The thyroid gland lies in the midline of the anterior neck, just caudal to the thyroid cartilage. To inspect the thyroid gland, the examiner stands in front of the patient. The examiner asks the seated patient to dorsiflex (extend) the neck and swallow a sip of water. Minor enlargement of the gland may only become apparent on inspection in this position. Palpation of the thyroid gland is typically performed with the examiner standing behind the patient. Both lobes and the isthmus of the thyroid gland should be palpated for any nodules or diffuse enlargement. Mobility of the thyroid gland with swallowing should be assessed with palpation. Nodules arising from the thyroid gland typically move with swallowing. A hard, fixed thyroid gland could indicate malignancy. If a central nodule is identified, the patient is asked to protrude the tongue. Upward movement of the central nodule on protrusion of the tongue indicates a thyroglossal cyst. Auscultation is performed at the superior poles of bilateral lobes as this is where the superior thyroid artery is most superficial and bifurcates into its terminal branches. A bilateral bruit over the superior poles suggests Graves disease. Examination of the thyroid gland is completed by palpating the regional cervical lymph nodes for any enlargement.

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This particular video is intended as a demonstration of Neurologic Examination. This demonstration is intended as an example of a neurologic exam which may be used as part of the initial evaluation of patients with complaints that may have an underlying neurologic origin. This video is solely for educational purposes and intended for use to prepare for OSCEs incorporating standardized patient encounters. It is not intended as a demonstration of a comprehensive neurologic examination and is not intended as medical advice or medical guidelines.

It is not intended as a complete instructional video and should not be considered a source of complete physical examination instruction.

Instead, it should be treated as a supplement to independent learning using primary Osteopathic Clinical Skills instructional resources. Clinical skills are best learned and developed with support from faculty in the context of a complete Osteopathic Medical School Curriculum.

Osteopathic Clinical Skills is a channel dedicated to discussing and exploring Osteopathic Clinical Skills concepts for medical students, residents, and clinicians and presenting them in an easy to understand manner.

Attributions:
Many thanks to the University of North Texas Health Science Center Texas College of Osteopathic Medicine (UNTHSC - TCOM) for permitting use of the Simulation facilities and equipment during the production of this video.

Additional thanks to the UNTHSC-TCOM standardized patient and faculty volunteers who participated in this production and provided permission for the use of their image in this video.

Watch that video of Bodybuilder's Colon Contains 10 lbs of Meat Worms

Baby Delivery

Glass ampules are often used to store medication, and as a nurse, you'll need to know how to use them.

In this video, I demonstrate how to clean an ampule using alcohol prep, how to open (or break) an ampule, as well as how to dispose of the ampule.

In addition, I show how to use an ample filter straw while drawing up (withdrawing) medication, how to use the syringe, and how to remove the air bubbles in the syringe.

This is another video in our series on clinical nursing skills.

Notes: https://www.registerednursern.....com/how-to-withdraw-
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http://www.mediplus.co.uk A new and safer method of inserting a Foley catheter suprapubically. The technique allows the insertion to be carried out in an Outpatient setting, thus saving time, cost and effort. By using the Seldinger technique, the product reduces the chances of bowel or bladder perforation and resultant morbidity.
The product has been chosen by The NHS National Technology Adoption Centre to help facilitate adoption of the product

Anatomy of The Upper Limb Joints

In this instructional video, Director of Critical Care Nephrology, Sevag Demirjian, MD goes over the steps for in-hospital production of ultra-pure continuous hemodialysis fluid.

By using the information in this video and/or any other materials made available by Cleveland Clinic related to the dialysate solution, you agree to comply with and be bound by the terms of the Permissive Use Agreement, a copy of which is available at https://bit.ly/3f9lN4j

Watch Dr. Robert Thomas, of Panorama Orthopedics & Spine Center, perform a Mako Knee replacement. He narrates each step of the process.

