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Pediatrics abdominal examination
The examination room should be quiet, warm and well lit. After you have finished interviewing the patient, provide them with a gown (a.k.a. "Johnny") and leave the room (or draw a separating curtain) while they change. Instruct them to remove all of their clothing (except for briefs) and put on the gown so that the opening is in the rear. Occasionally, patient's will end up using them as ponchos, capes or in other creative ways. While this may make for a more attractive ensemble it will also, unfortunately, interfere with your ability to perform an examination! Prior to measuring vital signs, the patient should have had the opportunity to sit for approximately five minutes so that the values are not affected by the exertion required to walk to the exam room. All measurements are made while the patient is seated. Observation: Before diving in, take a minute or so to look at the patient in their entirety, making your observations, if possible, from an out-of-the way perch. Does the patient seem anxious, in pain, upset? What about their dress and hygiene? Remember, the exam begins as soon as you lay eyes on the patient. Temperature: This is generally obtained using an oral thermometer that provides a digital reading when the sensor is placed under the patient's tongue. As most exam rooms do not have thermometers, it is not necessary to repeat this measurement unless, of course, the recorded value seems discordant with the patient's clinical condition (e.g. they feel hot but reportedly have no fever or vice versa). Depending on the bias of a particular institution, temperature is measured in either Celcius or Farenheit, with a fever defined as greater than 38-38.5 C or 101-101.5 F. Rectal temperatures, which most closely reflect internal or core values, are approximately 1 degree F higher than those obtained orally. Respiratory Rate: Respirations are recorded as breaths per minute. They should be counted for at least 30 seconds as the total number of breaths in a 15 second period is rather small and any miscounting can result in rather large errors when multiplied by 4. Try to do this as surreptitiously as possible so that the patient does not consciously alter their rate of breathing. This can be done by observing the rise and fall of the patient's hospital gown while you appear to be taking their pulse. Normal is between 12 and 20. In general, this measurement offers no relevant information for the routine examination. However, particularly in the setting of cardio-pulmonary illness, it can be a very reliable marker of disease activity. Pulse: This can be measured at any place where there is a large artery (e.g. carotid, femoral, or simply by listening over the heart), though for the sake of convenience it is generally done by palpating the radial impulse. You may find it helpful to feel both radial arteries simultaneously, doubling the sensory input and helping to insure the accuracy of your measurements. Place the tips of your index and middle fingers just proximal to the patients wrist on the thumb side, orienting them so that they are both over the length of the vessel.
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Watch that Female Foley Genital Catheter Insertion Procedure
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***
The products of a surgical abortion.
Many women have complained about huge breast size. Huge breast is not only socially embarrassing problem but also cause pain in neck and shoulder and therefore women opt for breast reduction surgery. Let's learn more about breast reduction surgery
When to Consider Breast Reduction
-If your breasts are too large for your body frame and create back, shoulder or neck pain
-If you have heavy breasts with nipples and areolas (pigmented skin surrounding the nipples) that point downward
-If one breast is much larger than the other
-If you are unhappy and self-conscious about the large appearance of your breasts
Breast Reduction Preparation :
Breast reduction surgery, which usually takes from two hours or less do not require an overnight stay. The patient goes back home on the day of the surgery.
Firstly it is very important to know what is the present size of the breast and what size does the patients want the breast to be reduced? This present size and expected size needs to be clearly defined so that the doctor, as well as the patient, will know what is the desired size which will help in performing the surgery precisely. This is about the Cup size.
Secondly, The other measurement is regarding the band size which needs to be discussed in order to reduce. So that the size will be defined and the surgery will be done precisely.
The shape of the breast also needs to be discussed. A lot of women when they have saggy, huge breast do not have upper pole fullness and cleavage. Dr. Rajat Gupta performs surgery in such a manner that along with the desired size, the shape of the breast will also be achieved which will make it look aesthetic giving it upper pole fullness and defined cleavage.
Breast reduction surgery recovery
The breast reduction recovery process needs to be discussed with your doctor. Usually, breast reduction surgery is a daycare procedure The patient does not experience pain but they have " skin stretched feeling" as the doctor has reduced the size for which the doctors give pain killers. The patient can do all their daily activities from the next day. It is a very comfortable process but this needs to be discussed with your doctor as well.
Before undergoing the breast reduction surgery the patient needs to discuss the desired cup shape, band size, recovery process, shape of the breast, the shape of the cleavage and the scar of the surgery.
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About Dr Rajat Gupta and RG Aesthetics
At RG Aesthetics, India’s best plastic surgeon, Dr Rajat Gupta is at your service! With 10 years of experience, brand-certification, and international recognition, Dr Gupta is the solution to all your contouring needs.
His expertise in liposuction techniques combined with the state-of-the-art technology available at RG Aesthetics ensures we continue providing the most reliable services with incredible, instantaneous results!
Our equipment allows for every kind of liposuction there is – especially the minimal invasive kinds. Dr Gupta reflects RG Aesthetics’ belief of the patient’s comfort always being paramount. Procedures at RG Aesthetics, under Dr Rajat Gupta, minimize trauma and speed up recovery time for the best results!
For more information please visit our website: https://www.drrajatgupta.com/
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Robot-Assisted Laparoscopic Rectal resection for Endometriosis.Operation performed by D.Vitobello, director of divisione of Gynaecology, and G.Baldazzi,director of Surgical department. Abano Terme Hospital Padova (Italy)
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Abortion real ghraphics
Pelvic examinations during labor are used for several purposes, among them assessment of cervical dilatation, effacement, station of the presenting part, presentation, position, and pelvic capacity.Instruction in these techniques is particularly important for those health care providers involved in labor management, including physicians, nurses, midwives, paramedics and EMT personnel.
this video about identifying a hernia vs a cyst
this video shows how the adult circumcision is easy by the alisklamp
(cryptorchidism) is a testicle that hasn't moved into its proper position in the bag of skin hanging below the penis (scrotum) before birth. Usually just one testicle is affected, but about 10 percent of the time both testicles are undescended. An undescended testicle is uncommon in general, but common among baby boys born prematurely. The vast majority of the time, the undescended testicle moves into the proper position on its own, within the first few months of life. If your son has an undescended testicle that doesn't correct itself, surgery can relocate the testicle into the scrotum.
watch that Enema Insertion Medical Procedure
A video showing breast examination after breast implants
