Dr. Debbie Song at Gillette Children's describes in detail selective rhizotomy surgery.

A selective dorsal rhizotomy is an operation performed to treat spasticity. It is thought that high tone and spasticity arise from abnormal signals that are transmitted through sensory or dorsal nerve roots to the spinal cord. In a selective dorsal rhizotomy we identify and cut portions of the dorsal nerve roots that carry abnormal signals thereby disrupting the mechanisms that lead to spasticity. Potential patients go through a rigorous assessment that includes an in-depth gait and motion analysis as well as a physical therapy evaluation.

They are evaluated by a multidisciplinary team that includes a pediatric rehabilitation doctor, a neurosurgeon, and an orthopedist, Appropriate patient selection is vital. Ideal candidates for selective dorsal rhizotomy are children who are between four and ten years of age, have a history of being born prematurely, and have a diagnosis of diplegia cerebral palsy. These patients usually walk independently or with the assistance of crutches or a walker. They typically function at a level one, two, or three in the gross motor function classification system or gmfcs. A selective dorsal rhizotomy involves the coordinated efforts of the neurosurgery, physiatry, anesthesia and nursing teams. The operation entails making an incision in the lower back that is approximately six to eight inches long. We perform what we call a laminoplasty in which we remove the back part of the spinal elements from the lumbar one or l1 to l5 levels. At the end of the procedure the bone is put back on. We identify and open up the Dural sac that contain the spinal fluid spinal cord and nerve roots. Once the Dural sac is opened ,we expose the lumbar and upper sacral nerve roots that transmit information to and from the muscles of the lower extremities.

At each level we isolate the dorsal nerve root, which in turn is separated into as many as 30 smaller thread light fruitlets.

Each rootlet is then electrically stimulated. Specialized members of the physiatry team look for abnormal responses in the muscles of the legs as each rootless is being stimulated. If an abnormal response is observed then the rootlet is cut.

If a normal response is observed, then the rootlet is not cut. We usually end up cutting approximately 20 to 40 percent of the rootlets. The Dural sac is sutured closed and the l1 through l5 spinal elements are put back into anatomic position, thus restoring normal spinal alignment. The overlying tissues and skin are then closed and the patient is awoken from surgery. The entire operation takes between four and five hours. A crucial component to the success of our rhizotomy program is the extensive rehabilitation course following surgery. With their tone significantly reduced after a rhizotomy, patients relearn how to use their muscles to walk more efficiently through stretching, strengthening, and gait training. Approximately one to two years after a rhizotomy patients undergo repeat gait and motion analysis. The orthopedic surgeons assess the need for interventions to correct bone deformities, muscle contractures, poor motor control, impaired balance, or other problems related to cerebral palsy.

At Gillette we work closely with patients and families to ensure that our selective dorsal rhizotomy program meets their goals for enhancing their function and improving their quality of life.

VISIT https://www.gillettechildrens.org/ to learn more

0:00 Why choose selective dorsal rhizotomy?
0:56 Who is a good candidate for selective dorsal rhizotomy?
1:31 What does a selective dorsal rhizotomy entail?
3:26 What is recovery from selective dorsal rhizotomy like?

A Pap smear (also called a Pap test) is a screening procedure for cervical cancer. It tests for the presence of precancerous or cancerous cells on the cervix, the opening of the uterus. It's named after the doctor who determined that this was a useful way to detect signs of cervical cancer.

Basic Abdominal Clinical Exam

A video showing the repair of episiotomy

An inguinal hernia occurs when tissue, such as part of the intestine, protrudes through a weak spot in the abdominal muscles. The resulting bulge can be painful, especially when you cough, bend over or lift a heavy object. However, many hernias do not cause pain.

An inguinal hernia isn't necessarily dangerous. It doesn't improve on its own, however, and can lead to life-threatening complications. Your doctor is likely to recommend surgery to fix an inguinal hernia that's painful or enlarging. Inguinal hernia repair is a common surgical procedure.

