Sensational Sphincters Operation Ouch!

-He's Dr Chris.

-He's Dr Xand.

-Yes, he's still got his beard.

-And we're still identical twins.

Your body's amazing. And we're going to show you why.

We're head to head in Operation Takeover...

Man overboard!

Ouch and About hits the wards...

What kind of ambulance did you get?

I didn't get an ambulance. I got an helicopter.

There are more first-aid tips...

We do need to get Xand to hospital.

..meet our new brilliant Ouch! patients.

Hello.

And our lab experiments will...

..blow...

..your...

..mind!

That is an amazing view.

Are you ready to join us?

Well, it's lucky I was wearing my swimming trunks today.

-Coming up today on...

-Super Xand!

..Operation Ouch!.

We're in for the chop...

As they say, it'll always grow back.

Things get snappy...

Looking at it, I think you've broken the bones.

And we get a bum deal.

Oi, brain, I need the toilet!

But first...

..Chris, Chris.

Apparently there's a new case in the emergency department.

That's all right, Xand, the medical team there have got it covered.

-Oh! Well, phew!

-Phew.

Over in Sheffield, 12-year-old Uzair is waiting with his dad.

What have you done, fella?

-I fell on my arm.

-You fell on your arm?

Yikes, Chris, look at that. What happened?

It was home time,

and Uzair was standing on the street

outside the drama classroom.

Ooh! Had he just come out of drama class?

I wonder if he'd been acting like a tree.

Or perhaps he'd been miming.

Or learning Shakespeare.

"To be or not to be, that is the question!"

Enough of the theatrics, Xand. Uzair hadn't been DOING drama.

"My! Hadst he not?!"

No, he just happened to be standing outside the drama classroom.

Everyone was in a rush to head home

when all of a sudden, he tripped and fell on his arm.

BOTH: Ouch!

Now, that's what you call a bump.

Ready to remedy a rickety wrist

is consultant Sally Gibbs.

Uzair is given an anaesthetic nasal spray to ease the pain.

Then it's time to check the movement in his wrist and hands.

Does it hurt at all across your hand?

-Feel there.

-Yeah, yeah.

-We need to get an X-ray.

Looking at it, I think you've broken the bones.

Get ready for your close-up, Uzair.

All finished.

So, consultant Sally, what's the plan?

So, he has definitely broken the bones in his wrist,

on the radius bone.

That bit should be sitting on top of that part.

Uh-oh! Time to tell Uzair the news.

There's a break across the bone.

And if you imagine the bone's like a long tube,

and the end of it has just been knocked off sideways.

We need to get that back in place

so it can heal.

I think it is going to need a little operation to...

-Just to put it right.

-Back where it should be.

Before his operation

he'll need a temporary cast to keep him comfortable.

I'll take his jacket off so we can get to his arm to cast it...

Oh, no - Uzair's got to have his favourite coat cut off.

But don't worry, everyone's going to take a photo so you don't forget.

How many more pictures could we have of you?

Put the phone down, Dad, it's time for Uzair's operation.

Find out later how he gets on.

And now to our lab!

It's time for some Big Body Experiments.

Some of them gory...

This is not for the squeamish.

Some extreme.

It's freezing!

So, are you ready?

Just don't try anything you see here at home.

Take a look at Chris's eye.

This is one of my favourite views of the human body.

What you're looking at there is his iris,

that brown-coloured ring, which is incredibly beautiful up close.

And in the middle of it is the pupil.

And the pupil is the hole where light enters the eye.

The iris is constantly twitching

and contracting to regulate very

carefully the amount of light going into the eye.

So if I shine a torch into Chris's eye,

you can see how much the bright light

affects the diameter of his pupil.

There you go, look at that.

Look at how much it tightens up,

to prevent too much light getting into his eye.

And then, as I take it away,

the pupil gets much larger again. Look at that, relaxing.

And the muscle that controls all of that

is the sphincter pupillae muscle in Chris's iris.

Let's have a look at another ring of muscle

that joins your oesophagus, or food pipe, to the stomach.

