Peripheral Vascular Examination OSCE - Clinical Skills - Dr Gill

In the cardiovascular examination, particularly in the case of an OSCE station, we conclude the examination often by stating that the examiner would want to perform:
- An ECG
- Check full blood count
- and "do a peripheral vascular examination

In this video, we demonstrate that oft-talked about, but comparatively less common examination.

Starting off, with the examination of the hands, the radial, brachial and carotid pulses. before moving down to assess for a AAA, checking the femoral and popliteal pulses, before wrapping up around the ankle with the posterior tibial and dorsalis pedis pulses

For completeness, the cardiovascular examination is demonstrated here
https://www.youtube.com/watch?v=ECs9O5zl6XQ&t=2s

#PeripheralVascular #ClinicalSkills #DrGill

Dr. Erik Beyer, Florida Medical Center's chief of cardiac surgery, discusses performed a procedure called a micro-thoracotomy.

Watch that video to know the Serious Side Effects of Steroids on The Human Body

External cephalic version, or version, is a procedure used to turn a fetus from a breech position or side-lying (transverse) position into a head-down (vertex) position before labor begins. When successful, version makes it possible for you to try a vaginal birth.

What Is a Paronychia (Nail Infection)? An infection that develops along the edge of the fingernail or toenail is called a paronychia (pear-ah-NIK-ee-ah). It is the most common hand infection and, if left untreated, can progress to a more severe infection of the entire finger or toe. Paronychia is distinguished from other infections such as onychomycosis and herpetic whitlow by its location and appearance.

OverviewSymptomsTestingComplicationsTreatmentPreventionTakeawayRead This Next What is gonorrhea? Highlights Some people may never develop noticeable symptoms. Gonorrhea is usually treated with an antibiotic injection or oral antibiotics. You’re at a higher risk of contracting gonorrhea if you’ve had any other STDs. Gonorrhea is a sexually transmitted disease (STD). It’s caused by infection with the bacterium Neisseria gonorrhoeae. It tends to infect warm, moist areas of the body, including the: urethra (the tube that drains urine from the urinary bladder) eyes throat vagina anus female reproductive tract (the fallopian tubes, cervix, and uterus) Gonorrhea passes from person to person through unprotected oral, anal, or vaginal sex. People with numerous sexual partners or those who don’t use a condom are at greatest risk of infection. The best protections against infection are abstinence, monogamy (sex with only one partner), and proper condom usage. Behaviors that make a person more likely to engage in unprotected sex also increase the likelihood of infection. These behaviors include alcohol abuse and illegal drug abuse, particularly intravenous drug use. Advertisement Symptoms of gonorrhea Symptoms

A subdural hematoma (SDH) is a collection of blood below the inner layer of the dura but external to the brain and arachnoid membrane (see the images below). Subdural hematoma is the most common type of traumatic intracranial mass lesion. Subdural hematoma occurs not only in patients with severe head injury but also in patients with less severe head injuries, particularly those who are elderly or who are receiving anticoagulants. Subdural hematoma may also be spontaneous or caused by a procedure, such as a lumbar puncture (see Etiology). Rates of mortality and morbidity can be high, even with the best medical and neurosurgical care (see Prognosis). Subdural hematomas are usually characterized on the basis of their size and location and the amount of time elapsed since the inciting event age (ie, whether they are acute, subacute, or chronic). When the inciting event is unknown, the appearance of the hematoma on neuroimaging studies can help determine when the hematoma occurred. These factors, as well as the neurologic and medical condition of the patient, determine the course of treatment and may also influence the outcome. Generally, acute subdural hematomas are less than 72 hours old and are hyperdense compared with the brain on computed tomography scans. The subacute phase begins 3-7 days after acute injury. Chronic subdural hematomas develop over the course of weeks and are hypodense compared with the brain. However, subdural hematomas may be mixed in nature, such as when acute bleeding has occurred into a chronic subdural hematoma. Presentation varies widely in acute subdural hematoma (see Clinical). Many of these patients are comatose on admission. However, approximately 50% of patients with head injuries who require emergency neurosurgery present with head injuries that are classified as moderate or mild (Glasgow Coma Scale scores 9-13 and 14-15, respectively). Many of these patients harbor intracranial mass lesions. In a large series of patients who developed intracranial hematomas requiring emergent decompression, more than half had lucid intervals and were able to make conversation between the time of their injury and subsequent deterioration. In a more comprehensive review of the literature on the surgical treatment of acute subdural hematomas, lucid intervals were noted in up to 38% of cases. These patients may be more likely to benefit from medical and surgical intervention when instituted in a timely fashion (ie, before further neurological deterioration).

