If you have been diagnosed with a bulging disc, you are not alone. Bulging discs, also known as a disc protrusion, are a very common occurrence. They usually remain asymptomatic; however, they can cause discomfort and disability in various parts of the body if the disc compresses an adjacent nerve root or the spinal cord. As we age, the outer fibrous portion of our discs can weaken. Pressure from the central core of the disc can then stretch to the outer rim, causing the disc to bulge. If left untreated, the disc can continue to bulge until it tears, which is classified as a herniated disc.

Watch Spinal Stenosis Videos Spinal stenosis occurs when the spinal cord in the neck (cervical spine) or the spinal nerve roots in the lower back (lumbar spine) are compressed. Symptoms of lumbar stenosis often include leg pain (sciatica) and leg tingling, weakness, or numbness. Arm pain is a typical symptom of cervical spinal stenosis. For cervical spinal stenosis with myelopathy, difficulty with coordination often occurs. Stenosis treatment may include non-surgical options (exercise, anti-inflammatory medication, epidural injections, and activity modification) or back surgery.

Common causes of the knee pain
Knee pain is very common and in this video we will present the most common problems that can cause pain in the knee. (Patella) itself, which is in front of the knee, or from the tendons that are attached to the kneecap (patellar tendon and quadricep tendon). One of the most common problems is patellar chondromalacia which is chronic pain due to the softening of the cartilage beneath the kneecap. The cartilage of the kneecap will have some erosions, defects, or holes from mild to complete inside the joint (exactly in the back of the kneecap).
• Pain in the front of the knee
• Occurs more in young people
• Becomes worse from climbing up stairs and going downstairs
Treatment is usually nonsteroidal anti-inflammatory medication, physical therapy, and surgery is very rare. Also in front of the kneecap, the patient may get pain due to prepatellar bursitis.
When there is prepatellar bursitis, the patient will see that the swelling, the inflammation, and the pain is located over the front of the kneecap. The bursa becomes inflamed and fills with fluid at the top of the knee, causing pain, swelling, tenderness and a lump in that area on top of the kneecap. If the pain is in front of the knee but below or above the patella, this may indicate that the patient has tendonitis. Patellar tendonitis is an overuse condition that often occurs in athletes who perform repetitive jumping activities. Patellar tendonitis is a knee pain that is associated with focal patellar tendon tenderness and it is usually activity related. It is located below the kneecap and is called "jumper's knee". Patellar tendonitis affects approximately 20% of jumping athletes. There will be tenderness to palpation at the distal pole of the patella in extension and not in flexion. Quadriceps inflexibility, atrophy and hamstring tightness are predisposing factors for this condition. Treatment is rest, anti-inflammatory medication, stretching and strengthening of the hamstrings and quadriceps. Use an eccentric exercise program. The early stages of patellar tendonitis will respond well to nonoperative treatment. Another important cause of knee pain is a meniscal tear. The meniscus is the cushion that protects the cartilage in the knee. Injury will cause pain on the medial or the lateral side of the knee exactly at the level of the joint. The patient will complain of a history of locking, instability and swelling of the knee. McMurray test will be positive. A painful pop or click is obtained as the knee is brought from flexion to extension with either internal or external rotation of the knee. Arthritis of the knee Knee arthritis is very common. The cartilage cells die with age and its repair response decreases in the joint collapses with increased breakdown of the framework of the cartilage. The patient will have progressive blurring away of the cartilage of the joint with decreased joint space as seen on x-rays. Another source of pain is the Baker's cyst. The cyst is in the back of the knee between the semimembranosus yes and the medial gastrocnemius muscles. Another important source of knee pain is a ligament injury. Here is a normal knee without a ligament injury. Here you can see from the front, you can see the lateral and medial collateral ligament. You can see the ACL and PCL from the side view. These ligaments are usually injured as a result of a sports activity. Here is an example of a sports knee injury. Here is an example of the medial collateral ligament injury. This is the most commonly injury knee ligament injury to this ligament is on the inner part of the knee. Here is an example of an injury of the anterior cruciate ligament. It involves a valgus stress to the knee. Lachman test is usually positive, and MRI is diagnostic. Another important cause of knee pain is iliotibial band syndrome of the knee. Inflammation of the thickening of the iliotibial band results from excessive friction as the iliotibial band slides over the lateral femoral condyle. The iliotibial band is a thick band of fascia that extends along the lateral thigh from the iliac crest to the knee. And as the knee moves, the IT band was repeatedly shifted forwards and backwards across the lateral femoral condyle. The patient will complain of swelling, tenderness, and crepitus over the lateral femoral condyle. The condition occurs in the ITB S occurs in runners, cyclist and athletes that require repeated knee flexion and extension. The pain may be reproduced by doing a single-leg squat. The Ober's test is used to at assess tightness of the iliotibial band. MRI may show edema in the area of the ITB. Treatment is usually nonoperative with rest and ice, physical therapy, with stretching, proprioception, and improvement in neuromuscular coordination. Training modification and injections may be helpful. Surgery is a last resort. Surgical excision of the scarred inflamed part of the iliotibial band.