Um... OK, I suppose so.

If you could wrap your mouth around the slit lamp.

Xand, I'm not going to swallow the slit lamp.

-I mean, we can use the image on the computer.

-Oh, yeah.

This is my oesophageal sphincter.

It's at the entrance to my stomach.

And just like the one in my eye, it's a circular ring of muscle.

Now, you have over 50 types of sphincter in your body,

and they all open and close holes to let things through.

Sphincters regulate light, blood, air,

food, saliva, enzymatic fluid,

mucus, poo,

bile, urine, poo -

you name it, sphincters regulate the flow of it.

-That was an impressive list.

-Did I mention poo?

-Yes, twice.

The point is, there are far too many individual sphincters to count.

You find them everywhere -

even regulating blood flow through tiny vessels.

And they mostly work without you ever knowing about it.

In fact, there are only a few

that you have any conscious control over at all,

including two very important ones in your...

Xand! I don't think we can talk about THOSE sphincters.

Why not? Because they're in your...?

I know where they are, Xand!

I just don't know if we're allowed to mention them.

Have you cleared this with whoever's in charge?

I'm in charge. This is Operation Ouch!.

And there's nothing we won't talk about.

You know what, Xand? You're right.

We're going to show you the two amazing sphincters

that help you go for a poo.

This is not for the squeamish.

Xand, your pig's bum.

YOU'RE a pig's bum!

What? No, this is your pig's bum that you wanted me to dissect,

-so we could look at the anal sphincters. Remember?

-Yeah.

Well, in that case, come and have a look at this.

Now, this is a pig's bum, but it's a lot like yours.

In the middle here,

you can see this is the pig's bum hole, or anus.

And around it we've cut away the skin

to expose this ring of muscle.

This is the external anal sphincter.

And underneath it, there's another ring of muscle a bit like it

called the internal anal sphincter.

And these rings of muscle

are naturally tense, or contracted.

And what that means is that the poo,

which is stored in the rectum here,

doesn't leak out the pig's anus.

Which is good. Because no-one wants poo running down their leg.

That's right, absolutely no-one.

No-one!

Now, together, these muscles are how you know when to go for a poo.

And we're going to show you how.

I'm excited about this, Chris!

This is the Sphinctermatic 8.0.

8.0? What happened to the other seven?

Well, let's just say the lab got a little messy.

Anyway, this is to demonstrate

how your internal and external sphincters work.

These tubes represent your colon,

and rectum, where your poo is stored.

And the internal

and external anal sphincters.

-Right, Chris, you've got a bowl of poo.

-Eurgh!

Put it in the colon.

Come on, come on, we haven't got all day.

Come on. Fill it up.

There we go.

Good job. So now the rectum is full of poo,

some of the poo is touching the internal anal sphincter,

and that causes it to relax.

This lets a little bit of poo through, which touches the nerve

endings in the external anal sphincter,

which sends a message to the brain saying,

"Oi, Brain, I need the toilet!"

It's important to say that your brain can tell your external anal

sphincter to stay closed for little bit,

but don't hold the poo for too long or it could make you constipated.

Right, come on. We're on the toilet, you sit down,

you un-kink your colon. Lots of muscles relax,

including the external and internal anal sphincters.

And then the rectum squeezes, with peristalsis, all that smooth muscle,

and the poo can start to go into the toilet.

Good job.

All done -

and you can go about your day.

-Finished!

-TOILET FLUSHES

So, we've shown you that sphincters are rings of muscle

that open and close holes to let things through.

And you've seen that they control all sorts of actions in your body,

from how much light enters your eye

to when you can go to the toilet for a poo.

And what's amazing about those nerve endings in your external anal

sphincter is they can tell the difference

between solid poo, runny poo,

-or if it's just a...

-PHH-RRR-RT!

Was that you?!

No... It's the Sphinctermatic 8.0 playing up.

I'd better get to work on version 9.

We're both Ouch and About!

