#season09

[laybee104857ilyouo]

✨🧽SpongeBob hugs squidward✨🐙 in season09 ep199a sold!

[theblacklistbrsubs]

1ª episodio da 9ª Temporada legendado já liberado em nosso canal do telegram o link está na descrição da página. #theblacklist #subtitles #season09 https://www.instagram.com/p/CVYyIxurP03/?utm_medium=tumblr

[wetread]

Season 9 Case 6

Hx: survey CXR after MVA

Answer: Continuous Diaphragm sign of Pneumomediastinum 

The heart rests on the medial diaphragms, so normally they are silhouetted out. When we see them (blue arrows) it means there is air between the heart and diaphragm 

This can be seen with pneumomediastinum or pneumopericardium. 

 There is a more subtle lucency about the high left heart border (yellow arrow) which is also consistent with pneumomediastinum. 

These findings can be difficult to see on CXRs, esp when not involving the neck/axilla. 

Multitude of causes but besides penetrating trauma, my experience has been tracheobronchial barotrauma is very common.   

Boerhaave's always seems to come up so inquire for correct hx (wretching/vomiting ?pill stuck?) and for  pleural fluid. Esophagram still gold standard to r/o

FYI: There does seem to be an association of this with inhaled illicit drug use (marijuana, cocaine). Typically in young males, ?barotrauma from breathe hold and deep coughing (I hear ) Condition is generally benign but often gets big w/u to exclude more concerning etiologies.

[umlewis]

lewis hamilton with the mbe he was given by the queen at buckingham palace, london, england - march 10, 2009 📷 johnny green / getty

[umseb]

sebastian vettel at the fia gala, monaco - december 11, 2009 📷 fia / motorsport images

[azzzaell]

Valentina @allaboutvalentina i hope she likes it. I absolutely adore her. @rupaulsdragrace Yes sir I can boogie #allaboutvalentina #valentinadragrace #dragrace #rpdr #valentina #season09 #yessiricanboogie #rpdrs09 #dragqueen #queen

[burnt-remains]

Drag Race 09x01

Other all it was an amazing episode. However a returning Queen is an amazing chance and should always be awarded to a queen who did amazing and can show more. Cynthia is the rumored queen but what did she show on her first run through? She made a catch phrase based on her butt, which is odd and unusual and had three challenges to show her talents. She didn't win, nor stand out from all of the other queens that deserve another chance to win. She won Miss Congeniality, which she deserved. I just wish another Queen such as Laila who was eliminated early and didn't get to show even half of her talents. I don't know, I just don't like her returning. I want Max to return so badly buy that screenshot ain't her.

[theblacklistbrsubs]

Legenda oficial do 1ª episodio da 9ª Temporada #TheBlacklist já está liberada no site http://legendas.tv #TheBlacklist #theblacklistbr #season09 #subtitles #legenders #legenda https://www.instagram.com/p/CVYwV5LrxIj/?utm_medium=tumblr

[wetread]

Season 9 Case 5

Hx: Abdominal pain

Answer: Ischemic Bowel 

Fluid filled ?dilated bowel loops? YES

So they all look the same? No

Right abdominal loops (red) = thickened w/o enhancement vs those in the left abdomen (blue) which = early obstruction or ileus. 

 Surgery=necrotic bowel!   

Small Bowel Ischemia 

  -life threatening EMERGENCY!! 

- +wall thickening +/- dilation 

-absent enhancement (use other bowel for comparison) 

-bowel wall hyperdensity can be due to intramural hemorrhage (can  on non-con!) so I look at the mucosa 

-pneumatosis = infarction ( for PV gas!)

-CTA helpful to look for arterial etiology (majority) 

-Also venous occlusion, systemic hypoTN (shock bowel), trauma, obstruction (ie closed-loop). 

 -Don't forget this on non-con exams! UGLY segment of bowel +  lactate =  CALL SURGERY!! 

 Time = bowel = survival!!

[dashablog1990]

Dean Winchester 9x21 The scene where Dean was killing Abaddon. I hope that you like it.

