Carefully select the site for injection so major blood vessels and nerves are avoided. Buttock (Gluteus Medius)- Hip (Ventrogluteal) - Leg (Vastus Lateralis) - Arm (Deltoid)

Could this be a viable alternative to open heart surgery?

Physical assessment is taking an educated, systematic look at all aspects of an individual’s health status utilizing knowledge, skills and tools of health history and physical exam. To collect data- information about the client’s health, including physiological, psychological, sociocultural and spiritual aspects To establish actual and potential problems To establish the nurse-client relationship Method: The history is done first, then the physical examination focuses on finding data associated with the history. Health History- obtained through interview and record review. Physical exam- accomplished by tools and techniques ** A complete assessment is not necessarily carried out each time. A comprehensive assessment is part of a health screening examination. On admission, you will do an admission assessment (not necessarily including everything presented here) and document it on the admission form. You will do a daily shift assessment (patient systems review). And, if client has a specific problem, you may assess only that part of the body (focused). Data Collection: Information is organized into objective and subjective data: Subjective: Apparent only to person affected; includes client’s perceptions, feelings, thoughts, and expectations. It cannot be directly observed and can be discovered only asking questions. Objective: Detectable by an observer or can be tested against an acceptable standard; tangible, observable facts; includes observation of client behavior, medical records, lab and diagnostic tests, data collected by physical exam. ** To obtain data for the nursing health history, you must utilize good interview techniques and communications skills. Record accurately. DO NOT ASSUME. D. Frameworks for Health Assessment There are two main frameworks utilized in health assessment: Head to Toe- systematic collection of data starting with the head and working downward. Functional Health Assessment- Gordon’s 11 functional health patterns that address the behaviors a person uses to maintain health. PERSON is the ACC-ADN framework for assessment. It is similar to Gordon's functional health patterns.

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

Homan’s sign test also called dorsiflexon sign test is a physical examination procedure that is used to test for Deep Vein Thrombosis (DVT). A positive Homan’s sign in the presence of other clinical signs may be a quick indicator of DVT. Clinical evaluation alone cannot be relied on for patient management, but when carefully performed, it remains useful in determining the need for additional testing (like D-dimer test, ultrasonography, multidetector helical computed axial tomography (CT), and pulmonary angiography) [1][2].

Urogenital neoplasms spreading to the inguinal lymph nodes are penile carcinoma (the most frequent), urethral and scrotum cancers, tumors of the testis with scrotal violation. Penile carcinoma is an uncommon malignant disease and accounts for as many 0.4-0.6% of male cancers. Most patients are elder...ly. It rarely occurs in men under age 60 and its incidence increases progressively until it reaches a peak in the eighth decade 1. The risk of a lymph node invasion is greater with high grade and high stage tumors 2. Some investigators have reported the inaccuracy of the sentinel node biopsy 3, 4, described by Cabanas 5. Patients with metastatic lymph node penis cancer have a very poor prognosis if penectomy only is performed. Ilioinguinal lymphadenectomy is basically carried out as a treatment modality and not only as a staging act. Patients with lymph node invasion have a 30-40% cure rate. Ilioinguinal lymphadenectomy should be also performed in patients with disseminated neoplasms for the local control of the disease. The 5 years survival rate of patients with clinically negative lymph nodes treated with a modified inguinal lymphadenectomy is 88% versus 38% in patients not initially treated with lymphadenectomy 6. This video-tape clearly shows a therapeutic algorithm, the anatomy of the inguinal lymph nodes, according to Rouviere 7 and Daseler 8, the radical ilioinguinal node dissection with transposition of the sartorius muscle and the modified inguinal lymphadenectomy proposed by Catalona 9. References: 1. Lynch D.F. and Schellhammer P: Tumors of the penis. In Campbell’s Urology Seventh Edition, edited by Walsh P.C., Retik A.B., Darracott Vaughan E. and Wein A.J. W.B. Saunders Company, Vol. 3, chapt. 79, p. 2458, 1998. 2. Pizzocaro G., Piva L., Bandieramonte G., Tana S. Up-to-date management of carcinoma of the penis. Eur. Urol. 32: 5-15, 1997 3. Perinetti E., Crane D.B. and Catalona W.J. Unreliability of sentinel lymph node biopsy for staging penile carcinoma. J. Urol. 124: 734, 1980 4. Fowler J.E. Jr. Sentinel lymph node biopsy for staging penile cancer. Urology 23: 352, 1984 5. Cabanas R.M. An approach for the treatment of penile carcinoma. Cancer 39: 456, 1977 6. Russo P. and Gaudin P. Management strategies for carcinoma of the penis. Contemporary Urology;5:48-66, 2000 7. Rouviere H. Anatomy of the human lymphatic system. Edwards Brothers, p. 218, 1938 8. Daseler E.H., Anson B.J., Reimann A.F. Radical excision of the inguinal and iliac lymph glands: a study based on 450 anatomical dissections and upon supportive clinical observations. Surg. Gynecol. Obstet. 87: 679, 1948 9. Catalona W.J. Modified inguinal lymphadenectomy for carcinoma of the penis with preservation of saphenous veins: technique and preliminary results. J. Urol. 140: 306-310, 1988