Chris is hitting the wards with his Ouch bleeper.

Apparently you've got a question for me. It's pretty cool, isn't it?

And I'm hitting the streets to answer your medical mysteries.

Awesome!

In the hospital, Chris is extremely busy doing his homework.

I did it!

Come on, jump to it.

It's a message from Olivia. She's had an operation on her arm.

Olivia, hi.

Hi.

-Apparently, you have a question for me.

-Yes.

Why did they have to cut into my arm?

What's the diagnosis, Doc?

So it sounds to me like you have a case of...

You're out on a LIMB with this one.

So tell me what happened.

I fell out of bed and I broke my arm, just above my elbow.

-What happened next?

-I had no pulse in my arm.

So you didn't have a pulse in your wrist.

And that can be really serious.

You have a big bone here connecting your shoulder to your elbow.

That bone's called your humerus. And you have blood vessels

running down your arm,

and then you can feel a pulse at the wrist.

But if you break this bone,

it can hurt the artery here,

and cut off the blood supply to the hand.

So the surgeons fix the humerus,

and then the blood will flow nicely down your arm,

supplying all these muscles and the muscles of your hand.

Well, I think you have earned an Ouch! sticker.

-OK, nice to meet you. Bye.

-Bye!

Meanwhile, I'm out on the street,

hunting down quirky queries.

Hello, Matthew! Have you got a question for me?

When you're exercising,

your muscles use oxygen and a fuel source,

which is usually sugar,

so your muscles can get tired if they run out of oxygen

or they run out of sugar.

But if you're lifting a very heavy weight, you get other things

building up in the muscles, like lactic acid, and they can hurt.

So it depends on what kind of exercise you're doing.

-What sort of exercise do you normally do?

-Press-ups.

-Oh, right, how many can you do?

-Five. How many can YOU do?

200. Show me.

I want to see this.

Great question, Matthew.

But you need to train your muscles a bit more, Xand.

I'd like to see you do better, Chris.

Sorry, I'm far too busy.

I've got a call from Alfie.

He's just had an operation to remove his appendix.

-Hi, Alfie.

-Hi.

What is your question?

How does your appendix work?

What's the diagnosis, Doc?

So it sounds to me like you have a case of...

Over to you, Chris.

So, Alfie, you have a tube, and YOU have a tube

as well, that connects your mouth to your bottom.

It's called your gut.

And that gut digests food and then turns it into poo,

which is the stuff you don't need.

But dangling off a little bit of your gut

is a finger-like dangly bit,

and that is your appendix.

And most people think it doesn't really do very much.

It might store bacteria that help you digest your food,

but you can live perfectly well without it

and we know that because in a lot of people it has to be removed.

Alfie, what happened to YOUR appendix?

-It erupted.

-It erupted?

-Yeah.

-If the opening of the appendix into the tube of your bowel gets

blocked, then it gets infected, and then it can burst.

Alfie, did I answer your question?

Yeah. Great. Well, I think you have earned an Operation Ouch! sticker.

-Thank you.

-See you soon.

-Bye!

Job done for today. Clinic closed.

Back in the emergency department,

Uzair is getting surgery for his broken wrist.

Let's go see how the doctors do it. Come on!

Wait for me.

Earlier, Uzair came into the emergency department

with a lumpy limb.

Everyone was in a rush to get home at the end of school

when Uzair tripped over, falling on his arm.

Ouch!

X-rays revealed the radius bone in his arm was totally skew-whiff!

He's been given an anaesthetic,

so he'll be asleep for the operation and

won't feel a thing. Leading the operation is surgeon Mr Owain Evans.

First, Uzair's arm is pulled in opposite directions

to pop the bone back into place.

Next, the bones are pinned back together.

One surgeon holds Uzair's wrist in place...

Here comes a gross alert.

..while the other drills in two pins into the middle of his radius bone.

They keep the bones perfectly straight while they heal.

Finally, a cast is put on.

And the next morning, our patient is looking chirpy.

-How are you feeling, fella?

-Yeah, I feel better.

