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Leopold's Maneuvers are difficult to perform on obese women and women who have hydramnios. The palpation can sometimes be uncomfortable for the woman if care is not taken to ensure she is relaxed and adequately positioned. To aid in this, the health care provider should first ensure that the woman has recently emptied her bladder. If she has not, she may need to have a straight urinary catheter inserted to empy it if she is unable to micturate herself. The woman should lie on her back with her shoulders raised slightly on a pillow and her knees drawn up a little. Her abdomen should be uncovered, and most women appreciate it if the individual performing the maneuver warms their hands prior to palpation. First maneuver: Fundal Grip While facing the woman, palpate the woman's upper abdomen with both hands. A professional can often determine the size, consistency, shape, and mobility of the form that is felt. The fetal head is hard, firm, round, and moves independently of the trunk while the buttocks feel softer, are symmetric, and the shoulders and limbs have small bony processes; unlike the head, they move with the trunk. Second maneuver After the upper abdomen has been palpated and the form that is found is identified, the individual performing the maneuver attempts to determine the location of the fetal back. Still facing the woman, the health care provider palpates the abdomen with gentle but also deep pressure using the palm of the hands. First the right hand remains steady on one side of the abdomen while the left hand explores the right side of the woman's uterus. This is then repeated using the opposite side and hands. The fetal back will feel firm and smooth while fetal extremities (arms, legs, etc.) should feel like small irregularities and protrusions. The fetal back, once determined, should connect with the form found in the upper abdomen and also a mass in the maternal inlet, lower abdomen. Third maneuver: Pawlick's Grip In the third maneuver the health care provider attempts to determine what fetal part is lying above the inlet, or lower abdomen.[2] The individual performing the maneuver first grasps the lower portion of the abdomen just above the symphysis pubis with the thumb and fingers of the right hand. This maneuver should yield the opposite information and validate the findings of the first maneuver. If the woman enters labor, this is the part which will most likely come first in a vaginal birth. If it is the head and is not actively engaged in the birthing process, it may be gently pushed back and forth. The Pawlick's Grip, although still used by some obstetricians, is not recommended as it is more uncomfortable for the woman. Instead, a two-handed approach is favored by placing the fingers of both hands laterally on either side of the presenting part. Fourth maneuver The last maneuver requires that the health care provider face the woman's feet, as he or she will attempt to locate the fetus' brow. The fingers of both hands are moved gently down the sides of the uterus toward the pubis. The side where there is resistance to the descent of the fingers toward the pubis is greatest is where the brow is located. If the head of the fetus is well-flexed, it should be on the opposite side from the fetal back. If the fetal head is extended though, the occiput is instead felt and is located on the same side as the back. Cautions Leopold's maneuvers are intended to be performed by health care professionals, as they have received the training and instruction in how to perform them. That said, as long as care taken not to roughly or excessively disturb the fetus, there is no real reason it cannot be performed at home as an informational exercise. It is important to note that all findings are not truly diagnostic, and as such ultrasound is required to conclusively determine the fetal position.

The peroneal artery is closely positioned to the fibula. The artery arises from the tibioperoneal trunk, distal to the takeoff of the anterior tibial artery (seen in the illustration below perforating the interosseous membrane). The peroneal artery sends perforators laterally to the skin of the lower leg, sometimes in a septocutaneous fashion via the lateral intermuscular septum, but often with muscular perforators. The length of the pedicle is usually short, but can be increased substantially by dissecting the peroneal artery and its venae from the fibula and using the distal bone for reconstruction.

tep+lc

Describe pre-procedure considerations for administering a subcutaneous injection.

Describe and demonstrate the preparation for administering a subcutaneous injection.

Describe and demonstrate needle and blood safety.

Describe and demonstrate suitable injection sites for subcutaneous injections.

Discuss the appropriate needle and syringe sizes for subcutaneous injection.

Describe and demonstrate the preparation of the substance to be injected.

Describe and demonstrate safe and correct administration of a subcutaneous injection.

Understand and apply Occupational Safety and Health Administration (OSHA) guidelines.

Understand and apply drug administration safety guidelines (seven rights).

Understand correct post-procedure considerations.

Describe and demonstrate correct documentation.

Define and demonstrate correct recording and reporting procedures.

Define and use related medical terminology.

Explain the Patient Privacy Rule (HIPAA), Patient Safety Act, and Patients' Bill of Rights.

