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

Dr. Jordana Gaumond of The Oregon Clinic Portland Surgeons explains what to do with an inguinal hernia.

Please note: If you live in Oregon, Dr. Gaumond is available for a consultation. The state licensing boards require that she can only treat people in the states where she is licensed.

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Overview
Heart bypass surgery creates a new route, called a bypass, for blood and oxygen to reach the heart.

Heart bypass surgery begins with an incision in the chest, and the breastbone is cut exposing the heart. Next, a portion of the saphenous vein, which is very large, is harvested from the inside of the leg. Pieces of this large vein are used to bypass the blocked coronary arteries, which are arteries that supply blood to the heart. The venous graft is sewn to the aorta, the main artery of the body, and to the affected coronary artery, to bypass the blocked site.

The internal mammary artery from the chest may also be used to bypass a clogged artery.

Several arteries may be bypassed depending on the condition of the heart. After the graft is created, the breastbone and chest are closed.

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Tracheotomy and tracheostomy are surgical procedures that create an opening in the trachea (windpipe) to help patients breathe when they have difficulty doing so through the nose or mouth. Though they are similar in purpose, there are some key differences between them.

Tracheotomy is a temporary procedure that involves creating a small incision in the trachea to insert a breathing tube. The tube is typically removed once the patient no longer requires it, and the incision heals on its own. Tracheostomy, on the other hand, is a more permanent solution that involves creating a hole in the trachea and inserting a tracheostomy tube, which remains in place for an extended period.

Indications for these procedures include:

Airway obstruction due to trauma, tumors, or infection
Severe respiratory distress or failure
Prolonged mechanical ventilation
Inability to protect the airway due to neurological disorders or impaired consciousness
Steps for performing a tracheotomy and tracheostomy:

Preparation: The patient is positioned, and the neck area is cleaned and draped. Local anesthesia is often administered, although general anesthesia may be used in some cases.
Incision: A small incision is made in the neck, and the muscles and tissues are carefully separated to expose the trachea.
Tracheal opening: A small opening is made in the trachea, typically between the second and third tracheal rings.
Tube insertion: A tracheotomy tube is inserted through the incision and into the trachea for a tracheotomy, while a tracheostomy tube is inserted for a tracheostomy. Both tubes are secured in place.
Confirmation: Proper placement of the tube is confirmed by listening for breath sounds and checking for adequate ventilation.
Pre-operative care typically involves a thorough assessment of the patient's medical history, as well as any necessary imaging studies or lab tests to ensure the procedure is appropriate and safe. Informed consent should be obtained from the patient or their legal representative.

Post-operative care includes monitoring the patient's vital signs, ensuring the tube remains secure and patent, and managing any pain or discomfort. For tracheostomy patients, regular cleaning and maintenance of the stoma (the opening in the trachea) and the tracheostomy tube are essential to prevent infection and other complications. Long-term care may involve speech therapy, respiratory therapy, and support from a multidisciplinary team to address any ongoing needs.

It's crucial to remember that these procedures should only be performed by trained medical professionals in a clinical setting.



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Introduction to the Brachial Plexus Examination, 4 of 5 videos demonstrating the physical exam for evaluation of Brachial Plexus conditions.

Brachial plexus injury - Care at Mayo Clinic:
https://www.mayoclinic.org/dis....eases-conditions/bra

Watch all the videos in this series on this playlist:
https://www.youtube.com/playli....st?list=PLSWR1ylG_6J

In this video, I have covered Inguinal hernia under the following headings: Definition, Parts of Hernia, Surgical anatomy, Types of inguinal hernia, Aetiology of hernia, Clinical features of hernia, complications of hernia, Clinical examination, Surgical principles, and explanation of a few surgeries (Herniotomy, Bassini suture repair, Shouldice repair, Lichtenstein tension-free open meshplasty, hernia plugs, Laparoscopic techniques like TEP(Totally extraperitoneal approach) and TAPP(Transabdominal preperitoneal approach) surgical procedures).

