STOP LETTING THOSE PENGUINS TOUCH THE CHICKEN'S HEAD!!!!!!!!!!!!!!!!!!!!!!

WHAT A WONDERFUL ANKLE N KNEE REPORT SCAN!!!!!!!!!!!!!!!!!!!!!

Patient history:

Patient is 21 years old male, a football player, complain of pain at the right ankle and left knee.


RIGHT ANKLE:

Anteriorly: Tibia-talus join - no effusion.

Laterally: Fibula-calcanium - no effusion.

Laterally & Medially: both menisci do not have effusion, intact and homogenous.

Posteriorly: - Tendoachilis is intact, no bursitis, calcaneal spur, or edema seen.


LEFT KNEE:

Anterior:
Patella - no bursitis
Suprapatella - quadriceps tendon - no fluid collection.
Infrapatella - no tendinitis, bone is intact with good surface.

Medially - the cruciate ligament intact.
- medial meniscus - no effusion, intact and homogenous.

Laterally - lateral meniscus - no effusion, intact and homogenous.

Articular ligaments are intact medially and laterally.

Posterior - No popliteal cysts noted. The lateral and medial head of the gastrocnemius do not have efusion.

I DONT KNOW IF IM REPEATING MYSELF!!!!!!!! ELBOW SCAN REPORT FOR THE WIN!!!!!!!

Patient history:
- Patient is a 45 chinese male with left elbow pain.
- He feels the pain during flexion and extension of his elbow and with physical pressing on the radial humeral joint.
- he has had no previous injuries or accidents to the indicated area.
- he is a site manager but claims that he seldom involved in heavy lifting
- no other apparent relevant clinical history noted.

Left elbow scan:
Anterior, posterior, lateral and medial aspects of the elbow were scanned.
All ligaments and tendons were visualized and intact.
No fluid collections was seen.
No tendon thickening was seen, no bursitis noted.

OMG COOTIES AND BOOBIES!!!!!! ULTRASOUND OF THE BREASTS REPORT!!!!!!

Patient history:
61 years old female came in for breast scan.
She complained of right breast pain.
She has hypertension and is under medication for hypertension.
She has family history of hypertension.

Ultrasound findings:
Normal breast appearance was noted on both breasts.
Normal parenchyma and stroma were noted.
No palpable lumps, mass or lesions noted.
No enlarged lymph nodes were noted.

YAY YAY YAY WE LURV THYROID REPORT SCANNING SCAN SCAN!!!!!! WHEE AT LASSSSSTTTTTT!!!!!!!!!!!1

PATIENT HISTORY:
A 26 years old Malay lady came for a thyroid scan. She had a painless swelling in her left neck region.
She does not have a family history of goiter.
She is not on any medication.

THYROID US Findings:
Right Thyroid
Normal thyroid lobe with homogenous appearance noted with the measurement of 1.20cm x 1.69cm x 5.82cm.
The color Doppler examination shows normal vascularity.
No nodules noted.
No lymph node noted.

Left Thyroid
Enlarged thyroid lobe with homogenous appearance noted with measurement of 2.26cm x 1.32cm x 6.44cm.
The color Doppler examination shows normal vascularity.
An oval nodule with homogenous echogenic content measuring 2.82cm x 1.55cm x 3.78cm was seen in the lower pole of the left thyroid. It had some peripheral and internal vascularity.
No lymph nodes noted.
Left and right thyroid lobes have similar parenchyma echotexture.

Isthmus
Normal thickness with measurement of 0.10cm.














Patient’s History:
30 years old Malay female came with an indication of palpable right anterior neck mass. Patient complained of palpable mass at the right neck region for 5 years. No family history of thyroid enlargement or diseases.


