The pelvic floor or pelvic diaphragm is composed of muscle fibers of the levator ani, the coccygeus, and associated connective tissue which span the area underneath the pelvis. The pelvic diaphragm is a muscular partition formed by the levatores ani and coccygei, with which may be included the parietal pelvic fascia on their upper and lower aspects. The pelvic floor separates the pelvic cavity above from the perineal region (including perineum) below.

The right and left levator ani lie almost horizontally in the floor of the pelvis, separated by a narrow gap that transmits the urethra, vagina, and anal canal. The levator ani is usually considered in three parts: pubococcygeus, puborectalis, and iliococcygeus. The pubococcygeus, the main part of the levator, runs backward from the body of the pubis toward the coccyx and may be damaged during parturition. Some fibers are inserted into the prostate, urethra, and vagina. The right and left puborectalis unite behind the anorectal junction to form a muscular sling . Some regard them as a part of the sphincter ani externus. The iliococcygeus, the most posterior part of the levator ani, is often poorly developed.

The coccygeus, situated behind the levator ani and frequently tendinous as much as muscular, extends from the ischial spine to the lateral margin of the sacrum and coccyx.

The pelvic cavity of the true pelvis has the pelvic floor as its inferior border (and the pelvic brim as its superior border.) The perineum has the pelvic floor as its superior border.

Some sources do not consider “pelvic floor” and “pelvic diaphragm” to be identical, with the “diaphragm” consisting of only the levator ani and coccygeus, while the “floor” also includes the perineal membrane and deep perineal pouch. However, other sources include the fascia as part of the diaphragm. In practice, the two terms are often used interchangeably.

Inferiorly, the pelvic floor extends into the anal triangle.

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.

What to expect during the day of a pediatric surgery at Sutter Children's Center Sacramento.

Watch that video to know how to treat premature ejaculation naturally

If you have a lung disease, a type of surgery called a lobectomy is one treatment option your doctor may suggest. Your lungs are made up of five sections called lobes. You have three in your right lung and two in your left. A lobectomy removes one of these lobes. After the surgery, your healthy tissue makes up for the missing section, so your lungs should work as well or better than they did before.

Watch that Ectopic Pregnancy Medical Abortion Procedure

What Gets Rid Of Ringworm, How To Cure Ringworm On Face, How To Cure Ringworm Naturally, Ringworms ---- http://ringworm-cure.plus101.com --- There are many cures, treatments and home remedies available at your disposal. While most doctors prescribe some type of weird fungus cream or medication, this isn't always the best route and can do more harm to your body than good. Think about it, anything that isn't natural and is made up of chemicals isn't going to nourish and provide your body with the strength it needs. The worst thing you can do is to "sit and wait" for it to magically heal on it's own. When people do this, they're often in for a lot more pain and discomfort than they need to go through. You want this Ringworm condition over and done with quickly, so that you can move on with your life and have this be something of the past. Over the years I've spent studying and researching Ringworm, I've tested almost every treatment and remedy available on the market. I began exploring home-made remedies, as they are more ideal for your body, are inexpensive, and have been around for centuries. You'd be amazed at what our planet provides us and the power these natural ingredients can have in healing our bodies. I've broken down the cure for Ringworm into several steps: 1) Treat the rash immediately by getting rid of any itchiness, discomfort and pain. I suggest bathing procedures for this, which are mentioned in my Fast Ringworm Cure e-book program. A bath, combined with special home remedies and ingredients, can get rid of all symptoms quickly and begin healing the rash rapidly. 2) Use natural creams, lotions, or even oils on the rash. This will help kill the fungus and heal the rash quickly. There are certain ingredients, such as special oils, honey, and many others that have powerful healing affects. 3) Strengthen the immune system and body so that it can naturally fight off any infection and heal the body from the inside out. This is often something overlooked, as most people think of a skin condition as an external thing. But by consuming the right foods, while avoiding others, you can heal Ringworm much faster. Certain supplements that your body may be deprived of are key. Not only that, but a strong immune system and body means that you won't have to worry about getting Ringworm, or any other condition for that matter, again in the future. William Oliver is a nutritionist, medical researcher, and author of the Fast Ringworm Cure e-book. To find out how to cure Ringworm in 3 days or less, click below: http://ringworm-cure.plus101.com

