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Acute Pain: Intensely discomforting, distressful, or agonizing sensation associated with trauma or disease, with well-defined location, character, and timing.
 Science Education: Essentials of Physical Examinations II

Abdominal Exam IV: Acute Abdominal Pain Assessment

JoVE Science Education

Source: Joseph Donroe, MD, Internal Medicine and Pediatrics, Yale School of Medicine, New Haven, CT

Abdominal pain is a frequent presenting concern in both the emergency department and the office setting. Acute abdominal pain is defined as pain lasting less than seven days, while an acute abdomen refers to the abrupt onset of severe abdominal pain with features suggesting a surgically intervenable process. The differential diagnosis of acute abdominal pain is broad; thus, clinicians must have a systematic method of examination guided by a careful history, remembering that pathology outside of the abdomen can also cause abdominal pain, including pulmonary, cardiac, rectal, and genital disorders. Terminology for describing the location of abdominal tenderness includes the right and left upper and lower quadrants, and the epigastric, umbilical, and hypogastric regions (Figures 1, 2). Thorough examination requires an organized approach involving inspection, auscultation, percussion, and palpation, with each maneuver performed purposefully and with a clear mental representation of the anatomy. Rather than palpating randomly across the abdomen, begin palpating remotely from the site of tenderness, moving systematically toward the tender region, and thi

 JoVE Behavior

Use of the Operant Orofacial Pain Assessment Device (OPAD) to Measure Changes in Nociceptive Behavior

1Department of Oral and Maxillofacial Surgery, University of Florida College of Dentistry, 2Department of Neuroscience, McKnight Brain Institute, University of Florida College of Medicine, 3Stoelting Co., 4Department of Orthodontics, University of Florida

JoVE 50336

 JoVE Medicine

3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache

1Headache & Orofacial Pain Effort (H.O.P.E.), Biological & Materials Sciences Department, University of Michigan School of Dentistry, 2Michigan Center for Oral Health Research (MCOHR), University of Michigan School of Dentistry, 3Translational Neuroimaging Laboratory, Molecular & Behavioral Neuroscience Institute, University of Michigan, 4PET Physics Section, Division of Nuclear Medicine, Radiology Department, University of Michigan, 53DLab, University of Michigan, 6Department of Obstetrics and Gynecology, University of Michigan

JoVE 50682

 JoVE Medicine

Technique and Considerations in the Use of 4x1 Ring High-definition Transcranial Direct Current Stimulation (HD-tDCS)

1Laboratory of Neuromodulation, Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, 2School of Medicine, Pontifical Catholic University of Ecuador, 3Charité University Medicine Berlin, 4The City College of The City University of New York, 5Headache & Orofacial Pain Effort (H.O.P.E.), Biologic & Materials Sciences, School of Dentistry, University of Michigan

JoVE 50309

 JoVE Medicine

Primary Outcome Assessment in a Pig Model of Acute Myocardial Infarction

1Department of Experimental Cardiology, University Medical Center Utrecht, 2Department of Cardiology, University Medical Center Utrecht, 3Department of Clinical Chemistry and Hematology, University Medical Center Utrecht, 4Interuniversity Cardiology Institutes of the Netherlands (ICIN)

JoVE 54021

 JoVE Neuroscience

Non-restraining EEG Radiotelemetry: Epidural and Deep Intracerebral Stereotaxic EEG Electrode Placement

1Department of Neuropsychopharmacology, Federal Institute for Drugs and Medical Devices (Bundesinstitut für Arzneimittel und Medizinprodukte, BfArM), 2Molecular and Cellular Cognition Lab, German Center for Neurodegenerative Diseases (Deutsches Zentrum für Neurodegenerative Erkrankungen, DZNE)

JoVE 54216

 JoVE Medicine

Bile Duct Ligation in Mice: Induction of Inflammatory Liver Injury and Fibrosis by Obstructive Cholestasis

1Institute of Molecular Pathobiochemistry, Experimental Gene Therapy and Clinical Chemistry, RWTH Aachen University, 2Institute for Laboratory Animal Science and Experimental Surgery, RWTH Aachen University, 3Department of Medicine III, RWTH Aachen University

JoVE 52438

 JoVE Medicine

Ischemic Tissue Injury in the Dorsal Skinfold Chamber of the Mouse: A Skin Flap Model to Investigate Acute Persistent Ischemia

1Department of Plastic Surgery and Hand Surgery, Klinikum rechts der Isar, Technische Universität München, 2Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital of Basel, 3Institute for Clinical and Experimental Surgery, University of Saarland, 4Division of Plastic and Hand Surgery, University Hospital Zurich

