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Examination of Peripheral Vascular System - Clinical Skills OSCE Revision - Dr Gill
In this video, we demonstrate the peripheral vascular examination - a less common examination, but still vitally important, particularly amongst the older population
Starting with the examination of the hands looking for clinical signs of vascular compromise, we then check the pulses of the major arteries of the upper body - the radial, brachial and carotid arteries, before moving down to assess for an abdominal aortic aneurysm.
At this point, I feel it's a practical step to check the femoral pulses before doing the overview of the legs.
After visually assessing we must examine the major vascular areas of leg.- namely the popliteal pulses, before wrapping up around the ankle with the posterior tibial and dorsalis pedis pulses
For completeness, the cardiovascular examination is demonstrated here
https://www.youtube.com/watch?v=ECs9O5zl6XQ&t=2s
#PeripheralVascular #ClinicalSkills #DrGill
A pheochromocytoma (fee-o-kroe-moe-sy-TOE-muh) is a rare, usually noncancerous (benign) tumor that develops in cells in the center of an adrenal gland. You have two adrenal glands, one above each kidney. Your adrenal glands produce hormones that give instructions to virtually every organ and tissue in your body. If you have a pheochromocytoma, an adrenal gland releases hormones that cause persistent or episodic high blood pressure. If left untreated, a pheochromocytoma can result in severe or life-threatening damage to other body systems, especially the cardiovascular system. Most people with a pheochromocytoma are between the ages of 20 and 50, but the tumor can develop at any age. Surgical treatment to remove a pheochromocytoma usually returns blood pressure to normal.
fetal position in womb at 34 weeks fetal position in womb week by week fetal position in womb at 19 weeksUnborn babies toss and turn and hold many different positions within the womb during the gestation period; pregnant women everywhere will attest to the fact that their children always start up the gymnastics at bedtime.
Reactive arthritis is a painful form of inflammatory arthritis (joint disease due to inflammation). It occurs in reaction to an infection by certain bacteria. Most often, these bacteria are in the genitals (Chlamydia trachomatis) or the bowel (Campylobacter, Salmonella, Shigella and Yersinia). Chlamydia most often transmits by sex. It often has no symptoms, but can cause a pus-like or watery discharge from the genitals. The bowel bacteria can cause diarrhea. If you develop arthritis within one month of diarrhea or a genital infection – especially with a discharge – see a health care provider. You may have reactive arthritis. - See more at: https://www.rheumatology.org/i-am-a/patient-caregiver/diseases-conditions/reactive-arthritis#sthash.PukaaQhj.dpuf
49-years old patient complaining of cough, fever and pleuritic pain for 2 weeks. At admission he was febrile and tachypnic. Chest X-Ray showed left pleural effusion. Thoracocentesis revealed purulent fluid. Chest CT-scan showed large and loculated left pleural effusion and pleural thickening. VATS decortication was performed through three incisions.
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Perfect for patient education purposes.
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LASIK, or "laser-assisted in situ keratomileusis," is the most commonly performed laser eye surgery to treat myopia, hyperopia and astigmatism. The goal of the treatment is to reshape the cornea to correct the refractive error of the eye.
The cornea is the transparent dome-shaped structure in front of the eye. The cornea refracts light and accounts for about two-thirds of the eye's total optical power. Altering the curvature of the cornea changes the way light rays enter the eye. As a result, the light rays can be focused properly onto the retina for clearer vision.
For nearsighted people, the laser is used to flatten the cornea. For farsighted people, the cornea is made steeper. For patients with astigmatism, the laser is used to smooth the irregularly-shaped cornea into a more regular shape.
The outer layer of the cornea - the epithelium – is capable of replacing itself within a few days after being damaged or removed. The deeper layer of the cornea – the stroma, on the contrary, is a permanent corneal tissue with very limited regenerative capacity. The stroma, if reshaped by a laser, will remain that way permanently.
In this procedure, a thin, circular "FLAP" is created in the surface of the cornea to gain access to the permanent corneal tissue. This can be done with a mechanical cutting tool called a microkeratome, OR, for a blade-free experience, by a femtosecond laser. An excimer laser is then used to remove some corneal tissue to reshape the cornea. Excimer laser uses cool ultraviolet light beams to vaporize microscopic amounts of tissue in a precise manner to accurately reshape the cornea. The excimer laser is computer-controlled and is programmed based on the patient’s refractive error. The flap is then laid back in place and is allowed to heal.