In patients age ;::25, HPV DNA testing is the preferred next step in management if the initial cytology shows ASC-US. In this method, samples are collected for both cytology and reflex HPV DNA. If cytology results are positive, HPV DNA testing is performed. If cytology results are negative, the sample for HPV DNA is discarded. HPV DNA testing along with Pap smear at 3 years is recommended if initial cytology shows ASC-US but HPV DNA testing is negative

Epley maneuver: Step 1 You will sit on the doctor's exam table with your legs extended in front of you. The doctor will turn your head so that it is halfway between looking straight ahead and looking directly to the side that causes the worst vertigo. Without changing your head position, the doctor will guide you back quickly so that your shoulders are on the table but your head is hanging over the edge of the table. In this position, the side of your head that is causing the worst vertigo is facing the floor. The doctor will hold you in this position for 30 seconds or until your vertigo stops. Epley maneuver: Step 2 Then, without lifting up your head, the doctor will turn your head to look at the same angle to the opposite side, so that the other side of your head is now facing the floor. The doctor will hold you in this position for 30 seconds or until your vertigo stops. Epley maneuver: Step 3 The doctor will help you roll in the same direction you are facing so that you are now lying on your side. (For example, if you are looking to your right, you will roll onto your right side.) The side that causes the worst vertigo should be facing up. The doctor will hold you in this position for another 30 seconds or until your vertigo stops. Epley maneuver: Step 4 The doctor will then help you to sit back up with your legs hanging off the table on the same side that you were facing. This maneuver is done with the assistance of a doctor or physical therapist. A single 10- to 15-minute session usually is all that is needed. When your head is firmly moved into different positions, the crystal debris (canaliths) causing vertigo will move freely and no longer cause symptoms.

The head-to-toe assessment in nursing is an important physical health assessment that you'll be performing as a nursing student and nurse.

Head-to-toe assessments allow nurses to assess the health status of patients by following a checklist of criteria.

On the job, your head-to-toe nursing assessment will be performed much faster, and it may be different or more specialized to accommodate the patients' needs within your nursing specialty.

This assessment represents a general assessment checklist (or cheat sheet) that you might encounter in nursing school. (Note: Always follow your instructor's requirements or your employer's assessment protocols).

This nursing head-to-toe examination video guide will focus on the following areas/skills:

-Vital Signs (pulse rate, respiration rate, temperature, oxygen saturation, blood pressure, pain assessment)
https://www.youtube.com/watch?v=gUWJ-6nL5-8
-Cranial Nerve examination
-Head assessment (hair, cranium, eyes, nose, mouth, ears, sinuses)
-Neck assessment (jugular vein, thyroid, trachea, carotid)
-Heart sounds assessment: https://www.youtube.com/watch?v=H48WsyIjFs0&t=73s
-Lung sounds assessment: https://www.youtube.com/watch?v=KNrcG077brQ
-Abdominal assessment
-Assessing extremities (arms, hands, legs, feet)
-Back assessment
-and more

While performing your comprehensive head-to-toe assessment, you'll want to record your findings in the documentation.

Nursing Gear: https://teespring.com/stores/registerednursern

Subscribe: http://www.youtube.com/subscri....ption_center?add_use

Notes: http://www.registerednursern.c....om/head-toe-assessme

Nursing School Supplies: http://www.registerednursern.c....om/the-ultimate-list

Visit our website RegisteredNurseRN.com for free quizzes, nursing care plans, salary information, job search, and much more: http://www.registerednursern.com

Check out other Videos: https://www.youtube.com/user/R....egisteredNurseRN/vid
All of our videos in a playlist: https://www.youtube.com/watch?v=pAhHxt663pU&list=PLQrdx7rRsKfXMveRcN4df0bad3ugEaQnk

Popular Playlists:

NCLEX Reviews: https://www.youtube.com/playli....st?list=PLQrdx7rRsKf
Fluid & Electrolytes: https://www.youtube.com/playli....st?list=PLQrdx7rRsKf
Nursing Skills: https://www.youtube.com/playli....st?list=PLQrdx7rRsKf
Nursing School Study Tips: https://www.youtube.com/playli....st?list=PLQrdx7rRsKf
Nursing School Tips & Questions" https://www.youtube.com/playli....st?list=PLQrdx7rRsKf
Teaching Tutorials: https://www.youtube.com/playli....st?list=PLQrdx7rRsKf
Types of Nursing Specialties: https://www.youtube.com/playli....st?list=PLQrdx7rRsKf
Healthcare Salary Information: https://www.youtube.com/playli....st?list=PLQrdx7rRsKf
New Nurse Tips: https://www.youtube.com/playli....st?list=PLQrdx7rRsKf
Nursing Career Help: https://www.youtube.com/playli....st?list=PLQrdx7rRsKf
EKG Teaching Tutorials: https://www.youtube.com/playli....st?list=PLQrdx7rRsKf
Dosage & Calculations for Nurses: https://www.youtube.com/playli....st?list=PLQrdx7rRsKf
Diabetes Health Managment: https://www.youtube.com/playli....st?list=PLQrdx7rRsKf

