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Detailed examination of the joints is usually not included in the routine medical examination. However, joint related complaints are rather common, and understanding anatomy and physiology of both normal function and pathologic conditions is critically important when evaluating the symptomatic patient. By gaining an appreciation for the basic structures and functioning of the joint, you'll be able to "logic" your way thru the exam, even if you can't remember the eponym attached to each specific test!
The heart itself is made up of 4 chambers, 2 atria and 2 ventricles. De-oxygenated blood returns to the right side of the heart via the venous circulation. It is pumped into the right ventricle and then to the lungs where carbon dioxide is released and oxygen is absorbed. The oxygenated blood then travels back to the left side of the heart into the left atria, then into the left ventricle from where it is pumped into the aorta and arterial circulation.
The pelvic diaphragm is composed of muscle fibers of the levator ani, the coccygeus, and associated connective tissue which span the area underneath the pelvis. The pelvic diaphragm is a muscular partition formed by the levatores ani and coccygei, with which may be included the parietal pelvic fascia on their upper and lower aspects. The pelvic floor separates the pelvic cavity above from the perineal region (including perineum) below.
The right and left levator ani lie almost horizontally in the floor of the pelvis, separated by a narrow gap that transmits the urethra, vagina, and anal canal. The levator ani is usually considered in three parts: pubococcygeus, puborectalis, and iliococcygeus. The pubococcygeus, the main part of the levator, runs backward from the body of the pubis toward the coccyx and may be damaged during parturition. Some fibers are inserted into the prostate, urethra, and vagina. The right and left puborectalis unite behind the anorectal junction to form a muscular sling . Some regard them as a part of the sphincter ani externus. The iliococcygeus, the most posterior part of the levator ani, is often poorly developed.
The coccygeus, situated behind the levator ani and frequently tendinous as much as muscular, extends from the ischial spine to the lateral margin of the sacrum and coccyx.
The pelvic cavity of the true pelvis has the pelvic floor as its inferior border (and the pelvic brim as its superior border.) The perineum has the pelvic floor as its superior border.
Some sources do not consider “pelvic floor” and “pelvic diaphragm” to be identical, with the “diaphragm” consisting of only the levator ani and coccygeus, while the “floor” also includes the perineal membrane and deep perineal pouch.
External cephalic version is a process by which a breech baby can sometimes be turned from buttocks or foot first to head first. External cephalic version (ECV) is a manual procedure that is advocated by national guidelines for breech presentation singleton pregnancy, in order to enable vaginal delivery.
Plantar warts are hard, grainy growths that usually appear on the heels or balls of your feet, areas that feel the most pressure. This pressure also may cause plantar warts to grow inward beneath a hard, thick layer of skin (callus). Plantar warts are caused by the human papillomavirus (HPV). The virus enters your body through tiny cuts, breaks or other weak spots on the bottom of your feet. Most plantar warts aren't a serious health concern and may not require treatment. But plantar warts can cause discomfort or pain. If self-care treatments for plantar warts don't work, you may want to see your doctor to have them removed.
Microcalcifications in the breast can be the first sign of cancer. They are, as the name says, very small and clustered. A precise biopsy without pain under stereotactic guidance is the standard procedure. What makes this Spirotome different from the vacuum assisted biopsies is that only a few biopsies are needed and that the approach of the needle towards the microcalcifications is direct and frontal. There is no damage to the surrounding tissues making this procedure rather painfree and with minimal bleeding.
Magnetic Resonance Imaging (MRI) "sees" inside the body by mapping the position of water molecules, which exist at different densities in different types of tissue. Watch the video above for a sample of some impressive MRI images of the human body in action.
An omentectomy is a surgical procedure designed to remove the omentum, which is a thin fold of abdominal tissue that encases the stomach, large intestine and other abdominal organs. This fatty lining contains lymph nodes, lymph vessels, nerves and blood vessels.
Vasectomy is a minor surgical procedure wherein the vasa deferentia of a man are severed, and then tied or sealed in a manner such to prevent sperm from entering the seminal stream (ejaculate). Typically done in an outpatient setting, a traditional vasectomy involves numbing (local anesthetic) of the scrotum after which 1 (or 2) small incisions are made, allowing a surgeon to gain access to the vas deferens.
Delayed puberty is defined as the absence of any signs suggestive of puberty by 14 years of age. In this case, the patient's pubertal delay appears to be constitutional because of his positive family history, absence of syndromic features or systemic illness, and bone age of 12 years. Puberty correlates more closely with bone age than chronological age. On follow-up, the patient will most likely demonstrate a similar onset of puberty as his father.