Physical Examination Introduction

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Chapters

0:00 Introduction
1:04 Why do doctors perform laparoscopy?
2:11 How is laparoscopy performed?
3:22 Result
3:47 Risk of laparoscopy

Laparoscopy (from Ancient Greek λαπάρα (lapára) 'flank, side', and σκοπέω (skopéō) 'to see') is an operation performed in the abdomen or pelvis using small incisions (usually 0.5–1.5 cm) with the aid of a camera. The laparoscope aids diagnosis or therapeutic interventions with a few small cuts in the abdomen.[1]

Laparoscopic surgery, also called minimally invasive procedure, bandaid surgery, or keyhole surgery, is a modern surgical technique. There are a number of advantages to the patient with laparoscopic surgery versus an exploratory laparotomy. These include reduced pain due to smaller incisions, reduced hemorrhaging, and shorter recovery time. The key element is the use of a laparoscope, a long fiber optic cable system that allows viewing of the affected area by snaking the cable from a more distant, but more easily accessible location.

Laparoscopic surgery includes operations within the abdominal or pelvic cavities, whereas keyhole surgery performed on the thoracic or chest cavity is called thoracoscopic surgery. Specific surgical instruments used in laparoscopic surgery include obstetrical forceps, scissors, probes, dissectors, hooks, and retractors. Laparoscopic and thoracoscopic surgery belong to the broader field of endoscopy. The first laparoscopic procedure was performed by German surgeon Georg Kelling in 1901. There are two types of laparoscope:[2]

A telescopic rod lens system, usually connected to a video camera (single-chip or three-chip)
A digital laparoscope where a miniature digital video camera is placed at the end of the laparoscope, eliminating the rod lens system

The mechanism mentioned in the second type is mainly used to improve the image quality of flexible endoscopes, replacing conventional fiberscopes. Nevertheless, laparoscopes are rigid endoscopes. Rigidity is required in clinical practice. The rod-lens-based laparoscopes dominate overwhelmingly in practice, due to their fine optical resolution (50 µm typically, dependent on the aperture size used in the objective lens), and the image quality can be better than that of the digital camera if necessary. The second type of laparoscope is very rare in the laparoscope market and in hospitals.[citation needed]

Also attached is a fiber optic cable system connected to a "cold" light source (halogen or xenon) to illuminate the operative field, which is inserted through a 5 mm or 10 mm cannula or trocar. The abdomen is usually insufflated with carbon dioxide gas. This elevates the abdominal wall above the internal organs to create a working and viewing space. CO2 is used because it is common to the human body and can be absorbed by tissue and removed by the respiratory system. It is also non-flammable, which is important because electrosurgical devices are commonly used in laparoscopic procedures.[3]
Procedures
Surgeons perform laparoscopic stomach surgery.
Patient position

During the laparoscopic procedure, the position of the patient is either in Trendelenburg position or in reverse Trendelenburg. These positions have an effect on cardiopulmonary function. In Trendelenburg's position, there is an increased preload due to an increase in the venous return from lower extremities. This position results in cephalic shifting of the viscera, which accentuates the pressure on the diaphragm. In the case of reverse Trendelenburg position, pulmonary function tends to improve as there is a caudal shifting of viscera, which improves tidal volume by a decrease in the pressure on the diaphragm. This position also decreases the preload on the heart and causes a decrease in the venous return leading to hypotension. The pooling of blood in the lower extremities increases the stasis and predisposes the patient to develop deep vein thrombosis (DVT).[4]
Gallbladder

Rather than a minimum 20 cm incision as in traditional (open) cholecystectomy, four incisions of 0.5–1.0 cm, or more recently, a single incision of 1.5–2.0 cm,[5] will be sufficient to perform a laparoscopic removal of a gallbladder. Since the gallbladder is similar to a small balloon that stores and releases bile, it can usually be removed from the abdomen by suctioning out the bile and then removing the deflated gallbladder through the 1 cm incision at the patient's navel. The length of postoperative stay in the hospital is minimal, and same-day discharges are possible in cases of early morning procedures.[citation needed]
Colon and kidney

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A clinical examination of the hands using the standard Look, Feel, Move approach. Specific​ examination structure derived from MacLeod's Clinical Examination 14th edition. Performed by Dr James Gill

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✨This video is on the structure and functions of the three types of cartilage (Hyaline, Elastic and Fibrocartilage). I hope it helps! ☀️

🌟What's in this video?
0:00 - Intro
0:07 - Connective Tissue Recap
1:16 - Structure of Connective Tissue
1:57 - Structural Components of Cartilage
3:38 - Types of Cartilage
3:49 - Hyaline Cartilage
8:05 - Elastic Cartilage
8:55 - Fibrocartilage

✨ Other videos you may need:
🔅 Connective Tissue : https://youtu.be/xw_ALdt5n-A
🔅 Collagen : https://youtu.be/3e2JYMNS_W4
🔅 Ossification: https://youtu.be/86V9SNWD_No
🔅Histology: https://www.youtube.com/playli....st?list=PL1rG930trF2


💫 For more videos like this, subscribe to my channel!
Byte Size Med: https://youtube.com/channel/UC....ZghvlgylH3r_CWfA18eF

📚Factual References & for Further Reading:
- DiFiore's Atlas of Histology
- Junqueira's Basic Histology
- Gartner's Concise Histology
- Openstax Anatomy and Physiology
https://openstax.org/details/b....ooks/anatomy-and-phy
- Openstax Biology
https://openstax.org/details/books/biology-2e
(The last two are links to open-source references. They are NOT affiliate links)

🌤 Note:
These are just a collection of my notes. So use them the way you would use borrowed notes from a friend. 📝
The images in this video are hand-drawn for illustration and explanation only.✍️ Hence, they may not be anatomically accurate. I am just one person making these videos. If there are any errors, that is unintentional. I try super hard to avoid them. Please let me know if you find any, so it gets clarified for other viewers. Science constantly evolves and changes. New discoveries are made everyday. So some of the information in these videos may become outdated. If you notice that, please let me know so I can update them.










⚡️Disclaimer:
These videos are NOT a substitute for a medical textbook. Textbooks are written by experts (which I do not claim to be), edited, proofread and referenced. Please use them.
The information has been sourced from multiple references as mentioned above. I draw all the pictures myself. But if I have inadvertently infringed on any copyright, that is completely unintentional. I only make these videos to impart education. If I have accidentally violated copyright in any way, do let me know so I can make the necessary changes or give credit to anyone who is owed the same.
These videos are NOT intended for patient education. They are NOT a substitute for diagnosis and treatment by a licensed medical professional. Always seek the advice of a qualified health care provider for any questions you may have regarding any medical condition, so that they can address your individual needs.

🔅They are ONLY meant to help students of medicine and health sciences with studying, and should be used for just that purpose and absolutely nothing else.


Byte Size Med. All Rights Reserved.

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