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Dr. Debbie Song at Gillette Children's describes in detail selective rhizotomy surgery.
A selective dorsal rhizotomy is an operation performed to treat spasticity. It is thought that high tone and spasticity arise from abnormal signals that are transmitted through sensory or dorsal nerve roots to the spinal cord. In a selective dorsal rhizotomy we identify and cut portions of the dorsal nerve roots that carry abnormal signals thereby disrupting the mechanisms that lead to spasticity. Potential patients go through a rigorous assessment that includes an in-depth gait and motion analysis as well as a physical therapy evaluation.
They are evaluated by a multidisciplinary team that includes a pediatric rehabilitation doctor, a neurosurgeon, and an orthopedist, Appropriate patient selection is vital. Ideal candidates for selective dorsal rhizotomy are children who are between four and ten years of age, have a history of being born prematurely, and have a diagnosis of diplegia cerebral palsy. These patients usually walk independently or with the assistance of crutches or a walker. They typically function at a level one, two, or three in the gross motor function classification system or gmfcs. A selective dorsal rhizotomy involves the coordinated efforts of the neurosurgery, physiatry, anesthesia and nursing teams. The operation entails making an incision in the lower back that is approximately six to eight inches long. We perform what we call a laminoplasty in which we remove the back part of the spinal elements from the lumbar one or l1 to l5 levels. At the end of the procedure the bone is put back on. We identify and open up the Dural sac that contain the spinal fluid spinal cord and nerve roots. Once the Dural sac is opened ,we expose the lumbar and upper sacral nerve roots that transmit information to and from the muscles of the lower extremities.
At each level we isolate the dorsal nerve root, which in turn is separated into as many as 30 smaller thread light fruitlets.
Each rootlet is then electrically stimulated. Specialized members of the physiatry team look for abnormal responses in the muscles of the legs as each rootless is being stimulated. If an abnormal response is observed then the rootlet is cut.
If a normal response is observed, then the rootlet is not cut. We usually end up cutting approximately 20 to 40 percent of the rootlets. The Dural sac is sutured closed and the l1 through l5 spinal elements are put back into anatomic position, thus restoring normal spinal alignment. The overlying tissues and skin are then closed and the patient is awoken from surgery. The entire operation takes between four and five hours. A crucial component to the success of our rhizotomy program is the extensive rehabilitation course following surgery. With their tone significantly reduced after a rhizotomy, patients relearn how to use their muscles to walk more efficiently through stretching, strengthening, and gait training. Approximately one to two years after a rhizotomy patients undergo repeat gait and motion analysis. The orthopedic surgeons assess the need for interventions to correct bone deformities, muscle contractures, poor motor control, impaired balance, or other problems related to cerebral palsy.
At Gillette we work closely with patients and families to ensure that our selective dorsal rhizotomy program meets their goals for enhancing their function and improving their quality of life.
VISIT https://www.gillettechildrens.org/ to learn more
0:00 Why choose selective dorsal rhizotomy?
0:56 Who is a good candidate for selective dorsal rhizotomy?
1:31 What does a selective dorsal rhizotomy entail?
3:26 What is recovery from selective dorsal rhizotomy like?
Computed tomography (CT)-guided transthoracic needle biopsy is a well-established, minimally invasive diagnostic tool for pulmonary lesions. Few large studies have been conducted on the diagnostic performance and adequacy for molecular testing of transthoracic core needle biopsy (TCNB) for small pulmonary lesions.
Dr. Alex Campbell and Dr. Carolina Restrepo of Premium Care Plastic Surgery in Cartagena, Colombia perform a Mommy Makeover on an international patient. Watch the procedure as Dr. Campbell and Dr. Restrepo work together to offer this patient more surgery in less time, which leads to a quicker recovery and better results.
Site enhancement oil, often called "santol" or "synthol" (no relation to the Synthol mouthwash brand), refers to oils injected into muscles to increase the size or change the shape. Some bodybuilders, particularly at the professional level, inject their muscles with such mixtures to mimic the appearance of developed muscle where it may otherwise be disproportionate or lagging. This is known as "fluffing".Synthol is 85% oil, 7.5% lidocaine, and 7.5% alcohol. It is not restricted, and many brands are available on the Internet. The use of injected oil to enhance muscle appearance is common among bodybuilders, despite the fact that synthol can cause pulmonary embolisms, nerve damage, infections, sclerosing lipogranuloma,[60] stroke,[55] and the formation of oil-filled granulomas, cysts or ulcers in the muscle. Rare cases might require surgical intervention to avoid further damage to the muscle and/or to prevent loss of life. Sesame oil is often used in such mixtures, which can cause allergic reactions such as vasculitis.