Right Thyroid
Homogeneous appearance with measurement of 5.15cm x 3.09cm x 3.12cm.
Lateral border of right lobe lie over the right carotid artery.
Well defined border thyroid mass noted at the mid to lower pole, measurement of 3.16cm x 3.97cm x 2.32cm.
There is mild to moderate increase in vascularity within the mass and peripherally to the mass.
There was no retrosternal extension.
No enlarged lymph nodes noted
No adjacent neck tissue pathology noted

Left Thyroid
Homogeneous appearance with measurement of 4.42cm x 1.19cm x 1.14cm.
Lateral border of left lobe lie over the left carotid artery.
There was no retrosternal extension.
Normal in vascularity in color Doppler examination.
No enlarged lymph nodes noted
No adjacent neck tissue pathology noted
No nodules or abnormalities noted

Isthmus
Appeared normal with measurement of 0.61cm

I CANT'T BELEIVE ITZ A KNEE AND SHOULDER SCAN REPORT!!!!!!!! (cannot use for all cases)

Patient history:
Patient is a 54 year old Indian male.
Patient had right shoulder pain at the AC joint when performing should external rotation.
Patient had left lateral aspect of the knee when performing squats.
Patient has not had any accidents or injuries that may have led to the pain in the indicated areas.

Shoulder scan:
Biceps tendon was normal.
Subscapularis was normal.
Infraspinatus was normal.
Supraspinatus showed signs of calcification.
No impingement was seen.
No effusion was seen.

Knee scan:
Suprapatellar bursa showed signs of fluid collection and bursa thickening.
Medial meniscus was normal.
Lateral meniscus was normal.
Articular cartilage of the knee was normal.

WOWZERS ITS A 3RD TRIMESTER TRI TRI GROWTH SCAN!!!!!

PATIENT HISTORY:
A 26 years old Malay lady with G1 P0 A0 came for a 3rd trimester scan. Her menses was irregular.
She does not have gestational DM and HPT.

LMP: 8/2/2009
EDD by LMP: 15/11/2009 (37w2d)
EDD by average U/S today: 21/11/2009
GA by average U/S today: 36w3d

Obstetrics Ultrasound Findings:
A viable singletone and intrauterine fetus was noted
Fetal is lying cephalic and longitudinally.
Placenta is in right lateral upper segment of the uterus.

Heart rate : 135bpm (within normal range)
AFI: 20.19cm (within normal range)
EFW: 2930gms
Umbilical artery RI: 0.65






Impression:
Growth scan done.
EDD by U/S today correlate with LMP.






CAN ALSO USE FOR 2ND TRI TRI TRIMESTER!!!!!!!!!!!!!!!!!!!!!!

ITZY BITSEE TEANY WEEENEE YELLAR POLKER DOT BAHKEENEE!!!!!!!!!!

What Chris does at home instead of preparing for his PBL...

Try JibJab Sendables® eCards today!

Stories for my Plumber - Trouble in the Loo

There was one fine day like any other when I was defecating in my toilet. As I was happily emptying my bowels I happened to glance up for no particular reason. And then I saw it - an infernal cockroach, perched on my bathroom wall in a twitchy yet serene manner. Now it wasn't a very big cockroach; I estimated it to be an infant, so its disgust factor was not very high. Nevertheless, the sight of such vermin lurking in the same room where I keep my toothbrush was not exactly a very comforting notion. Thus I made the conscious decision to not only extricate the creature from the premises, but also to inflict as much suffering upon it before it expires completely. I therefore proceeded to evacuate the last remnants of my fecal matter and stood up from the cistern. Then, carefully, using a piece of toilet roll, I gently grabbed the offending insect which, at my touch, twitched incessantly, which irritated me to no end. In fact, I was downright disgusted; repulsed even. Nevertheless, I strived to continue with my mission. I then dropped the cockroach from a considerable height into the middle of the toilet bowl. It was at this moment that I took the time to watch the heathen wallowing in unadulterated human waste. It gave me great pleasure to imagine the screams of total and utter despair being inflicted on my victim. For those of you who can't imagine it, picture your mother being submerged in a tank full of elephant dung from an elephant with severe gastrointestinal parasitic infestation. And it had diarrhoea too. And not the kind of clear, watery diarrhoea, but the sticky, goey, floccuous, viscous diarrhoea. Now imagine this on a cockroach. I hope you get the very idea. When my sadistic desires had been completely satiated, I bade my dear friend goodbye and depressed the toilet lever. Goodbye old friend. May you have a safe and pleasant journey. Thus ends Part 1 of my dramatic TOILET SAGA. (Excerpt from the memoirs of Lady Wellington of Eton Hall)

SUPER DUPER STANDARD NORMAL MEASUREMENTS!!!!!!!!

