Mr Brian MacCormack talking about Paediatric Surgery Emergencies. This talk is part of the Paediatric Emergencies 2022 event. To get your CME certificate for watching the video please visit https://www.paediatricemergenc....ies.com/conference/p

#PaediatricEmergencies #PaediatricEmergencies2022 #PaediatricSurgery

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Tracheostomy Suctioning- Nursing Skills

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Tracheostomy Suctioning- Nursing Skills:

In this video we’re going to talk about suctioning a tracheostomy. You may need to do this before you do trach care or just because the patient requires suctioning. Make sure that you assess the patient before you start so that you know what their one sounds are, and what their oxygen saturation is. We love you guys! Go out and be your best selves today! And, as always, happy nursing!

Bookmarks:
0.05 Introduction to trach suctioning
0:21 Suction setup
0:42 Opening suction kit
1:55 Sterile water
2:13 Starting trach suctioning
2:00 Catheter insertion
3:00 Catheter pass #2
3:26 Listen to lungs
3:31 Outro

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Discover A Simplified Approach to Master the Complexity of Anatomy with me, Dr. David Morton ... The Noted Anatomist!

This video tutorial discusses an Introduction to Histology (study of tissues):
0:00​. Intro
0:35. Hierarchical organization of living matter
1:56​. H&E stains
3:00​. Epithelium overview (characteristics and classifying scheme)
- 9:12. Simple squamous epithelium
- 11:05. Simple cuboidal epithelium
- 12:20. Simple columnar epithelium
- 13:36. Stratified squamous epithelium
- 15:51. Urinary epithelium (transitional epithelium)
- 16:45. Pseudo-stratified ciliated columnar epithelium (respiratory epithelium)
18:55. Connective tissue overview (characteristics and classifying scheme)
- 21.14. Connective tissue proper (loose CT, dense irregular CT, dense regular CT, adipose tissue)
- 24:50. Cartilage (hyaline cartilage, elastic cartilage, fibrocartilage)
- 26:04. Bone (osteoblasts, osteocytes, osteoclasts, calcium ...)
- 27:34. Blood (RBC, WBC, platelet, plasma)
28:54. Muscle tissue (skeletal muscle, cardiac muscle, smooth muscle)
32:54. Nervous tissue (neurons and glial cells)
36:58​. In-a-Nutshell
37:07​. Acknowledgements

For a more detailed study of histology go to The Histology Wizard: https://www.youtube.com/channe....l/UCAeLLruy9RkUWaW_r

lowerlimb motor assesment

A clue cell appears smudged, with indistinct contents and fuzzy, poorly defined borders.

This video shows the Assessment of coordination

This is the biggest known operation ever.The Whipple procedure(pancreatoduodenectomy) is the most common operation performed for pancreatic cancer and may be used to treat other cancers such as small bowel cancer. Surgeons remove the head of the pancreas, most of the duodenum (a part of the small intestine), a portion of the bile duct and sometimes a portion of the stomach. After the pancreatoduodenectomy, the surgeon reconstructs the digestive tract. At Mayo Clinic, surgeons perform more than 100 Whipple procedures annually. Patients leave the hospital in an average of 14 days.

Sensory and reflexes exam of the upper limb from the USMLE collection Sensory and reflexes exam of the upper limb

عملية تجميل أو اعادة شكل الانف
د. محمد الروبى
استشارى جراحات التجميل - جامعة عين شمس

The complex circuitry interconnecting different areas in the brain, known collectively as white matter, is composed of millions of axons organized into fascicles and bundles. Upon macroscopic examination of sections of the brain, it is difficult to discern the orientation of the fibers. The same is true for conventional imaging modalities. However, recent advancements in magnetic resonance imaging (MRI) make such task possible in a live subject. By sensitizing an otherwise typical MRI sequence to the diffusion of water molecules it is possible to measure their diffusion coefficient in a given direction1. Normally, the axonal membrane and myelin sheaths pose barriers to the movement of water molecules and, thus, they diffuse preferentially along the axon2. Therefore, the direction of white matter bundles can be elucidated by determining the principal diffusivity of water. The three-dimensional representation of the diffusion coefficient can be given by a tensor and its mathematical decomposition provides the direction of the tracts3; this MRI technique is known as diffusion tensor imaging (DTI). By connecting the information acquired with DTI, three-dimensional depictions of white matter fascicles are obtained4. The virtual dissection of white matter bundles is rapidly becoming a valuable tool in clinical research.

Our journey begins with a transverse section of tightly packed axons as seen through light microscopy. Although represented as a two-dimensional "slice", we see that these axons in fact resemble tubes. A simulation of water molecules diffusing randomly inside the axons demonstrates how the membranes and myelin hinder their movement across them and shows the preferred diffusion direction --along the axons. The tracts depicted through DTI slowly blend in and we ride along with them. As we zoom out even more, we realize that it is a portion of the corpus callosum connecting the two sides of the brain we were traveling on and the great difference in relative scale of the individual axons becomes evident. The surface of the brain is then shown, as well as the rest of the white matter bundles--a big, apparently chaotic tangle of wires. Finally, the skin covers the brain.

With the exception of the simulated water molecules, all the data presented in the animation is obtained through microscopy and MRI. Computer algorithms for the extraction of the cerebral structures and a custom-built graphics engine make our journey through the brain's anatomy possible in a living person.

