Heart and Blood Vessels Physical Examination

Various laparoscopic techniques have been described for the insertion of peritoneal dialysis catheters. However, most use 3 to 4 ports, thus multiplying the potential risk for abdominal wall complications (hemorrhage, hernia, leaking). With the technique presented herein a Tenckhoff catheter is plac...ed laparoscopically, using just 1 port, in 13 consecutive patients with end-stage renal failure. The catheter is fixed in the abdominal cavity with no additional ports for this purpose. The simplicity and the rapidity of the method justifies serious consideration for its use as the standard Tenckhoff catheter placement.

This gentleman has a significant lumbar herniated disc with a positive well straight leg raise test. In this evaluation I test his deep tendon reflexes, sensation, muscle strength, and perform a straight leg raise test, Braggards's test and Well straight leg raise test.

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SCOOP transtracheal oxygen is indicated for patients with chronic hypoxemia which persists in spite of optimal medical therapy. Arterial blood gases obtained while breathing room air should show a PaO2< 55 mm Hg. SCOOP transtracheal oxygen is also indicated for patients with a PaO2 of 56-59 mm Hg ...

if they also have: 1) dependent edema suggesting congestive heart failure, 2) "P" pulmonale on EKG (P wave greater than 3mm in standard leads II, III or AVF), or 3) erythrocythemia with a hematocrit of >55%.

Watch that Large Jelly Like Hematoma Extraction

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A ureteroscopy is an examination or procedure using a ureteroscope. A ureteroscope, like a cystoscope, is an instrument for examining the inside of the urinary tract. The urologist can insert small instruments through the cystoscope to treat problems in the urethra and bladder or perform a biopsy. For a ureteroscopy, the urologist passes the ureteroscope through the bladder and into a ureter.

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

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 is the postmortem of a male who died of due to a blunt injury to abdomen n thus the ruptue of the spleen. there was no any scra or wond on epidermis. but the 4th rib was fractured. all the above mentioned conditions are clearly seen in this video.

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

Anatomy of The Upper Limb Joints

breast augmentation-breast implants

Prenatal repair of myelomeningocele (MMC), the most common and severe form of spina bifida, is a delicate surgical procedure where fetal surgeons open the uterus and close the opening in the baby's back while they are still in the womb.

A simple conversation can go a long way in protecting your loved ones from atrial fibrillation related strokes.

Musculoskeletal Physical Examination Lecture