No Scalpel Vasectomy

49-years old patient complaining of cough, fever and pleuritic pain for 2 weeks. At admission he was febrile and tachypnic. Chest X-Ray showed left pleural effusion. Thoracocentesis revealed purulent fluid. Chest CT-scan showed large and loculated left pleural effusion and pleural thickening. VATS decortication was performed through three incisions.

A 55-year-old man presented with recurrent epistaxis. After endoscopic sphenopalatine artery cauterization, the bleeding stopped. The patient was doing well at last follow up.

This shows a full Abdominoplasty surgery performed by Dr. Art Foley in Olympia Washington. Abdominoplasty is also commonly referred to as a "Tummy Tuck." Tummy tuck is a surgical procedure also known as abdominoplasty to remove excess skin and fat from the middle and lower abdomen and to tighten the muscles of the abdominal wall. The procedure can dramatically reduce the appearance of a protruding abdomen. But bear in mind, it does produce a permanent scar.

An abscess is a collection of pus. Pus is a thick fluid that usually contains white blood cells, dead tissue and germs (bacteria). The usual cause of an abscess is an infection with bacteria. Certain bacteria are more likely to be 'pus-forming' as they make chemicals (toxins) that can damage the body's tissues.

Open Appendectomy Surgery Video

watch that video of Navel stone removal from a dirty bellybutton

Retinitis pigmentosa is a rare, inherited degenerative eye disease that causes severe vision impairment. Symptoms often begin in childhood. They include decreased vision at night or in low light and loss of side vision (tunnel vision).

IMPLANT POCKETS - an educational animation explaining the different implant pockets

Rehabilitation time for a meniscus repair is about 3 months. A meniscectomy requires less time for healing — approximately 3 to 4 weeks. Meniscus tears are extremely common knee injuries. With proper diagnosis, treatment, and rehabilitation, patients often return to their pre-injury abilities.

nee joint aspiration and injection are performed to aid in diagnosis and treatment of knee joint diseases. The knee joint is the most common and the easiest joint for the physician to aspirate. One approach involves insertion of a needle 1 cm above and 1 cm lateral to the superior lateral aspect of the patella at a 45-degree angle. Once the needle has been inserted 1 to 1½ inches, aspiration aided by local compression is performed. Local corticosteroid injections can provide significant relief and often ameliorate acute exacerbations of knee osteoarthritis associated with significant effusions. Among the indications for arthrocentesis are crystal-induced arthropathy, hemarthrosis, unexplained joint effusion, and symptomatic relief of a large effusion. Contraindications include bacteremia, inaccessible joints, joint prosthesis, and overlying infection in the soft tissue. Large effusions can recur and may require repeat aspiration. Anti-inflammatory medi

Watch that video of a v

Big wart blister after freezing with liquid nitrogen.