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Cardiovascular Examination Clinical skills - Medical School Revision - Dr Gill
The cardiac exam is one of the clinical skills that medical students learn completely, as more often than not, patients will consult regularly about chest pain, and it is important to be able to identify key cardiovascular signs
As a junior doctor, the examination of the cardiovascular system can be almost a dreaded examination, as cardiac murmurs can literally take years of exposure in order to gain confidence with their identification through cardiac auscultation.
This video demonstrates not merely the examination of the heart, but the complete cardiovascular system including its peripheries.
I hope these clinical skill revision videos are helpful, please like and subscribe and join the community so that we can create more effective videos to help with your journey through medical school
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Some people have found this video useful for ASMR
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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How to study General Surgery in med school: (Tips and Tricks)
https://youtu.be/_tad4i2Kdes
1-minute hernia videos: (Complete playlist by Skeleton)
https://www.youtube.com/watch?v=GsmAPYMiK_s&list=PL-dMZTUxuTxAi7rFqOy9o0pv1g-aZ1GXz
(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)
Study with me:
https://www.youtube.com/watch?v=lBkmmYcUBDo&t=291s
Hydrocele video:
https://www.youtube.com/watch?v=s6ICxMMtpYk&t=65s
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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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Laser-assisted in situ keratomileusis (LASIK) eye surgery can correct or improve your sight by using a laser to change the shape of the cornea. Find out more here: https://www.bupa.co.uk/health-....information/eyes-sig and https://www.bupa.co.uk/health-....information/eyes-sig/laser-eye-surgery
The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.
Recovery Tips
LASIK eye surgery is the best known and most commonly performed laser refractive surgery to correct vision problems. The total recovery time is 1 to 2 weeks. However, vision may fluctuate slightly over the next 2 months.
Avoid watching television or reading for the first few days.
You can get back to work after 1 week.
Avoid applying pressure on the eyes for 7 days.
Avoid dust, smoke, yard and garden work, and eye make-up.
Wear eye shields at night given by a surgeon for 1 week.
Driving is allowed after 4 to 5 days.
Avoid swimming or using a hot tub for 2 weeks after surgery.
While using the computer, take frequent breaks and lubricate your eyes with artificial tears.
For treatment assistance in your country or abroad:
Email: hello@vaidam.com
Phone/WhatsApp/Viber: +91-9650001746
Website: www.vaidam.com
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Cost of Lasik Eye Surgery: https://www.vaidam.com/cost/lasik-procedure-cost-in-india
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If a fetal lung lesion is causing heart failure, fetal surgery may be performed to remove the CCAM before birth. http://fetalsurgery.chop.edu
N. Scott Adzick, MD, Mark Johnson, MD, and Holly Hedrick, MD, experts from the Center for Fetal Diagnosis and Treatment at Children’s Hospital of Philadelphia, explain when fetal intervention for CCAM is recommended, the various approaches that may be used to treat the most complex fetal lung lesions before birth, and how these procedures are performed.
One concern with fetal lung lesions is that they take up space in the chest. If the lung mass grows and pushes the heart and other organs out of place, it can lead to complications such as fetal hydrops (heart failure in the fetus). If this happens, a fetal surgery procedure may be performed to remove the CCAM before birth.
In other cases, an EXIT procedure may be performed to partially deliver the baby, so the team can remove the mass before the baby is fully delivered.
In this video series, parents, nurses and doctors from Children’s Hospital of Philadelphia’s Center for Fetal Diagnosis and Treatment talk about the different types of fetal lung lesions like congenital cystic adenomatoid malformation (CCAM) and bronchopulmonary sequestration (BPS), the importance of accurate diagnosis and monitoring, and the most advanced treatment options currently available. They also discuss follow-up care and long-term outcomes for babies diagnosed with fetal lung lesions.
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Chapters
0:00 Introduction
1:04 Why do doctors perform laparoscopy?
2:11 How is laparoscopy performed?
