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This video illustrates an IM injection for deltoid muscle.
Note that vaccines and other medications can be administered through the deltoid muscle. I will give you some tips through this video.

It is important to check your client’s details such as their medication, time, dose, and the route to be used. Different research works are subject to change the protocols for insertion thus, it is necessary to be up to date with the current changes.

Assemble all the supplies and conduct hand sanitation. Usually, I wear gloves before giving any injection in as much as the CDC may state it is optional unless the patient has an open lesion and contact of body fluids is likely to happen.

Use the acromion process landmark to locate the deltoid muscle. Move your fingers about two widths below the landmark. The patient’s adipose tissue determines the choice of needle length. Note that the needle gauge is determined by the type of medication you plan to give to the patient.

The Z-track technique is recommended rather than pinching the patient’s skin. Pull the patient’s skin to the side using one hand. Use a 90 degree angle to insert the needle to the patient’s skin. At the rate of 10 seconds per mL gently depress the plunger.

Remove the needle carefully and engage the safety precautions then dispose of the needle appropriately in the sharps container. Gauzing helps to cover the injection site.

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Piriformis syndrome refers to when the piriformis muscle irritates the sciatic nerve and caues pain along the back of the leg and foot.

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A complete organized library of all my videos, digital slides, pics, & sample pathology reports is available here: https://kikoxp.com/posts/5084 (dermpath) & https://kikoxp.com/posts/5083 (bone/soft tissue sarcoma pathology)

Topics discussed:

Epidermis:
Layers of epidermis: 0:10
Melanocytes vs Keratinocytes: 5:16
Langerhans cells: 10:10 & 33:30 & 57:30

Dermis:
Papillary and reticular dermis: 11:50
Three types of white empty spaces on a slide: vessels, glands/ducts/cysts, or artifact: 15:25
Blood vessels & nerves: 18:24 & 48:50 & 58:59
Arrector pili & other dermal smooth muscle: 20:00

Adnexal:
Sebaceous gland: 21:10
Hair follicle 23:14
Eccrine sweat glands and ducts 24:45 & 50:00
Gland/duct vs blood vessel 27:20 & 48:50
Apocrine glands: this video https://kikoxp.com/posts/7837 (at 12:30)
Acrosyringium: this video https://kikoxp.com/posts/7837 (at 10:00)

Three types of pink bundles: smooth muscle, nerve, dense connective tissue: 27:50

Acral skin (palm sole) with contact dermatitis 29:37
Parakeratosis 30:00
Perivascular lymphocytes 30:40
Eosinophils vs neutrophils 31:20
Spongiosis with desmosome keratinocyte spines 32:10
Spongiotic vesicles with Langerhans cells 33:30
Normal acral skin (palm & sole) with stratum lucidum 34:20
Normal glomus body/apparatus (canal of Sucquet-Hoyer) 35:40
Nerve 36:46 & 51:50
Adipose tissue (white fat cells) in subcutis with Lochkern 37:55
Normal scalp skin with large anagen hair follicles: 39:30
Hair follicle anatomy (bulb/matrix, inner root sheath, outer root sheath, hair shaft, isthmus, infundibulum): 40:55 (labeled images):
https://kikoxp.com/posts/3661 & https://kikoxp.com/posts/7899
Pacinian corpuscle 50:40
Meissner corpuscle 1:02:28

Dense regular connective tissue (Fascia/Tendon/Ligament) vs Smooth Muscle 53:00

Basic Normal Skin Immunohistochemistry:
-cytokeratin in epidermis: 55:33
-S100 in melanocytes and Langerhans cells and adipocytes: 57:30
-Desmin in smooth muscle (arrector pili and blood vessels): 58:59
-CD31 in endothelial cells of blood vessels: 59:33
-SOX-10 in melanocytes: 1:00:40

Digit/Finger/Toe histology (amputation for subungual acral melanoma) 1:04:10 & 1:08:30
-bone 1:05:40
-glomus body 1:05:15
-tendon/ligament 1:06:10
-artery 1:06:58
-fingernail/toenail 1:08:54
-acrosyringium 1:10:45

Solar elastosis (what wrinkles look like microscopically!) 1:11:50

Other videos you might like:
Tendon vs Nerve Histology Made Simple with the Ramen Noodle Sign (of Fulton) video: https://kikoxp.com/posts/4466
Melanocytes vs Keratinocytes made easy video: https://kikoxp.com/posts/3802
Blood Vessel vs Gland vs Artifact Made Easy video: https://kikoxp.com/posts/4808

The basic normal structures of the skin discussed and described by a dermatopathologist. This material is intended for use by medical students, junior pathology or dermatology residents, or for anyone else studying normal human histology. Special thanks to two of my medical students at UAMS for helping make this video possible. Miki Lindsey convinced me that I really needed to sit down and record this video. Akash Patel took time to edit the video and make it ready for YouTube. My sincere thanks to both of them for helping me overcome procrastination.

Huge thanks to Abigail Cline, a medical student at Medical College of Georgia, for volunteering to type a transcript of this ENTIRE video (over 14,000 words!) so that I could provide closed caption subtitles for those with hearing impairments and for those who may need assistance in understanding spoken English (particularly given how quickly I speak!). You can access a text version of her transcript of my video here: https://kikoxp.com/posts/5390

Correction - I made a mistake in the video. I said that sebaceous gland secretions are turned into smelly substances by bacteria and that this makes body odor. That is incorrect. That is actually true of APOCRINE gland secretions not sebaceous secretions.

Also, in the past I used "keratinocyte" and "squamous cell" interchangeably (this is because in dermatopathology, we see and talk about squamous cell carcinomas all the time, and those tumors are composed of keratinocytes). But technically, in normal skin histology, "squamous cell" refers only to the flattened keratinocytes in the superficial epidermis. Thankfully, a histology PhD colleague pointed this out to me and corrected my lazy nomenclature!

Please check out my Soft Tissue Pathology & Dermatopathology survival guide textbooks: http://bit.ly/2Te2haB ‬

This video is geared towards medical students, pathology or dermatology residents, or practicing pathologists or dermatologists. Of course, this video is for educational purposes only and is not formal medical advice or consultation.

Presented by Jerad M. Gardner, MD. Please subscribe to my channel to be notified of new pathology teaching videos.

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Giant cell tumors of the tendon sheath are common lesions and are the second most frequent tumors in the hand, after synovial cysts. They are diagnosed by means of clinical examination and complementary examinations (simple radiography and magnetic resonance). Erosion and invasion of the phalangeal bone affected may be seen on radiological examination. Magnetic resonance may show a “fluorescent or radiant effect” may be observed, caused by the high quantity of hemosiderin inside the tumor. Surgical treatment is the commonest practice, and complete excision is important for avoiding recurrence of the tumor, especially when bone invasion is observed on imaging examinations, which is generally related to greater tumor recurrence. In this paper, a case of a giant cell tumor of the tendon sheath in the middle phalanx of the third finger of a 45-year-old female patient is presented. This was successfully treated by means of surgery using a double access approach (dorsal and volar)

Colon polyp facts Colon polyps are growths on the inner lining of the colon and are very common. Colon polyps are important because they may be, or may become malignant (cancerous). They also are important because based on their size, number, and microscopic anatomy (histology); they can predict which patients are more likely to develop more polyps and colon cancer. Changes in the genetic material of cells lining the colon are the cause of polyps. There are different types of colon polyps with differing tendencies to become malignant and abilities to predict the development of more polyps and cancer. It is important to recognize families with members who have familial genetic conditions causing polyps because some of these conditions are associated with a very high incidence of colon cancer, and the cancer can be prevented or discovered early.