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Skin laceration repair is an important skill in family medicine. Sutures, tissue adhesives, staples, and skin-closure tapes are options in the outpatient setting. Physicians should be familiar with various suturing techniques, including simple, running, and half-buried mattress (corner) sutures. Although suturing is the preferred method for laceration repair, tissue adhesives are similar in patient satisfaction, infection rates, and scarring risk in low skin-tension areas and may be more cost-effective. The tissue adhesive hair apposition technique also is effective in repairing scalp lacerations. The sting of local anesthesia injections can be lessened by using smaller gauge needles, administering the injection slowly, and warming or buffering the solution. Studies have shown that tap water is safe to use for irrigation, that white petrolatum ointment is as effective as antibiotic ointment in postprocedure care, and that wetting the wound as early as 12 hours after repair does not increase the risk of infection. Patient education and appropriate procedural coding are important after the repair.

It’s not tummy tuck procedure.. it’s liposuction only.. don’t get confused with both procedure..



#beforeandafter #kmc #nose #aesthetic #antiaging #beauty #drhabibhairtransplant #peshawar #nose #islamabad #swat #kohat #nowshehra #karakin #mardan

The baby will move head down if there is room or if there is tone in the support to the uterus to direct baby head down. Before 24-26 weeks most babies lie diagonal or sideways in the Transverse Lie position. Between 24-29 weeks most babies turn vertical and some will be breech.

Ankle and Foot Clinical Examination - Clinical Skills - Dr Gill

When it comes to joints of the body, the ankle is one of the joints most commonly injured. This is vitally important to be able to effectively examine a patient who is complaining of pain in the ankle and foot.

In this video we will perform a demonstration of the ankle and foot examination.

Examination of the foot, and the ankle joint, follows the standard orthopaedic approach of look, feel, move.

There is a connected video to the foot and ankle examination, on the causes of carpal tunnel syndrome - here

https://youtu.be/aXx6NfBWDSs

________

Please note that there is no ABSOLUTE way to perform a clinical examination. Different institutions and even clinicians will have differing degrees of variations - the aim is the effectively identify medically relevant signs.

However during OSCE assessments. Different medical schools, nursing colleges, and other health professional courses will have their own preferred approach to a clinical assessment - you should concentrate on THEIR marks schemes for your assessments.

The examination demonstrated here is derived from Macleod's Clinical Examination - a recognized standard textbook for clinical skills.


#footpain #clinicalexamination #DrGill

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Survivor is coming up on its 43rd season this fall (whaaat??), and with all that reality TV goodness in the can already I knew there would be some medical moments to react to. Turns out, I was right, in that there have been a bunch of ailments on the show over the years! These injuries span the entire length of the whole series, so if you're a long time Survivor and Jeff Probst fan, this one is for you!

I LOVE reading your comments and take your suggestions seriously. If there’s a subject you want me to discuss or something you’d like for me to react to, leave a comment down below. Many of my videos have been born out of suggestions directly from you, so don’t hold back!
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Executive Producer: Doctor Mike
Production Director and Editor: Dan Owens
Managing Editor and Producer: Sam Bowers
Editor and Designer: Caroline Weigum

* Select photos/videos provided by Getty Images *

** The information in this video is not intended nor implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images, and information, contained in this video is for general information purposes only and does not replace a consultation with your own doctor/health professional **

Austin Vampire Facelift provider Dr. David Sneed gives us a comprehensive overview of this new facial rejuvenation technology also known as PRP. This nonsurgical anti-aging treatment utilizes the patient's own blood to stimulate the growth of new collagen, tighten skin and smooth out wrinkles.

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Each person's knee is different. This is why UC San Diego Health offers several surgical options for knee replacements to tailor care to each person's injury and health. Each surgical approach has benefits for the right surgical candidate. Our surgeons can discuss what option is most appropriate for each person.

To learn more about knee replacement options at UC San Diego Health, visit:
https://health.ucsd.edu/specia....lties/orthopedics/jo

Francis Gonzales, MD, is a board-certified orthopedic surgeon who specializes in adult hip and knee joint replacement surgery. Learn more about Dr. Gonzales: https://providers.ucsd.edu/det....ails/11935/orthopedi

UC San Diego Health is repeatedly ranked among the nation's best in orthopedic care by U.S. News & World Report. We are also a Blue Distinction Center recognized for our treatment expertise and better overall patient results for knee replacement, as well as a designated Center of Excellence for orthopedic care by Optum. This means you'll receive expert, safe and cost-effective care.

