphenhydramine (Benadryl), to help with itching. Clean the area with soap and water to prevent infection. Apply antibiotic ointment to the area if blisters develop. Seek medical attention if you’re showing symptoms of a spider bite or if the symptoms don’t go away over time. Always seek medical attention if you suspect you’ve been bitten by one of the following species: brown recluse black widow hobo spider tarantula Brazilian wandering spider
This gentleman has a significant lumbar herniated disc with a positive well straight leg raise test. In this evaluation I test his deep tendon reflexes, sensation, muscle strength, and perform a straight leg raise test, Braggards's test and Well straight leg raise test.
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Transurethral resection of the prostate (also known as TURP, plural TURPs and as a transurethral prostatic resection TUPR) is a urological operation. It is used to treat benign prostatic hyperplasia (BPH). As the name indicates, it is performed by visualising the prostate through the urethra and removing tissue by electrocautery or sharp dissection. This is considered the most effective treatment for BPH. This procedure is done with spinal or general anesthetic. A large triple lumen catheter is inserted through the urethra to irrigate and drain the bladder after the surgical procedure is complete. Outcome is considered excellent for 80-90% of BPH patients. Because of bleeding risks associated with the surgery, TURP is not considered safe for many patients with cardiac problems. As with all invasive procedures, the patient should first discuss medications they are taking with their doctor, most especially blood thinners or anticoagulants, such as warfarin (Coumadin), or aspirin. These may need to be discontinued prior to surgery. Postop complications include bleeding (most common), clotting and hyponatremia (due to bladder irrigation).
Additionally, transurethral resection of the prostate is associated with low but important morbidity and mortality.
*How to setup a dialysis Machine*
This is part one of two parts of *How to setup a dialysis Machine* Setting up the Fresenius 2008K hemodialysis machine.
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Additional Resources:
Technical training | Fresenius Medical Care
https://fmcna.com/faq/technical-training/
The Technical Training team Fresenius Renal Technologies, a division of ... closed room environment, as well as hands-on instruction using current machines. ... 2008® Series Troubleshooting Hemodialysis Systems – Workshop, Level II, 2.4 ...
[PDF]2008K Level I Training Manual - Fresenius Medical Care
https://fmcna.com/wp-content/u....ploads/documents/490
I 2008K TRAINING COURSE AGENDA. II HEMODIALYSIS REVIEW. III HYDRAULIC DESCRIPTION. IV MACHINE OPERATION. V INSTALLATION CHECKLIST ...
Training & education - Fresenius Medical Care
https://www.freseniusmedicalca....re.com/en/healthcare
Fresenius Medical Care — training and education for health care professionals. For patient support, home treatment, regulatory requirements, supporting guides ...
At-Home Hemodialysis Training | Fresenius Kidney Care
https://www.freseniuskidneycare.com › Treatments › At-Home Hemodialysis
Depending on the type of dialysis machine you will use, the training program lasts for about 4 to 8 weeks. You will continue to get your dialysis treatments while ...
Training with Fresenius 2008K - HD For Patients - Home Dialysis ...
forums.homedialysis.org › ... › HD For Patients
Nov 16, 2006 - 6 posts - 5 authors
Stacy and I have been in training with the Fresenius Baby K for the past 4 weeks. ... my doctor about doing home hemodialysis, so a much deserv… ... on giving you a quiet RO and makes the machine as quiet as possible.
The Dialysis Machine — Dialysis Technician's Training
https://dialysistechnicianstra....ining.com/the-dialys
The dialysis machine acts as an artificial replacement for the kidneys, ... Inc. Gambro; Fresenius Medical Care; Wilmed Global – reconditioned machines ...
Training – Renal Dynamics
https://www.renaldynamics.com › Services
Machines: • Fresenius Level I and II training • Introduction to dialysis and machines • Hands on demonstrations • Practical and written exams • Certification upon ...
