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Examination of Peripheral Vascular System - Clinical Skills OSCE Revision - Dr Gill
In this video, we demonstrate the peripheral vascular examination - a less common examination, but still vitally important, particularly amongst the older population
Starting with the examination of the hands looking for clinical signs of vascular compromise, we then check the pulses of the major arteries of the upper body - the radial, brachial and carotid arteries, before moving down to assess for an abdominal aortic aneurysm.
At this point, I feel it's a practical step to check the femoral pulses before doing the overview of the legs.
After visually assessing we must examine the major vascular areas of leg.- namely the 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
Breast cancer usually starts off in the inner lining of milk ducts or the lobules that supply them with milk. A malignant tumor can spread to other parts of the body. A breast cancer that started off in the lobules is known as lobular carcinoma, while one that developed from the ducts is called ductal carcinoma. The vast majority of breast cancer cases occur in females. This article focuses on breast cancer in women. We also have an article about male breast cancer. Breast cancer is the most common invasive cancer in females worldwide. It accounts for 16% of all female cancers and 22.9% of invasive cancers in women. 18.2% of all cancer deaths worldwide, including both males and females, are from breast cancer. Breast cancer rates are much higher in developed nations compared to developing ones. There are several reasons for this, with possibly life-expectancy being one of the key factors - breast cancer is more common in elderly women; women in the richest countries live much longer than those in the poorest nations. The different lifestyles and eating habits of females in rich and poor countries are also contributory factors, experts believe. According to the National Cancer Institute, 232,340 female breast cancers and 2,240 male breast cancers are reported in the USA each year, as well as about 39,620 deaths caused by the disease.
A small-bowel obstruction (SBO) is caused by a variety of pathologic processes. The leading cause of SBO in industrialized countries is postoperative adhesions (60%), followed by malignancy, Crohn disease, and hernias, although some studies have reported Crohn disease as a greater etiologic factor than neoplasia.
Cerebral palsy refers to brain damage that occurs before a child is five years old. Therefore, adults cannot develop cerebral palsy. However, cerebral palsy does not get better or worse with age, so when a child has the condition, he or she will continue to have the condition into adulthood.
The usual reason given for people getting fat is that they eat too much and/or exercise too little. That reflects one of the basic laws of thermodynamics—I forget which one. The amount of energy you put into a system minus the energy you take out has to be stored somewhere i.e. FAT! This formulation—true though it is—does not entirely explain obesity since some people seem to eat more than fat people and exercise no more than these same fat people, and yet they are not fat! Chalking this fact up to the general perversity of the universe is not sufficient explanation. Other factors must come into play. I mention below some of the ideas thoughtful people have proposed to explain why fat people become fat:
The Zika virus, first identified in Uganda in 1947, is transmitted by the same type of mosquito that carries dengue fever, yellow fever, and chikungunya virus. A mosquito bites an infected person and then passes those viruses to other people it bites. Outbreaks did not occur outside of Africa until 2007, when it spread to the South Pacific.
This video demonstrates how to perform a cardiovascular examination in an OSCE station.
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Chapters:
- Introduction 00:00
- General inspection 00:35
- Hands 00:46
- Schamroth's window test 01:07
- Capillary refill 01:27
- Pulses 01:35
- Carotid auscultation 02:21
- Carotid pulse 02:43
- Jugular venous pressure 02:55
- Hepatojugular reflux 03:09
- Inspection of the face 03:21
- Inspection of the chest 03:49
- Apex beat 04:12
- Heaves and thrills 04:28
- Heart valve ausculation 04:49
- Accentuation manoeuvres 05:45
- Lung base auscultation 06:23
- Sacral and pedal oedema 06:43
- Summary 07:10
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Normal heart sounds and aortic regurgitation/stenosis sounds
Recorded on a Thinklabs Digital Stethoscope (https://www.thinklabs.com)
Some people have found this video useful for ASMR purposes.
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This is one of the most interesting medical topics to discuss. What are the responsibilities of a doctor? What are the basic skills a doctor needs to have? and what are the responsibilities of a doctor?
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How do you make a working human heart? Scientists can turn stem cells into beating heart cells, but getting them to organize into a 3D heart requires a scaffold. At the Massachusetts General Hospital in Boston, Harald Ott and his team are reusing the scaffold that nature provides. They’re stripping away all the living cells from dead hearts, before filling in the leftover matrix with healthy new cells. In this video, Brendan Maher finds out how the technique could be used to develop parts of the heart, like the aortic root and valve, for transplant.
The vast majority of glucocorticoid activity in most mammals is from cortisol, also known as hydrocortisone. Corticosterone, the major glucocorticoid in rodents, is another glucocorticoid. Cortisol binds to the glucocorticoid receptor in the cytoplasm and the hormone-receptor complex is then translocated into the nucleus, where it binds to its DNA response element and modulates transcription from a battery of genes, leading to changes in the cell's phenotype. Only about 10% of circulating cortisol is free. The remaining majority circulates bound to plasma proteins, particularly corticosteroid-binding globulin (transcortin). This protein binding likely decreases the metabolic clearance rate of glucocorticoids and, because the bound steroid is not biologically active, tends to act as a buffer and blunt wild fluctuations in cortisol concentration.
Guest surgeon Dr. Nicole Callan gives us an introduction to hernias. She discusses what a hernia is, the different types of hernias, and an introduction to treatment.
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