The anatomy of the direct and indirect inguinal hernia.


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Berries and Lime by Gregory David
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Thyroid nodules are solid or fluid-filled lumps that form within your thyroid, a small gland located at the base of your neck, just above your breastbone. The great majority of thyroid nodules aren't serious and don't cause symptoms. Thyroid cancer accounts for only a small percentage of thyroid nodules. You often won't know you have a thyroid nodule until your doctor discovers it during a routine medical exam. Some thyroid nodules, however, may become large enough to be visible or make it difficult to swallow or breathe.

Dr. Debbie Song at Gillette Children's describes in detail selective rhizotomy surgery.

A selective dorsal rhizotomy is an operation performed to treat spasticity. It is thought that high tone and spasticity arise from abnormal signals that are transmitted through sensory or dorsal nerve roots to the spinal cord. In a selective dorsal rhizotomy we identify and cut portions of the dorsal nerve roots that carry abnormal signals thereby disrupting the mechanisms that lead to spasticity. Potential patients go through a rigorous assessment that includes an in-depth gait and motion analysis as well as a physical therapy evaluation.

They are evaluated by a multidisciplinary team that includes a pediatric rehabilitation doctor, a neurosurgeon, and an orthopedist, Appropriate patient selection is vital. Ideal candidates for selective dorsal rhizotomy are children who are between four and ten years of age, have a history of being born prematurely, and have a diagnosis of diplegia cerebral palsy. These patients usually walk independently or with the assistance of crutches or a walker. They typically function at a level one, two, or three in the gross motor function classification system or gmfcs. A selective dorsal rhizotomy involves the coordinated efforts of the neurosurgery, physiatry, anesthesia and nursing teams. The operation entails making an incision in the lower back that is approximately six to eight inches long. We perform what we call a laminoplasty in which we remove the back part of the spinal elements from the lumbar one or l1 to l5 levels. At the end of the procedure the bone is put back on. We identify and open up the Dural sac that contain the spinal fluid spinal cord and nerve roots. Once the Dural sac is opened ,we expose the lumbar and upper sacral nerve roots that transmit information to and from the muscles of the lower extremities.

At each level we isolate the dorsal nerve root, which in turn is separated into as many as 30 smaller thread light fruitlets.

Each rootlet is then electrically stimulated. Specialized members of the physiatry team look for abnormal responses in the muscles of the legs as each rootless is being stimulated. If an abnormal response is observed then the rootlet is cut.

If a normal response is observed, then the rootlet is not cut. We usually end up cutting approximately 20 to 40 percent of the rootlets. The Dural sac is sutured closed and the l1 through l5 spinal elements are put back into anatomic position, thus restoring normal spinal alignment. The overlying tissues and skin are then closed and the patient is awoken from surgery. The entire operation takes between four and five hours. A crucial component to the success of our rhizotomy program is the extensive rehabilitation course following surgery. With their tone significantly reduced after a rhizotomy, patients relearn how to use their muscles to walk more efficiently through stretching, strengthening, and gait training. Approximately one to two years after a rhizotomy patients undergo repeat gait and motion analysis. The orthopedic surgeons assess the need for interventions to correct bone deformities, muscle contractures, poor motor control, impaired balance, or other problems related to cerebral palsy.

At Gillette we work closely with patients and families to ensure that our selective dorsal rhizotomy program meets their goals for enhancing their function and improving their quality of life.

VISIT https://www.gillettechildrens.org/ to learn more

0:00 Why choose selective dorsal rhizotomy?
0:56 Who is a good candidate for selective dorsal rhizotomy?
1:31 What does a selective dorsal rhizotomy entail?
3:26 What is recovery from selective dorsal rhizotomy like?

A myringotomy is a procedure in which your doctor creates a small hole in the eardrum so fluids such as water, blood, or pus can drain out. In many cases, your doctor will put in a tube so it won't get backed up again. The tube, which will usually fall out on its own in about six to 18 months, lets air flow through and keeps the middle ear dry. Tubes also: Reduce pain Improve hearing Cut down on the number of infections your child may have

The 12-lead ECG is a vital tool for EMT’s and paramedics in both the prehospital and hospital setting. It is extremely important to know the exact placement of each electrode on the patient. Incorrect placement can lead to a false diagnosis of infarction or negative changes on the ECG.

