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This particular video is intended as a demonstration of a physical exam that may be useful in evaluating a patient with shoulder pain.
It is not intended as a complete instructional video and should not be considered a source of complete physical examination instruction. It is also intended not as a perfect example of a physical exam that would be performed for a patient in clinical practice, but is designed to optimize function and efficiency for a OSCE testing setting.
Instead, it should be treated as a supplement to independent learning using primary Osteopathic Physical Examination instructional resources. Clinical skills are best learned and developed with support from faculty in the context of a complete Osteopathic Medical School Curriculum.
Osteopathic Clinical Skills is a channel dedicated to discussing and exploring Osteopathic Clinical Skills concepts for medical students, residents, and clinicians and presenting them in an easy to understand manner.
Attributions:
Many thanks to the University of North Texas Health Science Center Texas College of Osteopathic Medicine (UNTHSC - TCOM) for permitting use of the Medical Education Training (MET) facilities and equipment during the production of this video.
Additional thanks to the UNTHSC-TCOM learner and faculty volunteers who participated in this production and provided permission for the use of their image in this video.
Testing for the four features of Gerstmann Syndrome in this patient with two separate left sided strokes (left frontoparietal ischaemic stroke followed by left posterior parietal haemorrhagic stroke). He exhibits (i) acalculia, (ii) agraphia, (iii) left-right disorientation, and (iv) finger agnosia. Complicating the issue is his obvious nonfluent aphasia (expressive dysphasia) with paraphasic errors (replacing words with associated words (e.g. says 'fork' instead of 'spoon')) and some comprehension issues.
A pilonidal sinus (PNS) is a small cyst or abscess that occurs in the cleft at the top of the buttocks. A PNS usually contains hair, dirt, and debris. It can cause severe pain and can often become infected. If it becomes infected, it may ooze pus and blood and have a foul odor. A PNS is a condition that mostly affects men and is also common in young adults. It’s also more common in people who sit a lot, like cab drivers.
Wisdom teeth extractions can rear their ugly head later in life. This is a video of a patient with neck pain and neck weakness. When we stimulated the nerve fibers in the area of the extracted teeth there was an immediate improvement in her ability to control her neck muscles.
It can treat spider veins and tiny varicose veins just under the skin's surface. ... (If you have poor blood circulation feeding these tiny veins, the larger "feeder" vein must first be treated with surgery, endovenous laser or radiofrequency treatment, or sclerotherapy.) Endovenous laser treatment.
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.
How to approach histology for Human Anatomy students. Using a key will help get you through it! Add some penguin fairy dust will help too!
Please note: I mis-spoke and said "striated" instead of "stratified epithelium" a couple of times... apologies!
There are lots of histology keys out there, but the one I showed in the video is here: http://www.penguinprof.com/upl....oads/8/4/3/1/8431323
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Details:
Tissue in the human body:
Epithelial: Is made of cells arranged in a continuous sheet with one or more layers, has apical & basal surfaces.
A basement membrane is the attachment between the basal surface of the cell & the underlying connective tissue.
Two types of epithelial tissues: (1) Covering & lining epithelia and (2) Glandular Epithelium.
The number of cell layers & the shape of the cells in the top layer can classify epithelium.
Simple Epithelium - one cell layer
Stratified epithelium - two or more cell layers
Pseudostratified Columnar Epithelium - When cells of an epithelial tissue are all anchored to the basement Membrane but not all cells reach the apical surface.
Glandular Epithelium -- (1) Endocrine: Release hormones directly into the blood stream and (2) Exocrine - Secrete into ducts.
Connective: contains many different cell types including: fibroblasts, macrophages, mast cells, and adipocytes. Connective Tissue Matrix is made of two materials: ground substance - proteins and polysaccharides, fiber -- reticular, collagen and elastic.
Classification of Connective Tissue:
Loose Connective - fibers & many cell types in gelatinous matrix, found in skin, & surrounding blood vessels, nerves, and organs.
Dense Connective - Bundles of parallel collagen fibers& fibroblasts, found in tendons& ligaments.
Cartilage - Cartilage is made of collagen & elastin fibers embedded in a matrix glycoprotein & cells called chondrocytes, which was found in small spaces.
Cartilage has three subtypes:
Hyaline cartilage -- Weakest, most abundant type, Found at end of long bones, & structures like the ear and nose,
Elastic cartilage- maintains shape, branching elastic fibers distinguish it from hyaline and
Fibrous Cartilage - Strongest type, has dense collagen & little matrix, found in pelvis, skull & vertebral discs.
Muscle: is divided into 3 categories, skeletal, cardiac and smooth.
Skeletal Muscle -- voluntary, striated, striations perpendicular to the muscle fibers and it is mainly found attached to bones.
Cardiac Muscle -- involuntary, striated, branched and has intercalated discs
Smooth Muscle -- involuntary, nonstriated, spindle shaped and is found in blood vessels & the GI tract.
Nervous: Consists of only two cell types in the central nervous system (CNS) & peripheral nervous system (PNS):
Neurons - Cells that convert stimuli into electrical impulses to the brain, and Neuroglia -- supportive cells.
Neurons -- are made up of cell body, axon and dendrites. There are 3 types of neurons:
Motor Neuron -- carry impulses from CNS to muscles and glands,
Interneuron - interpret input from sensory neurons and end responses to motor neurons
Sensory Neuron -- receive information from environment and transmit to CNS.
Neuroglia -- is made up of astrocytes, oligodendrocytes, ependymal cells and microglia in the CNS, and schwann cells and satellite cells in the PNS.
An abdominal aortic aneurysm is an enlarged area in the lower part of the aorta, the major blood vessel that supplies blood to the body. The aorta, about the thickness of a garden hose, runs from your heart through the center of your chest and abdomen. Because the aorta is the body's main supplier of blood, a ruptured abdominal aortic aneurysm can cause life-threatening bleeding. Depending on the size and the rate at which your abdominal aortic aneurysm is growing, treatment may vary from watchful waiting to emergency surgery. Once an abdominal aortic aneurysm is found, doctors will closely monitor it so that surgery can be planned if it's necessary. Emergency surgery for a ruptured abdominal aortic aneurysm can be risky.