The big bang is the moment when the uterus, vagina, and anus contract simultaneously at 0.8-second intervals. A small orgasm may consist of three to five contractions; a biggie, 10 to 15. Many women report feeling different kinds of orgasms

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

Full examination of the female from head to toe by Loyola Medical School, Chicago. Part 3

MRCPCH Clinical Revision - more videos at http://mrcpch.paediatrics.co.uk

Revise for your MRCPCH Clinical exam, with videos and high quality content created by the London Paediatrics Trainees Committee.

Examiner: Jonathan Round
Candidate: Amitav Parida

Filming: Mary Chesshyre, Huey Miin Lee, Chris Kelly

Thank you to the Evelina Children's Hospital for allowing us to film during their MRCPCH Revision Course (https://www.guysandstthomaseve....nts.co.uk/mrcpch-cli

Contact us to find out more http://www.londonvisionclinic.com/contact-us/ Mr Carp explains the risks involved in losing sight as being extremely rare. Only 1 in 5 million may lose sight in one eye.

Endoscopy in Hiatal Hernia.

Childbirth (also called labour, birth, partus or parturition) is the culmination of a human pregnancy or gestation period with birth of one or more newborn infants from a woman’s uterus. The process of normal human childbirth is categorized in three stages of labour: the shortening and dilation of the cervix, descent and birth of the infant, and birth of the placenta. In some cases, childbirth is achieved through caesarean section, the removal of the neonate through a surgical incision in the abdomen, rather than through vaginal birth

Take your left leg and place your ankle against the knee. Hold the position for a moment before changing legs. This helps stretch the tiny piriformis muscle, which sometimes becomes inflamed and presses against the sciatic nerve causing pain. Repeat by switching sides and doing the same exercise with the other leg.

The primary functions of the liver are: Bile production and excretion. Excretion of bilirubin, cholesterol, hormones, and drugs. Metabolism of fats, proteins, and carbohydrates. Enzyme activation. Storage of glycogen, vitamins, and minerals. Synthesis of plasma proteins, such as albumin, and clotting factors.

Dont worry sister!

catheterization of the male urethra by a foley catheter

What is Venipuncture? While venipuncture can refer to a variety of procedures, including the insertion of IV tubes into a vein for the direct application of medicine to the blood stream, in phlebotomy venipuncture refers primarily to using a needle to create a blood evacuation point. As a phlebotomist, you must be prepared to perform venipuncture procedures on adults, children, and even infants while maintaining a supportive demeanor and procedural accuracy. Using a variety of blood extraction tools, you must be prepared to respond to numerous complications in order to minimize the risk to the patient while still drawing a clean sample. In its entirety, venipuncture includes every step in a blood draw procedure—from patient identification to puncturing the vein to labeling the sample. Patient information, needle placement, and emotional environment all play a part in the collection of a blood sample, and it's the fine details that can mean the difference between a definite result and a false positive. After placing the tourniquet and finding the vein, it's time for the phlebotomist to make the complex choice on what procedure will best suit the specific situation. Keeping this in mind, it should be noted that the following information is not an instructional guide on how to perform these phlebotomy procedures. Rather, the information below is intended to serve as an educational resource to inform you of the equipment and procedures you will use. Venipuncture Technqiues Venipuncture with an Evacuated or Vacuum Tube: This is the standard procedure for venipuncture testing. Using a needle and sheath system, this procedure allows multiple sample tubes to be filled through a single puncture. This procedure is ideal for reducing trauma to patients. After drawing the blood, the phlebotomist must make sure the test stopper is correctly coded and doesn't contact exposed blood between samples. Venipuncture with a Butterfly Needle : This is a specialized procedure that utilizes a flexible, butterfly needle adaptor. A butterfly needle has two plastic wings (one on either side of the needle) and is connected to a flexible tube, which is then attached to a reservoir for the blood. Due to the small gauge of the needle and the flexibility of the tube, this procedure is used most often in pediatric care, where the patients tend to have smaller veins and are more likely to move around during the procedure. After being inserted into a vein at a shallow angle, the butterfly needle is held in place by the wings, which allow the phlebotomist to grasp the needle very close to the skin. Phlebotomists should be careful to watch for blood clots in the flexible tubing. Venipuncture with a Syringe: This technique is typically only used when there is a supply shortage, or when a technician thinks it is the appropriate method. It uses the classic needle, tube, and plunger system, operating in a similar manner to the vacuum tube but requiring multiple punctures for multiple samples. Additionally, after the blood is drawn it must be transferred to the appropriate vacuum tube for testing purposes. If you choose to use this method, remember to check for a sterile seal, and use a safety device when transferring the sample. Fingerstick (or Fingerprick): This procedure uses a medical lance to make a small incision in the upper capillaries of a patient's finger in order to collect a tiny blood sample. It is typically used to test glucose and insulin levels. When performing a Fingerstick, the phlebotomist should remember to lance the third or fourth finger on the non-dominant arm. Never lance the tip or the center of the finger pad; instead, lance perpendicular to the fingerprint lines. Heelstick (or Heelprick): Similar to the Fingerstick procedure, this process is used on infants under six months of age. A medical lance is used to create a small incision on the side of an infant's heel in order to collect small amounts of blood for screening. As with a Fingerstick, the incision should be made perpendicular to the heel lines, and it should be made far enough to the left or right side of the heel to avoid patient agitation. Before performing a Heelstick, the infant's heel should be warmed to about 42 degrees Celsius in order to stimulate capillary blood and gas flow. Therapeutic Phlebotomy: This involves the actual letting of blood in order to relieve chemical and pressure imbalances within the blood stream. Making use of a butterfly needle, this therapy provides a slow removal of up to one pint of blood. Though the blood removed is not used for blood transfusions, the procedure and concerns are the same as with routine blood donation. As with any phlebotomy procedure, one should pay close attention to the patient in order to prevent a blood overdraw. Bleeding Time: A simple diagnostic test that is used to determine abnormalities in blood clotting and platelet production. A shallow laceration is made, followed by sterile swabbing of the wound every 30 seconds until the bleeding stops. Average bleed times range between one and nine minutes. As a phlebotomist, you should familiarize yourself with the application and cross-application of these procedures in order to recognize when a procedure is necessary, and what the risks are for each.

