Dr. Ebraheim’s educational animated video describes the Anatomy and Injury of the flexor tendons of the fingers. The ability to flex the fingers consists of a system of flexor muscles in the forearm and their tendons are inserted into the bones of the fingers. A flexor tendon injury can cause loss of flexion (bending) of the fingers or thumb. Anatomy •Flexor digitorum profundus tendon : inserted into the ditsla phalanx •Flexor digitorum superficialis tendon : inserted into the middle phalanx. These retinacular structures keep the flexor tendons in place during flexion of the fingers. A1,A2,A3,A4. A2 & A4 pulleys are necessary to insure efficient flexion of the fingers. Flexor tendon injury zones •Zone I: distal to superficialis insertion •Zone II: fibroosseous tunnel : A1 pulley to zone I •Zone III: carpal tunnel to A1 pulley •Zone IV: carpal tunnel •Zone V: prxiaml to carpal tunnel Testing for injury •Check the integrity of the profundus tendon : Kepp the PIP of the finger extended and see if the patient can flex the DIP. •Check the integrity of the superficialis tendon: keep the other fingers extended and then see if the patient can flex the PIP joint of the involved finger. •When multiple slips of the superficialis tendon are cut, identify the tendons properly. The superficialis tendons of the long and ring fingers are volar at the wrist. Flexor digitorum profundus tendon avulsion (jersey finger) •75% involving the ring finger •Minimal clinical symptosm •Get an x-ray for bony avulsions Leddy classification Type I •Tendon retraction into the palm •Re-insert the tendon into P3 within 7-10 days to avoid contracture and necrosis of the tendon •Neglected injuries: DIP arthrodesis, staged reconstruction. Type II •Tendon retraction to the PIP level, can be inserted up till 6 weeks. •May include a small bony fragment Type III Large bony fragment blocks proximal retraction FDP at the A4 pulley. Become a friend on facebook: http://www.facebook.com/drebraheim Follow me on twitter: https://twitter.com/#!/DrEbraheim_UTMC
ICD-10 Training | Initial Encounter vs. Subsequent http://www.cco.us/icd-10-cm-full-course-yt Q: [ICD-10 initial encounter vs. subsequent] If a patient had an injury and went to the ER for initial treatment and sutures were placed. When they came to our office for suture removal, would that be an initial encounter as it is the first time at our office with this diagnosis? Or would it be subsequent? A: I kind of went out on steroids and gave you a lot of additional information on this, because the answer is actually simple, so I added some extra stuff on there. Laureen: Oh! It looks like one of your lovely graphic ones. Alicia: It is and it’s got a lot of information on it, so I’m sorry. Laureen: That’s OK. Alicia: That means Laureen has to slide down as I’m talking. Read more here http://www.cco.us/icd10-training-initial-encounter-vs-subsequent-video/ Get more ICD-10 coding tutorial, ICD-10 training, ICD-10 certification, medical coding training, medical coding certification at http://www.cco.us/cco-yt
Help on Fracture Medical Coding http://go.cco.us/certified-physician-practice-manager-course Q: I am looking for help in fracture coding. Is there a good webinar? Suggestions? A: Well, first of all, I want you to know we’ve talked a lot about fractures because quite honestly, I just like talking about fractures. So, there are some YouTube videos already out there with comments about coding for fractures in ICD-9 and ICD-10 and you can find those on our YouTube channel MedicalCodingCert. [Ed. Note: http://youtube.com/MedicalCodingCert.] But now, if it’s something that you’re struggling with and you want a more broad webinar, absolutely we can do that for you. But this is really a broad question so I thought let’s break it down, let’s talk about the terms that you’re going to see often and those key terms are going to be with the fractures and the treatments that are involved. If you don’t know what the medical abbreviation for fracture is, it’s “Fx” and the medical abbreviation for treatment is “Tx.” The first term that you want to be aware of is open, an open fracture. What that means is bone is sticking out of the wound and that it broke through the skin. This doesn’t mean that the bone has to be exposed the whole time because sometimes the bone will pop out and then go back in, which is also additionally a very bad thing because it allows you to introduce outside organisms and infection into the bone, and if you didn’t know, your bones help produce blood cells, the bone marrow does, and if you get an infection in a part of your body, like the blood, it goes throughout the whole body because your blood goes throughout your whole body. Read more here: http://www.cco.us/help-on-fracture-medical-coding-video/ Get More Medical Coding Training, Medical Coding Course, Medical Coding Tips, Medical Coding Certification and CEU Credits at http://www.cco.us/cco-monthly-newsletter
