Brain Surgery: Removal of large brain tumor (meningioma)
Surgical footage of resection of a complex brain tumor (meningioma) abutting the motor cortex by Dr. Farhad Limonadi. View is through the surgical microscope.
Nail Pitting in Psoriasis
A 28-year-old man presented to the dermatology clinic with fingernail changes that had developed over a period of 3 years. Examination revealed multiple small depressions (pits) in the surface of the nails on both hands, with yellow discoloration of the distal nail. Scaly, erythematous plaques were also present on the extensor surfaces of both elbows and both knees. The patient had no joint tenderness, swelling, or stiffness. A clinical diagnosis of psoriasis was made. Nail changes are common in patients with psoriasis. Signs of psoriasis in the nails include discoloration (e.g., areas of yellow or pink discoloration known as oil-drop discoloration or salmon patches), onycholysis, subungual hyperkeratosis, nail plate crumbling, and splinter hemorrhages. Other conditions in which nail pitting can be seen include alopecia areata, eczematous dermatitis, and traumatic occupational injury. Isolated pits can develop in normal nails. In this patient, a high-potency glucocorticoid in nail lacquer was initiated, and cutaneous psoriasis was treated with a combination topical vitamin D analogue and a glucocorticoid. At follow-up 6 months after the initiation of treatment, the patient’s nail pitting and skin plaques had abated and joint involvement had not developed.
Whats your diagnosis?
And whats the treatment for early stage of this disease?
Repaired stab wound to the right ventricle!
This case presented a patient with a cardiac stab wound who underwent definitive repair of the wound with sutures. Control of hemorrhage in penetrating cardiac trauma is essential and immediate control can be achieved most easily by direct finger pressure. For large wounds, a Foley catheter or Satinsky clamp may be used. Techniques for definitive repair (as seen above) of cardiac wounds include sutures isolated or combined with Teflon pledgets, particularly in large wounds. Placement of sutures can be challenging and time consuming in the beating heart. The use of staples has been reported to be a safe and quick method to achieve temporary control of hemorrhage from penetrating cardiac wounds.
Name That Anatomy - Episode 167
Play the video and pause when you've guessed the answer correctly. Take note of your score (bottom left) and share it in the comments. Please don't spoil the answer in the comments.
A degloving accident of a boy who had a ring on his finger that got caught on a fence as he jumped off it. A degloving injury is a type of avulsion in which an extensive section of skin is completely torn off the underlying tissue, severing its blood supply. It is named by analogy to the process of removing a glove.Typically, degloving injuries affect the extremities and limbs. Any injury which would induce degloving of the head or torso is likely to be lethal. However, controlled facial degloving is often featured in plastic surgery.Degloving injuries invariably require major surgical interventions. Treatment options include replantation or revascularization of the degloved skins, or when these are not possible, skin grafts or skin flaps. While the preservation of the extremities and limbs is normally preferred, in some cases amputations may be advised or required. Post-operative physiotherapy is of particular importance for degloving injuries involving the hand.
An Arteriovenous Malformation (AVM)
An Arteriovenous Malformation (AVM) is a congenital malformation of the vascular system in which arteries and veins are directly connected, bypassing capillaries. The result is a giant tangle of arteries and veins, and in space restricted areas like the brain you can imagine the negative affect one these can have on a person. The first-line treatment for an AVM is surgical embolization; they go in through the vascular system and cut the blood supply to the malformation off. The AVM then dies and stops putting pressure on the surrounding tissues. If the AVM is superficial in the brain they can perform a craniotomy and slowly shrink and remove the AVM.