Artist: Meg & Dia Song: Monster (DotEXE Remix)

[waveystore]

@futur SEASON09 “MW G Fit Striped L/S” Mocha & Forrest Green Now Available #futur #paris #waveystore #selectshop #skateclothing #supportyourlocal #everythingisart #三軒茶屋 #三茶 #茶沢通り (Waveystore) https://www.instagram.com/p/B125SV0gxpD/?igshid=1dht169r4oisv

[csggblogs]

Mr and Ms Onyx Crowns 2018

The search is over. The palace of Onyx is now ready to showcase their candidates to the upcoming glamorous battle of beauties and wit in CSGG crowns.  April 7th of 2018, Cavite Smart Guys Global had its event called Mr and Ms Onyx Crowns 2018. This is to select two pairs of candidates who will join the upcoming battle of all the palaces in CSGG. The lovely candidates had showcased their uniqueness on the said event, and that made it so well. Based on the assigned theme, it should be "Mardigras festival" but because of the shortcomings and financial capability, the theme had not been executed. Despite of the challenges, the palace of intimacy and desire proved their tagline "Wiser, Stronger and Crazier Onyx of CSGG" these new generation continued the event without having a single step back. They still produced 3 pairs to fight for the  titles. The program started with a very energetic and hot performance of their Duchess Fukuda Zaragosa who shared her sexy moves to the people of CSGG and to the people who were watching that night. Her palace must be proud of her! Of course, since the event was about Onyx, another performance have shared by their talented minister Joshie Zaragosa with his female-like singing talent. He deserves a round of applause! The night turned into hotter and fiercer when the candidates started to ramp on the stage and introduced themselves. We have Pia, Clouie and Gillianne Zaragosa fighting for the Ms Onyx crown on the other hand, we also have Cj, renz and Prince Nikko for the Mr onyx 2018. Additionally, the candidates proved that they were not just liberated but sophisticated too. They gave their relevant advocacy that will benefit the entire LGBT community. The said segment was thoroughly graded by the judges that night. It was well selected piece. And the search is over. Cj and Clouie Zaragoza brought the crowns of Mr. And Ms Onyx 2018 plus their own special awards. Cj got two special awards. Thus, Ms Onyx Clouie won a special award too,  every palace must have another candidates to join for the battle of palaces in CSGG soon. And there we have Pia and Renz Zaragosa as Onyx's first prince and princess. Another additional flavor of the event was the q and a portion that made the audiences alive from laughing. Loving the creativeness! The night was ended with a very energetic closing number when each palace of CSGG were required to perform their winning zumba moves. It was really fun!  Because of that, Zumba stuff was initiated and now ready to be part of every event that we have soon. Wiser, Stronger and Crazier generation of Onyx are now ready to bring back to the top! So palaces of CSGG,  be prepared and Good luck! Blogger: Franklin Zaragosa Onyx: Head Minister of Marketing & Ads #CSGGonyxCrown #LGBTproud #Equality #Mardigras #Season09

[theblacklistbrsubs]

Diego Klattenhoff e Harry Lennix no set de The Blacklist iem Madison Square Park Nova Iorque em 10 de setembro de 2021 (📷 rob.ordonez) #Theablacklist #listanegra #season09 https://www.instagram.com/p/CTuOLbfLboo/?utm_medium=tumblr

[wetread]

Season 9 Case 4

Hx: MVA, neck pain

Answer: Unilateral Facet Dislocation 

Normal L & R superior articular facets overlap/aligned to the C6-C7 where 1 is shifted anterior(red dash) 

 -Ant & post vertebral lines (green) ?ok 

-Spinolaminar line (orange)=broken

 -Poseriort spinous line (purple) = gap

Perched facet = subluxed joint with tip of inferior facet resting on tip of super facet of lower body 

Dislocated/jumped/locked facet = complete dislocation with inferior tip ANTERIOR to superior facet of lower body (thus "locked") 

 Get the CT and ALWAYS look for the fracture!

Unilateral jumped facets can be tough on X-ray as the vert body doesn't have to displace much (vert lines ok). 

ALWAYS look at spinolaminar & posterior spinous lines! 

 Facets = "shingles on a roof" 

 Any abrupt change/rotation should be concerning!

For completeness, here is a bilateral facet dislocation. 

ALL spinal lines disrupted. No rotation. Both inferior facets jumped and locked anterior to the superior facets of the lower body. 

 - MRI=diffuse ligamentous injury

- neurologically devastating

[crilag]

About Heaven Sent...

I

I CAN’T

WAIT

I

JUST

CAN’T.

IT’S NEARLY THE BEST DOCTOR WHO EPISODE I’VE EVER SEEN.

EXCUSE-ME, I’M GOING TO CRY IN THE CORNER OF MY ROOM. I COME BACK NEXT WEEK.

[bgabriela24]

😈🔥💀