Leopold's Maneuvers are difficult to perform on obese women and women who have hydramnios. The palpation can sometimes be uncomfortable for the woman if care is not taken to ensure she is relaxed and adequately positioned. To aid in this, the health care provider should first ensure that the woman has recently emptied her bladder. If she has not, she may need to have a straight urinary catheter inserted to empy it if she is unable to micturate herself. The woman should lie on her back with her shoulders raised slightly on a pillow and her knees drawn up a little. Her abdomen should be uncovered, and most women appreciate it if the individual performing the maneuver warms their hands prior to palpation. First maneuver: Fundal Grip While facing the woman, palpate the woman's upper abdomen with both hands. A professional can often determine the size, consistency, shape, and mobility of the form that is felt. The fetal head is hard, firm, round, and moves independently of the trunk while the buttocks feel softer, are symmetric, and the shoulders and limbs have small bony processes; unlike the head, they move with the trunk. Second maneuver After the upper abdomen has been palpated and the form that is found is identified, the individual performing the maneuver attempts to determine the location of the fetal back. Still facing the woman, the health care provider palpates the abdomen with gentle but also deep pressure using the palm of the hands. First the right hand remains steady on one side of the abdomen while the left hand explores the right side of the woman's uterus. This is then repeated using the opposite side and hands. The fetal back will feel firm and smooth while fetal extremities (arms, legs, etc.) should feel like small irregularities and protrusions. The fetal back, once determined, should connect with the form found in the upper abdomen and also a mass in the maternal inlet, lower abdomen. Third maneuver: Pawlick's Grip In the third maneuver the health care provider attempts to determine what fetal part is lying above the inlet, or lower abdomen.[2] The individual performing the maneuver first grasps the lower portion of the abdomen just above the symphysis pubis with the thumb and fingers of the right hand. This maneuver should yield the opposite information and validate the findings of the first maneuver. If the woman enters labor, this is the part which will most likely come first in a vaginal birth. If it is the head and is not actively engaged in the birthing process, it may be gently pushed back and forth. The Pawlick's Grip, although still used by some obstetricians, is not recommended as it is more uncomfortable for the woman. Instead, a two-handed approach is favored by placing the fingers of both hands laterally on either side of the presenting part. Fourth maneuver The last maneuver requires that the health care provider face the woman's feet, as he or she will attempt to locate the fetus' brow. The fingers of both hands are moved gently down the sides of the uterus toward the pubis. The side where there is resistance to the descent of the fingers toward the pubis is greatest is where the brow is located. If the head of the fetus is well-flexed, it should be on the opposite side from the fetal back. If the fetal head is extended though, the occiput is instead felt and is located on the same side as the back. Cautions Leopold's maneuvers are intended to be performed by health care professionals, as they have received the training and instruction in how to perform them. That said, as long as care taken not to roughly or excessively disturb the fetus, there is no real reason it cannot be performed at home as an informational exercise. It is important to note that all findings are not truly diagnostic, and as such ultrasound is required to conclusively determine the fetal position.

Misgav Ladach - Joel Cohen approach for breech presentation

Multiple sclerosis (MS) is a disease of the central nervous system estimated to affect 2.3 million people worldwide. It is a chronic disease in which the immune system abnormally attacks the insulation and support around the nerve cells (myelin sheath) in the brain, spinal cord and optic nerves, causing inflammation and consequent damage. MS is a leading cause of non-traumatic disability in young people, usually striking between 20 and 40 years of age. There is no cure for MS, but research continues to better understand and treat the disease.

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.

A stress ulcer is a single or multiple mucosal defect which can become complicated by upper gastrointestinal bleeding during the physiologic stress of serious illness.

Polyarteritis nodosa Email this page to a friend Email this page to a friend Facebook Twitter Google+ Polyarteritis nodosa is a serious blood vessel disease. The small and medium-sized arteries become swollen and damaged. Causes Arteries are the blood vessels that carry oxygen-rich blood to organs and tissues. The cause of polyarteritis nodosa is unknown. The condition occurs when certain immune cells attack the affected arteries. More adults than children get this disease. The tissues that are fed by the affected arteries do not get the oxygen and nourishment they need. Damage occurs as a result. People with active hepatitis B or hepatitis C may develop this disease.

