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The Zipper-Release Myth

Video Author: Larry Mellick, MD
Published on: 07.23.2013

Dr. Mellick’s suspicions smoldered for years; he even thought the problem resided with his technique. But one patient made him realize that the textbooks were just wrong: Wire cutters were not going to release a zipper from penile skin.

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his video shows a lung point, the transition between normal lung sliding and pneumothorax. Christine Butts, MD, says note the sliding motion on the left of the image and the lack of sliding on the right. Read more in her column at http://bit.ly/SpeedSound.
Creator: Christine Butts, MD
Duration: 00:04
This video shows a lack of sliding, says Christine Butts, MD. Note also the absence of comet tails because the visceral pleura is not visible here. Read more in her column at http://bit.ly/SpeedSound.
Creator: Christine Butts, MD
Duration: 00:06
This video demonstrates the “slide sign” in which the visceral and parietal pleural layers slide past each other. Christine Butts, MD, says also note the comet tails, the short vertical lines emanating from the pleural layers that appear and disappear with movement. Read more in her column at http://bit.ly/SpeedSound.
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Creator: Christine Butts, MD
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This video shows the apical four-chamber view where the RV and LV are the same size. But Christine Butts, MD, and Shawn Sethi, DO, say the RV should be no larger than two-thirds the size of the LV, and the arrow indicates the area in which McConnell’s sign occurs. Read more in their column at http://bit.ly/SpeedSound.
Creator: Christine Butts, MD
Duration: 0:04
Christine Butts, MD, says the finding of a lung point, or the point at which the parietal and visceral pleural layers come back together (and the pneumothorax stops), can be demonstrated to confirm further that the lack of sliding is caused by a pneumothorax, not another process. Note the sliding on the left side of the image, which disappears on the right. Read more in her column at http://bit.ly/SpeedSound.
Creator: Christine Butts, MD
Duration: 0:04
Christine Butts, MD, says when air is present between the visceral and parietal pleura, as in a pneumothorax, the visceral pleura is obscured by the air, and only the static, nonsliding parietal pleura is seen. Read more in her column at http://bit.ly/SpeedSound.
Creator: Christine Butts, MD
Duration: 0:06
Christine Butts, MD, says a high-frequency transducer is typically used to evaluate the pleura when looking for a pneumothorax. When the visceral and parietal pleura are in contact, they can be seen to slide against each other as the patient breathes in and out, as seen in this video showing lung sliding in the absence of a pneumothorax. Note the rib, with shadowing on the left of the image. Read more in her column at http://bit.ly/SpeedSound.
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Duration: 4:03
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Duration: 3:56
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