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One man is speaking out about the potential risks of laser eye surgery, after he says the procedure left his vision permanently impaired.

For a full Surgical Airway Techniques resource: https://bit.ly/2rb9Nud
Video courtesy of Gauri Mankekar, MBBS, MS, PhD

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Nursing skills lab procedure for wound care dressing change with irrigation and packing.

A tummy tuck is a surgical process that removes excess fat and skin. Learn more about the procedure by watching this video!

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Un tummy tuck es un procedimiento quirúrgico que elimina el exceso de grasa y piel. ¡Aprenda más sobre este procedimiento viendo este video!

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A complete organized library of all my videos, digital slides, pics, & sample pathology reports is available here: https://kikoxp.com/posts/5084 (dermpath) & https://kikoxp.com/posts/5083 (bone/soft tissue sarcoma pathology)

Topics discussed:

Epidermis:
Layers of epidermis: 0:10
Melanocytes vs Keratinocytes: 5:16
Langerhans cells: 10:10 & 33:30 & 57:30

Dermis:
Papillary and reticular dermis: 11:50
Three types of white empty spaces on a slide: vessels, glands/ducts/cysts, or artifact: 15:25
Blood vessels & nerves: 18:24 & 48:50 & 58:59
Arrector pili & other dermal smooth muscle: 20:00

Adnexal:
Sebaceous gland: 21:10
Hair follicle 23:14
Eccrine sweat glands and ducts 24:45 & 50:00
Gland/duct vs blood vessel 27:20 & 48:50
Apocrine glands: this video https://kikoxp.com/posts/7837 (at 12:30)
Acrosyringium: this video https://kikoxp.com/posts/7837 (at 10:00)

Three types of pink bundles: smooth muscle, nerve, dense connective tissue: 27:50

Acral skin (palm sole) with contact dermatitis 29:37
Parakeratosis 30:00
Perivascular lymphocytes 30:40
Eosinophils vs neutrophils 31:20
Spongiosis with desmosome keratinocyte spines 32:10
Spongiotic vesicles with Langerhans cells 33:30
Normal acral skin (palm & sole) with stratum lucidum 34:20
Normal glomus body/apparatus (canal of Sucquet-Hoyer) 35:40
Nerve 36:46 & 51:50
Adipose tissue (white fat cells) in subcutis with Lochkern 37:55
Normal scalp skin with large anagen hair follicles: 39:30
Hair follicle anatomy (bulb/matrix, inner root sheath, outer root sheath, hair shaft, isthmus, infundibulum): 40:55 (labeled images):
https://kikoxp.com/posts/3661 & https://kikoxp.com/posts/7899
Pacinian corpuscle 50:40
Meissner corpuscle 1:02:28

Dense regular connective tissue (Fascia/Tendon/Ligament) vs Smooth Muscle 53:00

Basic Normal Skin Immunohistochemistry:
-cytokeratin in epidermis: 55:33
-S100 in melanocytes and Langerhans cells and adipocytes: 57:30
-Desmin in smooth muscle (arrector pili and blood vessels): 58:59
-CD31 in endothelial cells of blood vessels: 59:33
-SOX-10 in melanocytes: 1:00:40