This video is really sad. You can literally watch this man dying. He was shot in the chest and rushed to the emergency room. His heart has stopped beating or has arrested. As a last resort, surgeons did an extreme procedure called an open thoracotomy which is that crazy tool you see there that basically splits the ribs open and allows easy open access to the heart. They did this so they could give him a cardiac massage. A cardiac massage is when surgeons are manually trying to pump the heart after it has stopped working on its own (cardiac arrest). Unfortunately he lost so much blood from his gun shot wound and he was pronounced dead. There are cases of patients surviving after having this kind of invasive resuscitation but it is rare.

German Video showing examination of the urinary bladder

The infection is generally transmitted by direct contact with the mucus or sores of someone else with strep. Common symptoms include sore throat, fever, and swollen lymph nodes in the neck. Rarely, complications can involve the heart or kidneys. Treatment is important to reduce complications. Oral antibiotics like penicillin, amoxicillin, cephalexin, or azithromycin are commonly used. Other medicines such as acetaminophen or ibuprofen can help with pain and fever.

Over one million Americans have the sexually transmitted virus, HIV, which can lead to the deadly disease known as AIDS.
HIV can be transmitted in the sexual fluids, blood or breast milk of an infected person. HIV prevention therefore involves a wide range of activities including prevention of mother-to-child transmission, needle exchanges and harm reduction for injecting drug users, and precautions for health care workers.

Rehabilitation time for a meniscus repair is about 3 months. A meniscectomy requires less time for healing — approximately 3 to 4 weeks. Meniscus tears are extremely common knee injuries. With proper diagnosis, treatment, and rehabilitation, patients often return to their pre-injury abilities.

Vaginoplasty is any surgical procedure that results in the construction or reconstruction of the vagina. It is a type of genitoplasty. Pelvic organ prolapse is often treated with one or more surgeries to repair the vagina.

When diving into a Breast Reduction procedure, there are many things to consider. Even as a patient, being aware of any concerns and how the procedure works is important. Therefore, when a plastic surgeon operates on a patient, the results are clear. Dr. Linder, a Breast surgeon specialist in Beverly Hills, helps explain what goes into a Breast Reduction Procedure.

Cardioversion is a medical procedure by which an abnormally fast heart rate (tachycardia) or cardiac arrhythmia is converted to a normal rhythm using electricity or drugs. Synchronized electrical cardioversion uses a therapeutic dose of electric current to the heart at a specific moment in the cardiac cycle.

An animation showing vaginal childbirth (delivery)

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Watch that Cutting Inside Human Fat Body video

WORLD'S FIRST TRULY ANATOMIC MULTI-ROOTED ZIRCONIA DENTAL IMPLANT SOLUTION dentistry video

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Rubber band ligation is a procedure in which the hemorrhoid is tied off at its base with rubber bands, cutting off the blood flow to the hemorrhoid. This treatment is only for internal hemorrhoids. To do this procedure, a doctor inserts a viewing instrument (anoscope) into the anus. The hemorrhoid is grasped with an instrument, and a device places a rubber band around the base of the hemorrhoid. The hemorrhoid then shrinks and dies and, in about a week, falls off. A scar will form in place of the hemorrhoid, holding nearby veins so they don't bulge into the anal canal. The procedure is done in a doctor's office. You will be asked whether the rubber bands feel too tight. If the bands are extremely painful, a medicine may be injected into the banded hemorrhoids to numb them. After the procedure, you may feel pain and have a sensation of fullness in the lower abdomen. Or you may feel as if you need to have a bowel movement. Treatment is limited to 1 to 2 hemorrhoids at a time if done in the doctor's office. Several hemorrhoids may be treated at one time if the person has general anesthesia. Additional areas may be treated at 4- to 6-week intervals.

Robotic-assisted endoscopic thyroid surgery using the daVinci® Surgical System can safely and effectively offer those needing thyroid surgery relief without neck incisions. Dr. Ron Kuppersmith and Dr. Andrew deJong are now performing this procedure at the College Station Medical Center in Texas.