ICD-10 Practice Question — Medical Coding Practice Test http://www.cco.us/icd-10-coding-training-certification-products-yt FREE ICD-10 Online Practice Exam http://www.cco.us/free-icd-10-cm-online-practice-exam-yt Q: ICD-10 Practice Question: I am having a little trouble on this practice question, maybe I’m only over thinking. Can you help? Thank you.” You know what, what an interesting thing is that you usually are over thinking it A 23-year-old male who previously suffered a metacarpal fracture of the left hand, 2nd metacarpal bone, as the result of a gunshot wound develops a non-union of the metacarpal. A: You know what, I honestly don’t know if I answered this. I don’t think I did. So, let’s talk through it. One of things that is different in ICD-10 than ICD-9 is when a person comes in for a sequela which is a late effect and this person has a late effect, it’s a nonunion of the metacarpal. And the metacarpal bones are in the hand, you have the carpals are the little square bones, and then the long bones in the hands are the metacarpals. Then you have the phalanges, then you have the digits; your phalanges are your fingers. So, the long bones that are between your wrist and that first knuckle in your hand that you can feel in there, those long bones, that’s the metacarpals. So obviously, this guy has an injury; he had a gunshot wound in the hand, and it developed a nonunion (the bones didn’t stay lined up). [Ed. Note: Definition of nonunion: failure of the ends of a fractured bone to unite.]
Dr. Oller talks about tuft fracture: diagnosis, treatment, follow up.
In this video I discuss what an open approach and percutaneous approach means in ICD-10-PCS, some examples of each, key terms/phrases that indicate which approach a procedure is, and some resources for more information on this topic. ICD-10-PCS Approach Terms: https://youtu.be/rd95oza4PHo OPEN Approach Procedures Open heart surgery: Spinal fusion surgery: https://youtu.be/4hdTrqxhxRI Removal of tumor on finger: https://youtu.be/y8ywxgRUzYs PERCUTANEOUS Approach Procedures Needle Core Biopsy: https://youtu.be/DMn1Su956Yg Needle Aspiration: https://youtu.be/WagpploVooM PTCA: https://youtu.be/FEYC4KLRU4w Insertion of Nephrostomy: https://youtu.be/0PFKjNBt9xM Knee Arthroscopy (Percutaneous Endoscopic Approach): https://youtu.be/pguNCtOwzEc Laparoscopic Cholecystectomy (Percutaneous Endoscopic Approach): https://youtu.be/ffoKThdqo4I
Have you ever suffered from an ingrown toenail? Then you know how painful it can be when the side of a toenail grows into the soft skin nearby. Though it usually happens to the toenails, a fingernail can actually become ingrown too. How does this happen? And what are some ways to take care on an ingrown toenail? An ingrown toenail can be caused by shoes that are too tight, nails not being cut right, a nail injury, or having uncommonly curved toenails. Also, people who have diabetes, or other health problems that stop the blood from flowing to the feet properly, are more likely to get ingrown toenails. Some signs of an ingrown toenail are pain that doesn’t stop, redness, and swelling. If not treated right away, onychocryptosis, or ingrown toenail, can lead to infection. This will be seen by redness and swelling around the nail, and pus and watery discharge which is colored with blood. There are ways to treat an ingrown toenail at home. However, if you already see signs of infection, go to a doctor, because an infection can spread and lead to problems. Warm Water Soak If you’re looking to lessen the pain, swelling, and tenderness brought on by an ingrown toenail, try soaking your foot in warm water a few times a day. - Fill a foot tub with warm water. - Soak your feet for 15- 20 minutes - Do this three to four times a day to help pain. Cotton Wedge Under the Nail After you soak your foot in the warm water, you can try putting a cotton wedge under your nail