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A flail chest occurs when a segment of the thoracic cage is separated from the rest of the chest wall. This is usually defined as at least two fractures per rib (producing a free segment), in at least two ribs. A segment of the chest wall that is flail is unable to contribute to lung expansion. Large flail segments will involve a much greater proportion of the chest wall and may extend bilaterally or involve the sternum. In these cases the disruption of normal pulmonary mechanics may be large enough to require mechanical ventilation.
Detailed examination of the joints is usually not included in the routine medical examination. However, joint related complaints are rather common, and understanding anatomy and physiology of both normal function and pathologic conditions is critically important when evaluating the symptomatic patient. By gaining an appreciation for the basic structures and functioning of the joint, you'll be able to "logic" your way thru the exam, even if you can't remember the eponym attached to each specific test!
Cerclage is indicated in a patient with a history of painless cervical dilation and a second trimester loss. It is also indicated in a patient with a history of preterm birth and a short cervix found on ultrasound between 16-24 weeks gestation. Cerclage placement occurs after the first trimester in case the pregnancy is genetically abnormal and would likely result in a first trimester loss.
Normal sperm densities range from 15 million to greater than 200 million sperm per milliliter of semen. You are considered to have a low sperm count if you have fewer than 15 million sperm per milliliter or less than 39 million sperm total per ejaculate.
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Occiput or cephalic — the baby's head is down, and the baby is facing the mother's abdomen. This position results in back pain and a prolonged labor. Transverse — the baby is lying crosswise in the uterus, side-to-side over the mother's pelvis, in a horizontal position rather than vertical.