Watch that video of Stuck Sex Toy Medical Removal Surgery

Patient Greg Grindley communicates with host Bryant Gumbel and his wife for the first time while undergoing deep brain stimulation surgery at University Hospital's Case Medical Center in Cleveland, Ohio.
➡ Subscribe: http://bit.ly/NatGeoSubscribe

About National Geographic:
National Geographic is the world's premium destination for science, exploration, and adventure. Through their world-class scientists, photographers, journalists, and filmmakers, Nat Geo gets you closer to the stories that matter and past the edge of what's possible.

Get More National Geographic:
Official Site: http://bit.ly/NatGeoOfficialSite
Facebook: http://bit.ly/FBNatGeo
Twitter: http://bit.ly/NatGeoTwitter
Instagram: http://bit.ly/NatGeoInsta

Greg's First In-Surgery Conversation | Brain Surgery Live
https://youtu.be/zvqV_2zncNU

National Geographic
https://www.youtube.com/natgeo

Kite flap, Guy Fouchier flap, 2nd finger to thumb. Cadaver dissection. Prof Steven Hovius demonstrates dissection technique and planning for a kite flap.

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.

Item #ANIM026

Rhinoplasty, sometimes referred to as a "nose job" or "nose reshaping" by patients, enhances facial harmony and the proportions of your nose. It can also correct impaired breathing caused by structural defects in the nose. What surgical rhinoplasty can treat Nose size in relation to facial balance Nose width at the bridge or in the size and position of the nostrils Nose profile with visible humps or depressions on the bridge Nasal tip that is enlarged or bulbous, drooping, upturned or hooked Nostrils that are large, wide or upturned Nasal asymmetry If you desire a more symmetrical nose, keep in mind that everyone's face is asymmetric to some degree. Results may not be completely symmetric, although the goal is to create facial balance and correct proportion. Rhinoplasty to correct a deviated septum Nose surgery that's done to improve an obstructed airway requires careful evaluation of the nasal structure as it relates to airflow and breathing. Correction of a deviated septum, one of the most common causes of breathing impairment, is achieved by adjusting the nasal structure to produce better alignment.

Actual Footage of Cell Division (Kidney Cells) see more http://www.kidneymy.com/

this video about identifying a hernia vs a cyst

Endoscopy in Hiatal Hernia.

This poor old lady came with swelling in her left buttock for 10 days.She had history of injection in her buttocks two weeks back. She developed painful swelling and redness in her left gluteal region with difficulty in walking.It was diagnosed as injection abscess left gluteal region which needs incision and drainage under local anesthesia.Patient part painted and drapped.2% Lignocaine with adrenaline was infiltrated around the swelling for proper filed block.I use no-11 blade for stab incision over the swelling at the most fluctuating point of the abscess.You can watch how pus was flowing out from the cavity.The aim is to drain all pus from the abscess cavity.Finger exploration is essential to break all loculi inside the cavity, to know the depth and extend of the cavity and to fascilitate proper drainage of residual pus.after pus evacuation,, the cavity should be irrigated with normal saline and betadine solution.lastly the cavity to be packed with betadine soaked guage pieces.Proper dressing is essential.the dressing to be changed after 24 hours.daily dressing is essential with a good antibiotic coverage.the cavity usually obliterates within a period of seven to ten days.

This is a surgical video that shows the removal of a volar ganglion cyst. This is a common surgical procedure and this video may help you better understand the steps that occur during the procedure.

This patient presented to the ER for umbilical pain and had a history of umbilical hernia. He was concerned about the possibility of incarceration of the hernia.

In this video we explain how the clinical exam helps to differentiate a simple painful hernia from an incarcerated one.

***Thanks to the patient for sharing his history and exam with YouTube world***