Micrograph courtesy of Dr. Christian Beaulieu, University of Alberta.
Music by Mario Mattioli.

References:
1. Stejskal, E.O., et al., J. Chem. Phys., 1965. 42:
2. Beaulieu, C., NMR Biomed., 2002. 15:435-55.
3. Basser, P.J., et al., J. Magn. Reson. B, 1994. 103:247-54.
4. Mori, S., et al., NMR Biomed., 2002. 15:468-80.

ENDOSCOPIC (NON-SURGICAL) REMOVAL OF MULTIPLE LARGE TUMORS FROM STOMACH IN A PATIENT WITH PEUTZ-JEGHERS SYNDROME
PEUTZ-JEGHERS SYNDROME: Peutz-Jeghers syndrome (PJS) is a familial syndrome consisting of mucocutaneous pigmentation, gastrointestinal polyposis and cancers of gut & other sites like breast, ovary, and testes. PJS has an autosomal dominant inheritance with variable and incomplete penetrance. Germline mutations of STK11/LKB1 gene on 19p cause this syndrome. Mucocutaneous pigmentation may be noted in early infancy. These deposits of melanin are most commonly found around the mouth, nose, lips, buccal mucosa, hands, and feet, and may also be present in perianal and genital areas. PJS polyps may be found in stomach, small intestine, or colon, but they tend to be prominent in the small intestine. These polyps may increase in size and cause small intestinal obstruction or intussusceptions that may occur in early infancy. Acute upper gastrointestinal bleeding and chronic faecal blood may complicate the disease.
PATIENT: The patient was a 25 yr male who had mucocutaneous pigmentation and multiple polyps in the stomach and duodenum. He presented with bleeding from gastric polyps. As the polyps in stomach were numerous, (more than 20 in number) and were large in size (some equal to small egg size), he had been advised to undergo surgery. Surgery planned was total gastrectomy.
PROCEDURE: The patient underwent video-endoscopy of the esophagus, stomach and duodenum. All polyps were examined for size and presence or absence of stalk. A plan to remove all the gastric polyps at endoscopy was made in the same sitting. He received light conscious sedation. Flat polyps were raised form the gastric wall by injection of saline in to polyp base to let these lesions have a stalk. This was done by needle injector. Each polyp was engaged in a snare and the polyp stalk was cut by coagulation cutting current. The cuts were clean without any bleeding. All polyps were recovered for histology. The histology revealed all polyps to be hamartomous lesions. None of the polyps were cancerous. Patient has been followed up for over one year and is doing fine without any further bleeding or pain.
Video shows the procedure of videoendoscpy and endoscopic removal of polyps.

This endoscopy shows a patient with cancer of the larynx, Laryngeal cancer is the most common cancer of the upper respiratory tract. The incidence of laryngeal tumors is closely correlated with smoking, as head and neck tumors occur 6 times more often among cigarette smokers than among nonsmokers. The age-standardized risk of mortality from laryngeal cancer appears to have a linear relationship with increasing cigarette consumption. Death from laryngeal cancer is 20 times more likely for the heaviest smokers than for nonsmokers. It should be suspected in any patient with hoarseness of the voice for three weeks or longer until proven otherwise.

The colonoscope is slowly withdrawn during this screening colonoscopy down from the transverse colon, back around the splenic flexure, and down the descending colon, and reveals this finding a colonic diverticula. Diverticulosis is a common, acquired, age-related occurrence affecting over 50% of the... western adult population over the age of 50. It is seen rarely in Africa and Asia where the dietary fiber content is traditionally higher. Thus most investigators feel that low fiber diets are related to the development of this condition. Ironically, colonic diverticula are not true diverticula but rather pseudodiverticula in that the sac includes layers of the mucosa and submucosa that push through rather than include the outer muscular layer. As with the small bowel the colon has an inner circular muscular layer, but the outer longitudinal layer is composed of three bands of muscle that run the length of the colon known as teniae. Diverticula occur in rows between the mesenteric and two antimesenteric teniae where the colonic wall is further weakened by the defect caused by the perforating vasa recti artery which supplies the colonic mucosa. Occasionally, the anatomic propensity of diverticula to form in rows is quite apparent as seen when this clip is replayed in slow motion. Most often, however, the arrangement of the diverticula appears random due to the angulation of the bowel and thickening of the semi lunar folds. The conditions that cause these pulsion diverticula are not know with certainty but may include high intrahaustral pressures, muscular hypertrophy, and age related alterations in collagen cross linking. Diverticula can bleed or can abscess and perforate. The incidence of diverticulitis or diverticular bleeding is in the range of 1:1,000 patients with diverticulosis.

Cholecystectomy & Retroperitoneal Tumor Removal

Complete Pineal Tumor excision by using Supracerebellar Infratentorial approach in sitting position was performed. The young adult male is up and about after surgery.

Tracheal Deviation Technique

Preparing Syringes for Injections

Vaccines are extremely safe. Adverse reactions are uncommon. The most common reaction is pain and swelling at the vaccine site, which is easily treated, and has no longterm problems. An allergic reaction to vaccines are rare. Dr. Michael Davis dispells this and other vaccine myths, including myths about autism and vaccines.

The video will describe possible reasons of raised hemidiaphragm. It will also show some good examples. Please see my website for discalimer.

Ultrasound Guided Sclerotherapy for Varicose Veins