This document provides guidance on performing an abdominal examination through inspection, palpation, percussion, and auscultation. It describes the techniques for superficial and deep palpation of the abdomen while assessing for organomegaly. Specific instructions are given for palpating the liver and spleen, including common examination methods to determine size, edge, consistency, surface, tenderness, and pulsation. Causes of apparent or tender hepatomegaly and huge splenomegaly are also listed.
The abdominal examination consists of four basic components: inspection, palpation, percussion, and auscultation. It is important to begin with the general examination of the abdomen with the patient in a completely supine position. The presence of any of the following signs may indicate specific disorders.
The abdominal examination consists of four basic components: inspection, palpation, percussion, and auscultation. It is important to begin with the general examination of the abdomen with the patient in a completely supine position. The presence of any of the following signs may indicate specific disorders.
The first stage of labor and birth occurs when you begin to feel regular contractions, which cause the cervix to open (dilate) and soften, shorten and thin (effacement). This allows the baby to move into the birth canal. The first stage is the longest of the three stages.
UG CASE PRESENTATION ON INGUINAL HERNIAAyesha Huma
I have added viva notes after this proforma for quick revision of important stuff asked in exam.
LINK FOR EXAMINATION VIDOES :
1. https://youtu.be/uO-w_9w5okI
2. https://youtu.be/Vc_ZH_-Oad4
The first stage of labor and birth occurs when you begin to feel regular contractions, which cause the cervix to open (dilate) and soften, shorten and thin (effacement). This allows the baby to move into the birth canal. The first stage is the longest of the three stages.
UG CASE PRESENTATION ON INGUINAL HERNIAAyesha Huma
I have added viva notes after this proforma for quick revision of important stuff asked in exam.
LINK FOR EXAMINATION VIDOES :
1. https://youtu.be/uO-w_9w5okI
2. https://youtu.be/Vc_ZH_-Oad4
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Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
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Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
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Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
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These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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4. Palpation
• Patient should have an empty bladder
• Patient supine, arms at sides or folded across chest -
avoid arms above the head as this tightens the abdomen
• Before you begin, ask the patient to point to areas of pain
and examine last
• Warm hands and stethoscope; avoid long nails; approach
slowly
• Distract the patient with conversation or questions
5. Superficial Palpation
•Always start palpation away from any site of
pain. Palpate systematically all abdominal
regions. Always observe patients face for signs
of discomfort.
•Superficial palpation:
•Using light pressure assess for tone, tenderness
and any obvious abnormalities
6. Use the flat of the
palmar surface of
fingers to palpate
through the
abdominal wall
7. Abdominal Regions
•Conventionally the abdomen is divided into 9
regions
•There are 4 dividing lines:
• Midclavicular (2) -vertical
• Subcostal - upper horizontal
• Trans-tubercular - lower horizontal
•Alternatively they can be divided into 4 quadrants
8.
9.
10.
11.
12.
13. Assessing muscle tone with
superficial palpation
• Gentle pressure applied to the abdominal wall should allow the
examiner to depress the anterior wall of the abdomen as the muscles
relax
• Contraction of the muscles underlying the hand as pressure is applied
is called “guarding” and may indicate some underlying inflammation
• A rigid abdominal wall, resisting any attempt to push back the
abdominal wall and usually not moving with respiration, indicates
underlying peritoneal inflammation and is called “rigidity”
• A marked, acute exacerbation of pain on sudden release of pressure
applied to the abdominal wall is called “rebound”.
14. Deep Palpation
•Deep!
•Using firm pressure to assess for deep
swellings/abnormalities
•Deep palpation must be done with the palmar
aspect of the fingers (get on the same level as the
abdomen)
15. Can be done using 1
or 2 hands. Making
sure not to push down
on fingertips
18. Examination:
• Upper border by Tidal Percussion.
• Lower Border:
1.Radial border of right hand: right MCL and ML.
2.Tips of fingers from down upwards in right MCL
and ML.
3.Tips of fingers of BOTH HANDS (Hutchinson’s
method) under costal margin.
4.Hooking method.
19. •Bimanual (for pulsations):
• One hand below right costal margin and
the other in the loin. Press by both hands
against each other and ask the patient to
hold his breathing.
• Put one hand on the left lobe and other
hand on the right lobe. Press down and
ask the patient to hold his breathing.
• Dipping in ascites.
• Scratch method (Macleod’s method):
scratch from right iliac fossa till right
hypochondrium with the use of stethoscope.
28. Causes of apparent hepatomegaly
•Ptosed liver:
•Emphysema
•Right pneumothorax
•Visceroptosis
•Reidel’s Lobe: unusual tongue of liver
(DD with GB mass or right kidney)
31. Some Pitfalls:
• If you find splenomegaly, it is enlarged more
than 3 times its normal size.
• Huge splenomegaly, if it cross umbilicus
VERTICAL or HORIZONTAL.
•Direct downward direction of enlargement: if
Malignant or traumatic.
32. Methods of palpation:
1- Tips of fingers from right iliac fossa till left hypochondrium.
2- If not found bimanual approach to support.
3- If not found palpate with the patient on his right side.
4- If not found stand on his left side and do Hooking: palpate under
costal margin.
5- If huge: feel it from left iliac fossa to feel its border and direction of
descend.
6- Try to find the notch on its ant. border.
7- Dipping in ascites.