Dr. Ebraheim’s educational animated video describing the anatomy and associated injuries of the knee joint.
Disrupted quadriceps
•Patient is unable to actively extend the knee.
The most common cause of ACL ruptures:
•Traumatic force being applied during twisting motion.
•Side stepping or landing from a jump.
Patient complains of:
•Immediate pain
•Knee giving way
•Swelling
Aspiration of the knee
•If aspiration of the knee joint shows evidence of blood within the joint there is 75-80% chance of ACL and meniscal injury.
Lachamn’s test- ACL knee exam
•Knee is flexed at 30 degrees.
•ACL tear of the knee is identified by pulling on the tibia and examining the frontward motion of the lower leg in comparison to the upper leg.
Radiological exam – ACL
•MRI of the knee joint shows bone lesions or bruising associated with tears of the ACL. Injury is found in the typical location; middle of the femoral condyle and posterior part of the tibia laterally.
Posterior cruciate ligament tear (PCL)
•Common cause of injury is a bent knee hitting a dashboard in a car accident.
Tibial Sag Test –PCL knee exam
Quadriceps active test-PCL knee exam
•The examiner stabilizes the leg of the patient and then the patient is asked to actively contract the quadriceps muscle.
•The tibia is seen actively reduced from the posterior subluxed position.
Lachman’s test-PCL knee exam
•Knee is bent 20-30 degrees.
•The posterior drawer test is carried out while the patient is in a supine position and the knee is flexed to 90 degrees.
•The amount of translation of the tibia relative to the femur is observed.
The dial test is performed while the patient is in the supine or prone position and both knees are in 90 and 30 degrees of flexion. More than 10 degrees of external rotation indicates significant injury.
Common meniscal tears
Symptoms include
•Knee pain
•Pain with straightening the knee
•Swelling
•Locking
•Weakness

This video depicts how a stent is placed in the coronary artieries. We first place a guiding wire in the heart artery through a catheter, usually from the groin. Then the stent is inflated by a balloon in the artery, which is then removed. The stent remains permanently. Blood thinners, aspirin and plavix, are both required after a stent is placed in your heart artery.

Bacterial abscess of the liver is relatively rare; however, it has been described since the time of Hippocrates (400 BCE), with the first published review by Bright appearing in 1936. In 1938, Ochsner's classic review heralded surgical drainage as the definitive therapy; however, despite the more aggressive approach to treatment, the mortality remained at 60-80%.[1] The development of new radiologic techniques, the improvement in microbiologic identification, and the advancement of drainage techniques, as well as improved supportive care, have reduced mortality to 5-30%; yet, the prevalence of liver abscess has remained relatively unchanged. Untreated, this infection remains uniformly fatal. The three major forms of liver abscess, classified by etiology, are as follows: Pyogenic abscess, which is most often polymicrobial, accounts for 80% of hepatic abscess cases in the United States Amebic abscess due to Entamoeba histolytica accounts for 10% of cases [2] Fungal abscess, most often due to Candida species, accounts for fewer than 10% of cases

he inflatable penile prosthesis consists of two attached cylinders -- a reservoir and a pump -- which are placed surgically in the body. The two cylinders are inserted in the penis and connected by tubing to a separate reservoir of saline. The reservoir is implanted under the rectus muscles in the lower abdomen.

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.

McMurray's maneuver is used to detect the presence of meniscal tears. To detect a medial meniscal injury, the patient is put in a supine position with the knee in maximum flexion. One hand of the examiner is placed on the posteromedial margin of the involved knee and the other hand supports the foot. The tibia is then externally rotated, and the knee is extended slowly. The test is positive if there is an audible or palpable click or popping sensation during extension of the involved knee.

Tendons are thick cords that join your muscles to your bones. When these tendons become irritated or inflamed, it is called tendinitis. This condition causes acute pain and tenderness, making it difficult to move the affected joint. Read more

A nephron (from Greek νεφρός (nephros) meaning "kidney") is the basic structural and functional unit of the kidney. Its chief function is to regulate the concentration of water and soluble substances like sodium salts by filtering the blood, reabsorbing what is needed and excreting the rest as urine.

DIRTIEST PARTS OF YOUR BODY

Medical examination of the abdomen from Loyola University, Chicago

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.