UC San Diego Health's orthopedic surgeons are the first and only in San Diego to offer customized knee replacements with the ROSA knee system — for a faster recovery and more natural feeling knee. Talk to one of our surgeons about whether a ROSA knee replacement is right for you. https://health.ucsd.edu/specia....lties/orthopedics/jo#a

A recap of Mater Hospital patient Helen's story as she progressed from experiencing chronic knee pain due to osteoarthritis, through to knee replacement treatment and ultimately a new lease on life.

Dedicated to surgical excellence and patient-centred care, the Mater Hospital North Sydney is regarded as a leading orthopaedic hospital and the only Australian hospital to be accepted into the International Society of Orthopaedic Centres.

For more information, click here: https://bit.ly/3bvhY8G

Buerger's disease (thromboangiitis obliterans) is a rare disease of the arteries and veins in the arms and legs. In Buerger's disease, your blood vessels become inflamed, swell and can become blocked with blood clots (thrombi). This eventually damages or destroys skin tissues and may lead to infection and gangrene. Buerger's disease usually first shows in your hands and feet and may eventually affect larger areas of your arms and legs. Virtually everyone diagnosed with Buerger's disease smokes cigarettes or uses other forms of tobacco, such as chewing tobacco. Quitting all forms of tobacco is the only way to stop Buerger's disease. For those who don't quit, amputation of all or part of a limb is sometimes necessary.

Perdre Du Ventre, Comment Maigrir Des Cuisses, Regime Soupe, Prendre Du Muscle, Maigrir Des Hanches ---- http://perte-poids-rapide.info-pro.co --- Comment maigrir pour un homme ? Les régimes ne sont pas une exclusivité féminine et les hommes ont eux aussi des comptes à rendre à leur balance. Pour séduire, pour se sentir mieux dans leur corps, pour leur travail, ils ont eux aussi des raisons pour se délester de quelques kilos. Hommes et femmes : différentes face aux kilos Les hommes et les femmes ne réagissent pas de la même manière face au poids. Le corps non plus. La première différence est au niveau de la silhouette. La gente féminine va accumuler les kilos en trop au niveau des fesses et des cuisses alors que pour les hommes, la prise de poids se situe surtout au niveau du visage, du cou et du ventre. L’autre différence entre les hommes et les femmes est la faculté à perdre du poids. Si vous avez décidé de suivre un régime en couple, sachez Mesdames que les hommes maigrissent plus vite ! Cette « injustice » est expliquée par le fait que les hommes ou plutôt leur organisme, va brûler plus de calories au repos et à l’effort que les femmes grâce à leur masse corporelle plus importante. Par contre, ces dames sont plus motivées à tenir un régime sur la longueur. Les hommes et les régimes, c’est toute une histoire ! C’est pourquoi ils doivent faire un régime qui leur corresponde et qui est adapté à leur vie au quotidien ! Maigrir lorsque l’on est un homme Les hommes sont de plus en plus nombreux à vouloir perdre du poids. Surtout entre 40 et 45 ans. Mais même s’ils maigrissent plus vite que les femmes, la partie est loin d’être gagnée. Pourquoi ? Parce qu’il est plus compliqué pour eux de modifier leurs habitudes alimentaires. En effet, ce sont les vrais champions d’une alimentation riche en matières grasses, peu variée et très déséquilibrée. Il faut donc qu’ils adoptent de nouvelles habitudes alimentaires tout en conservant une certaines notion de plaisir et qu’ils combattent certaines mauvaises habitudes, souvent responsable de leurs kilos en trop. "Découvrez comment jean-jacques a réussi à perdre 3,2 kilos et 7 cm de tour de taille en 2 semaines, sans peser les aliments ni compter les calories." Cliquez ici: http://perte-poids-rapide.info-pro.co

Histology of Thin Skin

Cytomegalovirus (CMV) continues to have a tremendous impact in solid organ transplantation despite remarkable advances in its diagnosis, prevention and treatment. It can affect allograft function and increase patient morbidity and mortality through a number of direct and indirect effects. Patients may develop asymptomatic viremia, CMV syndrome or tissue-invasive disease. Late-onset CMV disease continues to be a major problem in high-risk patients after completion of antiviral prophylaxis. Emerging data suggests that immunologic monitoring may be useful in predicting the risk of late onset CMV disease. There is now increasing interest in the development of an effective vaccine for prevention. Novel antiviral drugs with unique mechanisms of action and lesser toxicity are being developed. Viral load quantification is now undergoing standardization, and this will permit the generation of clinically relevant viral thresholds for the management of patients. This article provides a brief overview of the contemporary epidemiology, clinical presentation, diagnosis, prevention and treatment of CMV infection in solid organ transplant recipients.

Laparotomy Closure Abdomen Animation