The pelvic diaphragm is composed of muscle fibers of the levator ani, the coccygeus, and associated connective tissue which span the area underneath the pelvis. The pelvic diaphragm is a muscular partition formed by the levatores ani and coccygei, with which may be included the parietal pelvic fascia on their upper and lower aspects. The pelvic floor separates the pelvic cavity above from the perineal region (including perineum) below.

The right and left levator ani lie almost horizontally in the floor of the pelvis, separated by a narrow gap that transmits the urethra, vagina, and anal canal. The levator ani is usually considered in three parts: pubococcygeus, puborectalis, and iliococcygeus. The pubococcygeus, the main part of the levator, runs backward from the body of the pubis toward the coccyx and may be damaged during parturition. Some fibers are inserted into the prostate, urethra, and vagina. The right and left puborectalis unite behind the anorectal junction to form a muscular sling . Some regard them as a part of the sphincter ani externus. The iliococcygeus, the most posterior part of the levator ani, is often poorly developed.

The coccygeus, situated behind the levator ani and frequently tendinous as much as muscular, extends from the ischial spine to the lateral margin of the sacrum and coccyx.

The pelvic cavity of the true pelvis has the pelvic floor as its inferior border (and the pelvic brim as its superior border.) The perineum has the pelvic floor as its superior border.

Some sources do not consider “pelvic floor” and “pelvic diaphragm” to be identical, with the “diaphragm” consisting of only the levator ani and coccygeus, while the “floor” also includes the perineal membrane and deep perineal pouch.

Totally Laparoscopic Collis-Nissen Fundoplication

A detailed video showing how to clinically exam the abdomen

Bronchiectasis is an abnormal dilation of the proximal and medium-sized bronchi (>2 mm in diameter) caused by weakening or destruction of the muscular and elastic components of the bronchial walls. Affected areas may show a variety of changes, including transmural inflammation, edema, scarring, and ulceration, among other findings. Distal lung parenchyma may also be damaged secondary to persistent microbial infection and frequent postobstructive pneumonia. Bronchiectasis can be congenital but is most often acquired.[9] Congenital bronchiectasis usually affects infants and children. These cases result from developmental arrest of the bronchial tree. Acquired forms occur in adults and older children and require an infectious insult, impairment of drainage, airway obstruction, and/or a defect in host defense. The tissue is also damaged in part by the host response of neutrophilic proteases, inflammatory cytokines, nitric oxide, and oxygen radicals. This results in damage to the muscular and elastic components of the bronchial wall. Additionally, peribronchial alveolar tissue may be damaged, resulting in diffuse peribronchial fibrosis.[12] The result is abnormal bronchial dilatation with bronchial wall destruction and transmural inflammation. The most important functional finding of altered airway anatomy is severely impaired clearance of secretions from the bronchial tree. Impaired clearance of secretions causes colonization and infection with pathogenic organisms, contributing to the purulent expectoration commonly observed in patients with bronchiectasis. The result is further bronchial damage and a vicious cycle of bronchial damage, bronchial dilation, impaired clearance of secretions, recurrent infection, and more bronchial damage

Preventing Perineal Tears HD

Ear irrigation is a routine procedure used to remove excess earwax, called cerumen, or foreign materials from the ear. The ear naturally secretes earwax to protect, lubricate, keep debris out, and regulate bacterial growth. Under normal conditions, the body keeps the amount of earwax in the ears .

Transmetatarsal Amputation for Gangrene

The spleen is an organ in the upper far left part of the abdomen, to the left of the stomach. The spleen varies in size and shape between people, but it’s commonly fist-shaped, purple, and about 4 inches long. Because the spleen is protected by the rib cage, you can’t easily feel it unless it’s abnormally enlarged. The spleen plays multiple supporting roles in the body. It acts as a filter for blood as part of the immune system. Old red blood cells are recycled in the spleen, and platelets and white blood cells are stored there. The spleen also helps fight certain kinds of bacteria that cause pneumonia and meningitis.