For patients in extremis from respiratory failure or shock, securing vascular access is crucial, along with establishing an airway and ensuring adequacy of breathing and ventilation. Peripheral intravenous catheter insertion is often difficult, if not impossible, in infants and young children with circulatory collapse. Intraosseous (IO) needle placement, shown in the images below, provides a route for administering fluid, blood, and medication. An IO line is as efficient as an intravenous route and can be inserted quickly, even in the most poorly perfused patients.

breast augmentation-breast implants

Benefits of Breast Feeding

Transcript of the videos for you:
What we will be talking about to you today is post massive weight loss body contouring procedures. If you are someone who has lost a lot of weight or if you know someone who has lost a lot of weight, then this video is for you because I will be discussing in-depth about post massive weight loss body contouring.
Keep watching this video because this might benefit you and may change your life forever.
I am Dr. Rajat Gupta, a board-certified plastic surgeon working in Delhi, with an experience of over 2000 body contouring procedures.
So, let’s talk about what is massive weight loss.
Now, any individual can lose a lot of weight. But massive weight loss means the loss of at least 10kg in 3 months time. So, lot of individuals lose a lot of weight either due to exercise, dieting or they undergo some procedures like bariatric surgery, in which there are different options of sleeve gastrectomy, roux en y bypass – all as simple as a balloon insertion into the stomach.
After all these interventions, a person loses a lot of weight and they reduce their subcutaneous fat a lot. Now, once they lose this weight and the subcutaneous fat what happens is that their skin starts sagging or the skin gets loose.
You may notice that they lose fat from their face and neck and the face and neck skin start loosening up. Or, majorly, they lose a lot of fat from their abdomen and their abdominal skin gets loose and it doesn’t look nice if they remove their clothes. There is a huge amount of skin which is sagging. At the same time,
they may have some loose skin in their thigh area which does not look nice.
In females, once they lose a lot of fat, they may also get breast sagging. Their breasts may sag. Which also doesn’t look nice. Depending upon what areas an individual has got sagging and in, we plan the correction for those areas. Basically, what they need is removal of excess skin.
Now, whether this excess skin is in their neck, in their chest, in their abdomen, in their arms or thighs, the treatment is customized depending upon what an individual’s needs or requirements are. So, suppose someone has a lot of excess skin in their abdomen. What it needs is the removal of excess skin from the lower abdomen or a procedure known as tummy tuck or abdominoplasty. If a person has excess skin in their thighs or arms, then they need a reduction in their excess skin, in those areas and the procedure is called a thigh lift or an arm lift. For face and neck sagging, a person may undergo a procedure
called face or neck lift. And for the sagging of breasts, they need a procedure called breast lift or mastopexy.
Now, all these procedures are actually customized and tailored for each individual. But a person who has lost a large amount of weight and has sagging skin, they would eventually need this because sagging skin is
not only an aesthetic concern but that area is also very difficult to clean. The sweat gets accumulated, they may have some fungal infections there, and it doesn’t look nice altogether. I’ve seen such individuals, when they remove their clothes, it’s not only that they don’t look nice, they also lose a lot of their confidence.
They display inhibitions even though they have lost such a large amount of weight and they look nice with clothes on. They would be inhibited by removing their clothes and going swimming or for a beach holiday.
So, understand that the ramifications of this procedure are not only for aesthetic concerns but also for the self-confidence of that person.
These procedures are reasonably safe procedures if done by a good plastic surgeon at a good center. Now, you need to choose your plastic surgeon keeping in mind a person who has experience with post massive weight loss contouring because these are some things which are very different to contour, the skin excess is in all dimensions, and therefore your plastic surgeon has to be smart enough and artistic enough that they understand how to remove the excess skin while giving you minimal scars and, at the same time,
enhancing the shape of your body.
I’ve tried to answer the indications of body contouring after post massive weight loss procedures. If you have any more questions regarding these procedures, please write into us and I will be there to help you. Thank you.

#plasticsurgery #bodycontouring #drrajatgupta

Watch that Large Jelly Like Hematoma Extraction

Robot-Assisted Laparoscopic Rectal Resection for Endometriosis

.

