Examination of pulse, blood pressure and capillary refilling time

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 ..

Defecography showing Internal Rectal Prolapse

9 Months In The Womb: A Remarkable Look At Fetal Development Through Ultrasound

Our General Surgery team treats hernia patients on a daily basis. In fact, you could consider them to be hernia experts. We sat down with one of those experts, Dr. Heater Dunlap, to talk about the common signs and symptoms of hernias and to answer the question of when to see a doctor.

A hematoma is a collection of blood outside of a blood vessel. There are several types of hematomas and they are often described based on their location. Examples of hematomas include subdural, spinal, under the finger or toenail bed (subungual), ear, and liver (hepatic). Some causes of hematomas are as pelvic bone fractures, fingernail injuries (subungual), bumps, passing blood clots, blood clot in the leg (DVT), blood cancers, and excessive alcohol use. Symptoms of hematomas depend upon their location and whether adjacent structures are affected by the inflammation and swelling associated with the bleeding and may include

The anatomy of the direct and indirect inguinal hernia.


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Berries and Lime by Gregory David
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The examination room should be quiet, warm and well lit. After you have finished interviewing the patient, provide them with a gown (a.k.a. "Johnny") and leave the room (or draw a separating curtain) while they change. Instruct them to remove all of their clothing (except for briefs) and put on the gown so that the opening is in the rear. Occasionally, patient's will end up using them as ponchos, capes or in other creative ways. While this may make for a more attractive ensemble it will also, unfortunately, interfere with your ability to perform an examination! Prior to measuring vital signs, the patient should have had the opportunity to sit for approximately five minutes so that the values are not affected by the exertion required to walk to the exam room. All measurements are made while the patient is seated. Observation: Before diving in, take a minute or so to look at the patient in their entirety, making your observations, if possible, from an out-of-the way perch. Does the patient seem anxious, in pain, upset? What about their dress and hygiene? Remember, the exam begins as soon as you lay eyes on the patient. Temperature: This is generally obtained using an oral thermometer that provides a digital reading when the sensor is placed under the patient's tongue. As most exam rooms do not have thermometers, it is not necessary to repeat this measurement unless, of course, the recorded value seems discordant with the patient's clinical condition (e.g. they feel hot but reportedly have no fever or vice versa). Depending on the bias of a particular institution, temperature is measured in either Celcius or Farenheit, with a fever defined as greater than 38-38.5 C or 101-101.5 F. Rectal temperatures, which most closely reflect internal or core values, are approximately 1 degree F higher than those obtained orally. Respiratory Rate: Respirations are recorded as breaths per minute. They should be counted for at least 30 seconds as the total number of breaths in a 15 second period is rather small and any miscounting can result in rather large errors when multiplied by 4. Try to do this as surreptitiously as possible so that the patient does not consciously alter their rate of breathing. This can be done by observing the rise and fall of the patient's hospital gown while you appear to be taking their pulse. Normal is between 12 and 20. In general, this measurement offers no relevant information for the routine examination. However, particularly in the setting of cardio-pulmonary illness, it can be a very reliable marker of disease activity. Pulse: This can be measured at any place where there is a large artery (e.g. carotid, femoral, or simply by listening over the heart), though for the sake of convenience it is generally done by palpating the radial impulse. You may find it helpful to feel both radial arteries simultaneously, doubling the sensory input and helping to insure the accuracy of your measurements. Place the tips of your index and middle fingers just proximal to the patients wrist on the thumb side, orienting them so that they are both over the length of the vessel.

Sex reassignment surgery for male-to-female involves reshaping the male genitals into a form with the appearance of, and, as far as possible, the function of female genitalia. Prior to any surgeries, patients usually undergo hormone replacement therapy (HRT), and, depending on the age at which HRT begins, facial hair removal. There are associated surgeries patients may elect to, including facial feminization surgery, breast augmentation, and various other procedures.

General Examination - Clinical Skills OSCE - Dr Gill

The general examination is one of those early exams, which is essentially used to start medical students off with their clinical skills studies.

In the real world, it's mainly used with regard to gaining an overview of a patient, such as for a medical check up, or a baseline examination, for example, a health report.

They have been a couple of comments about the pulse monitor used in the video. For those who are interested. I’ve reached out to the manufacturer, and they’ve requested that the following code is provided to viewers, in order to get 20% off, if they decide on themselves.

Product model number: Vibeat SP20
Official Website: https://vibeatstore.com/produc....ts/sp20-handheld-pul
Special 20% OFF code: JAMES

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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.

Some people watching this video may experience an ASMR effect

#DrGill #Asmr #Clinicalskills

#drgill #clinicalskills #asmr

A bodybuilder gets his shoulder leaking because of synthol use on the stage while posing back double biceps

Glaucoma Surgery 3D Animation

Use warm water and sea salt. Soak the wart for 10 to 15 minutes in warm salt water to moisten the skin. Scrape the dead skin layers off the wart using a nail file, pumice stone or mild sandpaper. You could also use your fingers, but wash them thoroughly before and after, as warts can easily spread.

External cephalic version is a process by which a breech baby can sometimes be turned from buttocks or foot first to head first. External cephalic version (ECV) is a manual procedure that is advocated by national guidelines for breech presentation singleton pregnancy, in order to enable vaginal delivery.

Laparoscopic Liver Surgery 3D Animation

The typical radiograph is of a well-defined, rounded, retrocardiac opacity with an air-fluid level. In this image, the radiolucent gas is highlighted in blue, while the gastric contents are highlighted in the green. In many cases of hiatal hernia, there will not be an air bubble below the left hemidiaphragm. This is a relatively expected finding considering that the stomach is no longer in its usual position. The anatomical position of the herniated organ can be further elucidated on the lateral radiograph. Here we can see that the stomach is in the middle mediastinum posterior to the heart and above the diaphragm. Hiatal hernias can look similar to a retrocardiac lung abscess or another cavitary lesion, but it will change in size and shape between radiographs. Large hernias can shift the mediastinum to the right and result in a widening of the carinal angle. They can even give the appearance of cardiomegaly. In this radiograph, the cardiac silhouette is distinctly visible within the confines of the hiatal hernia. To review, a hiatal hernia on an AP chest radiograph typically appears as a round retrocardiac opacity with an air-fluid level.

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Disclaimer: All the information provided by Medical Education for Visual Learners and associated videos are strictly for informational purposes only. It is not intended as a substitute for medical advice from your health care provider or physician. It should not be used to overrule the advice of a qualified healthcare provider, nor to provide advice for emergency medical treatment. If you think that you or someone that you know may be suffering from a medical condition, then please consult your physician or seek immediate medical attention.

Ridge splitting with bone expansion is a technique of manipulation of bone to form receptor site for implant without removing any bone from the implant site.

This is a diabetic foot ulcer. The patient reportedly went on vacation and noticed this ulcer upon their return. Debridement (removal of damaged tissue) to the level of healthy bleeding tissue is medically necessary as damaged tissue acts an impediment to wound healing. Due to their diabetic neuropathy, they did not feel any pain or indication that a wound was forming. This ulcer appeared to have penetrated to the level of subcutaneous tissue or even fascia, but turned out to be much deeper than that. These are serious wounds and are the beginnings of what lead to foot and leg amputations if they are not treated promptly by your healthcare provider, AKA Podiatrist.

A tonsillolith lodged in the tonsillar crypt. Specialty. Otorhinolaryngology. Tonsilloliths, also known as tonsil stones, are clusters of calcified material that form in the tonsillar crypts, the crevices of the tonsils. While they occur most commonly in the palatine tonsils, they may also occur in the lingual tonsils.