Cranial nerves exam 1st to 7th from the USMLE collection

Sensory and reflexes exam of the upper limb from the USMLE collection Sensory and reflexes exam of the upper limb

http://www.wss4m.com/vb

Permanent pacemaker insertion is considered a minimally invasive procedure. Transvenous access to the heart chambers under local anesthesia is the favored technique, most commonly via the subclavian vein, the cephalic vein, or (rarely) the internal jugular vein or the femoral vein.

Sed rate, or erythrocyte sedimentation rate ( ESR ), is a blood test that can reveal inflammatory activity in your body. A sed rate test isn't a stand-alone diagnostic tool, but it can help your doctor diagnose or monitor the progress of an inflammatory disease. ... Inflammation can cause the cells to clump.

Your body is a brilliant machine with many important parts. Watch movies to learn more

Top 10 Foods that Can Kill You

atrial septal defect (ASD) is a hole in the wall between the two upper chambers of your heart (atria). The condition is present from birth (congenital). Small atrial septal defects may close on their own during infancy or early childhood. Large and long-standing atrial septal defects can damage your heart and lungs. Small defects may never cause a problem and may be found incidentally. An adult who has had an undetected atrial septal defect for decades may have a shortened life span from heart failure or high blood pressure that affects the arteries in the lungs (pulmonary hypertension). Surgery may be necessary to repair atrial septal defects to prevent complications

Liver Metastasis Resection. A Technique That Makes It Easier. Authors: de Santibañes E, Sánchez Clariá R, Palavecino M, Beskow A, Pekolj J. Background: Liver resection is the only therapeutic option that achieves long-term survival for patients with hepatic metastases. We propose a tech...nique that causes traction and counter traction on the resection area, thus easily exposing the structures to be ligated. Since the parenchyma protrudes like a cork from a bottle we named this procedure “Corkscrew Technique”. Objective: To describe an original surgical technique to resect liver metastases. Technique: We delimite the resection area at 2 cm from the tumor. We place separated stitches, in a radiate way. The needle diameter must allow passing far from the deepest margin of the tumor. The stitches must be tractioned all together to separate the tumor from the normal parenchyma. Material and Methods: Between years 1983 and 2006, we perform 1270 liver resection. We used the corkscrew technique like only procedure in 612 patients whereas in 129 patients we associated it to an anatomic resection. Results: Mortality was 1%. Morbidity was 16% with a reoperation rate of 3%. Conclusions: The Corkscrew Technique is simple and safe, it spares surgical time, avoids blood loss, ensures free tumor margins and it is easy to perform.

A simple continuous stitch can be a useful technique for skin closure when speed is important, e.g. closing a scalp laceration on a screaming child. The simple running, or continuous suture, is begun in the same way as a simple interrupted suture.

This is the CT of a 43 year old male patiënt with infected necrotizing pancreatitis that will undergo a VARD procedure; Videoscopic Assisted Retroperitoneal Debridment. Two weeks before this procedure two large bore percutaneous drains were placed in the peripancreatic collection. The patient i...s placed in supine position with the left side 30 degrees elevated. A 5-7 cm subcostal incision is made in the left flank. With help of CT images and by following the percutaneous drain, the subcutaneous tissue and the fascia are dissected and we enter the retroperitoneal peripancreatic collection. First, with a regular suction device any pus encountered is removed. Two long sympathectomy hooks are inserted in order to keep in the incision open. We than insert the zero degree laparoscope. The first necrosis encountered is removed under direct sight with the use of long grasping forceps. Following the percutaneous drain deeper into the cavity, parts of loosely adherent necrotic material are removed. Gently pulling we remove the necrotic tissue. The suction device is helpful in removing any fluid obstructing the view. Complete necrosectomy is not the ultimate aim of this procedure. Only loosely adherent pieces of necrosis are removed thereby keeping the risk of tearing underlying blood vessels to a minimum. In the rare case of extensive bleeding, the retroperitoneal cavity can be easily packed, either awaiting the bleeding to definitely stop or to act as a bridge to angiographic coiling. This patient is now 6 weeks after onset of disease. We always try to postpone surgical intervention, if possible up to 30 days. On the left side of the collection is the percutaneous drain. In this patient the drain had worked well for 2 weeks. When the patient deteriorated again it was decided to perform the VARD procedure. Large pieces of necrotic pancreas can be removed with VARD. This is a big advantage ov VARD over pure endosopic or percutaneous techniques. When all the necrotic tissue is removed we clean the cavity. Two drains are left in situ as a postoperative lavage system. The VARD procedure is performed via a 6 cm incision, which is closed and continuous postoperative lavage started immediately.

Colectomy Anterior Approach

Polycystic ovary syndrome (PCOS) is a common endocrine system disorder among women of reproductive age. Women with PCOS may have enlarged ovaries that contain small collections of fluid — called follicles — located in each ovary as seen during an ultrasound exam. Infrequent or prolonged menstrual periods, excess hair growth, acne, and obesity can all occur in women with polycystic ovary syndrome. In adolescents, infrequent or absent menstruation may raise suspicion for the condition. The exact cause of polycystic ovary syndrome is unknown. Early diagnosis and treatment along with weight loss may reduce the risk of long-term complications, such as type 2 diabetes and heart disease.

quick-stitch endoscopic sutering system in laproscopic Gastric Bypass surgery

What could cause a blockage in the stomach? Mechanical causes of intestinal obstruction may include: Adhesions or scar tissue that forms after surgery. Foreign bodies (objects that are swallowed and block the intestines) Gallstones (rare) Hernias. Impacted stool. Intussusception (telescoping of one segment of bowel into another) Tumors blocking the intestines. Less common radiologic signs are seen in specific circumstances. Most closed-loop obstructions (75%) are caused by adhesions. A closed-loop obstruction occurs when a loop of bowel is not decompressed by the caudal passage of gas and fluid.

Endometrial cancer is a type of cancer that begins in the uterus. The uterus is the hollow, pear-shaped pelvic organ in women where fetal development occurs. Endometrial cancer begins in the layer of cells that form the lining (endometrium) of the uterus. Endometrial cancer is sometimes called uterine cancer. Other types of cancer can form in the uterus, including uterine sarcoma, but they are much less common than endometrial cancer. Endometrial cancer is often detected at an early stage because it frequently produces abnormal vaginal bleeding, which prompts women to see their doctors. If endometrial cancer is discovered early, removing the uterus surgically often cures endometrial cancer.

Colon - Polypectomy, Saline lift, Adenomas

Recommendations for clipping in endoscopic stomach surgery

Various laparoscopic techniques have been described for the insertion of peritoneal dialysis catheters. However, most use 3 to 4 ports, thus multiplying the potential risk for abdominal wall complications (hemorrhage, hernia, leaking). With the technique presented herein a Tenckhoff catheter is plac...ed laparoscopically, using just 1 port, in 13 consecutive patients with end-stage renal failure. The catheter is fixed in the abdominal cavity with no additional ports for this purpose. The simplicity and the rapidity of the method justifies serious consideration for its use as the standard Tenckhoff catheter placement.

Management of postpartum hemorrhage at vaginal delivery. The approach to treatment of postpartum hemorrhage (PPH) differs somewhat depending on the cause and whether hemorrhage occurs after a vaginal birth or after a cesarean delivery.