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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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If the artery were severed, blood would flow out unimpeded, although the artery wall would contract in an effort to stop the bleeding. After losing >30% of one's blood volume blood pressure would start dropping, and with less pressure the rate of bleeding would go down. At this stage if the blood loss wasn't replaced the person could die. Losing halve to two thirds of one's blood volume is considered to be fatal even if later on blood transfusion is attempted. One's total blood volume at 70ml/kg is estimated to be between 5 to 7 liters, so that makes a blood loss of between 2,5 to 4,7 L.

Musculoskeletal Physical Examination Lecture

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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.

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Osteochondroma. Osteochondromas (osteocartilaginous exostoses), the most common benign bone tumors, may arise from any bone but tend to occur near the ends of long bones. ... Enchondroma. ... Chondroblastoma. ... Chondromyxofibroma. ... Osteoid osteoma. ... Nonossifying fibroma (fibrous cortical defect) ... Benign giant cell tumor of bone.

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

• Define and use related medical terminology.
• Describe and demonstrate techniques for imaging the thyroid gland.
• Discuss functional abnormalities of the thyroid gland.
• Correlate laboratory data relevant to the thyroid and parathyroid glands.
• Describe, and recognize on images, pathologies of the thyroid gland.
• Identify the anatomy of the parathyroid glands on diagrams and sonograms.
• Describe and demonstrate techniques for imaging the parathyroid glands.
• Describe, and recognize on images, pathologies of the parathyroid glands.
• List and describe other neck masses.
• Follow relevant protocols when scanning.
• Differentiate the sonographic appearances of the female reproductive organs in relation to the menstrual cycle, the use of contraceptives and hormone replacement, and following chemotherapy.
• Explain the Patient Privacy Rule (HIPAA) and Patient Safety Act (see reference).

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Breast reduction can relieve strain from shoulder straps, neck, back, and upper arms.
It can provide an uplift to help clothes fit and look better. Traditionally, insurance companies would provide benefits for a broad range of breast sizes and gram weight of tissue to be removed from each breast. At present most insurance companies limit authorization when the doctor plans to remove less than 500gm weight per breast. Since many patients present with symptoms in a D cup to DD cup, often, the very removal of over 500 grams weight may reduce the breasts too much. This amount of reduction may not be in harmony with body shape. Newer methods of breast assembly after reduction, will tighten things using internal brassiere techniques that also compact and reduce breast volume. Therefore, a gram weight reduction of 500gms in some patients combined with internal tightening efforts, could pose an over-reduction. With the unreliability of insurance support in some cases, it is best not to look solely at gram weight in the surgical planning of breast reduction. When excess skin and weight is removed, the improved location of the breasts on the chest will give marked relief of symptoms.

Surgery takes from 2 to 5 hours and can be done as an outpatient or with a brief overnight stay. When possible, no scarring other than around the areola can be planned which follows the Brazilian and French methods (Goes and Benelli). For very large reductions, a vertical method, or T pattern approach is offered. Recovery is a few days, with special care to avoid strain for 4 to 6 weeks. Some soreness may persist for a few weeks. The breasts can appear tight, swollen, and bruised at first, but will usually settle to their near final look by 6 weeks. There may be sutures to be removed in some cases. Costs relate to the severity of the sag, and weight of the breasts.

The operation can make a stunning change in body image, relief of upper body symptoms, and offer a cosmetic lift to naturally sloping breasts.

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