Cranial nerves exam 1st to 7th from the USMLE collection

⁣Facial Skin Cancer Surgery

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Dressing Changes- Wet to Dry (Nursing Skills)

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Dressing Changes- Wet to Dry (Nursing Skills):
In this video we’re going to look at how to do a wet to dry dressing change. Wound care and dressing changes should be performed at least daily or more often depending on orders. Dressing changes should be sterile to avoid introducing any new bacteria to the wound and to promote wound healing.

Bookmarks:
0:05 Introduction
0:10 Wound Assessment link above
0:24 Dressing Change Prep
1:24 Wet vs Dry Gauze
1:37 Soaking Gauze
2:00 Gauze Ring Out
2:25 Packing the wound
3:00 Covering the wound bed
3:37 Dry gauze barrier
4:00 ABD pad application
4:46 Documentation
4:54 Outro

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External cephalic version, or version, is a procedure used to turn a fetus from a breech position or side-lying (transverse) position into a head-down (vertex) position before labor begins. When successful, version makes it possible for you to try a vaginal birth.

Venous cutdown is an emergency procedure in which the vein is exposed surgically and then a cannula is inserted into the vein under direct vision. It is used to get vascular access in trauma and hypovolemic shock patients when peripheral cannulation is difficult or impossible

Glass ampules are often used to store medication, and as a nurse, you'll need to know how to use them.

In this video, I demonstrate how to clean an ampule using alcohol prep, how to open (or break) an ampule, as well as how to dispose of the ampule.

In addition, I show how to use an ample filter straw while drawing up (withdrawing) medication, how to use the syringe, and how to remove the air bubbles in the syringe.

This is another video in our series on clinical nursing skills.

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Endometrial Biopsy of Uterus

Stress-related mucosal disease (SRMD) is an acute, erosive gastritis representing conditions ranging from stress-related injury to stress ulcers (1, 2). Stress-related injury is superficial mucosal damage that presents primarily as erosions, whereas stress ulcers are deep, focal mucosal damage penetrating the submucosa with high risk for gastrointestinal bleeding (2, 3). Mucosal damage has been reported to occur during the first 24 hours of hospital admission in 75% to 100% of intensive care unit (ICU) patients (4, 5). Clinically important gastrointestinal bleeding can cause hemodynamic instability and increase the need for red blood cell transfusions (1). Significant bleeding may also increase the length of stay in the ICU and mortality (1).

To learn more about robotically assisted heart surgery, please visit https://cle.clinic/2Y6aHXH

Robotically assisted heart surgery is a minimally invasive option most often used for mitral valve repair. Cleveland Clinic cardiothoracic surgeons explain how it works and what to expect.

To learn more about our cardiothoracic experts, please visit
Marc Gillinov, MD - https://cle.clinic/2ZtNM7b
Daniel Burns, MD - https://cle.clinic/2W1MdxI

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@Samaritan Medical Center engaging in education and practicing skills are key. We are committed to programs that do just this. This October, all nursing staff attended the required Annual Skills Fair. Our amazing nursing team not only has a chance to learn and practice but also to network with their colleagues. Our Clinical Educators and Nurse Leaders organize the event and spend the time investing in your staff.
If you are interested in becoming part of the Samaritan nursing team, apply today: www.samaritanhealth.com/careers.
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The headache, lethargy, and neck stiffness suggest subarachnoid hemorrhage secondary to rupture of a mycotic aneurysm. Mycotic or infected arterial aneurysms can develop due to metastatic infection from IE, with septic embolization and localized vessel wall destruction in the cerebral (or systemic) circulation. Intracerebral mycotic aneurysms can present as an expanding mass with focal neurologic findings or may not be apparent until aneurysm rupture with stroke or subarachnoid hemorrhage. The diagnosis of mycotic cerebral aneurysm can usually be confirmed with computed tomography angiography. Management includes broad-spectrum antibiotics (tailored to blood culture results) and surgical intervention (open or endovascular).