Hirschsprung's (HIRSH-sproongz) disease is a condition that affects the large intestine (colon) and causes problems with passing stool. The condition is present at birth (congenital) as a result of missing nerve cells in the muscles of the baby's colon. A newborn who has Hirschsprung's disease usually can't have a bowel movement in the days after birth. In mild cases, the condition might not be detected until later in childhood. Uncommonly, Hirschsprung's disease is first diagnosed in adults.

Guest surgeon Dr. Nicole Callan gives us an introduction to hernias. She discusses what a hernia is, the different types of hernias, and an introduction to treatment.

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Medical emergency
Do NOT use the Video for medical emergencies. If you have a medical emergency, call a physician or qualified healthcare provider, or CALL 911 immediately. Under no circumstances should you attempt self-treatment based on anything you have seen or read on the Video.

General information is not medical advice
The general information provided on the Video is for informational purposes only and is not professional medical advice, diagnosis, treatment, or care, nor is it intended to be a substitute therefore. Always seek the advice of your physician or other qualified health provider properly licensed to practise medicine or general healthcare in your jurisdiction concerning any questions you may have regarding any information obtained from this Video and any medical condition you believe may be relevant to you or to someone else. Never disregard professional medical advice or delay in seeking it because of something you have read on this Video. Always consult with your physician or other qualified healthcare provider before embarking on a new treatment, diet, or fitness program. Information obtained on the Video is not exhaustive and does not cover all diseases, ailments, physical conditions, or their treatment.

Orchidectomy and Orchidopexy in testis Torsion

Thoracentesis is a procedure used to obtain a sample of fluid from the space around the lungs. Normally, only a thin layer of fluid is present in the area between the lungs and chest wall. However, some conditions can cause a large amount of fluid to accumulate. This collection of fluid is called a pleural effusion.

Each month inside your ovaries, a group of eggs starts to grow in small, fluid-filled sacs called follicles. Eventually, one of the eggs erupts from the follicle (ovulation). It usually happens about 2 weeks before your next period. Hormones Rise After the egg leaves the follicle, the follicle develops into something called the corpus luteum. The corpus luteum releases a hormone that helps thicken the lining of your uterus, getting it ready for the egg. The Egg Travels to the Fallopian Tube After the egg is released, it moves into the Fallopian tube. It stays there for about 24 hours, waiting for a single sperm to fertilize it. All this happens, on average, about 2 weeks after your last period.

Arthritis occurs when the cartilage breaks down explains Dr. Derek Papp, Sports Medicine Physician with Miami Orthopedics & Sports Medicine Institute. This it’s a very common knee injury such as the damage of the cartilage and meniscus tear.
ACL tears is another common injury especially in sports like soccer or Australian football, the specialist explains.

Shoulder Clinical Examination - Medical School Clinical Skills - Dr Gill

Personally, I find the shoulder examination the most complex examination possibly as there are so many variations and special tests. Some of which overlap and some will relate specifically to a patients presentation.

Often in a medical school syllabus, only select special tests will be used. In this shoulder exam demonstration, we include the Hawkins-Kennedy Test looking for impingement. This is dovetailed with examination for bicipital tendonitis as this is another possible cause of impingement type symptoms.

This shoulder upper limb exam follows the standard "Look, Feel, Move" orthopaedic exam approach, and overall order as set out in MacLeods Clinical Examination

Watch further orthopaedic examinations for your OSCE revision:

The Spine Examination:
https://youtu.be/pJxMHa6SCgU

Knee Examination
https://youtu.be/oyKH4EYfJDM

Hip Joint Clinical Examination
https://youtu.be/JC9GKq5nSdQ
________

Please note that there is no ABSOLUTE way to perform a clinical examination. Different institutions and even clinicians will have differing degrees of variations - the aim is the effectively identify medically relevant signs.

However during OSCE assessments. 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.

The examination demonstrated here is derived from Macleods Clinical Examination - a recognized standard textbook for clinical skills.


#ShoulderExamination #ClinicalSkills #DrGill

Menorrhagia is the medical term for menstrual periods with abnormally heavy or prolonged bleeding. Although heavy menstrual bleeding is a common concern, most women don't experience blood loss severe enough to be defined as menorrhagia. With menorrhagia, you can't maintain your usual activities when you have your period because you have so much blood loss and cramping. If you dread your period because you have such heavy menstrual bleeding, talk with your doctor. There are many effective treatments for menorrhagia.