The most reliable clinical sign to detect ascites is checking for bilateral flank dullness. If a patient with ascites is lying supine, fluid accumulates in the flank regions, leading to dullness on percussion. At the same time, the air-filled bowel loops are forced upwards by the free fluid due to buoyancy, resulting in tympanitic percussion. To locate specifically where dullness shifts to tympany, or the air-fluid level, percussion should be performed from the sides towards the middle. To confirm that the dullness is caused by ascites, ask the patient to switch to a lateral decubitus position. If ascites is present, the air-filled bowel loops will shift accordingly and remain at the surface of the fluid. As a result, the air-fluid level will shift as well. This is known as shifting dullness.

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Eric's Home Dialysis

Watch that Medical Abortion Surgical Procedure

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Learn how to start your Kegels or pelvic floor exercises after hysterectomy.

Tongue and lip-tie are common causes of nipple pain, uneven breast drainage, slow weight gain and low milk supply. Many physicians do not properly assess for tongue or lip-tie or recognize their impact on the breastfeeding relationship, leaving babies vulnerable to early weaning. Ultrasound studies have shown that the tongue movements used by tongue-tied babies are qualitatively different from those used by by babies who are not tongue-tied. These movements are not as effective at removing milk from the breast and can cause significant pain and nipple damage. In these studies, tongue-tied babies also did not draw the nipple as deeply into the mouth as babies who were not tongue-tied.

A very funny video

Watch that video of Enema Medical Insertion Procedure

Knee reflex video from the USMLE collection

Watch that video of people who Survived Deadly Snake Bites

The spleen is one of the most frequently injured intraperitoneal organs, and management of splenic injuries may require splenectomy .. The spleen is an wedge-shaped organ that lies in relation to the ninth and 11th ribs, located in the left hypochondrium and partly in the epigastrium; thus, it is situated between the fundus of the stomach and the diaphragm. The spleen is highly vascular and reddish purple; its size and weight are variable. A normal spleen is not palpable. The spleen's key function is the removal of old red blood cells "RBCs", defective circulating cells, and circulating bacteria. In addition, the spleen helps maintain normal erythrocyte morphology by processing immature erythrocytes, removing their nuclei, and changing the shape of the cellular membrane. Other functions of the spleen include the removal of nuclear remnants of RBCs, denatured hemoglobin, and iron granules ..

Otto Placik MD. a board certified Chicago based plastic surgeon presents Vulvar Vaginal Genital anatomy lesson reviewing the Vulva, Mons Pubis, clitoral hood, prepuce, frenulum, labia minora & majora, vagina, urethra and fourchette with surgical implications and techniques. Photos pictures and video of anatomic models are reviewed in detail on different models. Great for patients thinking about or planning before labiaplasty or vaginal cosmetic surgery

The cardiac cycle is the sequence of events that occurs when the heart beats. As the heart beats, it circulates blood through pulmonary and systemic circuits of the body. There are two phases of the cardiac cycle. In the diastole phase, the heart ventricles are relaxed and the heart fills with blood

Bacterial meningitis is very serious and can be deadly. Death can occur in as little as a few hours. While most people with meningitis recover, permanent disabilities such as brain damage, hearing loss, and learning disabilities can result from the infection. There are several types of bacteria that can cause meningitis. Some of the leading causes of bacterial meningitis in the United States include Streptococcus pneumoniae, group B Streptococcus, Neisseria meningitidis, Haemophilus influenzae, and Listeria monocytogenes.

exam

Prinzmetal's or Prinzmetal angina (/ˈprɪntsmɛtəl/, sounds like "prints metal") (also known as variant angina, vasospastic angina (VSA), angina inversa, or coronary vessel spasm) is a syndrome typically consisting of angina (cardiac chest pain) at rest that occurs in cycles.

Superior capsule reconstruction (SCR) is a promising alternative treatment for irreparable posterosuperior rotator cuff tears (Figure 1). It utilizes a graft from the superior glenoid to the greater tuberosity to stabilize the humeral head. In a study by Mihata and colleagues of 23 patients who underwent SCR with a fascia lata autograft at a minimum of 2 years follow-up, the American Shoulder and Elbow Surgeons (ASES) score improved significantly from 23.5 preoperatively to 92.9. Postoperative MRI showed 83% of patients had intact reconstructions with no progression of muscle atrophy.

Mesenteric Vessel Ligation

Although your body may harbor the bacteria that cause tuberculosis, your immune system usually can prevent you from becoming sick. For this reason, doctors make a distinction between: Latent TB. In this condition, you have a TB infection, but the bacteria remain in your body in an inactive state and cause no symptoms. Latent TB, also called inactive TB or TB infection, isn't contagious. It can turn into active TB, so treatment is important for the person with latent TB and to help control the spread of TB. An estimated 2 billion people have latent TB. Active TB. This condition makes you sick and can spread to others. It can occur in the first few weeks after infection with the TB bacteria, or it might occur years later. Signs and symptoms of active TB include: Coughing that lasts three or more weeks Coughing up blood Chest pain, or pain with breathing or coughing Unintentional weight loss Fatigue Fever Night sweats