DOWN SYNDROME PENGUIN FTW!!!!!

LOLZ UPPER ABDOMEN, KUB RENAL, FEMALE PELVIC LOWER ABDOMEN, THYROID, 2ND TRIMESTER OBSTETRICS PROTOCOL

The Baseline Upper Abdominal Scan

· Fasted patient – 6 to 8 hours
· Determine patient clinical history.
· Explanation of procedure to patient.
· System configuration presets established
· Survey ROI for gross pathology – patient supine
· Examination must not be limited to just one patient position
· The standard images recommended below are to reflect the sonographers systematic approach for a complete assessment of the upper abdomen. These can be reduced or extended, depending on the pathology seen.

Images

· Scan through from the xyphoid to the umbilicus in transverse

· Pancreas : Trans may require multiple images
demonstrate CBD if possible
Sagt pancreas head
· Para Aorta : Long demonstrate the SMA branching
measure distal segment
· Liver : Trans left lobe – portal vein
right/left lobe – hepatic veins (playboy sign)
right lobe – right hepatic vein
right lobe – portal vein
right lobe – dome/high
Sagt left lateral lobe
lateral left lobe with caudate lobe (include IVC)
right lobe with whole diaphragm at level of GB
right lobe with whole diaphragm at level of right kidney
measurement : mid-clavicular
· Gall bladder : Long demonstrate neck and fundus
demonstrate in at least two planes and with patient in more than one position
Trans dual screen – neck and fundus
measure wall thickness at fundus (portion closest to the transducer)
· Common : Long proximal and distal portions
Bile Duct measure maximum diameter
· Right kidney : Long liver and kidney echotexture comparison
bipolar measurement (horizontal kidney)
must include both upper and lower poles
may require multiple images

Trans upper, mid (show renal pelvis) and lower poles
· Left kidney : as per right kidney
echotexture comparison with the spleen
· Spleen : Coronal measurement
Trans include splenic hilum

Scan through the gallbladder again with the patient standing upright.

Renal ultrasound

· Fasted patient – 6 to 8 hours
· Full bladder imperative
· Determine patient clinical history.
· Explanation of procedure to patient.
· System configuration presets established
· Examination must not be limited to just one patient position
· The standard images recommended below are to reflect the sonographers systematic approach for a complete assessment of the renal system. These can be reduced or extended, depending on the pathology seen.

Images

· Bladder
Sagt left and right lateral aspects (scan through)
Mid - measurement
Trans superior and inferior (scan through)
Jets
Mid – measurement
Male
Prostate
Mid-sagittal measurement
Trans measurement

Post mictuarition bladder volume

Female
Post mictuarition bladder volume

· Right kidney : Long bipolar measurement
Parenchymal measurement
include both poles – multiple images
include right lobe liver
Trans upper, mid and lower poles
· Left kidney : Long bipolar measurement
Parenchymal measurement
include both poles – multiple images
include spleen
Trans upper, mid and lower poles


Female Pelvic Ultrasound

· Explanation of procedure to patient.
· Determine patient clinical history
· Previous surgery – myomectomy, oophrectomy etc
· Children? How many? Para and Grava to be recorded
· LNMP ?regularity
· Oral contraception
· System configuration presets established
· Survey performed in both planes – must include both fossae
· The standard images recommended below are to reflect the sonographers systematic approach for a complete assessment of the upper abdomen. These can be reduced or extended, depending on the pathology seen.