A little venom is drawn into a syringe. ... The quick coagulation or blood clotting caused by the Russell's viper venom is of particular interest to scientists — there's a lot of research into how it might be used in medicine. But this effect is only present in healthy blood.

Timothy Lovell, MD, an orthopedic surgeon, talks to Spokane, WA knee replacement surgery patients about the procedure, possible risks and complications of surgery, and about your recovery time.

Dr. Lovell addresses anesthesia, the size and location of the incision, and shows you what the knee replacement ball and socket joint looks like. He'll talk about the recovery process; using a crutches, a walker or a cane to get around; movements to avoid; and how long it takes to feel better and return to your normal, active life.

To learn more about Dr. Lovell, visit http://washington.providence.o....rg/find-a-provider/l

And, to learn more about having orthopedic surgery in Spokane, WA, visit http://washington.providence.o....rg/clinics/providenc

Surgical site infections (SSIs) remain a prevalent threat to patient safety. Proper surgical hand scrub or rub techniques are essential to decreasing the incidence of SSIs. This video provides instructions on the anatomical surgical hand scrub procedure using the brushstroke method. Learn more from the Department of Hospital Epidemiology and Infection Control (HEIC) at The Johns Hopkins Hospital: http://www.hopkinsmedicine.org/heic

Excerpt from my Normal Skin Histology video: https://kikoxp.com/posts/3660.

A complete organized library of all my videos, digital slides, pics, & sample pathology reports is available here: https://kikoxp.com/posts/5084 (dermpath) & https://kikoxp.com/posts/5083 (bone/soft tissue sarcoma pathology).

Please check out my Soft Tissue Pathology & Dermatopathology survival guide textbooks: http://bit.ly/2Te2haB ‬

Also, in the past I used "keratinocyte" and "squamous cell" interchangeably (this is because in dermatopathology, we see and talk about squamous cell carcinomas all the time, and those tumors are composed of keratinocytes). But technically, in normal skin histology, "squamous cell" refers only to the flattened keratinocytes in the superficial epidermis. Thankfully, a histology PhD colleague pointed this out to me and corrected my lazy nomenclature!

This video is geared towards medical students, pathology or dermatology residents, or practicing pathologists or dermatologists. Of course, this video is for educational purposes only and is not formal medical advice or consultation.

Presented by Jerad M. Gardner, MD. Please subscribe to my channel to be notified of new pathology teaching videos.

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Total laparoscopic hysterectomy using staples to secure major blood vessels. Vaginal colpotomy and mobilization of bladder performed initally with suture line at junction of vagina and cervix visualized laparoscopically.

Tonsillectomy 3D Animation

When your arteries cannot supply enough blood to your heart, your doctor may recommend coronary artery bypass graft (CABG) surgery. One of the most common heart surgeries in the United States, CABG surgery restores blood flow to your heart. Approximately every 10 minutes, someone has beating heart or "off-pump" bypass surgery1. Beating heart bypass surgery is — in simple terms — bypass surgery that is performed on your heart while it is beating. Your heart will not be stopped during surgery. You will not need a heart-lung machine. Your heart and lungs will continue to perform during your surgery. Surgeons use a tissue stabilization system to immobilize the area of the heart where they need to work. Beating heart bypass surgery is also called Off Pump Coronary Artery Bypass Surgery (OPCAB). Both OPCAB and conventional on-pump surgery restore blood flow to the heart. However, off-pump bypass surgery has proven to reduce side effects in certain types of patients.

A video shoing how to draw blood sample

USMLE Step 2 CS - EPIGASTRIC This is just preview video. To get full access please visit our website : www.usmletutoring.com

Watch that video to know How To Increase Your Testosterone Levels, Naturally

3D printing a titanium vertebrae

examination of Cranial nerves IX, X, XI & XII: Glossopharyngeal,Vagus,Accessory and hypoglossal nerves

Electronystagmography (ENG) is a diagnostic test to record involuntary movements of the eye caused by a condition known as nystagmus. It can also be used to diagnose the cause of vertigo, dizziness or balance dysfunction by testing the vestibular system.

Pregnancy is one of the beautiful phases of a woman’s life after their marriage. The feeling of the baby growing inside the womb is exceptional and very special.