Child Unresponsive Airway Obstruction

Tubal ligation using Fallope Ring

The exam should be performed in an orderly fashion as follows: 1. Have the patient stick out their tongue so that you can examine the posterior pharynx (i.e. the back of the throat). Ask the patient to say "Ah", which elevates the soft palate, giving you a better view. If you are still unable to see, place the tongue blade � way back on the tongue and press down while the patient again says "Ah," hopefully improving your view. This causes some people to gag, particularly when the blade is pushed onto the more proximal aspects of the tongue. It may occasionally be important to determine whether the gag reflex is functional (e.g. after a stroke that impairs CNs 9 or 10; or to determine if a patient with depressed level of consciousness is able to protect their airway from aspiration). This is done by touching a q-tip against the posterior pharynx, uvula or tongue. It is not necessary to do this during your routine exam as it can be quite noxious!
2. Note that the uvula hangs down from the roof of the mouth, directly in the mid-line. With an "Ah," the uvula rises up. Deviation to one side may be caused by CN 9 palsy (the uvula deviates away from the affected side), a tumor or an infection. CN9 Pasly Cranial Nerve 9 Dysfunction: Patient has suffered stroke, causing loss of function of left CN 9. As a result, uvula is pulled towards the normally functioning (ie right) side. 3. The normal pharynx has a dull red color. In the setting of infection, it can become quite red, frequently covered with a yellow or white exudate (e.g. with Strep. Throat or other types of pharyngitis).
4. The tonsils lie in an alcove created by arches on either side of the mouth. The apex of these arches are located lateral to and on a line with the uvula. Normal tonsils range from barely apparent to quite prominent. When infected, they become red, are frequently covered by whitish/yellow discharge. In the setting of a peritonsilar abscess, the tonsils appear asymmetric and the uvula may be pushed away from the affected side. When this occurs, the tonsil may actually compromise the size of the oral cavity, making breathing quite difficult.
5. Look carefully along the upper and lower gum lines and at the mucosa in general, which can appear quite dry if the patient is dehydrated.
6. Examine the teeth to get a sense of general dentition, particularly if the patient has a dental complaint. Pain produced by tapping on a tooth is commonly caused by a root abscess. Tooth Abscess: Tooth abscess involving left molar region. Associated inflammation of left face can clearly be seen. 7. Have the patient stick their tongue outside their mouth, which allows evaluation of CN 12. If there is nerve impairment, the tongue will deviate towards the affected side. Any obvious growths or abnormalities? Ask them to flip their tongue up so that you can look at the underside. If you see something abnormal, grasp the tongue with gauze so that you can get a better look. Left CN 12 Dysfunction: Stroke has resulted in L CN 12 Palsy. Tongue therefore deviates to the left.
8. Make note of any growths along the cheeks, hard palate (the roof of the mouth between the teeth), soft palate, or anywhere else. In particular, patients who smoke or chew tobacco are at risk for oral squamous cell cancer. Any areas which are painful or appear abnormal should also be palpated. Put on a pair of gloves to better explore these regions. What do they feel like? Are they hard? To what extent does a growth involve deeper structures? If the patient feels something that you cannot see, try to get someone else to hold the light source, freeing both your hands to explore the oral cavity with two tongue depressors.

different aging and other skin spots can be treated succesfully with Co2 laser.

Dr Chris Steele demonstrates a breast examination on a live model. This shows how to check yourself for early signs of tumours, cysts and other symptoms of breast cancer.

HCG Injection Procedure

If you are a medical student, a resident, a primary care physician or you practice in an emergency department, you can improve your suture skills with this detailed instruction. As you practice towards a cosmetically perfect technique, your confidence will increase, especially when dealing with complex wounds. Areas of study include: methods of closure, closure materials, anesthetics, suture removal, infection, prophylaxis, when to call in a plastic surgeon, recapping techniques and more

Another video showing different technique of child birth

A video showing the cesarean section birth

Purpose: To evaluate the results of LASIK and IntraLASIK treatment in myopic patients with nystagmus. Methods: Eight patients with congenital nystagmus (16 eyes), from 23 to 49 years of age, underwent LASIK surgery. Corneal flaps were created using either the Hansatome microkeratome or the Intral...ase femtosecond laser. The ablations were performed with the Bausch & Lomb excimer laser with an active tracking system. In some patients, the eyes were fixated with forceps or a fixation ring during the laser ablation. Results: The refractive errors were corrected in all cases. There was no decentration or loss of best corrected visual acuity greater than 1 line. In 56% of the eyes, the post-operative uncorrected visual acuity was better than the best spectacle corrected-visual acuity (BSCVA). 62.5% of the eyes improved their BSCVA. The overall visual performance was improved in all the patients. One patient that did not not drive before become eligible to get a driver license after the surgery. Conclusions: Selected patients with myopia and congenital nystagmus may benefit from laser refractive surgery. Laser refractive surgery may be safely and accurately performed by using either the Hansatome microkeratome or the Intralase femtosecond laser and an active tracking system with or without mechanical fixation. Certain patients improve their BSCVA post-operatively.

Periodontal diseases increases the risks of:
-Coronary Heart Disease
-Stoke
-Infective Endocarditis

Physical Examination of the abdomen

Abdomen Waist Liposuction for Weight Loss

At Hutzel Women's Hospital, Dr. Giancarlo Mari performs breakthrough in-utero surgery to save the lives of high-risk twins developing with a rare "shared" circulatory problem. ~ Detroit Medical Center

Re-educating the legs to walk again is the ultimate goal of this therapy for those who have suffered a stroke. ~ Detroit Medical Center

How to test radial & ulnar artery circulation

Ultrasound guided Femoral Nerve stimulating Catheter

Hernia Repair with Sofradim Mesh

The video will describe position of several tubes and lines that may be visible on a chest x-ray. Please see my website for discliamer.

Combination of Spinal and Epidural for Obstetric analgesia