There are three known companies providing capsule cameras as of June 2006. The originator, Given Imaging from Israel created the M2A Swallowable Imaging Capsule. Another company is MagnaChip and a third is Olympus medical. Cameras from all three companies transmit two images a second.
At the present time, the capsule camera is primarily used to visualize the small intestine. Whereas the upper gastrointestinal tract (esophagus, stomach, and duodenum) and the colon (large intestine) can be very adequately visualized with scopes (cameras placed at the ends of thin flexible tubes), the small intestine is very long (average 20-25 feet) and very convoluted. No available scope is able to traverse the entire length of the small intestine. The capsule camera travels through the length of the small intestine in about 4 hours, and wirelessly transmits two images every second to a receiver carried by the patient. The images are of very good quality, comparable to those from scopes. The test carries a high sensitivity and specificity for detecting lesions. The main uses today are for detecting the cause of gastrointestinal bleeding, and for inflammatory bowel disease, such as Crohn's disease.
Indications for Video Capsule Endoscopy
Use of VCE is now approved for the diagnosis of several GI conditions as well as for imaging of problems associated with the esophagus, when no contraindications exist. Indications include:
1. Detection of the source of obscure (microscopic) GI bleeding after conventional work-up such as endoscopy and small bowel series has been completed and has not revealed a source.
2. Assessment of the extent of Crohn's disease in the small bowel.
3. Evaluation of chronic diarrhea, as well as detecting small bowel tumors, assisting in the surveillance of small bowel polyps and premalignant disorders and detecting small bowel injury associated with the use of nonsteroidal antiinflammatory drugs.
4. Diagnosis of the esophageal mucosa, especially in relation to conditions associated with reflux problems
A new version of the capsule camera is available for visualizing the esophagus.
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An Otoscope or auriscope is a medical device which is used to look into the ears. Health care providers use otoscopes to screen for illness during regular check-ups and also to investigate when a symptom involves the ears. With an otoscope, it is possible to visualize the outer ear and middle ear.
Otoscopes consist of a handle and a head. The head contains an electric light source and a low power magnifying lens. The front end of the otoscope has an attachment for disposable plastic ear speculums. After inserting the ear speculum side of the otoscope into the external ear, the examiner looks through a lens on the rear of the instrument to see inside the ear canal. Many models have a detachable sliding rear window which allows the examiner to insert instruments through the otoscope into the ear canal, such as for removing earwax (cerumen). Most models also have an insertion point for a bulb capable of pushing air through the speculum. This puff of air allows an examiner to test the mobility of the tympanic membrane.
Many otoscopes used in doctors offices are wall-mounted, while others are portable. Wall-mounted otoscopes are attached by a flexible power cord to a base, which serves to hold the otoscope when it's not in use and also serves as a source of electric power, being plugged into an electric outlet. Portable models are powered by batteries in the handle; these batteries are usually rechargable and can be recharged from a base unit.
Diseases which may be diagnosed by an otoscope include otitis media and otitis externa, infection of the middle and outer parts of the ear, respectively.
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What are ganglia?
Ganglia are swellings that occur around joints, the most common sites being the wrist and ankle.
What causes ganglia and who is at risk?
The origin of ganglia is uncertain but they are probably caused by a breakdown of synovial tissue. This is the specialised tissue that lines most joints. It is smooth and produces a fluid (synovial fluid) that lubricates the joint, allowing it to move freely. This synovial tissue also lines the sheaths that surround tendons. Tendons are the tough, fibrous structures that connect muscles to bone. It is the breakdown of the synovial tissue of tendon sheaths that gives rise to most ganglia. This often occurs on its own but may be triggered by an injury.
What are the common symptoms and complications of ganglia?
Ganglia are among the most common lumps to arise on the body. They occur most commonly around the wrist but also along the fingers, around the ankle and on top of the foot. They are usually round in shape and vary in size from minute pin-head lumps affecting the fingers to pea-sized or larger lumps affecting the wrist or ankle. They are firm and rubbery in texture and may move freely under the skin. They are usually painless but the tiny ganglia that affect the fingers may be very tender. They are filled with a jelly-like fluid and can slowly increase in size, but they only rarely become very large. As ganglia are completely harmless, the most common cause for concern is how they look.