Digit/Finger/Toe histology (amputation for subungual acral melanoma) 1:04:10 & 1:08:30
-bone 1:05:40
-glomus body 1:05:15
-tendon/ligament 1:06:10
-artery 1:06:58
-fingernail/toenail 1:08:54
-acrosyringium 1:10:45

Solar elastosis (what wrinkles look like microscopically!) 1:11:50

Other videos you might like:
Tendon vs Nerve Histology Made Simple with the Ramen Noodle Sign (of Fulton) video: https://kikoxp.com/posts/4466
Melanocytes vs Keratinocytes made easy video: https://kikoxp.com/posts/3802
Blood Vessel vs Gland vs Artifact Made Easy video: https://kikoxp.com/posts/4808

The basic normal structures of the skin discussed and described by a dermatopathologist. This material is intended for use by medical students, junior pathology or dermatology residents, or for anyone else studying normal human histology. Special thanks to two of my medical students at UAMS for helping make this video possible. Miki Lindsey convinced me that I really needed to sit down and record this video. Akash Patel took time to edit the video and make it ready for YouTube. My sincere thanks to both of them for helping me overcome procrastination.

Huge thanks to Abigail Cline, a medical student at Medical College of Georgia, for volunteering to type a transcript of this ENTIRE video (over 14,000 words!) so that I could provide closed caption subtitles for those with hearing impairments and for those who may need assistance in understanding spoken English (particularly given how quickly I speak!). You can access a text version of her transcript of my video here: https://kikoxp.com/posts/5390

Correction - I made a mistake in the video. I said that sebaceous gland secretions are turned into smelly substances by bacteria and that this makes body odor. That is incorrect. That is actually true of APOCRINE gland secretions not sebaceous secretions.

Also, in the past I used "keratinocyte" and "squamous cell" interchangeably (this is because in dermatopathology, we see and talk about squamous cell carcinomas all the time, and those tumors are composed of keratinocytes). But technically, in normal skin histology, "squamous cell" refers only to the flattened keratinocytes in the superficial epidermis. Thankfully, a histology PhD colleague pointed this out to me and corrected my lazy nomenclature!

Please check out my Soft Tissue Pathology & Dermatopathology survival guide textbooks: http://bit.ly/2Te2haB ‬

This video is geared towards medical students, pathology or dermatology residents, or practicing pathologists or dermatologists. Of course, this video is for educational purposes only and is not formal medical advice or consultation.

Presented by Jerad M. Gardner, MD. Please subscribe to my channel to be notified of new pathology teaching videos.

Follow me on:
Snapchat: JMGardnerMD
Twitter: @JMGardnerMD
Instagram: @JMGardnerMD
Facebook: https://www.facebook.com/JMGardnerMD/

In order to be able to look at tissues under a microscope, we need to first stain them with the right technique. Learn the main staining techniques used in histology today on our full video: https://khub.me/aux9w

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As you probably know, histology is the study of the microscopic anatomy of cells and tissues. So we use staining methods to visualize and distinguish the different parts of cells and tissues since cells and their structures are usually transparent or colorless. The types of dyes used to color cells and their components can either be specific to particular structures, chemical groups or even molecules, and it can also be non-specific in which case most of the cell is stained in the same way.

When staining tissue samples, dyes that are used are either acidic or basic or a combination of the two. And why is that, you might be asking. Well, cellular structures such as nucleic acids or proteins have charged groups which are known as phosphate groups or carboxyl groups, just to name a couple. The dyes used in histology are colored organic compounds which also have a charge. Acidic dyes carry a negative charge and so they bind to positively-charged cell structures.

In the full version of this tutorial, we will cover some of the most common types of dyes used in histological staining of cells and their structures:
- basic dyes vs acidic dyes vs neutral dyes;
- hematoxylin and eosin;
- PAS - staining;
- Golgi method;
- Toluidine blue;
- Masson's trichrome;
- Osmium tetroxide;

To master this topic, click on the link and carry on watching the full video (available to Premium members): https://khub.me/aux9w !

Want to test your knowledge on the different types of cells and tissues? Take this quiz: https://khub.me/3g19f

Read more on how to interpret different histological sections on this complete article which goes through the different stains used in histology https://khub.me/saimh

For more engaging video tutorials, interactive quizzes, articles and an atlas of Human anatomy and histology, go to https://khub.me/pkvz2

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