The examination room should be quiet, warm and well lit. After you have finished interviewing the patient, provide them with a gown (a.k.a. "Johnny") and leave the room (or draw a separating curtain) while they change. Instruct them to remove all of their clothing (except for briefs) and put on the gown so that the opening is in the rear. Occasionally, patient's will end up using them as ponchos, capes or in other creative ways. While this may make for a more attractive ensemble it will also, unfortunately, interfere with your ability to perform an examination! Prior to measuring vital signs, the patient should have had the opportunity to sit for approximately five minutes so that the values are not affected by the exertion required to walk to the exam room. All measurements are made while the patient is seated. Observation: Before diving in, take a minute or so to look at the patient in their entirety, making your observations, if possible, from an out-of-the way perch. Does the patient seem anxious, in pain, upset? What about their dress and hygiene? Remember, the exam begins as soon as you lay eyes on the patient. Temperature: This is generally obtained using an oral thermometer that provides a digital reading when the sensor is placed under the patient's tongue. As most exam rooms do not have thermometers, it is not necessary to repeat this measurement unless, of course, the recorded value seems discordant with the patient's clinical condition (e.g. they feel hot but reportedly have no fever or vice versa). Depending on the bias of a particular institution, temperature is measured in either Celcius or Farenheit, with a fever defined as greater than 38-38.5 C or 101-101.5 F. Rectal temperatures, which most closely reflect internal or core values, are approximately 1 degree F higher than those obtained orally. Respiratory Rate: Respirations are recorded as breaths per minute. They should be counted for at least 30 seconds as the total number of breaths in a 15 second period is rather small and any miscounting can result in rather large errors when multiplied by 4. Try to do this as surreptitiously as possible so that the patient does not consciously alter their rate of breathing. This can be done by observing the rise and fall of the patient's hospital gown while you appear to be taking their pulse. Normal is between 12 and 20. In general, this measurement offers no relevant information for the routine examination. However, particularly in the setting of cardio-pulmonary illness, it can be a very reliable marker of disease activity. Pulse: This can be measured at any place where there is a large artery (e.g. carotid, femoral, or simply by listening over the heart), though for the sake of convenience it is generally done by palpating the radial impulse. You may find it helpful to feel both radial arteries simultaneously, doubling the sensory input and helping to insure the accuracy of your measurements. Place the tips of your index and middle fingers just proximal to the patients wrist on the thumb side, orienting them so that they are both over the length of the vessel.

Histology of Neurovascular Bundle

A sneeze, or sternutation, is a semi-autonomous, convulsive expulsion of air from the lungs through the nose and mouth, usually caused by foreign particles irritating the nasal mucosa

A Cryptic Pregnancy is a pregnancy, where the feotus is hidden or camouflaged in its natural environment; due to no HcG hormone being produced by the placenta and/or by difficulty in finding with ultrasound devices.

Dr. Katherine Scovner from the Division of Nephrology at Massachusetts General Hospital discusses kidney dialysis.

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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When placement of a urethral catheter is contraindicated or unsuccessful, percutaneous suprapubic urinary bladder catheterization is a commonly performed procedure to relieve urinary retention. [1, 2] This topic describes the Catheter over needle technique. The Seldinger technique is described in the Clinical Procedures topic Suprapubic Aspiration.

Histology of Peripheral Nerve

A clinical examination of the hands using the standard Look, Feel, Move approach. Specific​ examination structure derived from MacLeod's Clinical Examination 14th edition. Performed by Dr James Gill

he Allium Ureteral Stents are intended for temporary long or short-term use in malignant or benign chronic Ureteral Stenosis. Allium Ureteral Stents are mounted on a ready to use 8 or 10Fr delivery system. By using the appropriate delivery system their deployment procedure can be performed either retrogradely or percutaneously. Indicated for all chronic ureteral stricturesLarge caliber for intra-lumenal flowLong dwelling timeAntegrade or retrograde insertionEasy insertion and stent positioningExcellent patient comfortNo tissue in-growthAnti-reflux designEasy removal of the device

If you’re wondering ‘what’s the cause of my knee pain?’ or ‘what kind of knee pain do I have?’ the position of your knee pain can often tell you what type of knee pain you have.
You confirm this if you know the common symptoms an aggravations for each type of knee problem. So if you want to know ‘why my knee hurts’... here’s a quick look at the most common type of knee problems...

Patellofemoral Pain Syndrome (Or Runner’s Knee) (Old Name: Chondromalacia Patellae)
Infrapatellar Fat Pad Syndrome (Hoffa's Syndrome)
Patella Tendonitis (Jumper’s Knee)
Prepatellar Bursitis
Osgood-Schlatter Disease
Meniscus Tear
Medial Collateral Ligament Tear
Osteoarthritic Knee Pain
Pes Anserine Bursitis.
Iliotibial Band Syndrome
Quadriceps Tendinopathy
Popliteus Strain
Baker’s Cyst
ACL Or PCL Tear/Rupture

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https://youtube.com/@BodyFixExercises

OTHER VIDEOS:
How To Fix Pain In The Front Of The Knee… (Runner's Knee) https://youtu.be/g0qmx_0enAA

Knee Strengthening Exercises To Prevent Knee Pain
https://youtu.be/Pk-ae_lyx7M

How To Treat Patellar Tendinopathy (Jumper’s Knee) & Quadriceps Tendinopathy
https://youtu.be/MkPwsb-rQwU

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Care must be taken to prevent stenosis at the anastomotic site. If the diameter of the anastomosis is less than 2 cm, the anastomosis should be taken down and resected. A classic end-to-end anastomosis should be performed to ensure adequate diameter to the intestine. If the posterior wall of the colon has been preserved, care should be taken to close the colostomy prior to opening the peritoneal cavity. This will reduce intraperitoneal contamination from the stoma site. Copious irrigation of the wound should be made prior to primary closure. If gross contamination has occurred, delayed closure of the wound should be considered.

Overview
Heart bypass surgery creates a new route, called a bypass, for blood and oxygen to reach the heart.

Heart bypass surgery begins with an incision in the chest, and the breastbone is cut exposing the heart. Next, a portion of the saphenous vein, which is very large, is harvested from the inside of the leg. Pieces of this large vein are used to bypass the blocked coronary arteries, which are arteries that supply blood to the heart. The venous graft is sewn to the aorta, the main artery of the body, and to the affected coronary artery, to bypass the blocked site.

The internal mammary artery from the chest may also be used to bypass a clogged artery.

Several arteries may be bypassed depending on the condition of the heart. After the graft is created, the breastbone and chest are closed.

Local Anaesthetic Injection

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Transvenous cardiac pace maker, also called endocardial pacing, is a potentially life saving intervention used primarily to correct profound bradycardia. It can be used to treat symptomatic bradycardias that do not respond to transcutaneous pacing or to drug therapy.

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