When both mucosa and stroma are parts of the suspect lesion, a deep biopsy is needed. The Cervicore is designed to harvest samples from the cervix and vagina with minimal collateral injury to the surrounding tissues. The procedure is easy with minimal discomfort to the patient.
✨This video is on the structure and functions of the three types of cartilage (Hyaline, Elastic and Fibrocartilage). I hope it helps! ☀️
🌟What's in this video?
0:00 - Intro
0:07 - Connective Tissue Recap
1:16 - Structure of Connective Tissue
1:57 - Structural Components of Cartilage
3:38 - Types of Cartilage
3:49 - Hyaline Cartilage
8:05 - Elastic Cartilage
8:55 - Fibrocartilage
✨ Other videos you may need:
🔅 Connective Tissue : https://youtu.be/xw_ALdt5n-A
🔅 Collagen : https://youtu.be/3e2JYMNS_W4
🔅 Ossification: https://youtu.be/86V9SNWD_No
🔅Histology: https://www.youtube.com/playli....st?list=PL1rG930trF2
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📚Factual References & for Further Reading:
- DiFiore's Atlas of Histology
- Junqueira's Basic Histology
- Gartner's Concise Histology
- Openstax Anatomy and Physiology
https://openstax.org/details/b....ooks/anatomy-and-phy
- Openstax Biology
https://openstax.org/details/books/biology-2e
(The last two are links to open-source references. They are NOT affiliate links)
🌤 Note:
These are just a collection of my notes. So use them the way you would use borrowed notes from a friend. 📝
The images in this video are hand-drawn for illustration and explanation only.✍️ Hence, they may not be anatomically accurate. I am just one person making these videos. If there are any errors, that is unintentional. I try super hard to avoid them. Please let me know if you find any, so it gets clarified for other viewers. Science constantly evolves and changes. New discoveries are made everyday. So some of the information in these videos may become outdated. If you notice that, please let me know so I can update them.
⚡️Disclaimer:
These videos are NOT a substitute for a medical textbook. Textbooks are written by experts (which I do not claim to be), edited, proofread and referenced. Please use them.
The information has been sourced from multiple references as mentioned above. I draw all the pictures myself. But if I have inadvertently infringed on any copyright, that is completely unintentional. I only make these videos to impart education. If I have accidentally violated copyright in any way, do let me know so I can make the necessary changes or give credit to anyone who is owed the same.
These videos are NOT intended for patient education. They are NOT a substitute for diagnosis and treatment by a licensed medical professional. Always seek the advice of a qualified health care provider for any questions you may have regarding any medical condition, so that they can address your individual needs.
🔅They are ONLY meant to help students of medicine and health sciences with studying, and should be used for just that purpose and absolutely nothing else.
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Rhinoplasty, sometimes referred to as a "nose job" or "nose reshaping" by patients, enhances facial harmony and the proportions of your nose. It can also correct impaired breathing caused by structural defects in the nose. What surgical rhinoplasty can treat Nose size in relation to facial balance Nose width at the bridge or in the size and position of the nostrils Nose profile with visible humps or depressions on the bridge Nasal tip that is enlarged or bulbous, drooping, upturned or hooked Nostrils that are large, wide or upturned Nasal asymmetry If you desire a more symmetrical nose, keep in mind that everyone's face is asymmetric to some degree. Results may not be completely symmetric, although the goal is to create facial balance and correct proportion. Rhinoplasty to correct a deviated septum Nose surgery that's done to improve an obstructed airway requires careful evaluation of the nasal structure as it relates to airflow and breathing. Correction of a deviated septum, one of the most common causes of breathing impairment, is achieved by adjusting the nasal structure to produce better alignment.
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Watch the BBC first on iPlayer 👉 https://bbc.in/iPlayer-Home http://www.bbc.co.uk/human Richard Edwards undergoes a double hand transplant in which his hands are amputated and replaced with hands from a donor. This is the first time this has been done. Three months later the new hands are already changing his life.
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WARNING: Explicit and Educational Surgical Content.
Visage Clinic's Dr. Marc DuPéré - located in Toronto, Ontario, Canada discusses Liposuction (upper bra, back rolls, lower back rolls, love handles & abdomen) and "Tummy Tuck" (Abdominoplasty): Skin excision, muscle repair and umbilicoplasty.
For more info and to book a consultation visit www.VisageClinic.com/cosmetic-....surgery/mommy-makeov or call (416) 929-9800.
OB_A_1013
3D animation depicting the operating room and initial procedure preparing the patient for a laparoscopic hysterectomy. The patient is prepped and draped in the usual fashion and surrounded by the surgeon and surgical assistants. The skin is elevated, an infraumbilical incision is made, a trocar port is inserted through the incision and the abdomen is insufflated. Finally, a laparoscope is inserted into the port to allow for direct visualization of the uterus and the surgery can begin.
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