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MRCPCH Clinical Revision - more videos at http://mrcpch.paediatrics.co.uk
Revise for your MRCPCH Clinical exam, with videos and high quality content created by the London Paediatrics Trainees Committee.
Examiner: Jonathan Round
Candidate: Amitav Parida
Filming: Mary Chesshyre, Huey Miin Lee, Chris Kelly
Thank you to the Evelina Children's Hospital for allowing us to film during their MRCPCH Revision Course (https://www.guysandstthomaseve....nts.co.uk/mrcpch-cli
The typical radiograph is of a well-defined, rounded, retrocardiac opacity with an air-fluid level. In this image, the radiolucent gas is highlighted in blue, while the gastric contents are highlighted in the green. In many cases of hiatal hernia, there will not be an air bubble below the left hemidiaphragm. This is a relatively expected finding considering that the stomach is no longer in its usual position. The anatomical position of the herniated organ can be further elucidated on the lateral radiograph. Here we can see that the stomach is in the middle mediastinum posterior to the heart and above the diaphragm. Hiatal hernias can look similar to a retrocardiac lung abscess or another cavitary lesion, but it will change in size and shape between radiographs. Large hernias can shift the mediastinum to the right and result in a widening of the carinal angle. They can even give the appearance of cardiomegaly. In this radiograph, the cardiac silhouette is distinctly visible within the confines of the hiatal hernia. To review, a hiatal hernia on an AP chest radiograph typically appears as a round retrocardiac opacity with an air-fluid level.
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Disclaimer: All the information provided by Medical Education for Visual Learners and associated videos are strictly for informational purposes only. It is not intended as a substitute for medical advice from your health care provider or physician. It should not be used to overrule the advice of a qualified healthcare provider, nor to provide advice for emergency medical treatment. If you think that you or someone that you know may be suffering from a medical condition, then please consult your physician or seek immediate medical attention.
Do you think you have a hernia?
What are hernias?
The hernias we address in this http://DoctorsExpressHartsdale.com Medical Minute are inguinal, or groin, hernias. More common in men than women, an inguinal hernia can occur when part of the small intestine protrudes through a weakness or tear in the area between your abdomen and your thigh- or your groin. It's possible for anyone to get an inguinal hernia, but it is more commonly found in males.
Hernias form a bulge and can be accompanied by pain. Men have an approximate 26% lifetime risk of having hernia at some point in their life, where as women have a much lower chance of one- only about 3% of women will experience a hernia at some point in their life. There are other types of hernias, such as abdominal, or "hiatal" hernias but groin hernias outnumber abdominal hernias by about 3 to 1.
What causes a hernia?
The cause of a hernia is not always known, but hernias are often the result of weak spots in the abdominal wall. Weaknesses can be due to congenital defects (present at birth) or formed later in life. Some risk factors for inguinal hernia include:
• fluid or pressure in the abdomen
• heavy lifting
• straining during urination or bowel movements
• obesity
• chronic cough
• pregnancy
Hernias often form in people with weakened abdominal muscles or in those who do a lot of heavy lifting or straining, which is why we see it quite often in young men. Physiology plays a part: men have testicles and scrotum which descend through the inguinal canal-much larger in men than in women. That is part of the reason men tend to be more susceptible to hernias than women.
Symptoms of hernia
Symptoms of inguinal hernia usually include a bulge in the groin area and pain, pressure, or aching at the bulge—especially when lifting, bending, or coughing. These symptoms usually subside during rest periods. Men may also experience swelling around the testicles.
Screening and Diagnosis of Hernias
If you are having abdominal pain or pelvic bulge and pain, you want to see physician, and he or she will do an exam. They will use their finger, to see if you have a bulge in your scrotum or on your groin and they'll see if its reducible or not. If the exam doesn't give them the answer, they can then perform an ultrasound, an inexpensive test that can tell you the same day whether a hernia is present.
What to do if you think you have a hernia
Most of the time hernias do not cause problems. People often live with hernias their entire life without them becoming aggravated or painful. When they do cause pain though, there is concern that complications may have arisen. Most common hernias are what we call reducible; you can take your finger or you can lie down in bed and due to the effects of gravity, the bulge in the groin will actually disappear, which means the intestinal contents actually go back into the abdominal cavity or to the correct location. If it's not reducible by lying down or using a finger or having a physician trying to reduce it, then there are concerns about complications such as strangulation, or incarceration occurring. If those concerns are there, then you need to see a surgeon, and there may be a need for surgery.
How to Treat a Hernia
As stated earlier, hernias can often be watched for years without being treated. If however, they are causing pain, we generally refer you to a surgeon who can do a very simple laparoscopic surgery.
If you suspect a hernia, but have not been diagnosed, you should see your doctor, and of course, we are happy to see you here at Doctors Express
This gentleman has a significant lumbar herniated disc with a positive well straight leg raise test. In this evaluation I test his deep tendon reflexes, sensation, muscle strength, and perform a straight leg raise test, Braggards's test and Well straight leg raise test.
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Business Insider's Michelle Yan has been nearsighted since she was 9 years old. After laser eye surgery, she has 20/20. She walks us through the pre-surgery steps, the actual surgery, as well as the recovery process.
