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Identify the anatomy and explain the physiology of the breast on diagrams and sonograms.
Describe and demonstrate the protocol for sonographic scanning of the breast, including the clock and quadrant methods, and targeted examinations based on mammographic findings.
Describe the various diagnostic pathways that may lead to a sonographic breast examination, and explain how the ultrasound findings are correlated with other imaging modalities.
Identify and describe sonographic images of benign and malignant features and common breast pathologies.
Explain biopsy techniques for breast tumors.
Define and use related medical terminology.
Explain the Patient Privacy Rule (HIPAA) and Patient Safety Act (see reference
Identify the anatomy and explain the physiology of the scrotum on diagrams and sonograms.
Describe and demonstrate the protocol for sonographic scanning of the scrotum.
Identify and describe sonographic images of congenital abnormalities of the scrotum.
Identify and describe sonographic images of pathologies of the scrotum.
Identify and describe sonographic images of extratesticular disease processes.
Identify the anatomy and explain the physiology of the prostate on diagrams and sonograms.
Describe and demonstrate the protocol for transabdominal and endorectal sonographic scanning of the prostate.
Identify and describe sonographic images of benign and malignant pathologies of the prostate, including benign hyperplasia, prostatitis, carcinoma, and calculi.
Explain the technique for prostate biopsy.
Define the criteria for an ultrasound appearance of prostate tumor staging.
Explain the technique for radiation seed implantation.
Explain the Patient Privacy Rule (HIPAA) and Patient Safety Act (see reference).
Amyotrophic lateral sclerosis The disorder causes muscle weakness and atrophy throughout the body caused by degeneration of the upper and lower motor neurons. Unable to function, the muscles weaken and atrophy. Affected individuals may ultimately lose the ability to initiate and control all voluntary movement, although bladder and bowel sphincters and the muscles responsible for eye movement are usually, but not always, spared. Cognitive function is generally spared for most patients although some (~5%) also have frontotemporal dementia.A higher proportion of patients (~30-50%) also have more subtle cognitive changes which may go unnoticed but are revealed by detailed neuropsychological testing. Sensory nerves and the autonomic nervous system, which controls functions like sweating, are generally unaffected but may be involved for some patients. The earliest symptoms of ALS are typically obvious weakness and/or muscle atrophy. Other presenting symptoms include muscle fasciculation (twitching), cramping, or stiffness of affected muscles; muscle weakness affecting an arm or a leg; and/or slurred and nasal speech. The parts of the body affected by early symptoms of ALS depend on which motor neurons in the body are damaged first. About 75% of people contracting the disease experience "limb onset" ALS i.e. first symptoms in the arms ("upper limb", not to be confused with "upper motor neuron") or legs ("lower limb", not to be confused with "lower motor neuron"). Patients with the leg onset form may experience awkwardness when walking or running or notice that they are tripping or stumbling, often with a "dropped foot" which drags along the ground. Arm-onset patients may experience difficulty with tasks requiring manual dexterity such as buttoning a shirt, writing, or turning a key in a lock. Occasionally, the symptoms remain confined to one limb for a long period of time or for the whole course of the illness; this is known as monomelic amyotrophy. About 25% of cases are "bulbar onset" ALS. These patients first notice difficulty speaking clearly or swallowing. Speech may become slurred, nasal in character, or quieter. Other symptoms include difficulty swallowing, and loss of tongue mobility. A smaller proportion of patients experience "respiratory onset" ALS where the intercostal muscles that support breathing are affected first. Regardless of the part of the body first affected by the disease, muscle weakness and atrophy spread to other parts of the body as the disease progresses. Patients experience increasing difficulty moving, swallowing (dysphagia), and speaking or forming words (dysarthria). Symptoms of upper motor neuron involvement include tight and stiff muscles (spasticity) and exaggerated reflexes (hyperreflexia) including an overactive gag reflex. An abnormal reflex commonly called Babinski's sign (the big toe extends upward and other toes spread out) also indicates upper motor neuron damage. Symptoms of lower motor neuron degeneration include muscle weakness and atrophy, muscle cramps, and fleeting twitches of muscles that can be seen under the skin (fasciculations). Around 15–45% of patients experience pseudobulbar affect, also known as "emotional lability", which consists of uncontrollable laughter, crying or smiling, attributable to degeneration of bulbar upper motor neurons resulting in exaggeration of motor expressions of emotion.
Adult Still's disease is a rare type of inflammatory arthritis that features fevers, rash and joint pain. Some people have just one episode of adult Still's disease. In other people, the condition persists or recurs. This inflammation can destroy affected joints, particularly the wrists. Treatment involves medications, such as prednisone, that help control inflammation
Graphic images focusing on the reconstruction of an ear after the removal of a long-standing skin cancer that this patient allowed to slowly grow over many years because he was afraid of what the surgery to remove might entail. Go to www.skincancercentre.com to learn more about the importance of the early diagnosis of skin cancer. BTW, when you put on your sunscreen, don't forget your ears, and wear a broad brimmed hat to cover this very vulnerable area of your anatomy. www.skincancercentre.com
Frontotemporal dementia (frontotemporal lobar degeneration) is an umbrella term for a diverse group of uncommon disorders that primarily affect the frontal and temporal lobes of the brain — the areas generally associated with personality, behavior and language. In frontotemporal dementia, portions of these lobes shrink (atrophy). Signs and symptoms vary, depending upon the portion of the brain affected. Some people with frontotemporal dementia undergo dramatic changes in their personality and become socially inappropriate, impulsive or emotionally indifferent, while others lose the ability to use language.
Chalazions are extremely common, and having a sound surgical technique to drain a chalazion is a fundamental in general ophthalmology and oculoplastic surgery. I believe one of the biggest downfalls in treating chalazions is inadequate local anesthetic. Please that both the outer and inner surface to the eyelid need to receive local anesthesia to make the patient totally comfortable. It is important to be careful in delivering the local anesthetic and making sure you have control of the head position, and the position of your needle is bent to minimize any possibility of contact with the globe.