3D scans show still pictures of your baby in three dimensions. 4D scans show moving 3D images of your baby, with time being the fourth dimension. It's natural to be really excited by the prospect of your first scan. But some mums find the standard 2D scans disappointing when all they see is a grey, blurry outline.

Commentary:

0:24
He may not look like he’s in good condition but you can guesst that his somewhere in nirvana at this point
0:44
After the operation, this patient loses more than just color in his skin but apparently he loses his nipples as well
1:43
This sedated patient is equipped with his own hand-gun. No pun intended
2:17
His anesthesia dose came with the usual side effects of crazy talk with a dash of attitude and sarcasm
3:17
The only thing crazier than love is being sedated during an endometriosis surgery
4:36
This may come as a surprise to some but penguins don’t actually reside in Alaska. In case you didn’t know that well now you do
5:09
If the doctor advises you against something you can’t resist doing, how many of us would still listen to him?
6:35
When them meds start kicking in , it’s time to frame this experience as an excuse to divulge some of your secret fantasies
7:05
There’s a time and place dirty jokes but anesthesia told this guy any times the right time
7:24
Her 16 year old son talks about the last thing he remembers right after surgery and this is what he says
8:35
She’s definitely not in the mood at all. I wouldn’t wanna tick her off during this time if I were you
8:44
A feeling of relief after your operation may be followed by some emotional changes such as mood swings and over sensitivity
9:44
Even if you do say something you wouldn't normally say while you are under sedation, according to some doctors, “it's always kept within the operating room”
10:38
The beeping sounds of the medical equipments tip this patient over the edge. so she tries to drown out the noise with her own voice
11:08
Anyone who's received anesthesia can attest to feeling pretty loopy. Although many won't remember it's fairly common to say some wacky things after waking up
11:53
It's typical for people to feel sad or vulnerable after surgery. Kind of like how this girl is feeling right now
12:04
If she wasn’t under the influence in the hospital right now , it would be pretty hard to justify this type of behavior
12:17
Imagine working as an anesthesiologist. You might become numb to a lot of strange behaviors and everything unusual becomes the new norm for you

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Tonsil Stone Removal with New Tools