Images

· Uterus : Sagt include bladder
Zoom in
right and left lateral views (scan through)
midline length and height
Trans include bladder (midline)
Zoom in
superior and inferior (scan through)
measure width
cervix – Nabothian cysts
· Endometrium zoomed sagt with measurement
Note stage of cycle
Align from vagina to fundus

· Right ovary : Long zoomed with measurements
Trans measurement
· Left ovary : as per right ovary

· Left and right adnexa

· Sagittal left and right kidney



· The scan may proceed to transvaginal if indicated.
· It is important to precede the transvaginal scan with all measurements and findings recorded from the trans abdominal scan. Improved image quality is not guaranteed on transvaginal scanning.
· Disinfection technique to be practiced.
· Patient consent necessary.
Thyroid ultrasound

· Hyperextend the patient’s neck by requesting the patient to lie in supine, placing the shoulders above a small pillow
· Determine patient clinical history.
· Explanation of procedure to patient.
· System configuration presets established
· The standard images recommended below are to reflect the sonographers systematic approach for a complete assessment of the renal system. These can be reduced or extended, depending on the pathology seen

Images

· Right lobe: Trans: Upper pole
Middle pole (measure width and height)
Lower pole

Sagt: Measure length
Assess vascularity with Colour Doppler

Scan through the right lateral neck along the neck vessels to identify the presence of lymph nodes. Document if seen

· Left lobe: As per the right lobe

· Isthmus: Trans: Measure height

· Whole thyroid gland



2nd Trimester Obstetric Scan

1. Fetal number
2. Assess fetal viability and position
3. Assess entire uterus and maternal adnexa
4. Cervix – length, open/closed
5. Placenta – localization, placenta edge (from os), placenta cord insert
6. Biometry – BPD, HC, AC, FL
7. Brain/head :
- Falx, Cavum septum pellucidum, Skull bone
- Lateral ventricles, choroid plexus
- Cerebellum, cisterna magna, nuchal thickness
- Orbits
- Nose & lips
8. Heart (assess whenever the fetus is in a favourable position):
- 4 chambered heart – heart position, axis, chamber size
- Intraventricular septum
- Mitral valve, Tricuspid valve
- Right and Left outflow tracts
- 3 vessel view
- Heart rate
9. Diaphragm
10. Stomach/situs
11. Cord insertion/abdominal wall
12. 3VC
13. Bladder
14. Kidneys (trans & sagt)
15. Spine (trans & sagt/coronal)/skin line
16. Limbs
- Upper and lower limbs (12 long bones)
- Hand & feet
17. Amniotic fluid volume
18. Reassess cervix before completing the examination

ADORABLE BABIE PENGOOINS!!!!!

SUPER KAWAII KUB REPORT!!!!!!!

Patient history:
A 44 years old Malay male came for a KUB scan presented with gout history.
Patient complained of middle lumbar pain for 1 month and frequent urination.
Patient had hypertension and under medication for 3 months.

U/S findings (KUB):
Right Kidney:
Right kidney appear normal in bipolar length and homogenous texture.
Contour appearance was irregular.
Corticol medullary differenciation is still preserved.
BPL length: 9.38 cm
Parenchymal thickness: 1.09 cm

Left Kidney:
Left kidney appear normal in bipolar length and homogenous texture.
Contour appearance was regular.
Corticomedullary differenciation is still preserved.
BPL length: 9.79 cm.
Parenchymal thickness: 1.25 cm

Bladder:
Bladder volume was 184.03 ml and post void volume was 25.15 ml.
Bladder jets were visible.
Patient is nil by oral (didn't drink) due to Muslim fasting month.
No other abnormalities noted.

Prostate:
Prostate volume was 6.87 ml.
Prostate appears normal in size.
Prostate contains echogenicity in the medial region indicating calcification.


Incidental findings:
Moderate fatty liver.
Hepatomegaly was detected with midclavicular length of 17.94 cm.
Multiple galls stones.
Slightly enlarged spleen with longitudinal length of 14.21 cm.

SUPER KAWAII REPORTING GUIDELINES!!!!!!!

