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Ankle and Foot Clinical Examination - Clinical Skills - Dr Gill
When it comes to joints of the body, the ankle is one of the joints most commonly injured. This is vitally important to be able to effectively examine a patient who is complaining of pain in the ankle and foot.
In this video we will perform a demonstration of the ankle and foot examination.
Examination of the foot, and the ankle joint, follows the standard orthopaedic approach of look, feel, move.
There is a connected video to the foot and ankle examination, on the causes of carpal tunnel syndrome - here
https://youtu.be/aXx6NfBWDSs
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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 Macleod's Clinical Examination - a recognized standard textbook for clinical skills.
#footpain #clinicalexamination #DrGill
What is Venipuncture? While venipuncture can refer to a variety of procedures, including the insertion of IV tubes into a vein for the direct application of medicine to the blood stream, in phlebotomy venipuncture refers primarily to using a needle to create a blood evacuation point. As a phlebotomist, you must be prepared to perform venipuncture procedures on adults, children, and even infants while maintaining a supportive demeanor and procedural accuracy. Using a variety of blood extraction tools, you must be prepared to respond to numerous complications in order to minimize the risk to the patient while still drawing a clean sample. In its entirety, venipuncture includes every step in a blood draw procedure—from patient identification to puncturing the vein to labeling the sample. Patient information, needle placement, and emotional environment all play a part in the collection of a blood sample, and it's the fine details that can mean the difference between a definite result and a false positive. After placing the tourniquet and finding the vein, it's time for the phlebotomist to make the complex choice on what procedure will best suit the specific situation. Keeping this in mind, it should be noted that the following information is not an instructional guide on how to perform these phlebotomy procedures. Rather, the information below is intended to serve as an educational resource to inform you of the equipment and procedures you will use. Venipuncture Technqiues Venipuncture with an Evacuated or Vacuum Tube: This is the standard procedure for venipuncture testing. Using a needle and sheath system, this procedure allows multiple sample tubes to be filled through a single puncture. This procedure is ideal for reducing trauma to patients. After drawing the blood, the phlebotomist must make sure the test stopper is correctly coded and doesn't contact exposed blood between samples. Venipuncture with a Butterfly Needle : This is a specialized procedure that utilizes a flexible, butterfly needle adaptor. A butterfly needle has two plastic wings (one on either side of the needle) and is connected to a flexible tube, which is then attached to a reservoir for the blood. Due to the small gauge of the needle and the flexibility of the tube, this procedure is used most often in pediatric care, where the patients tend to have smaller veins and are more likely to move around during the procedure. After being inserted into a vein at a shallow angle, the butterfly needle is held in place by the wings, which allow the phlebotomist to grasp the needle very close to the skin. Phlebotomists should be careful to watch for blood clots in the flexible tubing. Venipuncture with a Syringe: This technique is typically only used when there is a supply shortage, or when a technician thinks it is the appropriate method. It uses the classic needle, tube, and plunger system, operating in a similar manner to the vacuum tube but requiring multiple punctures for multiple samples. Additionally, after the blood is drawn it must be transferred to the appropriate vacuum tube for testing purposes. If you choose to use this method, remember to check for a sterile seal, and use a safety device when transferring the sample. Fingerstick (or Fingerprick): This procedure uses a medical lance to make a small incision in the upper capillaries of a patient's finger in order to collect a tiny blood sample. It is typically used to test glucose and insulin levels. When performing a Fingerstick, the phlebotomist should remember to lance the third or fourth finger on the non-dominant arm. Never lance the tip or the center of the finger pad; instead, lance perpendicular to the fingerprint lines. Heelstick (or Heelprick): Similar to the Fingerstick procedure, this process is used on infants under six months of age. A medical lance is used to create a small incision on the side of an infant's heel in order to collect small amounts of blood for screening. As with a Fingerstick, the incision should be made perpendicular to the heel lines, and it should be made far enough to the left or right side of the heel to avoid patient agitation. Before performing a Heelstick, the infant's heel should be warmed to about 42 degrees Celsius in order to stimulate capillary blood and gas flow. Therapeutic Phlebotomy: This involves the actual letting of blood in order to relieve chemical and pressure imbalances within the blood stream. Making use of a butterfly needle, this therapy provides a slow removal of up to one pint of blood. Though the blood removed is not used for blood transfusions, the procedure and concerns are the same as with routine blood donation. As with any phlebotomy procedure, one should pay close attention to the patient in order to prevent a blood overdraw. Bleeding Time: A simple diagnostic test that is used to determine abnormalities in blood clotting and platelet production. A shallow laceration is made, followed by sterile swabbing of the wound every 30 seconds until the bleeding stops. Average bleed times range between one and nine minutes. As a phlebotomist, you should familiarize yourself with the application and cross-application of these procedures in order to recognize when a procedure is necessary, and what the risks are for each.
This 3D medical animation contains the discharge instructions for removal of a Foley catheter from a man. The step-by-step procedures for emptying the Foley bag and removing the Foley catheter are shown. Symptoms requiring a follow-up call to the surgeon are listed.
Diagnosis of this condition is based on clinical symptoms alone, as there are no diagnostic laboratory tests. In order to meet the criteria for Tourette syndrome, both motor and vocal tics must be present before the age of 21 , and the tics must occur many times a day for at least 12 months which is the case in this patient. Tourette syndrome is associated with several comorbid conditions, with attention-deficit hyperactivity disorder (ADHD) and obsessive compulsive disorder (OCD) the most common. OCD is therefore the condition this child is most at risk of developing in the future.