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(includes femoral hernia, obturator hernia, epigastric hernia, umbilical hernia, Spigelian hernia, Richter hernia, lumbar hernia, incisional hernia, Hiatal hernia, congenital diaphragmatic hernia, contents of spermatic cord, triangles of hernia)

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Our General Surgery team treats hernia patients on a daily basis. In fact, you could consider them to be hernia experts. We sat down with one of those experts, Dr. Heater Dunlap, to talk about the common signs and symptoms of hernias and to answer the question of when to see a doctor.

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Discover how hemodialysis works and the different options available for this dialysis treatment.

Related articles on DaVita.com:
What Is Hemodialysis? (http://www.davita.com/treatmen....t-options/hemodialys
How Does a Dialysis Machine Work? (http://www.davita.com/treatmen....t-options/hemodialys

Medical technology continues to advance and help doctors continue to treat patients. From face transplants to LASIK eye surgery watch the video below for 8 medical procedures that are improving lives.

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8 Medical Procedures That Are Improving Lives

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This animation by Nucleus shows you the function of plant and animal cells for middle school and high school biology, including organelles like the nucleus, nucleolus, DNA (chromosomes), ribosomes, mitochondria, etc. Also included are ATP molecules, cytoskeleton, cytoplasm, microtubules, proteins, chloroplasts, chlorophyll, cell walls, cell membrane, cilia, flagellae, etc.

0:07 What is a cell?




0:35 What are the 2 categories of cells?

1:22 What is an Organelle? DNA, Chromatin, Chromosomes

2:06 Organelles: Ribosomes, Endoplasmic Reticulum

2:59 Organelles: ER function, Vesicles, Golgi Body (Apparatus)

3:50 Organelles: Vacuole, Lysosome, Mitochondrion

4:45 Organelles: Cytoskeleton

5:04 Plant Cell Chloroplast, Cell Wall

5:43 Unique Cell Structures: Cilia

Watch another version of this video, narrated by biology teacher Joanne Jezequel here: https://youtu.be/cbiyKH9uPUw


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This animation won a Platinum Best of Show Aurora Award in 2016.

Today on Crash Course Anatomy & Physiology, Hank breaks down the parts and functions of one of your body's unsung heroes: your epithelial tissue.

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Chapters:
Introduction 00:00
Proper Epithelium & Glandular Epithelium 1:38
We're All Just Tubes! 2:12
Cell Shapes: Squamous, Cuboidal, or Columnar 3:34
How Form Relates to Function 4:15
Layering: Simple or Stratified 5:26
Epithelial Cells: Apical & Basal Sides 7:06
Glandular Epithelial Tissue Forms Endocrine & Exocrine Glands 8:20
Review 9:16
Credits 9:54

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Hi! Are you someone who is suffering from resistant areas of fat in certain areas of your body? Are you someone who is exercising a lot and still feel difficult to achieve your dream body shape?

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Hello! I am doctor Rajat Gupta. I am a boarded-certified plastic surgeon working in New Delhi. Let me tell you something about what is liposuction? Liposuction is the procedure to remove resistant areas of fat in your body and we deposit this fat component beneath your skin. So whatever areas you want to contour, can easily be shaped to your dream shape by removing such fat.

How is liposuction done?
Whatever area you want to contour, we make small holes of 3-4 mm. We put in some fluid that will melt and emulsify the fat that we want to remove and then remove this fat. At the end of the procedure, you can see how much fat we have removed and you can also see an immediate change in your body shape. Now, imagine you are removing fat is beneath your skin and this fat is actually beneath the skin and above the muscle. We also call this subcutaneous fat. When we remove this fat, we also want the skin to shrink and stick to the muscle behind so one needs to wear something known as compression garment for the next 4 to 6 weeks after surgery so that the skin shrinks and gives you a shape what you want.

What I help you achieve is an improved version of your own body shape. For a female, we can carve out an hourglass shape or an hourglass body so they look very aesthetics. For a male, we can carve out of a V-shape athletic body. At the same time in certain individuals we can also carve out 6 packs or 8 packs looks, so that result looks very-very natural and aesthetic.

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