Obstetrics:The Science & The Art

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Eisenmenger Syndrome

Over time, increased blood flow can damage the small blood vessels in the lungs. This causes high blood pressure in the lungs. As a result, the blood backs up and does not go to the lungs to pick up oxygen. Instead, the blood goes from the right side to the left side of the heart, allowing oxygen-poor blood to travel to the rest of the body.

[FURTHER READING]

Circulatory changes at birth

Primitive Reflexes

1) Foot placing reflex



2) Stepping reflex


3) Grasp/palmar reflex


4) Moro reflex


For further elaborations, please check HERE =)

Liver and spleen palpation

CVS and Respiratory Examination

Sounds

Normal breathe sounds

CVS Examination

Introduction

Introduce yourself

Explain what you would like to examine

Gain consent

Place patient at 45° with chest exposed

Ask if patient has any pain anywhere before you begin!

General Inspection

Bedside for treatments or adjuncts – GTN spray, O², Tablets, Wheelchair, Warfarin

Comfortable at rest?

SOB

Malar Flush

Chest for scars & visible pulsations

Legs for harvest site scars and peripheral oedema

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Hands

Temperature - poor peripheral vasculature

Capillary refill – should be <2 seconds

Colour – cyanosis

Clubbing

Splinter haemorrhages, Jane-way lesions, Oslers Nodes – infective endocarditis

Palmar Erythema – hyperthyroidism, pregnancy, polycythaemia

Nicotine Staining – smoker

 

Pulses

Radial Pulse – rate & rhythm

Radial-Radial Delay – aortic coarctation

Collapsing Pulse – aortic regurgitation

BP – narrow pulse pressure = Aortic Stenosis | wide pulse pressure = Aortic Regurgitation

Carotid – character & volume

JVP – measure and also possibly carry out hepatojugular reflex

 

Face

Eyes – conjunctival pallor, jaundice, corneal arcus, xanthelasma

Mouth – central cyanosis, angular stomatitis

Dental hygiene – infective endocarditis 

 

Close Inspection Of Chest

Scars - lateral thoracotomy (mitral valve), midline sternotomy (CABG), clavicular (pacemaker)

Apex beat – visible in aortic regurgitation and thyrotoxicosis

Chest wall deformities – pectus excavatum, pectus carniatum

 

 

Palpation

Apex beat – 5th intercostal space, mid clavicular

Heaves- left sternal edge – seen in left & right ventricular hypertrophy

Thrills – Palpatable murmurs over aortic valve & apex

 

Auscultation

Listen over 4 valves - ensure palpation of carotid pulse to determine first heart sound

Roll onto left side & listen in mitral area – mitral stenosis

Lean forward & listen over aortic area-  aortic regurgitation

Carotids - radiation of aortic stenosis murmurs & bruits

Lung bases – pulmonary oedema

Sacral Oedema & Pedal Oedema

 

To complete the examination

Thank Patient

Wash hands

Summarise Findings

 

 

Say you would

Assess peripheral pulses

Carry out an ECG

Dipstick urine

Bedside Blood Glucose

Fundoscopy

 

source : 

•  Macleod

• http://geekymedics.com/osce/cardiovascular-examination-2/

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Heart Sounds

Wheezes & Percussion

Endotracheal intubation

Activated Charcoal

tonsillectomy

http://www.medicinenet.com/tonsillectomy/article.htm

Epistaxis treatment

Bawah ni dikongsikan video first aid to stop nose bleed,anterios&posterior nasal packing dan cauterization.







tapi ni tak tahu bahasa apa, tak faham apa je, tapi korang tengok la cara dia buat, iA nampak gambaran sikit-sikit...

ORL class 14 Mac

Takyah susah-susah XD

Website ni menghimpunkan segala macam gambar dan segala macam video ORL.

Meh hari-hari disiplinkan diri untuk lepak sini sambil cuci mata

GHORAYEB 

Cholesteatoma

Nose

Ear exam

Ear Examinations dekat sini diceritakan secara teori macam mana nak buat ear exam.

Ada je video untuk ditonton tapi leceh sebab kena download.

Video dekat bawah ni diambil dari website lain.. Dekat website ni ada banyak lagi medical videos yang disusun mengikut branches of medicine.