LASIK eye surgery is mostly painless and can be completed within minutes. Improved vision can usually be seen overnight.
PRK, or photorefractive keratectomy, was the first type of laser eye surgery for vision correction and is the predecessor to the popular LASIK procedure. In PRK, NO flap is created. Rather, the epithelial cells on the eye surface are simply removed. An excimer laser is then used to reshape the cornea just like it does in LASIK.
The vision correction outcomes of PRK surgery are comparable to those of LASIK, but the recovery period is longer. This is because the epithelium is completely removed in PRK and it takes a few days to regenerate. PRK patients also have more discomfort and haziness of vision in the first few days after the surgery. Improved vision also takes longer to achieve.
PRK does, however, offer certain advantages. Because PRK does not involve creation of a flap, which contains both epithelial and deeper stromal tissue, the entire thickness of the stroma is available for treatment. The treatment range is therefore higher. This is particularly useful for patients with high levels of myopia or for those whose cornea is too thin for LASIK. PRK is also free of flap-related complication risks.
The heart itself is made up of 4 chambers, 2 atria and 2 ventricles. De-oxygenated blood returns to the right side of the heart via the venous circulation. It is pumped into the right ventricle and then to the lungs where carbon dioxide is released and oxygen is absorbed. The oxygenated blood then travels back to the left side of the heart into the left atria, then into the left ventricle from where it is pumped into the aorta and arterial circulation.
Frostbite is an injury caused by freezing of the skin and underlying tissues. First your skin becomes very cold and red, then numb, hard and pale. Frostbite is most common on the fingers, toes, nose, ears, cheeks and chin. Exposed skin in cold, windy weather is most vulnerable to frostbite. But frostbite can occur on skin covered by gloves or other clothing. Frostnip, the first stage of frostbite, doesn't cause permanent skin damage. You can treat very mild frostbite with first-aid measures, including rewarming your skin. All other frostbite requires medical attention because it can damage skin, tissues, muscle and bones. Possible complications of severe frostbite include infection and nerve damage.
Mastectomy is surgery to remove all breast tissue from a breast as a way to treat or prevent breast cancer. For those with early-stage breast cancer, mastectomy may be one treatment option. Breast-conserving surgery (lumpectomy), in which only the tumor is removed from the breast, may be another option.
Surgeons at St Mary's Hospital, part of Imperial College Healthcare have come up with a new surgical procedure that cures heartburn with a device called RefluxStop.
Mr Ahmed Ahmed, a consultant surgeon, says surgery should now be seen as an alternative to life-long drug treatment - as Sky's Thomas Moore reports.
Read more: https://news.sky.com/story/new....-nhs-heartburn-surge
#heartburncure #surgery #skynews
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How to use a Syphilis rapid test kit for self-diagnosis of Syphilis (fingerstick blood). Convenient, Easy to Use, and over 99% Accurate. Certified GMP and ISO13485. Test yourself at home with Complete Privacy. Buy online today at: http://www.stdrapidtest.com
A leg ulcer is simply a break in the skin of the leg, which allows air and bacteria to get into the underlying tissue. This is usually caused by an injury, often a minor one that breaks the skin. In most people such an injury will heal up without difficulty within a week or two. However, when there is an underlying problem the skin does not heal and the area of breakdown can increase in size. This is a chronic leg ulcer.
As a pediatric surgeon at NewYork-Presbyterian/Weill Cornell Medical Center, Dr. Nitsana Spigland treats newborns, children, teens, and young adults requiring surgical interventions. She specializes in antenatal counseling and newborn congenital malformations.
Learn more about Dr. Spigland at: https://www.nyp.org/physician/nspigland.
Breast implants do not last forever, and during its lifetime, it may rupture. Dr. Linder, Beverly Hills breast surgeon specialist, breaks down how removing breast implants works. To learn more about Dr. Stuart Linder and his expertise, Visit: www.drlinder.com
A 76 year-old, female, presented with a three day history of melena without any abdominal pain. She had one episode of hematemesis (about 100 ml blood) in the emergency room, patient has a strong alcoholic drink abuse.
An upper endoscopy with magnification was performed.
multiple ulcers were detected across of the gastric camera,
esophageal varices was also detected