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During the examination, the doctor gently puts a lubricated, gloved finger of one hand into the rectum. He or she may use the other hand to press on the lower belly or pelvic area. A digital rectal exam is done for men as part of a complete physical examination to check the prostate gland .
This video will cover, in detail, the motor, sensory, reflect components of a neurological examination.
This video is created for the UBC Medicine Neurology Clinical Skills curriculum as part of MEDD 419 FLEX projects.
Filmed, written, and directed by:
John Liu
Vincent Soh
Chris Calvin
Kashi (Siyoung) Lee
Kero (Yue) Yuen
Ge Shi
Doctor - Dr. Jason Valerio (Department of Neurology, UBC)
Supervised by:
Dr. Alex Henri-Bhargava (Department of Neurology, UBC)
Zac Rothman (UBC FOM Digital Solutions: Ed Tech)
Edited by:
Stephen Gillis
Produced by UBC FOM Digital Solutions EdTech team facilitates innovation by UBC Medicine learners and faculty.
Website: https://education.med.ubc.ca/
Subscribe: https://www.youtube.com/ubcmed....vid?sub_confirmation
UBCMLN Podcast Network: https://tinyurl.com/ubcmedicinelearningnetwork
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With respect the Lekwungen peoples on whose traditional territory the Island Medical Program and the University of Victoria stand and the Songhees, Esquimalt and WSÁNEĆ peoples whose historical relationships with the land continue to this day.
We acknowledge our traditional hosts and honour their welcome and graciousness to the students who seek knowledge here.
© UBC Faculty of Medicine
All rights reserved. Reproduction and distribution of this presentation without written permission from UBC Faculty of Medicine is strictly prohibited.
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.
The G-SHOT® (clinical description: G-Spot Amplification™ or GSA™), is a simple, nonsurgical, physician-administered treatment that can temporarily augment the Grafenburg spot (G-Spot) in sexually active women with normal sexual function.
http://vencer-la-diabetes-rapido.info-pro.co/ Como Controlar La Diabetes Tipo 2 Naturalmente Sin Medicamentos, Pre Diabetes Y Diabetes Tipo 1. https://youtu.be/BOSkQ5MnjT0 Que es la Insulina? Una definición practica sin adentrarnos en terminos estrictamente medicos es que la insulina es una hormona formada por 51 aminoácidos. Dentro del páncreas, las células beta producen la hormona llamada insulina. Con cada comida, las células beta liberan insulina para ayudar al cuerpo a utilizar o almacenar en la sangre la glucosa que se obtiene de los alimentos. Su déficit provoca la diabetes mellitus y su exceso provoca hiperinsulinismo con hipoglucemia. En las personas con diabetes tipo 1, el páncreas no produce insulina. Las células beta han sido destruidas y se necesitan inyecciones de insulina para utilizar la glucosa de las comidas. Las personas con diabetes tipo 2 producen insulina, pero sus cuerpos no responden bien a la misma. Algunas personas con diabetes tipo 2 necesitan medicamentos para la diabetes o inyecciones de insulina para ayudar a su cuerpo a utilizar la glucosa para obtener energía. * La insulina no se puede tomar como una píldora, ya que se descompone durante la digestión al igual que la proteína en los alimentos. Se debe inyectar en la grasa debajo de la piel para que llegue a la sangre. Existen diferentes tipos de insulina en función de la rapidez con que trabajan, y en funcion de su duración. La insulina viene en diferentes concentraciones, la más común es U-100. Tipos de insulina: * De Acción Rápida: Comienza a trabajar unos 15 minutos después de la inyección, con picos en aproximadamente 1 hora, y continúa trabajando por un tiempo de 2 a 4 horas. Tipos: Insulina glulisina (Apidra), la insulina lispro (Humalog) y la insulina aspart (NovoLog). * Regular o de Acción Corta: Generalmente llega al torrente sanguíneo a los 30 minutos después de la inyección, picos de entre 2 a 3 horas después de la inyección, y es efectiva durante aproximadamente 3 a 6 horas. Tipos: Humulin R, Novolin R * De Acción Intermedia: Generalmente llega al torrente sanguíneo de aproximadamente 2 a 4 horas después de la inyección, picos de 4 a 12 horas y eseficaz durante aproximadamente 12 a 18 horas. Tipos: NPH (Humulin N, Novolin N) * De Acción Prolongada: Alcanza el torrente sanguíneo varias horas después de la inyección y tiende a disminuir los niveles de glucosa de manera bastante uniforme durante un período de 24 horas. Tipos: La insulina detemir (Levemir) y la insulina glargina (Lantus) Nota: Esta información debes consultarla siempre con tu medico especialista. La insulina Tiene 3 Características: El inicio: Es el tiempo antes de que la insulina alcance el torrente sanguíneo y se inicie la reducción de la glucosa en sangre. Pico: Es el tiempo durante el cual la insulina está surtiendo el máximo efecto en términos de reducción de la glucosa en sangre. La duración: Es cuánto tiempo la insulina continúa reduciendo la glucosa sanguínea.