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This video has been updated to include an alternate name for the internal thoracic arteries. View the updated video here: https://youtu.be/kxc22Fjd1NQ
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This video, created by Nucleus Medical Media, shows a coronary artery bypass graft (CABG) procedure used to combat coronary artery disease. Beginning with a midline sternal incision, the heart is connected to a perfusion machine which will take over the duties of the heart while the surgery takes place. Two different grafts are used to bypass the blocked coronary arteries: the internal thoracic artery from inside the chest wall, and the saphenous vein from the leg. After the procedure, the heart is shocked to restart its beating. A drainage tube is left at the incision site to drain away excess fluid. The animation continues to show two other types of approaches to a coronary artery bypass graft, off-pump bypass surgery and minimally invasive bypass surgery.
This is similar to the procedure performed on former president Bill Clinton and former California governor Arnold Schwarzenegger.
#HeartBypassSurgery #CABG #heart
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At one time, women who had delivered by cesarean section in the past would usually have another cesarean section for any future pregnancies. The rationale was that if allowed to labor, many of these women with a scar in their uterus would rupture the uterus along the weakness of the old scar. Over time, a number of observations have become apparent: Most women with a previous cesarean section can labor and deliver vaginally without rupturing their uterus. Some women who try this will, in fact, rupture their uterus. When the uterus ruptures, the rupture may have consequences ranging from near trivial to disastrous. It can be very difficult to diagnose a uterine rupture prior to observing fetal effects (eg, bradycardia). Once fetal effects are demonstrated, even a very fast reaction and nearly immediate delivery may not lead to a good outcome. The more cesarean sections the patient has, the greater the risk of subsequent rupture during labor. The greatest risk occurs following a “classical” cesarean section (in which the uterine incision extends up into the fundus.) The least risk of rupture is among women who had a low cervical transverse incision. Low vertical incisions probably increase the risk of rupture some, but usually not as much as a classical incision. Many studies have found the use of oxytocin to be associated with an increased risk of rupture, either because of the oxytocin itself, or perhaps because of the clinical circumstances under which it would be contemplated. Pain medication, including epidural anesthetic, has not resulted greater adverse outcome because of the theoretical risk of decreasing the attendant’s ability to detect rupture early. The greatest risk of rupture occurs during labor, but some of the ruptures occur prior to the onset of labor. This is particularly true of the classical incisions. Overall successful vaginal delivery rates following previous cesarean section are in the neighborhood of 70 This means that about 30of women undergoing a vaginal trial of labor will end up requiring a cesarean section. Those who undergo cesarean section (failed VBAC) after a lengthy labor will frequently have a longer recovery and greater risk of infection than had they undergone a scheduled cesarean section without labor. Women whose first cesarean was for failure to progress in labor are only somewhat less likely to be succesful in their quest for a VBAC than those with presumably non-recurring reasons for cesarean section. For these reasons, women with a prior cesarean section are counseled about their options for delivery with a subsequent pregnancy: Repeat Cesarean Section, or Vaginal Trial of Labor. They are usually advised of the approximate 70successful VBAC rate (modified for individual risk factors). They are counseled about the risk of uterine rupture (approximately 1in most series), and that while the majority of those ruptures do not lead to bad outcome, some of them do, including fetal brain damage and death, and maternal loss of future childbearing. They are advised of the usual surgical risks of infection, bleeding, anesthesia complications and surgical injury to adjacent structures. After counseling, many obstetricians leave the decision for a repeat cesarean or VBAC to the patient. Both approaches have risks and benefits, but they are different risks and different benefits. Fortunately, most repeat cesarean sections and most vaginal trials of labor go well, without any serious complications. For those choosing a trial of labor, close monitoring of mother and baby, with early detection of labor abnormalities and preparation for
Dysfunction in the sacroiliac joint, also called the SI joint, can sometimes cause lower back and/or leg pain. Leg pain from sacroiliac joint dysfunction can be particularly difficult to differentiate from radiating leg pain caused by a lumbar disc herniation (sciatica) as they can feel quite similar.
Overbite is a type or malocclusion or an overjet. A lot of people don’t realize that they have an overbite, as they believe their condition is not serious enough to obtain dental attention. This could also for the reason that other cases of overbites are so minor to be noticeable. However, others have serious overbite condition that can make the person’s top jaw look much larger or the bottom jaw significantly smaller. But one thing to remember, overbite can actually cause some dental problems. This condition can change the structure of your face and affect the way you talk. The most popular form of overbite correction is orthodontic treatment. Your dentist will fix the overbite with the help of rubber bands and dental braces to pull the upper teeth back. Tooth extraction may be suggested if overcrowding complicates the overbite so as to provide room for your front teeth. In extreme conditions, overbite surgery may be needed to place your jaw backwards or forwards. Furthermore, if severe overbite is not corrected during adulthood, the teeth may continue to shift and trigger dental issues such as gum disease.
This minimally invasive procedure connects electrodes to the brain and places a pacemaker-like device under the skin. When activated, electrical impulses minimize shaking due to "dyskinesia syndrome" in patients with Parkinson's disease. ~ Detroit Medical Center
http://plantar-fasciitis-solution.info-pro.co Foot Arch Pain, Sharp Pain In Heel, Pain In Foot, Achilles Heel Pain, Chronic Plantar Fasciitis What is Plantar Fasciitis? Plantar fasciitis is a common injury that affects the heel of a person’s foot. The arches of the feet are supported by a tough and fibrous tissue known as the plantar fascia and when this tissue is used repetitively, injury may occur. It can be easy to overuse the feet, especially when participating in activities such as sporting events. Hence, plantar fasciitis is more commonly found in athletes or others who are constantly using their feet for long durations. With excessive use, the planar fascia will eventually give in and this condition may also be progressive. Runners and those who are known to participate in similar activities need to ensure that they do not damage this important band of tissue. In addition, body weight could be a factor that leads to the occurrence of plantar fasciitis. If a person is overweight, the feet and subsequently the plantar fascia tissue could become overwhelmed. Improper footwear could also cause a strain on the plantar fascia tissue and this could gradually become severe over time. plantar fasciitis relief in 7 days click here. http://plantar-fasciitis-solution.info-pro.co
Presence of abdominal pain and distension. Presence of urinary symptoms - Such as dysuria, oliguria, flank pain, and hematuria. Occurrence of any symptoms of hypocalcemia - Such as anorexia, vomiting, cramps, seizures, spasms, altered mental status, and tetany. Symptoms of hyperkalemia - Such as weakness and paralysis.
Ophthalmoscopy - Eye Clinical Examination - OSCE - Dr Gill
Direct Ophthalmoscopy use of the eyes is a very challenging clinical skill, incorporating both the examiner's knowledge of the retina, but also understanding the use of the ophthalmoscope
In this clinical skills tutorial, we look at the use of the direct ophthalmoscope as part of an ophthalmic examination
it should be noted that in the ideal circumstances, the room lights will be dimmed during the examination, and dilating eye drops used to improve the visualisation of the fundus
Some people may notice an ASMR effect from this clinical examination
#DrGill #Ophthalmoscopy #ClinicalSkills #EyeExam
An ectopic pregnancy (EP) is a condition in which a fertilized egg settles and grows in any location other than the inner lining of the uterus. The vast majority of ectopic pregnancies are so-called tubal pregnancies and occur in the Fallopian tube.