The thyroid gland lies in the midline of the anterior neck, just caudal to the thyroid cartilage. To inspect the thyroid gland, the examiner stands in front of the patient. The examiner asks the seated patient to dorsiflex (extend) the neck and swallow a sip of water. Minor enlargement of the gland may only become apparent on inspection in this position. Palpation of the thyroid gland is typically performed with the examiner standing behind the patient. Both lobes and the isthmus of the thyroid gland should be palpated for any nodules or diffuse enlargement. Mobility of the thyroid gland with swallowing should be assessed with palpation. Nodules arising from the thyroid gland typically move with swallowing. A hard, fixed thyroid gland could indicate malignancy. If a central nodule is identified, the patient is asked to protrude the tongue. Upward movement of the central nodule on protrusion of the tongue indicates a thyroglossal cyst. Auscultation is performed at the superior poles of bilateral lobes as this is where the superior thyroid artery is most superficial and bifurcates into its terminal branches. A bilateral bruit over the superior poles suggests Graves disease. Examination of the thyroid gland is completed by palpating the regional cervical lymph nodes for any enlargement.

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What Is a Hair Transplant? It's a type of surgery that moves hair you already have to fill an area with thin or no hair. Doctors have been doing these transplants in the U.S. since the 1950s, but techniques have changed a lot in recent years. You usually have the procedure in the doctor's office. First, the surgeon cleans your scalp and injects medicine to numb the back of your head. Your doctor will choose one of two methods for the transplant: follicular unit strip surgery (FUSS) or follicular unit extraction (FUE). With FUSS, the surgeon removes a 6- to 10-inch strip of skin from the back of your head. He sets it aside and sews the scalp closed. This area is immediately hidden by the hair around it. Next, the surgeon’s team divides the strip of removed scalp into 500 to 2,000 tiny grafts, each with an individual hair or just a few hairs. The number and type of graft you get depends on your hair type, quality, color, and the size of the area where you’re getting the transplant. If you’re getting the FUE procedure, the surgeon’s team will shave the back of your scalp. Then, the doctor will remove hair follicles one by one from there. The area heals with small dots, which your existing hair will cover. After that point, both procedures are the same. After he prepares the grafts, the surgeon cleans and numbs the area where the hair will go, creates holes or slits with a scalpel or needle, and delicately places each graft in one of the holes. He’ll probably get help from other team members to plant the grafts, too. Depending on the size of the transplant you’re getting, the process will take about 4 to 8 hours. You might need another procedure later on if you continue to lose hair or decide you want thicker hair. Expectations and Recovery After the surgery, your scalp may be very tender. You may need to take pain medications for several days. Your surgeon will have you wear bandages over your scalp for at least a day or two. He may also prescribe an antibiotic or an anti-inflammatory drug for you to take for several days. Most people are able to return to work 2 to 5 days after the operation. Within 2 to 3 weeks after surgery, the transplanted hair will fall out, but you should start to notice new growth within a few months. Most people will see 60% of new hair growth after 6 to 9 months. Some surgeons prescribe the hair-growing drug minoxidil (Rogaine) to improve hair growth after transplantation, but it’s not clear how well it works. Risks and Costs of Treatment The price of a hair transplant will depend largely on the amount of hair you’re moving, but it generally ranges from $4,000 to $15,000. Most insurance plans don’t cover it.

The surgical video details a robotic assisted hysterectomy in a patient with early stage endometrial/uterine cancer. Anatomy of the pelvis and the technique of a robotic hysterectomy is demonstrated in this video.

Head to Toe Assesment

In this instructional video, Director of Critical Care Nephrology, Sevag Demirjian, MD goes over the steps for in-hospital production of ultra-pure continuous hemodialysis fluid.

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open multi puncture testicular biopsy to retrieve sperm for ICSI (IntaCytoplasmic Sperm Injection)

Level of fundus and exam

Sex reassignment surgery for male-to-female involves reshaping the male genitals into a form with the appearance of, and, as far as possible, the function of female genitalia. Prior to any surgeries, patients usually undergo hormone replacement therapy (HRT), and, depending on the age at which HRT begins, facial hair removal. There are associated surgeries patients may elect to, including facial feminization surgery, breast augmentation, and various other procedures.

Male Urethral Prostate Stent/Catheter.Removal and insertion.

Watch that video of Penile Lengthening and Girth Enhancement Plastic Surgery

Extracorporeal shock wave lithotripsy (ESWL) uses shock waves to break a kidney stone into small pieces that can more easily travel through the urinary tract camera.gif and pass from the body. See a picture of ESWL camera.gif. You lie on a water-filled cushion, and the surgeon uses X-rays or ultrasound tests to precisely locate the stone. High-energy sound waves pass through your body without injuring it and break the stone into small pieces. These small pieces move through the urinary tract and out of the body more easily than a large stone. The process takes about an hour. You may receive sedatives or local anesthesia. Your surgeon may use a stent if you have a large stone. A stent is a small, short tube of flexible plastic mesh that holds the ureter open. This helps the small stone pieces to pass without blocking the ureter.

Patients are generally placed in a supine position with the head in an extended position. As noted above, Gardner-Wells tongs can be used for additional cervical traction. The hands can also be tied downward to increase the operative exposure. Once the surgical site is properly prepared with cleansing material, the appropriate surgical level is identified with intraoperative radiographs. A scalpel is used to make a linear longitudinal incision just medial to the body of the sternocleidomastoid muscle. The incision is made long enough to include at least 2 vertebral levels if a 1-level discectomy is being performed. Alternatively, transverse skin incisions over the targeted vertebral level can also be performed. The platysmal muscle is identified and incised. The platysmal incision can be extended if a multilevel decompression is the surgical aim. Extensive subplatysmal dissection is performed to reduce retraction injury.

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An animation of blood flow inside the Hemodialysis circuit.

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inspection, auscultation and palpation

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Stoma Care- Changing a Colostomy Bag (Nursing Skills)

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Stoma Care- Changing a Colostomy Bag (Nursing Skills)

In this video, we’re going to talk about stoma care. Now, the wafer and bag for an ostomy only NEEDS to be changed every 3 days, or if it’s leaking. But, you still need to be able to assess the stoma itself. In this case we’re going to show you how to replace the bag and clean and assess the stoma. Start by putting a towel under the patient on the side of the stoma. We love you guys! Go out and be your best selves today! And, as always, happy nursing!

Bookmarks:
0.05 Introduction to Stoma Care
0:20 Assessing the stoma
0:47 Cleaning the stoma
1:12 Inspecting the stoma
1:25 Measuring and cutting the stoma
2:00 Applying and sealing the bag
2:35 Documentation
2:41 Outro

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Dental Braces Animation

A biopsy is a diagnostic test that involves collecting small pieces of tissue, usually through a needle, for examination with a microscope. A kidney biopsy can help in forming a diagnosis and in choosing the best course of treatment.

Open Appendectomy Surgery Video

Recommended range without diabetes is 70 to 130mg/dL. (The standard for measuring blood glucose is "mg/dL" which means milligrams per deciliter.) If your blood glucose level is above 130mg/dL, that's fasting hyperglycemia. Fasting hyperglycemia is a common diabetes complication.