Dr Darshan Sn
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Incubation in children
Trachealization” of the Esophagus
A 32-year-old man presented to the emergency department with difficulty swallowing oral secretions and the feeling that food was stuck in his throat after he ate a pizza roll. The patient reported that similar episodes had occurred previously, but in each instance the feeling resolved spontaneously, and he did not seek medical care. At the time of presentation, the patient was drooling. Upper endoscopy revealed impacted food material (Panel A) and prominent mucosal rings extending 20 cm from the incisors to the level of the gastroesophageal junction, with two discrete areas of narrowing and associated linear furrows (Panel B). Biopsy specimens were obtained, and esophagitis was observed, with more than 40 eosinophils per high-power field (Fig. S1 in the Supplementary Appendix). An endoscopic finding of fixed esophageal rings, or “trachealization,” is suggestive of eosinophilic esophagitis, although a definitive diagnosis is made on the basis of clinical presentation, histologic findings, and the exclusion of other causes of esophageal eosinophilia, such as proton-pump inhibitor–responsive esophageal eosinophilia. The patient was treated with an 8-week course of omeprazole, but there was no symptom resolution or histologic improvement on repeat endoscopic biopsies, which confirmed the diagnosis of eosinophilic esophagitis. He was started on an 8-week course of both swallowed fluticasone and a six-food elimination diet (elimination of the six most commonly identified types of allergenic food — wheat, milk, soy, nuts, eggs, and seafood). No additional endoscopies were performed after completion of treatment with fluticasone and the elimination diet. At a 1-year follow-up visit, the patient reported no further symptoms of food impaction.
A twenty-three-year old male patient was brought to our emergency service by an ambulance. Trauma mechanism reported by the paramedic team indicated that the patient was seated in the driver seat without his seatbelt on, and he had crushed his face to the steering wheel during the accident. After the initial examination, it was noted that the patient’s bilateral orbitas; maxillary, zygomatic and nasal bone structures were not observed. The patient was conscious, breathing spontaneously in tripod position and he had tachypnea. He had midfacial bleeding due to maxillofacial trauma. He was cooperated and oriented but vocal and ocular responses were suboptimal due to damages. Vital signs were: blood pressure 160/90 mmHg, heart rate 110, respiratory rate 22 and fingertip saturation 99%.(Figure1, figure 2, Figure 3) On his primary survey, his hemorrhage control was maintained with aspiration. Oxygen saturation was normal while sitting but he was not able to keep his airway open in supine position. After stabilization of the patient, urgent plastic surgery was planned. Because of his severe facial fractures, surgical airway (tracheostomy) placement was performed accompanied by a otolaryngologist. On his secondary survey, other system examinations were normal. In his cranial computed tomography (CT) imaging there was neither damage in brain parenchyma; nor hemorrhage or hematoma on epidural, subdural or subarachoidal spaces. Lateral, superior, medial and inferior walls of bilateral orbitas and bilateral multiple zygomatic arch fractures were detected. Right bulbus oculi was not in its cavity, left bulbus oculi was displaced antero-superiorly. The relationship between the left temporomandibular joint was absent. After performing cranial imaging, the patient was referred to Plastic and Reconstructive Surgery for operation.
A 58-year-old man presented to the otorhinolaryngology outpatient clinic with a 2-year history of progressive hoarseness and swelling on the left side of his neck. He had no associated dysphagia, regurgitation of food, or dyspnea. He worked as a farmer and had no history of tobacco use. On physical examination, he had nontender, compressible swelling in the left cervical region that transmitted light on transillumination (Panel A). The swelling was accentuated when the Valsalva maneuver was performed Examination with a flexible fiberoptic laryngoscope showed a bulge over the left false vocal cord that was partially obstructing the airway lumen . A diagnosis of laryngocele was confirmed by radiography of the neck (Panel B) and by computed tomography (Panel C), both of which showed a well-defined lobulated structure located in the left paralaryngeal space and extending through the thyrohyoid membrane. A laryngocele is a dilatation of the laryngeal saccule within the sinus of Morgagni, the space between false and true vocal cords. It can result from activity that increases intralaryngeal pressure, such as excessive coughing, straining, playing a wind instrument, or glass blowing. The patient underwent a complete excision of the laryngocele. He remained asymptomatic at a follow-up visit 8 months later.
| 2 days ago
What’s the longest you’ve had to go without sleep?
Fatma R. Badr
It occurs when the feet are wet for long periods of time (days or weeks) Skin is red then turns purple or blue with tingling and itching sensation. Blisters may develop and in sever cases gangrene may develop.