to make sure it grows above the skin. This will help the pain and let it heal faster. - Soak your feet in warm water and dry them very well. - Lift the nail carefully with a pair of tweezers that is not too sharp. - Put a small rolled up piece of cotton between the nail and skin. - To stop infection, use a new piece of cotton each time you soak your feet. Note: you may feel some pain in the beginning, but it will get better quickly. Make sure not to push the cotton roll more than the swollen skin lets. Epsom Salt Another good cure for an ingrown toenail is Epsom salt, or magnesium sulphate. It will help make the skin soft, so that it will be easier to bring out the ingrown toenail, and will bring down the swelling. - Fill a foot tub with warm water and put in one tablespoon of Epsom salt. - Soak your feet in the mixture for twenty minutes. - Take your feet out and dry them well. - Do this three to four times a week. Apple Cider Vinegar Apple cider vinegar is a good cure for ingrown toenail because it kills bacteria and brings down swelling. Also, because of the little amount of acid in the vinegar, it helps stop infection. Here are two different ways to use apple cider vinegar to cure ingrown toenail. Use either one until you feel they have worked. - In a small foot tub, mix the same amount of raw, unfiltered apple cider vinegar and warm water. Soak your toenail in the mixture for - Another way to do it is to soak only a cotton ball in raw, unfiltered apple cider vinegar and then put it on your toe. Leave it covered with a bandage for a few hours before taking it off. Hydrogen Peroxide Because hydrogen peroxide kills bacteria, it lessens the risk of an ingrown toenail getting infected. It also helps lessen the pain and swelling that come from an ingrown toenail. - Mix about ½ a cup of hydrogen peroxide in a small tub filled with warm water. - Let your foot soak in the mixture for twenty minutes. - Do this one to two times a day. Another thing to be careful of, is shoes. If your shoes are too tight, they can push the nail into the nearby skin. It’s better to wear shoes made of softer fabrics with more room for your toes. Women should try not to wear high heels, to keep pressure off the toes. Resource(s): http://www.health.harvard.edu/diseases-and-conditions/staying-one-step-ahead-of-toenail-fungus https://www.earthclinic.com/nail-fungus/apple-cider-vinegar.html The materials and the information contained on Natural Cures channel are provided for general and educational purposes only and do not constitute any legal, medical or other professional advice on any subject matter. These statements have not been evaluated by the FDA and are not intended to diagnose, treat or cure any disease. Always seek the advice of your physician or other qualified health provider prior to starting any new diet or treatment and with any questions you may have regarding a medical condition. If you have or suspect that you have a medical problem, promptly contact your health care provider.
An epidermoid cyst (Epidermal Inclusion cyst, Infundibular cyst), is a benign growth commonly found in the skin and typically appears on the face, neck or trunk, but can occur anywhere on the body. Another name used is “sebacous cyst” but this is actually an antiquated misnomer, and is not a term used by dermatologists. They are also the most common type of cutaneous cysts. Epidermoid cysts result from the reproduction of epidermal cells within a confined space of the dermis. The pasty contents are mostly composed of macerated keratin (wet skin cells), which creates this “cheesy” consistency, and there can be a pungent odor. An epidermoid cyst may have no symptoms and are typically harmless. Usually people seek removal but they don’t like the appearance of these bumps, or the cyst has ruptured or been inflamed or “infected” in the past. Rupture is associated with sudden redness, pan, swelling, and local heat, and can lead to abscess formation. Also, a history of inflammation, often increases scar tissue in the area, makes the cyst more firmly adherent to surrounding skin, and makes it more difficult to remove. Surgical excision is curative, but the complete cyst removal including the entire cyst sac and contents need to be removed to ensure that the cyst won’t reoccur. A Dilated pore of Winer is essentially a large, solitary open comedone/blackhead. Dead skin cells get trapped and help widen this