Upper Abdomen

1. PANCREAS
Transverse and longitudinal scanning required, particularly in the head
Comment on:
The degree of visualisation particularly if suboptimal
Size of the head, body and tail
Parenchymal texture
Focal lesions: including soft tissue masses, cysts, and calcification
Pancreatic duct; calibre, contour and stones
Peripancreatic lesions; solid masses, lymphadenopathy and cysts
2. GALL BLADDER
Demonstrate in at least two planes and with patient in more than one
position (i.e. oblique and erect)
Comment on:
Intraluminal lesions; number, size, posterior shadowing and
mobility
Wall thickness (versus degree of distension)
Presence of mural gas or calcification
Distension - physiological, pathological
Point tenderness
Pericholeic collections
3. EXTRAHEPATIC BILE DUCT
Attempt to demonstrate the full length of the common bile duct and common hepatic duct.
Comment on:
Duct diameter - measured inside to inside, at level of portal vein bifurcation and more distally,
if the proximal measurement is at or above the upper limit of normal Duct dilatation - degree
and extent of dilatation, level of obstruction, regularity of calibre
Intraluminal lesions - number, size, echogenicity, posterior shadowing, and mobility within
duct
4. LIVER
Longitudinal and transverse views usually sufficient.
Comment on:
Adequacy of visualisation of the whole of the liver
Overall size, caudate lobe size
Borders - smooth, irregular
Parenchymal echogenicity, texture and attenuation
Focal lesions; number, size, location echo characteristics
Intrahepatic bile ducts
Hepatic veins, portal veins
Perihepatic collections
Right pleural space
5. SPLEEN
Size
Parenchyma - texture and echogenicity
Focal lesions - number, size, location, echo characteristics
Perisplenic collections, collateral veins
Left pleural space
6. KIDNEYS
Size - measure bipolar distance
Outline
Parenchyma - echogenicity cortex and medulla
Focal masses - number, size, location, cystic or solid
Collecting systems - hydronephrosis, prominent extrarenal pelvis,
dilated ureter, intraluminal lesions
Peri-renal and para- renal collections and masses
7. ADRENALS
Visualisation should be attempted
Size and texture if enlarged
Focal masses: cystic, solid, bilateral, unilateral
8. UPPER ABDOMINAL VASCULATURE
Demonstration of the upper abdominal vasculature is the key to upper abdominal anatomy.
The level of ultrasonic evaluation of the vasculature will depend on the clinical indication for
the scan. The following vessels should be identified.
Aorta
Coeliac axis
Superior mesenteric artery
Left renal vein
Inferior vena cava
Splenic vein
Superior mesenteric vein
Main portal vein and its branching pattern in liver
Splenic artery
Hepatic artery
Replaced right hepatic artery (common variant)
Hepatic veins
9. AORTA
Size: measure the outer AP diameter of the aorta.
Comment on:
Aneurysmal dilatation
Calcification, plaques and thrombus
Para-aortic masses; size number location
10. PERITONEAL CAVITY
Ascites
Loculated collections; size, site, echo characteristics
Peritoneal masses; size and site
Bowel wall: thickness, dilatation, peristalsis
Assess appendix.




KUB

Kidney - size
- Shape
- Margin
- Position
- Parenchyma thickness & echogenicity
- Cortico-medullary differentiation
- Central renal complex? hydronephrosis
- ? Focal lesions? renal calculi ? mass ? collection


Ureter ? hydroureter

Bladder - wall thickness and contour
- lesion?
- Urinary jet
- Pre-void volume
- Post-void volume

Prostate - size
- echotexture


Female Pelvic

the age of the patient
presenting symptoms
parity
menstrual history
last menstrual period (LMP),
any previous gynaecological surgery
any current hormonal treatment
results of any available hormonal tests for pregnancy
FAMILY PATHO HISTORY ON PELVIC

Uterus - size, shape, position, mobility
- endometrium - thickness, B mode appearance, classification, vascularity,
intracavity masses and if present their mobility.
- myometrium - masses (size, number, echotexture, vascularity, position,
particularly in relation to the endometrial cavity)
- serosal surface - any masses as above
Ovaries - positive identification of both ovaries and location
- size, echotexture
- follicles, cysts, solid masses
- mobility and tenderness
Adnexa - masses, characteristics
- free fluid
Kidneys - position, exclude hydronephrosis