Thank goodness. And it looks like you can head home.

See you later, Uzair.

BOTH: Bye!

Still to come, it's getting a bit hairy.

I didn't cut off any ears. There's no blood.

We're a sight for sore eyes...

It's really itchy.

And it's a jungle out there!

Sort of like a caterpillar that lives in water.

But first...

Did you know that when your hair gets wet,

the water temporarily breaks some of the bonds

between the protein molecules in each strand?

This means wet hair

can stretch up to 30% more than normal.

Wow!

Amazing people do lots of important jobs inside and outside hospitals

that help to keep you safe. But what will happen when WE have a go?

I feel a bit silly.

This...is Operation Takeover.

Can you guess who today's hero is? Well, I'll give you a clue.

They might use some of these.

-They're a gardener.

-No, Xand.

You might find them using some of this.

Oh! Well, they're definitely a gardener.

No, Xand. OK, last clue.

They often use this stuff.

Are they the head gardener?

Well, I...suppose they are, in a way. Did you guess it?

We're about to take over the job of today's hospital hero,

volunteer hairdresser Andrew.

He's the top stylist for the patients

at the Chelsea and Westminster Hospital in London.

Probably not many people think of hospitals as having

hairdressers. Why do you need a hairdresser in a hospital?

I just think, a bit of normality in the midst of everything that they're

going through is just so important. So, getting a haircut.

Some people have not had their hair washed for days or weeks

or months. And the guys haven't had a shave.

So, not being able to do that must be so frustrating.

One person in need of Andrew's services is 16-year-old Nailah,

who's desperate for a quick trim.

The important thing for me is, I want your hair to look great

but I want you to be comfortable.

So, are you OK to stand while I cut your hair?

-Yeah.

-Would that be all right?

So, Nailah, is it good that there's a hairdresser on the hospital?

I was actually quite shocked.

But it's nice to have, you know...

especially if you have been here for, like, a long time.

Tell us a bit about the technique of what you're doing.

OK, so I'm just cutting it, getting all the dead ends off.

I'm cutting a couple of inches off.

And I'm just keeping it one length.

Just keeping it really neat and really classic and simple.

A few more snips and nips later, and Nailah's ready to go.

Let's have a look... Just feels better, as well.

You looked great when we arrived, but you do look even better now.

Absolutely.

Thank you!

We've seen just how important and challenging

the job of being a hospital hairdresser really is.

That's right, Chris. And I am really looking forward to this challenge

but I'm a little worried we might not make the CUT.

Get it? Like the haircut, like the scissors...

It's time for us to take over as hospital hairdressers.

Andrew, what is our challenge today?

I've got two volunteers who want their hair cut and styled.

Are these sort of dummies wearing wigs or are these real human beings?

No, these are real people with real hair,

so they will be a bit nervous about cutting too much off.

They know how they like to wear their hair so that's

all part of the challenge.

No pressure, then! Yikes!

We're going to be judged on consultation -

speaking to the client and asking what they want done.

Technique - how we cut and style the hair.

And the presentation - the final look,

and making sure the client is happy. Eek!

Uh-oh, I feel slightly worried for our two very brave volunteers,

Lizzie and Cassie.

I'll go first. Watch and learn, Xand.

OK, so show me how much you'd like taken off the end.

Perhaps an inch or two?

I know I'm trying to look as if I'm really like weighing up the options

and deciding what cut I'm going to give you,

but, actually, I'm just stalling because I'm a bit nervous.

Maybe he shouldn't have said he was nervous,

that might not be the best thing to say

with a pair of scissors in your hand.

Consultation done, it's time to get snipping.

There we go, the first cut.

I think less is going to be more here, Lizzie.

I'm just going to do a tiny bit more.

I'm not sure Andrew taught us the zig-zag technique!

As they say, it'll always grow back.

I'd be worried too, Lizzie!

What looks, when Andrew was doing it,

like it would all go in a straight line... Even that,

like if I go along here and I'm just taking the tiniest bit off

at the end of it,

it's not a straight line and I don't see any way of

getting it straighter.