The Closure Procedure for Varicose Veins is a clinically proven, minimally invasive procedure that treats varicose veins and their underlying cause, venous reflux, with little or no pain. Closure patients can walk away from the vein procedure and be back to everyday activities – either at home or at work – typically within a day.

A tracheotomy or a tracheostomy: is simply an opening surgically created through the neck into the trachea (windpipe) to allow direct access to the breathing tube and is commonly done in an operating room under general anesthesia. A tube is usually placed through this opening to provide an airway and to remove secretions from the lungs. Breathing is done through the tracheostomy tube rather than through the nose and mouth. The term “tracheotomy” refers to the incision into the trachea (windpipe) that forms a temporary or permanent opening, which is called a “tracheostomy,” however; the terms are sometimes used interchangeably.

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.

How Did Insects Evolve To Feast On Your Blood?

DMC Orthopaedic Specialists are the state leaders in a unique new procedure to resurface the knee joint, preserving more bone for the patient. ~ Detroit Medical Center

Butt implants are a popular plastic surgery procedure among those who wish to enhance the appearance, shape, and size of their rear ends. Buttock augmentation involves the surgical insertion of artificial body implants into a patient’s buttocks to create a larger, shapelier, and more sensuous rear end. Patients who have underdeveloped buttocks can achieve a more proportionate figure with butt implants. Women who wish to achieve an “hour glass” figure or are unhappy with the size of their buttocks can benefit from female butt implants. Men with flat or poorly developed buttocks can enhance the shape of the area to their liking with male butt implants. Many buttock augmentation patients say that their clothes fit better, they feel more attractive, and their confidence levels have improved.

It involves placing a small, expandable tube called a stent in the narrowed artery. This procedure is also called carotid angioplasty and stenting. There are two carotid arteries-one on each side of the neck-that supply blood to the brain. These arteries can be narrowed and damaged by fatty deposits called plaque.

Alzheimer’s disease is an irreversible, progressive brain disorder that slowly destroys memory and thinking skills, and eventually the ability to carry out the simplest tasks. In most people with Alzheimer’s, symptoms first appear in their mid-60s. Estimates vary, but experts suggest that more than 5 million Americans may have Alzheimer’s. Alzheimer's disease is currently ranked as the sixth leading cause of death in the United States, but recent estimates indicate that the disorder may rank third, just behind heart disease and cancer, as a cause of death for older people. Alzheimer’s is the most common cause of dementia among older adults. Dementia is the loss of cognitive functioning—thinking, remembering, and reasoning—and behavioral abilities to such an extent that it interferes with a person’s daily life and activities. Dementia ranges in severity from the mildest stage, when it is just beginning to affect a person’s functioning, to the most severe stage, when the person must depend completely on others for basic activities of daily living. The causes of dementia can vary, depending on the types of brain changes that may be taking place. Other dementias include Lewy body dementia, frontotemporal disorders, and vascular dementia. It is common for people to have mixed dementia—a combination of two or more disorders, at least one of which is dementia. For example, some people have both Alzheimer's disease and vascular dementia. Alzheimer’s disease is named after Dr. Alois Alzheimer. In 1906, Dr. Alzheimer noticed changes in the brain tissue of a woman who had died of an unusual mental illness. Her symptoms included memory loss, language problems, and unpredictable behavior. After she died, he examined her brain and found many abnormal clumps (now called amyloid plaques) and tangled bundles of fibers (now called neurofibrillary, or tau, tangles). These plaques and tangles in the brain are still considered some of the main features of Alzheimer’s disease. Another feature is the loss of connections between nerve cells (neurons) in the brain. Neurons transmit messages between different parts of the brain, and from the brain to muscles and organs in the body.

