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Pelvic Floor: Soft tissue formed mainly by the pelvic diaphragm, which is composed of the two levator ani and two coccygeus muscles. The pelvic diaphragm lies just below the pelvic aperture (outlet) and separates the pelvic cavity from the Perineum. It extends between the Pubic bone anteriorly and the Coccyx posteriorly.
 JoVE Bioengineering

Training Persons with Spinal Cord Injury to Ambulate Using a Powered Exoskeleton

1Department of Veterans Affairs (VA) Rehabilitation Research and Development National Center of Excellence for the Medical Consequences of Spinal Cord Injury, James J. Peters VA Medical Center, 2Department of Veterans Affairs (VA) Spinal Cord Injury Service, James J. Peters VA Medical Center


JoVE 54071

 Science Education: Essentials of Physical Examinations II

Pelvic Exam I: Assessment of the External Genitalia

JoVE Science Education

Source:
Alexandra Duncan, GTA, Praxis Clinical, New Haven, CT
Tiffany Cook, GTA, Praxis Clinical, New Haven, CT
Jaideep S. Talwalkar, MD, Internal Medicine and Pediatrics, Yale School of Medicine, New Haven, CT

The pelvic exam can feel invasive to patients, so it is important to do everything possible to make patients feel comfortable and empowered, rather than vulnerable. Clinicians should be aware of how they are communicating, both verbally and nonverbally, and should give their patients control whenever possible. There are many ways to do this, from how the exam table is positioned to how the patient is engaged throughout the exam. As many as 1 in 5 patients may have experienced sexual trauma; therefore, it is important to avoid triggering those patients, but it's not always possible to know who they are. The exam in this video demonstrates neutral language and techniques that can be employed with all patients to create the best experience possible. It's important to keep the patient covered wherever possible and to minimize extraneous contact. A clinician should be careful to tuck fingers that aren't being used to examine the patient to avoid accidental contact with the clitoris or anus. Before performing the pelvic e

 JoVE Neuroscience

In Vitro Recording of Mesenteric Afferent Nerve Activity in Mouse Jejunal and Colonic Segments

1Laboratory of Experimental Medicine and Pediatrics, Division of Gastroenterology, University of Antwerp, 2Visceral Pain Group, Discipline of Medicine, University of Adelaide, 3Department of Biomedical Sciences, University of Sheffield, 4Department of Pharmacy, Pharmacology and Postgraduate Medicine, University of Hertfordshire, 5Department of Gastroenterology and Hepatology, Antwerp University Hospital


JoVE 54576

 Science Education: Essentials of Physical Examinations II

Pelvic Exam II: Speculum Exam

JoVE Science Education

Source:

Alexandra Duncan, GTA, Praxis Clinical, New Haven, CT

Tiffany Cook, GTA, Praxis Clinical, New Haven, CT

Jaideep S. Talwalkar, MD, Internal Medicine and Pediatrics, Yale School of Medicine, New Haven, CT

Providing comfortable speculum placement is an important skill for providers to develop, since the speculum is a necessary tool in many gynecological procedures. Patients and providers are often anxious about the speculum exam, but it is entirely possible to place a speculum without patient discomfort. It's important for the clinician to be aware of the role language plays in creating a comfortable environment; for instance, a provider should refer to the speculum "bills" rather than "blades" to avoid upsetting the patient. There are two types of speculums: metal and plastic (Figure 1). This demonstration utilizes plastic, as plastic speculums are most commonly used in clinics for routine testing. When using a metal speculum, it's recommended to use a Graves speculum if the patient has given birth vaginally, and a Pederson speculum if the patient has not. Pederson and Graves speculums are different shapes, and both come in many different sizes (me

 JoVE Medicine

Flexible Colonoscopy in Mice to Evaluate the Severity of Colitis and Colorectal Tumors Using a Validated Endoscopic Scoring System

1Division of Gastroenterology, Case Western Reserve University School of Medicine, Cleveland, 2Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, 3Digestive Health Research Center, Case Western Reserve University School of Medicine, Cleveland


JoVE 50843

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 JoVE Medicine

Intraoperative Detection of Subtle Endometriosis: A Novel Paradigm for Detection and Treatment of Pelvic Pain Associated with the Loss of Peritoneal Integrity

1Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Greenville Hospital System, 2Department of Pathology, Duke University Health System, 3Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Duke University


JoVE 4313

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 Science Education: Essentials of Physical Examinations II

Pelvic Exam III: Bimanual and Rectovaginal Exam

JoVE Science Education

Source:

Alexandra Duncan, GTA, Praxis Clinical, New Haven, CT

Tiffany Cook, GTA, Praxis Clinical, New Haven, CT

Jaideep S. Talwalkar, MD, Internal Medicine and Pediatrics, Yale School of Medicine, New Haven, CT