JoVE 51900

 JoVE Medicine

Development of an Algorithm to Perform a Comprehensive Study of Autonomic Dysreflexia in Animals with High Spinal Cord Injury Using a Telemetry Device

1International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia, 2Department of Medicine, Division of Physical Medicine and Rehabilitation, University of British Columbia, GF Strong Rehabilitation Centre

JoVE 52809

 JoVE Medicine

Chronic Thromboembolic Pulmonary Hypertension and Assessment of Right Ventricular Function in the Piglet

1Surgical Research Lab, Marie Lannelongue Hospital, 2Department of Pathology, Marie Lannelongue Hospital, 3Department of Thoracic and Vascular Surgery, Marie Lannelongue Hospital, 4Thoracic and Cardiovascular Surgery, University Hospital of Rennes, 5INSERM U999 Paris-Sud University

JoVE 53133

 JoVE Behavior

Repetitive Transcranial Magnetic Stimulation to the Unilateral Hemisphere of Rat Brain

1Department of Rehabilitation Medicine, Chungnam National University Hospital, Daejeon, 2Department of Biomedical Engineering, Seoul National University College of Medicine, 3Institute of Medical and Biological Engineering, Medical Research Center, Seoul National University, 4Department of Biomedical Engineering, Seoul National University Hospital, 5Department of Nuclear Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 6Department of Rehabilitation Medicine, Gangwon Do Rehabilitation Hospital, 7Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine

JoVE 54217

 JoVE Medicine

Diffuse Optical Spectroscopy for the Quantitative Assessment of Acute Ionizing Radiation Induced Skin Toxicity Using a Mouse Model

1Department of Radiation Oncology, University of Toronto, 2Department of Physics, Ryerson University, 3Department of Medical Biophysics, University of Toronto, 4Ontario Cancer Institute / Campbell Family Institute for Cancer Research

JoVE 53573

 Science Education: Essentials of Physical Examinations I

Measuring Vital Signs

JoVE Science Education

Source: Meghan Fashjian, ACNP-BC, Beth Israel Deaconess Medical Center, Boston MA

The vital signs are objective measurements of a patient's clinical status. There are five commonly accepted vital signs: blood pressure, heart rate, temperature, respiratory rate, and oxygen saturation. In many practices, pain is considered the sixth vital sign and should regularly be documented in the same location as the other vital signs. However, the pain scale is a subjective measurement and, therefore, has a different value according to each individual patient. The vital signs assessment includes estimation of heart rate, blood pressure (demonstrated in a separate video), respiratory rate, temperature, oxygen saturation, and the presence and severity of pain. The accepted ranges for vital signs are: heart rate (HR), 50-80 beats per minute (bpm); respiratory rate (RR), 14-20 bpm; oxygen saturation (SaO2), > 92%; and average oral temperature, ~98.6 °F (37 °C) (average rectal and tympanic temperatures are ~1° higher, and axillary temperature is ~1° lower compared to the average oral temperature). Vital signs serve as the first clue that something may be amiss with a patient, especially if the patient is unable to communicate. Although there are

 JoVE Behavior

Neuro-rehabilitation Approach for Sudden Sensorineural Hearing Loss

1Department of Integrative Physiology, National Institute for Physiological Sciences, 2Department of Otolaryngology, Head and Neck Surgery, Nagoya City University Graduate School of Medical Sciences and Medical School, 3Department of Otorhinolaryngology, Kansai Rosai Hospital, 4Institute for Biomagnetism and Biosignalanalysis, University of Muenster, 5Institute for Epidemiology and Social Medicine, University of Muenster, 6Sokendai Graduate University for Advanced Studies

JoVE 53264

 JoVE Medicine

Non-invasive Imaging of Acute Allograft Rejection after Rat Renal Transplantation Using 18F-FDG PET

1Department of Internal Medicine D, Experimental Nephrology, University of Münster, 2Department of Nuclear Medicine, University of Münster, 3European Institute for Molecular Imaging, University of Münster

JoVE 4240

 JoVE Medicine

A Novel Microsurgical Model for Heterotopic, En Bloc Chest Wall, Thymus, and Heart Transplantation in Mice

1Johns Hopkins University School of Medicine, 2Burn and Complex Wound Center, 3Section of Plastic and Reconstructive Surgery, University of Chicago Medical Center, 4Division of Plastic, Reconstructive, and Maxillofacial Surgery, R Adams Cowley Shock Trauma Center, 5Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, 6Vascularized Composite Allotransplantation (VCA) Lab, Johns Hopkins University School of Medicine

JoVE 53442

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