A video discussing Causes of Itching in the Vulva

UPDATE 1/30/15: Watch the updated version of this animation: https://www.youtube.com/watch?v=LVP6JngpgEE

This 3D medical animation shows how adhesions in the abdomen may cause complications. These problems may include obstruction, twisting, and dislocating areas of the small intestine. Adhesions can be separated with laparoscopic instruments.

ANH00037

A simple continuous stitch can be a useful technique for skin closure when speed is important, e.g. closing a scalp laceration on a screaming child. The simple running, or continuous suture, is begun in the same way as a simple interrupted suture.

INDICATIONS Administration of agents into the central vasculature Central circulation and intracardiac access Maintenance of venous access Hemodialysis and plasmapheresis

Respiratory syncytial virus (RSV) is a virus that causes infections of the lungs and respiratory tract. It's so common that most children have been infected with the virus by age 2. Respiratory syncytial (sin-SISH-ul) virus can also infect adults. In adults and older, healthy children, the symptoms of respiratory syncytial virus are mild and typically mimic the common cold. Self-care measures are usually all that's needed to relieve any discomfort. Infection with respiratory syncytial virus can be severe in some cases, especially in premature babies and infants with underlying health conditions. RSV can also become serious in older adults, adults with heart and lung diseases, or anyone with a very weak immune system (immunocompromised).

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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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Ejaculating into a partner’s mouth is a common practice during oral sex/fellatio. In a safe situation (where there is no danger of catching an STD), the semen-receiving partner may choose to spit the semen out, or to swallow it. Before you engage in fellatio, I’d recommend that you and your partner both get tested for sexually transmitted infections (STIs). If not, please use barriers for oral sex and abstaining from making contact with ejaculate. Semen is mostly water, but also contains amino acids and protein, sugars such as fructose and glucose, minerals such as zinc and calcium, vitamin C, and a few other nutrients. Sperm cells themselves make up less than one percent of semen. Semen is edible, and if swallowed, will travel down the esophagus and into the stomach, where it will be digested in the same way that food is. You can never get pregnant by swallowing semen. Some people accept the taste of semen, but others complain that swallowing semen can give them an upset stomach. In rare cases, you may have an allergy to the proteins found in semen. What does It Taste Like? The taste of semen varies. Bitter, sweet, metallic. So, one may expect to find the taste of semen anywhere from enjoyable to tasteless to disgusting. But there is a way of controlling the taste of semen, which is through diet. Keep track of the diet, and communicate with the partner about when it tastes better or worse.

Colorectal surgeon Conor Delaney, MD, explains laparoscopic surgery for colon cancer, including how it works and what patients can typically expect before, during, and after the procedure.

Learn more about colon cancer at http://cancer.org/coloncancer

he Allium Ureteral Stents are intended for temporary long or short-term use in malignant or benign chronic Ureteral Stenosis. Allium Ureteral Stents are mounted on a ready to use 8 or 10Fr delivery system. By using the appropriate delivery system their deployment procedure can be performed either retrogradely or percutaneously. Indicated for all chronic ureteral stricturesLarge caliber for intra-lumenal flowLong dwelling timeAntegrade or retrograde insertionEasy insertion and stent positioningExcellent patient comfortNo tissue in-growthAnti-reflux designEasy removal of the device

Tracheostomy

Stomach cancer usually begins in the mucus-producing cells that line the stomach. This type of cancer is called adenocarcinoma. For the past several decades, rates of cancer in the main part of the stomach (stomach body) have been falling worldwide. During the same period, cancer in the area where the top part of the stomach (cardia) meets the lower end of the swallowing tube (esophagus) has become much more common. This area of the stomach is called the gastroesophageal junction.

Ovarian teratoma is a type of germ cell tumour. Germ cell tumours are cancers that begin in egg cells in women or sperm cells in men. There are 2 main types of ovarian teratoma. Mature teratoma, which is benign. Immature teratoma, which is cancerous.