I'm not sure I'm putting Cassie at ease.

So - with a quick cut here and a chop, chop there,

we're ready for the presentation.

I didn't cut off any ears.

There's no blood. The hair will grow back.

I'm going to put down the scissors.

Right, spin around...

-OK.

-Grab the chair.

Hand you the mirror and you can have a look.

-Just what I wanted.

-Yes!

And this is the finished product.

Crikey. I hope the jagged look's in fashion.

Andrew, how did we do?

OK, so you're both fantastic, but I think initially, Chris,

you started off amazing.

Your consultation was great.

Xand, I think you actually said at one point, "I'm a bit nervous."

-I did.

-And that wasn't a good start.

-Wasn't what she wanted to hear.

However, I think, Xand, your technique

was a little bit better than yours, Chris.

You cut a straighter line - and with yours, Chris,

you didn't use the client's back as a guideline.

So what's the overall verdict?

I think the overall winner - it really has to be Xand.

Yes!

Well, we may have learned that

you are a tiny bit better than me in some aspects of hairdressing,

but what we've definitely seen is just how important the hospital

hairdresser is in making patients feel good.

This is most definitely a job best left to the professionals.

Andrew, we're handing our aprons back.

-Thank you very much.

-Thank you very much indeed.

I hear, Chris, that you're off to visit some of the world's

most dangerous creatures. So I've brought you some safety goggles.

I've got cushions to defend yourself against teeth and claws, and I have

a pasta strainer for your head.

Xand, I don't think any of this is helpful or necessary.

Well, better safe than sorry, Chris.

After all, if you didn't come back,

who'd be around to cook me my favourite spaghetti bolognese?

I think it's time for Investigation Ouch.

So today, I'm looking for one of the world's deadliest creatures.

It's roamed the Earth for over 200 million years.

I know - it has to be the deadly T-rex.

Don't be ridiculous, Xand, T-rex are extinct.

-What about a snake?

-No, it's not a snake.

The creature I'm talking about can

drink up to three times its own body weight in blood.

I've got it. It's a mosquito.

Mosquitoes are small insects which can give you a nip.

You've probably been bitten by one.

In some countries,

mosquitoes are dangerous

because they transmit infectious diseases like

dengue fever and malaria to humans when they bite us.

In the UK, mosquito bites are generally pretty harmless,

just a bit itchy and uncomfortable,

but in fact remarkably little is known about our local mosquito

population. Has it started to change, for example?

Could it contain mosquitoes which might transmit disease?

To find out, I'm meeting some of the only scientists researching

mosquitoes in the UK.

Excuse me, do you know where there are any scientists around here?

Dr Chris, we ARE the scientists.

You are the scientists?! Well...

I was expecting them to be a bit older.

Right, well, what do I need?

Have you brought your mosquito larvae retrieval device?

Have you got one I can borrow?

Yeah, you can use this one.

Brilliant, thank you.

It's like a piece of bamboo with a measuring jug

-on the end of it.

-Come on, Chris, let's go.

Why have we come to these ponds to look for mosquitoes?

So, they lay their eggs in water.

They then become pupae,

and then they turn into larvae.

So it's sort of like a caterpillar that lives in water.

Why are you guys interested in looking at the mosquito larvae?

So we can classify them and then see if they're

mosquitoes that can carry malaria

and dengue fever and things like that.

Did you know, there are currently 34 species of mosquito in the UK?

Luckily none of them carry dangerous diseases,

but there are 3,500 species worldwide

so it's important to check

whether new ones have arrived.

So what am I looking for in the water?

You're looking for little black bobbly things.

Oh, I see, is it these things that are wriggling around?

-Yeah.

-So how are we going to tell what species they are?

So we're going to put them in one of the containers and take them back to

the lab, and we will classify them under the microscope.

Wow, look at that, up close they look quite frightening.

Maya and Asmaa

are using an identification chart

to work out which type of mosquito we caught.