EVALUATION OF MASSES
- site of origin, relationship to uterus and ovaries
- dimensions
- borders (well defined, irregular, poorly defined, thick walled)
- cystic, solid, mixed, loculated or septated
- contents of cysts
- echogenicity and architecture of solid areas
- vascularity
- mobility



Scrotum

TESTIS
- size
- echotexture (compared with contralateral testis)
- capsule
- mediastinum testis (location to assess rotation)
- vascularity
- appendix testis (seen in the presence of a small hydrocoele)
EPIDIDYMIS
- assess head, body and tail
- size
- echotexture
- vascularity
- appendix epididymis (occasionally seen if hydrocoele is present)
OTHER SCROTAL ANATOMY
- spermatic cord
- tunica vaginalis
- scrotal wall
EVALUATION OF INTRATESTICULAR MASSES
- dimensions
- borders (well defined, irregular, poorly defined)
- cystic, solid or complex
- echogenicity compared with normal testis
- vascularity (if colour Doppler is available)
EVALUATION OF EXTRATESTICULAR MASSES
- hydrocoele, haematocoele and pyocoele
- varicocoele (size and location)
- scrotal hernia
- epididymal lesions (cyst, spermatocoele, acute inflammatory mass, granuloma, solid tumours)



Breast

Assess:
Size
Shape:
a) Ellipsoid
b) Taller than wide
Margins:
a) Spiculated
b) Angular
c) Branch extension
d) Duct extension
Lobulations:
a) Number
b) Characteristics, gentle or microlobulations
Shadowing
Echogenicity:
a) Markedly hypoechoic
b) Hyperechoic Calcification
Capsular thickness



3rd Trimester OB

The last menstrual period (LMP) or previously calculated estimated date of delivery (EDD) and
previous obstetric history should be noted. It is often useful to review any available ultrasound
records. The indication for the examination should be carefully considered and the examination
targeted to answer the clinical problem.
1. Fetal number, presentation and lie
2. Fetal cardiac activity
3. Measurements of fetal size
4. Fetal anatomy,Pelvis-3,5,10mm
5. Fetal wellbeing
6. Placental localisation
7. Amniotic fluid volume,<2cm >8cm,8-22cm
8. Detection and evaluation of maternal pelvic or adnexal masses

WTF LOL BBQ ITS DA PELVIC REPORT!!!!!

Patient history:
Patient is a 33 year old Indian female with 1 child and 1 prior miscarriage. Her only child was born via Caesarian section.
Her LMP is estimated at 13/8/2009. She has regular menses.
She complains of intense rectal pain during menses in the last 5 months.
She had an IUCD removed 5 months ago.


Ultrasound Findings:
Uterus had homogenous echotexture with a well defined border. No mass or cystic structures were detected
She had an anteverted uterus with measurements:
Uterus length:7.73cm
Uterus height:2.10cm
Uterus width :6.63cm
Endometrium thickness: 0.93cm

Right ovary volume was 4.95cc
Left ovary volume was 4.95cc

No mass or fluid collection was found in right and left adnexa.

No evidence of hydronephrosis noted in left and right kidney.

Stories for my Plumber - Why Seals are Stupid

Seals are stupid for many reasons. The main reason is that they are the most tiny brained creatures to have ever inhabited the earth. This makes them the most stupic things ever!!!! I hate those stupid mother f****** seals!!!!! Why do they even exist on this planet??? Nobody likes them!!!! They are PURE EVIL!!!!!!!! We should just create a law where you would get a million zillion dollars every time you shoot those f***heads in the ass!!!!! Then everybody would get out of their f****** houses, grab their f****** guns, and blast those sons of b****** out of this world!!!

LOLZ its da babanahs is pahjahmahs!!!!!!