A bimanual exam is a thorough check of a patient's cervix, uterus, and ovaries. It can tell an experienced provider a great deal, as it may lead to the discovery of abnormalities, such as cysts, fibroids, or malignancies. However, it's useful even in the absence of such findings, as it allows the practitioner to establish an understanding of the patient's anatomy for future reference. Performing the bimanual exam before the speculum exam can help relax patients, mentally and physically, before what is often perceived as the "most invasive" part of the exam. A practitioner already familiar with the patient's anatomy can insert a speculum more smoothly and comfortably. However, lubrication used during the bimanual exam may interfere with processing certain samples obtained during the speculum exam. Providers must be familiar with local laboratory processing requirements before committing to a specific order of examination. This demonstration begins

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 JoVE Behavior

Contextual and Cued Fear Conditioning Test Using a Video Analyzing System in Mice

1Division of Systems Medical Science, Institute for Comprehensive Medical Science, Fujita Health University, 2Japan Science and Technology Agency, Core Research for Evolutionary Science and Technology (CREST), 3Center for Genetic Analysis of Behavior, National Institute for Physiological Sciences, National Institutes of Natural Sciences


JoVE 50871

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 JoVE Medicine

Adapting Human Videofluoroscopic Swallow Study Methods to Detect and Characterize Dysphagia in Murine Disease Models

1Department of Otolaryngology - Head and Neck Surgery, University of Missouri, 2Department of Communication Science and Disorders, University of Missouri, 3Department of Medicine, University of Missouri


JoVE 52319

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 JoVE Environment

Methods of Soil Resampling to Monitor Changes in the Chemical Concentrations of Forest Soils

1New York Water Science Center, U.S. Geological Survey, 2School of Forest Resources, University of Maine, 3Natural Resources Canada, Canadian Forest Service, 4Northern Research Station, U.S. Forest Service, 5Department of Plant and Soil Science, University of Vermont, 6Ottauquechee NRCD, USDA Natural Resources Conservation Service, 7Green Mountain National Forest, U.S. Forest Service, 8Direction de la Recherche Forestière, Ministère du Québec, 9Department of Civil and Environmental Engineering, Syracuse University, 10Division of Environmental Science, SUNY College of Environmental Science and Forestry, 11White Mountain National Forest, U.S. Forest Service, 12Natural Resources and Earth System Sciences, University of New Hampshire, 13Greenwich, NY Field Office, USDA Natural Resources Conservation Service


JoVE 54815

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 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

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 JoVE Medicine

In Vivo and Ex Vivo Approaches to Study Ovarian Cancer Metastatic Colonization of Milky Spot Structures in Peritoneal Adipose

1Section of Urology, Department of Surgery, The University of Chicago, 2Department of Pathology, Robert Wood Johnson Medical School, 3Campbell Family Institute for Breast Cancer Research, Princess Margaret Cancer Centre, University Health Network, 4Department of Laboratory Medicine and Pathobiology, Campbell Family Institute for Breast Cancer Research, Princess Margaret Cancer Centre, University of Toronto, University Health Network, 5Departments of Medicine, Pharmacology, and Cancer Biology, Duke University Medical Center


JoVE 52721

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 JoVE Behavior

Morris Water Maze Test: Optimization for Mouse Strain and Testing Environment

1Department of Psychology, Behavioral Neuroscience, West Virginia University, 2Department of Physiology and Pharmacology, West Virginia University, 3Department of Neurology, N. Bud Grossman Center for Memory Research and Care, University of Minnesota, 4Department of Neuroscience, N. Bud Grossman Center for Memory Research and Care, University of Minnesota, 5GRECC, VA Medical Center, 6Center for Neuroscience, Center for Basic and Translational Stroke Research, West Virginia University


JoVE 52706

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 JoVE In-Press

In Vivo Model for Testing Effect of Hypoxia on Tumor Metastasis

1Department of Biochemistry and Molecular & Cellular Biology, Georgetown University Medical Center, 2Department of Nursing, Georgetown University, School of Nursing and Health Studies, 3Department of Human Science, Georgetown University, School of Nursing and Health Studies, 4School of Medicine, Georgetown University Medical Center, 5Department of Pathology and Neuropathology, Medical University of Gdańsk, 6Department of Oncology, Georgetown University Medical Center, 7Department of Pathology, Georgetown University Medical Center

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JoVE 54532

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 Science Education: Essentials of Lab Animal Research

Sterile Tissue Harvest

JoVE Science Education

Source: Kay Stewart, RVT, RLATG, CMAR; Valerie A. Schroeder, RVT, RLATG. University of Notre Dame, IN

In 1959 The 3 R's were introduced by W.M.S. Russell and R.L. Burch in their book The Principles of Humane Experimental Technique. The 3 R's are replacement, reduction, and refinement of the use of animals in research.1 The use of cell lines and tissue cultures that originated from research animals is a replacement technique, as it allows for many experiments to be conducted in vitro. Harvesting tissues and organs for use in cell and tissue cultures requires aseptic technique to avoid contamination of the tissues. Sterile harvest is also necessary for protein and RNA analysis and metabolic profiling of tissues. This manuscript will discuss the process of sterile organ harvest in rats and mice.

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