2008K@home Fresenius Home Hemodialysis Machine
https://fmcna-hd.com/2008kathome.html
Back to 2008K2 Fresenius Dialysis Machine Go to 2008T Fresenius Dialysis ... Same clinical, technical training and same spare parts as 2008k machines
Dilation and curettage (D&C) is a procedure to remove tissue from inside your uterus. Doctors perform dilation and curettage to diagnose and treat certain uterine conditions — such as heavy bleeding — or to clear the uterine lining after a miscarriage or abortion.
Elbow Exam - Orthopaedic OSCE - Clinical Skills - Dr Gill
The elbow examination is a core skill - in this video, we demonstrate how to perform an elbow EXAM for an Orthopaedic Clinical Skills OSCE, which should be one of the more accessible examination stations for medical students.
For a passing grade in your Clinical Skills OSCE, an elbow assessment should follow the LOOK, FEEL, MOVE approach
Initially looking for erythema, scars, swelling and position
Palpating the elbow - specifically the olecranon, medial and lateral epicondyles, and radial head for heat, oedema and crepitus
Finally assess range of movement with flexion and extension at the elbow, before determining for tennis and golfers' elbows
Watch further orthopaedic examinations for your OSCE revision:
The Elbow - Deep Dive
https://youtu.be/SX5buhtCVDw
The Spine Examination:
https://youtu.be/pJxMHa6SCgU
The Knee examination
https://youtu.be/oyKH4EYfJDM
The Hip examination
https://youtu.be/JC9GKq5nSdQ
The GALS examination
https://youtu.be/5qJaf7gW-B0 - Gait, Arms, Legs, Spine - GALS screen
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Please note that there is no ABSOLUTE way to perform a clinical examination. Different institutions and even clinicians will have differing degrees of variations - the aim is the effectively identify medically relevant signs.
However during OSCE assessments. Different medical schools, nursing colleges and other health professional courses will have their own preferred approach to a clinical assessment - you should concentrate on THEIR marks schemes for your assessments.
The examination demonstrated here is derived from Macleods Clinical Examination - a recognised standard textbook for clinical skills.
Some people viewing this medical examination video may experience an ASMR effect
#clinicalskills #Elbow #DrGill
Mini-Laparoscopic Cholecystectomy with Intraoperative Cholangiogram for Symptomatic Cholelithiasis (Gallstones) - Extended
Authors: Brunt LM1, Singh R1, Yee A2
Published: September 26, 2017
AUTHOR INFORMATION
1 Department of Surgery, Washington University, St. Louis, Missouri
2 Division of Plastic and Reconstructive Surgery, Washington University, St. Louis, Missouri
DISCLOSURE
No authors have a financial interest in any of the products, devices, or drugs mentioned in this production or publication.
ABSTRACT
Minimal invasive laparoscopic cholecystectomy is the typical surgical treatment for cholelithiasis (gallstones), where patients present with a history of upper abdominal pain and episodes of biliary colic. The classic technique for minimal invasive laparoscopic cholecystectomy involves four ports: one umbilicus port, two subcostal ports, and a single epigastric port. The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) has instituted a six-step strategy to foster a universal culture of safety for cholecystectomy and minimize risk of bile duct injury. The technical steps are documented within the context of the surgical video for (1) achieving a critical view of safety for identification of the cystic duct and artery, (2) intraoperative time-out prior to management of the ductal structures, (3) recognizing the zone of significant risk of injury, and (4) routine intraoperative cholangiography for imaging of the biliary tree. In this case, the patient presented with symptomatic biliary colic due to a gallstone seen on the ultrasound in the gallbladder. The patient was managed a mini-laparoscopic cholecystectomy using 3mm ports for the epigastric and subcostal port sites with intraoperative fluoroscopic cholangiogram. Specifically, the senior author encountered a tight cystic duct preventing the insertion of the cholangiocatheter and the surgical video describes how the author managed the cystic duct for achieving a cholangiogram, in addition to the entire technical details of laparoscopic cholecystectomy.