Laceration. ~assault by husband~
A 25 years old female presented with alleged history of assault by husband over the left face. There was degloving and avulsion of the left side of her face including the nose, forehead skin and eyebrow on the left side, upper and lower eyelids and part of the cheek. The globe as well as eyesight was intact. The extra ocular movements were present. A thorough debridement was undertaken, and the devitalized tissue was excised. Meticulous suturing was done to relocate the avulsed structures to their respective positions. After four weeks, costal cartilage graft was used for nasal augmentation. At follow-up one year after the trauma, and after two surgeries, the patient was satisfied with no functional defcit. There were no nasal or ocular complaints. Eye opening and closure were normal. Doctors felt that the cosmetic outcome was suboptimal, and offered the patient the options of scar revision over the forehead, staged removal of skin graft over the cheek, and a more appropriate eyebrow positioning. However the patient was satisfied and was not desirous of any other surgical procedures suggested to her.
| a day ago
My first experience of the app! Awesome is it! So much better than the similar ones... Easy to work, simple and really a place which the users wanna learn.
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There are six extraocular muscles that move the globe (eyeball). These muscles are named the superior rectus, inferior rectus, lateral rectus, medial rectus, superior oblique, and inferior oblique
𝐓𝐡𝐞 🍇 𝐨𝐟 𝐭𝐡𝐞 𝐛𝐨𝐝𝐲, 𝐭𝐡𝐞 𝐏𝐚𝐧𝐜𝐫𝐞𝐚𝐬! ⤵️ ✅ 𝐎𝐯𝐞𝐫𝐯𝐢𝐞𝐰 It is an organ sitting behind the stomach at about 6-8 inches long. The right side of the Pancreas is its widest part and is referred to as the head. It is cradled by the duodenum (1st part of small intestine). It moves upwards from right to left as the body of the Pancreas and ends at the spleen as the tail of the Pancreas. ✅ 𝟐 𝐆𝐥𝐚𝐧𝐝𝐬 𝐨𝐟 𝐏𝐚𝐧𝐜𝐫𝐞𝐚𝐬 Exocrine: about 95% consists of this tissue. secretes digestive enzymes into the pancreatic duct. Endocrine: about 5% secretes hormones such as insulin into the blood stream, with its cells known as Islets of Langerhans. It regulates the body’s sugar levels. ✅ 𝐃𝐢𝐬𝐞𝐚𝐬𝐞𝐬 𝐨𝐟 𝐏𝐚𝐧𝐜𝐫𝐞𝐚𝐬 Pancreatitis: inflammation and damage by its own digestive chemicals. Pancreas swells and tissue cells die. Pancreatic pseudocyst: with conditions of pancreatitis, a fluid filled cavity can form, referred to as a pseudocyst. Diabetes type 1: Disruption in the body’s immune system causes damage and destruction to the pancreas’ insulin-producing cells. Diabetes type 2: Pancreas loses ability to provide adequate release of insulin. Body continues to become resistant to insulin and blood sugar peaks. 🎥 𝐋𝐞𝐚𝐫𝐧 𝐀𝐧𝐚𝐭𝐨𝐦𝐲 𝐰𝐢𝐭𝐡 𝐨𝐮𝐫 𝐞𝐚𝐬𝐲 𝐚𝐧𝐝 𝐪𝐮𝐢𝐜𝐤 𝐯𝐢𝐝𝐞𝐨𝐬. 𝐂𝐥𝐢𝐜𝐤 𝐭𝐡𝐞 𝐥𝐢𝐧𝐤 𝐢𝐧 𝐛𝐢𝐨 𝐚𝐧𝐝 𝐠𝐞𝐭 𝐬𝐭𝐚𝐫𝐭𝐞𝐝 𝐍𝐎𝗪! 𝐒𝐮𝐩𝐩𝐨𝐫𝐭 𝐮𝐬 𝐛𝐲 𝐬𝐮𝐛𝐬𝐜𝐫𝐢𝐛𝐢𝐧𝐠 😊 Instagram: @rev.med
Dirofilaria immitis, the heartworm or dog heartworm, is a parasitic roundworm that is a type of filarial worm, a small thread-like worm, that causes dirofilariasis. It is spread from host to host through the bites of mosquitoes. The definitive host is the dog. Dirofilaria immitis is commonly called the "heartworm"; however, adults often reside in the pulmonary arterial system (lung arteries), as well as the heart, and a major effect on the health for the animal is a manifestation of damage to the lung vessels and tissues. Occasionally, adult heartworms migrate to the right heart and even the great veins in heavy infestations. Heartworm infection may result in serious disease for the host, with death typically as the result of congestive heart failure. @medicalcortex
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