I HEART PENGUIN MEGA LOLZZZ

21/8 friday scanning schedule

1. sherine
2. sathya
3. chris
4. pei siah
5. li ern
6. cia yee
7. yea theng*TIC*
8. jamie
9. szu hing
10. siti
11. for hae
12. lucy
13. sherine

ZOMG cool penguin!!!!!!!

abdomen and pelvic report template

Patient's history:
A 34 years old Chinese female patient came in for upper abdomen and pelvic ultrasound scan. She complained of abdominal pain at right lumbar region for two years before seeking medical attention. She has regular menses and has had no children before. LMP 9/8/2009

UPPER ABDOMEN

(1) Pancreas
The pancreas has a homogenous in echotexture. Head and body of the pancreas are seen. No evidence of mass or cystic structures in pancreatic head.

(2)Aorta:
The diameter of aorta measured was 1.65cm and no echogenic foci or plaque was detected.

(3)Liver:
Liver appeared homogeneous in echotexture with mid-clavicular measurement of 11.74cm.

(4)Gallbladder:
No abnormalities detected in the gallbladder.
The gallbladder wall thickness fall within normal range with measurement of 0.12cm. Bile duct is seen with no dilatation noted and measured 0.23cm.

(5) Kidneys
Bipolar length Right kidney: 8.81cm.
Bipolar length Left kidney: 9.32cm.
Both kidneys appeared normal in size and echotexture and their borders appeared normal and regular.

(6) Spleen
The size of spleen measured was 7.94cm. It had fine homogeneous echo-texture pattern.


LOWER ABDOMEN

Ultrasound Findings:
Uterus had homogenous echotexture with a well defined border. No mass or cystic structures were detected
She had an anteverted uterus with measurements:
Uterus length:6.16cm
Uterus height:2.10cm
Uterus width :6.03cm
Endometrium thickness: 0.91cm

Right ovary volume was 4.01cc
Left ovary volume was 6.86cc

Left ovary had a prominent follicle

No mass was found in right and left adnexa.

No evidence of hydronephrosis noted in left and right kidney.

INCIDENTAL FINDINGS
Colloid cyst with septations and two crystals with comet tail artifacts measuring 0.82 x 1.09 x 0.50 cm was found in right middle pole of thyroid gland. No vascularity was found within the cyst.

Stories for my Plumber - Final Words of a Cornered Madman

What is the meaning of our existence? That that exists must not not exist, and therefore, exist. We stumble through our lives confused, convoluted and confuddled and yet manage to survive the onslaught of trials and tribulations awaiting to crucify us for every single mistake. The durability of the human race is an inevitable result of our millennia of exposure to the harsh realities of the planet that does not want us living on it, and thus, it is time that we stand up and take a stand. We shall destroy all those who stand in our way, and the army of gaia shall not inhibit our progress no longer. Have you not tired of battling chaotic weather conditions, beastly creatures of all nature of hell, poisonous excretions of abominable flora and endured the vilest and most obnoxious terrain most unsuited for habitation? Have we forgotten that we, humans, are superior to anything that lives and breathes air, and anything that doesn’t? Is it not true that regardless of the respective communities and populations that dominate each landscape, it is the human race that conquers all? Yet now we wallow in despair, allowing our weakness to permeate our subconscious minds, while deluding ourselves that we are strong and powerful and dominating. Show yourself! Let your inner force flow freely through the dark fog of misinformation concocted by those who would cage your mind! Find your strength to exist once more, and regain your taste for blood…

OMEGA CUTENESS!!!!!!!!!

LOL winking owls 2 da max!!!!!!!

OMG it's the pediatrics presentation topic!!!!!!!!!!!!!!!!!!!!!!!!!

2. Ultrasound assessment of the infant spine requires and understanding of bony and soft tissue anatomy of the spine.
Visualization of the spine is best achieved during infancy
In light of this, discuss the sonographic technique and normal sonographic anatomy of the spine
X 2

Gaga for Kermit!!!!!!!!

Daddy penguin & Baby penguin is Super Kawaii!!!!!!!

Hoot is kawaii!!!!!!

Kawaii!!!!!!!!!!!!!!!!!!!!!!