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Abdominal Wall: The outer margins of the Abdomen, extending from the osteocartilaginous thoracic cage to the Pelvis. Though its major part is muscular, the abdominal wall consists of at least seven layers: the Skin, subcutaneous fat, deep Fascia; Abdominal muscles, transversalis fascia, extraperitoneal fat, and the parietal Peritoneum.

Biodegradable Magnesium Stent Treatment of Saccular Aneurysms in a Rat Model - Introduction of the Surgical Technique

1Department of Neurosurgery, Kantonsspital Aarau, 2Neuro Lab, Research Group for Experimental Neurosurgery and Neurocritical Care, Department of Intensive Care Medicine, University Hospital and University of Bern, 3Division of Neuroradiology, Department of Radiology, Kantonsspital Aarau

JoVE 56359


 Neuroscience

Abdominal Exam III: Palpation

JoVE 10089

Source: Alexander Goldfarb, MD, Assistant Professor of Medicine, Beth Israel Deaconess Medical Center, MA

Abdominal palpation, if performed correctly, allows for examination of the large and relatively superficial organs; for a skilled examiner, it allows for assessment of the smaller and deeper structures as well. The amount of information that can be obtained by palpation of the abdominal area also depends on the anatomical characteristics of the patient. For example, obesity might make palpation of internal organs difficult and require that additional maneuvers be performed. Abdominal palpation provides valuable information regarding localization of the problem and its severity, as abdominal palpation identifies the areas of tenderness as well as presence of organomegaly and tumors. The specific focus of palpation is driven by the information collected during history taking and other elements of the abdominal exam. Palpation helps to integrate this information and develop the strategy for subsequent diagnostic steps.


 Physical Examinations II

Abdominal Exam IV: Acute Abdominal Pain Assessment

JoVE 10120

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


 Physical Examinations II

A Model of Free Tissue Transfer: The Rat Epigastric Free Flap

1Anatomy Department, NOVA Medical School, Universidade NOVA de Lisboa, 2Plastic and Reconstructive Surgery Department and Burn Unit, Centro Hospitalar de Lisboa Central - Hospital de São José, 3UCIBIO, Life Sciences Department, Faculty of Sciences and Technology, Universidade NOVA de Lisboa, 4CEDOC, NOVA Medical School, Universidade NOVA de Lisboa, 5Physics Department, Faculty of Sciences and Technology, LIBPhys, 6Pathology Department, Centro Hospitalar de Lisboa Central – Hospital de São José

JoVE 55281


 Medicine

Abdominal Exam II: Percussion

JoVE 10090

Source: Alexander Goldfarb, MD, Assistant Professor of Medicine, Beth Israel Deaconess Medical Center, MA

Medical percussion is based on the difference in pitch between the sounds elicited by tapping on the body wall. The auditory response to tapping depends on the ease with which the body wall vibrates, and is influenced by underlying organs, strength of the stroke, and the state of the body wall. There are three main medical percussion sounds: resonance (heard over lungs), tympany (heard over the air-filled bowel loops), and dullness (heard over fluid or solid organs). The contrast between dullness vs. tympany or resonance allows for determination of the size and margins of organs and masses, as well as identification of fluid accumulation and areas of consolidation. Percussion remains an intricate part of the physical diagnosis since it was first introduced more than 200 years ago, and is especially useful in examination of the lungs and abdomen. As a part of an abdominal examination, percussion follows visual inspection and auscultation. The examiner should first percuss over each of the nine abdominal regions (epigastric region, right hypochondriac region, left hypochondriac region, umbilical region, right lumbar region, left lumbar region, hypogastric region, right inguinal region, and left


 Physical Examinations II

Abdominal Exam I: Inspection and Auscultation

JoVE 10088

Source: Alexander Goldfarb, MD, Assistant Professor of Medicine, Beth Israel Deaconess Medical Center, MA

Gastrointestinal disease accounts for millions of office visits and hospital admissions annually. Physical examination of the abdomen is a crucial tool in diagnosing diseases of the gastrointestinal tract; in addition, it can help identify pathological processes in cardiovascular, urinary, and other systems. As physical examination in general, the examination of the abdominal region is important for establishing physician-patient contact, for reaching the preliminary diagnosis and selecting subsequent laboratory and imaging tests, and determining the urgency of care. As with the other parts of a physical examination, visual inspection and auscultation of the abdomen are done in a systematic fashion so that no potential findings are missed. Special attention should be paid to potential problems already identified by the patient's history. Here we assume that the patient has already been identified, and has had history taken, symptoms discussed, and areas of potential concern identified. In this video we will not review the patient's history; instead, we will go directly to the physical examination. Before we get to the examination, let's briefly review s