Cervical cancer occurs when abnormal cells on the cervix camera.gif grow out of control. The cervix is the lower part of the uterus that opens into the vagina. Cervical cancer can often be successfully treated when it's found early. It is usually found at a very early stage through a Pap test.
Calcium channel blockers prevent calcium from entering cells of the heart and blood vessel walls, resulting in lower blood pressure. Calcium channel blockers, also called calcium antagonists, relax and widen blood vessels by affecting the muscle cells in the arterial walls. Some calcium channel blockers have the added benefit of slowing your heart rate, which can further reduce blood pressure, relieve chest pain (angina) and control an irregular heartbeat. Examples of calcium channel blockers Some calcium channel blockers are available in short-acting and long-acting forms. Short-acting medications work quickly, but their effects last only a few hours. Long-acting medications are slowly released to provide a longer lasting effect. Several calcium channel blockers are available. Which one is best for you depends on your health and the condition being treated. Examples of calcium channel blockers include: Amlodipine (Norvasc) Diltiazem (Cardizem, Tiazac, others) Felodipine Isradipine Nicardipine Nifedipine (Adalat CC, Afeditab CR, Procardia) Nisoldipine (Sular) Verapamil (Calan, Verelan) In some cases, your doctor might prescribe a calcium channel blocker with other high blood pressure medications or with cholesterol-lowering drugs such as statins.
MRCPCH Clinical Revision - more videos at http://mrcpch.paediatrics.co.uk
Revise for your MRCPCH Clinical exam, with videos and high quality content created by the London Paediatrics Trainees Committee.
Video Credits: Dr Caroline Fertleman, Dr Hermione Race, Dr Camilla Sen, Dr Chloe Macaulay, Dr Emma McLaren, Chris Knapp
Ellis demonstrates how to perform a central venous catheter (CVC) dressing change. Please note, you would want to perform hand hygiene after removing the clean gloves before donning the sterile gloves.
Our Critical Nursing Skills video tutorial series is taught by Ellis Parker MSN, RN-BC, CNE, CHS and intended to help RN and PN nursing students study for your nursing school exams, including the ATI, HESI and NCLEX.
#NCLEX #CVC #ClinicalSkills #HESI #Kaplan #ATI #NursingSchool #NursingStudent #Nurse #RN #PN #Education #LVN #LPN #nurseeducator
00:00 CVC Dressing Change
00:26 Preparing patient for CVC Change
00:54 Removing previous dressing
1:56 Removing gloves CVC Change
2:06 Opening CVC Change Kit
2:05 Sterile gloving CVC Change
3:22 Exploring CVC Change kit
3:36 Snap the scrubber CVC Change
3:49 Scrub site CVC Change
4:18 Applying antimicrobial patch CVC Change
4:41 Applying transparent dressing CVC Change
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This video clip shows an upper track endoscopy of A 75 year-old female, presented with severe adominal pain since three days. Endoscopy displays a deep ulcer at the lesser curvature of the stomach. This patient has a klatskin´s tumor (bile duct bifurcation).
symptoms of kidney dysfunction. I find kidney dysfunction in my patients very frequently. Lower back pain is a common indicator that the kidneys are starting to become irritated. Yes, lower back pain can come from many different areas, but one of the areas I always rule out is kidney congestion.
-Rectocele is a relatively common condition in older women and is characterized by the displacement of the rectum through posterior vaginal wall defect(s). The condition is typically caused by damage to the rectovaginal septum incurred during vaginal childbirth and is exacerbated by periodic increases in intraabdominal pressure (e.g., when laughing or coughing) and the effects of gravity. Women with symptomatic rectoceles who are poor surgical candidates may be treated with pessaries, which are structures designed to support the vaginal wall. Pessaries should only be used in conjunction with vaginal
About Us Contact Disclaimer Get Published! Follow Us Epomedicine Medical Students Clinical Discussion Cases Emergencies Blog Medical Mnemonics Clinical Skills Search Subjects Clinical examination Gastrointestinal system Internal medicine Updated on January 31, 2017 Percussion of Spleen Traube’s semilunar space Borders: Superiorly: Left 6th rib superiorly Laterally: Left midaxillary line or Left anterior axillary line Inferiorly: Left costal margin Method: Patient’s position: supine with left arm slightly abducted. Percuss: from medial to lateral Interpretation: Resonance (Normal) and Dullness (Splenomegaly) Also: Pleural effusion or mass in stomach may cause dullness in Traube’s space.
Giant cell arteritis is an inflammation of the lining of your arteries. Most often, it affects the arteries in your head, especially those in your temples. For this reason, giant cell arteritis is sometimes called temporal arteritis. Giant cell arteritis frequently causes headaches, scalp tenderness, jaw pain and vision problems. If left untreated, it can lead to stroke or blindness. Prompt treatment with corticosteroid medications usually relieves symptoms of giant cell arteritis and may prevent loss of vision. You'll likely begin to feel better within days of starting treatment. But even with treatment, relapses are common. You'll need to visit your doctor regularly for checkups and treatment of any side effects from taking corticosteroids.