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The most reliable clinical sign to detect ascites is checking for bilateral flank dullness. If a patient with ascites is lying supine, fluid accumulates in the flank regions, leading to dullness on percussion. At the same time, the air-filled bowel loops are forced upwards by the free fluid due to buoyancy, resulting in tympanitic percussion. To locate specifically where dullness shifts to tympany, or the air-fluid level, percussion should be performed from the sides towards the middle. To confirm that the dullness is caused by ascites, ask the patient to switch to a lateral decubitus position. If ascites is present, the air-filled bowel loops will shift accordingly and remain at the surface of the fluid. As a result, the air-fluid level will shift as well. This is known as shifting dullness.
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Your baby's sex is set at conception. At around 7 weeks, your baby's internal sex organs – such as ovaries and testes – begin to form in the abdomen. Male and female sex organs and genitalia look the same at this stage because they're derived from the same structures. At around 9 weeks, boys and girls begin to develop differently. In girls, a tiny bud emerges between the tissue of the legs. This bud will become the clitoris. The membrane that forms a groove below the bud separates to become the labia minora and the vaginal opening. By 22 weeks, the ovaries are completely formed and move from the abdomen to the pelvis. They already contain a lifetime supply of 6 million eggs. In boys, the bud develops into the penis and starts to elongate at around 12 weeks. The outer membrane grows into the scrotal sac that will later house the testicles. By 22 weeks, the testes have formed in the abdomen. They already contain immature sperm. Soon they'll begin their descent to the scrotum, but it's a long journey. They'll reach their destination late in pregnancy, or for some boys, after birth. If you're eager to find out whether you're having a girl or a boy, you'll have to wait until you're at least 17 weeks pregnant. That's when the genitals have developed enough to be seen on an ultrasound.
This patient presented to the ER for umbilical pain and had a history of umbilical hernia. He was concerned about the possibility of incarceration of the hernia.
In this video we explain how the clinical exam helps to differentiate a simple painful hernia from an incarcerated one.
***Thanks to the patient for sharing his history and exam with YouTube world***
Dr. Ailawadi, M.D., the Chair of Cardiac Surgery at Michigan Medicine, specializes in minimally invasive valve surgery as well as complex cardiac operations. This video shows step by step footage of a Coronary Artery Bypass Graft (CABG) in a complex patient. In this case, CABG was performed through a sternotomy (through the breast bone) using the internal thoracic artery and saphenous leg veins to bypass obstructed coronary arteries. In this video, Dr. Ailawadi will perform a triple vessel bypass (CABG) which has been shown to minimize the risk of future heart attack and help patients live longer in the setting of complex coronary artery disease.
To learn more about cardiac surgery at Michigan Medicine, visit: https://medicine.umich.edu/dept/cardiac-surgery
To learn more about Frankel Cardiovascular Center, visit: https://www.umcvc.org/
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In this video, Dr. Robert Rozbruch, chief of Limb Lengthening and Complex Reconstruction at Hospital for Special Surgery performs an osseointegration after a primary amputation. The patient, a 40 year old woman, had chronic nerve pain and compromised function of her residual limb.
For more information, visit: https://www.limblengthening.com/
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key words: Osseointegration, Amputee, Amputation, Limb Replacement, Tibia, Osseointegration
Are you worried about getting a sports hernia exam? In this video, we'll show you exactly what to expect when you get your hernia exam.
We'll take you through the various steps that are taken during the hernia exam, so you can have a more comfortable and informative experience. After watching this video, you'll have a better idea of what to expect and be prepared for your hernia exam!
#sportshernia #groinpain #california
A brain surgery called a craniectomy is performed to remove a part of your skull in order to relieve pressure in an area when your brain swells from a traumatic brain injury. It is also performed to treat medical conditions that cause your brain to swell or bleed that can be caused by an aneurysm, brain tumor or other cancer.
This 3d animation shows how the surgical procedure decreases intracranial pressure (ICP), intracranial hypertension (ICHT), or heavy bleeding (also called hemorrhaging) inside your skull. If left untreated, pressure or bleeding can compress your brain and push it down onto the brain stem. This can be fatal or cause permanent brain damage.
Brain surgery is a very serious procedure under any circumstances, but a craniectomy is done when there is an immediate risk to the brain and neurological function due to severe brain injury or stroke.
For more information about custom 3D animation depicting surgery, please visit https://www.amerra.com/.
Watch additional medical animations:
Accessing an implantable port training - 3D animation: https://youtu.be/xSTpxjyv4O4
Open Suctioning with a Tracheostomy Tube - 3D animation: https://youtu.be/wamB7jpWCiQ
Ventriculostomy Brain Surgery - 3d animation: https://youtu.be/pUy0YDzVNzs
Suctioning the endotracheal tube - medical animation: https://youtu.be/pN6-EYoeh3g
Functional endoscopic sinus surgery (FESS) - 3D animation: https://youtu.be/qKTRyowwaLA
How to insert a nasogastric tube for NG intubation - 3d animation: https://youtu.be/Abf3Gd6AaZQ
Oral airway insertion - oropharyngeal airway technique - 3D animation: https://youtu.be/caxUdNwjt34
Nasotracheal suctioning (NTS) - 3D animation: https://youtu.be/979jWMsF62c
Learn about hemorrhoids with #3d #animation: https://youtu.be/R6NqlMpsiiY
LASIK eye surgery - 3D animation: https://youtu.be/Bb8bnjnEM00
CPR cardiopulmonary resuscitation - 3D animation: https://youtu.be/G87knTZnhks
What are warts (HPV)? - 3D animation: https://youtu.be/guJ1J7rRs1w
How Macular Degeneration Affects Your Vision - 3D animation: https://youtu.be/ozZQIZ_52YY
NeoGraft hair transplant procedure – animation: https://youtu.be/C-eTdH2UPXI
The headache, lethargy, and neck stiffness suggest subarachnoid hemorrhage secondary to rupture of a mycotic aneurysm. Mycotic or infected arterial aneurysms can develop due to metastatic infection from IE, with septic embolization and localized vessel wall destruction in the cerebral (or systemic) circulation. Intracerebral mycotic aneurysms can present as an expanding mass with focal neurologic findings or may not be apparent until aneurysm rupture with stroke or subarachnoid hemorrhage. The diagnosis of mycotic cerebral aneurysm can usually be confirmed with computed tomography angiography. Management includes broad-spectrum antibiotics (tailored to blood culture results) and surgical intervention (open or endovascular).
An abscess is an infectious process characterized by a collection of pus surrounded by inflamed tissue. [1, 2] Abscesses can form anywhere in the body, from a superficial skin (subcutaneous) abscess to deep abscesses in muscle, organs, or body cavities. Patients with subcutaneous skin abscesses present clinically as a firm, localized, painful, erythematous swelling that becomes fluctuant (see the image below).
Renal artery stenosis is a narrowing of arteries that carry blood to one or both of the kidneys. Most often seen in older people with atherosclerosis (hardening of the arteries), renal artery stenosis can worsen over time and often leads to hypertension (high blood pressure) and kidney damage.