3:22 Result
3:47 Risk of laparoscopy
Laparoscopy (from Ancient Greek λαπάρα (lapára) 'flank, side', and σκοπέω (skopéō) 'to see') is an operation performed in the abdomen or pelvis using small incisions (usually 0.5–1.5 cm) with the aid of a camera. The laparoscope aids diagnosis or therapeutic interventions with a few small cuts in the abdomen.[1]
Laparoscopic surgery, also called minimally invasive procedure, bandaid surgery, or keyhole surgery, is a modern surgical technique. There are a number of advantages to the patient with laparoscopic surgery versus an exploratory laparotomy. These include reduced pain due to smaller incisions, reduced hemorrhaging, and shorter recovery time. The key element is the use of a laparoscope, a long fiber optic cable system that allows viewing of the affected area by snaking the cable from a more distant, but more easily accessible location.
Laparoscopic surgery includes operations within the abdominal or pelvic cavities, whereas keyhole surgery performed on the thoracic or chest cavity is called thoracoscopic surgery. Specific surgical instruments used in laparoscopic surgery include obstetrical forceps, scissors, probes, dissectors, hooks, and retractors. Laparoscopic and thoracoscopic surgery belong to the broader field of endoscopy. The first laparoscopic procedure was performed by German surgeon Georg Kelling in 1901. There are two types of laparoscope:[2]
A telescopic rod lens system, usually connected to a video camera (single-chip or three-chip)
A digital laparoscope where a miniature digital video camera is placed at the end of the laparoscope, eliminating the rod lens system
The mechanism mentioned in the second type is mainly used to improve the image quality of flexible endoscopes, replacing conventional fiberscopes. Nevertheless, laparoscopes are rigid endoscopes. Rigidity is required in clinical practice. The rod-lens-based laparoscopes dominate overwhelmingly in practice, due to their fine optical resolution (50 µm typically, dependent on the aperture size used in the objective lens), and the image quality can be better than that of the digital camera if necessary. The second type of laparoscope is very rare in the laparoscope market and in hospitals.[citation needed]
Also attached is a fiber optic cable system connected to a "cold" light source (halogen or xenon) to illuminate the operative field, which is inserted through a 5 mm or 10 mm cannula or trocar. The abdomen is usually insufflated with carbon dioxide gas. This elevates the abdominal wall above the internal organs to create a working and viewing space. CO2 is used because it is common to the human body and can be absorbed by tissue and removed by the respiratory system. It is also non-flammable, which is important because electrosurgical devices are commonly used in laparoscopic procedures.[3]
Procedures
Surgeons perform laparoscopic stomach surgery.
Patient position
During the laparoscopic procedure, the position of the patient is either in Trendelenburg position or in reverse Trendelenburg. These positions have an effect on cardiopulmonary function. In Trendelenburg's position, there is an increased preload due to an increase in the venous return from lower extremities. This position results in cephalic shifting of the viscera, which accentuates the pressure on the diaphragm. In the case of reverse Trendelenburg position, pulmonary function tends to improve as there is a caudal shifting of viscera, which improves tidal volume by a decrease in the pressure on the diaphragm. This position also decreases the preload on the heart and causes a decrease in the venous return leading to hypotension. The pooling of blood in the lower extremities increases the stasis and predisposes the patient to develop deep vein thrombosis (DVT).[4]
Gallbladder
Rather than a minimum 20 cm incision as in traditional (open) cholecystectomy, four incisions of 0.5–1.0 cm, or more recently, a single incision of 1.5–2.0 cm,[5] will be sufficient to perform a laparoscopic removal of a gallbladder. Since the gallbladder is similar to a small balloon that stores and releases bile, it can usually be removed from the abdomen by suctioning out the bile and then removing the deflated gallbladder through the 1 cm incision at the patient's navel. The length of postoperative stay in the hospital is minimal, and same-day discharges are possible in cases of early morning procedures.[citation needed]
Colon and kidney
This medical animation shows laparoscopically assisted gallbladder removal surgery, or cholecystectomy. The animation begins by showing the normal anatomy of the liver and gallbladder. Over time, gallstones form within the gallbladder, blocking the cystic duct, and causing the gallbladder to become enlarged and inflamed. The procedure, sometimes called a "lap-chole", begins with the insertion of four trocar devices, which allow the physician to see inside the abdomen without making a large incision. Air is added to the abdominal cavity to make it easier to see the gall bladder. Next, we see a view through the laparascope, showing two surgical instruments grasping the gallbladder while a third severs the cystic duct. After the gallbladder is removed, the camera pans around to show that the cystic artery and vein, have already been clipped to prevent bleeding.
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