Leopold's Maneuvers are difficult to perform on obese women and women who have hydramnios. The palpation can sometimes be uncomfortable for the woman if care is not taken to ensure she is relaxed and adequately positioned. To aid in this, the health care provider should first ensure that the woman has recently emptied her bladder. If she has not, she may need to have a straight urinary catheter inserted to empy it if she is unable to micturate herself. The woman should lie on her back with her shoulders raised slightly on a pillow and her knees drawn up a little. Her abdomen should be uncovered, and most women appreciate it if the individual performing the maneuver warms their hands prior to palpation. First maneuver: Fundal Grip While facing the woman, palpate the woman's upper abdomen with both hands. A professional can often determine the size, consistency, shape, and mobility of the form that is felt. The fetal head is hard, firm, round, and moves independently of the trunk while the buttocks feel softer, are symmetric, and the shoulders and limbs have small bony processes; unlike the head, they move with the trunk. Second maneuver After the upper abdomen has been palpated and the form that is found is identified, the individual performing the maneuver attempts to determine the location of the fetal back. Still facing the woman, the health care provider palpates the abdomen with gentle but also deep pressure using the palm of the hands. First the right hand remains steady on one side of the abdomen while the left hand explores the right side of the woman's uterus. This is then repeated using the opposite side and hands. The fetal back will feel firm and smooth while fetal extremities (arms, legs, etc.) should feel like small irregularities and protrusions. The fetal back, once determined, should connect with the form found in the upper abdomen and also a mass in the maternal inlet, lower abdomen. Third maneuver: Pawlick's Grip In the third maneuver the health care provider attempts to determine what fetal part is lying above the inlet, or lower abdomen.[2] The individual performing the maneuver first grasps the lower portion of the abdomen just above the symphysis pubis with the thumb and fingers of the right hand. This maneuver should yield the opposite information and validate the findings of the first maneuver. If the woman enters labor, this is the part which will most likely come first in a vaginal birth. If it is the head and is not actively engaged in the birthing process, it may be gently pushed back and forth. The Pawlick's Grip, although still used by some obstetricians, is not recommended as it is more uncomfortable for the woman. Instead, a two-handed approach is favored by placing the fingers of both hands laterally on either side of the presenting part. Fourth maneuver The last maneuver requires that the health care provider face the woman's feet, as he or she will attempt to locate the fetus' brow. The fingers of both hands are moved gently down the sides of the uterus toward the pubis. The side where there is resistance to the descent of the fingers toward the pubis is greatest is where the brow is located. If the head of the fetus is well-flexed, it should be on the opposite side from the fetal back. If the fetal head is extended though, the occiput is instead felt and is located on the same side as the back. Cautions Leopold's maneuvers are intended to be performed by health care professionals, as they have received the training and instruction in how to perform them. That said, as long as care taken not to roughly or excessively disturb the fetus, there is no real reason it cannot be performed at home as an informational exercise. It is important to note that all findings are not truly diagnostic, and as such ultrasound is required to conclusively determine the fetal position.

A very funny video

a complete discription of the instruments used in laparacopic surgeries and there function

At Nationwide Children’s, our Department of General Pediatric Surgery provides comprehensive surgical care for infants, children and adolescents with congenital and acquired conditions, including major congenital anomalies, traumatic and thermal injuries, and tumors. As the second largest pediatric treatment center in the United States our surgeons perform more than 4,000 operative procedures every year. We are dedicated to clinical excellence, generation of new knowledge through research and the training of the next generation of leaders in children’s surgery. Under the umbrella of a unified program, 11 surgical departments share a common mission, philosophy and approach to patient care.

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This patient education animation illustrates the internal anatomy of a prolapsed and herniated disc.

Watch as Dr. Benjamin Carson performs risky brain surgery on young Payton to remove a brain tumor. Dr. Carson, director of pediatric neurosurgery, is just one of the many reasons why Johns Hopkins Children's Center was recently ranked #1 in neurology and neurosurgery in America's Best Children's Hospitals 2008

Endoscopy of Mammary Ducts with Micro-Endoscope called Mammary Ductoscopy. Indication:- Nipple Discharge. In this case Papilloma seen quite clearly. Biopsy can also be possible with Ductoscopy. Mammary Ductoscopy is very useful for diagnosis of Breast Cancer in early stage.

