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There are four major blood groups determined by the presence or absence of two antigens – A and B – on the surface of red blood cells: Group A – has only the A antigen on red cells (and B antibody in the plasma) Group B – has only the B antigen on red cells (and A antibody in the plasma) Group AB – has both A and B antigens on red cells (but neither A nor B antibody in the plasma) Group O – has neither A nor B antigens on red cells (but both A and B antibody are in the plasma)
This video provides a guide peforming a respiratory examination in an OSCE station, including real-time auscultation sounds of common pathology such as coarse crackles, fine crackles, wheeze and stridor.
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Chapters:
- Introduction 00:00
- General inspection 00:40
- Inspection of the hands 00:50
- Schamroth's window test 01:09
- Heart rate and respiratory rate 01:50
- Jugular venous pressure 02:02
- Face, eyes and mouth 02:13
- Anterior chest inspection 02:36
- Trachea and cricosternal distance 03:01
- Palpation of apex beat 03:16
- Chest expansion 03:28
- Lung percussion 03:50
- Auscultation of lungs 04:21
- Vocal resonance 05:03
- Lymph node palpation 05:32
- Inspection of posterior chest 06:04
- Posterior chest expansion 06:10
- Percussion of posterior chest 06:32
- Auscultation of posterior chest 06:55
- Sacral and pedal oedema 08:04
- Summary of findings 08:39
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Always adhere to your medical school/local hospital guidelines when performing examinations or clinical procedures. DO NOT perform any examination or procedure on patients based purely upon the content of these videos. Geeky Medics accepts no liability for loss of any kind incurred as a result of reliance upon the information provided in this video.
Some people have found this video useful for ASMR purposes.
Special thanks to www.easyauscultation.com and Andy Howes for providing some of the respiratory sounds.
A young patient undergoes state of the art robotic surgery for Ovarian Cancer and Endometrial Cancer in Chicago, IL. The surgery is performed by noted gynecologic oncologist and expert robotic surgeon M. Patrick Lowe MD. Dr Lowe has been performing robotic surgery since 2006 and is one of a few gynecologic oncologist in the United States who utilizes robotics for ovarian cancer.
Multiple sclerosis (MS) affects the brain and spinal cord. Early MS symptoms include weakness, tingling, numbness, and blurred vision. Other signs are muscle stiffness, thinking problems, and urinary problems. Treatment can relieve MS symptoms and delay disease progression.
Learn Basic Laparoscopic Surgery, the components of a laparoscopic surgical setup, optimal positioning and ergonomics in laparoscopic surgery, and much more. Check out the full course for free here: https://www.incision.care/free-trial
What is Laparoscopic Surgery:
Laparoscopic surgery describes procedures performed using one or multiple small incisions in the abdominal wall in contrast to the larger, normally singular incision of laparotomy. The technique is based around principles of minimally invasive surgery (or minimal access surgery): a large group of modern surgical procedures carried out by entering the body with the smallest possible damage to tissues. In abdominopelvic surgery, minimally invasive surgery is generally treated as synonymous with laparoscopic surgery as are procedures not technically within the peritoneal cavity, such as totally extraperitoneal hernia repair, or extending beyond the abdomen, such as thoraco-laparoscopic esophagectomy. The term laparoscopy is sometimes used interchangeably, although this is often reserved to describe a visual examination of the peritoneal cavity or the purely scopic component of a laparoscopic procedure. The colloquial keyhole surgery is common in non-medical usage.
Surgical Objective of Laparoscopic Surgery:
The objective of a laparoscopic approach is to minimize surgical trauma when operating on abdominal or pelvic structures. When correctly indicated and performed, this can result in smaller scars, reduced postoperative morbidity, shorter inpatient durations, and a faster return to normal activity. For a number of abdominopelvic procedures, a laparoscopic approach is now generally considered to be the gold-standard treatment option.
Definitions
Developments of Laparoscopic Surgery:
Following a number of smaller-scale applications of minimally invasive techniques to abdominopelvic surgery, laparoscopic surgery became a major part of general surgical practice with the introduction of laparoscopic cholecystectomy in the 1980s and the subsequent pioneering of endoscopic camera technology. This led to the widespread adoption of the technique by the early- to mid-1990s. The portfolio of procedures that can be performed laparoscopically has rapidly expanded with improvements in instruments, imaging, techniques and training — forming a central component of modern surgical practice and cross-specialty curricula [2]. Techniques such as laparoscopically assisted surgery and hand-assisted laparoscopic surgery have allowed the application of laparoscopic techniques to a greater variety of pathology. Single-incision laparoscopic surgery, natural orifice transluminal endoscopic surgery, and minilaparoscopy-assisted natural orifice surgery continue to push forward the applications of minimally invasive abdominopelvic techniques; however, the widespread practice and specific indications for these remain to be fully established. More recently, robotic surgery has been able to build on laparoscopic principles through developments in visualization, ergonomics, and instrumentation.
