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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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Overview
Heart bypass surgery creates a new route, called a bypass, for blood and oxygen to reach the heart.
Heart bypass surgery begins with an incision in the chest, and the breastbone is cut exposing the heart. Next, a portion of the saphenous vein, which is very large, is harvested from the inside of the leg. Pieces of this large vein are used to bypass the blocked coronary arteries, which are arteries that supply blood to the heart. The venous graft is sewn to the aorta, the main artery of the body, and to the affected coronary artery, to bypass the blocked site.
The internal mammary artery from the chest may also be used to bypass a clogged artery.
Several arteries may be bypassed depending on the condition of the heart. After the graft is created, the breastbone and chest are closed.
Phlebitis may occur with or without a blood clot. It can affect surface or deep veins. When caused by a blood clot, it's called thrombophlebitis. Trauma to the vein, for instance from an IV catheter, is a possible cause. Symptoms include redness, warmth, and pain in the affected area. Treatments may include a warm compress, anti-inflammatory medication, compression stockings, and blood thinners.
Although the exact cause of abdominal aortic aneurysms is unknown, a number of factors may play a role, including: Tobacco use. ... Hardening of the arteries (atherosclerosis). ... High blood pressure. ... Blood vessel diseases in the aorta. ... Infection in the aorta. ... Trauma. ... Heredity.
Shoulder dystocia is a specific case of obstructed labour whereby after the delivery of the head, the anterior shoulder of the infant cannot pass below, or requires significant manipulation to pass below, the pubic symphysis. It is diagnosed when the shoulders fail to deliver shortly after the fetal head. Shoulder dystocia is an obstetric emergency, and fetal demise can occur if the infant is not delivered, due to compression of the umbilical cord within the birth canal. It occurs in approximately 0.3-1% of vaginal births. Contemporary management of shoulder dystocia requires a calm operator and a well-thought-out plan of action. It is imperative that if not already present, help is summoned immediately after shoulder dystocia is recognized. This help may include additional nursing staff, an anesthesiologist, a pediatrician or neonatologist and an additional obstetrician or midwife. Future coordination may demonstrate that rapid response teams are best suited to attend to this emergency.
Rare condition disorder known as Diprosopus, also known as craniofacial duplication. Diprosopus is a congenital defect also known as craniofacial duplication. The exact description of diprosopus refers to a fetus with a single trunk, normal limbs, and facial features that are duplicated to a certain degree. A less severe instance is when the fetus has a duplicated nose and the eyes are spaced far apart. In the most extreme instances, the entire face is duplicated, hence the name diprosopus, which is Greek for two-faced. Fetuses with diprosopus often also lack brains (anencephaly), have neural tube defects, or heart malformations. In some cases, if the brain is formed, it may have duplicated structures. Most infants with diprosopus are stillborn and there are fewer than fifty cases documented since 1864.
Trigeminal neuralgia is a chronic pain condition that affects the trigeminal nerve, which carries sensation from your face to your brain. If you have trigeminal neuralgia, even mild stimulation of your face — such as from brushing your teeth or putting on makeup — may trigger a jolt of excruciating pain. You may initially experience short, mild attacks. But trigeminal neuralgia can progress and cause longer, more-frequent bouts of searing pain. Trigeminal neuralgia affects women more often than men, and it's more likely to occur in people who are older than 50. Because of the variety of treatment options available, having trigeminal neuralgia doesn't necessarily mean you're doomed to a life of pain. Doctors usually can effectively manage trigeminal neuralgia with medications, injections or surgery.