The "sunshine" vitamin is a hot topic. You may have recently found out that you are deficient or know someone who is. It's shocking for most people when they have never had a problem before and believe nothing has changed to make it a problem now. The truth is that a lot has changed, and vitamin D deficiency and insufficiency is now a global public-health problem affecting an estimated 1 billion people worldwide. The most well-known consequences to not having enough vitamin D are rickets in children and osteomalacia in adults. These are far from the only problems associated with a vitamin D deficiency.

Osteoporosis is a disease that weakens bones over time. Because of this, it puts you at risk for breaking a bone. Postmenopausal osteoporosis is the most common form of osteoporosis. It affects many women after menopause, leaving some women at high risk for fracture. - See more at: https://www.prolia.com/postmenopausal-osteoporosis/deeper-look/?WT.z_co=A&WT.z_in=PMO&WT.z_ch=PDS&WT.z_st=Site1&WT.z_mt=Broad&WT.z_pdskw=www%20osteoporosis&WT.z_ag=Osteoporosis%20Information%20-%20Broad&WT.z_se=G&WT.srch=1&WT.z_prm=DSE__&WT.mc_id=A_PMO_PDS_G_DSE___Broad_www%20osteoporosis_Osteoporosis%20Information%20-%20Broad#sthash.x5Ys3Now.dpuf

The MAKOplasty® procedure is an FDA-cleared treatment option for patients who suffer from osteoarthritis damage in the medial (inner) portion of the knee. ... Only the diseased portion of your knee is removed, leaving the healthy bone and tissue surrounding it untouched.

Indications for intervention in patients with a renal artery aneurysm (RAA) include the following [20, 8, 13, 14] : Rupture Symptomatic RAA - Hypertension (from associated renal artery stenosis, refractory to medical management), pain, renal ischemia or infarction secondary to embolization from the aneurysm sac RAAs in females who are pregnant or are contemplating pregnancy Diameter greater than 2 cm Enlarging RAA RAA associated with acute dissection Currently, there is no consensus regarding the size at which an RAA should be repaired in an asymptomatic patient. Experts have recommended RAA repair at diameters ranging from 1.5 to 3 cm, [8] though most suggest 2 cm. Some reports have even suggest that larger asymptomatic saccular aneurysms may be managed expectantly. Note that aneurysm rupture at a diameter of 1.5 cm has been reported. Complete calcification of the wall of the aneurysm sac manifests in about 40% of patients. This was once believed to confer protection against rupture [21] ; however, this belief has since been questioned. [30] Asymptomatic, small (<2 cm in diameter) RAAs do not usually require treatment. One notable exception is an RAA in a woman who is pregnant or contemplating pregnancy. In view of the increased risk of rupture in such cases, even small asymptomatic aneurysms should be repaired in this population. For diagnosis and preinterventional planning, gadolinium-enhanced magnetic resonance angiography (MRA) and computed tomography (CT) angiography (CTA) with three-dimensional (3D) reconstruction have essentially replaced conventional arteriography. Regular follow-up examination with ultrasonography (US) or CT) is recommended in patients who are treated expectantly. Spontaneous cure by thrombosis of small aneurysms has been described. Further refinements in endovascular techniques may allow more RAAs to be treated in this manner. So far, excellent short- and intermediate-term results have been described in the literature [40] ; however, there remains a need for further long-term outcome data.

1 yıldır astım tedavisi gören 45 yaşında bayan hasta. Nefes darlığı şikayeti artması üzerine yapılan bronkoskopide trakea lümenini tamayakın tıkayan kitle gözlendi. Coller insizyonu ve parsiyel sternotomi ile yaklaşıldı ve rezeke edildi.