 Physical Examinations II

A New Murine Model of Endovascular Aortic Aneurysm Repair

1INSERM U698 Cardiovascular Remodelling, Hôpital X. Bichat, AP-HP, Paris, 2Bio-Ingénierie des Polymères Cardiovasculaires (BPC), Institut Galilée - Université Paris 13, Paris, France, 3Service de Chirurgie Vasculaire, Hôpital Henri Mondor, AP-HP, Université Paris-Est Creteil, 4Ecole de chirurgie de l'assistance publique des hôpitaux de Paris, 5Service de Chirurgie Cardiaque et Vasculaire, Hôpital Européen Georges Pompidou, AP-HP, Université René Descartes

JoVE 50740


 Medicine

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


 Neuroscience

Heterotopic Renal Autotransplantation in a Porcine Model: A Step-by-Step Protocol

1Multi Organ Transplant Program, Department of Surgery, Toronto General Hospital, 2Division of Nephrology, The Hospital for Sick Children, 3Programa de Doctorat en Medicina, La Universitat Autónoma de Barcelona, 4Laboratory Medicine and Pathobiology, Toronto General Hospital, 5Department of Medicine, Toronto General Hospital, 6Departments of Surgery (Urology) & Physiology, Developmental & Stem Cell Biology, The Hospital for Sick Children

JoVE 53765


 Medicine

Rat Model of the Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy (ALPPS) Procedure

1Institute of Physiology - Center for Integrative Human Physiology, University of Zurich, 2Department of Surgery, Rush University Medical Center, 3Department of Surgery, Cantonal Hospital Winterthur, 4Institute of Anesthesiology, University and University Hospital Zurich

JoVE 55895


 Medicine

Pelvic Exam III: Bimanual and Rectovaginal Exam

JoVE 10163

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


 Physical Examinations II

Techniques of Sleeve Gastrectomy and Modified Roux-en-Y Gastric Bypass in Mice

1l'Institut du Thorax, INSERM, CNRS, UNIV Nantes, 2CHU Nantes, Institut des Maladies de l'Appareil Digestif, INSERM U913, 3l'Institut du Thorax, INSERM, CNRS, UNIV Nantes, CHU Nantes, 4Service de Clinique Chirurgicale Digestive et Endocrinienne, CHU de Nantes

JoVE 54905


 Medicine

Instrumentation of Near-term Fetal Sheep for Multivariate Chronic Non-anesthetized Recordings

1Département de sciences cliniques, CHUV, Université de Montréal, St-Hyacinthe, QC, 2Département d'obstetriques et de gynécologie, CHU Ste-Justine Research Centre, Université de Montréal, 3Département de neurosciences, CHU Ste-Justine Centre de recherche, Université de Montréal, 4Centre de recherche en reproduction animale (CRRA), Université de Montréal, St-Hyacinthe, QC

JoVE 52581


 Developmental Biology

A Bioluminescent and Fluorescent Orthotopic Syngeneic Murine Model of Androgen-dependent and Castration-resistant Prostate Cancer

1Department of Urology, Northwestern University Feinberg School of Medicine, 2The Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, 3Department of Pathology, Northwestern University Feinberg School of Medicine

Video Coming Soon

JoVE 57301


 JoVE In-Press

Murine Kidney Transplant Technique

1Colorado Center for Transplantation Care, Research and Education, University of Colorado, Denver, 2Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado, Denver, 3Department of Medicine, Division of Renal Diseases and Hypertension, Medical Center and University of Colorado, Denver, 4Department of Surgery, Division of Transplant Surgery, University of Colorado School of Medicine, University of Colorado-Denver, 5Renal Section, Denver Veterans Affairs Medical Center

JoVE 52848


 Medicine

A Novel Surgical Approach for Intratracheal Administration of Bioactive Agents in a Fetal Mouse Model

1Molecular Virology and Gene Therapy, KU Leuven, 2Department of Woman and Child, KU Leuven, 3Neurobiology and Gene Therapy, KU Leuven, 4Division of Nuclear Medicine, KU Leuven, 5Biomedical NMR Unit/ MoSAIC, KU Leuven

JoVE 4219


 Medicine

Performing and Processing FNA of Anterior Fat Pad for Amyloid

1Department of Pathology, Medical College of Wisconsin, 2Current Address: Department of Pathology, Wayne State University School of Medicine Detroit Medical Center, 3Department of Neurology, Medical College of Wisconsin, 4Department of Medicine, Medical College of Wisconsin, 5Division of Neoplastic Diseases and Related Disorders, Medical College of Wisconsin

JoVE 1747


 Medicine

Advanced Animal Model of Colorectal Metastasis in Liver: Imaging Techniques and Properties of Metastatic Clones

1Department of Surgery, The University of Chicago, 2Department of Radiation and Cellular Oncology and Ludwig Center for Metastasis Research, The University of Chicago

JoVE 54657


 Cancer Research

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