pore, and plugs up the opening. The expression of this plug squeezes out the macerated, white, soggy keratin/skin cells from the deeper portion of the pore. Once the content of the dilated pore is expressed, this whole process of the dilated pore filling once again with keratin is common. They are completely benign and are usually expressed for cosmetic reasons. A comedone extractor can be used to do this. Subscribe to my Dermatology educational channel, Dr Pimple Popper University! Link is here: https://www.youtube.com/channel/UCvaD01Jb_ruxsAcVqVmTHzQ To buy your own Official Dr. Pimple Popper Comedone Extractor, click here: https://www.drpimplepopper.com/shop For more content, exclusive content, and of course to get more Dr. Pimple Popper schwag, visit us at www.drpimplepopper.com! Instagram: @DrPimplePopper for 24/7 pops @DrSandraLee for my work, my life, my pops Facebook: facebook.com/DrSandraLeeDermatology Twitter: @SandraLeeMD Snapchat: drpimplepopper Periscope: Dr. Sandra Lee You can watch my TV appearances here: https://www.youtube.com/channel/UCOixDRVQAsKe4STSuWU8U0Q This video may contain dermatologic surgical and/or procedural content. The content seen in this video is provided only for medical education purposes and is not intended to be a substitute for professional medical advice, diagnosis, or treatment.
A College Student's life is thrown into hell when she begins having growths come out of her head that look like fingernails, making her hair fall out. What is the cause? | For more go to http://www.discoverylife.com/tv-shows/diagnose-me/#mkcpgn=ytda1 Subscribe to Discovery Life: http://www.youtube.com/subscription_center?add_user=discoverylife
Surgery of the Foot and Ankle: http://astore.amazon.com/nichogiovi-20 Popular Running Shoes: http://astore.amazon.com/nichogiovi-20?_encoding=UTF8&node=2 www.DrGlass.org email@example.com Project Lead: Nicholas Giovinco Contributing Authors: Kristen Diehl Doug Doxey Resource Consultant: Kelly Powers Producer: Nicholas Giovinco A "Hammer-Toe" deformity, describes a pathological condition of abnormal or exaggerated contracture at the metatarsal-phalangeal and inter-phalangeal joints of the toes. This is mainly due to an imbalance between the muscular flexors and extensors as well as intrinsic interossei and lumbrical muscles within the forefoot. A hammer toe deformity may present as one of three morphological variations. A true hammer-toe deformity will exhibit dorsiflexion at the metatarsal-phalangeal joint and plantar flexion at the proximal interphalangeal joint. Whereas a mallet toe solely results from a plantarflexory contracture of the distal interphalangeal joint. A simultaneous combination of these two conditions is thus known as a claw toe. Clinically, a hammer toe may present with hypertrophic callosities on the plantar surface of the corresponding metatarsal head and the distal/plantar tip of the toe in addition to a painful corn over the proximal interphalangeal joint. A radiographic analysis of a hammer-toe deformity in the Anterior/Posterior or Dorsal/Plantar view will reveal a hallowed point or gun barrel appearance of the middle phalanx. Although conservative care may involve shoe modifications, padding, strapping, and custom orthosis; surgical reconstruction may be required to alleviate painful and immobilizing hammer-toe conditions. This surgical management of the hammer-toe deformity is performed by variable means of "Sequential Reduction." By this, a hammer-toe contracture is alleviated through various procedures in order to re-establish a functional position during active motion as well as rest. This process may include, a lengthening of the extensor tendons, followed by a resection of the extensor hood. An "Arthroplasty" may be utilized to increase useable joint space within the proximal inter-phalangeal joint by removing the head of the proximal phalanx. In more extreme deformities, a tenotomy of the flexor tendon may be utilized. This may be accompanied by a fusion of the joint itself, known as an "Arthrodesis," whereby the base of the middle phalanx and the head of the proximal phalanx are combined to form one continuous bone mass. By balancing the forces of plantarflexion and dorsiflexion at the joints of the toe, a Hammer-toe operation may result in a drastic improvement of the functional mobility of the foot and leg during gait. 2009 DrGlass.org firstname.lastname@example.org