Chapters

0:00 Introduction
1:04 Why do doctors perform laparoscopy?
2:11 How is laparoscopy performed?
3:22 Result
3:47 Risk of laparoscopy

Laparoscopy (from Ancient Greek λαπάρα (lapára) 'flank, side', and σκοπέω (skopéō) 'to see') is an operation performed in the abdomen or pelvis using small incisions (usually 0.5–1.5 cm) with the aid of a camera. The laparoscope aids diagnosis or therapeutic interventions with a few small cuts in the abdomen.[1]

Laparoscopic surgery, also called minimally invasive procedure, bandaid surgery, or keyhole surgery, is a modern surgical technique. There are a number of advantages to the patient with laparoscopic surgery versus an exploratory laparotomy. These include reduced pain due to smaller incisions, reduced hemorrhaging, and shorter recovery time. The key element is the use of a laparoscope, a long fiber optic cable system that allows viewing of the affected area by snaking the cable from a more distant, but more easily accessible location.

Laparoscopic surgery includes operations within the abdominal or pelvic cavities, whereas keyhole surgery performed on the thoracic or chest cavity is called thoracoscopic surgery. Specific surgical instruments used in laparoscopic surgery include obstetrical forceps, scissors, probes, dissectors, hooks, and retractors. Laparoscopic and thoracoscopic surgery belong to the broader field of endoscopy. The first laparoscopic procedure was performed by German surgeon Georg Kelling in 1901. There are two types of laparoscope:[2]

A telescopic rod lens system, usually connected to a video camera (single-chip or three-chip)
A digital laparoscope where a miniature digital video camera is placed at the end of the laparoscope, eliminating the rod lens system

The mechanism mentioned in the second type is mainly used to improve the image quality of flexible endoscopes, replacing conventional fiberscopes. Nevertheless, laparoscopes are rigid endoscopes. Rigidity is required in clinical practice. The rod-lens-based laparoscopes dominate overwhelmingly in practice, due to their fine optical resolution (50 µm typically, dependent on the aperture size used in the objective lens), and the image quality can be better than that of the digital camera if necessary. The second type of laparoscope is very rare in the laparoscope market and in hospitals.[citation needed]

Also attached is a fiber optic cable system connected to a "cold" light source (halogen or xenon) to illuminate the operative field, which is inserted through a 5 mm or 10 mm cannula or trocar. The abdomen is usually insufflated with carbon dioxide gas. This elevates the abdominal wall above the internal organs to create a working and viewing space. CO2 is used because it is common to the human body and can be absorbed by tissue and removed by the respiratory system. It is also non-flammable, which is important because electrosurgical devices are commonly used in laparoscopic procedures.[3]
Procedures
Surgeons perform laparoscopic stomach surgery.
Patient position

During the laparoscopic procedure, the position of the patient is either in Trendelenburg position or in reverse Trendelenburg. These positions have an effect on cardiopulmonary function. In Trendelenburg's position, there is an increased preload due to an increase in the venous return from lower extremities. This position results in cephalic shifting of the viscera, which accentuates the pressure on the diaphragm. In the case of reverse Trendelenburg position, pulmonary function tends to improve as there is a caudal shifting of viscera, which improves tidal volume by a decrease in the pressure on the diaphragm. This position also decreases the preload on the heart and causes a decrease in the venous return leading to hypotension. The pooling of blood in the lower extremities increases the stasis and predisposes the patient to develop deep vein thrombosis (DVT).[4]
Gallbladder

Rather than a minimum 20 cm incision as in traditional (open) cholecystectomy, four incisions of 0.5–1.0 cm, or more recently, a single incision of 1.5–2.0 cm,[5] will be sufficient to perform a laparoscopic removal of a gallbladder. Since the gallbladder is similar to a small balloon that stores and releases bile, it can usually be removed from the abdomen by suctioning out the bile and then removing the deflated gallbladder through the 1 cm incision at the patient's navel. The length of postoperative stay in the hospital is minimal, and same-day discharges are possible in cases of early morning procedures.[citation needed]
Colon and kidney

This implantation method is very common and used in both FUE hair transplant surgery and strip surgery (FUSS). During this implantation method, site creation and graft implantation are performed simultaneously as part of a one or two step process.

The cardiac conduction system is a group of specialized cardiac muscle cells in the walls of the heart that send signals to the heart muscle causing it to contract. The main components of the cardiac conduction system are the SA node, AV node, bundle of His, bundle branches, and Purkinje fibers.

The Epley Maneuver for Vertigo can be very effective at relieving vertigo symptoms, but it’s a procedure that should be performed by a physical therapist or other health care professional. This video is for demonstration purposes only. See Doctor Jo’s blog post about the Epley