4 mth old child with left incomplete cleft lip repaired with advancement-rotation flap. Markings, steps of procedure recorded

Doctors save the life of an unborn baby who was injured along with her mother in a missile attack in the Syrian city of Aleppo. The video shows a team of emergency medical workers delivering the baby by Cesarean section and then treating the newborn for the shrapnel wounds covering her body and one very large gash in her head. “Medics can be seen frantically reviving the baby, after delivering her by emergency cesarean, as she lies motionless,” the article states. “Eventually the tiny newborn begins to cry and seemingly comes to life as she is given an oxygen mask and rubbed vigorously.” “According to Reuters, the woman also has three other children, all of whom were injured in the attack, but are reported by doctors in the hospital to be in a good condition,” the Daily Mirror article states. The article does not provide the gestational age of the baby before it was delivered. The article said the pregnant woman was hit by a barrel bomb – “crude explosives and shrapnel and dropped from helicopters used by [Syrian] President Bashir al-Assad’s regime." The article notes an estimated 7.6 million Syrians have been displaced by the ongoing civil war and that 320,000, including 11,000 children, have been killed in the conflict. The Daily Mirror also reports that the doctors suggested that the tiny girl be named Amal, which means hope in Arabic. UK Daily Mirror: Incredible footage shows Syrian doctors perform lifesaving caesarean after missile strike leaves shrapnel embedded in unborn baby's face

The circulatory system consists of three independent systems that work together: the heart (cardiovascular), lungs (pulmonary), and arteries, veins, coronary and portal vessels (systemic). The system is responsible for the flow of blood, nutrients, oxygen and other gases, and as well as hormones to and from cells

Usually a sebaceous cyst grows very slowly and doesn't cause pain. However, they can become inflamed or infected, with the overlying skin becoming red, tender, and sore. Sometimes, they occur on a site that is constantly irritated, such as a cyst on your neck that rubs against your collar.

A subdural hematoma is a collection of blood outside the brain. Subdural hematomas are usually caused by severe head injuries. The bleeding and increased pressure on the brain from a subdural hematoma can be life-threatening.

MRI-guided laser ablation for minimal invasive Neurosurgery.

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Nurses often prime IV lines with the hopes that there are no air bubbles. In this video, I will share a couple of tips to help reduce the risk or frequency of air bubbles during line priming. I will also talk about how to troubleshoot the air bubbles when they appear during an infusion

Providing patient care and influencing safe patient outcomes requires that registered nurses and licensed practice nurses maintain air free IV lines. Learn the strategies and tips to decrease the risk of air bubbles appearing in your primary or secondary medication line as well as troubleshooting tips to remove those alarming bubbles. Your patients will thank you!

Whether you are providing normal saline, a medication, or a combination, ensure that all fluids are compatible.

Supplies used in this video include the Alaris Primary Infusion line, alcohol swabs and a sterile 10 cc syringe ... and a nail in the wall :)

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❤️ ~ You may also be interested in watching ~ ❤️

PICC line assessment https://youtu.be/tnKClpU-J1g
How To Access a PICC line https://youtu.be/SCF6bmk8KWc
Putting on Sterile Gloves https://youtu.be/xNwkKLqDJn4
Organizational Plans for Nursing https://youtu.be/_NATxwPwHzc
Medication Conversions https://youtu.be/TCPBXg2TYCs

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Lipomas are slow-growing soft tissue tumours that rarely reach a size larger than 2 cm. Lesions larger than 5 cm, so-called giant lipomas, can occur anywhere in the body but are seldom found in the upper extremities. The authors present their experiences with eight patients having giant lipomas of the upper extremity. In addition, a review of the literature, and a discussion of the appropriate evaluation and management are included.

A successful cardiovascular exam includes visual examination, palpation of the apical impulse, auscultation of Erb's point, auscultation of the carotids, and auscultation over the four different heart valve locations (aortic, pulmonic, tricuspid, and mitral). Additionally, the radial pulse is palpated while auscultating to distinguish whether a murmur is diastolic or systolic.

Video Index:
0:13 - Inspection of the thorax
0:29 - Palpation of the apex heart beat
0:59 - Auscultation of the heart
1:16 - Auscultation of the Erb’s point
1:33 - Using Erb’s point to check the heart rate
1:45 - Systolic and diastolic heart sound identification
2:01 - Ascultating individual valves: aortic, pulmonary, tricuspid, mitral
2:41 - Ascultation of the carotids
2:54 - Ascultating the pulmonary and aortic valves
3:04 - Ascultation of the mitral valve
3:16 - Mitral valve murmurs

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A pilonidal sinus (PNS) is a small cyst or abscess that occurs in the cleft at the top of the buttocks. A PNS usually contains hair, dirt, and debris. It can cause severe pain and can often become infected. If it becomes infected, it may ooze pus and blood and have a foul odor. A PNS is a condition that mostly affects men and is also common in young adults. It’s also more common in people who sit a lot, like cab drivers.