This Basic Laparoscopic Surgery Course Will Teach You:
- Abdominal access techniques and the different ways of establishing a pneumoperitoneum
- Principles of port placement and organization of the operative field
- Key elements of laparoscopic suturing, basic knotting and clip application
Specific attention is paid to the following hazards you may encounter:
- Fire hazard and thermal injury
- Lens fogging
- Contamination of insufflation system
- Complications from trocar introduction
- Limitations of Veress needle technique
- Limitations of open introduction technique
- Complications of the pneumoperitoneum
- Gas embolism
- Mirroring and scaling of instrument movements
- Firing clip applier without a loaded clip
The following tips are designed to improve your understanding and performance:
- Anatomy of a laparoscope
- Checking for optic fiber damage
- "White balance" of camera
- Checking integrity of electrosurgical insulation
- Access at Palmer's point
- Lifting abdominal wall before introduction
- Confirming position of Veress needle
- Umbilical anatomy
- Identification of inferior epigastric vessels under direct vision
- Translumination of superficial epigastric vessels
- Selection of trocar size
- Aiming of trocar
- Working angles in laparoscopic surgery
- Choice of suture material
- Instruments for suturing
- Optimal ergonomics for suturing
- Extracorporeal needle positioning
- Optimal suture lengths
- "Backloading" needle
- Intracorporeal needle positioning
- Hand movements when suturing
- Optimal positioning of scissors
- Extracorporeal knot tying
- Visualization of clip applier around target structure
- Common clip configurations
Most of the time when someone with cancer is told they have cancer in the bones, the doctor is talking about a cancer that has spread to the bones from somewhere else. This is called metastatic cancer. It can be seen in many different types of advanced cancer, like breast cancer, prostate cancer, and lung cancer. When these cancers in the bone are looked at under a microscope, they look like the tissue they came from. For example, if someone has lung cancer that has spread to bone, the cells of the cancer in the bone still look and act like lung cancer cells. They do not look or act like bone cancer cells, even though they are in the bones. Since these cancer cells still act like lung cancer cells, they still need to be treated with drugs that are used for lung cancer. For more information about metastatic bone cancer, please see our document called Bone Metastasis, as well as the document on the specific place the cancer started (Breast Cancer, Lung Cancer, Prostate Cancer, etc.). Other kinds of cancers that are sometimes called “bone cancers” start in the blood forming cells of the bone marrow − not in the bone itself. The most common cancer that starts in the bone marrow and causes bone tumors is called multiple myeloma. Another cancer that starts in the bone marrow is leukemia, but it is generally considered a blood cancer rather than a bone cancer. Sometimes lymphomas, which more often start in lymph nodes, can start in bone marrow. Multiple myeloma, lymphoma, and leukemia are not discussed in this document. For more information on these cancers, refer to the individual document for each. A primary bone tumor starts in the bone itself. True (or primary) bone cancers are called sarcomas. Sarcomas are cancers that start in bone, muscle, fibrous tissue, blood vessels, fat tissue, as well as some other tissues. They can develop anywhere in the body. There are several different types of bone tumors. Their names are based on the area of bone or surrounding tissue that is affected and the kind of cells forming the tumor. Some primary bone tumors are benign (not cancerous), and others are malignant (cancerous). Most bone cancers are sarcomas.
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.
Alcoholic hepatitis is inflammation of the liver caused by drinking alcohol. Alcoholic hepatitis is most likely to occur in people who drink heavily over many years. However, the relationship between drinking and alcoholic hepatitis is complex. Not all heavy drinkers develop alcoholic hepatitis, and the disease can occur in people who drink only moderately. If you're diagnosed with alcoholic hepatitis, you must stop drinking alcohol. People who continue to drink alcohol face a high risk of serious liver damage and death.
Barrett's esophagus is a complication of chronic (long lasting) and usually severe gastrointestinal reflux disease (GERD), but occurs in only a small percentage of patients with GERD. Criteria are needed for screening patients with GERD for Barrett's esophagus. Until validated criteria are available, it seems reasonable to do screening endoscopies in GERD patients who cannot be taken off acid suppression therapy after two to three years. The diagnosis of Barrett's esophagus rests upon seeing (at endoscopy) a pink esophageal lining that extends a short distance (usually less than 2.5 inches) up the esophagus from the gastroesophageal junction and finding intestinal type cells (goblet cells) on biopsy of the lining. There is a small but definite increased risk of cancer of the esophagus (adenocarcinoma) in patients with Barrett's esophagus.
A colonoscope is the special tool used to perform a colonoscopy. It is a thin, flexible, tubular ‘telescope’ with a light and video camera that your doctor carefully guides through your colon in order to see and determine the health of your colon. Watch this animation to learn about the features of the colonoscope, how the colonoscopy procedure is performed and how polyps are removed, and the follow-up care you and your doctor should talk about after your procedure.