MORE MEDICAL TECH:
8 Medical Procedures That Are Improving Lives
https://www.youtube.com/watch?v=kTMMrAP6DNI
13 Medical Procedures Changing The Health World
https://www.youtube.com/watch?v=VAR44vnxWis
Lifelike Medical Robot Actually Bleeds
https://www.youtube.com/watch?v=IjnhmcCQLsc
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What It's Like To Get Laser Eye Surgery
Recovery Tips
LASIK eye surgery is the best known and most commonly performed laser refractive surgery to correct vision problems. The total recovery time is 1 to 2 weeks. However, vision may fluctuate slightly over the next 2 months.
Avoid watching television or reading for the first few days.
You can get back to work after 1 week.
Avoid applying pressure on the eyes for 7 days.
Avoid dust, smoke, yard and garden work, and eye make-up.
Wear eye shields at night given by a surgeon for 1 week.
Driving is allowed after 4 to 5 days.
Avoid swimming or using a hot tub for 2 weeks after surgery.
While using the computer, take frequent breaks and lubricate your eyes with artificial tears.
For treatment assistance in your country or abroad:
Email: hello@vaidam.com
Phone/WhatsApp/Viber: +91-9650001746
Website: www.vaidam.com
Vaidam is an ISO and NABH accredited medical assistance company. Patients from 100+ countries have used our services.
Useful Links:
India
Doctors: https://www.vaidam.com/doctors/opthalmology/lasik-procedure/india
Hospitals: https://www.vaidam.com/hospitals/opthalmology/lasik-procedure/india
Cost of Lasik Eye Surgery: https://www.vaidam.com/cost/lasik-procedure-cost-in-india
Turkey
Doctors: https://www.vaidam.com/doctors/opthalmology/lasik-procedure/turkey
Hospitals: https://www.vaidam.com/hospitals/opthalmology/lasik-procedure/turkey
New research from Mount Sinai Health System says these surgeries have limited effectiveness and can be economically unjustifiable when they're done on patients with less severe symptoms.
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New Study Questions Effectiveness Of Knee Replacement Surgery | NBC Nightly News
Dr. James Wall performs a bilateral inguinial hernia repair surgical procedure.
Featured:
James Wall, MD
Assistant Professor of Surgery, Pediatric Surgery
Assistant Professor of Bioengineering (By Courtesy)
Lucile Salter Packard Children's Hospital
Micaela Esquivel, MD
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High Quality Surgical videos and uncut stories ▶ https://surgeoncut.com
Join Dr. Parsia Vagefi, Chief of Surgical Transplantation and Dr. Steven Hanish, Surgical Director of Liver Transplantation, as they grant unprecedented access to the OR while performing a #Liver #Transplant #Surgery.
To find out more about UT Southwestern's transplant programs visit:
https://www.utswmed.org/transplant
Lumpectomy means that a focal area of cancer is going to be removed. A lot of patients with a lumpectomy don’t need any specific breast reconstruction, explains Dr. Miguel Angel Medina, Director of Microsurgery with Miami Cancer Institute.
Al the end of surgical treatment, all those patients go on to need radiation therapy. For patients who have large breasts, physicians have to take a larger lumpectomy than normal.
For those that aren't good LASIK candidates, PRK is a procedure that offers the same great results! Watch Dr. Ferguson explain each step during Samantha's procedure. Her reaction at the end is incredible!
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
Dr. Horacio Asbun, Mayo Clinic in Florida, explains the Whipple procedure using this animated graphic of a pancreas. Cancer of the pancreas affects 45,000 people every year in the U.S., and it is the fourth leading cause of cancer-related deaths. The five-year overall survival rate if a tumor is detected early and surgically removed is 22 percent, versus 6 percent without early detection and surgery. To learn more, visit http://mayocl.in/2zk7FDi.
This video in Spanish/español: https://www.youtube.com/watch?v=N_zWboNMKWk
This video has been updated to include an alternate name for the internal thoracic arteries. View the updated video here: https://youtu.be/kxc22Fjd1NQ
For Employees of Hospitals, Schools, Universities and Libraries: Download 8 FREE medical animations from Nucleus by signing up for a free trial: http://nmal.nucleusmedicalmedi....a.com/free-trial-mem
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This video, created by Nucleus Medical Media, shows a coronary artery bypass graft (CABG) procedure used to combat coronary artery disease. Beginning with a midline sternal incision, the heart is connected to a perfusion machine which will take over the duties of the heart while the surgery takes place. Two different grafts are used to bypass the blocked coronary arteries: the internal thoracic artery from inside the chest wall, and the saphenous vein from the leg. After the procedure, the heart is shocked to restart its beating. A drainage tube is left at the incision site to drain away excess fluid. The animation continues to show two other types of approaches to a coronary artery bypass graft, off-pump bypass surgery and minimally invasive bypass surgery.
This is similar to the procedure performed on former president Bill Clinton and former California governor Arnold Schwarzenegger.
#HeartBypassSurgery #CABG #heart
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http://www.amerra.com In this patient education video from Colorectal Surgical Associates in Houston, Texas, learn more about the single incision laparoscopic colectomy procedure. This minimally invasive procedure uses a mini incision that
results in less pain, fewer complications, earlier recovery, and a smaller scar. Colorectal cancer is the second leading cause of cancer death in the United States. For more information please visit our website: www.csamd.com or call (713)-790-0600.