There's the developed head...

There's the thorax.

-OK. And that's its little air pipe, is it, that's how it breathes?

-Yeah.

So unlike you, a mosquito larvae breathes through kind of its bottom,

-is that right?

-Well,

you can see it has one tuft of hair,

and it says on the identification chart

Aedes has one tuft of hair.

Some kinds of mosquitoes can carry diseases.

Can you tell if this is one of those?

Well, it is hard to identify if it could until it's an adult mosquito.

So you're going to let the larvae grow into an adult

-and then you'll be able to tell?

-Yes.

With climate change meaning the UK's getting hotter,

this work is more important than ever.

What's incredible about this research is it will enable us

to know if there are any mosquitoes in the UK

that are spreading disease - and if we

know about them, we can prepare for any dangers.

And not only that,

but the research here,

tracking one of the deadliest creatures on Earth

is being done by kids your age.

The team in the emergency department are ready for their next patient.

Ooh! Well, let's see...

who it's going to be!

Eye-eye, who's this, then?

It's nine-year-old Caleb and his mum,

in Alder Hey Emergency Department with a very swollen eye.

It feels quite itchy and painful.

Like a pain in my eye.

How did it happen?

Well, this one is impossible to work out.

If anyone can do it, I can.

OK, well, Caleb went to bed as normal and fell asleep.

Mysteriously, during the night, his eye started to go red.

I know, I know - one of those shooting stars

sprung off the wall, and those PJ superheroes dived to catch it.

As battle commenced, a loose high kick went wrong

-and Caleb got clobbered in the eye!

-No, definitely not,

there was no stardust on the floor so it can't be that.

-Good point.

-It just happened.

Poor Caleb woke up and his eye was sore and very swollen.

Ouch! It's really itchy.

Don't worry, Caleb. There's a nurse on the way to fix that itch.

Let's play a game whilst you wait.

I spy with my little eye something beginning with...EB.

EB, that's a tough one.

Erm... Enormous bed.

No.

Emergency button.

-No.

-Energetic banana!

RAVE MUSIC PLAYS

Don't be ridiculous, Xand.

-We give up, Caleb.

-Empty bin!

Empty bin! Missed that one. Mum.

My turn. I spy with my...

No time, Xand. Advanced nurse practitioner Sarah Jackson

has arrived.

Nurse Sarah checks Caleb's eye to see where the pain is.

-All right?

-Yeah.

And she checks his vision to make sure he can see clearly.

V, Y, O...

Nurse Sarah is going to use eye drops, to make sure Caleb's cornea

isn't damaged.

So, have you had drops in your eyes before?

Yeah.

Your cornea is a clear layer that protects your eye.

It's very sensitive and when you get something in your eye,

it can easily get scratched.

This damage could lead to an infection.

Scratches are difficult for doctors to see,

so they use special fluorescein eye drops, which contain an orange dye.

This temporarily stains any scratches.

Then Nurse Sarah shines a blue light into Caleb's eye.

The combination of the light and the dye

makes any problems really easy to spot.

It looks like it's preseptal cellulitis.

Preseptal cellulitis is an infection of the soft tissue around the eye

which will need antibiotics.

We'll give you some oral antibiotics

and then hopefully it will get better.

Well, that's eye-mazing!

Maybe you can get some eyes-cream on the way home!

Anyway, see you later, Caleb.

BOTH: Bye!

Next time on Operation Ouch!...

-Join the queue...

-Hello, it's Chris here.

-Dr Chris here...

-I'm going to miss my appointment.

..get ready for combat...

I'm going to protect people's hearts.

And if you can't beat 'em, join 'em.

So that's it until next time, from Super Xand and his space cape.

And Operation Ouch!.

Chris! My cape!

My cape...

This is to demonstrate how your

internal and external sphincters work.

CHRIS SNEEZES

Remarkably little is known about our local mosquiko... Mosquiko?!

CHRIS SNEEZES

The thing I'm looking for...the creature I'm... Hold on.

HE SNEEZES