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Main Entry: HPIFunction: abbreviation
history of present illness
when writing HPI, look only at the symptoms/complaints pertinent to the diagnosis
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A-V MALFORMATION - A hemangioma, or arteriovenous malformation is a tangle of abnormal vessels that forms an abnormal communication between the arterial and venous systems. Most are developmental (congenital). If large enough, they may produce a shunt of sufficient magnitude to raise the cardiac output. AVM's may occur in the brain, brainstem, and spinal cord, where they may cause headaches, seizures, or bleeding (subarachnoid hemorrhage).
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Detect Cholesterol in the Eye
Interestingly, there are two eye conditions that can alert a doctor that a patient may have cholesterol problems. The first is called arcus senilis, which refers to a thin, white line circling the edge of the cornea. The whiteness of the line is due to the deposition of cholesterol and fat in the eye.
The second is called a Hollenhorst plaque, which is a piece of cholesterol that has broken off from a cholesterol deposit elsewhere in the body and lodged in the blood vessels of the retina.
Arcus senilis (or Arcus senilis corneae. Latin: senile bow) is a peripheral corneal opacity caused by a deposition of phospholipid and cholesterol granules in the corneal stroma (or substantia propria).
It typically appears bilaterally and symmetrically as a partial or complete whitish arc highly visible over the iris. It is most often found in the elderly, hence the name.
It can be a sign of disturbance in lipid metabolism, an indicator of conditions such as hypercholesterolemia, hyperlipoproteinemia or hyperlipidemia.
A unilateral arcus is a sign of carotid artery disease or ocular hypotony.
In younger individuals the condition is called Arcus juvenilis.
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Ophthalmoscopy is a test that allows a health professional to see inside the back of the eye (called the fundus) and other structures using a magnifying instrument (ophthalmoscope) and a light source. It is done as part of an eye examination and may be done as part of a routine physical examination.
The fundus contains a lining of nerve cells (the retina), which detects images seen by the clear, outer covering of the eye (cornea). The fundus also contains blood vessels and the optic nerve. See an illustration of the structures of the eye 
.
There are two types of ophthalmoscopy.
- Direct ophthalmoscopy. Your health professional uses an instrument about the size of a small flashlight with several lenses that can magnify up to about 15 times. This type of ophthalmoscopy is most commonly done during a routine physical examination.
- Indirect ophthalmoscopy. Your health professional wears a light attached to a headband and uses a small handheld lens. Indirect ophthalmoscopy provides a wider view of the inside of the eye and allows a better view of the fundus even if the lens is clouded by cataracts.
Traditional Snellen chart used for visual acuity testing. Illustration only; this is a scaled image and hence not suitable for vision testing.
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An examination of pupilary function includes inspecting the pupils for equal size (1 mm or less of difference may be normal), regular shape, reactivity to light, and direct and consensual accommodation. These steps can be easily remembered with the mnemonic PERRLA (D+C): Pupils Equal and Regular; Reactive to Light and Accommodation (Direct and Consensual)
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Ocular motility should always be tested, especially when patients complain of double vision or physicians suspect neurologic disease. First, the doctor should visually assess the eyes for deviations that could result from strabismus, extraocular muscle dysfunction, or oculomotor nerve dysfunction. Saccades are assessed by having the patient move his or her eye quickly to a target at the far right, left, top and bottom.
Slow tracking is assessed by the 'follow my finger' test, in which the examiner's finger traces an imaginary "H", which touches upon the six cardinal fields of gaze. These test the inferior, superior, lateral and medial rectus muscles of the eye, as well as the superior and inferior oblique muscles.
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Main Entry: oro·phar·ynx
Pronunciation: -
far-i
(k)sFunction: noun
Inflected Form(s): plural -pha·ryn·ges /-f
-rin-(
)j
z /; also -phar·ynx·es: the part of the pharynx that is below the soft palate and above the epiglottis and is continuous with the mouth
[oropharynx illustration]
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The uvula is a small mass of tissue hanging down from the soft palate, near the back of the throat. The word is derived from the diminutive of uva, the Latin word for "grape", due to the uvula's grape-like shape.
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Erythema is an abnormal redness of the skin caused by capillary congestion. It is one of the cardinal signs of inflammation.
It can be caused by infection, massage, electrical treatments, allergies, exercise or solar radiation (sunburn), any of which can cause the capillaries to dilate, resulting in redness.
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The sclera is the (usually) white outer coating of the eye made of tough fibrin connective tissue which gives the eye its shape and helps to protect the delicate inner parts.
In children, it is thinner and shows some of the inlying blueness.
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